Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2024 Jan 8:56:jrm18326.
doi: 10.2340/jrm.v56.18326.

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

Pascale Gränicher  1 , Loes Mulder  2 , Ton Lenssen  2 , Sandro F Fucentese  3 , Jaap Swanenburg  4 , Rob De Bie  5 , Johannes Scherr  6
Affiliations
Randomized Controlled Trial

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

Pascale Gränicher et al. J Rehabil Med. .

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.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
Consolidated Standards of Reporting Trials (CONSORT) flow chart of randomized controlled trials. CG: control group; IG: intervention group; prehab: prehabilitation.
Fig. 2
Fig. 2
Frequency distribution of Tegner Activity Scale (TAS) levels T1-T4 per group. CG: control group; IG: intervention group; preop: preoperative; postop: postoperative; wk: weeks.
Fig. 3
Fig. 3
Change of mean values in Knee Osteoarthritis Outcome Score (KOOS) sports. Preop: preoperative; postop: postoperative; CG: control group; IG: intervention group; wk: weeks.
Fig. 4
Fig. 4
Change of mean values on Tegner Activity Scale (TAS). Preop: preoperative; postop: postoperative; wk: weeks; CG: control group; IG: intervention group.
See this image and copyright information in PMC

References

    1. Beck M, Christen B, Zdravkovic V, Brand C. Implantatregister SIRIS Hüfte und Knie: Kurzfassung – SIRIS Report 2022. Bern: SIRIS; 2022.
    1. Ben-Shlomo Y, Blom A, Boulton C, et al. . The National Joint Registry 19th Annual Report 2022 [Accessed November 30, 2023]. London: National Joint Registry. Available from: https://www.ncbi.nlm.nih.gov/books/NBK587525/. - PubMed
    1. Klem NR, Kent P, Smith A, Dowsey M, Fary R, Schutze R, et al. . Satisfaction after total knee replacement for osteoarthritis is usually high, but what are we measuring? A systematic review. Osteoarthr Cartil Open 2020; 2: 100032. DOI: 10.1016/j.ocarto.2020.100032 - DOI - PMC - PubMed
    1. Mohammad HR, Gooberman-Hill R, Delmestri A, Broomfield J, Patel R, Huber J, et al. . Risk factors associated with poor pain outcomes following primary knee replacement surgery: analysis of data from the clinical practice research datalink, hospital episode statistics and patient reported outcomes as part of the STAR research programme. PLoS One 2021; 16: e0261850. DOI: 10.1371/journal.pone.0261850 - DOI - PMC - PubMed
    1. Olsen U, Lindberg MF, Rose C, Denison E, Gay C, Aamodt A, et al. . Factors correlated with physical function 1 year after total knee arthroplasty in patients with knee osteoarthritis: a systematic review and meta-analysis. JAMA Netw Open 2022; 5: e2219636. DOI: 10.1001/jamanetworkopen.2022.19636 - DOI - PMC - PubMed

Publication types