A scoping review of prehabilitation interventions for arthroplasty patients.
Prithi Pillay-Jayaraman, Verusia Chetty, Stacy Maddocks
PMID 38059055WHAT IT FOUND
Prehabilitation before joint replacement showed mixed results across 34 studies.
Most included strengthening exercises, but few targeted balance, proprioception, or foot pain, which are common issues in patients waiting for surgery.
Key findings
01Of the 34 studies reviewed, 21 reported significant results and 11 did not.
02Strengthening exercises were the most common intervention, used in 22 studies, while balance and proprioceptive exercises were rare.
03No study specifically evaluated the efficacy of balance and proprioceptive exercises, despite their potential relevance to patients with foot pain and deformities.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The included studies had small sample sizes and lacked standardisation in prehabilitation protocols, making it difficult to draw firm conclusions about which specific exercises are most effective. Most studies did not report power analyses, and the review itself notes that the small sample sizes could lead to over- or underestimation of results. There was only one South African-based study included, limiting the direct applicability of the findings to the specific context of long waiting lists and resource constraints described in the introduction.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that prehabilitation reliably improves outcomes. The evidence is mixed, with 11 of 34 studies showing no significant results. Furthermore, the lack of standardisation means that 'prehabilitation' can refer to very different programmes, so the effectiveness of one protocol may not apply to another.