Taking 7,500 Daily Steps Prior to Surgery Can Decrease the Likelihood of Complications

Walking more prior to having a surgical treatment could lessen the chance for post-surgery problems, according to recent studies.

The research data were shared during the previous week's American College of Surgeons (ACS) Clinical Congress. The results indicated that attaining a minimum of 7,500 steps every day before surgery could decrease the likelihood of complications by as much as 51%.

Exercise in preparation for an operation, often referred to as "prehabilitation", can assist individuals in steering clear of complications such as infections, blood clots, and reactions to anesthesia.

Primary predictors of complication risk include how healthy a person was on baseline, explained Daniel McIsaac, MD, an anesthesiologist at The Ottawa Hospital in Canada. He added that the healthier a person's condition, the less probable they are to have a complication.

Prehabilitation is gaining significant attention nowadays. It encompasses practices like exercising, an improved diet, and stress management prior to surgery.

McIsaac noted that while the effectiveness of this method in decreasing complications is beginning to become evident, the concept is relatively new. The main challenge is ensuring consistency in health improvements prior to surgery.

The latest study analyzed FitBit data from 475 individuals before they underwent a variety of surgeries such as orthopedic and general procedures. The mean age among the participants was 57 years. The researchers studied the data spanning from the farthest point in the past, even several years before the surgery, in order to understand the participants' health habits.

About 12.6% of the subjects experienced complications within 90 days post-surgery.

The 30-day post-surgery complication probability decreased by 45% amongst participants who took over 7,500 steps daily when compared to those with less than 7,500 steps. Meanwhile, the 90-day post-surgery complication risk dropped by 51%.

Carson Gehl, lead author of the study and a medical student at the Medical College of Wisconsin in Milwaukee, stated that merging Fitbit data with electronic health records (EHRs) could provide vital assistance in preparing pre- and post-surgery care strategies.

Gehl expressed that identifying and closely monitoring high-risk patients before possible problems get out of control could be possible through Fitbit tools. He also mentioned the ambition to modify pre-operative physical activity to enhance post-operative outcomes, although more data and studies are required to confirm this.

Several theories discuss how fitness can be beneficial prior to surgery. One belief is that sedentary individuals who average less than 5,000 steps daily might find recovering from surgery more challenging due to difficulties in oxygen utilization in their tissues.

Another proposition, explained by Kari Clifford, PhD, a researcher at Otago Medical School in New Zealand, is that people with less physical prowess could have weaker immune systems, attributing to the occurrence of complications.

Healthier people, on the other hand, are believed to have the capacity to stay active and avoid complications through heightened mobility, Clifford added.

It remains unclear how long a person needs to maintain an active lifestyle before surgery to reduce the chance of complications. Marc Licker, MD, a researcher from Switzerland clarified that the duration, intensity, and frequency of exercises are crucial, with two weeks of preparation generally deemed sufficient.

Highly active individuals are likely to have been exercising for long periods, according to Aron Onerup, MD, a researcher at the University of Gothenburg Institute of Clinical Sciences in Sweden.

Previous research findings regarding the role of pre-surgery fitness in preventing complications have been inconsistent, but the general consensus leans toward the benefits of enhanced activity.

In two separate studies led by Onerup in 2019 and 2022, physically active individuals were observed to have fewer post-surgery complications for colon cancer. A 2018 study reported similar findings for those who engaged in high-intensity endurance training prior to abdominal surgery. Moreover, a 2023 study led by Clifford found that high-intensity interval training (HIIT) before surgery improved cardiorespiratory fitness and reduced chances of post-surgery issues.

On the other hand, a 2023 study revealed that walking fewer than 4,300 steps a day was linked to higher complication rates in patients undergoing pancreas removal.

But not all efforts to work out before surgery have been shown to avert complications. Onerup’s 2022 study also assessed people who did home-based interventions two weeks before and four weeks after colon cancer surgery; it didn’t find a difference in recovery perceptions between those who did and didn’t exercise.

The way people look at physical activity, the populations studied, and the outcomes (severe complications versus all complications) can vary—so the results can differ as well, said Clifford.

Despite the mixed results on whether or not exercise can thwart 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 to clear medicines and waste products, they may shut down if not up to the task,” Clifford explained. “This is why being fitter gives you a better chance at healing.” 

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 undergo surgery without prior training,” she told Health.

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

“Not doing anything prior to surgery is the worst thing that someone can do,” Scheede-Bergdahl said. “The ‘rest is best’ mentality needs to be revised to ‘whatever you can do is better than doing nothing at all.’”

There isn’t necessarily a “right” kind of activity, either—just make sure the exercise gets your heart and respiratory rate up. Shoot for 10 minutes of the high-intensity exercise, Clifford suggested, adding that anything that gets your heart pumping is good.

“People who are in better condition to face physical challenges,” Scheede-Bergdahl said, “usually have less surgical complications and recover faster.”