Other researchers have looked at the potential benefits of “prehabilitation”—exercise to get patients in better shape before surgery. Most patients preparing for major surgery may have only a few weeks between diagnosis and transfer to the operating room, so prompt and effective exercise intervention is crucial, experts say.
In the studies included in the analysis, some of the HIIT sessions lasted as little as 18 to 20 minutes. This popular form of exercise “It can get people fitter and faster,” he said Kari Cliffordfirst author of the review and a researcher in the department of surgical sciences at the University of Otago in New Zealand.
Get fitter with HIIT
Most of the patients in the review underwent major abdominal surgeries. Researchers found that HIIT can improve the physical condition of patients before surgery in a “significant way,” Clifford said.
This improvement was measured using several indicators of cardiovascular fitness, including a six-minute walk test and improvements in maximal oxygen uptake, which is a measure of the maximum amount of oxygen your body can use during intense exercise.
“That’s important because your body needs oxygen to recover and heal after surgery,” Clifford said.
In a 2022 study Included in the review, participants aged 45 to 85 years undergoing major abdominal surgery were randomized to 14 sessions of HIIT over four weeks compared to standard care. Standard care would normally include general information about staying active and reducing alcohol and tobacco use before surgery, but not a specific training program, Clifford said.
In the 2022 study, HIIT sessions involved about 30 minutes of stationary cycling. But instead of cycling for 30 minutes straight, patients were asked to alternate between one minute of high-intensity cycling, with the goal of reaching 90 percent of maximum heart rate, and one minute of recovery. active.
The study, which Clifford co-authored, found a significant improvement in peak oxygen consumption before surgery after just 12 to 14 sessions over four weeks.
The overall findings of the larger meta-analysis were limited by the fact that not all studies in the review were based on the same measures of fitness or used the same HIIT routines. Researchers often defined HIIT in different ways, and while most exercise programs lasted less than four weeks, some interventions lasted six weeks or longer. The medical problems faced by the patients also varied.
“In general, I think it’s good to look at HIIT, specifically,” he said. Daniel McIsaac, an associate professor of anesthesiology and pain medicine at the University of Ottawa who was not involved in the new review. “But I think the review leaves more questions than answers.”
Reduced complications after HIIT
The patients not only improved their fitness, but the HIIT exercises reduced the risk of problems after surgery, Clifford said.
The study found that “prehab” HIIT exercises before surgery reduced the odds of postoperative complications by 56 percent, according to eight studies in the review that reported on postoperative complications among 770 patients.
In the 2022 Clifford study, researchers measured complications by personally seeing participants during their hospital stay and recording any complications. They also sent a follow-up questionnaire six weeks after the operation.
In addition, the review authors analyzed length of hospital stay. Although the research suggested that HIIT exercise before surgery could reduce the length of hospital stay by about three days, the finding was not statistically significant, so no firm conclusions could be drawn.
The benefits of exercising before surgery
McIsaac, who has conducted his own studies on prehabilitation exercise, notes that the studies in the review did not compare HIIT with other exercise interventions, such as moderate-intensity aerobic exercise. A traditional pre-rehabilitation program would likely include three to five weeks of exercise, such as brisk walking, jogging, bicycling or swimming, he said.
Whether HIIT is more effective than other forms of exercise for prehabilitation cannot be determined from the new review, but Clifford said his team is working on this research.
“I think that anyone preparing for surgery, if they can increase their level of physical activity and improve their nutrition, they can expect to have better results after surgery,” McIsaac said. “This review suggests that if they are interested in high-intensity interval training, it could be of benefit to them. If not, there is probably as much or more evidence that other, more traditional forms of exercise would probably be just as beneficial.”
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