Pre/Post surgical rehabilitation

Benefits of Exercise Pre and Post Surgery

The effect of exercise on outcomes after surgery has been extensively studied in a number of populations. The most common populations studied are

  • Post-hip replacement
  • Post-knee replacement
  • Post-cardiac surgery
  • Post-abdominal surgery
  • Other surgical groups such as colorectal, thoracic, post-cancer resection, vascular and urological.

Whilst the evidence is good in general terms, unfortunately, as yet there is no clear consensus on the specifics of exercise prescription pre-surgery[1].

Studies can be divided into those that look at the effect of interventions pre-operatively on post-surgical outcomes and those that look at the effect of different exercise interventions post-surgery.

What Are the General Benefits of Preoperative Exercise?

The evidence that if cardiorespiratory fitness (CRF) is measured preoperatively, it is predictive of complications in the postoperative period is compelling, with several studies demonstrating this across different types of surgeries The measure of CRF also offers significant advantage when compared to age alone in predicting mortality after major surgery.

  • CRF is a significant independent predictor of length of stay in hospital with patients older than 75
  • A low CRF is associated with an average of 11 days longer in hospital and 2 days longer in critical care

Pre-operative exercise reduces the length of stay both in Intensive Care facilities and in hospital.It also exerts beneficial effects on physical fitness and postoperative outcomes measures across various surgical fields, including cardiac surgery, orthopedic surgery, abdominal surgery, thoracic surgery, vascular surgery and urologic surgery. In their scoping study, Pouwels et al (2016) conclude that more research is needed to focus on heterogeneous outcome measures, patient populations and guidelines for exercise regimes.