Journal of Clinical Medicine (2025/2026) network meta-analysis comparing effectiveness of different pre-operative exercise types on VO₂max. Exercise vs control: effect size 0.44.
High-altitude trail above Sankt Moritz at dawn: firm steps on packed snow, breath visible in the cold air; no faces.
HIIT recorded the highest effect (ES: 0.51).
The meta-analysis results
HIIT delivers the greatest VO₂max improvement (ES: 0.51) while structured walking (ES: 0.44) remains highly effective.
Detail of boots and a smartwatch counting steps on a snowy ridge, raking morning light; no faces.
Every increase in VO₂max reduces surgical risk by improving physiological reserve during operative stress.
When to choose HIIT and when walking
HIIT suits patients with good functional baseline.
A climb at altitude with a frozen Engadine lake behind, clear sky, measured aerobic effort; no faces.
Structured walking (5,000–10,000 steps/day) suits patients with functional limitations, elderly patients, or COPD. The Digital Twin assigns the correct protocol based on individual profile.
The optimal intensity for surgery
Breath and stride on a snowy mountain path at first light, VO₂max as an oxygen reserve; Alpine landscape, no faces.
Excessively intense exercise in the last 48–72 hours before the procedure can elevate cortisol and reduce immune defences. The Digital Twin calculates optimal tapering — progressive intensity reduction in the final weeks.
High-altitude trail above Sankt Moritz at dawn: firm steps on packed snow, breath visible in the cold air; no faces.
Real-time VO₂max monitoring
The Digital Twin tracks estimated VO₂max week by week, documenting the patient's biological improvement with objective data.
Detail of boots and a smartwatch counting steps on a snowy ridge, raking morning light; no faces.
Network Meta-Analysis — Journal of Clinical Medicine (2025-2026) — https://www.mdpi.com/2077-0383/15/1/175 · www.mdpi.com
On the same topic
- 5,000 Steps a Day Before Surgery. A Simple Protocol with a Measurable Clinical Result.Walking at 5,000 steps/day significantly improves VO₂ peak and 6MWT distance in pre-operative COPD patients.
- ERAS + Early Mobilisation: The Protocol That Transforms Surgical Recovery.ERAS and early mobilisation reduce complications, accelerate ambulation and lower hospital stay. The post-operative Gold Standard monitored by the Digital Twin.
- Exercise Before Surgery Reduces Complications by 48%. The Systematic Review Proves It.Pre-operative physical training increases VO₂max by +2 ml/kg/min and reduces post-op pulmonary complications by 48%.