Perioperative medicine & outcomes
Assessing impact of supervision in aerobic exercise training on fitness and clinical outcomes: a systematic review and meta-analysis
Authors' conclusion
Both supervised and unsupervised exercise improved 6MWT distance. Supervised high-intensity exercise programmes significantly reduced postoperative complications.
Study context
- Population
- Adult clinical populations (exercise prehabilitation)30 supervised, 12 unsupervised studies
- Comparison
- Supervised or unsupervised moderate-to-high-intensity aerobic exercise vs controls
- Supervisedn = 3,157
- Unsupervisedn = 1,848
- Outcome
- Changes in V˙ O2peak (ml min-1 kg-1) and 6MWT distance (metres); incidence of postoperative complications
Methodological detailsprospectively registered, PRISMA
- Prospectively registered
- PRISMA
Pooled result
As reported in the abstract
Each group vs controlsCumulative mean difference, m (95% CI)P value
Unsupervised6MWT distance; only significant association for unsupervised exercise
0.51(0.14–0.87)
P = 0.016Supervised6MWT distance
0.39(0.07–0.70)
P = 0.025Each group vs controlsCumulative mean difference, ml min-1 kg-1 (95% CI)P value
SupervisedV˙ O2peak
0.88(0.49–1.27)
P < 0.001Each group vs controlsOdds ratio (95% CI)P value
Supervisedpostoperative complications
0.60(0.39–0.93)
P = 0.026Further pooled results
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Complications, supervised high-intensity exercise (subgroup)Supervised vs Controls | 0.53 (0.30–0.92) | P = 0.030 | |
| Complications, supervised, low risks for bias and therapeutic ineffectiveness (subgroup)Supervised vs Controls | 0.41 (0.22–0.76) | P = 0.019 | |
| 0.20.5125Odds ratio (log scale) |
Original publication
Assessing impact of supervision in aerobic exercise training on fitness and clinical outcomes: a systematic review and meta-analysis. Br J Anaesth. Published 4 August 2026. doi:10.
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