Lecture 15 - PA & Prehabilitation Flashcards
Lecture 15:
Define Prehabilitation & it’s purpose
Process of care that occurs between time of diagnosis & beginning of acute treatment
- provides targeted interventions that improve patient’s health to reduce incidence & severity of current & future impairments
Lecture 15:
What is the important strategy of Prehabilitation?
- 3 things it buffers against
Improve physiologic & psychosocial reservoirs to buffer against;
- deconditioning
- treatment side-effects
- threats to quality of life
Lecture 15:
What is the benefit of Prehabilitation prior to treatment?
Patients in better condition compared to acute post treatment period (always in better shape than they would be after treatment)
Lecture 15:
What does Prehabilitation prior to treatment permit?
Permits more intense exercise intervention
- offers opportunity for patients to “feel in control”
Lecture 15:
What are some general conditioning exercises used in Prehabilitation?
Resistance, flexibility, &/or aerobic training program
- most beneficial to overall musculoskeletal & cardiovascular fitness
Lecture 15:
Why are general conditioning exercises beneficial for clients fitness & Prehabilitation stage?
- It lowers perioperative complication rates
- allows faster recovery from surgery
- improves aerobic conditioning prior to chemotherapy
Lecture 15:
What is the VO2peak equivalent of a 40year old breast cancer patient?
Mean VO2 peak for an average 40 year old breast cancer patient is comparable to a sedentary 70 year old woman!
Lecture 15:
What did a randomized control trial of 24 women receiving first dose of doxorubicin (chemo) find about general conditioning exercises ?
Participants participated in acute bout of aerobic exercise 24hrs before 1st dose and found;
- this exercise caused less severe decline in cardiac function compared to the control group 1 day after receiving dosage
Lecture 15:
What is Targeted Prehabilitation Exercise?
Use of exercises specific to a body region that is susceptible to dysfunction from treatment/disease
Lecture 15:
What is an example of targeted Prehabilitation exercise?
- breast cancer patients typically lose ROM in shoulder of affected side so; shoulder exercise before surgery reduces pain &
improves ROM to allow treatment to
proceed (e.g., radiation therapy)
Lecture 15:
In a targeted exercise study of 60 breast cancer patients with scheduled surgery, what were their prehab exercises?
- results?
Prehab exercises included; stir the pot, wall angels, & reach for the pillow
- these exercises resulted in improved shoulder function & reduced incidence of seromas
Lecture 15:
What is the best “cure” for Preoperative non-small cell lung cancer?
Lung resection offers the best chance for cure
Lecture 15:
What are the morbidity & mortality rates of Preoperative non-small cell lung cancer?
Morbidity & mortality rates from postoperative complications are high primarily due to cardiopulmonary complications
Lecture 15:
How does exercise improve Preoperative non-small cell lung cancer?
- exercise tolerance allows for decision making
- increased fitness = increased eligibility for surgery & in turn, surgery = increased survival
Lecture 15:
When discussing a study of Preoperative Small Cell Lung Cancer patients, how many patients were studied ?
16 pre-operative SCLC patients studied through a home-based exercise program & 13 patients finished this
Lecture 15:
What were the exercises done for the 16 Pre-operative SCLC patients who went through a home based exercise program?
A 4-week long home-based exercise program was done where patients had to walk or cycle 3x/week
- all patients completes >75% of prescribed exercise
Lecture 15:
What were the results of the pre-operative SCLC training patients?
- cycle endurance & 6 minute walk tests improved
- deltoid, triceps, & hamstring strength increased
Lecture 15:
Is Prehabilitation feasible?
Prehabilitation is well tolerated by patients & they may be receptive
- it is an emerging field but may be a promising care strategy for patients to improve outcomes & reduce morbidity/mortality
Lecture 15:
What is the limiting factor of Prehabilitation?
Short intervention duration (short time between diagnosis & treatment)
- eg; breast cancer patients Prehabilitation period is less than a month
