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

Research output: Contribution to journalReview article

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.

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Subject classification (UKÄ) – MANDATORY

  • Public Health, Global Health, Social Medicine and Epidemiology
Original languageEnglish
Pages (from-to)55-61
JournalClinical Health Promotion
Volume1
Issue number2
Publication statusPublished - 2011
Publication categoryResearch
Peer-reviewedYes