Benefits of 'Pre Operative' exercise

People often think that if they are going to have an operation (ligament repair, joint replacement, arthroscopy etc.) that there is nothing they can do before the operation that will improve the overall outcome. However in many situations this is not the case, in fact the 'pre-operative' period is an ideal time to prepare your body for surgery and can improve the overall outcome. This does necessarily mean you need to go out running every day it means having a specific plan designed for you and your condition.

What a pre-operative plan should include

When you are facing an operation it is important to prepare your body and the area being operated on for the surgery. This should include strengthening the muscles and tissues that act on and around the targeted joint/area and correct any muscle imbalances. After surgery your movement may be restricted for a period of time therefore if you improve your strength levels prior to surgery the effect of post surgery muscle loss will be reduced. As well as strengthening the area to be operated it is important not to neglect the rest of your body. If you are having a surgery on your knee the other leg will be required to work harder post surgery so it is important that this leg is strong and injury free to be able to work as it will be required. You may also spend time using walking aids so it is also important to consider your upper body and core strength. 

During early stages of recovery following surgery movement is often limited and your body will require time to rest and repair. During these periods your body will not move as much as normal day to day life and this itself can cause problems. This leads us to the another important area to be worked on, which is flexibility. Retaining good range of motion and flexibility prior to surgery will give your body a good base and help reduce stiffness post surgery. This is a key issue as later on in post surgery rehabilitation you will want to regain joint range of movement this will be more difficult is prior to surgery the range of movement was not maintained as much as possible.

It is well documented that overall health and fitness level is directly linked to post operative recovery and that patients with a better level of fitness reduced their risks of pot surgery complications.

What to do if you have are due to have surgery in the future

The aim of this blog is to provide the reader with some information and research on the benefits of a structured pre-operative (pre-habilitation) exercise plan. Ideally this would be combined with a post-operative rehabilitation plan to achieve the best possible surgical outcome for the individual. Always check with your GP and surgeon prior to starting a preoperative exercise plan.

Have a look at the links below for research supporting 'pre-habilitation' prior to surgery. If you would like any further information or would like to book a consultation contact me via this blog, on twitter @pos_movement or email me at cassie@positivemovement.co.uk

1. Shahril R, Shaarani, Christopher O'Hare, Alison Quinn, Niall Moyna, Raymond Moran, John M O'Brian. The effect of prehabilitation on anterior cruciate ligament reconstruction. The American Journal of Sports Medicine. http://ajs.sagepub.com/content/early/2013/07/10/0363546513493594.abstract
2. Robert Topp, RN, Ph.D, Ann Swank Ph.D., Peter M. Queada Ph.D, John Nyland, Ed.D, PT, Arthur Malkani, MD: The Effect of Prehabilitation Exercise on Strength and Functioning After Total Knee Arthroplasty. American Academy of Physical Medicine and Rehabilitation, 2009, Vol 1 (729 - 735) http://www.actiontherapyservices.com/pdf/prehabilitation.pdf
3. Robert Topp, RN, Ph.D., Phil Page, Med, PT: Improve Function before Knee Replacement Surgery. Functional Exercise and Activity for Healthy Aging, March-April, 2009, Vol.7 No 2 (1-8) http://www.thera-bandacademy.com/elements/clients/docs/Topp-Page-Prehab%20TKA%20FunctionalU_MarApr2009__200904DD_023000.pdf
4. Rooks D, HuangJ, Bierbaum B, Bolus S, Rubano J, Connolly C, Alpert S, Iversen M, Katz J: Effect of Preoperative Exercise on Measures of Functional Status in Men and Women Undergoing Total Hip and Knee Arthroplasty. Arthritis & Rheumatism (Arthritis Care & Research).2006; 55 [5], 700-708 http://www.mendeley.com/research/effect-preoperative-exercise-measures-functional-status-men-women-undergoing-total-hip-knee-arthroplasty/#page-1
5. Prehabilitation exercise for total knee replacement helps patients with severe end-stage arthritis. Academy Blog: Research and News, Feb. 22, 201 http://www.hygenicblog.com/2011/02/22/prehabilitation-exercise-for-total-knee-replacement-helps-patients-with-severe-end-stage-arthritis/
6. Improving Function after Total Knee Arthroplasty (TKA) with Balance Training. Academy Blog: Research and News, May 31, 2011 http://www.hygenicblog.com/2011/05/31/improving-function-after-total-knee-arthroplasty-tka-with-balance-training
7. Prehabilitation before total knee arthroplasty increases strength and function in older adults with severe osteoarthritis. J Strength Cond Res. 2011 Feb;25(2):318-25 http://www.ncbi.nlm.nih.gov/pubmed/21217530
8. Kent Brown, MS, CSCS; Joseph A. Brosky Jr., PT, MS, SCS; Dave Pariser, PT, PhD; and Robert Topp, RN, PhD: Preoperative exercise boosts TKA outcomes. Lower Extremity Review, March, 2011 http://www.lowerextremityreview.com/article/preoperative-exercise-boosts-tka-outcomes
9. Barbay, K.: Research evidence for the use of preoperative exercise in patients preparing for total hip or total knee arthroplasty. Orthop Nurs. 2009 May-Jun; 28(3):127-33 http://www.ncbi.nlm.nih.gov/pubmed/19494760