What does the term prehabilitation mean and how does it fit within the scheme of PT? Prehabilitation is therapy that is done prior to a surgical procedure or prior to beginning chemotherapy or radiation therapy. To better explain this concept, let’s think of a prize fighter preparing for the biggest fight of her or his career. A skilled fighter wouldn’t just show up for a fight unprepared. The fighter spends hours, days, weeks and months preparing for that big fight. Prehabilitation can be thought of as the training before the fight. Once a patient is aware of an upcoming procedure it is of great benefit for that patient to prepare so their body is able to heal as quickly and efficiently as possible. Let’s take a brief look at the benefits of prehabilitation for a patient preparing to undergo treatment for breast cancer including mastectomy with lymph node removal followed by chemotherapy and radiation therapy.
The patient is first educated about the surgical procedure including a discussion about limitations following surgery and strategies to successfully maintain those precautions. Next, strength, posture, and range of motion are assessed and limb volume measurements are taken. The patient is then educated on lymphedema risk reduction principles. These measurements enable the physical therapist to better monitor the patient for shoulder dysfunction and the early stages of lymphedema.
The findings from the prehabilitation evaluation provide the physical therapist with valuable information needed to develop and prescribe a home exercise program that the patient is to begin working on prior to surgery. The patient will return following surgery where the physical therapist will progress exercises, re-check limb volume to more closely monitor for lymphedema, and look for changes in strength and range of motion.
If chemotherapy or radiation therapy will be part of the treatment, the prehabilitation evaluation will include the assessment of the patient’s current level of fitness and goals for therapy while undergoing treatment. The patient is also taught how to monitor blood values during chemotherapy and radiation therapy to assist the patient in how to determine a safe and effective exercise routine. Treatment may be continued during cancer treatment to ensure strength needed for chemotherapy and to improve shoulder range of motion to allow proper positioning for radiation therapy.
Prehabilitation is an essential piece of the treatment for patients undergoing treatment for breast cancer that is slowly moving to the forefront. Since implementing the cancer prehabilitation program at Complete Physical Therapy over a year ago I have seen firsthand the benefits this program offers my patients. They are empowered with the knowledge they receive and feel more confident and in control on their road to recovery. They understand the importance of early detection of lymphedema and I am able to earlier detect common issues, such as lymphatic cording, protective posturing, and swelling, before they become a bigger problem.
To learn how a physical therapist at Complete Physical Therapy can assist you in preparing for an upcoming fight, whether it be a surgical procedure or prior to beginning chemotherapy or radiation treatments, call Complete Physical Therapy at 402.483.0006. Schedule a visit with us today to assist you in creating an individualized prehabilitation program. Complete Physical Therapy, where no one fights alone.