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Gränicher P, Mulder L, Lenssen T, Fucentese SF, Swanenburg J, De Bie R, Scherr J. Exercise- and education-based prehabilitation before total knee arthroplasty: a pilot study. J Rehabil Med 2024; 56:jrm18326. [PMID: 38192160 PMCID: PMC10859968 DOI: 10.2340/jrm.v56.18326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/06/2023] [Indexed: 01/10/2024] Open
Abstract
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.
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Affiliation(s)
- Pascale Gränicher
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Peter Debyeplein 1, 6229 HA Maastricht, The Netherlands; University Center for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Forchstrasse 319, CH-8008 Zurich, Switzerland.
| | - Loes Mulder
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Peter Debyeplein 1, 6229 HA Maastricht, The Netherlands; Maastricht University MUMC+, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Ton Lenssen
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Peter Debyeplein 1, 6229 HA Maastricht, The Netherlands; Maastricht University MUMC+, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Sandro F Fucentese
- Department of Orthopedic Surgery, Balgrist University Hospital, University of Zurich, Forchstrasse 340, CH-8008 Zurich, Switzerland
| | - Jaap Swanenburg
- Integrative Spinal Research ISR, Department of Chiropractic Medicine, Balgrist University Hospital. Forchstrasse 340, 8008, Zurich, Switzerland; UZH Space Hub, Air Force Center - Überlandstrasse 271, 8600 Dübendorf, Switzerland; Institute of Anatomy, Faculty of Medicine, University of Zurich - Winterthurerstrasse 190, 8057 Zurich, Switzerland
| | - Rob De Bie
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Peter Debyeplein 1, 6229 HA Maastricht, The Netherlands
| | - Johannes Scherr
- University Center for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Forchstrasse 319, CH-8008 Zurich, Switzerland
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