Two RCTs, one moderate(1) and one weak quality(2), examined the effectiveness of multicomponent interventions incorporating exercise and psychological components amongst patients waiting for coronary artery bypass graft and/or valve surgery(1), and total knee or hip replacement (2).
The first RCT (1) compared a 2-week hospital based preoperative program amongst patients awaiting coronary artery bypass graft and/or valve surgery to a usual care control group. The intervention comprised of four supervised exercise sessions, four self-directed exercise sessions and four individualised sessions of a mental stress reduction program, incorporating education on relaxation techniques. Following completion, the intervention group was encouraged to practice relaxation techniques and continue regular physical activity at home, until surgery.
The second RCT (2) compared a 12-week program amongst patients awaiting hip or knee replacement to a control group receiving usual care. The intervention comprised of targeted exercise and behaviour change counselling based on the Health Action Process Approach (HAPA). The exercise component comprised of 24 supervised group sessions and directions to continue exercises at home.
Health-related Quality of Life:
Might not be effective (2 studies; 1 moderate (1) and 1 weak quality (2), both showing no effect for intervention when compared to control. Evidence graded as inconsistent overall due to one of the included studies being of weak quality).
Daily physical activity:
Might not be effective (1 weak quality study showing no effect for intervention when compared to control) (2).
Pain:
Might not be effective (1 weak quality study showing no effect for intervention when compared to control) (2).
Function:
Might not be effective (1 weak quality study showing no effect for intervention when compared to control) (2).
Biomarkers of metabolic health (BMI, waist circumference, body fat %, blood pressure, blood glucose and Glycosylated haemoglobin HbA1c):
Might not be effective (1 weak quality study showing no effect for intervention when compared to control) (2).
Psychological HAPA-based constructs (current exercise behaviour, habit strength, intention to exercise, social support, perceived behavioural control, action planning, and action control):
Might not be effective (1 weak quality study showing no effect for intervention when compared to control) (2).
Evidence Service comments:
It is worth mentioning that one study (2) failed to recruit the required sample size, thereby decreasing their likelihood of finding evidence of an effect for the intervention.