New research shows encouraging
evidence for a role of exercise training in patients in the weeks leading up to
major surgery.
Led by consultant anaesthetist
Professor Gerard Danjoux from The James Cook University Hospital (Middlesbrough),
the multi-site, National Institute for Health Research (NIHR) funded study
focused on patients who had abdominal aortic aneurysms – a potentially
life-threatening swelling on the main abdominal blood vessel.
The study was a collaborative
effort involving academics and clinicians from Northumbria and Teesside
Universities, and Hospital Trusts across Middlesbrough, York and
Sheffield. The main aim of the study was
to determine whether high-intensity interval training (HIIT), performed three
times a week for four weeks prior to aneurysm surgery, was feasible to deliver and
acceptable to patients. Information on the costs and effects of the exercise
programme was also collected.
Dr Garry Tew, an investigator on
this project from Northumbria University’s Department of Sport, Exercise and
Rehabilitation, said: “Evidence shows that the fitter you are before surgery
the better your outcome. We know that HIIT is a time-efficient way of
increasing fitness in people without medical conditions, but less is known
about how feasible and useful it is in people awaiting surgery. A potential
concern in people with aneurysms is that surges in blood pressure during
exercise may cause complications.”
Fifty-three people took part in
the study, most of whom were men, and the average age was 75 years.
The findings supported the potential
benefits of the exercise programme. No serious medical events occurred in the
people who exercised, and many of them showed improvements in fitness. There
was also evidence of a higher level of independence and physical functioning at
12 weeks after surgery among participants who exercised compared with those who
did not.
The main study report, entitled
‘Randomised feasibility trial of high-intensity
interval training before elective abdominal aortic aneurysm repair’ – has
been published in the British Journal of Surgery http://onlinelibrary.wiley.com/doi/10.1002/bjs.10669/full
Professor Danjoux said: “I am
very grateful to our patients and research team for getting involved in this
ground-breaking study. Feedback from patients was that the programme was very
enjoyable and they were very grateful for efforts to improve their health prior
to surgery. We now plan to use our findings to enhance care in patients
awaiting surgery in Middlesbrough.”
As a result of this study, South
Tees Hospitals NHS Foundation Trust, which is responsible for the James Cook
University Hospital, has been funded to deliver a service improvement project.
This project is in collaboration with partners from Northumbria University,
South Tees CCG and Public Health (Middlesbrough, Redcar and Cleveland).
The project will introduce a
community-based service for people awaiting major surgery, focussed on improving
their health and fitness through lifestyle changes such as regular exercise,
stopping smoking and reducing alcohol consumption.
