None listed
Conditions
Brief summary
The primary purpose of this study is to investigate high intensity interval training (HIIT) compared to moderate intensity interval training (MICT) on cardiorespiratory fitness (6MWT) and Inspiratory muscle strength (MIP) among patient undergoing for upper abdominal surgery. The hypothesis is HIIT exercise is effective in improving Cardiorespiratory Fitness, physical performance,fatigue, psychological recovery and health-related quality of life compared to standard care (MICT)Both groups will receive body conditioning and respiratory muscle strength exercises. For the intervention group, participants will receive HIIT and the control group MICT. This will be one-hour therapist-supervised intervention sessions for at least 4 weeks of exercise duration with 2 sessions per week before the surgery. The patient will be assessed at baseline, before the operation, before discharge and 4 weeks postoperatively and 3 months postoperatively. The outcomes will be assessed using multi-domain recovery measures that include physical measures (6MWT), Short Physical Performance Battery and 1 minute Sit to Stand), upper limb strength (Hand Grip Test), fatigue (Fatigue Severity Scale), psychological recovery (the Hospital Anxiety Depression Scale (HADS) and health-related quality of life (EuroQoL). Data will be analysed using intention-to-treat analysis. The changes from all timelines in the secondary outcomes will be analysed using the ANOVA test.
Interventions
This will be a tailored and supervised by a single Physiotherapist (more than 10 years clinical experiences in cardiorespiratory) in outpatient hospital setting. Participants will engage in a graduated aerobic, strengthening exercise and inspiratory muscles training program prior to the date of their surgery.
For aerobic exercise this will be a moderate intensity which is 55-75% of maximum heart rate (MHR) in week one with graduation to high intensity in week 2 on < 80% of MHR. Aerobic exercise
This will be a tailored and supervised by a single Physiotherapist (more than 10 years clinical experiences in cardiorespiratory) in outpatient hospital setting. Participants will engage in a graduated aerobic, strengthening exercise and inspiratory muscles training program prior to the date of their surgery. For aerobic exercise this will be a moderate intensity which is 55-75% of maximum heart rate (MHR) in week one with graduation to high intensity in week 2 on < 80% of MHR. Aerobic exercise training (eg: Treadmill, Cycle ergometer, body weight exercises) 1-3 times per week (30 minutes) for overall duration typical 2-4 week prior to date of surgery. Patients’ Maximum Heart rate (210-age) and Karvonen Formula will be used for targeted heart rate. Patients’s heart rate will be monitored along the aerobic training using smartwatch. The interval training will be 30-60 seconds of high intensity training with 1- 2 minutes of active recovery (light activity or complete rest) between intervals to facilitate recovery. Repeat for a total of 5-10 cycles. Aim for a total session duration of about 20-30 minutes, including warm-up and cool-down. This include 10-15 minutes of HIIT, depending on the patient's tolerance. Sessions will be done 1-3 times per week, with rest days in between to allow for recovery. For the progressive resistance exercise, the following muscle groups will be targeted: biceps brachii, triceps brachii, pectoralis major and minor, latissimus dorsi, deltoid and rhomboids using free weights. The intensity will be 70-80% of estimated 10 repetitions maximum.The load not provided joint pain or severe muscle fatigue and/or arm fatigue on RPE score of 10-13 on 6-20 of Rating Perceived Exertion Scale (RPE). In our study, in addition to the PVC weighted bar, we also used different types of resistance training such as band, dumbells, kettlebells. Inspiratory muscles training will be given 20 mins per day with 30% of maximum inspiratory pressure (MIP) In addition, participants will be given an illustrated handout to assist further training support by the carer (advice regarding maintaining a set amount of aerobic/strength exercise per week standard. Detailed session attendance checklist and vital sign will be recorded for every attendance for adherence monitoring
Sponsors
Universiti kebangsaan Malaysia
Study design
Allocation
Randomised controlled trial
Intervention model
Other
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
• Adults aged 18 years years old and over • Scheduled for upper abdominal surgery. • Able to perform the Six-Minute Walk Test (6MWT). • 6MWT distance between 300-450 meters (moderate risk) or >450 meters (low risk). • Provide written informed consent.
Exclusion criteria
• Emergency operation • Medically unstable or severe comorbidities that contraindicate exercise (e.g., unstable cardiovascular disease). • Impaired cognition or confusion • Impaired vision, cognition or physical impairment (UL and LL) in functional task components • 6MWT distance <300 meters (high risk).
Outcome results
None listed