Prehabilitation program for older adults shows potential to improve postoperative outcomes

A pilot study published in the Journal of the American Geriatrics Society found that a prehabilitation program that combines physical therapy, nutrition, and mindset support in the weeks leading up to major elective surgery is feasible and has the potential to improve postoperative outcomes.

Entitled "Multi-Component Prehabilitation Program for Older Adults Undergoing Major Elective Surgery: A Pilot and Feasibility Study," the study found that among the participants who completed the intervention, post-surgical walking speeds increased by 0.2 meters per second, while time to complete the five "chair stands" test - a standard measure of lower body strength in older adults - dropped by 3.4 seconds. Additionally, patient-reported physical function scores increased by about 4.4 points at 90 days post-surgery compared to baseline.

The study's main finding is that this type of prehabilitation is feasible to deliver within the short three to four-week window that many patients have before surgery. However, researchers note challenges that could limit widespread adoption, including a lack of a coordinated system to facilitate timely access to physical therapists and dieticians before surgery in routine care.

Why this matters

Many older adults face major surgeries and emerge weaker, slower, or with reduced ability to do everyday tasks. This study suggests that preparing older patients in multiple ways three to four weeks before surgery - including exercise, nutrition, and psychological interventions - has the potential to reduce the risk, enabling them to recover more effectively. Even modest improvements in speed, strength, and function can mean more independence and fewer complications.

We know that older patients often struggle after surgery, not because of age alone, but because their bodies don't have what they need going in. The main finding of our study is that it is feasible to deliver this kind of multicomponent program in the three to four weeks before surgery, although scheduling and access challenges remain. Still, the fact that patients were able to complete the program and show improvements is encouraging."

Dae Hyun Kim, MD, MPH, ScD, associate director and senior scientist, Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife

"If you are an older adult scheduled for major surgery, this study suggests that to help you recover more fully, you and your medical team may consider exercising with a trainer or physical therapist, optimizing your nutrition, addressing anxiety or mood, and building strength. While more research is needed, this early evidence points to the potential value of preparing both body and mind before surgery," Kim added.

The results from this study suggest that further, larger-scale studies are necessary to compare the effect of prehabilitation and usual care without such a program.