Exercise- and education-based prehabilitation before total knee arthroplasty: a pilot study

• Published in: Journal of rehabilitation medicine Vol. 56; p. jrm18326
• Main Authors: Gränicher, Pascale, Mulder, Loes, Lenssen, Ton, Fucentese, Sandro F., Swanenburg, Jaap, De Bie, Rob, Scherr, Johannes
• Format: Journal Article
• Language: English
• Published: Sweden Journal of Rehabilitation Medicine 08.01.2024; Medical Journals Sweden AB; Medical Journals Sweden
• Subjects: Aged; Arthroplasty; Arthroplasty, Replacement, Knee; Clinical outcomes; Critical incidents; Customization; Exercise; Exercise Therapy; Feasibility; Humans; Intervention; Joint replacement surgery; Knee; Knee Joint; Original Report; Osteoarthritis; Patients; Pilot Projects; Preoperative Exercise; Recovery of Function; Surgery
• ISSN: 1651-2081; 1650-1977; 1651-2081
• DOI: 10.2340/jrm.v56.18326

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 4–8-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, η² = 0.139) and Tegner Activity Scale (F(2.2/39.1) = 3.20, p = 0.048, η² = 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.