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Prehabilitation as an integral procedure in predictive, preventive and personalized medicine and modern and effective healthcare
Title Prehabilitation as an integral procedure in predictive, preventive and personalized medicine and modern and effective healthcare Author info Barbara Mrázová, Marko Kapalla ... [et al.] Author Mrázová Barbara (10%)
Co-authors Kapalla Marko (10%)
Marko Ľubomír (8%)
Lapuníková Miriam (8%)
Baláž Vladimír (8%)
Martuliak Igor (8%)
Flašková Martina (8%)
Skladaný Ľubomír (8%)
Patarák Michal (8%)
Líška Dávid 1994- (8%) UMBFF09 - Katedra telesnej výchovy a športu
Tosegiová Ľubomíra (8%)
Ďurajová Viktória (8%)
Source document EMPA World Congress 2021 : book of posters´abstract, Wrocław, 20-22 September 2021. S. 21-22. - Wrocław : Wrocław University of Science and Technology, 2021 ; EMPA World Congress 2021 international congress Keywords rehabilitácie cvičenie - exercise - training fyzické aktivity celková psychická pohoda zotavenie zdravotná starostlivosť - health care preventívne faktory Form. Descr. abstrakty - abstracts Language English Country Poland Annotation Background According to our search in the scientific literature, one of the first use of the term “prehabilitation” can be traced back to the beginning of 1940’s of the 20th century, during the WW II [1], when it was suggested by Selective Service System of the US Army recruiting young men for the service in the army. Originally it was understood as the procedure dedicating to solve health-related problems prior to the recruitment or prior to the unwanted manifestation during a military operation. In parallel, the pre-placement examinations of the employees in the industry was introduced by W.A. Sawyer in 1942 [2]. Later on, in 1952, in the German journal, the term “preoperative” is used in relation to the preoperative breathing exercise in thoracic surgery [3]. In the beginning of the 1980’s the meaning of the “prehabilitation” changed and it is now defined as “the process of expanding patient’s functional and psychological capacity to reduce potential deleterious effects of a significant stressor, which is the surgical procedure itself” [4]. The Cambridge dictionary defines “prehabilitation” in medical context as “activities done by someone before they have a medical operation in order to improve their physical strength and help them to recover more quickly after the operation” [5]. According to the BJA Education journal, prehabilitation is “the practice of enhancing a patient’s functional capacity before surgery, with the aim of improving postoperative outcomes” [6]. The Collins dictionary defines “prehabilitation as “the preparation of patients prior to major surgical procedures to enhance general health and well-being with the outcome of decreasing morbidity and mortality” [7]. So, basically, all definitions of “prehabilitation” are currently, one way or the other linked to surgery. Prehabilitation and PPPM Here we want to emphasize and extend the meaning of “prehabilitation” in the context of predictive, preventive and personalized medicine as presented by EPMA [8,9] because we find it to be an excellent example of practical application of PPPM in the modern healthcare services. Prehabilitation can use all the tools and knowledge accumulated and published so far in the predictive, preventive and personalized medicine, including the research in suboptimal health state [10] of the particular patient who is to undergo a planned therapeutic/surgical procedure, outcome of which depends on the particular health status of the patient. This status, in our opinion, should be assessed with the help of available medical technologies in order to predict potential problems and avoiding them through using adequate preventive actions, being it personalized nutritional support based on the particular analysis of the patient’s blood, particular physical exercises to increase fitness, psychological support, disease/procedure-related education of the patient, as well as using health-supporting environmental factors in all potential medical fields such as surgery, organ transplantation, oncology, obstetrics, dentistry, neurodegenerative diseases, genetically determined diseases, pandemic management, and other fields of medical care. In the context of our previous plans for implementation of PPPM in the hospital structure [11], here we propose implementation of prehabilitation into the routine procedures of medical care in any hospital that wants to increase the quality of provided healthcare and bring predictive, preventive and personalized medicine to the patients who will, undoubtedly, benefit from such a change. We are aware that realization of this vision is not an 22 easy mission to be accomplished and the question of proof-of-concept as it was in 2017 [5] but we suggest international cooperation among all subjects who share the same attitude towards turning current healthcare into the future healthcare may speed up the realization. The network of EPMA institutional members provides a very good platform for such a cooperation. Conclusion and expected impacts The vision is long-term but at the very beginning, it is reasonable to focus on the patients at high risk for postoperative morbidity and mortality, such as older surgical patients who are frail [12, 13]. Nonetheless, in the later phases of implementation it may likely be of value, as several researchers already propose [14] , to offer prehabilitation for a much wider spectrum of surgical patients, and, as we believe, also for other patients in need of specific medical procedures. The baseline in each of multimodal approach of prehabilitation (exercise & physical activity, nutritional optimization, psychological wellbeing, education and other), is personalized intervention, given the possibility of prediction, thus preventing negative clinical outcomes. A rapid return to full physical function after major surgery and/or other intervening medical procedures, has the potential to improve outcomes for patients, thus allowing them to return home and resume normal activities earlier. Furthermore, accelerated recovery is expected to have economic benefits and potentially more efficient use of both, the available hospital beds, as well as the use of always-limited financial resources in healthcare [15]. URL Link na plný text Public work category BFA No. of Archival Copy 50560 Catal.org. BB301 - Univerzitná knižnica Univerzity Mateja Bela v Banskej Bystrici Database xpca - PUBLIKAČNÁ ČINNOSŤ 
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