Exercise before surgery improves outcomes and shortens recovery time—new research

Before undergoing major surgery, patients typically concentrate on the procedure itself but often overlook the demanding recovery process. A crucial factor in recovery is cardiorespiratory reserve – the body's ability to handle sudden increases in oxygen demand, such as during physical activity or an infection. This reserve aids in coping with surgery stress, inflammation, and regaining mobility.

Prehabilitation involves improving physical fitness and readiness for recovery before surgery, incorporating exercise, nutrition, psychological preparation, and managing other medical conditions. Exercise is often the main focus, but an open question remains: does exercise under supervision yield better results than home-based exercise?

A new systematic review of 42 studies involving 4,825 adults, including those preparing for colorectal, lung, cardiac, vascular, and other major surgeries, sheds light on this matter. The findings indicate that both supervised and unsupervised exercise programs resulted in improvements in the six-minute walk test, which assesses functional capacity, but the difference was small, averaging less than one meter.

However, supervised exercise was associated with a 40% lower risk of post-operative complications, especially in high-intensity exercise programs. This suggests that while patients can enhance their fitness through exercise, supervision may be particularly beneficial for delivering high-intensity workouts, as it ensures safety monitoring, behavioral encouragement, and progressive intensity increases.

Patients should consult their surgical or primary-care team to determine if prehabilitation programs are available and suitable for their specific needs.