Effectiveness of prehabilitation on outcomes following total knee and hip arthroplasty for osteoarthritis: a systematic review and meta-analysis of randomized controlled trials.

Autor: Adebero T; Faculty of Health Sciences, Department of Health and Rehabilitation Sciences, University of Western Ontario, London, Canada., Omana H; Faculty of Health Sciences, Department of Health and Rehabilitation Sciences, University of Western Ontario, London, Canada., Somerville L; Schulich School of Medicine & Dentistry, Department of Surgery, University of Western Ontario, London, Canada., Lanting B; Schulich School of Medicine & Dentistry, Department of Surgery, University of Western Ontario, London, Canada., Hunter SW; Faculty of Health Sciences, Department of Health and Rehabilitation Sciences, University of Western Ontario, London, Canada.; School of Physical Therapy, University of Western Ontario, London, Canada.
Jazyk: angličtina
Zdroj: Disability and rehabilitation [Disabil Rehabil] 2024 Feb 13, pp. 1-20. Date of Electronic Publication: 2024 Feb 13.
DOI: 10.1080/09638288.2024.2313128
Abstrakt: 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.
Databáze: MEDLINE
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