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There's growing evidence that adding a "p" to rehabilitation improves patient outcomes pre- and postsurgery and following cancer treatments—and saves money, too.

Feature - Prerehabilitation

"There's no way I would've been able to handle chemotherapy if I hadn't done this first."

That was the assessment of a patient who'd had surgery for abdominal cancer, lost 40 pounds, and initially was "so weak she couldn't even complete half of our fitness testing," recalls Cheryl Guarna, PT, MPT, CLT, STAR/C, owner of Oncology Rehab and Wellness Resources in Ashburn, Virginia. Over the course of 4 weeks of prehabilitation leading up to chemotherapy, Guarna worked with the patient to build up her strength and conditioning. As a result, she tolerated chemotherapy well.

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  1. Powers J. The Effects of Prehabilitation on Endurance, Length of Stay, and Quality of Life for Patients with Cancer: An Evidence-Based Review and Meta-Analysis. https://ucsf.app.box.com/s/nhy1le0k4u8da9t5vlsy. Accessed November 17, 2015.
  2. Snow R, Granata J, Ruhil AV, et al. Associations between preoperative physical therapy and post-acute care utilization patterns and cost in total joint replacement. J Bone Joint Surg Am. 2014;96(19):e165.
  3. Gillis C, Li C, Lee L, et al. Prehabilitation versus rehabilitation: a randomized control trial in patients undergoing colorectal resection for cancer. Anesthesiology. 2014;121(5):937-947.
  4. Andrews A. To boost patient health, rehab sometimes starts before cancer treatment. http://khn.org/news/to-boost-patient-health-rehab-sometimes-starts-before-cancer-treatment/. Kaiser Health News. July 28, 2015.
  5. Brown B, Brosky JA, Topp R. Lajoie, AS. Prehabilitation and quality of life three months after total knee arthroplasty: a pilot study. Perceptual & Motor Skills. 2012;115(3):765-774.
  6. Silver JK, Baima J, Mayer RS. Impairment-driven cancer rehabilitation: an essential component of quality care and survivorship. CA: A Cancer Journal for Clinicians. 2013;63(5):295-317.
  7. Centers for Medicare & Medicaid Services. Comprehensive Care for Joint Replacement Model. https://innovation.cms.gov/initiatives/cjr. Accessed November 17, 2015.

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