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July 1, 2020Cochrane libraryOpen Access

Prehabilitation exercise therapy before abdominal aortic aneurysm repair

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Key result

Prehabilitation exercise therapy before elective abdominal aortic aneurysm repair has uncertain effects on 30-day mortality (RR 1.33; 95% CI 0.31-5.77) but may reduce cardiac and renal complications.

Why the study?

Perioperative and postoperative morbidity is common after elective AAA repair, and existing studies evaluating prehabilitation exercise interventions have shown conflicting results.

Does prehabilitation exercise therapy reduce perioperative and postoperative morbidity and mortality in patients waiting for elective abdominal aortic aneurysm repair?

Population

232 participants with clinically diagnosed AAA suitable for elective intervention across 4 RCTs

Comparison

Prehabilitation exercise therapy vs usual care (no exercise)

Design

Systematic review and meta-analysis of RCTs

Authors

CFCandida FentonUAUkachukwu Okoroafor AbaraoguATAudrey R Tan

Discussion

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Overview

May merit prehabilitation consideration before AAA repair to reduce complications; leaves mortality effect uncertain, warranting higher-certainty trials.

Study Design

Type

Systematic Review (n=232)

Structured PICO

Does prehabilitation exercise therapy reduce perioperative and postoperative morbidity and mortality in patients waiting for elective abdominal aortic aneurysm repair?

P
Population
232 participants with clinically diagnosed abdominal aortic aneurysm awaiting elective repair across 4 randomized controlled trials.
I
Intervention
Prehabilitation exercise therapy (circuit training, moderate-intensity continuous exercise, or high-intensity interval training) for 1 to 6 weeks (3-6 sessions per week, 1 hour per session).
C
Comparator
Usual care (no exercise; participants maintained normal physical activity).
O
Outcome
Perioperative and postoperative morbidity and mortality associated with elective abdominal aortic aneurysm repair (including 30-day mortality, cardiac, renal, and pulmonary complications).hard clinical

Main Result

Relative Risk: 1.33 (95% CI 0.31–5.77)

Prehabilitation exercise therapy before elective AAA repair may slightly reduce cardiac and renal complications, but evidence is of low certainty and its effect on mortality remains uncertain.

Limitations

  • All included trials were at a high risk of bias
  • Small sample sizes leading to imprecision
  • Low to very low certainty of evidence
  • High risk of bias in all included trials
  • Small sample sizes (imprecision)

Cite This Study

Fenton et al. (2020) conducted a systematic review in Abdominal aortic aneurysm (AAA) (n=232). Prehabilitation exercise therapy vs. Usual care (no exercise) was evaluated on 30-day mortality post-AAA repair (RR 1.33, 95% CI 0.31 to 5.77). Prehabilitation exercise therapy before elective abdominal aortic aneurysm repair has uncertain effects on 30-day mortality (RR 1.33; 95% CI 0.31-5.77) but may reduce cardiac and renal complications.

synapsesocial.com/papers/6a636ececd7899abd6b70b26https://doi.org/10.1002/14651858.cd013662
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Prehabilitation exercise therapy before elective abdominal aortic aneurysm repair2021 · 32 citations
  2. 2Changes in functional health status following open abdominal aortic aneurysm repair and the role of exercise-based rehabilitation: a systematic review2023
  3. 3Exercise, Vascular Health, and Abdominal Aortic Aneurysms2012 · 7 citations
  4. 4Preoperative Supervised Exercise Improves Outcomes After Elective Abdominal Aortic Aneurysm Repair2016 · 134 citations
  5. 5Randomized feasibility trial of high-intensity interval training before elective abdominal aortic aneurysm repair2017 · 65 citations