Abstract
BackgroundExercise in the preoperative period, or prehabilitation, continues to evolve as an important tool in optimising patients awaiting major intra-abdominal surgery. It has been shown to reduce rates of post-operative morbidity and length of hospital stay. The mechanism by which this is achieved remains poorly understood. Adaptations in mesenteric flow in response to exercise may play a role in improving post-operative recovery by reducing rates of ileus and anastomotic leak.AimsTo systematically review the existing literature to clarify the impact of exercise on mesenteric arterial blood flow using Doppler ultrasound.MethodsPubMed, EMBASE and the Cochrane library were systematically searched to identify clinical trials using Doppler ultrasound to investigate the effect of exercise on flow through the superior mesenteric artery (SMA). Data were extracted including participant characteristics, frequency, intensity, timing and type of exercise and the effect on SMA flow. The quality of each study was assessed using the Downs and Black checklist.ResultsSixteen studies, comprising 305 participants in total, were included. Methodological quality was generally poor. Healthy volunteers were used in twelve studies. SMA flow was found to be reduced in response to exercise in twelve studies, increased in one and unchanged in two studies. Clinical heterogeneity precluded a meta-analysis.ConclusionThe weight of evidence suggests that superior mesenteric arterial flow is reduced immediately following exercise. Differences in frequency, intensity, timing and type of exercise make a consensus difficult. Further studies are warranted to provide a definitive understanding of the impact of exercise on mesenteric flow.
Highlights
The systemic benefits of exercise have been recorded in the literature from as early as the time of Hippocrates [1]
To systematically review the existing literature to clarify the impact of exercise on mesenteric arterial blood flow using Doppler ultrasound
PubMed, EMBASE and the Cochrane library were systematically searched to identify clinical trials using Doppler ultrasound to investigate the effect of exercise on flow through the superior mesenteric artery (SMA)
Summary
The systemic benefits of exercise have been recorded in the literature from as early as the time of Hippocrates [1]. In the 60 years that have elapsed since Morris and colleagues produced their landmark work ‘‘Coronary heart disease and physical activity of work’’ [2], which described lower rates of heart disease among physically active workers, strides have been undertaken in the use of exercise as preventative medicine. This is evidenced in the development of rehabilitation programmes following cardiac events which aim to reduce the likelihood of further events while returning patients to their baseline [3]. The quality of each study was assessed using the Downs and Black checklist
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