Physical Activity

Poor functional capacity and physical fitness are associated with poor surgical outcomes including prolonged hospital length of stay and increased risk of postoperative complications. Increasing physical fitness can improve resilience and recovery after surgery. (1,2)

Screening Tools

The Physical Activity Vital Sign (PAVS) Calculator is a quick and easy way to flag sedentary patients for referral and counseling.

Prehabilitation and Optimization Algorithm

Prehabilitation and Optimization Recommendations

Patient Education
  • Recommend at least 150 min of moderate- to vigorous-intensity aerobic physical activity per week, in bouts of 10 minutes or more.
    • Moderate intensity activity: brisk walk or riding a bicycle; you can talk but not sing
    • Vigorous intensity activity: jogging or swimming; you are out of breath and can talk but don’t want to
  • Recommend muscle- and bone-strengthening activities at least 2 days per week.
  • Refer to online patient resources for preoperative exercise program.
  • Refer to the FREE Choose to Move program for personalized physical activity coaching and support. Participants set goals, build a tailored physical activity plan, and connect with peers while receiving information on health and wellness. In-person and online programs available.
Referral for Tailored Prehabilitation
  • Consider referral to physiotherapy for tailored preoperative exercise guidance for patients with medical limitations such as:
    • Frailty (See frailty)
    • Symptomatic cardiorespiratory disease
    • Chronic pain
    • Inflammatory arthritis
    • Neurological conditions
  • Refer to online provider resources for physiotherapy resources, referral templates, and information on who can access physio for free in BC

References

1. Barberan-Garcia, A., Ubré, M., Roca, J., Lacy, A. M., Burgos, F., Risco, R., Momblán, D., Balust, J., Blanco, I., & Martínez-Pallí, G. (2018). Personalised Prehabilitation in High-risk Patients Undergoing Elective Major Abdominal Surgery: A Randomized Blinded Controlled Trial. Annals of surgery, 267(1), 50–56. https://doi.org/10.1097/SLA.0000000000002293

2. Gillis, C., Ljungqvist, O., & Carli, F. (2022). Prehabilitation, enhanced recovery after surgery, or both? A narrative review. British journal of anaesthesia, 128(3), 434–448. https://doi.org/10.1016/j.bja.2021.12.007

Surgical Prehabilitation Toolkit