By Gary Burgess, PTA
Director of Therapy
Arlington Court Skilled Nursing & Rehab
Prehab, or prehabilitation, is a relatively new accepted term for a concept that includes strength training for the prevention of injury or working out a muscle group prior to a surgery. I was first subjected to this concept, albeit not known as prehab, in my first clinical rotation after therapy schooling. A relatively young lady came to our Skilled Nursing Facility with physician orders for quadriceps strengthening prior to a knee replacement. She was directed by her physician to strengthen this muscle group in preparation for acute muscle weakening associated with the surgery. The prehab was accountable for decreased recovery time and she felt back to normal in only a 2 week period instead of the average 4 week period.
Strengthening muscles surrounding vulnerable joints for injury prevention is also considered a form of rehab. Prehab of the muscle groups that provide shoulder and elbow movement essentially decrease the risk of injury associated with wear and tear by repetition.
In 2013, a pilot study of prehabilitation in colorectal surgery found that it improved postoperative functional recovery, measured in terms of the walking capacity at 4 weeks and 8 weeks (although the time in hospital and post-operative complications were similar),  is also being considered for use in some cardiovascular interventions,  and may also be of some benefit for preventing lung complications, such as pulmonary atelactasis, in general surgery. 
- Li C, Carli F, Lee L, et al. (April 2013). “Impact of a trimodal prehabilitation program on functional recovery after colorectal cancer surgery: a pilot study”. Surgical Endoscopy. 27 (4): 1072–82. doi:10.1007/s00464-012-2560-5. PMID 23052535.
- Alkarmi A, Thijssen DH, Albouaini K, et al. (June 2010). “Arterial prehabilitation: can exercise induce changes in artery size and function that decrease complications of catheterization?”. Sports Medicine. 40 (6): 481–92. doi:10.2165/11531950-000000000-00000. PMID 20524713.
- Jack S, West M, Grocott MP (September 2011). “Perioperative exercise training in elderly subjects”. Best Practice & Research. Clinical Anaesthesiology. 25 (3): 461–72. doi:10.1016/j.bpa.2011.07.003. PMID 21925410.