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Prehabilitation as a Prophylactic Measure to Mitigate the Postoperative Pulmonary Complications among Patients Undergoing Abdominal Surgeries – A Randomized Controlled Trial

James Komisharajan, Ajith Kumar Pichai, Thillaigovindarajan Senthil Kumar, Natrajan Venkatesh

Abstract

Objective: Abdominal surgeries are performed extensively worldwide, and the prevalence of post-operative pulmonary complications (PPC) following upper abdominal procedures remains high. Despite emerging interest, the impact of prehabilitation on functional capacity and postoperative outcomes remains unclear. The study evaluated the effectiveness of prehabilitation in preventing postoperative pulmonary complications, enhancing functional capacity, and reducing the length of hospital stay.
Material and Methods: A total of 80 participants, planned for abdominal surgeries, were randomized into the experimental group (n=40) and control group (n=40) based on the inclusion criteria: participants aged 18-60, willing to participate, and with an adequate preoperative period to attend the prehabilitation sessions. The experimental group underwent eight prehabilitation sessions, while the control group received a single education session. Both groups received the standard postoperative care. PPCs were assessed within the first 24 hours postoperatively using the Melbourne Group Scale, and functional capacity was assessed both preoperatively and postoperatively before discharge. Length of stay was monitored.
Results: Prehabilitation significantly reduced the incidence of postoperative pulmonary complications in the experimental group compared to the control group (p-value<0.001), and there were significant improvements in functional capacity (p-value<0.001). However, no significant difference was found between groups in length of stay (p-value>0.068).
Conclusion: Prehabilitation before abdominal surgery effectively reduces postoperative pulmonary complications and enhances functional capacity, highlighting it as an effective preventive strategy in perioperative care. Further research is warranted to explore its long-term clinical and functional outcomes.

 Keywords

Abdominal surgery; functional capacity; length of stay; prehabilitation; postoperative pulmonary complication

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DOI: http://dx.doi.org/10.31584/jhsmr.20261487

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About The Authors

James Komisharajan
Department of Cardiopulmonary Physiotherapy, Faculty of Physiotherapy, Sri Ramachandra Institute of Higher Education and Research (Deemed University), Chennai, Tamil Nadu 600116,
India

Ajith Kumar Pichai
Department of Cardiopulmonary Physiotherapy, Faculty of Physiotherapy, Sri Ramachandra Institute of Higher Education and Research (Deemed University), Chennai, Tamil Nadu 600116,
India

Thillaigovindarajan Senthil Kumar
Department of Cardiopulmonary Physiotherapy, Faculty of Physiotherapy, Sri Ramachandra Institute of Higher Education and Research (Deemed University), Chennai, Tamil Nadu 600116,
India

Natrajan Venkatesh
Department of Cardiopulmonary Physiotherapy, Faculty of Physiotherapy, Sri Ramachandra Institute of Higher Education and Research (Deemed University), Chennai, Tamil Nadu 600116,
India

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