Pre-hab is a MUST before any Men’s Pelvic Health Treatment
The Context:
Men’s health conditions such as testicular and prostate cancer may require surgery as treatment. Once this decision has been finalised with you and your urologist, you may have weeks or months before going under the knife. This is where the gold is. Time. The 2017–2018 mean wait time from prostate cancer diagnosis to surgery in public hospitals in Australia was 47 days
Australian Institute of Health and Welfare. Elective Surgery Waiting Times 2017–18. Australian Hospital Statistics (Australian Institute of Health and Welfare, 2018).
The surgical wait time, once viewed as an impediment, now presents an opportunity for the implementation of pre-habilitation programs to prepare patients physically and psychologically to manage the predictable consequences of whichever treatment they're receiving (i.e. Prostatectomy)
Aim of Prehab:
Prehab aims to
Reduce your risks of post-operative functional impairments
Increase your physical capacity, including aerobic capacity, muscle strength, and psychosocial well-being.
Many post-operative rehab programs are reactive to whatever complications or impairments may occur post-surgery.
What this model provides is a 'Proactive' approach
This is an individualised approach to each person preparing for Men's Pelvic Health treatment. The Key Areas that are focused on are:
Pelvic Floor Training
Heart Health / Cardiovascular fitness
Strength Training
Psychosocial
Pre-Hab: Pelvic Floor Training
Self-taught pelvic floor or kegel exercises often result in men recruiting the incorrect muscles. Men are AMAZING at believing they are recruiting their pelvic floor but the truth is they often recruit the incorrect muscles when performed unsupervised This is why here at High Line Active, physiotherapy prescribed Pelvic floor exercises are critical to an aspect of Pre-Hab. A specific pelvic floor exercise program is effective at increasing the strength, coordination, and endurance of the pelvic floor Evidence: Pelvic Floor Pre-Hab can increase continence outcomes 3-months post-prostatectomy (Hall, Neumann, Hodges - 2020)
Training the Male Pelvic Floor can be quite difficult as it is,
can you imagine how hard it can following treatment?
Pre-Hab: Cardiovascular Fitness
If you aren't physically active or have little strength before treatment, trying to improve those areas while navigating the side effects of treatment or surgery can be challenging.
2/3 of men with prostate cancer had pre-existing cardiovascular disease or cardiovascular risk factors
Evidence: Exercise before a prostatectomy:
Improves muscle strength
Improves physical function
Reduces Fatigue
In those with Prostate Cancer (Hall, Neumann, Hodges - 2020)
At High Line Active, Dane is a certified Strength and Conditioning coach (ASCA) and aims to get you as fit and active as possible in the time available before treatment. Let's tackle these risk factors
Pre-Hab: Strength Training
Strength training before treatment can assist with post-treatment functional outcomes (walking, stairs, lifting & balance).
4 weeks is what we prefer as a MINIMUM for Prehab to get you in the best shape before treatment
Evidence: 4 weeks of resistance training can increase strength outcomes with Prostate Cancer (Mungovan, 2021)
Pre-Hab: Psychosocial
During surgical wait times, patients can experience
Anxiety
uncertainty
Depression
Fear of disease progression
Having a plan and knowing expectations of pre and post-treatment allow for clarity
Evidence: Pre-Op Education about surgery, rehab, and exercises can reduce anxiety in patients
(Jurys et al - 2020)
Summary
We are lucky to witness the benefits of pre-habilitation here at High Line Active Men's Health Physiotherapy. The evidence presented here supports what we see so regularly in the clinic. Dane will get you in the best shape he can in preparation for any Men's Health Condition