Supervised strength-based prehabilitation interventions

Supervised strength-based prehabilitation exercise training interventions for patients on wait lists for total knee replacement(1-5). 

Intervention:

Five studies(1-5) examined the effectiveness of supervised strength-based training in patients awaiting total knee replacement. 

The interventions commenced between eight and three weeks prior to the date of surgery and consisted of between 12 and 30 supervised exercise sessions. In one study (moderate quality) (4), patients were supervised via video-call. In one study (strong quality)(3) exercise sessions took place in the hospital. The remainder of the studies did not report the intervention setting. In one study (moderate quality) (2) patients also received postoperative rehabilitation as part of the intervention.

Control group comparisons consisted of usual care (3, 4), no intervention (5), postoperative rehabilitation only (2) and receiving print material, alongside one meeting with a physiotherapist (1). Four of the five studies (1, 3-5) were three-armed RCTs, which also included other intervention groups. Only outcomes for the supervised exercise group, compared to a control group have been reported in this summary.

Supervised strength-based prehabilitation interventions for patients on wait lists for total knee replacement are likely to be effective for the following outcomes: 

Pain:

Might be effective (4 studies; 3 moderate (1, 2, 4), 1 weak quality(5), all showing improvements in the intervention group compared to control [note: in two studies the statistical significance is not reported (1, 5)]).

Balance:

Might be effective (3 Studies; 1 strong(3), 1 moderate(4), 1 weak quality(5). All showing significant improvements in the intervention groups compared to control).