Does the amount of physical exercise before arthroplasty influence the postoperative outcome?

P Rottbøll Nielsen, Hanne Tønnesen

    Research output: Contribution to journalReview articlepeer-review

    Abstract

    Background:
    Clinical studies have evaluated a correlation between preoperative walking capacity or function and outcome
    after hip and knee joint replacement surgery with contradictory results. Our aim was to investigate the effect of preoperative
    metabolic and/or aerobic exercise on surgical outcome, as well as to evaluate the effect of cumulated exercise by using a cutoff
    value at 3.5 hours through a systematic review.

    Methods:
    The literature search was performed in Pubmed, Embase, and Cochrane Library databases. The inclusion criteria
    were randomised controlled trials, full paper publications, describing the preoperative exercise program and reporting
    outcome data. Exclusion criteria were inadequate randomisation, and unclear interventions or outcomes. The final literature
    analysis involved 12 studies. The review included meta-analyses on postoperative complications, specifically deep venous
    thrombosis, and length of stay.

    Results:
    The trials included 616 patients in samples sizing from 20 to 131. The duration of follow-up ranged from 12 to 96
    weeks. The preoperative period of training ranged from 4 to 8 weeks; the number and duration of individual sessions varied
    from 9 to 56 and from 30 to 60 minutes, respectively. All trials reported one or more primary outcome. Meta-analyses were
    possible for postoperative complications and lengths of stay. Neither development of deep venous thrombosis, odds ratio
    0.48 (95% CI 0.18 to1.25) nor the total complication was significantly reduced, 1.08 (0.64 to 1.86). The result for length of stay was –0.22 (-0.86 to 0.42).

    Conclusion:
    This review showed that preoperative exercise had no effect on the surgical outcome, neither overall nor for the
    cut-off value of 3.5 hours per week.
    Original languageEnglish
    Pages (from-to)55-61
    JournalClinical Health Promotion
    Volume1
    Issue number2
    Publication statusPublished - 2011

    Subject classification (UKÄ)

    • Public Health, Global Health, Social Medicine and Epidemiology

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