Pre-Rehabilitation before Major Abdominal Surgery: The Emerging Role of Physiotherapists in Reducing Postoperative Complications - A Narrative Review
Year: 2023
Type: review
Abstract: Background: Major abdominal surgery causes a rapid reduction in physiological reserve and exposes patients to pulmonary complications, delayed mobility and loss of functional independence. Prehabilitation seeks to improve capacity during the interval between surgical decision and operation. Objective: To synthesize literature published from 2012 through 2020 concerning physiotherapy-led and multimodal prehabilitation before major abdominal surgery, with emphasis on postoperative complications and functional recovery. Methods: A structured narrative review approach was used. Peer-reviewed English-language studies and guidance published between January 2012 and December 2020 were considered when they examined preoperative exercise, inspiratory muscle training, physiotherapy education, functional assessment or multimodal prehabilitation in adults undergoing major abdominal surgery. Results: Evidence supports preoperative risk identification and indicates that aerobic and resistance exercise, inspiratory muscle training, education and immediate postoperative breathing strategies are feasible for selected patients. A multicentre trial showed that a single preoperative physiotherapy session reduced pulmonary complications after upper abdominal surgery. Multimodal programmes frequently improve preoperative functional capacity, although effects on complications and length of stay are inconsistent across heterogeneous studies. Conclusion: Physiotherapists can make a distinct contribution by assessing functional reserve, prescribing individualized exercise, teaching respiratory and mobility strategies, monitoring response and coordinating postoperative continuity. Prehabilitation should complement enhanced recovery pathways and be adapted to surgical timing, comorbidity and patient access. Standardized, adequately powered trials are required.
Institution: Mahatma Gandhi University
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7204201342