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Cindy Lin, Ellen Casey, Daniel Herman, Nicole Katz, Adam Tenforde
Common sports injuries include bone stress injuries (BSI), anterior cruciate ligament injuries (ACL), and concussions. Less commonly recognized are the specific sex differences in epidemiology, risk factors, and outcomes of these conditions by sex. An understanding of these factors can improve their clinical management, from prescribing appropriate prehabilitation to guiding post injury rehabilitation and return to play. This narrative review summarizes the sex differences in the diagnosis and management of BSI, ACL injuries, and concussions...
March 14, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Ana Abreu
No abstract text is available yet for this article.
January 1, 2018: European Journal of Preventive Cardiology
Alison Luther, Joseph Gabriel, Richard P Watson, Nader K Francis
BACKGROUND: Despite advances in perioperative care, post-operative clinical and functional outcomes after major abdominal surgery can be suboptimal. Prehabilitation programmes attempt to optimise a patient's preoperative condition to improve outcomes. Total body prehabilitation includes structured exercise, nutritional optimisation, psychological support and cessation of negative health behaviours. This systematic review aims to report on the current literature regarding the impact of total body prehabilitation prior to major abdominal surgery...
March 15, 2018: World Journal of Surgery
Bente T Jensen, Susanne V Lauridsen, Jørgen B Jensen
PURPOSE OF REVIEW: Whether prehabilitation in radical cystectomy adds to the effort of reducing postoperative morbidity and impairments in the survivorship phase has until recently received limited attention. This narrative review aims to summarize the current evidence base on prehabilitaion interventions focusing on the efficacy of procedure-specific interventions and the influence on postoperative outcomes. RECENT FINDINGS: Given the oncological risk, there is a relative short window to intervene and proactively optimize the patient before radical cystectomy...
March 13, 2018: Current Opinion in Urology
Carol Keen, Julie Skilbeck, Helen Ross, Lauren Smith, Karen Collins, Joanne Dixey, Stephen Walters, Diana M Greenfield, John A Snowden, Susan Mawson
INTRODUCTION: While myeloma is an incurable malignancy, developments in disease management have led to increased life expectancy in recent years. Treatment typically involves stem-cell transplantation. Increased survival rates equate to more patients living with the burden of both the disease and its treatment for increasing number of years, rendering myeloma a long-term condition.Evidence exists to demonstrate the benefits of exercise for patients recovering from stem-cell transplantation, and prehabilitation-exercise before treatment-has been shown to be effective in other disease areas...
March 9, 2018: BMJ Open
Vanessa Ferreira, Ramanakumar V Agnihotram, Andreas Bergdahl, Stefanus J van Rooijen, Rashami Awasthi, Francesco Carli, Celena Scheede-Bergdahl
PURPOSE: Multimodal prehabilitation programs (exercise, nutrition, and anxiety reduction) have been shown to be successful for enhancing patients' physical function prior to surgery, although adherence remains a challenge. Given the short pre-operative period, maintaining adherence is critical to maximize program effectiveness. This study was designed to better understand patients' perspectives of prehabilitation and to identify factors related to program adherence. METHODS: A qualitative descriptive study was conducted based on 52 cancer patients enrolled in a prehabilitation program at the Montreal General Hospital, Montreal, Canada...
February 24, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Annefleur E M Berkel, Bart C Bongers, Marie-Janne S van Kamp, Hayke Kotte, Paul Weltevreden, Frans H C de Jongh, Michiel M M Eijsvogel, A N Machteld Wymenga, Marloes Bigirwamungu-Bargeman, Job van der Palen, Marc J van Det, Nico L U van Meeteren, Joost M Klaase
No abstract text is available yet for this article.
