Does prehabilitation improve preoperative and postoperative outcomes compared to usual care in patients undergoing orthopedic surgery?
Patients undergoing orthopedic surgery (specifically total knee replacement [TKR], total hip replacement [THR], and lumbar surgery)
Prehabilitation
Usual care
Preoperative function, strength, health-related quality of life (HRQOL), and back pain; postoperative functionpatient reported
Prehabilitation provides moderate-to-high certainty evidence for improving preoperative and postoperative functional outcomes, strength, and quality of life in patients undergoing major orthopedic surgeries.
In this systematic review and meta-analysis of RCTs, moderate-certainty evidence supported prehabilitation over usual care in improving preoperative function and strength in TKR and HRQOL and muscle strength in THR, high-certainty evidence in reducing back pain, and moderate-certainty evidence in improving HRQOL in lumbar surgery. Postoperatively, moderate-certainty evidence supported prehabilitation for function following TKR at 6 weeks and lumbar surgery at 6 months. Prehabilitation showed promising results for other outcomes, although high risk of bias and heterogeneity affected overall quality of evidence. Additional RCTs with a low risk of bias investigating preoperative and postoperative outcomes for all orthopedic surgical procedures are required.
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Anuj Punnoose
Cambridge University Hospitals NHS Foundation Trust
Leica S. Claydon
Anglia Ruskin University
Ori Weiss
Meir Medical Center
JAMA Network Open
Western University
National Health Service
Cambridge University Hospitals NHS Foundation Trust
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Punnoose et al. (Thu,) studied this question.
synapsesocial.com/papers/69d83b2152654bb436d18c78 — DOI: https://doi.org/10.1001/jamanetworkopen.2023.8050
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