Exercise prehabilitation in elective intra-cavity surgery: A role within the ERAS pathway? A narrative review

Orange, Sam, Northgraves, Matthew, Marshall, Phil, Madden, Leigh and Vince, Rebecca (2018) Exercise prehabilitation in elective intra-cavity surgery: A role within the ERAS pathway? A narrative review. International Journal of Surgery, 56. pp. 328-333. ISSN 1743-9191

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Official URL: http://dx.doi.org/10.1016/j.ijsu.2018.04.054

Abstract

The Enhanced Recovery after Surgery (ERAS) model integrates several elements of perioperative care into a standardised clinical pathway for surgical patients. ERAS programmes aim to reduce the rate of complications, improve surgical recovery, and limit postoperative length of hospital stay (LOHS). One area of growing interest that is not currently included within ERAS protocols is the use of exercise prehabilitation (PREHAB) interventions. PREHAB refers to the systematic process of improving functional capacity of the patient to withstand the upcoming physiological stress of surgery. A number of recent systematic reviews have examined the role of PREHAB prior to elective intra-cavity surgery. However, the results have been conflicting and a definitive conclusion has not been obtained. Furthermore, a summary of the research area focussing exclusively on the therapeutic potential of exercise prior to intra-cavity surgery is yet to be undertaken. Clarification is required to better inform perioperative care and advance the research field. Therefore, this “review of reviews” provides a critical overview of currently available evidence on the effect of exercise PREHAB in patients undergoing i) coronary artery bypass graft surgery (CABG), ii) lung resection surgery, and iii) gastrointestinal and colorectal surgery. We discuss the findings of systematic reviews and meta-analyses and supplement these with recently published clinical trials. This article summarises the research findings and identifies pertinent gaps in the research area that warrant further investigation. Finally, studies are conceptually synthesised to discuss the feasibility of PREHAB in clinical practice and its potential role within the ERAS pathway.

Item Type: Article
Uncontrolled Keywords: Exercise training, Prehabilitation, Presurgical period, Intra-cavity surgery, Enhanced recovery after surgery
Subjects: B100 Anatomy, Physiology and Pathology
C600 Sports Science
Department: Faculties > Health and Life Sciences > Sport, Exercise and Rehabilitation
Depositing User: Becky Skoyles
Date Deposited: 29 Nov 2018 11:32
Last Modified: 11 Oct 2019 08:40
URI: http://nrl.northumbria.ac.uk/id/eprint/36957

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