Preoperative exercise training for adults undergoing elective major vascular surgery: A systematic review

Tew, Garry, Caisley, Kim and Danjoux, Gerard (2022) Preoperative exercise training for adults undergoing elective major vascular surgery: A systematic review. PLoS ONE, 17 (1). e0263090. ISSN 1932-6203

[img]
Preview
Text
pone.0263090.pdf - Published Version
Available under License Creative Commons Attribution 4.0.

Download (1MB) | Preview
[img]
Preview
Text
PONE_D_21_32818R1_FTC.pdf - Accepted Version
Available under License Creative Commons Attribution 4.0.

Download (381kB) | Preview
Official URL: https://doi.org/10.1371/journal.pone.0263090

Abstract

Patients undergoing major vascular surgery may have an increased risk of postoperative complications due to poor ‘fitness for surgery’. Prehabilitation aims to optimise physical fitness and risk factors before surgery to improve outcomes. The role of exercise-based prehabilitation in vascular surgery is currently unclear. Therefore, the aim of this systematic review was to assess the benefits and harms of preoperative exercise training in adults undergoing elective vascular surgery. We searched MEDLINE, Embase, CINAHL, and CENTRAL databases, trial registries, and forward and backward citations for studies published between January 2008 and April 2021. We included randomised trials that compared patients receiving exercise training with those receiving usual care or no training before vascular surgery. Outcomes included mortality, complications, and health-related quality of life (HRQOL). Three trials with 197 participants were included. All studies involved people undergoing abdominal aortic aneurysm (AAA) repair. Low-certainty evidence could not differentiate between rates of all-cause mortality. Moderate-certainty evidence indicated that postoperative cardiac and renal complications were less likely to occur in people who participated in preoperative exercise training compared with those who did not. Low-certainty evidence also indicated better postoperative HRQOL outcomes in people who undertook prehabilitation. There were no serious exercise-related adverse events. The evidence on preoperative exercise training for AAA patients is promising, but currently insufficiently robust for this intervention to be recommended in clinical guidelines. High quality trials are needed to establish its clinical and cost-effectiveness. Research is also needed to determine the feasibility and effects of prehabilitation before lower-limb revascularisation.

Item Type: Article
Uncontrolled Keywords: prehabilitation, vascular disease, surgery, systematic review
Subjects: A100 Pre-clinical Medicine
C600 Sports Science
Department: Faculties > Health and Life Sciences > Sport, Exercise and Rehabilitation
Depositing User: John Coen
Date Deposited: 18 Jan 2022 10:26
Last Modified: 09 Feb 2022 12:15
URI: http://nrl.northumbria.ac.uk/id/eprint/48195

Actions (login required)

View Item View Item

Downloads

Downloads per month over past year

View more statistics