The effectiveness of prehabilitation or preoperative exercise for surgical patients: a systematic review

Cabilan, C. J., Hines, Sonia and Munday, Judy (2015) The effectiveness of prehabilitation or preoperative exercise for surgical patients: a systematic review. JBI Database of Systematic Reviews & Implementation Reports, 13 1: 146-187. doi:10.11124/jbisrir-2015-1885

Author Cabilan, C. J.
Hines, Sonia
Munday, Judy
Title The effectiveness of prehabilitation or preoperative exercise for surgical patients: a systematic review
Journal name JBI Database of Systematic Reviews & Implementation Reports   Check publisher's open access policy
ISSN 2202-4433
Publication date 2015
Sub-type Article (original research)
DOI 10.11124/jbisrir-2015-1885
Open Access Status Not Open Access
Volume 13
Issue 1
Start page 146
End page 187
Total pages 42
Place of publication Adelaide, SA, Australia
Publisher University of Adelaide * Faculty of Health Sciences
Collection year 2016
Language eng
Formatted abstract
BACKGROUND:  Major surgery can induce functional decline and pain, which can also have negative implications on health care utilization and quality of life. Prehabilitation is the process of optimizing physical functionality preoperatively to enable the individual to maintain a normal level of function during and after surgery. Prehabilitation training can be a combination of aerobic exercises, strength training, and functional task training to suit individual needs.

OBJECTIVES:  To evaluate the impact of prehabilitation on physical functional status, health care utilization, quality of life, and pain after surgery.

INCLUSION CRITERIA:  Types of participants: Studies of adult surgical patients, excluding day surgery patients. Types of interventions: Any preoperative exercise interventions identified in the study as part of a prehabilitation or preoperative exercise program, versus usual care. Types of studies: Randomized controlled trials. Types of outcomes: Functional status, health care utilization, quality of life and pain.

SEARCH STRATEGY:  Published (CINAHL, CENTRAL, EMBASE, MEDLINE, PEDro) and unpublished studies between 1996 and March 2013 were searched extensively.

METHODOLOGICAL QUALITY:  All studies were assessed independently by two reviewers for relevance, eligibility and methodological quality.

DATA COLLECTION:  Data from included papers were extracted using a modified data extraction tool.

DATA SYNTHESIS:  Where possible, study results were pooled in statistical meta-analysis. Alternatively, results are presented in narrative and table form.

RESULTS:  A total of 3167 citations were identified; after removal of duplicates, assessment for relevance and eligibility, 33 studies underwent critical appraisal. Seventeen studies met the quality criteria and were included in quantitative synthesis. Thirteen studies were conducted in orthopedics (mainly knee or hip arthroplasty for osteoarthritis), one in colorectal, two in cardiac and one in upper gastrointestinal/hepatobiliary. Function, pain and quality of life were quantified according to prehabilitation dose and postoperative months. Prehabilitation, at any dose, did not demonstrate benefits in objective and self-reported function at any of the postoperative time points. Prehabilitation did not demonstrate benefits in quality of life or pain; however, there was significant evidence that prehabilitation doses of more than 500 minutes reduced the need for postoperative rehabilitation, but no significant reduction was found in readmissions or nursing home placement.

CONCLUSIONS:  Results from this review reveal that prehabilitation has no significant postoperative benefits in function, quality of life and pain in patients who have had knee or hip arthroplasty for osteoarthritis; however, there is evidence that prehabilitation may reduce admission to rehabilitation in this population. The evidence on postoperative benefits of prehabilitation in other surgical populations is limited; however, preliminary evidence does not demonstrate better outcomes.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Mater Research Institute-UQ (MRI-UQ)
Institute for Molecular Bioscience - Publications
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Created: Thu, 31 Mar 2016, 12:31:26 EST by Julia McCabe on behalf of Learning and Research Services (UQ Library)