Key result
Preoperative exercise modestly reduces postoperative pain within two months of joint replacement surgery versus controls.
Why the study?
Preoperative exercise is commonly used to reduce pain and improve postoperative function, but its therapeutic benefits across various surgical types needed to be determined.
Does a preoperative exercise program reduce postoperative pain and improve function in individuals undergoing surgery?
Meta-Analysis
Does a preoperative exercise program reduce postoperative pain and improve function in individuals undergoing surgery?
Effect estimate: SMD -0.34 (95% CI -0.59 to -0.09)
Preoperative exercise provides modest, short-term improvements in pain, function, and quality of life, and reduces complications within the first 6 months after joint replacement surgery.
Supports preoperative exercise for early post-joint replacement pain relief; extends Level 1 evidence for prehabilitation in orthopedics.
OBJECTIVE: Preoperative exercise (prehabilitation) is commonly used as a method to reduce pain and improve function postoperatively. The purpose of this systematic review was to determine therapeutic benefits of preoperative exercise on postoperative pain, function, quality of life (QOL), and risk of complications across various types of surgeries. METHODS: Three electronic databases were used to perform a literature search. Full articles with randomized designs comparing a preoperative exercise program vs no formal program were included. The primary outcome was postoperative pain. QOL, function, and postoperative complications were analyzed as secondary outcomes. The primary meta-analysis was performed in those with joint replacement surgery because there were only 5 with other surgical types. RESULTS: A total of 28 articles were included, of which 23 were from individuals with total joint replacement surgery. Preoperative exercise resulted in lower pain ≤2 months and 3 to 5 months after joint replacement surgery with a moderate standardized mean difference (95% CI at <2 months = -0.34 [-0.59 to -0.09]; at 3 to 5 months = -0.41 [-0.70 to -0.11]) compared with nonexercised controls. However, ≥6 months after joint replacement surgery, preoperative exercise groups showed no significant differences in postoperative pain (standardized mean difference = -0.17 [-0.35 to 0.01]) compared with nonexercised controls. QOL and subjective and objective function were improved ≤2 months after joint replacement surgery but were not different ≥6 months post-surgery. Reduction in risk of postoperative complications was favored with preoperative exercise. CONCLUSION: Preoperative exercise has a modest effect on postoperative pain, function, and quality of life within the first 6 months after surgery and reduces the risk of developing postoperative complications in individuals undergoing joint replacement surgery. The effect of preoperative exercise on other surgery types is inconclusive. IMPACT: This systematic review supports using preoperative exercise to improve pain and function outcomes for those with joint replacement surgery.
No takes yet. Share an insight, caveat, or question.
Hayashi et al. (2022) conducted a meta-analysis in Joint replacement surgery. Preoperative exercise vs. No formal program (nonexercised controls) was evaluated on Postoperative pain ≤2 months after joint replacement surgery (SMD -0.34, 95% CI -0.59 to -0.09). Preoperative exercise modestly reduced postoperative pain at ≤2 months (SMD -0.34; 95% CI -0.59 to -0.09) after joint replacement surgery compared with nonexercised controls.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: