The better your strength and range of motion are before orthopedic surgery (e.g., joint replacement surgery), the better off you’ll be after. That’s the philosophy behind prehabilitation, says physical therapist Gopal T. Raghunath, PT MS, DPT, CSCS, of Buffalo Grove Physical Therapy & Sports Rehabilitation, P.C.
“The aim of prehabilitation is to optimize an individual’s strength, mobility and overall functional capacity prior to an anticipated orthopedic procedure through a comprehensive, therapeutic exercise program,” Dr. Raghunath said. “This not only prepares the body for the stress of actual surgery, but also for the post-operative rehabilitation program to follow in an effort to maximize the success of the patient’s recovery.”
Researchers have supported this claim. A study published in the October 2014 edition of the Journal of Bone & Joint Surgery determined that physical therapy before joint replacement surgery – a prehabilitation program – can reduce the need for post-operative care by nearly 30 percent, saving the patient both time and money.
The American Academy of Orthopedic Surgeons (AAOS) states that approximately 700,000 total knee replacement and 300,000 total hip replacement surgeries are performed each year in the U.S.
“When an individual has reached the point where he or she needs joint replacement surgery, their body compensates in direct relation to his or her impairments,” Dr. Raghunath said. “Moreover, these dysfunctional patterns can have a snowball effect on the entire system, resulting in whole-body weakness and poor mobility, all of which can and should be addressed through prehabilitation.”
According to Dr. Raghunath, an effective prehabilitation program consists of therapeutic exercise that includes cardiorespiratory conditioning as well as progressive resistance and flexibility training, all with an emphasis on replicating daily functional tasks. The goal is to help the patient combat the effects of inactivity.
Additionally, prehabilitation provides physical therapists the opportunity to prepare patients mentally and emotionally for their surgery and postoperative rehab, educating them about what to expect immediately after the procedure and coaching them on exercises they will need to know during post-operative rehabilitation.
“Patients often approach the unknown journey toward surgery and post-surgery with a certain level of anxiety, understandably so,” said Dr. Raghunath. “Fortunately, educating patients through our knowledge is one of our strengths as clinicians, which in turn helps alleviate this anxiety.”
Dr. Raghunath says that in order to optimize the benefits of prehabilitation, the program should include two to three sessions per week beginning six to eight weeks before surgery. To learn more about the benefits of prehabilitation, those facing the potential for joint replacement should consult their physicians as well as their physical therapist.