Prehabilitation: high-quality evidence is still required

Prehabilitation comprises multidisciplinary healthcare interventions, including exercise, nutritional optimisation, and psychological preparation, which aim to dampen the metabolic response to surgery, shorten the period of recovery, reduce complications, and improve the quality of recovery and quality of life. This editorial evaluates the potential benefits and limitations of and barriers to prehabilitation in surgical patients. The results of several randomised clinical trials and meta-analyses on prehabilitation show differing results, and the strength of the evidence is relatively weak. Heterogeneity in patient populations, interventions, and outcome measures, with a wide range for compliance, contribute to this variation. Evidence could be strengthened by the conduct of large-scale, appropriately powered mul-ticentre trials that have unequivocal clinically relevant and patient-centric endpoints. Studies on prehabilitation should concentrate on recruiting patients who are frail and at high risk. Interventions should be multimodal and exercise regimens should be tailored to each patient's ability with longitudinal measurements of impact.

Automated summary

Prehabilitation comprises multidisciplinary healthcare interventions aimed at reducing metabolic response to surgery, shortening recovery period, decreasing complications, and improving quality of recovery and life. However, the results of previous studies on prehabilitation show varying outcomes and weak evidence, partly due to heterogeneity in patient populations, interventions, and outcome measures. More large-scale, multicentre trials with clear clinically relevant endpoints are needed to strengthen the evidence and focus on recruiting frail, high-risk patients for prehabilitation interventions tailored to their abilities with longitudinal measurements of impact.