Stuart Cavill1, Kylie McKenzie1, Adrienne Munro2, Janice McKeever3, Lucy Whelan4, Luke Biggs4, Elizabeth H Skinner5,6, Terry P Haines5,7. 1. a Department of Physiotherapy , Monash Medical Centre, Monash Health , Clayton , Victoria , Australia. 2. b Department of Occupational Therapy , Alfred Hospital , Prahran , Victoria , Australia. 3. c Department of Occupational Therapy , Dandenong Hospital, Monash Health , Dandenong , Victoria , Australia. 4. d Department of Physiotherapy, Community Rehabilitation , Monash Health , Cranbourne , Victoria , Australia. 5. e Allied Health Research Unit, Monash Medical Centre, Monash Health , Clayton , Victoria , Australia. 6. f Department of Physiotherapy , Sunshine Hospital, Western Health, Sunshine , Victoria , Australia. 7. g Department of Physiotherapy, Faculty of Medicine Nursing and Health Science , Monash University , Frankston , Victoria , Australia.
Abstract
OBJECTIVE: The study investigated the effect of prehabilitation on the quality of life and function in patients having total knee replacement (TKR)/total hip replacement (THR). METHODS: A pilot randomized controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis was conducted. Sixty-four people undergoing elective lower-limb arthroplasty were included. Prehabilitation included one-hour twice-weekly sessions for at least three and a maximum of four weeks prior to surgery. Control participants did not complete any pre-surgical programs. Health utility and quality of life as measured by the EQ-5D-3L and the patient-specific functional scale were the primary outcomes measured before allocation and eight weeks post-operatively. RESULTS: No between-group differences were evident in health utility (main effect of the group -0.04 (95% Confidence Interval [CI] -0.16 to 0.08, p = 0.50) or patient-specific functional scale (main effect of the group -0.59 (95% CI -1.8 to 0.6, p = 0.73), but the group-by-joint interaction effects for the timed up and go (TUG) (7.6 (95% CI -0.9 to 16.1, p = 0.08)) and the EQ-5D VAS (-18.3 (95% CI -41.1 to 4.5), p = 0.11) were larger. Prehabilitation participants' knee flexion improved by 12.6 degrees (95% CI 5.2-20, p = 0.001). CONCLUSIONS: Prehabilitation improved knee flexion, but this did not translate into improved functional mobility or quality of life.
RCT Entities:
OBJECTIVE: The study investigated the effect of prehabilitation on the quality of life and function in patients having total knee replacement (TKR)/total hip replacement (THR). METHODS: A pilot randomized controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis was conducted. Sixty-four people undergoing elective lower-limb arthroplasty were included. Prehabilitation included one-hour twice-weekly sessions for at least three and a maximum of four weeks prior to surgery. Control participants did not complete any pre-surgical programs. Health utility and quality of life as measured by the EQ-5D-3L and the patient-specific functional scale were the primary outcomes measured before allocation and eight weeks post-operatively. RESULTS: No between-group differences were evident in health utility (main effect of the group -0.04 (95% Confidence Interval [CI] -0.16 to 0.08, p = 0.50) or patient-specific functional scale (main effect of the group -0.59 (95% CI -1.8 to 0.6, p = 0.73), but the group-by-joint interaction effects for the timed up and go (TUG) (7.6 (95% CI -0.9 to 16.1, p = 0.08)) and the EQ-5D VAS (-18.3 (95% CI -41.1 to 4.5), p = 0.11) were larger. Prehabilitation participants' knee flexion improved by 12.6 degrees (95% CI 5.2-20, p = 0.001). CONCLUSIONS: Prehabilitation improved knee flexion, but this did not translate into improved functional mobility or quality of life.
Entities:
Keywords:
Activities of daily living; arthroplasty (replacement); range of motion (articular); rehabilitation
Authors: Rachel Perry; Georgia Herbert; Charlotte Atkinson; Clare England; Kate Northstone; Sarah Baos; Tim Brush; Amanda Chong; Andy Ness; Jessica Harris; Anne Haase; Sanjoy Shah; Maria Pufulete Journal: BMJ Open Date: 2021-09-30 Impact factor: 3.006