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Effect of Prehabilitation in Older Adults Undergoing Total Joint Replacement: an Overview of Systematic Reviews

  • Neurology of Aging (K Marder, Section Editor)
  • Published:
Current Geriatrics Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To review and discuss the findings of systematic reviews that synthesized the evidence on the effect of preoperative exercises (prehabilitation) on postoperative functional recovery in older adults undergoing total knee or hip joint replacement.

Recent Findings

Ten systematic reviews (8 meta-analyses) were included in this review. Findings from the systematic reviews indicated that prehabilitation decreases length of hospital stay but does not improve postoperative functional recovery in older adults undergoing joint replacement. Individual studies in the systematic reviews varied considerably in prehabilitation protocol, assessment timepoints, and outcome measures. Most importantly, systematic reviews did not assess the outcomes pre-post prehabilitation, as this timepoint was not addressed in most individual studies. Therefore, it is not known whether the prehabilitation programs improved outcomes preoperatively.

Summary

There is a need to develop comprehensive prehabilitation protocols and systematically assess the preoperative and postoperative effectiveness of prehabilitation protocols on functional outcomes (i.e., self-reported and performance-based) in older adults undergoing total joint replacement.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Department of Physical Therapy, School of Health Professions, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, Mail Code 6247, San Antonio, TX, 78229-3900, USA

    Gustavo J. Almeida

  2. Department of Orthopaedics, Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA

    Gustavo J. Almeida & Boris A. Zelle

  3. Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA

    Samannaaz S. Khoja

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  1. Gustavo J. Almeida
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Correspondence to Gustavo J. Almeida.

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Conflict of Interest

Gustavo J. Almeida and Samannaaz S. Khoja have nothing to disclose. Boris A. Zelle has consulted for KCI Inc. USA and DepuySynthes® and received compensation. Dr. Zelle has received speaker fees from AO North America and research grants from DepuySynthes, KCI, Department of Defense, and the Orthopedic Trauma Association. Dr. Zelle has received educational grants from Smith and Nephew Inc. and Arthrex®. None of these activities are related to the content of this article.

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Almeida, G.J., Khoja, S.S. & Zelle, B.A. Effect of Prehabilitation in Older Adults Undergoing Total Joint Replacement: an Overview of Systematic Reviews. Curr Geri Rep 9, 280–287 (2020). https://doi.org/10.1007/s13670-020-00342-6

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  • DOI: https://doi.org/10.1007/s13670-020-00342-6

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