Pre-operative exercise substantially helps with recovery, study confirms

A University of Otago study has highlighted the importance of policy-makers paying attention to the benefits of high intensity interval training (HIIT) prior to surgery for improved recovery. The study, published in JAMA Network Open, examined 12 studies involving 832 patients who underwent preoperative high-intensity interval training. This form of training entails alternating periods of intense aerobic exercise at around 80% of maximum heart rate with active recovery periods.

Lead investigator Dr. Kari Clifford emphasized that the study encompassed various major surgeries, including liver, lung, colorectal, urologic, and mixed major abdominal surgeries, with a focus on procedures lasting over two hours or involving anticipated blood loss exceeding 500ml. The average age of participants in the intervention group was 66, while the control group had an average age of 67.

The findings demonstrated that HIIT is both safe and effective for surgical patients. Within a span of four to six weeks, a HIIT program significantly enhances a patient’s fitness, subsequently leading to a reduction in postoperative complications and hospital stays.

A key outcome of the study was the improvement in cardiorespiratory fitness (CRF), which measures the body’s ability to consume and distribute oxygen to muscles and organs during prolonged exercise. The analysis indicated that HIIT led to an average increase of 2.39 ml/min/kg in cardiorespiratory fitness. This improvement not only surpassed the outcomes of standard surgical care but also held clinical significance, as it corresponded to a decreased risk of adverse postoperative outcomes.

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

The pooled results of the study indicated that HIIT decreased the risk of complications by an impressive 56%, with patients spending, on average, three fewer days in the hospital.

These findings strongly suggest that even a short period of high intensity interval training prior to surgery—lasting as little as four weeks—can substantially enhance patient outcomes and provide significant benefits across various patient populations.

The next phase of research involves determining effective implementation strategies for such programs. As supervised exercise programs can be costly, the focus is on assessing the efficacy of supporting patients in training at home or in the community. Funding these programs may yield long-term cost savings by reducing hospital stay expenses and surgical complications.