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BMC Musculoskeletal Disorders

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Open Access 01-12-2021 | Knee Osteoarthritis | Research article

A pilot study of aquatic prehabilitation in adults with knee osteoarthritis undergoing total knee arthroplasty – short term outcome

Authors: Sunghye Kim, Fang-Chi Hsu, Leanne Groban, Jeff Williamson, Stephen Messier

Published in: BMC Musculoskeletal Disorders | Issue 1/2021

Abstract

Background

Knee osteoarthritis (KOA) is increasingly more prevalent and significant number of patients require knee arthroplasty. Although knee arthroplasty is generally successful, it takes months to recover physical function. Preoperative physical function is known to predict postoperative outcomes and exercise can improve preoperative physical function. However, patients with KOA have difficulty exercise on land due to pain and stiffness, while water exercise can be better tolerated. We hypothesized that preoperative water exercise to improve preoperative physical function will improve postoperative outcomes after total knee arthroplasty (TKA).

Methods

We enrolled 43 participants who were scheduled for elective TKA in 4–8 weeks and scored at or below 50th percentile in mobility assessment tool-sf (MAT-sf). All enrolled participants were assessed on 1) clinical osteoarthritis symptom severity using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), 2) physical function using Short Physical Performance Battery (SPPB), 3) self-reported mobility using Mobility Assessment Tool-short form (MAT-sf), 4) depression using Geriatric Depression Scale-short form (GDS-sf), 5) cognitive function using Montreal Cognitive Assessment (MoCA). Blood samples for high-sensitivity-C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) were stored at − 80 °C then all samples were analyzed together. All the enrolled participants were randomly assigned to the aquatic exercise intervention (AEI) or usual care group. Sixty minute sessions of AEI was conducted three times a week for 4–8 weeks. Participants in both groups were evaluated within 1 week before their scheduled surgery, as well as 4 weeks after the surgery.

Results

The mean age was 67.1 (±6.2), 44% were female, 74% were White. There is no statistically significant difference in combined outcome of any complication, unscheduled ER visit, and disposition to nursing home or rehab facility by AEI. However, AEI was associated with more favorable outcomes: WOMAC scores (p < 0.01), chair-stand (p = 0.019), MAT-sf as well as improved depression (p = 0.043) and cognition (p = 0.008).

Conclusion

4–8 weeks of aquatic exercise intervention resulted in improved functional outcomes as well as improved depression and cognition in elderly patients undergoing TKA. A larger study is warranted to explore the role of water exercise in clinical and functional outcomes of TKA.

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Title: A pilot study of aquatic prehabilitation in adults with knee osteoarthritis undergoing total knee arthroplasty – short term outcome
Authors: Sunghye Kim
Fang-Chi Hsu
Leanne Groban
Jeff Williamson
Stephen Messier
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Knee Osteoarthritis
Osteoarthrosis
Mood Disorders
Osteoarthrosis
Affective Disorder
Knee Osteoarthritis
Published in: BMC Musculoskeletal Disorders / Issue 1/2021
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-021-04253-1

At a glance: The STEP trials

Springer Medicine

A pilot study of aquatic prehabilitation in adults with knee osteoarthritis undergoing total knee arthroplasty – short term outcome

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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