interventions where components consist of both supervised and self-directed elements

Exercise prehabilitation interventions consisting of both supervised and self-directed elements, for patients on wait lists for Orthopaedic surgery (13-16).

Intervention summary:

Three moderate quality RCTs published across five papers(13-17) examined prehabilitation exercise interventions consisting of both supervised and self-directed elements. One RCT each took place in patients awaiting TKR(16, 17), THR (14, 15) and high tibial osteotomy or prosthetic knee replacement(13).

The interventions lasted between five and eight weeks and all consisted of both clinic-based supervised sessions and home-based self-directed exercises. The control groups consisted of usual care (14-17) or no intervention (13). Exercises generally aimed to improve strength, flexibility, and range of motion.

There is moderate quality evidence to suggest that exercise prehabilitation interventions where components consist of both supervised and self-directed elements, for patients on orthopaedic surgical wait lists, are likely to be ineffective for the following outcomes:

Pain:

Might not be effective (three moderate quality studies showing no effect for the intervention compared to control) (13, 15, 16).