OBJECTIVE: To summarize the evidence regarding the effectiveness and dose-response characteristics of pre-operative exercise programmes on post-operative physical function following total knee arthroplasty. DATA SOURCES: CINAHL, Cochrane Library, PubMed, SPORTDiscus and EMBASE. STUDY SELECTION: Randomized controlled trials were eligible if they provided full description of physiological stress (i.e. mode, frequency, intensity and duration). DATA EXTRACTION: Data extraction and evaluation were performed by one reviewer. Methodological quality of the selected studies was assessed using the Physiotherapy Evidence Database scale. DATA SYNTHESIS: Twelve candidate studies were identified, but only 3 papers satisfied all inclusion criteria: 2 studies evaluated the effect of resistance training and 1 trial investigated proprioceptive training. The latter study elicited significantly enhanced post-operative gains in function for indices of standing balance (overall stability index: Hedges' g = -1; anteroposterior stability index: Hedges' g = -1.15; 6 weeks post-surgery). Results of meta-analysis based on the findings of 2 studies showed that, compared with controls, prehabilitative exercise involving resistance training offered no additional gains in isometric quadriceps muscle strength at 6 and 12 weeks post-operatively. CONCLUSION: Despite a potential for efficacy of exercise-based conditioning, this review highlights the scarcity of robust dose-response evidence to guide the formulation of total knee arthroplasty prehabilitation effectively.
OBJECTIVE: To summarize the evidence regarding the effectiveness and dose-response characteristics of pre-operative exercise programmes on post-operative physical function following total knee arthroplasty. DATA SOURCES: CINAHL, Cochrane Library, PubMed, SPORTDiscus and EMBASE. STUDY SELECTION: Randomized controlled trials were eligible if they provided full description of physiological stress (i.e. mode, frequency, intensity and duration). DATA EXTRACTION: Data extraction and evaluation were performed by one reviewer. Methodological quality of the selected studies was assessed using the Physiotherapy Evidence Database scale. DATA SYNTHESIS: Twelve candidate studies were identified, but only 3 papers satisfied all inclusion criteria: 2 studies evaluated the effect of resistance training and 1 trial investigated proprioceptive training. The latter study elicited significantly enhanced post-operative gains in function for indices of standing balance (overall stability index: Hedges' g = -1; anteroposterior stability index: Hedges' g = -1.15; 6 weeks post-surgery). Results of meta-analysis based on the findings of 2 studies showed that, compared with controls, prehabilitative exercise involving resistance training offered no additional gains in isometric quadriceps muscle strength at 6 and 12 weeks post-operatively. CONCLUSION: Despite a potential for efficacy of exercise-based conditioning, this review highlights the scarcity of robust dose-response evidence to guide the formulation of total knee arthroplasty prehabilitation effectively.
Authors: Jungae An; Ho-Kwang Ryu; Suk-Joo Lyu; Hyuk-Jong Yi; Byoung-Hee Lee Journal: Int J Environ Res Public Health Date: 2021-06-04 Impact factor: 3.390
Authors: Rasmus Skov Husted; Anders Troelsen; Kristian Thorborg; Michael Skovdal Rathleff; Henrik Husted; Thomas Bandholm Journal: Trials Date: 2018-01-18 Impact factor: 2.279