(12-10-12) Does exercise reduce pain and improve physical function before hip or knee replacement surgery?

A systematic review and meta-analysis of randomized controlled trials.

Gill SD, McBurney H.
Source
Barwon Health, Australia.
Abstract
OBJECTIVE:
To investigate the pre-operative effects of exercise-based interventions on
pain and physical function for people awaiting joint replacement surgery of the
hip or knee.
DATA SOURCES:
Four computer databases (CINAHL, MEDLINE, Embase, and Cochrane Library) were
searched until July 4, 2012. Search terms included knee, hip, joint
replacement, arthroplasty, physiotherapy, physical therapy, exercise,
hydrotherapy, rehabilitation, and pre-operative. Reference lists of retrieved
articles were also screened.
STUDY SELECTION:
Randomized or quasi-randomized studies comparing an exercise-based
intervention with a no-intervention group for people awaiting hip or knee joint
replacement surgery were included. Outcomes were pain and physical function
including self-reported function, walking speed, and muscle strength. One of
two reviewers determined that 18 studies met the inclusion criteria.
DATA EXTRACTION:
The methodological quality of each study was independently assessed by two
reviewers using the PEDro scale and a final PEDro score was determined by
discussion and consensus between the reviewers. Participants' characteristics,
content and design of the interventions, and data for quantitative synthesis
were extracted by one reviewer.
DATA SYNTHESIS:
For participants awaiting knee replacement surgery, quantitative data
synthesis found no significant differences between the exercise and no-
intervention groups for pain, self-reported function, walking speed or muscle
strength. For participants awaiting hip replacement surgery, quantitative data
synthesis found a significant difference between the groups with standardized
mean differences (SMD) indicating a medium sized effect in favor of
intervention for both pain (SMD .45, 95% CI .15 to .75) and self-reported
function (SMD .46, 95% CI .20 to .72).
CONCLUSIONS:
Exercise-based interventions can reduce pain and improve physical function for
people awaiting hip replacement surgery but not knee replacement surgery.


Source: Arch Phys Med Rehabil. 2012 Sep 4. [Epub ahead of print]

News

---

In evidenza

"L'informazione presente nel sito serve a migliorare, e non a sostituire, il rapporto medico-paziente."

Per coloro che hanno problemi di salute si consiglia di consultare sempre il proprio medico curante.