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Exercise-based prehabilitation before cardiac surgery: a systematic review, meta-analysis, meta-regression, and proposal for a clinical implementation model

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dc.contributor.authorHurtado-Borrego, Juan Carlos
dc.contributor.authorBayonas-Ruiz, Adrián
dc.contributor.authorBonacasa Fernández, Bárbara
dc.contributor.departmentFisiología
dc.date.accessioned2026-02-09T08:21:17Z
dc.date.available2026-02-09T08:21:17Z
dc.date.copyright© 2025 The Authors
dc.date.issued2025-11-19
dc.description.abstractBackground/Objectives: Major cardiac surgery is associated with a high rate of postoperative complications, particularly in older and frail patients. Prehabilitation—defined as a preoperative intervention based on structured exercise—aims to enhance patients’ physiological and functional reserve before surgery. To evaluate the effectiveness of prehabilitation programs on functional capacity and postoperative complications in cardiac surgery and to propose a clinical exercise-based intervention model tailored to these patients. Methods: A systematic search was conducted in PubMed, Cochrane, PEDro, and LILACS (2005–2025). Randomized controlled trials investigating preoperative exercise interventions in adults undergoing cardiac surgery were included. Outcomes assessed included functional measures (6-Minute Walk Test [6MWT], Timed Up and Go test [TUG], maximal oxygen uptake [VO2max], maximal inspiratory pressure [MIP]), frailty (Clinical Frailty Scale [CFS], Essential Frailty Toolset [EFT]), postoperative complications and quality of life. Results: Nine studies comprising a total of 873 patients were included. Prehabilitation significantly improved functional capacity (∆6MWT: +52.4 m; p < 0.001), reduced respiratory complications (pneumonia, atelectasis) and shortened hospital stay (−15.2 h; p < 0.001). The greatest benefits were observed in multimodal programs lasting ≥4 weeks. Conclusions: Exercise-based prehabilitation is an effective and safe strategy in patients awaiting cardiac surgery. Its systematic implementation should be considered as part of the perioperative pathway, reinforcing the role of exercise as a therapeutic tool in this clinical context.
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dc.format.extent17
dc.identifier.citationJ. Clin. Med. 2025, 14, 8195
dc.identifier.doihttps://doi.org/10.3390/jcm14228195
dc.identifier.urihttp://hdl.handle.net/10201/201621
dc.languageeng
dc.publisherMDPI
dc.relationSpanish Ministry of Universities (FPU22/04352)
dc.relation.publisherversionhttps://www.mdpi.com/2077-0383/14/22/8195
dc.rightsAttribution 4.0 International*
dc.rights.accessRightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.subjectPreoperative exercise
dc.subjectPreoperative care [MeSH]
dc.subjectExercise therapy [MeSH]
dc.subjectHeart surgical procedures [MeSH]
dc.subjectRehabilitation [MeSH]
dc.subjectExercise capacity [MeSH]
dc.subjectSarcopenia [MeSH]
dc.subject.odsObjetivo 3: Salud
dc.titleExercise-based prehabilitation before cardiac surgery: a systematic review, meta-analysis, meta-regression, and proposal for a clinical implementation model
dc.typeinfo:eu-repo/semantics/article
dc.type.versioninfo:eu-repo/semantics/publishedVersion
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relation.isAuthorOfPublication.latestForDiscovery6a642dfb-d0e6-4dcf-ae7e-c19949e99a85
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