February 21, 2018: BMC Gastroenterology
D Z H Levett, S Jack, M Swart, J Carlisle, J Wilson, C Snowden, M Riley, G Danjoux, S A Ward, P Older, M P W Grocott
The use of perioperative cardiopulmonary exercise testing (CPET) to evaluate the risk of adverse perioperative events and inform the perioperative management of patients undergoing surgery has increased over the last decade. CPET provides an objective assessment of exercise capacity preoperatively and identifies the causes of exercise limitation. This information may be used to assist clinicians and patients in decisions about the most appropriate surgical and non-surgical management during the perioperative period...
March 2018: British Journal of Anaesthesia
Javier Ripollés-Melchor, Francesco Carli, Miquel Coca-Martínez, Macarena Barbero-Mielgo, José M Ramírez-Rodríguez, José A García-Erce
In the era of perioperative medicine, important advances have been made in the perioperative care of patients, usually within those known as Enhanced Recovery After Surgery (ERAS) protocols. These have led to a decrease in postoperative complications and the duration of hospital stays; however, there is still a lack of preoperative care, which could make perioperative medicine more prominent. Elderly patients, malnourished, anaemic and ones with a low physical function before surgery are likely to have sub-optimal recovery from surgery...
February 14, 2018: Minerva Anestesiologica
Thomas A Murray, Ying Yuan, Peter F Thall, Joan H Elizondo, Wayne L Hofstetter
A design is proposed for randomized comparative trials with ordinal outcomes and prognostic subgroups. The design accounts for patient heterogeneity by allowing possibly different comparative conclusions within subgroups. The comparative testing criterion is based on utilities for the levels of the ordinal outcome and a Bayesian probability model. Designs based on two alternative models that include treatment-subgroup interactions are considered, the proportional odds model and a non-proportional odds model with a hierarchical prior that shrinks toward the proportional odds model...
January 22, 2018: Biometrics
Felicity Rhian Williams, Alice Vallance, Thomas Faulkner, Jennifer Towey, Derek Kyte, Simon Durman, Jill Johnson, Andrew Holt, M Thamara Perera, James Ferguson, Matthew James Armstrong
INTRODUCTION: Liver disease is the third most common cause of premature mortality in the UK. Liver failure accelerates frailty, resulting in skeletal muscle atrophy, functional decline and an associated risk of liver transplant waiting list mortality. However, there is limited research investigating the impact of exercise on patient outcomes pre and post liver transplantation. The waitlist period for patients listed for liver transplantation provides a unique opportunity to provide and assess interventions such as prehabilitation...
January 21, 2018: BMJ Open
Bruno Neuner, Daniel Hadzidiakos, Gabriella Bettelli
Postoperative delirium (POD) is an adverse clinical outcome characterized by cognitive, affective and behavioral symptoms with typically an acute onset and a fluctuating course. POD is attributed to certain patients' predisposing factors as well as to treatment-related precipitating factors. While there are several single-component interventions for the prevention of POD, evolving evidence suggests the importance of a system approach in the prevention of POD. This involves strategies by multidisciplinary teams with additional geriatric consultation services to identify risk factors for POD and to modify their impact on the perioperative course...
January 20, 2018: Aging Clinical and Experimental Research
Filipe Marmelo, Vânia Rocha, Daniel Gonçalves
Introduction Cardiac surgery is an aggressive procedure, inducing a great level of stress and disturbance to the homeostasis of the organism and underlying several postoperative complications. Surgical prehabilitation comprises pre-operative physical conditioning designed to improve the physiological and functional capacities of the individual, prepare the organism for surgical stress and reduce the risk of postoperative morbidity. Aim This systematic review and meta-analysis is aimed at evaluating the ability of prehabilitation to prevent post-surgical complications in cardiac patients...
