Authors (including presenting author) :
Tam KL(1), Chan WY(1), Cheung TK(1), Cheung KY(1), Wong SW(1), Szeto YL(1), Tsang HC(1), To YL(1), Luk WY(2), Ng CK(2), Sun TF(3)
Affiliation :
(1) Physiotherapy department, North District Hospital, (2) Department of Surgery, North District Hospital, (3) Hospital Chief Executive office, North District Hospital
Introduction :
A physiotherapy prehabilitation program was launched since October 2019 to enhance physical capacity and reduce post-operative complications of patients undergoing 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. Two 60-minute sessions of training were provided weekly in the outpatient setting for the target patients. Patients who attended more than three 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 2021 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 distance (6MWD), Activities of Daily livings (ADL) in terms of Barthel index and quality of life (QoL) in terms of Short form-36.
Result & Outcome :
A total of 59 patients with mean age of 67.7 (range: 46-85) completed the prehabilitation with mean outpatient attendance of 5.5 (range: 3-17). No adverse event was reported. Among the 59 patients, 25 received colorectal surgeries, 15 received hepatic operations, 14 received upper gastrointestinal surgeries and 5 received cholecystectomy. Significant improvements were found in physical function in terms of right and left handgrip strength (p<0.001), 30-seconds sit to stand test (p<0.001) and 6MWD (p<0.001). No significant changes were found in ADL and QoL. 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 whom received various abdominal surgeries and is able to prevent post-operative complications.
