Integration of resistance exercise into a multimodal approach to prehabilitation for patients with sarcopenia prior to surgery: a narrative review.
Harsh Patel, Khang Duy Ricky Le, Annie Jiao Wang and 1 others
PMID 40432907WHAT IT FOUND
Pre-surgery resistance training for sarcopenia lacks standardised protocols, but evidence supports 4-6 weeks of multi-set exercises performed 2-3 times weekly.
Safety requires supervised, patient-specific programming, ideally combining isotonic movements with nutritional optimisation including high protein intake.
Key findings
01There are currently no standardised frameworks or best-practice recommendations for integrating resistance exercise into prehabilitation programs for sarcopenic patients.
02Resistance training principles for prehabilitation include multi-set protocols (2-3 sets), frequencies of up to twice weekly per muscle group, and progressive overload, with a focus on injury prevention through supervised, patient-specific programming.
03Nutritional support is integral to prehabilitation, with guidelines suggesting a minimal protein intake of 1.2 g per kilogram of bodyweight to support muscle hypertrophy.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
As a narrative review, it does not provide a systematic synthesis of evidence or quantify effect sizes. The paper notes a lack of standardisation in current protocols, meaning recommendations are based on general exercise physiology principles rather than specific prehabilitation trial data. Evidence for some interventions, such as blood flow restriction and specific micronutrients, is described as requiring further robust research. The review does not address patients undergoing emergency surgery, as prehabilitation is only feasible for elective procedures with sufficient lead time.
Declared interests
The authors declare no financial support was received for the research or publication of this article.
The easy way to misread this
Do not interpret the suggested exercise parameters (e.g., 2-3 sets, 2-3 times weekly) as a rigid, evidence-based protocol proven to improve surgical outcomes in sarcopenic patients. The review explicitly states that current protocols lack standardisation and that these principles are derived from general hypertrophy literature, requiring careful adaptation to individual patient frailty and safety.