World Journal of Surgery

, Volume 37, Issue 4, pp 711–720 | Cite as

Effect of Preoperative Exercise on Cardiorespiratory Function and Recovery After Surgery: a Systematic Review

  • Daniel P. LemanuEmail author
  • Primal P. Singh
  • Andrew D. MacCormick
  • Bruce Arroll
  • Andrew G. Hill



This systematic review aims to investigate the extent to which preoperative conditioning (PREHAB) improves physiologic function and whether it correlates with improved recovery after major surgery.


An electronic database search identified randomized controlled trials (RCTs) investigating the safety and efficacy of PREHAB. The outcomes studied were changes in cardiorespiratory physiologic function, clinical outcomes (including length of hospital stay and rates of postoperative complications), and measures of changes in functional capacity (physical and psychological).


Eight low- to medium-quality RCTs were included in the final analysis. The patients were elderly (mean age >60 years), and the exercise programs were significantly varied. Adherence to PREHAB was low. Only one study found that PREHAB led to significant improvement in physiologic function correlating with improved clinical outcomes.


There are only limited data to suggest that PREHAB confers any measured physiologic improvement with subsequent clinical benefit. Further data are required to investigate the efficacy and safety of PREHAB in younger patients and to identify interventions that may help improve adherence to PREHAB.


Inspiratory Muscle Inspiratory Muscle Training Inspiratory Muscle Strength Physiologic Endpoint Physiologic Improvement 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This study required no external sources of funding. Dr, Lemanu is the recipient of a Clinical Research Training Fellowship awarded by the Health Research Council of New Zealand.

Conflicts of interest

The authors have no potential or real conflicts of interest to declare.


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Copyright information

© Société Internationale de Chirurgie 2013

Authors and Affiliations

  • Daniel P. Lemanu
    • 1
    • 3
    Email author
  • Primal P. Singh
    • 1
  • Andrew D. MacCormick
    • 1
  • Bruce Arroll
    • 2
  • Andrew G. Hill
    • 1
  1. 1.Department of Surgery, South Auckland Clinical SchoolUniversity of AucklandAucklandNew Zealand
  2. 2.Department of General Practice and Primary Health CareUniversity of AucklandAucklandNew Zealand
  3. 3.Department of Surgery, South Auckland Clinical SchoolMiddlemore HospitalAucklandNZ

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