title: Prehabilitation in our most frail surgical patients: are wearable fitness devices the next frontier?
abstract: OBJECTIVE
  Frailty is the concept of accumulating physiologic declines that make people less able to deal with stressors, including surgery. Prehabilitation is intervention to enhance functional capacity before surgery. Frailty and prehabilitation among transplant populations and the role of wearable fitness tracking devices (WFTs) in delivering fitness-based interventions will be discussed.
  
  
  RESULTS
  Frailty is associated with increased complications, longer length of hospital stay and increased mortality after surgery. Frail kidney transplant patients have increased delayed graft function, mortality and early hospital readmission. Frail lung or liver transplant patients are more likely to delist or die on the waitlist. Prehabilitation can mitigate frailty and has resulted in decreased length of hospital stay and fewer postsurgical complications among a variety of surgical populations. Increasingly, WFTs are used to monitor patient activity and improve patient health. Interventions using WFTs have resulted in improved activity, weight loss and blood pressure.
  
  
  CONCLUSIONS
  Frailty is a measurable parameter that identifies patients at risk for worse health outcomes and can be mitigated through intervention. Prehabilitation to reduce frailty has been shown to improve postsurgical outcomes in a variety of populations. WFTs are being integrated in healthcare delivery for monitoring and changing health behavior with promising results.
authors: aDepartment of Surgery, Stanford University bStanford School of Medicine, Palo Alto, California, USA.
authors: Kristen K
authors: KK
authors: Rumer
authors: Anirudh
authors: A
authors: Saraswathula
authors: Marc L
authors: ML
authors: Melcher
mesh_terms: D004066:Digestive System Diseases / Q000534:rehabilitation* / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000009:adverse effects; D006801:Humans; D007902:Length of Stay; D010359:Patient Readmission; D011183:Postoperative Complications; D012307:Risk Factors