Authors (including presenting author) :
Tam KL(1), Cheung TK(1), Chan WY(1), Lee YS(1), Cheung KY(1), Wong SW(1), Tsang HC(1), To YL(1), Luk WY(2), Ng CK(2), Sun TF(3)
Affiliation :
(1) Physiotherapy department, North District Hospital, (2) Surgery department, North District Hospital, (3) Hospital Chief Executive office, North District Hospital
Introduction :
A physiotherapy prehabilitation program was launched since October 2019 to enhance recovery and reduce post-operative complications of patients receiving elective abdominal surgeries. Patients scheduled for abdominal surgeries were referred to physiotherapy department and those with higher risk of post-operative complications were triaged to prehabilitation program. The program consisted of pre-operative education, breathing technique training, supervised aerobic exercise and strengthening exercise training with home exercise prescription. Patients were trained twice a week, 60 minutes each in the outpatient setting. Patients who attended more than four outpatient physiotherapy sessions were evaluated before surgery.
Objectives :
1. To enhance physical capacity of patients planning for elective abdominal surgeries.
2. To prevent post-operative complications.
Methodology :
Data of patients who were referred outpatient physiotherapy for prehabilitation from October 2019 to September 2020 were retrieved and analyzed retrospectively. Paired t-test was used for normally distributed data while Wilcoxon Signed-Rank Test was used for data which is not normally distributed. Outcome measures were categorized into physical function in terms of handgrip strength, 30–second sit to stand test, six-minute walk test (6MWT), Activities of Daily livings (ADL) in terms of Barthel index and quality of life (QoL)in terms of Short form-36.
Result & Outcome :
Result:
A total of 24 patients with mean age of 69.6 (range: 57-85) completed the prehabilitation with mean outpatient attendance of 5.8 (range: 4-13). No adverse event was reported. Significant improvements were found in physical function in terms of total handgrip strength (p< 0.001), 30-seconds sit to stand test (p< 0.001), 6MWT (p< 0.001). No significant changes were found in ADL and QoL. Among the 24 patients, 10 received colorectal surgeries, 5 received hepatic operations, 5 received upper gastrointestinal surgeries, 3 received breast surgery, renal operation and cholecystectomy respectively. One patient was not fit for surgery eventually. The median length of stay was 9 days. No episode of post-operative pneumonia and venous thromboembolism was reported.
Conclusion:
Prehabilitation is safe and effective in improving physical function pre-operatively for patients undergo elective surgeries and is able to help preventing post-operative complications like pneumonia and venous thromboembolism.
