PREHABILITATION AN INNOVATIVE CONCEPT TO COUNTER CORONA VIRUS

PREHABILITATION A INNOVATIVE CONCEPT TO COUNTER CORONA VIRUS 

We all know that social distancing, hand washing, wearing masks play an important role in our war against the pandemic. Today I am discussing another strategy called prehabilitation in our fight against corona. This is a strategy with a scientific basis. This is not a cure and does not need nay equipment for implementation. It aims at improving a person’s health to withstand the massive stress the body and mind have to encounter.

The concept of prehabilitation was first introduced during the Second World War. It was used to enhance the physical and mental condition of individuals prior to enlisting in the British army. The rejection rate came down drastically once this concept was introduced. Mountain climbers also use the same concept and they call it acclimatization. 

This concept has been utilized of late in health care. Of late the number of surgical procedures have increased worldwide and so as the associated complications. The present surgical population also is elderly with lots of co existing problems. Obesity, heart diseases, diabetes are some of them. Surgery is a major stress on the body both physically and mentally. Here the concept of prehabilitation plays a major role.

What constitutes prehabilitation?

1. Physical conditioning and exercises to build muscle mass, to improve the heart and lung condition
2. Cessation of smoking
3. Nutritional assessment and inputs to improve the status.
4. Strict control of diabetes
5. Breathing exercises and psychological strengthening 

With reduced physical activity there will be muscle

and cardiopulmonary deconditioning. This results in difficulty in maintaining oxygenation in post operative period.

What sort of exercises?

1. Avoiding prolonged sitting
2. Walking around the house and spot jogging
3. Dancing
4. Deep breathing and breath holding.

We follow lots of dietary restrictions during illness resulting in decreased protein intake. Intensive feeding with high protein intake helps a lot. Eggs, chicken, paneer, soya, dals and milk are a must. Artificial protein supplements can also be tried. Quitting smoking is of paramount importance. Smokers have higher lung complications and the same is true for corona deaths. Control of diabetes is also equally important.

Prehabilitation when implemented can do no harm, though it has not been evaluated in a pandemic situation. It can be done along with social distancing and quarantine. The greatest benefit can be seen in the elderly with co existing disease. The downside of lockdown is decreased physical activity, which can be countered by prehabilitation.