Walking 7,500 daily steps before surgery can reduce the risk of complications

Walking 7,500 daily steps before surgery can reduce the risk of complications

Taking more than 7,500 daily steps before surgery can reduce postoperative complications, according to a new study. Exercising before surgery - known as "prehabilitation" - can help reduce the risk of post-operative complications such as infections and blood clots. In addition to exercise, eating good health and managing stress can also help improve surgical outcomes.

Whether you're scheduled for surgery or not, walking more before going under the knife may reduce your risk of complications, new research shows.

The news follows findings presented last week at the American College of Surgeons (ACS) Clinical Congress that showed taking at least 7,500 steps per day before surgery can reduce the risk of complications by 51%.

By exercising before surgery - what experts call "prehabilitation" - patients can avoid complications such as infections, blood clots and reactions to anesthesia.

“One of the most important things that predicts risk of complications is how healthy people are at baseline,” said Dr. Daniel McIsaac, an anesthesiologist at the Ottawa Hospital in CanadaHealthafter reviewing the research. “The healthier someone is, the less likely they are to experience a complication.”

There is a major push for prehabilitation, which includes exercise, better nutrition, and stress management before surgery.

“The evidence that this approach reduces complications is emerging, but it is still in its early stages,” McIsaac said. “The biggest challenge is that it can be difficult to get people to consistently make these health changes before surgery.”

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Walking more reduces complications after surgery

For the new study, researchers examined FitBit data from 475 people before they underwent a variety of surgeries such as orthopedic surgery and general procedures. The average person was 57 years old. The researchers did not limit their data analysis to a period immediately before surgery; They looked as far back as possible — even a few years before surgery — to get a picture of a person's health habits.

Of those studied, approximately 12.6% experienced a complication within 90 days of surgery.

The risk of a complication in the 30 days after surgery was 45% lower in people who took more than 7,500 steps per day before surgery compared to those who walked fewer than 7,500 steps. In the 90 days after surgery, the risk decreased by 51%.

Carson Gehl, lead study author and medical student at the Medical College of Wisconsin in Milwaukee, said in a news release that integrating Fitbit data into electronic health records (EHRs) can help doctors better plan pre- and post-operative care.

“Using these Fitbit tools, when we find people who are at high risk, we can monitor them more closely as they perform their procedures, so we can catch problems before they get out of control,” Gehl said in the press release. "Another goal of our research is to modify physical activity in the preoperative period and improve postoperative outcomes. We need more studies and evidence to answer this question."

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Benefits of an active lifestyle before surgery

There are a few theories as to why fitness can be protective before surgery. Some researchers believe that sedentary people - those who take fewer than 5,000 steps per day - have difficulty using oxygen in their tissues, making recovery from surgery more difficult.

Other experts believe people who aren't as fit have weaker immune function, which can lead to complications, said Kari Clifford, PhD, a surgery researcher at Otago Medical School in New ZealandHealth.

Healthier people may be able to move and step more, allowing them to remain physically active. If they're not as active, comorbidities can predispose them to complications, Clifford said.

Researchers aren't entirely sure how long you need to be active before surgery to avoid complications.

“Starting as early as two weeks before surgery is enough,” said Dr. Marc Licker, a researcher from Switzerland who has studied prehabilitation in lung cancer patientsHealthafter reviewing the research. He said the duration of the exercise, the intensity and the frequency of the session are most important.

People who report being very active have probably been so for a long time, Dr. Aron Onerup, researcher at the Institute of Clinical Sciences at the University of Gothenburg in SwedenHealth.

Research on whether fitness before surgery can actually prevent complications is mixed, although it is widely believed that being more active is helpful.

In two previous studies led by Onerup, published in 2019 and 2022, research showed that physically active people had fewer complications after colorectal cancer surgery.

Similarly, a 2018 study showed the same thing in people who participated in high-intensity endurance training before abdominal surgery. And a 2023 analysis by Clifford found that high-intensity interval training (HIIT) before surgery improved cardiorespiratory fitness and reduced the risk of postoperative problems.

Conversely, walking fewer than 4,300 steps per day was associated with more complications in people who had their pancreas removed, a 2023 study showed.

However, it has been shown that not all efforts to exercise before surgery can prevent complications. Onerup's 2022 study also looked at people who performed procedures at home two weeks before and four weeks after colon cancer surgery; No difference was found in perceptions of recovery between those who exercised and those who did not exercise.

The way people look at physical activity, the populations studied, and the outcomes (severe complications versus all complications) can be different — so the results can be different, too, Clifford said.

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Preparing for an upcoming procedure

Despite the mixed results on whether or not exercise can prevent complications, experts say it's better to stay active before a procedure.

"Surgery is hard on the body, and when a person's systems have to work harder to heal or eliminate medications and waste products, they can shut down if they are not up to the task," Clifford explained. “That’s why you have a better chance of recovery if you’re fitter.”

Celena Scheede-Bergdahl, PhD, who works with the perioperative program at Montreal General Hospital, said exercise prepares your body for the stress of surgery.

“You would never run a marathon without prior training, nor should you have surgery without prior training,” she saidHealth.

By walking, you teach your body to handle physical stress and improve your ability to deal with the respiratory, neurological, cardiovascular or metabolic challenges that can arise from surgery, Scheede-Bergdahl said.

“Doing nothing before surgery is the worst thing anyone can do,” Scheede-Bergdahl said. “The ‘rest is best’ mentality needs to be changed to ‘anything you can do is better than doing nothing’.”

There isn't necessarily a "right" type of activity either - just make sure the exercise gets your heart and breathing rates up. Do 10 minutes of high-intensity exercise, Clifford suggested, adding that anything that gets your heart racing is good.

“People who are in better shape to handle physical challenges,” Scheede-Bergdahl said, “typically have fewer surgical complications and recover more quickly.”