title: A pre-operative group rehabilitation programme provided limited benefit for people with severe hip and knee osteoarthritis.
abstract: OBJECTIVE
  To determine if a pre-operative group rehabilitation programme can improve arthritis self-efficacy for people with severe hip and knee osteoarthritis.
  
  
  METHODS
  Single group, repeated measures design: 4-week baseline phase followed by a 6-week intervention phase of water exercise, and education with self-management strategies. The primary outcome was arthritis self-efficacy. The secondary outcomes were measures of pain (WOMAC), activity limitation (WOMAC), activity performance (30 s chair stand test, 10 m walk test) and health-related quality of life (EuroQol).
  
  
  RESULTS
  Twenty participants (10 knee osteoarthritis and 10 hip osteoarthritis) with a mean age of 71 years (SD 7) attended 92% (SD 10%) of the scheduled sessions. All measures demonstrated baseline stability between two time points for measurements at week 1 and measurements at week 4. After the 6-week intervention programme there were no significant improvements for arthritis self-efficacy. There was a 12% increase for fast walking speed (mean increase of 0.14 m/s, 95% CI 0.07, 0.22). There were no significant improvements for other secondary outcomes.
  
  
  CONCLUSIONS
  A pre-operative water-based exercise and educational programme did not improve arthritis self-efficacy, self-reported pain and activity limitation, and health-related quality of life for people with hip and knee osteoarthritis who were candidates for joint replacement. While there was a significant increase in one measure of activity performance (walking speed), these findings suggest the current programme may be of little value. Implications for Rehabilitation This pre-operative group rehabilitation programme for people with severe hip and knee osteoarthritis did not change arthritis self-efficacy, pain, activity limitation and health-related quality of life. This programme may have little value in preparing people for joint replacement surgery. The optimal pre-operative programme requires further design and investigation.
authors.affiliation: School of Allied Health, La Trobe University , Melbourne , Australia .
authors.forename: Jason A
authors.initials: JA
authors.lastname: Wallis
authors.forename: Kate E
authors.initials: KE
authors.lastname: Webster
authors.forename: Pazit
authors.initials: P
authors.lastname: Levinger
authors.forename: Cynthia
authors.initials: C
authors.lastname: Fong
authors.forename: Nicholas F
authors.initials: NF
authors.lastname: Taylor
mesh_terms: D000368:Aged; D001315:Australia; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D051346:Mobility Limitation; D009520:New Zealand; D015207:Osteoarthritis, Hip / Q000523:psychology / Q000534:rehabilitation; D020370:Osteoarthritis, Knee / Q000523:psychology / Q000534:rehabilitation; D057234:Preoperative Period; D015397:Program Evaluation; D011788:Quality of Life; D012648:Self Care / Q000379:methods / Q000523:psychology; D020377:Self Efficacy; D012720:Severity of Illness Index; D016896:Treatment Outcome; D016138:Walking
keywords: Hip; knee; osteoarthritis; pre-operative rehabilitation; self-efficacy