Strength Training Enhances Recovery After Surgery (Steras)

Undergoing general anaesthetic and complex surgery is associated with significant risk. Compounding this, reduced muscle mass is proven to be linked to increased post-operative complications and increased length of stay. Exercise focused prehabilitation research is emergent and increasingly supportive of preventive strategies to improve post-surgical outcomes. PURPOSE To investigate the role of a multi-site strength focussed exercise intervention in improving patient condition prior to surgery to enhance recovery METHODS 43 (26 male, 17 females; 68.3 ± 9.3 years) patients scheduled for surgery were randomly assigned to one of 3 groups; 1) prehabilitation [pre-surgery exercise] 2) prehabilitation + rehabilitation [pre and post-surgery exercise] or 3) usual care. The exercise program consisted of an aerobic component and 6 resistance exercises targeting the major muscle groups. Primary outcomes were length of stay (days) and post-operative complications. Secondary measures included; whole body resistance, muscular strength, aerobic fitness, physical function and quality of life. RESULTS There was no difference in length of stay between groups (prehab: 11.2±10.3; pre+rehab: 13.2±6.2; control: 13.9±12.4). Post-operative complications were not different between groups. A significant time*group interaction was observed for isometric grip strength (p=0.046). Patients reported significantly greater quality of recovery in the prehab+rehab exercise group compared to control (p=0.05). No differences were observed between groups for whole body resistance, aerobic fitness, measures of physical function or self-reported quality of life. CONCLUSION The preliminary results of this study indicate resistance-based exercise training prior to and following surgery results in greater muscular strength and enhanced quality of recovery compared to current standard care practices. These findings provide promising support for the development of future strength focused prehabilitation programs to improve patient function prior to surgery and reduce the surgery stress response, promoting an accelerated recovery. Supported by WA Cancer and Palliative Care Network NMHS20193593; Spinnaker Medical Research Foundation