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Impact of prehabilitation on objectively measured physical activity levels in elective surgery patients: a systematic review

Wagnild, Janelle M; Akowuah, Enoch; Maier, Rebecca H; Hancock, Helen C; Kasim, Adetayo

Impact of prehabilitation on objectively measured physical activity levels in elective surgery patients: a systematic review Thumbnail


Authors

Enoch Akowuah

Rebecca H Maier

Helen C Hancock

Adetayo Kasim



Abstract

Objective: To systematically review the impact of prehabilitation on objectively measured physical activity (PA) levels in elective surgery patients. Data sources: Articles published in Web of Science Core Collections, PubMed, Embase (Ovid), CINAHL (EBSCOHost), PsycInfo (EBSCOHost) and CENTRAL through August 2020. Study selection: Studies that met the following criteria: (1) written in English, (2) quantitatively described the effect(s) of a PA intervention among elective surgery patients prior to surgery and (3) used and reported objective measures of PA in the study. Data extraction and synthesis: Participant characteristics, intervention details, PA measurement, and clinical and health-related outcomes were extracted. Risk of bias was assessed following the revised Cochrane risk of bias tool. Meta-analysis was not possible due to heterogeneity, therefore narrative synthesis was used. Results: 6533 unique articles were identified in the search; 21 articles (based on 15 trials) were included in the review. There was little evidence to suggest that prehabilitation is associated with increases in objectively measured PA, but this may be due to insufficient statistical power as most (n=8) trials included in the review were small feasibility/pilot studies. Where studies tested associations between objectively measured PA during the intervention period and health-related outcomes, significant beneficial associations were reported. Limitations in the evidence base precluded any assessment via meta-regression of the association between objectively measured PA and clinical or health-related outcomes. Conclusions: Additional large-scale studies are needed, with clear and consistent reporting of objective measures including accelerometry variables and outcome variables, to improve our understanding of the impact of changes in PA prior to surgery on surgical and health-related outcomes.

Citation

Wagnild, J. M., Akowuah, E., Maier, R. H., Hancock, H. C., & Kasim, A. (2021). Impact of prehabilitation on objectively measured physical activity levels in elective surgery patients: a systematic review. BMJ Open, 11(9), Article e049202. https://doi.org/10.1136/bmjopen-2021-049202

Journal Article Type Article
Acceptance Date Aug 18, 2021
Online Publication Date Sep 7, 2021
Publication Date 2021
Deposit Date Oct 28, 2021
Publicly Available Date Oct 28, 2021
Journal BMJ Open
Electronic ISSN 2044-6055
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 11
Issue 9
Article Number e049202
DOI https://doi.org/10.1136/bmjopen-2021-049202

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Publisher Licence URL
http://creativecommons.org/licenses/by-nc/4.0/

Copyright Statement
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.






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