Effects of prehabilitation training on skeletal muscle mass and strength prior to total joint replacement: A systematic review and meta-analysis.

TY - ABST

T1 - Effects of prehabilitation training on skeletal muscle mass and strength prior to total joint replacement: 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

Y1 - 2022

N2 - Twenty percent of patients receiving total hip or knee replacement (TJR) report non- optimal postoperative outcome. Increasing preoperative lower-limb-strength prior to TJR may improve postoperative functional performance.MATERIALS AND METHODSEligibility criteria: RCTs 1) comparing preoperative lower-limb-exercises before TJR with standard care 2) explicitly reporting the exercise intensity and 3) reporting functional performance were included.Information sources: Cochrane Central, MEDLINE, EMBASE, and PEDro were searched in August 2021.Risk of bias: Cochrane Risk of Bias tool was used to evaluate the risk of bias and conducted by to reviewers.Synthesis of results: Functional performance knee-extensor strength 3 months postoperatively as well as 12 months postoperative.RESULTSSeven RCTs including 234 participants were included.A moderate effect favoring prehabilitation training on sit-to-stand performance was observed three months postoperatively (SMD(95%CI) (0.77; 0.43 to 1.12), along with moderate-to-large effects on Timed Up&Go (-1.33; -2.55 to -0.11), walking speed (-0.78; -1.16 to -0.41) and knee extensor-strength (0.55; 0.11 to 0.99).Small-to-moderate effects favoring prehabilitation were observed twelve months postoperatively for sit-to-stand (0.49; 0.12-0.86), walking speed (-0.37; -0.74 to -0.00), stairclimbing (-0.55;-1.03 to -0.06) and knee-extensor strength (0.49; 0.16 to 0.81).CONCLUSIONPrehabilitation prior to TJR induce long-lasting improvements in functional performance and knee extensor muscle strength that are of moderate-to-large effect size.

AB - Twenty percent of patients receiving total hip or knee replacement (TJR) report non- optimal postoperative outcome. Increasing preoperative lower-limb-strength prior to TJR may improve postoperative functional performance.MATERIALS AND METHODSEligibility criteria: RCTs 1) comparing preoperative lower-limb-exercises before TJR with standard care 2) explicitly reporting the exercise intensity and 3) reporting functional performance were included.Information sources: Cochrane Central, MEDLINE, EMBASE, and PEDro were searched in August 2021.Risk of bias: Cochrane Risk of Bias tool was used to evaluate the risk of bias and conducted by to reviewers.Synthesis of results: Functional performance knee-extensor strength 3 months postoperatively as well as 12 months postoperative.RESULTSSeven RCTs including 234 participants were included.A moderate effect favoring prehabilitation training on sit-to-stand performance was observed three months postoperatively (SMD(95%CI) (0.77; 0.43 to 1.12), along with moderate-to-large effects on Timed Up&Go (-1.33; -2.55 to -0.11), walking speed (-0.78; -1.16 to -0.41) and knee extensor-strength (0.55; 0.11 to 0.99).Small-to-moderate effects favoring prehabilitation were observed twelve months postoperatively for sit-to-stand (0.49; 0.12-0.86), walking speed (-0.37; -0.74 to -0.00), stairclimbing (-0.55;-1.03 to -0.06) and knee-extensor strength (0.49; 0.16 to 0.81).CONCLUSIONPrehabilitation prior to TJR induce long-lasting improvements in functional performance and knee extensor muscle strength that are of moderate-to-large effect size.

M3 - Conference abstract for conference

SP - xx-xx

ER -