Preoperative exercise regime reduces placement into a rehab facility after discharge.


While exercise is often used successfully in treating postop joint replacement patients, a presurgical exercise regime can be beneficial, too, according to a study published in Arthritis Care & Research.

The study looked at 108 men and women scheduled to have either total hip arthroplasty (THA) or total knee arthroplasty (TKA). The participants in the study took part in a 6 week program, attending sessions 3 times per week.

The exercise focused on strength training, aerobics and flexibility and was tailored for each patient’s specific needs. The control-group participants received educational materials. Outcomes were assessed through questionnaires and performance measures, which were examined before intervention, immediately before surgery and at 8 and 26 weeks after surgery.

The investigators found that at the time of hospital discharge, the exercising patients were more likely to walk more than 50 feet and could go directly home. “We were pleasantly surprised at the discharge statistics,” lead author Daniel S. Rooks, ScD of New England Baptist Hospital, Beth Israel Deaconess Medical Center and Harvard Medical School told Orthopedics Today. “Those who exercised decreased their odds of going to a rehab facility by 73%.”

With today’s society being less active and more sedentary, the idea of needing an exercise intervention to elevate a level of fitness is a logical step. For those people who did not exercise, their function continued to decline leading up to surgery.

Pre-surgical exercise also has potential economic benefits allowing more people to go home upon discharge instead of to a rehabilitation facility, Rooks said.

“Many of the things we heard from people was that they just felt more prepared, physically and mentally, for the rehabilitation step after surgery,” Rooks said.

The only patients that may not benefit from pre-surgical exercise are those who have severe physical limitations, where activity would either overstress the area or if they have some other limitation, such as a cardiovascular problem, he said.

However, doctors should be encouraged by these study results – and should also encourage their patients to partake in pre-surgical physical activity.

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