If you’ve ever played a video game, you might be familiar with the idea of a “boss battle”. At the end of a dungeon or the game, you have to fight a huge monster. It’s a big challenge! It requires preparation and training to overcome the boss.
Although modern medicine has grown in leaps and bounds, major surgery is still something like a boss battle. Going through surgery can be tough. It usually takes months, or even over a year for patients to get back to normal. What if there was a way to train and prepare the body like a video game character?
Researchers are working hard to make major surgery easier on the body. One of the newest ways of doing this is through pre-surgery training. A big team of researchers, led by two from the Centre de Recherche Saint-Antoine (Paris) and Stanford school of medicine, designed a new protocol. They developed special, person-specific programmes to train the body through exercise and tailored diets. They also worked on training the mind through meditation, mindfulness and cognitive training. Shockingly, the training didn’t just improve patients’ physical and mental outcomes. It changed how their immune systems were responding to surgery.
Why do doctors need to manage immune responses?
The immune system is the body’s army against infection. As soon as a foreign object – like a stitch or a scalpel, enters the body, immune soldiers come to fight. They swarm to ward off invaders and protect the body’s own cells. As vital as this army can be, sometimes they cause too much damage.
Inflammation, caused by an overactive immune system, can cause swelling and slow healing. The body overreacts to things which aren’t a problem, taking resources away from healing and getting better. Some elderly patients might even experience cognitive problems because of inflammation. There’s a sweet spot. If the immune system is too calm, the body doesn’t fight off infections. Too active, and it’s slow to heal. Personalized pre-hab seemed to help patients reach this balance.
How did researchers design their “pre-hab”?
Like all good medical research, participants were divided into two groups. This is a very important aspect of the study! Each group needs to be big enough that a full range of effects is seen. It’s also very important to compare the group that is receiving something new to a group that receives the usual treatment. This helps researchers understand whether the new treatment has had a real effect.
In this study, the “usual treatment” was a booklet outlining helpful exercises and guides. It wasn’t unique to each patient. The new treatment was a twice-weekly, one on one individualised consultation with different coaches and specialists. These sessions were tailored specially for each patient. Programs lasted between 2-6 weeks.
Why does this matter?
Almost one-third of all patients undergoing major surgery experience some form of complication which may compromise recovery, lead to a longer hospital stay, or increase costs. Although personalised treatment might seem like a long shot, it may actually be the most cost-effective option! The training sessions were even remote, suggesting how effective this intervention might be for those who live far away from hospitals, or have limited access to healthcare. This new research emphasises just how important engaging with patients, and even training them, before surgery is.
Scientists still don’t know what the long term benefits might be. After all, “this is a complex intervention…It’s not just a tablet.” Franco Carli, a leader in prehabilitation research at McGill University, told Science News.
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