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Meta-Analysis
. 2023 Apr 1;102(4):323-330.
doi: 10.1097/PHM.0000000000002097. Epub 2022 Sep 23.

Efficacy of Prehabilitation Before Cardiac Surgery: A Systematic Review and Meta-analysis

Carolin Steinmetz  1 , Birna Bjarnason-Wehrens, Thomas Walther, Tim Fabian Schaffland, Claudia Walther
Affiliations
Meta-Analysis

Efficacy of Prehabilitation Before Cardiac Surgery: A Systematic Review and Meta-analysis

Carolin Steinmetz et al. Am J Phys Med Rehabil. .

Abstract

Objective: Patients awaiting cardiac surgery seem to benefit from exercise-based prehabilitation, but the impact on different perioperative outcomes compared with standard care is still unclear.

Design: Eligible nonrandomized/randomized controlled studies investigating the impact of exercise-based prehabilitation in adults scheduled for elective cardiac surgery were searched on December 16, 2020, from electronic databases, including MEDLINE, CENTRAL, and CINAHL. The data were pooled and a meta-analysis was conducted.

Results: Of 1490 abstracts, six studies ( n = 665) were included into the review and meta-analysis. At postintervention interval and at postsurgery interval, 6-min-walking distance improved significantly in exercise-based prehabilitation group compared with controls (mean difference, 75.4 m; 95% confidence interval, 13.7 to 137.1 m, P = 0.02, and 30.5 m, 95% confidence interval, 8.5 to 52.6 m, P = 0.007, respectively). Length of hospital stay was significantly shorter in exercise-based prehabilitation group (mean difference, -1.00 day; 95% confidence interval, -1.78 to -0.23 day, P = 0.01). Participation in exercise-based prehabilitation revealed a significant decrease in the risk of postoperative atrial fibrillation in patients 65 yrs or younger (risk ratio, 0.34; 95% confidence interval, 0.14 to 0.83, P = 0.02).

Conclusions: The participation in exercise-based prehabilitation significantly improves postintervention and postsurgery 6-min walking distance, length of hospital stay, and decreases the risk of postoperative atrial fibrillation in patients 65 yrs or younger compared with controls.

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Conflict of interest statement

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

Figures

FIGURE 1
FIGURE 1
Flow diagram of study inclusion and exclusion process.
FIGURE 2
FIGURE 2
Risk of bias for all included studies.
FIGURE 3
FIGURE 3
1, Forest plot of the effect of prehabilitation versus standard care on 6MWD after intervention. 2, Forest plot of the effect of prehabilitation versus standard care on 6MWD after surgery. 3, Forest plot of the effect of prehabilitation versus standard care on 6MWD follow-up.
FIGURE 4
FIGURE 4
Forest plot of the effect of prehabilitation versus standard care on postoperative AF with subgroup analysis by age dichotomized at 65 yrs.
See this image and copyright information in PMC

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