Preoperative exercise in patients undergoing total knee arthroplasty: a pilot randomized controlled trial.
Pascale Gränicher, Thomas Stöggl, Sandro F Fucentese and 2 others
PMID 32774889WHAT IT FOUND
The main stair-climbing outcome did not differ between the exercise and control groups.
Some pain and activity scores showed group differences, but with 20 patients this pilot cannot show a treatment effect.
Key findings
01The primary outcome, stair-climbing time, did not differ between the exercise and control groups.
02The intervention group, which received endurance training, PNF stretching, patient education and individual interventions when indicated, showed a group difference on the pain sub-item of the Lysholm score.
03The same combined programme showed an increase over time and a group difference on the Tegner Activity Scale.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was designed as a pilot with 20 patients, so it cannot reliably show whether the programme works. The same physiotherapist delivered 81 out of 85 preoperative interventions and performed the measurements, and preoperative and follow-up measurements were not blinded. The intervention combined endurance training, PNF stretching, patient education and individual interventions when indicated, so the effect of any single component cannot be identified. The study was done in one clinic with the same surgical team, and postoperative care varied across settings. Costs and therapy session data partly came from patient diaries and could not be verified. The primary outcome was null, so the significant secondary pain and activity findings should be read cautiously.
The easy way to misread this
Do not conclude that preoperative exercise improves stair-climbing or overall knee function after total knee replacement. The primary stair-climbing outcome showed no group difference, and the positive pain and activity findings were secondary results from a 20-patient pilot.