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Effects of pre- or postoperative therapeutic exercise on the quality of life, before and after total knee arthroplasty for osteoarthritis
Evgeniadis G, Beneka A, Malliou P, Mavromoustakos S, Godolias G
Journal of Back and Musculoskeletal Rehabilitation 2008;21(3):161-169
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; 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 investigate the effects of a preoperative or postoperative rehabilitation program on health related quality of life, for patients affected by final-stage idiopathic knee osteoarthritis, before and after primary total knee arthroplasty. DESIGN: 53 successive patients (aged 68.76 +/- 5.64 years) were randomly assigned to receive a general strengthening exercise program for 3 weeks preoperatively (PROP, n = 18) or a specific strengthening rehabilitation program for 8 weeks postoperatively (POP, n = 15). The control group followed standard preoperative and postoperative care (CON, n = 20). MEASUREMENTS: Health status (Short Form-36), functional ability (Iowa Level of Assistance Scale), active range of motion (AROM). RESULTS: PROP group showed improvement in their mental health dimensions preoperatively and better functional readiness at hospital discharge. POP group achieved higher level of functional ability (p < 0.05) after the exercise intervention and realized a substantial increment of AROM (p < 0.05). CONCLUSIONS: A preoperative general strengthening exercise program is feasible, seems to be beneficial to patients' mental health affected by final-stage idiopathic knee osteoarthritis and assists in the early return of basic functional abilities during the in-patient rehabilitation period. A postoperative specific strengthening exercise intervention is effective in increasing the active range of motion and restoring rapidly the functional autonomy throughout the out-patient intermediate rehabilitation phase.

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