Effect of exercise prehabilitation on functional status of patients undergoing bowel resection: a systematic review

Abstract

Background: Bowel resections have high morbidity and mortality rates and are becoming increasingly common in Australia. To reduce the burden on patients and the health system, measures for improving patient outcomes after resection must be investigated. One possible method for improving patient outcomes is prehabilitation with exercise. The aim of this systematic review is to determine the effect that exercise prehabilitation has on the functional status of patients undergoing colorectal resection. Method: Studies examining the effect of exercise prehabilitation on colorectal patients were gathered from online databases, including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and the Australia New Zealand clinical trial registry. The study design, population, intervention and outcomes were extracted from each study. Results: This systematic review included six studies involving a total of 415 patients. Three studies were randomized control trials and three were prospective cohort studies. Those that tested participants post-operatively found that the intervention group improved their 6-min walking distance more than the control group. This result was statistically significant in three studies. Similarly, two studies found that self-reported physical activity was significantly greater in the intervention group than in control groups. The rate of complications and length of hospital stay were not significantly different between intervention and control groups in any study. Conclusion: Prehabilitation significantly improves functional capacity and self-reported physical activity but its effect on complication rate was not significant in this review.© 2020 Royal Australasian College of Surgeons ANZ J Surg 90 (2020) 693-701ANZJSurg.com

Comparison of Footsteps Using Connected Bracelets with the Timed Up-and-Go Test and the 6-Minutes Walking Test in a Prospective Colorectal Surgery Cohort

“…The evaluation and selection of patients at risk of poor postoperative physical activity and postoperative complications could permit to target special management to these patients and increase compliance to preoperative exercises. Recently, some reviews showed that prehabilitation improved significantly functional capacity and self-reported physical activity but the impact on postoperative complications was limited [19]. Furthermore, a recent randomized trial has shown that a multimodal prehabilitation program did not affect postoperative outcomes in frail patients undergoing colorectal cancer resection [20].…”

Cost-effectiveness of prehabilitation prior to elective surgery compared to usual preoperative care: protocol for a systematic review of economic evaluations

“…11 Their RCT was followed by a large number of primary studies whose results have been synthesised in various systematic reviews, the majority of which looked at abdominal surgery. [12][13][14][15][16][17][18][19][20][21][22] The cost-effectiveness of an intervention, that is, its value for money, is an important factor for health policymakers deciding about the implementation of a new programme. 23 However, despite the growing interest in prehabilitation programmes by healthcare professionals and policy-makers, only a subset of studies has evaluated the cost-effectiveness of prehabilitation.…”

Effects of preoperative walking on bowel function recovery for patients undergoing gynecological malignancy laparoscopy

“…8 However, there are few reports on whether preoperative exercise in improving effectively intestinal function through systematic literature retrieval. 9,10 Therefore, in this study, the preoperative walking protocol is appilied to patients with gynecological malignancy who plan laparoscopic surgery to explore the impact on the recovery of postoperative intestinal function, in order to provide clinical reference.…”