Researchers reviewed 153 studies about ways to prepare patients’ bodies and minds before surgery. They found that patients who did special exercises, ate better foods, got psychological support, and quit smoking before their operations had better outcomes and recovered faster. The most common preparation method was exercise, used in about 85% of studies. While most studies showed positive results, researchers say we need more research combining multiple preparation methods together and studying different types of surgeries to understand what works best for everyone.

The Quick Take

  • What they studied: Whether preparing patients’ bodies and minds before surgery through exercise, better nutrition, mental health support, and lifestyle changes helps them recover better and have fewer complications.
  • Who participated: 153 different research studies involving patients having various surgeries, mostly general surgery (like stomach or intestinal procedures), orthopedic surgery (bones and joints), and heart surgery. The studies were published mostly between 2017 and 2025.
  • Key finding: About 82% of studies found that patients who did prehabilitation (pre-surgery preparation) had better surgical outcomes, including faster recovery, fewer complications, and better quality of life after surgery compared to patients who didn’t prepare.
  • What it means for you: If you’re having surgery, talking to your doctor about preparing your body beforehand through exercise and nutrition may help you recover better. However, more research is needed to know exactly which combinations of preparation methods work best for different types of surgery.

The Research Details

This was a systematic review, which means researchers searched through thousands of published studies to find all the research about prehabilitation (preparing for surgery). They searched a medical database called PubMed on June 25, 2025, using specific search terms like “Prehabilitation AND Surgery” and “Prehabilitation AND Anesthesia.” They found 796 articles total and carefully selected 153 studies that met their quality standards.

The researchers looked at what types of surgeries were studied, what preparation methods were used, how long patients prepared, and what results the studies found. They organized the information by surgical specialty (like heart surgery, bone surgery, or general surgery) and by the type of preparation used (exercise, nutrition, mental health support, quitting smoking, or medical optimization).

The studies they reviewed included different research designs, from small pilot studies to large randomized controlled trials where some patients got prehabilitation and others didn’t. This mix of study types gave them a broad picture of how prehabilitation works across different situations.

This research approach is important because it brings together all the available evidence in one place, making it easier to see what’s working and what still needs to be studied. By looking at 153 different studies, the researchers could identify patterns about which preparation methods are most commonly used and which ones seem to help patients the most. This type of review helps doctors and patients make better decisions about pre-surgery preparation.

This review is a narrative review rather than a meta-analysis, which means the researchers summarized the studies but didn’t combine their numbers statistically. The studies reviewed were published in reputable medical journals, with most being recent (2017-2025), suggesting current evidence. However, the quality of individual studies varied, and the researchers noted that many studies used only one preparation method rather than combining several approaches. The fact that 82% of studies showed positive results is encouraging, but readers should know that studies showing positive results are more likely to be published than those showing no effect.

What the Results Show

The review found that prehabilitation—preparing your body before surgery—appears to help patients have better outcomes. About 82% of the 153 studies reviewed reported that patients who participated in prehabilitation had statistically significant improvements in their surgical outcomes. These improvements included things like shorter hospital stays, fewer complications after surgery, better pain control, and faster return to normal activities.

Exercise was by far the most common preparation method, used in 84.7% of studies. This included activities like walking, strength training, and breathing exercises. Nutritional interventions (eating better foods and getting proper nutrients) were the second most common, used in 29.5% of studies. Other preparation methods included psychological support (like counseling or stress management), helping people quit smoking, and medical optimization (managing existing health conditions better).

The researchers found that most studies (43%) used only one preparation method, while others combined multiple approaches. Multimodal (combination) approaches were more common in general surgery studies (36%) than in heart surgery studies (13%). The preparation programs typically lasted several weeks before surgery, though the exact length varied between studies.

The review identified that different surgical specialties used different preparation approaches. General surgery studies were most common (43% of all studies reviewed), followed by orthopedic surgery (21%) and cardiothoracic (heart) surgery (18%). This means we have more evidence about prehabilitation for some types of surgery than others. The researchers also noted that some studies included cancer patients receiving chemotherapy before surgery, which may have affected their results. The duration of prehabilitation programs varied widely, from just a few weeks to several months, but the review didn’t clearly show which timeframe worked best.

This review adds to growing evidence that preparing patients before surgery is beneficial. Previous research has suggested that patients in better physical and mental condition before surgery tend to recover better, and this comprehensive review confirms that finding across many different types of surgery. The emphasis on multimodal approaches (combining exercise, nutrition, and mental health support) represents a shift from earlier research that often focused on single interventions. This review suggests the field is moving toward more comprehensive preparation strategies.

The main limitation is that most studies reviewed used only one preparation method, making it hard to know if combining methods works better. The review is concentrated in a few surgical specialties (general, orthopedic, and heart surgery), so we don’t know as much about prehabilitation for other types of surgery. The quality and design of the 153 studies varied, and studies showing positive results are more likely to be published than those showing no benefit, which could make prehabilitation seem more effective than it actually is. Additionally, this is a narrative review rather than a meta-analysis, so the researchers didn’t combine the numbers from different studies to get overall statistics. The review was published on a preprint server (medRxiv), meaning it hasn’t yet gone through the full peer-review process that published journal articles undergo.

The Bottom Line

If you’re scheduled for surgery, talk to your doctor about prehabilitation options. The evidence suggests that preparing your body through exercise, eating nutritious foods, managing stress, and quitting smoking (if applicable) may help you recover better. Start preparing at least a few weeks before your surgery if possible. The confidence level for this recommendation is moderate to high based on the 82% of studies showing positive results, but individual results may vary depending on your health status and type of surgery.

Anyone scheduled for major surgery should consider prehabilitation, especially if they have general surgery, orthopedic surgery, or heart surgery planned. People with existing health conditions, older adults, and those who are overweight may benefit the most. However, people with certain medical conditions that make exercise unsafe should work closely with their doctor to develop a safe preparation plan. This research is less directly applicable to emergency surgeries where there’s no time to prepare.

Most studies looked at preparation periods of several weeks to a few months before surgery. You might start seeing benefits like improved strength and endurance within 2-4 weeks of starting an exercise program. The biggest benefits typically appear in the first few weeks after surgery, with faster recovery and fewer complications. Long-term benefits like better quality of life and faster return to normal activities may continue improving for several months after surgery.

Want to Apply This Research?

  • Track pre-surgery exercise sessions weekly, recording type of activity (walking, strength training, breathing exercises), duration in minutes, and how you felt. Also log daily nutrition with focus on protein intake and water consumption. Rate your stress level daily on a 1-10 scale.
  • Use the app to set a pre-surgery preparation goal (for example, “Exercise 4 times per week for 6 weeks before surgery”). Create reminders for exercise sessions, meal planning, and stress management activities. If quitting smoking, use the app to track smoke-free days and trigger avoidance strategies.
  • Create a pre-surgery dashboard showing exercise frequency, nutrition quality, stress levels, and smoking status over time. Set weekly check-ins to review progress toward preparation goals. After surgery, track recovery milestones like pain levels, activity tolerance, and return to normal activities to see if pre-surgery preparation correlated with better outcomes.

This review summarizes research about preparing for surgery but is not medical advice. The effectiveness of prehabilitation varies based on individual health conditions, type of surgery, and other factors. Always consult with your surgeon and medical team before starting any pre-surgery preparation program, especially if you have existing health conditions or take medications. This research is based on a preprint that has not yet completed peer review. Individual study quality varied, and more research is needed, particularly for surgical specialties beyond general, orthopedic, and heart surgery.