Effect of pre-operative physiotherapy in patients with end-stage osteoarthritis undergoing hip arthroplasty

Ferrara, Paola Emilia; Rabini, Alessia; Maggi, Loredana; Piazzini, Diana Barbara; Logroscino, Giandomenico; Magliocchetti, G.; Amabile, Eugenia; Tancredi, G; Aulisa, Angelo Gabriele; Padua, Luca; Aprile, Irene; Bertolini, Carlo

doi:10.1177/0269215508094714

Cited by 74 publications

(130 citation statements)

References 27 publications

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“…488,493,494,496,497,[501][502][503]510,[513][514][515]519,521,525,527,534 In the random-effects meta-analysis shown in Table 76 and Figure 38, the average SMD was 0.28 (95% CI 0.16 to 0.40) favouring intervention. Inspection of the funnel plot did not suggest publication bias.…”

Section: Exercise and Education Interventions Before Thr And Tkrmentioning

confidence: 99%

“…Of the 36 interventions (32 articles) targeting optimisation of pre-surgical health, 14 interventions were in patients waiting for THR, [487][488][489][493][494][495][496][497][500][501][502][503][504]507 17 in patients waiting for TKR, 500,503,509-515,517,519-521,523-525 and five in total hip and knee patients together. [526][527][528][529]534 Eighteen interventions were specifically exercise based, 488,494,497,502,503,509,[511][512][513][514][515]519,520,[523][524][525] nine were education based, 52,489,495,500,501,526,527,529 while nine were multifactorial with exercise and education components and, in some cases, an occupational therapy base.…”

Section: Optimising Pre-surgical Healthmentioning

confidence: 99%

“…[526][527][528][529]534 Eighteen interventions were specifically exercise based, 488,494,497,502,503,509,[511][512][513][514][515]519,520,[523][524][525] nine were education based, 52,489,495,500,501,526,527,529 while nine were multifactorial with exercise and education components and, in some cases, an occupational therapy base. 487,493,496,504,507,510,517,521,528 Effect on pre-surgical physical function Physical function before surgery was measured after 21 interventions using WOMAC (physical function or total), SF-36 physical function, HHS, HOOS, HSS, Arthritis Impact Measure Score 2 (AIMS2), AKSS or locally devised scores. 512 USA; date not specified; A and C Knee; osteoarthritis; n = 32 (17 : 15); age and sex not described Exercise; home and physical therapy clinic; partially supervised resistance and flexibility exercises and step training, training booklet; twice a week at home and once a week at physical therapy clinic for 50 minutes from 8 weeks before surgery; usual pre-operative care Exercise (functional); outpatient and home; twice per week for 3-6 weeks and home four times per week; one physical therapist-led group session 3 weeks before surgery 2-4 days before admission and up to 6 we...…”

Section: Optimising Pre-surgical Healthmentioning

confidence: 99%

“…488 WOMAC function: Ferrara and colleagues, 493 Gilbey and colleagues, 494 McGregor and colleagues, 501 Rooks and colleagues, 503 Beaupre and colleagues, 510 Gstoettner and colleagues, 515 (control values were baseline), McKay and colleagues, 519 Nuñez and colleagues 521 and Crotty and colleagues. 527 WOMAC total score:…”

Section: Painmentioning

confidence: 99%

“…In three education-based interventions 495,501,527 and five multifactorial interventions, 487,493,510,517,521 there were trends for benefit, with SMDs of 0.20 (95% CI -0.03 to 0.44) and 0.27 (95% CI -0.04 to 0.58). Numbers in some groups were small but all types of programme content showed benefit for patients waiting for THR.…”

Section: Exercise and Education Interventions Before Thr And Tkrmentioning

confidence: 99%

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Improving patients’ experience and outcome of total joint replacement: the RESTORE programme

