COVER STORY PRACTICE Rehab vs prehab What does this mean in chiropractic practice? M by brett guist any people seek out chiroprac-after the injury, often in conjunction with treatment, tors for the treatment of various while prehab programs occur prior to treatment musculoskeletal complaints, being given, often in the form of surgery. most notably lower back pain Research has found that those patients who re-ceive a targeted pre-surgical exercise program prior and neck pain. As chiropractors, to knee or hip replacement surgery can decrease the we know that approximately 80 odds of needing inpatient rehabilitation by up to 73 per cent of Canadians will expe-rience an episode of back pain at some point in per cent, with significant improvements in func-tional status and muscle strength (Rooks, 2006). An their life, and many people will suffer ongoing article by Jack, West, and Grocott (2011) discussed bouts of lower back pain related to poor posture, the usage of prehab for elderly subjects. The authors work positions, pregnancy, sports, etc. (Ruas and found that although there was a “paucity of Vieira, 2017). It is imperative that chiropractors be high-quality clinical trials,” prehabilitation can im-well versed at treating and hopefully preventing prove specific fitness measures prior to surgery in-these issues in their patients. This is where the role cluding levels of physical activity, fatigue, and health of rehabilitation (rehab) and prehabilitation (pre-related quality of life in cancer patients as well as hab) come into chiropractic practice. Rehab and prehab are common buzzwords REHABILITATION improved general fitness. More recently, a system-PROGRAMS within the manual medicine community, often with atic review by Cabilan, Hines, and Munday (2015) begin after the vague descriptors attached to them. The Oxford found that “…prehabilitation has no significant injury, often in post-operative benefits in function, quality of life Dictionary of Sports Science and Medicine defines rehabilitation as the “restoration of an injured conjunction with and pain in patients who have had knee or hip ar-throplasty for osteoarthritis; however, there is evi-treatment. person to the level of physical fitness he or she had dence that prehabilitation may reduce admission to before the injury.” Both rehabilitation and preha-PRE-rehabilitation in this population.” Despite the mixed bilitation programs are designed to build strength and increase functional capacity, but the timing of HABILITATION results in the literature, the bulk of the research PROGRAMS their delivery is different. Prehabilitation has tradi-appears to be favourable for the use of prehabilita-tion programs. occur prior to tionally been associated with preparation for sur-gery; with patients being given physical and/or treatment being lifestyle modifications to help improve recovery given, often in the Considering the needs of the patient time and decrease their post-surgery pain levels form of surgery. While some patients may be coming in for care in advance of an upcoming surgery, others are looking following surgery. Rehabilitation programs begin for traditional treatment and strategies to prevent DR. BRETT P. GUIST graduated from CMCC in 2015 and is a chiropractor future occurrences of their pain. Many research practicing in Burlington, Ont., with a focus on rehabilitation. In studies have shown that traditional treatments of-addition to his role as a chiropractor, he also teaches and conducts fered by chiropractors often perform better when research and has been published in several peer-reviewed journals. combined with exercise (Leininger et al, 2016; 14 Canadian Chiropractor February 2019 www.canadianchiropractor.ca Photo: Getty Images
Chiropractic + Naturopathic Doctor February 2019: Page 14
