Perioperative medicine & outcomes
Efficacy of supervised exercise prehabilitation programs to improve major abdominal surgery outcomes: A systematic review and meta-analysis
Authors' conclusion
In conclusion, prehabilitation programmes with more than one supervised session per week improved physical function but did not enhance surgical outcomes.
Study context
- Population
- Patients undergoing major abdominal surgery
- Participants
- 1,258 patients · 20 randomized controlled trials (RCTs)
- Comparison
- Supervised exercise prehabilitation vs usual care
- Outcome
- Physical function, cardiorespiratory capacity and surgical outcomes
Methodological detailspreregistered protocol
- Preregistered protocol
Pooled result
As reported in the abstract
after prehabilitation
MD (change in 6-min walking distance)
+33 m
95% CI 13–53P < 0.01
Prehabilitation
MD (change in peak oxygen uptake, maximum cardiopulmonary test)
+1.47 mL·kg-1·min-1
95% CI 0.68–2.25P < 0.01
Prehabilitation
- No significant difference between groups in change in oxygen uptake at anaerobic threshold (MD 0.47, 95% CI −0.16, 1.10)
- P:0.14
- Post-operative complications incidence similar between groups (RR 0.80, 95% CI 0.61, 1.05)
- P:0.11
Further pooled results
| Outcome | Mean difference (m) (95% CI) | P value | |
|---|---|---|---|
| Change in 6-min walking distance, studies with >1 supervised session/week (subgroup) · after prehabilitation | 47 (20–75) | P < 0.01 | |
| −50050100Difference, m (linear scale) |
Post-operative complications by frequency of supervised sessions per week (subgroup)
- Similar between groups irrespective of supervised session frequency (RR 0.67, 95% CI 0.43, 1.03)
- P:0.07
Original publication
Efficacy of supervised exercise prehabilitation programs to improve major abdominal surgery outcomes: A systematic review and meta-analysis. J Clin Anesth. Published 1 February 2023. doi:10.
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