January 1, 2018: European Journal of Preventive Cardiology
Guillaume Bousquet-Dion, Rashami Awasthi, Sarah-Ève Loiselle, Enrico M Minnella, Ramanakumar V Agnihotram, Andreas Bergdahl, Francesco Carli, Celena Scheede-Bergdahl
BACKGROUND: Prehabilitation has been previously shown to be more effective in enhancing postoperative functional capacity than rehabilitation alone. The purpose of this study was to determine whether a weekly supervised exercise session could provide further benefit to our current prehabilition program, when comparing to standard post-surgical rehabilitation. METHODS: A parallel-arm single-blind randomized control trial was conducted in patients scheduled for non-metastatic colorectal cancer resection...
January 12, 2018: Acta Oncologica
Jonathan H Waters, Peter Johnson, Mark H Yazer
BACKGROUND: Iron deficiency without anemia has been associated with decreases in functional work capacity and fatigue. The aim of this study was to determine the prevalence of iron deficiency without anemia in a preoperative cohort of orthopedic patients and to determine if iron deficiency is a condition which warrants inclusion into a prehabilitation program prior to surgery. METHODS: One hundred consecutive patients going through preoperative testing for total joint replacement were enrolled in the study...
January 10, 2018: Hematology (Amsterdam, Netherlands)
Alexander Franz, Fina Pauline Queitsch, Michael Behringer, Constantin Mayer, Rüdiger Krauspe, Christoph Zilkens
Osteoarthritis of the knee is one of the most commonly diagnosed joint ailments and responsible for increased rates of total knee arthroplasty surgeries worldwide. Whereas the surgical approach is able to diminish the perceived knee pain of concerned patients', the postoperative recovery is often accompanied by persistent skeletal muscle dysfunctions and atrophy, which is responsible for functional deficits for up to several years. Recent findings indicate that surgery induced adverse effects on skeletal muscles are largely associated with the use of pneumatic tourniquets, wherefore several studies try to reduce tourniquet use in orthopedic surgery...
January 2018: Medical Hypotheses
Francesco Carli, Vanessa Ferreira
Surgery in combination with risk factors such as poor physical and nutritional status have detrimental effects on short- and long-term aspects of recovery and quality of life, especially in elderly patients whose functional reserve is limited. Strategies to minimize these effects and accelerate return to baseline levels have focused on the intra- and post-operative period; however, this may not be the most opportune time to intervene. Instead, the preoperative period may be a more emotionally salient and physically enabling time to initiate an intervention aimed at attenuating surgical stress and enhancing recovery after surgery...
January 4, 2018: Aging Clinical and Experimental Research
Catherine A Britton-Jones
No abstract text is available yet for this article.
December 2, 2017: British Journal of Hospital Medicine
Rebecca Moyer, Kathy Ikert, Kristin Long, Jacquelyn Marsh
BACKGROUND: Existing evidence regarding the value of preoperative education and/or exercise (prehabilitation) for patients undergoing total joint replacement is conflicting. The purpose of this study was to conduct an updated, comprehensive systematic review with meta-analyses to determine the longitudinal effects and efficacy of prehabilitation on postoperative outcomes in patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA). METHODS: We searched 11 electronic databases (MEDLINE, AMED, CINAHL, Embase, Scopus, ProQuest, PEDro, SportDiscus, PsycINFO, and Cochrane) from their inception to May 2016 for randomized controlled trials that compared changes in pain, function, strength, anxiety, and hospital length of stay following THA or TKA...
December 2017: JBJS Reviews
Vladimir Bolshinsky, Michael H-G Li, Hilmy Ismail, Kate Burbury, Bernhard Riedel, Alexander Heriot
BACKGROUND: Prehabilitation reflects a proactive process of preoperative optimization undertaken between cancer diagnosis and definitive surgical treatment, with the intent of improving physiological capacity to withstand the major insult of surgery. Prehabilitation before GI cancer surgery is currently not widely adopted, and most research has focused on unimodal interventions such as exercise therapy, nutritional supplementation, and hematinic optimization. A review of the existing literature was undertaken to investigate the impact of multimodal prehabilitation programs as a "bundle of care...
January 2018: Diseases of the Colon and Rectum
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