Effectiveness of prehabilitation on outcomes following total knee and hip arthroplasty for osteoarthritis: a systematic review and meta-analysis of randomized controlled trials.
Disabil Rehabil
; : 1-20, 2024 Feb 13.
Article
en En
| MEDLINE
| ID: mdl-38349251
ABSTRACT
PURPOSE:
To quantify the effectiveness of prehabilitation prior to total knee and hip arthroplasty (TKA/THA) for osteoarthritis on postoperative outcomes assessed by self-report and performance-based measures.METHODS:
Embase, MEDLINE, CENTRAL, CINAHL and Scopus (inception-August 2022) were searched for randomized controlled trials. Self-report outcomes were function, health-related quality of life (HRQoL), and pain. Performance-based outcomes were strength, range of motion (ROM), balance, and functional mobility. The RoB 2.0 assessed risk of bias. Random-effects meta-analysis was performed up to 52 weeks after TKA/THA.RESULTS:
High risk of bias was found in 24 of 28 trials. Prehabilitation improved function (SMD = 0.50 [95%CI 0.23, 0.77]), pain (SMD = 0.44 [95%CI 0.17, 0.71]), HRQoL (SMD = 0.28 [95%CI 0.12, 0.43]), strength (SMD = 0.72 [95%CI 0.47, 0.98]), ROM (SMD = 0.31 [95%CI 0.02, 0.59]), and functional mobility (SMD = 0.39 [95%CI 0.05, 0.73]) post-TKA. No significant effect of prehabilitation on balance (SMD = 0.28 [95%CI -0.11, 0.66]) post-TKA. All outcomes assessed had significant heterogeneity (p < 0.01). There were limited and contradictory trials (n = 2) for THA.CONCLUSION:
High risk of bias and significant heterogeneity observed in our meta-analysis prevent conclusions regarding prehabilitation effectiveness on outcomes up to one year after TKA/THA.
Prehabilitation has been promoted to improve postoperative outcomes and shorten recovery periods after total knee/hip arthroplasty (TKA/THA) for osteoarthritisPrehabilitation improved relevant self-report and performance-based outcomes after TKA surgeryA high risk of bias and significant heterogeneity across trials prevent drawing any conclusionsMore high-quality research is required before recommending the implementation of prehabilitation programs in clinical practice for people awaiting TKA/THA.
Texto completo:
1
Banco de datos:
MEDLINE
Tipo de estudio:
Clinical_trials
/
Systematic_reviews
Idioma:
En
Revista:
Disabil Rehabil
Asunto de la revista:
REABILITACAO
Año:
2024
Tipo del documento:
Article
País de afiliación:
Canadá