Article

OBJECTIVE: To summarize the evidence regarding the effectiveness and
dose-response characteristics of pre-operative exercise programmes on
post-operative physical function following total knee arthroplasty. DATA SOURCES:
CINAHL, Cochrane Library, PubMed, SPORTDiscus and EMBASE. STUDY SELECTION:
Randomized controlled trials were eligible if they provided full description of
physiological stress (i.e. mode, frequency, intensity and duration). DATA EXTRACTION: Data extraction and evaluation were performed by one reviewer.
Methodological quality of the selected studies was assessed using the
Physiotherapy Evidence Database scale. DATA SYNTHESIS: Twelve candidate studies
were identified, but only 3 papers satisfied all inclusion criteria: 2 studies
evaluated the effect of resistance training and 1 trial investigated
proprioceptive training. The latter study elicited significantly enhanced
post-operative gains in function for indices of standing balance (overall
stability index: Hedges' g = -1; anteroposterior stability index: Hedges' g =
-1.15; 6 weeks post-surgery). Results of meta-analysis based on the findings of 2
studies showed that, compared with controls, prehabilitative exercise involving
resistance training offered no additional gains in isometric quadriceps muscle
strength at 6 and 12 weeks
post-operatively. CONCLUSION: Despite a potential for
efficacy of exercise-based conditioning, this review highlights the scarcity of
robust dose-response evidence to guide the formulation of total knee arthroplasty
prehabilitation effectively.

Langue : ANGLAIS