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Exercise- and education-based prehabilitation before total knee arthroplasty: a pilot study [with consumer summary] |
Granicher P, Mulder L, Lenssen T, Fucentese SF, Swanenburg J, De Bie R, Scherr J |
Journal of Rehabilitation Medicine 2024 Jan 8;56:jrm18326 |
clinical trial |
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
OBJECTIVE: To determine the feasibility and estimates of effects of a supervised exercise- and education-based prehabilitation programme aiming to improve knee functioning compared with usual care in patients awaiting total knee arthroplasty. DESIGN: A randomized controlled pilot study. SUBJECTS: Patients receiving primary, unilateral total knee arthroplasty. METHODS: Patients randomized to the intervention group participated in a personalized 4 to 8 week prehabilitation programme before surgery. Feasibility of the intervention and self-reported knee functioning, pain, physical performance and hospital stay were assessed at baseline, immediately preoperatively, 6 and 12 weeks after surgery. RESULTS: Twenty patients (mean age 72.7+/-5.95 years) were enrolled in this study. The personalized prehabilitation programme was found to be feasible and safe, with an exercise adherence of 90%. Significant medium interaction effects between groups and over time favouring prehabilitation were reported for the sport subscale of the Knee Osteoarthritis Outcome Score (F(3/54) = 2.895, p = 0.043, eta2 = 0.139) and Tegner Activity Scale (F(2.2/39.1) = 3.20, p = 0.048, eta2 = 0.151). CONCLUSION: The absence of adverse events and high adherence to the programme, coupled with beneficial changes shown in the intervention group, support the conduct of a full-scale trial investigating the effectiveness of prehabilitation.
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