Background/Objectives: Prehabilitation is a multimodal intervention introduced in preparation for various surgical procedures. The most effective treatment for obesity is bariatric surgery. Physiotherapy during prehabilitation for bariatric surgery may be an effective method of functional capacity improvement. We aimed to evaluate the impact of an individual outpatient 12-week, exercise-based physiotherapy program featuring prehabilitation on functional status, exercise tolerance, everyday mobility, and fatigue among patients qualified for bariatric surgery. Methods: The completion of an individual outpatient 12-week, exercise-based physiotherapy program during prehabilitation was an inclusion criterion for the study group. Participants included in the study and control groups were assessed twice, after enrollment into the prehabilitation program (the first assessment) and after prehabilitation but before surgery (the second assessment). Both assessments involved functional tests (a six-minute walking test [6MWT], a timed up and go test [TUG], a chest mobility test, anthropometric measures, a mobility index [Barthel], and a modified Borg scale). The collected anthropometric data and values from the 6MWT were used to create original linear models. This study followed STROBE recommendations. Results: The study group and control group did not differ statistically in terms of their anthropometric data. Statistically significant results were obtained between the first and second assessments in both groups in terms of body weight and waist circumference. However, only the study group showed improved results in the TUG test (p = 0.0001) and distance in the 6MWT (p = 0.0005). The study group presented with the normalization of blood pressure (BP) after exertion in the second assessment (systolic BP p = 0.0204; diastolic BP p = 0.0377), and the 6MWT results were close to the norms. According to the original linear model used to predict performance in the 6MWT, the primary modifiable determinant of exercise tolerance was the participant’s weight, while gender served as a non-modifiable determinant. Conclusions: Exercise-based physiotherapy in prehabilitation was associated with improved functional capacity in patients preparing for bariatric surgery, contributing to the improvement in 6MWT results in relation to the norms as well as exercise tolerance. Body weight may be an independent factor determining distance in the 6MWT for patients undergoing prehabilitation for bariatric surgery.

Background/Objectives: Bariatric surgery is an effective treatment for severe obesity. Although physiotherapy delivered before and after surgery may support functional recovery, evidence describing real-world multidisciplinary bariatric pathways with embedded perioperative physiotherapy remains limited. This study evaluated perioperative changes in anthropometric, functional, and haemodynamic outcomes in adults who completed preoperative and postoperative physiotherapy within the multidisciplinary Polish KOS-BAR bariatric pathway. Methods: We conducted a single-centre retrospective medical-record study at the University Clinical Centre in Gdańsk. The analysis included a complete-case cohort of 91 adults who completed both supervised physiotherapy cycles and had paired outcome data available. Assessments were performed at four time points: before and after prehabilitation (T1–T2) and before and after postoperative rehabilitation (T3–T4). Outcomes included body mass, body mass index (BMI), waist and chest circumference, 6 min walk test (6MWT) distance with Borg-rated exertion, and haemodynamic measures (heart rate, blood pressure, oxygen saturation) recorded before and after the 6MWT. Results: From T1 to T4, body mass decreased by a median of 26.0 kg and BMI by 8.98 kg/m², with reductions in waist (−19.0 cm) and chest (−13.0 cm) circumference. Exercise tolerance improved (6MWT median change +30.0 m), and post-test perceived exertion decreased (median −1.0 point). Pre-6MWT resting HR, post-6MWT HR, and blood pressure decreased. The 6MWT distance increased after prehabilitation (T1 → T2) and again after postoperative rehabilitation (T3 → T4). Exploratory correlations suggested weak nominal associations between greater weight loss and larger 6MWT improvement (Spearman r = 0.251, p = 0.016) and between BMI reduction and 6MWT improvement (r = 0.226, p = 0.031), but these associations did not remain statistically significant after Bonferroni correction. Conclusions: In this retrospective cohort of programme completers, participation in the multidisciplinary KOS-BAR pathway with embedded preoperative and postoperative physiotherapy was associated with improved anthropometric, functional, perceived-exertion, and haemodynamic outcomes across follow-up. Because of the uncontrolled retrospective design, these findings cannot establish the independent effect of physiotherapy relative to surgery and other components of multidisciplinary care. Prospective controlled studies are needed to clarify causality and long-term durability.

Background: Frailty is associated with adverse postoperative outcomes and functional decline in older adults undergoing colorectal cancer (CRC) surgery. The long-term course of frailty and functional outcomes among patients undergoing prehabilitation before CRC surgery remains insufficiently investigated. Methods: This prospective observational cohort study evaluated long-term functional and physiological outcomes in older adults with frailty syndrome undergoing colorectal cancer (CRC) surgery who participated in a structured prehabilitation program. Forty-one patients aged >70 years were assessed before prehabilitation and at one-year follow-up. Frailty (the Clinical Frailty Scale [CFS] and the 5-item Frailty Index [5-FI]), physical activity, postural function, respiratory parameters, and functional performance (the 6 min walk test [6MWT] and the Timed Up and Go [TUG] test) were evaluated. Results: Of the 93 eligible patients, 41 completed the one-year follow-up and were therefore included in the final analysis. A small but statistically significant increase in frailty was observed using 5-FI (mean difference = 0.029, p = 0.012), with no significant change in CFS. Postural function improved (p = 0.031), while physical activity and functional performance remained stable (6MWT: 392.71 vs. 384.36 m, p = 0.885; TUG: 12.36 vs. 10.42 s, p = 0.051). A significant reduction in pre- and post-exercise oxygen saturation was observed; however, the magnitude of change (before: −1.25%, p = 0.006; after: −0.91%, p < 0.001) was small and of uncertain relevance. Conclusions: Over a one-year follow-up of prehabilitated CRC patients with frailty, their functional performance remained stable despite a subtle progression of frailty. These findings suggest a dissociation between physiological vulnerability and functional status. Due to the observational design of the study and the lack of a control group, the results should be interpreted as descriptive rather than causal.