Article

OBJECTIVE: To investigate the preoperative 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 preoperative.
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 2 reviewers
determined that 18 studies met the inclusion criteria.
DATA EXTRACTION: The
methodologic quality of each study was independently assessed by 2 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 1 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 (SMDs) indicating a medium-sized effect in
favor of intervention for both pain (SMD=.45; 95% confidence interval .15-.75)
and self-reported function (SMD=.46; 95% confidence interval .20-.72).
CONCLUSIONS: Exercise-based interventions can reduce pain and improve physical
function for people awaiting hip replacement surgery but not knee replacement
surgery.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS