Medicine & Science in Sports & Exercise:
Friday Afternoon Poster Presentations: Posters displayed from 1:00-6:00 p.m.: One-hour author presentation times are staggered from 2:00-3:00 p.m., 3:00-4:00 p.m., and 4:00-5:00 p.m.: F-25 Free Communication/Poster - Clinical Exercise Testing II: FRIDAY, JUNE 2, 2006 2:00 PM - 5:00 PM: ROOM: Hall B
University of Louisville, Louisville, KY.
Conditioning the body to undergo physical stress is integral in sports. This concept can be applied to conditioning the body prior to stressful events such as joint arthroplasty and is termed prehabilitation.
PURPOSE: The purpose of this case study was to examine the effect of an 8-week prehabilitation intervention on functional ability following total knee arthroplasty (TKA).
METHODS: Two female subjects completed baseline assessments of their functional ability 8 weeks prior to their TKA. Subjects were randomized to either an 8-week prehabilitation intervention designed to increase their strength and range of motion, or a usual care condition. After 8 weeks subjects were re-assessed in the week prior to their TKA. Subjects completed a final assessment of their functional ability 12 weeks after TKA. These assessments of functional ability consisted of the distance covered in a 6-minute walk, the number of times up from a chair in 30-seconds, proprioception and self-reported pain and stiffness using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).
RESULTS: Compared to the Control Subject (CS), the data suggests that the 8 weeks of prehabilitation completed by the Exercise Subject (ES) prior her TKA may have had a positive effect on functional outcomes after TKA. The ES exhibited improvement in distance covered during the 6-minute walk (ES: 26% improvement, CS: 2% decline) and greater improvement in number of chair rise repetitions completed in 30-secconds (ES: 44% improvement, CS: 23% improvement). Additionally, knee proprioception improved greater for the ES, compared to the CS (angle reproduction: ES: 267% improvement, CS: 20% improvement; movement detection: ES: 100% improvement, CS: no change from baseline). The ES also reported less pain (ES: 1100% less, CS: 350% less) and less joint stiffness (ES: 100% less, CS: 67% less).
CONCLUSIONS: A prehabilitation intervention designed to increase strength and range of motion appears to result in improved functioning following surgery over usual care among TKA patients. Prehabilitation prior to TKA may contribute to improved recovery after surgery, thus reducing the amount of physical therapy hours.