Department of Rehabilitation, Nursing Science and Sport, Rudolf Magnus Institute of Neurosciences, University Medical Centre Utrecht, Utrecht, The Netherlands.
Clin Rehabil. 2011 Feb;25(2):99-111. doi: 10.1177/0269215510380830. Epub 2010 Nov 8.
To summarize the current evidence on the effects of preoperative exercise therapy in patients awaiting invasive surgery on postoperative complication rate and length of hospital stay.
A primary search of relevant key terms was conducted in the electronic databases of PubMed, EMBASE, PEDro and CINAHL.
Studies were included if they were controlled trials evaluating the effects of preoperative exercise therapy on postoperative complication rate and length of hospital stay. The methodological quality of included studies was independently assessed by two reviewers using the PEDro scale. Statistical pooling was performed when studies were comparable in terms of patient population and outcome measures. Results were separately described if pooling was not possible.
Twelve studies of patients undergoing joint replacement, cardiac or abdominal surgery were included. The PEDro scores ranged from 4 to 8 points. Preoperative exercise therapy consisting of inspiratory muscle training or exercise training prior to cardiac or abdominal surgery led to a shorter hospital stay and reduced postoperative complication rates. By contrast, length of hospital stay and complication rates of patients after joint replacement surgery were not significantly affected by preoperative exercise therapy consisting of strength and/or mobility training.
Preoperative exercise therapy can be effective for reducing postoperative complication rates and length of hospital stay after cardiac or abdominal surgery. More research on the utility of preoperative exercise therapy and its long-term effects is needed as well as insight in the benefits of using risk models.
总结目前关于术前运动疗法对接受侵入性手术的患者术后并发症发生率和住院时间的影响的证据。
在 PubMed、EMBASE、PEDro 和 CINAHL 电子数据库中对相关关键词进行了初步搜索。
如果研究评估了术前运动疗法对术后并发症发生率和住院时间的影响，则将其纳入研究。两位评审员使用 PEDro 量表独立评估纳入研究的方法学质量。如果研究在患者人群和结果测量方面具有可比性，则进行统计学合并。如果不可能进行合并，则分别描述结果。
纳入了 12 项关于关节置换术、心脏或腹部手术患者的研究。PEDro 评分从 4 分到 8 分不等。术前运动疗法包括吸气肌训练或心脏或腹部手术前的运动训练，可缩短住院时间并降低术后并发症发生率。相比之下，术前运动疗法（包括力量和/或活动能力训练）对关节置换术后患者的住院时间和并发症发生率没有显著影响。
术前运动疗法可有效降低心脏或腹部手术后的术后并发症发生率和住院时间。需要更多关于术前运动疗法的实用性及其长期效果的研究，以及对使用风险模型的益处的深入了解。
