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

Stuart Cavill, Kylie McKenzie, Adrienne Munro, Janice McKeever, Lucy Whelan, Luke Biggs, Elizabeth H. Skinner, Terry P. Haines

Research output: Contribution to journalArticleResearchpeer-review

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.

Original languageEnglish
Pages (from-to)262-270
Number of pages9
JournalPhysiotherapy Theory and Practice
Volume32
Issue number4
DOIs
Publication statusPublished - 18 May 2016

Keywords

  • Activities of daily living
  • arthroplasty (replacement)
  • range of motion (articular)
  • rehabilitation

Cite this

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title = "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.",
keywords = "Activities of daily living, arthroplasty (replacement), range of motion (articular), rehabilitation",
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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. / Cavill, Stuart; McKenzie, Kylie; Munro, Adrienne; McKeever, Janice; Whelan, Lucy; Biggs, Luke; Skinner, Elizabeth H.; Haines, Terry P.

In: Physiotherapy Theory and Practice, Vol. 32, No. 4, 18.05.2016, p. 262-270.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - The effect of prehabilitation on the range of motion and functional outcomes in patients following the total knee or hip arthroplasty

T2 - A pilot randomized trial

AU - Cavill, Stuart

AU - McKenzie, Kylie

AU - Munro, Adrienne

AU - McKeever, Janice

AU - Whelan, Lucy

AU - Biggs, Luke

AU - Skinner, Elizabeth H.

AU - Haines, Terry P.

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N2 - 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.

AB - 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.

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