Exercise-Based Prehabilitation Before Cardiac Surgery: A Systematic Review, Meta-Analysis, Meta-Regression, and...

Area of Science:

• Cardiology
• Geriatrics
• Rehabilitation Medicine

Background:

• Major cardiac surgery poses significant risks, especially for older and frail individuals.
• Postoperative complications are common, impacting patient recovery and healthcare resources.
• Prehabilitation, a preoperative exercise intervention, aims to boost physiological reserves before surgery.

Purpose of the Study:

• To assess the impact of prehabilitation on functional capacity in cardiac surgery patients.
• To evaluate the effectiveness of prehabilitation in reducing postoperative complications.
• To propose a clinical model for exercise-based prehabilitation in this population.

Main Methods:

• Systematic literature search across major databases (PubMed, Cochrane, PEDro, LILACS) from 2005-2025.
• Inclusion of randomized controlled trials on preoperative exercise interventions for adult cardiac surgery patients.
• Assessment of outcomes including functional measures (6MWT, TUG, VO2max, MIP), frailty, complications, and quality of life.

Main Results:

• Nine studies with 873 patients were analyzed.
• Prehabilitation significantly enhanced functional capacity (e.g., 6MWT distance increased by 52.4m).
• Reduced respiratory complications and hospital stay (by 15.2 hours) were observed, with optimal results from multimodal programs lasting ≥4 weeks.

Conclusions:

• Exercise-based prehabilitation is a safe and effective strategy for patients awaiting cardiac surgery.
• Systematic implementation of prehabilitation should be considered within the perioperative pathway.
• Exercise is a valuable therapeutic tool in cardiac surgery recovery.