The Tohoku Journal of Experimental Medicine
Online ISSN : 1349-3329
Print ISSN : 0040-8727
ISSN-L : 0040-8727
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Responsive Measures to Prehabilitation in Patients Undergoing Bowel Resection Surgery
Do Jun KimNancy E. MayoFranco CarliDavid L MontgomeryGerald S. Zavorsky
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2009 Volume 217 Issue 2 Pages 109-115

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Abstract

Surgical patients often show physiological and metabolic distress, muscle weakness, and long hospital stays. Physical conditioning might help recovery. We attempted to identify the most responsive measure of aerobic fitness from a four-week pre-surgical aerobic exercise program (prehabilitation) in patients undergoing major bowel resection. Twenty-one subjects randomized two to one (exercise: control) scheduled for colorectal surgery. Fourteen subjects [Body Mass Index (BMI) = 27 ± 6 kg/m2; maximal oxygen uptake (VO2max) = 22 ± 10 ml/kg/min] underwent 3.8 ± 1.2 weeks (27 ± 8 sessions) of progressive, structured pre-surgical aerobic exercise training at 40 to 65% of heart rate reserve (%HRR). Peak power output was the only maximal measure that was responsive to training [26 ± 27%, Effects Size (ES) = 0.24; Standardized Response Mean (SRM) = 1.05; p < 0.05]. For the submaximal measures, heart rate and oxygen uptake during submaximal exercise was most responsive to training (decrease by 13% ± 15%, ES = −0.24; SRM = −0.57; and 7% ± 6%, ES = −0.40; SRM −0.97; p < 0.05) at an exercise intensity of 76 ± 47 W. There was no change to maximal or submaximal measures in the control group. The distance walked over six minutes improved in both groups (by ∼30 m), but the effect size and t-statistic were higher in the exercise group. Heart rate and oxygen uptake during submaximal exercise, and peak power output are the most responsive measures to four weeks of prehabilitation in subjects with low initial fitness.

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© 2009 Tohoku University Medical Press
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