Effect of preoperative exercise on measures of functional status in men and women undergoing total hip and knee arthroplasty
Article first published online: 29 SEP 2006
Copyright © 2006 by the American College of Rheumatology
Arthritis Care & Research
Volume 55, Issue 5, pages 700–708, 15 October 2006
How to Cite
Rooks, D. S., Huang, J., Bierbaum, B. E., Bolus, S. A., Rubano, J., Connolly, C. E., Alpert, S., Iversen, M. D. and Katz, J. N. (2006), Effect of preoperative exercise on measures of functional status in men and women undergoing total hip and knee arthroplasty. Arthritis & Rheumatism, 55: 700–708. doi: 10.1002/art.22223
- Issue published online: 29 SEP 2006
- Article first published online: 29 SEP 2006
- Manuscript Accepted: 4 JAN 2006
- Manuscript Received: 2 AUG 2005
- New England Baptist Bone and Joint Institute
- New England Baptist Hospital
- NIH. Grant Numbers: RR-01032, K23-AR-48305, K24-AR-02123, P60-AR-47782, P60-AR-47782
- Arthritis Foundation Investigator Award
- Total joint replacement;
To evaluate the effect of a short preoperative exercise intervention on the functional status, pain, and muscle strength of patients before and after total joint arthroplasty.
A total of 108 men and women scheduled for total hip arthroplasty (THA) or total knee arthroplasty (TKA) were randomized to a 6-week exercise or education (control) intervention immediately prior to surgery. We assessed outcomes through questionnaires and performance measures. Analyses examined differences between groups over the preoperative and immediate postoperative periods and at 8 and 26 weeks postsurgery.
Among THA patients, the exercise intervention was associated with improvements in preoperative Western Ontario and McMaster Universities Osteoarthritis Index function score (improvement of 2.2 in exercisers versus decline of 3.9 in controls; P = 0.02) and Short Form 36 physical function score (decline of 0.4 in exercisers versus decline of 14.3 in controls; P = 0.003). No significant differences were seen in TKA patients. Exercise participation increased muscle strength preoperatively (18% in THA patients and 20% in TKA patients), whereas the control patients had essentially no change in strength (P > 0.05 for exercise versus education in both THA and TKA groups). Exercise participation prior to total joint arthroplasty substantially reduced the risk of discharge to a rehabilitation facility in THA and TKA patients (adjusted odds ratio 0.27, 95% confidence interval 0.074–0.998). The intervention had no effects on outcomes 8 and 26 weeks postoperatively.
A 6-week presurgical exercise program can safely improve preoperative functional status and muscle strength levels in persons undergoing THA. Additionally, exercise participation prior to total joint arthroplasty dramatically reduces the odds of inpatient rehabilitation.