In 2009 study conducted by Robert Topp and colleagues, the impact of preoperative exercise on knee pain, functional ability, and quadriceps strength in patients with knee osteoarthritis undergoing total knee arthroplasty (TKA) was investigated. This study aimed to assess the effectiveness of a prehabilitation program compared to standard care in enhancing postoperative outcomes.

Utilizing a repeated-measures design, the researchers compared two groups across four data collection points. The study recruited community-dwelling individuals with knee osteoarthritis scheduled for unilateral TKA, randomly assigning them to either a control group (n = 28) or a prehabilitation group (n = 26). The control group received standard care, while the prehabilitation group engaged in a structured exercise program including resistance training, flexibility exercises, and step training three times per week before TKA.

The findings revealed significant improvements in functional tasks among the prehabilitation group compared to the control group. At one week prior to TKA, prehabilitation exercisers demonstrated enhanced sit-to-stand performance, whereas the control group experienced increased pain without improvement in functional tasks. By three months post-TKA, the prehabilitation group exhibited further enhancements in functional tasks, decreased pain levels, and increased quadriceps strength in both surgical and nonsurgical legs. In contrast, the control group experienced declines in certain functional tasks, albeit with decreased pain levels and improvements in nonsurgical leg strength. Notably, the control group demonstrated greater leg strength asymmetry at three months post-TKA.

The study’s findings underscore the efficacy of prehabilitation exercises in optimizing postoperative outcomes for TKA patients. The results suggest that engaging in structured preoperative exercise interventions can alleviate pain, enhance functional ability, and improve quadriceps strength following TKA surgery. These findings lend support to the concept of prehabilitation as a valuable strategy in the management of knee osteoarthritis and subsequent TKA procedures.

Reference: Topp, R., Swank, A. M., Quesada, P. M., Nyland, J., & Malkani, A. (2009). The effect of prehabilitation exercise on strength and functioning after total knee arthroplasty. PM&R, 1(8), 729-735.