Study discovers how pre-operative exercise substantially speed up recovery
Dunedin, New Zealand: According to research from the University of Otago, exercising before undergoing all types of major surgery might help avoid complications after the operation and can dramatically speed up recovery.
Preoperative high-intensity interval training had been completed by 832 participants in the study, which was published in the journal Surgery. Repeated aerobic high-intensity periods at roughly 80 per cent of maximum heart rate are combined with active recovery during this type of training.
Lead investigator Dr Kari Clifford says the study included all types of major surgeries – those expected to last more than two hours or with an anticipated blood loss of greater than 500ml – and included liver, lung, colorectal, urologic and mixed major abdominal surgeries. The average age of participants in the intervention group was 66 and 67 in the control group.
“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 this reduces postoperative complications and length of stay.”
The most significant result was the change in cardiorespiratory fitness (CRF) – a measure of how well the body takes in oxygen and delivers it to the muscles and organs during prolonged periods of exercise.
“The pooled results suggest that HIIT increases cardiorespiratory fitness by 2.39 ml/min/kg. This is not only significantly different than standard surgical care, but is also clinically relevant: we know that this level of increase is associated with a lower risk of adverse postoperative outcomes.”
Generally, post operative complications occur in about 30 per cent of patients, or up to 50 per cent for frail patients. In the study, those who undertook high intensity interval training prior to surgery, showed a consistent reduction in post-surgery complications, such as cardiac complications, pneumonia, and postoperative bowel issues, she says.
“Our study’s pooled results showed that HIIT reduces the risk of having a complication by 56 per cent, which is substantial; and on average they stayed for three fewer days in hospital.”
“All of these findings suggest that a period – even as brief as four weeks – of pre-surgery high intensity interval training may substantially improve patient outcomes and bring with it robust benefits across patient populations,” she said.
The next step is to find out how to implement such programmes.
“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 may save money in the long term by reducing the cost of hospital stay and surgical complications.
“In the meantime, I would say to everyone, it is never too late to improve fitness, and this can really make a difference to health outcomes in the surgical context.”
