High-intensity interval training before surgery can improve recovery

Health policymakers are being urged to pay attention to a recent study conducted by the University of Otago, which provides evidence that a short program of high-intensity interval training (HIIT) before surgery can significantly aid in the recovery process.

Published in the journal Surgery, the study reviewed and analyzed 12 studies involving 832 patients who had undergone preoperative high-intensity interval training. This form of training entails engaging in repeated aerobic high-intensity intervals at around 80% of the maximum heart rate, followed by active recovery.

Dr. Kari Clifford, the lead investigator, explains that the study included various types of major surgeries, such as liver, lung, colorectal, urologic, and mixed major abdominal surgeries, with durations expected to exceed two hours or anticipated blood loss greater than 500ml. The average age of participants in the intervention group was 66, while it was 67 in the control group.

“We have discovered that high-intensity interval training (HIIT) is both safe and effective for surgical patients. Within four to six weeks, a HIIT program can significantly improve a patient’s fitness, leading to a reduction in postoperative complications and length of hospital stay.”

The most significant finding was the improvement in cardiorespiratory fitness (CRF), which measures the body’s ability to uptake and deliver oxygen to muscles and organs during prolonged exercise.

“The combined results suggest that HIIT increases cardiorespiratory fitness by 2.39 ml/min/kg. This difference is not only statistically significant compared to standard surgical care, but also clinically relevant, as we know that this level of improvement is associated with a lower risk of adverse postoperative outcomes.”

Typically, postoperative complications occur in approximately 30% of patients, rising to 50% for frail patients. However, the study revealed that individuals who underwent high-intensity interval training prior to surgery consistently experienced a reduction in complications, such as cardiac issues, pneumonia, and postoperative bowel problems.

“Our study’s pooled results demonstrated that HIIT reduces the risk of complications by 56%, which is a substantial improvement. Additionally, patients who participated in HIIT programs spent an average of three fewer days in the hospital.”

These findings suggest that even a brief period of pre-surgery high-intensity interval training, as short as four weeks, can substantially enhance patient outcomes and provide robust benefits across different patient populations.

The next step is to determine effective ways to implement such programs.

Supervised exercise programs can be costly, so we are exploring the effectiveness of supporting individuals who train at home or in the community. Funding these programs may lead to long-term cost savings by reducing hospital stays and surgical complications.

“In the meantime, I would encourage everyone to remember that it is never too late to improve fitness, and doing so can make a real difference in health outcomes within the surgical context.