Short-term High-Intensity Interval Training Improves Fitness Before Surgery: A Randomised Clinical Trial

Scand J Med Sci Sports. 2022 Jan 28. doi: 10.1111/sms.14130. Online ahead of print.

ABSTRACT

PURPOSE: Improving cardiopulmonary reserve, or peak oxygen consumption( $\dot{V}$ O_2peak ), may reduce postoperative complications, however this may be difficult to achieve between diagnosis and surgery. Our primary aim was to assess the efficacy of an approximate 14-session, preoperative High Intensity Interval Training(HIIT) program to increase $\dot{V}$ O_2peak by a clinically-relevant 2 mL·kg^-1 ·min^-1 . Our secondary aim was to document clinical outcomes.

METHODOLOGY: In this prospective study, participants aged 45-85 undergoing major abdominal surgery were randomised to standard care or 14 sessions of HIIT over 4 weeks. HIIT sessions involved approximately thirty minutes of stationary cycling. Interval training alternated one minute of high (with the goal of reaching 90% max heart rate at least once during the session) and low/moderate intensity cycling. Cardiopulmonary exercise testing(CPET) measured the change in $\dot{V}$ O_2peak from baseline to surgery. Clinical outcomes included postoperative complications, length of stay(LOS) and Short Form-36 quality of life questionnaire(SF-36).

RESULTS: Of 63 participants, 46 completed both CPETs and 50 completed clinical follow-up. There was a significant improvement in the HIIT group’s mean $\pm$ SD $\dot{V}$ O_2peak (HIIT 2.87 $\pm$ 1.94 mL·kg¹ ·min^-1 vs standard care 0.15 $\pm$ 1.93, with an overall difference of 2.73 mL·kg¹ ·min^-1 95%CI [1.53, 3.93] p<0.001). There were no statistically significant differences between groups for clinical outcomes, although the observed differences consistently favoured the exercise group. This was most notable for total number of complications (0.64 v 1.16 per patient, p=0.07), SF-36 physical component score (p=0.06), and LOS (mean 5.5 v 7.4 days, p=0.07).

CONCLUSIONS: There was a significant improvement in $\dot{V}$ O_2peak with a four-week preoperative HIIT program. Further appropriately-powered work is required to explore the impact of preoperative HIIT on postoperative clinical outcomes.

PMID:35088469 | DOI:10.1111/sms.14130