Pre-operative exercise significantly aids recovery: Study

A study from the University of Otago suggests that a short program of high-intensity interval training before surgery can greatly aid recovery.
The study, published in the journal Surgery, reviewed and analyzed 12 studies including 832 patients who underwent preoperative high-intensity interval training. This type of training involves repeated aerobic high-intensity intervals at approximately 80 percent of maximum heart rate followed by active recovery. Lead investigator Dr Kari Clifford says the study included all types of major surgery – those lasting longer than two hours or expected to result in more than 500ml of blood loss – and included liver, lung, colorectal , urologic and mixed major abdominal surgeries. The average age of participants in the intervention group was 66 and in the control group was 67.

“We have found that high intensity interval training (HIIT) is safe and effective for surgical patients. A HIIT program can meaningfully improve a patient’s fitness within four to six weeks, and it reduces postoperative complications and length of stay. The most important outcome was the change in cardiorespiratory fitness (CRF) – a measure of how well the body takes in oxygen and delivers it to muscles and organs during prolonged exercise.

“Compiled results suggest that HIIT increases cardiorespiratory fitness by 2.39 ml/min/kg. This is not only significantly different from standard surgical care, but also clinically relevant: we know that this level of enhancement is associated with a lower risk of adverse postoperative outcomes.

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In general, post-operative complications occur in about 30 percent of patients, or up to 50 percent in debilitated patients. In the study, she says, people who did high-intensity interval training before surgery showed a consistent reduction in post-surgery complications, such as heart complications, pneumonia, and bowel problems after the operation. “The pooled results of our study showed that HIIT reduced the risk of having a complication by 56 percent, which is substantial; And on average they stayed in the hospital three days less. All of these findings suggest that a period of high-intensity interval training prior to surgery – even as short as four weeks – can significantly improve patient outcomes and bring with it robust benefits across patient populations. she says.

The next step is to figure out how to implement such programs. “Supervised exercise programs can be expensive, so we are looking at how effective it is to support people training at home or in the community. Funding these programs could save money in the long term by reducing the cost of hospital stays and surgical complications. “In the meantime, I would say to everyone, it’s never too late to improve fitness, and it really can make a difference in health outcomes in a surgical context.”