title: Preoperative exercise therapy in surgical care: a scoping review.
abstract: OBJECTIVE
  Several systematic reviews have focused on the role of preoperative exercise therapy (PET) in various fields of surgical care. Aims of the present scoping review are to summarize research findings and to identify gaps in existing literature.
  
  
  METHODS
  Two authors independently conducted a comprehensive literature search on systematic reviews regarding PET. The risk of bias was assessed using "the methodology checklist for systematic reviews and meta-analyses of the Scottish Intercollegiate Guidelines Network (SIGN)." Findings of the included systematic reviews were summarized according to type of surgery and type of PET.
  
  
  RESULTS
  Twenty-one reviews on PET with a low risk of bias were included. Seven reviews investigated PET in multiple surgical fields and 14 in just a single surgical field. PET was studied before cardiac surgery (n = 9), orthopedic surgery (n = 8), abdominal surgery (n = 8), thoracic surgery (n = 8), vascular surgery (n = 3), and urologic surgery (n = 1).
  
  
  CONCLUSIONS
  Overall, it seems that PET exerts beneficial effects on physical fitness and postoperative outcome measures. Gaps in current literature are the heterogeneity in selected patient populations and outcome measures as well as lack of guidelines on the specific PET regimes. Therefore, there is increasing need for multicenter randomized trials with specifically designed PET programs and a carefully selected patient population to strengthen current evidence.
authors.affiliation: Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands; Department of Epidemiology, CAPHRI Research School, Maastricht University, Maastricht, the Netherlands. Electronic address: joep.teijink@catharinaziekenhuis.nl.
authors.forename: Sjaak
authors.initials: S
authors.lastname: Pouwels
authors.affiliation: Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands; Department of Epidemiology, CAPHRI Research School, Maastricht University, Maastricht, the Netherlands.
authors.forename: David
authors.initials: D
authors.lastname: Hageman
authors.affiliation: Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands; Department of Epidemiology, CAPHRI Research School, Maastricht University, Maastricht, the Netherlands.
authors.forename: Lindy N M
authors.initials: LN
authors.lastname: Gommans
authors.affiliation: Department of Surgery, Medisch Spectrum Twente, Enschede, the Netherlands.
authors.forename: Edith M
authors.initials: EM
authors.lastname: Willigendael
authors.affiliation: Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands.
authors.forename: Simon W
authors.initials: SW
authors.lastname: Nienhuijs
authors.affiliation: CARIM Research School, Maastricht University, Maastricht, the Netherlands; Department of Vascular Surgery, Maxima Medical Centre, Veldhoven, the Netherlands.
authors.forename: Marc R
authors.initials: MR
authors.lastname: Scheltinga
authors.affiliation: Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands; Department of Epidemiology, CAPHRI Research School, Maastricht University, Maastricht, the Netherlands.
authors.forename: Joep A W
authors.initials: JA
authors.lastname: Teijink
mesh_terms: D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D010809:Physical Fitness; D011300:Preoperative Care / Q000379:methods*; D013514:Surgical Procedures, Operative
keywords: Complications; Exercise therapy; Exercise training; Physical fitness; Preconditioning; Scoping review