The most strongly recommended non-pharmacological intervention is prehabilitation (specifically multimodal prehabilitation).
Rather than waiting for postoperative rehabilitation, prehabilitation proactively builds physiologic reserve before elective surgery.
Core Components of Multimodal Prehabilitation
Exercise Therapy:
Aerobic conditioning (e.g., walking, cycling) to improve cardiorespiratory reserve.
Resistance training to build muscle mass and counteract frailty-induced sarcopenia.
Inspiratory muscle training to reduce postoperative pulmonary complications.
Nutritional Optimization:
High-protein supplementation and tailored dietary interventions to address malnutrition and support muscle protein synthesis.
Psychological & Cognitive Support:
Anxiety reduction, mindfulness, and coping strategies to enhance treatment adherence and mental resilience.
Expected Outcomes
Improved Functional Capacity: Higher preoperative baseline functional capacity (measured via test modalities like the 6-Minute Walk Test).
Reduced Complications: Lower rates of postoperative pulmonary, cardiovascular, and surgical site complications.
Faster Recovery: Decreased hospital length of stay (LOS) and accelerated return to baseline physical independence.