Blom

Artz

Beswick

et al. 2016

Programme Grants Appl Res

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General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms PROGRAMME GRANTS FOR APPLIED RESEARCH VOLUME 4 ISSUE 12 AUGUST 2016 ISSN 2050 DOI 10.3310/pgfar04120Improving patients' experience and outcome of total joint replacement: the RESTORE programme Ashley W Blom, Neil Artz, Andrew D Beswick, Amanda Burston, Paul Dieppe, Karen T Elvers, Rachael Gooberman-Hill, Jeremy Horwood, Paul Jepson, Emma Johnson, Erik Lenguerrand, Elsa Marques, Sian Noble, Mark Pyke, Catherine Sackley, Gina Sands, Adrian Sayers, Victoria Wells and Vikki Wylde Improving patients' experience and outcome of total joint replacement: the RESTORE programme ISSN 2050-4330 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full PGfAR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/pgfar. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Programme Grants for Applied Research journalReports are published in Programme Grants for Applied Research (PGfAR) if (1) they have resulted from work for the PGfAR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. Programme Grants for Applied Research programmeThe Programme Grants for Applied Research (PGfAR) programme, part of the National Institute for Health Research (NIHR), was set up in 2006 to produce independent research findings that will have practical application for the benefit of patients and the NHS in the relatively near future. The Programme is managed by the NIHR Central Commissioning Facility (CCF) with strategic input from the Programme Director.The programme is a national response mode funding scheme that aims to provide evidence to improve health outcomes in England through promotion of health, prevention of ill health, and optimal disease management (including safety and quality), with particular emphasis on conditions causing significant disease burden.For more information about the PGfAR programme please visit the website: http://www.nihr.ac.uk/funding/programme-grants-forapplied-research.htm This reportThe research reported in this issue of the journal was funded by PGfAR as project number RP-PG-0407-10070. The contractual start date was in December 2008. The final report began editorial review in September 2014 and was accepted for publication in August 2015. As the funder, the PGfAR programme agreed the research questions and study designs in advance with the investigators. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The PGfAR editors and production house have tried to ensure the accurac...

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Section: Exercise and Education Interventions Before Thr And Tkrmentioning

confidence: 99%

Section: Optimising Pre-surgical Healthmentioning

confidence: 99%

Section: Optimising Pre-surgical Healthmentioning

confidence: 99%

Section: Painmentioning

confidence: 99%

Section: Exercise and Education Interventions Before Thr And Tkrmentioning

confidence: 99%

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Improving patients’ experience and outcome of total joint replacement: the RESTORE programme

Blom

Artz

Beswick

et al. 2016

Programme Grants Appl Res

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Evaluation of Exercise Interventions and Outcomes After Hip Arthroplasty

Saueressig¹,

Owen

Zebisch³

et al. 2021

JAMA Netw Open

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IMPORTANCE Preoperative and postoperative exercise interventions are commonly used in patients with total hip arthroplasty despite a lack of established efficacy. OBJECTIVE To explore clinical outcomes associated with exercise training before and after hip arthroplasty. DATA SOURCES PubMed, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, EMBASE, and Google Scholar were searched from their inception to March 2020. Reference lists of included trials and related reviews were also searched. STUDY SELECTION Randomized clinical trials of land-based exercise interventions before or after total hip arthroplasty were included. DATA EXTRACTION AND SYNTHESIS This systematic review and meta-analysis is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Data extraction was independently performed in duplicate. Random-effects meta-analyses with restricted maximum likelihood were performed for pooling the data. MAIN OUTCOMES AND MEASURES The primary prespecified outcome was self-reported physical function. Secondary prespecified outcomes were self-reported pain intensity, quality of life, gait speed, lower body muscle strength, lower body flexibility, anxiety, hospital length of stay, and adverse events. RESULTS A total of 32 randomized clinical trials with 1753 patients were included in the qualitative synthesis, and 26 studies with 1004 patients were included in the meta-analysis. Compared with usual care or no or minimal intervention, postoperative exercise training was not associated with improved self-reported physical function, with a moderate level of certainty, at 4 weeks

