prehabilitation Flashcards
what is prehabilitation non- cancer specific definition?
- process of enhancing functional capacity of the individual to enable him/ her to withstand a stressful event
what is the cancer specific definition of prehabilitation?
- defines timing, regime and mentions the possible outcomes
what people prefer the cancer specific definition of prehabilitation?
- preferred by subject-matter experts as it is more thorough
when is prehabilitation used?
- used before surgery to prevent respiratory complications e.g., infection, lung collapse, cough, secretions
what are the four multimodal components of prehabilitation?
- exercise therapy
- nutritional support
- psychological well- being
- lifestyle modifications
what does the multimodal approach help with?
- helps you to be in the best place you can be both physically and mentally before surgery or treatment
where on the cancer continuum of care does prehabilitation take place?
- occurs between the time of cancer diagnosis and the beginning of acute treatment
what are the four core areas where prehabilitation is used?
- cancer
- cardiac
- pulmonary
- transplant
why are there 4 core areas of prehabilitation?
- because pulmonary volumes reduced
- weak muscles so exercise can cause fatigue
when does cancer prehabilitation occur?
- before chemotherapy, radiotherapy, or surgery
when does cardiac prehabilitation occur?
- before CABG, valve replacement, heart transplant
when does pulmonary prehabilitation occur?
- occurs before lung resection, lung transplant
when does transplant prehabilitation occur?
- liver
- kidney
- lung
transplant candidates
why does prehabilitation occur before surgery? what is reduced?C
- major surgeries carry risks, especially in frail/ deconditioned patients
- reduces post- operative complications
what is linked to poorer surgical outcomes?
- sedentary lifestyle
what does prehabilitation improve? (3)
- recovery rates
- functional outcomes
- quality of life
what does prehabilitation decrease?
- decreases hospital stay duration
- decreases use of post- acute care services
what are the four stages when approaching prehabilitation?
- screening
- assessment
- interventions
- monitoring
what is screening?
- detects people at risk
- is the patient fit for prehabilitation?
what are some examples of screening?
- screening for evidence of malnutrition
- screening for physical inactivity
what is the assessment for? what does it help with?
- assessment interprets information
- makes informed decisions about interventions
what are interventions tailored to? - give some examples
- tailored to individual needs
e.g., exercise, nutrition, psychological
what should monitoring be proportionate to? what does it involve?
- proportionate to need
- regular monitoring/ adjustments of plan
what are the three levels of the tiered approach to prehabilitation?
- universal
- targeted
- specialised
what is the universal tier?
- everyone approaching surgery
what is the targeted tier?
- specific risk factor support
what is the specialist tier?
- complex needs
what does the universal tier include?
- basic education
- home activity
what does the targeted tier include?
- supervised prehab for moderate- risk patients
what does the specialised tier involve?
- high intensity prehab for high- risk patients
what does the MDT approach involve? (12)
- physiotherapist
- dietician
- smoking counsellor
- pharmacist
- alcohol counsellor
- health psychologist
- GP
- primary care nurse
- anaesthetist
- surgeon
- occupational therapist
- public health staff
what is coronary heart disease?
- atherosclerotic plaques in circulatory system, which leads to myocardial infarction
when is prehabilitation completed for patient with coronary heart disease? why do it at this time?
- before
- maximises exercise capacity to improve outcomes post- surgery
what does heart failure and cardiomyopathy change?
- physiological structure of the heart
- left or right side hypertrophy
what is congenital heart disease?
- born with physiological defect which affects the heart function
how do you manage COPD?
- lung volume reduction surgery
how do you manage bronchiectasis and cystic fibrosis?
- lung transplant
how do you deal with lung cancer?
- lobectomy
- segmentectomy
- pneumonectomy
what are the four main cancer patients?
- upper gastrointestinal
- lung
- bowel
- prostate
what does prehabilitation focus on for cancer patients? (3)
- varied diet
- physical activity
- mental health
what are the four modes of prehabilitation delivery?
- home based programme
- supervised face- to- face sessions
- group exercise classes
- hybrid models
what are some examples of home- based prehabilitation?
- tele- rehabilitation
- app- based coaching
what is the reason for completing group exercises?
- peer support and motivation
what does the hybrid model of prehabilitation combine?
- combines in person and virtual sessions
what are the main four sections of prehabilitation?
- exercise
- nutritional support
- mental and emotional support
- healthy lifestyle changes
what are the immediate effects of cancer prehabilitation?
- improved functional status
- improved cardiorespiratory reserve
