New thesis examines different aspects of personalized preoperative exercise

"There is a well-studied association between low physical fitness and an increased risk of complications after major abdominal surgery. My thesis examines different aspects of personalized preoperative exercise, consisting of inspiratory muscle training, aerobic exercise, and strength training, carried out in the patient’s home environment with support from a physiotherapist. The target group was older people with low physical fitness who were scheduled for colorectal cancer surgery" says Johanna Danielsson, PhD student at the Department of Neurobiology, Care Sciences and Society.

"In two of the studies, we evaluated whether preoperative exercise influenced the risk of postoperative complications and how preoperative training influenced changes in physical fitness before and after surgery. In a third study, we evaluated whether the measure we used to personalize exercises appeared relevant in this context. In a fourth study, we focused on describing patients’ experiences of performing preoperative exercise."

Which are the most important results?  

"We found that preoperative exercise improved inspiratory muscle strength after surgery. At the same time, recruitment was challenging, partly due to short waiting times for surgery, something that is positive in itself but may have limited the possibility to influence other aspects of physical fitness. Furthermore, we could not demonstrate an effect of preoperative exercise on the risk of postoperative complications." 

"Patients described that support from a physiotherapist and the possibility of exercising at home were important for being able to carry out preoperative exercise. It also emerged that engaging in preoperative exercise could provide a sense of actively contributing to a better recovery."

How can this new knowledge contribute to the improvement of people’s health?  

"It remains important to further develop preoperative interventions in this context but organizational conditions for implementing preoperative exercise need to be improved. Inspiratory muscle training is promising, especially if future studies can show associations to fewer complications in this patient group. My thesis also raises reflections on the alternative value of preoperative exercise and whether other outcome measures might better capture relevant aspects."  

What’s in the future for you? Will you continue to conduct research?   

"I will be on parental leave for a while, but my ambition is to continue conducting research afterward. I find it incredibly rewarding to contribute to new knowledge, especially knowledge that benefits older people, for whom there is great potential to improve health and quality of life with exercise."