e-space
Manchester Metropolitan University's Research Repository

    Efficacy of supervised exercise prehabilitation programs to improve major abdominal surgery outcomes: a systematic review and meta-analysis

    Duro-Ocana, P, Zambolin, F ORCID logoORCID: https://orcid.org/0000-0002-4178-6965, Jones, AW, Bryan, A, Moore, J, Quraishi-Akhtar, T, Mcphee, J, Degens, H ORCID logoORCID: https://orcid.org/0000-0001-7399-4841 and Bagley, L ORCID logoORCID: https://orcid.org/0000-0001-5538-0870 (2023) Efficacy of supervised exercise prehabilitation programs to improve major abdominal surgery outcomes: a systematic review and meta-analysis. Journal of Clinical Anesthesia, 86. p. 111053. ISSN 0952-8180

    [img]
    Preview
    Accepted Version
    Available under License Creative Commons Attribution Non-commercial No Derivatives.

    Download (416kB) | Preview

    Abstract

    The optimal package of components for a prehabilitation intervention remains unclear. The aim was to determine the efficacy of supervised exercise prehabilitation programs to enhance patient fitness and improve surgical outcomes. The protocol was preregistered (PROSPERO: CRD42020180693). PubMed, MEDLINE, CINAHL, AMED, CENTRAL, PeDro, ClinicalTrials.gov and the WHO International Clinical Trials Registry were searched. Randomized controlled trials (RCTs) of supervised prehabilitation programs before major abdominal surgery were included. Physical function, cardiorespiratory capacity and surgical outcomes were the primary outcomes measures. Risk of bias was assessed according to the Cochrane Risk of Bias 1.0 tool for RCTs. Data are summarized narratively, and where possible, quantitavely. Meta-analyses results are reported as risk ratios (RR), mean difference of changes between baseline and follow-up time points or mean difference between groups and 95% confidence interval (CI). Twenty RCTs were included in the analysis with a total of 1258 patients. The average 6-min walking distance change was +33 m in the prehabilitation group compared to the usual care (UC) group after prehabilitation (95% CI: [13, 53], P < 0.01). Only in studies with more than one supervised session per week changes in 6-min-walk distance were significantly higher in the prehabilitation group compared to the UC group after prehabiliatation (Mean difference: 47 m, 95% [CI]: [20–75], P < 0.01). The change in peak volume of oxygen uptake during a maximum cardiopulmonary test was +1.47 mL·kg−1·min−1 in the prehabilitation group compared to the UC group (95% CI: [0.68, 2.25], P < 0.01). There was no significant difference in the change in oxygen uptake at anaerobic threshold between groups (Mean differences: 0.47, 95% CI: [−0.16, 1.10], P:0.14). Post-operative complications incidence was similar between groups (RR: 0.80, 95% CI: [0.61, 1.05], P:0.11), irrespective of the frequency of supervised session per week (RR: 0.67, 95% CI: [0.43, 1.03], P:0.07). In conclusion, prehabilitation programmes with more than one supervised session per week improved physical function but did not enhance surgical outcomes.

    Impact and Reach

    Statistics

    Activity Overview
    6 month trend
    179Downloads
    6 month trend
    92Hits

    Additional statistics for this dataset are available via IRStats2.

    Altmetric

    Repository staff only

    Edit record Edit record