The effect of prehabilitation on the range of motion and functional outcomes in patients following the total knee or hip arthroplasty: A pilot randomized trial.

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.