title: The effect of prehabilitation on the range of motion and functional outcomes in patients following the total knee or hip arthroplasty: A pilot randomized trial.
abstract: OBJECTIVE
  The study investigated the effect of prehabilitation on the quality of life and function in patients having total knee replacement (TKR)/total hip replacement (THR).
  
  
  METHODS
  A pilot randomized controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis was conducted. Sixty-four people undergoing elective lower-limb arthroplasty were included. Prehabilitation included one-hour twice-weekly sessions for at least three and a maximum of four weeks prior to surgery. Control participants did not complete any pre-surgical programs. Health utility and quality of life as measured by the EQ-5D-3L and the patient-specific functional scale were the primary outcomes measured before allocation and eight weeks post-operatively.
  
  
  RESULTS
  No between-group differences were evident in health utility (main effect of the group -0.04 (95% Confidence Interval [CI] -0.16 to 0.08, p = 0.50) or patient-specific functional scale (main effect of the group -0.59 (95% CI -1.8 to 0.6, p = 0.73), but the group-by-joint interaction effects for the timed up and go (TUG) (7.6 (95% CI -0.9 to 16.1, p = 0.08)) and the EQ-5D VAS (-18.3 (95% CI -41.1 to 4.5), p = 0.11) were larger. Prehabilitation participants' knee flexion improved by 12.6 degrees (95% CI 5.2-20, p = 0.001).
  
  
  CONCLUSIONS
  Prehabilitation improved knee flexion, but this did not translate into improved functional mobility or quality of life.
authors.affiliation: a Department of Physiotherapy , Monash Medical Centre, Monash Health , Clayton , Victoria , Australia.
authors.forename: Stuart
authors.initials: S
authors.lastname: Cavill
authors.affiliation: a Department of Physiotherapy , Monash Medical Centre, Monash Health , Clayton , Victoria , Australia.
authors.forename: Kylie
authors.initials: K
authors.lastname: McKenzie
authors.affiliation: b Department of Occupational Therapy , Alfred Hospital , Prahran , Victoria , Australia.
authors.forename: Adrienne
authors.initials: A
authors.lastname: Munro
authors.affiliation: c Department of Occupational Therapy , Dandenong Hospital, Monash Health , Dandenong , Victoria , Australia.
authors.forename: Janice
authors.initials: J
authors.lastname: McKeever
authors.affiliation: d Department of Physiotherapy, Community Rehabilitation , Monash Health , Cranbourne , Victoria , Australia.
authors.forename: Lucy
authors.initials: L
authors.lastname: Whelan
authors.affiliation: d Department of Physiotherapy, Community Rehabilitation , Monash Health , Cranbourne , Victoria , Australia.
authors.forename: Luke
authors.initials: L
authors.lastname: Biggs
authors.affiliation: e Allied Health Research Unit, Monash Medical Centre, Monash Health , Clayton , Victoria , Australia.|f Department of Physiotherapy , Sunshine Hospital, Western Health, Sunshine , Victoria , Australia.
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Skinner
authors.affiliation: e Allied Health Research Unit, Monash Medical Centre, Monash Health , Clayton , Victoria , Australia.|g Department of Physiotherapy, Faculty of Medicine Nursing and Health Science , Monash University , Frankston , Victoria , Australia.
authors.forename: Terry P
authors.initials: TP
authors.lastname: Haines
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000534:rehabilitation*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000534:rehabilitation*; D001696:Biomechanical Phenomena; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000009:adverse effects; D005260:Female; D006621:Hip Joint / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D057194:Intention to Treat Analysis; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011300:Preoperative Care / Q000009:adverse effects / Q000379:methods*; D011446:Prospective Studies; D016059:Range of Motion, Articular; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D014739:Victoria
keywords: Activities of daily living; arthroplasty (replacement); range of motion (articular); rehabilitation