Prehabilitation program improved outcomes for patients undergoing orthopedic surgery
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Key takeaways:
- Prehabilitation improved several preoperative and postoperative outcomes for patients undergoing orthopedic surgery.
- Two prehabilitation sessions per week for 4 to 6 weeks may be recommended.
Published results showed a prehabilitation intervention program was associated with improved preoperative and postoperative outcomes for patients undergoing orthopedic surgery.
Anuj Punnoose, MSc, and colleagues performed a systematic review of 48 randomized controlled trials to compare outcomes of a prehabilitation program and a standard preoperative protocol for 3,570 patients (mean age of 64.1 years) who underwent total knee replacement, total hip replacement or lumbar surgery from Jan. 1, 2000, to June 30, 2022.
According to the study, the prehabilitation protocol consisted of muscle strengthening exercises, pain management, acupuncture and electrical stimulation. Outcomes were assessed preoperatively and postoperatively and included pain scores, muscle strength, function, health-related quality of life (HRQoL), anxiety, depression and range of motion.
Punnoose and colleagues found patients who received prehabilitation prior to TKR had improved function, muscle strength and flexion compared with those in a standard preoperative protocol. Patients who received prehabilitation prior to THR had improved HRQoL and SF-36 health survey scores, as well as improved muscle strength and abduction compared with those in the standard protocol. Similarly, patients who received prehabilitation prior to lumbar surgery had improved HRQoL scores.
Postoperatively, researchers noted prehabilitation was associated with improved function for patients who underwent TKR at 6 weeks and patients who underwent lumbar surgery at 6 months.
“Prehabilitation programs with a combination of supervised and unsupervised sessions can be safely administered with minimal risks,” the researchers wrote in the study. “A minimum duration of 4 to 6 weeks and two sessions per week may be recommended for patients undergoing orthopedic surgery,” they added.
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