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February 12, 2026BJS OpenOpen Access

Effect of preoperative prehabilitation on the 6-minute walk distance and postoperative outcomes in adult patients: meta-analysis

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Why the study?

Low cardiorespiratory fitness is associated with increased perioperative morbidity and mortality, but evidence regarding the effect of prehabilitation on cardiorespiratory fitness and postoperative outcomes remains inconclusive.

Does physical exercise prehabilitation improve 6-minute walk distance and postoperative outcomes in adult patients undergoing elective surgery?

Population

1649 adult patients scheduled for elective surgery across 21 RCTs

Comparison

Prehabilitation with physical exercise vs control

Design

Systematic review and meta-analysis of randomized clinical trials

Follow-up

First month after surgery

Key result

Prehabilitation with exercise improved preoperative 6-minute walk distance by 29m and persisted postoperatively but did not reduce hospital stay or mortality.

Authors

PDPablo Díaz-VidalCGCristina Gil-CasadoUFUxía Fernández-Vázquez

Discussion

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Overview

Improves perioperative fitness without shortening stay or cutting mortality; extends surrogate gains but challenges translation to clinical outcomes.

Key Points

  • The study aims to examine the impact of preoperative prehabilitation on cardiorespiratory fitness and postoperative outcomes, specifically the 6-minute walk distance.
  • Conducted a systematic review and meta-analysis of randomized clinical trials (RCTs)
  • Analyzed the effects of exercise-based prehabilitation on 6-minute walk distance
  • Included studies from PubMed and Web of Science published up to June 2025
  • Evaluated changes in 6MWD and postoperative outcomes such as hospital stay and mortality
  • Prehabilitation significantly improved preoperative 6MWD by a mean difference of 29 meters (P < 0.001)
  • Improvement in 6MWD persisted postoperatively with a mean difference of 22 meters (P = 0.05)
  • A higher proportion of the prehabilitation group reached clinically significant improvements both pre- and post-surgery
  • No significant differences in length of hospital stay or mortality between groups

Structured PICO

Does physical exercise prehabilitation improve 6-minute walk distance and postoperative outcomes in adult patients undergoing elective surgery?

P
Population
1,649 adult patients scheduled to undergo elective surgery across 21 RCTs (including 501 cardiac, 423 colorectal, and 364 thoracic surgery patients).
I
Intervention
Prehabilitation based on physical exercise.
C
Comparator
Control group (not explicitly detailed in abstract).
O
Outcome
Change in the 6-minute walk distance (6MWD) before surgery.surrogate

Preoperative physical exercise prehabilitation improves cardiorespiratory fitness before and after surgery, but does not significantly impact length of hospital stay or mortality.

Cite This Study

Díaz-Vidal et al. (2025) studied this question. Prehabilitation with exercise improved preoperative 6-minute walk distance by 29m and persisted postoperatively but did not reduce hospital stay or mortality.

synapsesocial.com/papers/698d6e5a5be6419ac0d53faehttps://doi.org/10.1093/bjsopen/zraf162
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