Short term high-intensity interval training in patients scheduled for major abdominal surgery increases aerobic fitness

Abstract

Background: Prehabilitation may improve postoperative clinical outcomes among patients undergoing major abdominal surgery. This study evaluated the potential effects of a high-intensity interval training (HIIT) program performed before major abdominal surgery on patients' cardiorespiratory fitness and functional ability (secondary outcomes of pilot trial NCT02953119).

Methods: Patients were included before surgery to engage in a low-volume HIIT program with 3 sessions per week for 3 weeks. Cardiopulmonary exercise and 6-min walk (6MWT) testing were performed pre- and post-prehabilitation.

Results: Fourteen patients completed an average of 8.6 ± 2.2 (mean ± SD) sessions during a period of 27.9 ± 6.1 days. After the program, [Formula: see text]O₂ peak (+ 2.4 ml min^-1 kg^-1, 95% CI 0.8-3.9, p = 0.006), maximal aerobic power (+ 16.8 W, 95% CI 8.2-25.3, p = 0.001), [Formula: see text]O₂ at anaerobic threshold (+ 1.2 ml min^-1 kg^-1, 95%CI 0.4-2.1, p = 0.009) and power at anaerobic threshold (+ 12.4 W, 95%CI 4.8-20, p = 0.004) were improved. These changes were not accompanied by improved functional capacity (6MWT: + 2.6 m, 95% CI (- 19.6) to 24.8, p = 0.800).

Conclusion: A short low-volume HIIT program increases cardiorespiratory fitness but not walking capacity in patients scheduled for major abdominal surgery. These results need to be confirmed by larger studies.

Keywords: Aerobic capacity; CPET; Exercise; Major abdominal surgery; Prehabilitation.

Fig. 1

Individual responses to prehabilitation: aerobic capacities. $\dot{\mathrm{V}}$O₂AT: oxygen uptake at anaerobic threshold (ml min⁻¹ kg⁻¹), $\dot{\mathrm{V}}$O₂peak: maximal oxygen uptake (ml min⁻¹ kg⁻¹), Power at anaerobic threshold (P AT, watts), Maximal aerobic power (MAP, watts). Dotted line represents the mean of the differences between before and after prehabilitation. Dashed line represents the zero of the mean of differences

Fig. 2

Individual responses to prehabilitation: heart rate. Bpm, beats per minute. Dotted line represents the mean of the differences between before and after prehabilitation. Dashed line represents the zero of the mean of differences

Fig. 3

Individual responses to prehabilitation: functional testing. 6MWT 1: 6-min walk test (meters) at baseline, 6MWT 2: 6-min walk test (meters) after prehabilitation. Dotted line represents the mean of the differences between before and after prehabilitation. Dashed line represents the zero of the mean of differences

Fig. 4

Correlation between maximum oxygen uptake and functional capacity before and after prehabilitation. 6MWT: 6-min walk test, $\dot{\mathrm{V}}$O₂peak: maximal oxygen uptake (ml·min⁻¹ kg⁻¹)