Effects of resistance training prior to total hip or knee replacement on postoperative recovery in functional performance: A systematic review and meta-analysis

TY - JOUR

T1 - Effects of resistance training prior to total hip or knee replacement on postoperative recovery in functional performance: A systematic review and meta-analysis

AU - Jørgensen, Stian Langgård

AU - Kierkegaard-Brøchner, Signe

AU - Bohn, Marie Bagger

AU - Aagaard, Per

AU - Mechlenburg, Inger

PY - 2022/7/22

Y1 - 2022/7/22

N2 - OBJECTIVE: To evaluate the effectiveness of pre-operative resistance training in patients allocated to TJR surgery on selected post-operative outcomes, via a meta-analysis of studies using exercise modalities and loading intensities objectively known to promote gains in muscle size and strength in adults of young-to-old age. DESIGN: A systematic review and meta-analysis.LITERATURE SEARCH: Cochrane Central, MEDLINE, EMBASE, and PEDro were searched on August 4th 2021.STUDY SELECTION: Randomized Controlled Trials (RCTs) were included if (i) they compared pre-operative lower-limb-exercises before elective TJR with standard care, (ii) explicitly reported the exercise intensity, and (iii) reported data on functional performance.DATA SYNTHESIS: This systematic review and meta-analysis is reported in accordance with the PRISMA reporting guidelines. A random effects model with an adjustment to the confidence interval was performed for pooling the data.RESULTS: One thousand studies were identified. After applying exclusion criteria, five RCTs were located including 256 participants (mean age ranged from 61 to 72 years, 54% women). Moderate-to-large improvements in functional performance and maximal knee extensor strength were observed at 3 months after surgery along with small-to-moderate effects 12 months post-operatively. For patient-reported outcomes, small-to-moderate improvements were observed at 3 months post-operatively with no-to-small improvements at 12 months.CONCLUSION: Prehabilitation efforts involving progressive resistance training provides an effective means to improve post-operative outcomes related to functional performance, knee extensor strength and patient-reported outcome in patients undergoing TJR. Due to large methodological diversity between studies, an optimal loading intensity remains unknown.SYSTEMATIC REVIEW REGISTRATION: Prospero ID: CRD42021264796.

AB - OBJECTIVE: To evaluate the effectiveness of pre-operative resistance training in patients allocated to TJR surgery on selected post-operative outcomes, via a meta-analysis of studies using exercise modalities and loading intensities objectively known to promote gains in muscle size and strength in adults of young-to-old age. DESIGN: A systematic review and meta-analysis.LITERATURE SEARCH: Cochrane Central, MEDLINE, EMBASE, and PEDro were searched on August 4th 2021.STUDY SELECTION: Randomized Controlled Trials (RCTs) were included if (i) they compared pre-operative lower-limb-exercises before elective TJR with standard care, (ii) explicitly reported the exercise intensity, and (iii) reported data on functional performance.DATA SYNTHESIS: This systematic review and meta-analysis is reported in accordance with the PRISMA reporting guidelines. A random effects model with an adjustment to the confidence interval was performed for pooling the data.RESULTS: One thousand studies were identified. After applying exclusion criteria, five RCTs were located including 256 participants (mean age ranged from 61 to 72 years, 54% women). Moderate-to-large improvements in functional performance and maximal knee extensor strength were observed at 3 months after surgery along with small-to-moderate effects 12 months post-operatively. For patient-reported outcomes, small-to-moderate improvements were observed at 3 months post-operatively with no-to-small improvements at 12 months.CONCLUSION: Prehabilitation efforts involving progressive resistance training provides an effective means to improve post-operative outcomes related to functional performance, knee extensor strength and patient-reported outcome in patients undergoing TJR. Due to large methodological diversity between studies, an optimal loading intensity remains unknown.SYSTEMATIC REVIEW REGISTRATION: Prospero ID: CRD42021264796.

U2 - 10.3389/fspor.2022.924307

DO - 10.3389/fspor.2022.924307

M3 - Journal article

C2 - 35911376

SN - 2624-9367

VL - 4

JO - Frontiers in Sports and Active Living

JF - Frontiers in Sports and Active Living

ER -