AUTHOR=Jørgensen Stian Langgård , Kierkegaard Signe , Bohn Marie Bagger , Aagaard Per , Mechlenburg Inger 

TITLE=Effects of Resistance Training Prior to Total Hip or Knee Replacement on Post-operative Recovery in Functional Performance: A Systematic Review and Meta-Analysis

JOURNAL=Frontiers in Sports and Active Living

VOLUME=4

YEAR=2022

URL=https://www.frontiersin.org/journals/sports-and-active-living/articles/10.3389/fspor.2022.924307

DOI=10.3389/fspor.2022.924307

ISSN=2624-9367

ABSTRACT=<sec><title>Objective</title><p>To evaluate the effectiveness of pre-operative resistance training in patients allocated to TJR surgery on selected post-operative outcomes, <italic>via</italic> a meta-analysis of studies using exercise modalities and loading intensities objectively known to promote gains in muscle size and strength in adults of young-to-old age.</p></sec><sec><title>Design</title><p>A systematic review and meta-analysis.</p></sec><sec><title>Literature Search</title><p>Cochrane Central, MEDLINE, EMBASE, and PEDro were searched on August 4th 2021.</p></sec><sec><title>Study Selection</title><p>Randomized Controlled Trials (RCTs) were included if (i) they compared pre-operative lower-limb-exercises before elective TJR with standard care, (ii) explicitly reported the exercise intensity, and (iii) reported data on functional performance.</p></sec><sec><title>Data Synthesis</title><p>This systematic review and meta-analysis is reported in accordance with the PRISMA reporting guidelines. A random effects model with an adjustment to the confidence interval was performed for pooling the data.</p></sec><sec><title>Results</title><p>One thousand studies were identified. After applying exclusion criteria, five RCTs were located including 256 participants (mean age ranged from 61 to 72 years, 54% women). Moderate-to-large improvements in functional performance and maximal knee extensor strength were observed at 3 months after surgery along with small-to-moderate effects 12 months post-operatively. For patient-reported outcomes, small-to-moderate improvements were observed at 3 months post-operatively with no-to-small improvements at 12 months.</p></sec><sec><title>Conclusion</title><p>Prehabilitation efforts involving progressive resistance training provides an effective means to improve post-operative outcomes related to functional performance, knee extensor strength and patient-reported outcome in patients undergoing TJR. Due to large methodological diversity between studies, an optimal loading intensity remains unknown.</p></sec><sec><title>Systematic Review Registration</title><p>Prospero ID: CRD42021264796.</p></sec>