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Prehabilitation for Patients Undergoing Orthopedic Surgery

et al. 2023

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ImportancePrehabilitation programs for patients undergoing orthopedic surgery have been gaining popularity in recent years. However, the current literature has produced varying results.ObjectiveTo evaluate whether prehabilitation is associated with improved preoperative and postoperative outcomes compared with usual care for patients undergoing orthopedic surgery.Data SourcesBibliographic databases (MEDLINE, CINAHL [Cumulative Index to Nursing and Allied Health Literature], AMED [Allied and Complementary Medicine], Embase, PEDRO [Physiotherapy Evidence Database], and Cochrane Central Register of Controlled Trials) were searched for published trials, and the Institute for Scientific Information Web of Science, System for Information on Grey Literature in Europe, and European clinical trials registry were searched for unpublished trials from January 1, 2000, to June 30, 2022.Study SelectionRandomized clinical trials (RCTs) comparing prehabilitation with standard care for any orthopedic surgical procedure were included.Data Extraction and SynthesisTwo independent reviewers screened trials. Data were pooled using a random-effects model. Recommendations were determined using the Grading of Recommendations Assessment, Development and Evaluation system and the study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline.Main Outcomes and MeasuresPain, function, muscle strength, and health-related quality of life (HRQOL).ResultsForty-eight unique trials involving 3570 unique participants (2196 women [61.5%]; mean [SD] age, 64.1 [9.1] years) were analyzed. Preoperatively, moderate-certainty evidence favoring prehabilitation was reported for patients undergoing total knee replacement (TKR) for function (standardized mean difference [SMD], −0.70 [95% CI, −1.08 to −0.32]) and muscle strength and flexion (SMD, 1.00 [95% CI, 0.23-1.77]) and for patients undergoing total hip replacement (THR) for HRQOL on the 36-item Short Form Health Survey (weighted mean difference [WMD], 7.35 [95% CI, 3.15-11.54]) and muscle strength and abduction (SMD, 1.03 [95% CI, 0.03-2.02]). High-certainty evidence was reported for patients undergoing lumbar surgery for back pain (WMD, –8.20 [95% CI, −8.85 to −7.55]) and moderate-certainty evidence for HRQOL (SMD, 0.46 [95% CI, 0.13-0.78]). Postoperatively, moderate-certainty evidence favoring prehabilitation was reported for function at 6 weeks in patients undergoing TKR (SMD, −0.51 [95% CI, −0.85 to −0.17]) and at 6 months in those undergoing lumbar surgery (SMD, −2.35 [95% CI, −3.92 to −0.79]). Other differences in outcomes favoring prehabilitation were of low to very low quality of evidence.Conclusions and RelevanceIn this systematic review and meta-analysis of RCTs, moderate-certainty evidence supported prehabilitation over usual care in improving preoperative function and strength in TKR and HRQOL and muscle strength in THR, high-certainty evidence in reducing back pain, and moderate-certainty evidence in improving HRQOL in lumbar surgery. Postoperatively, moderate-certainty evidence supported prehabilitation for function following TKR at 6 weeks and lumbar surgery at 6 months. Prehabilitation showed promising results for other outcomes, although high risk of bias and heterogeneity affected overall quality of evidence. Additional RCTs with a low risk of bias investigating preoperative and postoperative outcomes for all orthopedic surgical procedures are required.

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Effect of pre-operative physiotherapy in patients with end-stage osteoarthritis undergoing hip arthroplasty

Abstract: Pre-operative physiotherapy in patients undergoing hip arthroplasty does not improve impairment and health-related quality of life after intervention. Physiotherapy and educational therapy may be useful for end-stage osteoarthritis.

Cited by 74 publications

References 27 publications

Improving patients’ experience and outcome of total joint replacement: the RESTORE programme

Improving patients’ experience and outcome of total joint replacement: the RESTORE programme

Evaluation of Exercise Interventions and Outcomes After Hip Arthroplasty

Prehabilitation for Patients Undergoing Orthopedic Surgery

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