The effectiveness of preoperative exercise in older persons with knee osteoarthritis undergoing knee arthroplasty

Abstract

Due to the heavy usage and repeated stress placed on weightbearing joints, the knee is a common site for severe pathologies such as osteoarthritis. Knee arthroplasty intervention is required in a substantial proportion of patients with severe knee osteoarthritis. Current interventions focus on postoperative programs, however preoperative rehabilitation, in addition to postoperative rehabilitation, might be an effective intervention in the preparation for surgery in older adults. Utilising the Population Intervention Comparison Outcome framework, the undermentioned research question was devised "In older persons suffering with knee osteoarthritis (P), is there evidence to suggest that patients who undergo a combination of both knee arthroplasty and a preoperative exercise program (I), have an increased likelihood of recovery and/or independence (O), in comparison to those patients who opt to forego such preoperative exercises (C)?" Inclusion criteria included studies conducted in the English language managed in the previous ten years, disregarding geographical limitations and including subjects suffering from KOA of any gender or ethnic group and of at least 50 years of age. The exclusion criteria illuminated studies without ethical approval as well as anecdotal evidence. The literature search resulted in 7 significant articles, all randomized controlled trials, and the Critical Appraisal Skills Programme Tool was selected to evaluate the dependability of the selected for this study. Results show that preoperative exercise programs evidently benefits muscle strength, pain levels, everyday functional tasks particularly in sitting-to-standing, mobility, balance and stair climbing ability, and finally assistance to mental health. However, regarding joint range of motion, contrasting evidence was established which makes it challenging to confirm or deny if such exercises will benefit in this aspect.