The Impact of Fitness on Surgical Outcomes: The Case for Prehabilitation

Curr Sports Med Rep. Jul-Aug 2016;15(4):282-9. doi: 10.1249/JSR.0000000000000274.


In recent years, a growing body of research has demonstrated that an individual's fitness level is a strong and independent marker of risk for cardiovascular and all-cause mortality. In addition, modest improvements in fitness through exercise intervention have been associated with considerable health outcome benefits. These studies have generally assessed fitness as a baseline marker in traditional epidemiological cohorts. However, there has been a recent recognition that fitness powerfully predicts outcomes associated with a wide range of surgical interventions. The concept of 'prehabilitation' is based on the principle that patients with higher functional capability will better tolerate a surgical intervention, and studies have shown that patients with higher fitness have reduced postoperative complications and demonstrate better functional, psychosocial, and surgery-related outcomes. This review focuses on the impact of fitness on surgical outcomes and provides a rationale in support of routine application of prehabilitation in the management of patients undergoing surgery.

Publication types

  • Review

MeSH terms

  • Cardiorespiratory Fitness
  • Evidence-Based Medicine
  • Exercise Therapy / methods*
  • Humans
  • Physical Fitness*
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control*
  • Preoperative Care / methods*
  • Risk Factors
  • Surgical Procedures, Operative / adverse effects*
  • Surgical Procedures, Operative / rehabilitation*
  • Treatment Outcome