Overseen by Dr John Woodfield, a Colorectal Surgeon at Dunedin Hospital and a Senior Lecturer at the University of Otago, the research** summarised studies comparing the effect of preoperative HIIT and standard hospital care on preoperative fitness and surgical patient outcomes.
Comprehensive analysis, which included 11 separate studies and 581 patients found a positive impact of HIIT prior to surgery when compared with standard care, either on patient fitness or postsurgical outcomes, including:
• improvement in peak oxygen consumption;
• reduction in complications;
• shorter hospital stays.
Dr Woodfield said HIIT, which directly impacts cardiorespiratory fitness, improves physical function when increased prior to surgery, boosting postoperative outcomes.
“A program of preoperative HIIT allows surgical patients to recover faster and have fewer complications,” Dr Woodfield said.
“Generally, patients have about four weeks’ notice prior to surgery. Prehabilitation with approximately 12 sessions of HIIT can increase a patient’s base fitness level by 10 per cent over this period.
“We have also demonstrated this to be the case in frail patients with medial comorbidities.
“If the preoperative benefits of HIIT was offered as a tablet, there would be universal take up.”
Dr Woodfield said there can be challenges with patients adopting exercise programs which increase their heart rate prior to surgery.
“Issues include limited time between diagnosis and surgery and institutional challenges with hospitals not providing or not consistently promoting prehabilitation programs.
“For patients there are challenges with time, accessibility and motivation,” Dr Woodfield said.
“When and where possible, HIIT should be incorporated into all prehabilitation programs before major surgery.”
Dr Woodfield’s research will be unveiled at the Royal Australasian College of Surgeons’ Annual Scientific Congress in Ĺtautahi Christchurch, Aotearoa New Zealand (6-10 May).
The Congress is the largest multi-disciplinary surgical meeting held in the southern hemisphere and brings together some of the top surgical and medical minds from across Aotearoa New Zealand, Australia and the rest of the world.
For more information about the Royal Australasian College of Surgeons’ Annual Scientific Congress, please visit: https://asc.surgeons.org/
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*HIIT involves repeated aerobic high-intensity intervals at approximately 80 per cent of the maximum heart rate, followed by active recovery.
**A metanalysis using Medline, Embase, Cochrane and SCOPUS databases with no language constraints up to October 2022 was performed. Researchers included randomised controlled trials and prospective cohort studies with HIIT protocols in adult patients undergoing major surgery. Thirty-three of 1891 screened studies met initial selection criteria. The primary outcome was change in peak oxygen consumption. Secondary outcomes included postoperative complications, length of stay, changes in quality of life, six-minute walk test, anaerobic threshold and peak power output.