While cardiac and pulmonary rehabilitation programs traditionally involve exercise therapy and risk management following an event (eg, myocardial infarction and stroke), or an intervention (eg, coronary artery bypass surgery and percutaneous coronary intervention), prehabilitation involves enhancing functional capacity and optimizing risk profile prior to a scheduled intervention. The concept of prehabilitation is based on the principle that patients with higher functional capabilities will better tolerate an intervention, and will have better pre- and post-surgical outcomes. In addition to improving fitness, prehabilitation has been extended to include multifactorial risk intervention prior to surgery, including psychosocial counseling, smoking cessation, diabetes control, nutrition counseling, and alcohol abstinence. A growing number of studies have shown that patients enrolled in prehabilitation programs have reduced post-operative complications and demonstrate better functional, psychosocial, and surgery-related outcomes. These studies have included interventions such as hepatic transplantation, lung cancer resection, and abdominal aortic aneurysm (repair, upper gastrointestinal surgery, bariatric surgery, and coronary artery bypass grafting). Studies have also suggested that incorporation of prehabilitation before an intervention in addition to traditional rehabilitation following an intervention further enhances physical function, lowers risk for adverse events, and better prepares a patient to resume normal activities, including return to work. In this overview, we discuss prehabilitation coming of age, including key elements related to optimizing pre-surgical fitness, factors to consider in developing a prehabilitation program, and exercise training strategies to improve pre-surgical fitness.

中文翻译：

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成年预康复：对心脏和肺康复的影响。

虽然心肺康复计划传统上涉及事件（例如心肌梗塞和中风）或干预（例如冠状动脉搭桥手术和经皮冠状动脉介入治疗）后的运动疗法和风险管理，但预康复涉及增强功能能力和优化风险状况在预定的干预之前。预康复的概念基于以下原则：功能能力较高的患者能够更好地耐受干预，并且会获得更好的术前和术后结果。除了改善健康状况外，预康复还扩展到包括手术前的多因素风险干预，包括心理咨询、戒烟、糖尿病控制、营养咨询和戒酒。越来越多的研究表明，参加预康复计划的患者减少了术后并发症，并表现出更好的功能、心理和手术相关结果。这些研究包括肝移植、肺癌切除和腹主动脉瘤（修复、上消化道手术、减肥手术和冠状动脉旁路移植术）等干预措施。研究还表明，除了干预后的传统康复之外，在干预前纳入预康复可以进一步增强身体功能，降低不良事件的风险，并更好地为患者恢复正常活动（包括重返工作岗位）做好准备。在本概述中，我们讨论了成年前的康复，包括与优化术前健康相关的关键要素、制定预康复计划时需要考虑的因素以及提高术前健康的运动训练策略。