Recovering before surgery
Prehabilitation is a comprehensive preparation program carried out during the weeks leading up to surgery, typically between three and six weeks beforehand. Its central component is structured physical exercise, complemented by individualized nutritional support, optimization of medical treatments and psychological care focused on stress management and behavioral change.
The aim is for patients to arrive at surgery with better functional capacity and greater physical reserve to cope with the surgical process. At the same time, prehabilitation promotes an active role for patients in their own recovery.
“Prehabilitation has transformed the waiting period before surgery into a therapeutic opportunity,” explains Dr. Graciela Martínez Palli, physician in the Department of Anesthesiology, Critical Care and Pain Management at Hospital Clínic. “Instead of passively waiting for surgery, patients actively participate in their own recovery.”
A pioneering multidisciplinary model
Hospital Clínic established the first Prehabilitation Program in Spain and has accumulated nearly a decade of experience in this field. Today, it works with patients from most of the hospital’s surgical specialties.
Led by the Department of Anesthesiology, the program is based on a patient-centered care model, including shared decision-making and coordinated participation from professionals across different specialties. More than eight disciplines are involved, including anesthesiology, surgical specialties, nutrition, physiotherapy, rehabilitation, clinical psychology, oncology, preventive medicine, pulmonology and cardiology.
From research to clinical practice
Clinical activity within the program has gone hand in hand with an intense research effort. Early studies conducted at Hospital Clínic showed that prehabilitation could reduce postoperative complications by up to 50% in high-risk patients undergoing major abdominal surgery.
Since then, numerous studies have confirmed the benefits of this strategy, and Hospital Clínic has contributed significantly to the international scientific evidence supporting prehabilitation. The model developed at the hospital has been recognized by the OECD as an international best practice and is considered an example of successful translation of research into clinical practice.
“Prehabilitation allows us to address the problem earlier. We cannot change the surgery a patient needs, but we can help them face it with greater functional reserve, more confidence and a better capacity for recovery,” says Dr. Martínez Palli.
The challenge ahead
Today, the challenge is no longer proving that prehabilitation works but rather identifying which patients benefit the most, tailoring interventions to individual needs and ensuring access for a larger number of people.
To achieve this, Hospital Clínic is working towards a more personalized, accessible and digital model of prehabilitation. The hospital has also expanded this approach to the oncology setting, recognizing that patient preparation can be equally important before complex treatments such as chemotherapy or radiotherapy.
“The major challenge for the coming years is to make prehabilitation accessible to more people, ensure more equitable and personalized care, and fully integrate it into routine care pathways,” concludes Dr. Martínez Palli.
