title: Prehabilitation improves physical function of individuals with severe disability from hip or knee osteoarthritis.
abstract: OBJECTIVE
  To evaluate the effects of prehabilitation (enhancing physical capacity before total hip or knee joint arthroplasty) on pain and physical function of adults with severe hip and knee osteoarthritis (OA).
  
  
  METHODS
  Consecutive patients (n=650) from 2006 to 2008 with hip or knee OA awaiting total joint arthroplasty (TJA) attended a hospital outpatient clinic for a prehabilitation assessment. All participants completed self-report (Lower Extremity Functional Scale [LEFS] and visual analogue scale for pain [VAS]) and functional performance measures (self-paced walk [SPW], timed stair, and timed up-and-go [TUG] tests). A subset of 28 participants with severe disability participated in a structured outpatient prehabilitation programme. Between-group differences were assessed via independent t-tests; paired Student's t-tests and Wilcoxon signed rank tests were used to compare changes in pain and function following the prehabilitation programme.
  
  
  RESULTS
  A total of 28 individuals (16 female) with mean age 67 (SD 10) years and BMI 33 (8) kg/m(2) awaiting TJA (10 hips, 18 knees) participated in a prehabilitation programme of 9 (6) weeks' duration. Relative to baseline, there was significant improvement in LEFS score (mean change 7.6; 95% CI, 1.7-13.5; p=0.013), SPW (mean change 0.17 m/s; 95% CI, 0.07-0.26; p=0.001), TUG (mean change 4.2 s; 95% CI, 2.0-6.4; p<0.001), and stair test performance (mean change 3.8 s [SD 14.6]; p=0.005) following prehabilitation.
  
  
  CONCLUSIONS
  This study presents preliminary evidence that prehabilitation improves physical function even in the most severely compromised patients with OA awaiting TJA.
authors.affiliation: School of Rehabilitation, Faculty of Medicine ; University of Montreal Public Health Research Institute, University of Montreal ; Maisonneuve-Rosemont Hospital Research Center, University of Montreal Affiliated Research Center, Montreal.
authors.forename: François
authors.initials: F
authors.lastname: Desmeules
authors.affiliation: Hamilton Health Sciences Corporation, Hamilton, Ont.
authors.forename: Jayne
authors.initials: J
authors.lastname: Hall
authors.affiliation: Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton ; McCaig Institute for Bone and Joint Health, Calgary, Alta.
authors.forename: Linda June
authors.initials: LJ
authors.lastname: Woodhouse
keywords: arthroplasty; exercise; osteoarthritis; physical therapy specialty; rehabilitation