Good aerobic fitness and lean muscle mass provide patients with the physiological ‘reserve’ to meet the demands of the surgical stress response.

Poor aerobic fitness and a lack of muscle mass (sarcopenia) have been identified as independent predictors of poorer surgical outcomes.

A chronically sedentary and inactive lifestyle predisposes to development of these issues alongside multiple other chronic health conditions such as obesity, coronary heart disease and diabetes mellitus.

Approximately half of adults presenting for major surgery demonstrate chronic sedentary behaviour and inactivity with associated low levels of fitness.

International recommendations for weekly activity and exercise exist for healthy adults.

The WHO advises:

OR

Patients not currently undertaking WHO levels of activity or exercise should be encouraged to aim for this target. This should be tailored to the patient and structured around preferred activities and physical limitations. A combination of aerobic and resistance activity is likely to be most beneficial.

Patients not currently undertaking WHO levels of activity or exercise should be encouraged to aim for this target. This should be tailored to the patient and structured around preferred activities and physical limitations. A combination of aerobic and resistance activity is likely to be most beneficial.

Effective advice can be delivered both verbally and using dedicated patient information leaflets.

Safety of exercise is an important concern. However, exercise is widely considered a ‘safe’ healthcare intervention and clinician judgement can be utilised to identify the relatively small number of patients in which it may be inappropriate.

Depending where a patient lives, each local council is able to offer referral pathways to allow patients to access existing services to increase their activity levels.

City of Edinburgh (Edinburgh Leisure)

• Fit For Health Website
• Fit For Health Referral Form
• Fit For Health Flyer
• Fit For Health Timetable

Midlothian (Active Midlothian)

• Active Choices Website
• Active Choices Referral Form
• Active Choices Timetable

East Lothian (Enjoy Leisure)

• Enjoy Leisure Website
• MacMillan Move More Referral Form

West Lothian (West Lothian Leisure - Xcite)

• Xcite Health and Wellbeing Website
• Xcite Health and Wellbeing Referral Form
• Xcite Health and Wellbeing Pathways

Fife (Fife Sports and Leisure Trust)

• Health and Wellbeing Website
• Fife Sport and Leisure Trust Referral Form

Borders (Live Borders)

• Health Program Website
• Health Program Referral Form
• Health Program Brochure
• Health Program Info Sheet
• Health Program Timetable