Mounting evidence suggests that recovery begins before the surgical incision. The presurgery phase of recovery, namely the preparation for optimal surgical recovery, can be reinforced with prehabilitation. Prehabilitation is the approach of enhancing the functional capacity of the individual to enable them to withstand a stressful event. With this narrative review, we apply the Wilson and Cleary conceptual model of patient outcomes to specify the complex and integrative relationship of health factors that limit functional capacity before surgery. To have the greatest impact on patient outcomes, prehabilitation programs require individualised and coordinated care from medical, nutritional, psychosocial and exercise services.

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Cardiac surgical patients usually present a multifactorial reduction in aerobic capacity and a sedentary lifestyle. Multiple comorbidities, perception of severe illness and fear of worsening symptomatology contribute to physical inactivity and deterioration of their functional status. During the preoperative period there is a unique opportunity to optimize our patients, trying to decrease the incidence and severity of the postoperative complications.Trimodal prehabilitation has demonstrated a reduction on the incidence of postoperative complications in certain groups of patients undergoing major abdominal surgery. However, there is little experience regarding prehabilitation in cardiac surgery and most studies have only included low risk patients.Our objective is to assess the effect of a multimodal prehabiltation program on functional capacity in cardiac surgery candidates. Secondly, we aimed to analyze the feasibility and safety of the program.

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