{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T12:33:01Z","timestamp":1776169981927,"version":"3.50.1"},"reference-count":32,"publisher":"BMJ","issue":"8","funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,6,21]]},"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The objective of this systematic review was to study the impact of preoperative physical activity levels on adult cardiac surgical patients\u2019 postoperative: (1) major adverse cardiac and cerebrovascular events (MACCEs), (2) adverse events within 30\u2009days, (3) hospital length of stay (HLOS), (4) intensive care unit length of stay (ICU LOS), (5) activities of daily living (ADLs), (6) quality of life, (7) cardiac rehabilitation attendance and (8) physical activity behaviour.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A systematic search of MEDLINE, Embase, AgeLine and Cochrane library for cohort studies was conducted.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Eleven studies (n=5733\u2009patients) met the inclusion criteria. Only self-reported physical activity tools were used. Few studies used multivariate analyses to compare active versus inactive patients prior to surgery. When comparing patients who were active versus inactive preoperatively, there were mixed findings for MACCE, 30\u2009day adverse events, HLOS and ICU LOS. Of the studies that adjusted for confounding variables, five studies found a protective, independent association between physical activity and MACCE (n=1), 30-day postoperative events (n=2), HLOS (n=1) and ICU LOS (n=1), but two studies found no protective association for 30-day postoperative events (n=1) and postoperative ADLs (n=1). No studies investigated if activity status before surgery impacted quality of life or cardiac rehabilitation attendance postoperatively. Three studies found that active patients prior to surgery were more likely to be inactive postoperatively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Due to the mixed findings, the literature does not presently support that self-reported preoperative physical activity behaviour is associated with postoperative cardiac surgical outcomes. Future studies should objectively measure physical activity, clearly define outcomes and adjust for clinically relevant variables.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Registration<\/jats:title>\n                  <jats:p>Trial registration number <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT02219815\">NCT02219815<\/jats:ext-link>. PROSPERO number CRD42015023606.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-015712","type":"journal-article","created":{"date-parts":[[2017,8,11]],"date-time":"2017-08-11T20:25:24Z","timestamp":1502483124000},"page":"e015712","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":30,"title":["Systematic review of preoperative physical activity and its impact on postcardiac surgical outcomes"],"prefix":"10.1136","volume":"7","clinical-trial-number":[{"clinical-trial-number":"nct02219815","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"D Scott","family":"Kehler","sequence":"first","affiliation":[{"name":"Health, Leisure & Human Performance Research Institute, Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Manitoba, Canada"},{"name":"Institute of Cardiovascular Sciences, St. Boniface Hospital Research Centre, Winnipeg, 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