Preoperative lifestyle modifications combined with a structured exercise protocol on patient outcomes following total knee replacement surgery: A systematic review.

IF 1.5 Q3 RHEUMATOLOGY Musculoskeletal Care Pub Date : 2024-06-01 DOI:10.1002/msc.1899
A Kan, K Page, N Devine, A Rabajoli, L Sattler
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Abstract

Background: Medical guidelines recommend structured prehabilitation protocols consisting of lifestyle modifications and exercise to enhance post-operative outcomes for patients undergoing a total knee replacement (TKR). However, current research showing effectiveness is limited and has primarily focused on outcomes of exercise-based prehabilitation.

Objectives: To investigate whether a structured prehabilitation protocol consisting of exercise and lifestyle modifications improves physical function and patient-reported outcomes following TKR surgery compared with usual care.

Design: Systematic review.

Methods: Five databases were searched to identify randomised controlled trials comparing structured prehabilitation programs consisting of lifestyle modifications and exercise, with usual care, for those undergoing a TKR. Methodological quality of included studies was assessed via the RoB 2.0 tool and results synthesis via a Grading of Recommendation Assessment, Development and Evaluation approach was performed to determine the certainty evidence for each outcome.

Results/findings: Four studies were included in this review. Despite a positive trend supporting the inclusion of a structured prehabilitation protocol, additional improvements in post-operative pain, physical function and self-reported function were only seen in one study. Reductions in hospital length of stay were also seen in one study. No additional improvements in post-operative quality of life following prehabilitation were reported.

Conclusion: Limited evidence supporting prehabilitation reported in our review is likely attributed to the intervention type, intensity, and delivery model of included studies. However, there remains to be strong evidence supporting the use of a structured prehabilitation protocol consisting of lifestyle modifications and exercise to improve post-operative outcome.

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术前生活方式调整与结构化锻炼方案相结合对全膝关节置换手术后患者疗效的影响:系统性综述。
背景:医学指南建议,为提高全膝关节置换术(TKR)患者的术后效果,应制定由生活方式调整和运动组成的结构化康复方案。然而,目前显示其有效性的研究有限,而且主要集中在以运动为基础的术前康复结果上:目的:与常规护理相比,研究由运动和生活方式调整组成的结构化康复方案是否能改善 TKR 术后的身体功能和患者报告的疗效:设计:系统回顾:对五个数据库进行了检索,以确定针对接受 TKR 术者的随机对照试验,这些试验比较了由生活方式调整和运动组成的结构化预康复方案与常规护理。通过RoB 2.0工具对纳入研究的方法学质量进行评估,并通过建议分级评估、发展和评价方法对结果进行综合,以确定每项结果的确定性证据:本综述纳入了四项研究。尽管有支持纳入结构化康复治疗方案的积极趋势,但只有一项研究发现术后疼痛、身体功能和自我报告功能有额外改善。有一项研究还发现住院时间有所缩短。结论:支持术前康复的证据有限:结论:我们的综述中报告的支持术前康复的证据有限,这可能与纳入研究的干预类型、强度和实施模式有关。不过,仍有强有力的证据支持使用由生活方式调整和锻炼组成的结构化预康复方案来改善术后效果。
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来源期刊
Musculoskeletal Care
Musculoskeletal Care RHEUMATOLOGY-
CiteScore
2.30
自引率
7.70%
发文量
88
期刊介绍: Musculoskeletal Care is a peer-reviewed journal for all health professionals committed to the clinical delivery of high quality care for people with musculoskeletal conditions and providing knowledge to support decision making by professionals, patients and policy makers. This journal publishes papers on original research, applied research, review articles and clinical guidelines. Regular topics include patient education, psychological and social impact, patient experiences of health care, clinical up dates and the effectiveness of therapy.
期刊最新文献
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