Preoperative High-Intensity Interval Training Associated with Improved Surgical Outcomes, Reduced Complications

High-intensity interval training (HIIT) conducted before surgery has shown promising results in improving exercise capacity and reducing postoperative complications compared to standard care, according to a recent systematic review and meta-analysis. The study, published inJAMA Network Open, highlights the potential benefits of incorporating active prehabilitation programs, including HIIT, into the care of surgical patients.

Led by Dr. John C. Woodfield from the University of Otago in New Zealand, the research team examined 12 studies involving 832 patients to analyze the effects of preoperative HIIT compared to standard hospital care. HIIT involves repeated aerobic high-intensity intervals, followed by active recovery periods. It has previously been shown to enhance cardiorespiratory fitness (CRF) and thus holds the potential to improve surgical outcomes.

● The pooled results revealed several positive associations for HIIT when compared to standard care.

● There was moderate-quality evidence demonstrating a significant improvement in peak oxygen consumption among patients who underwent HIIT (cumulative mean difference = 2.59 mL/kg/min; 95% CI, 1.52-3.65).

● The analysis indicated moderate-quality evidence of a notable reduction in complications for patients who received HIIT (OR = 0.44; 95% CI, 0.32-0.6).

However, the study did not find any evidence that HIIT led to a difference in hospital length of stay. Further, the analysis revealed a low risk of bias but a high degree of heterogeneity in study outcomes, suggesting the need for more well-designed prospective studies in this area.

Dr. Woodfield emphasized that HIIT can be effective for improving fitness in patients, even those with health problems, during the 4-week period before surgery when supervised. He suggested that primary care providers should encourage secondary healthcare providers to implement active prehabilitation programs that incorporate HIIT, as it can lead to fewer complications, quicker recovery, and potentially shorter hospital stays.

The study's findings underscore the potential of preoperative HIIT as a valuable intervention to enhance surgical outcomes and reduce complications. With over one-third of complications being prevented or avoided, integrating HIIT into prehabilitation programs has the potential to significantly improve patient outcomes. Further research is needed to better understand the optimal implementation and benefits of HIIT in various surgical settings.

Reference:

Woodfield JC, et al. JAMA Netw Open. 2023;doi:10.1001/jamanetworkopen.2023.20527.