Department of Sport & Exercise Sciences, School of Social Sciences, Business & Law, Teesside University, Middlesbrough, UK.
Health and Social Care Institute, Teesside University, Middlesbrough, UK.
Perioper Med (Lond). 2016 Jan 14;5:2. doi: 10.1186/s13741-015-0026-8. eCollection 2016.
The advancement of perioperative medicine is leading to greater diversity in development of pre-surgical interventions, implemented to reduce patient surgical risk and enhance post-surgical recovery. Of these interventions, the prescription of pre-operative exercise training is gathering momentum as a realistic means for enhancing patient surgical outcome. Indeed, the general benefits of exercise training have the potential to pre-operatively optimise several pre-surgical risks factors, including cardiorespiratory function, frailty and cognitive function. Any exercise programme incorporated into the pre-operative pathway of care needs to be effective and time efficient in that any fitness gains are achievable in the limited period between the decision for surgery and operation (e.g. 4 weeks). Fortunately, there is a large volume of research describing effective and time-efficient exercise training programmes within the discipline of sports science. Accordingly, the objective of our commentary is to synthesise contemporary exercise training research, both from non-clinical and clinical populations, with the overarching aim of informing the development of effective and time-efficient pre-surgical exercise training programmes. The development of such exercise training programmes requires the careful consideration of several key principles, namely frequency, intensity, time, type and progression of exercise. Therefore, in light of more recent evidence demonstrating the effectiveness and time efficiency of high-intensity interval training-which involves brief bouts of intense exercise interspersed with longer recovery periods-the principles of exercise training programme design will be discussed mainly in the context of such high-intensity interval training programmes. Other issues pertinent to the development, implementation and evaluation of pre-operative exercise training programmes, such as individual exercise prescription, training session monitoring and potential barriers and risks to high-intensity exercise are also discussed. The evidence presented suggests that individually prescribed and supervised high-intensity interval training programmes, encompassing a variety of exercise modes represent an effective and safe means of exercise therapy prior to surgery.
围手术期医学的进步导致术前干预措施的发展更加多样化，这些干预措施旨在降低患者手术风险并促进术后康复。在这些干预措施中，术前运动训练的处方作为增强患者手术效果的现实手段越来越受到关注。事实上，运动训练的一般益处有可能在术前优化几个术前风险因素，包括心肺功能、虚弱和认知功能。任何纳入术前护理途径的运动方案都需要有效且高效，因为在决定手术和手术之间的有限时间内（例如 4 周）可以实现任何体能的提高。幸运的是，有大量研究描述了运动科学领域内有效且高效的运动训练方案。因此，我们评论的目的是综合当代运动训练研究，包括非临床和临床人群的研究，以实现为有效和高效的术前运动训练方案的制定提供信息。这些运动训练方案的制定需要仔细考虑几个关键原则，即运动的频率、强度、时间、类型和进展。因此，鉴于最近的证据表明高强度间歇训练的有效性和高效性——涉及短暂的剧烈运动与较长的恢复期相交替——运动训练方案设计的原则将主要在这种高强度间歇训练方案的背景下进行讨论。还讨论了与术前运动训练方案的制定、实施和评估相关的其他问题，例如个体运动处方、训练课程监测以及高强度运动的潜在障碍和风险。提出的证据表明，个体化和监督的高强度间歇训练方案，包括各种运动模式，代表了手术前运动治疗的有效和安全手段。
