Pre-operative Rehabilitation Exercise Program for Total Knee Arthroplasty

Study Overview
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Brief Summary
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The purpose of this study is to determine whether a pre-operative home rehabilitation exercise program designed for knee replacements is more effective than pre-operative usual care.

Detailed Description
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Patients with lower levels of function prior to total knee arthroplasty (TKA) attain lower functional endpoints after surgery. Therapeutic exercise improves function in patients with arthritis of the knee, yet little evidence has examined the impact of pre-operative exercise for TKA. Single blinded randomized clinical trial comparing a pre-operative home exercise program to pre-operative usual care for patients who are waiting for TKA.Comparison group is usual care within the health region which does not include pre-operative rehabilitation program. Primary outcome: WOMAC function subscale. Secondary outcomes: 1) quality of life; 2) ambulation; 3) self-efficacy; 4) anxiety; 5) patient satisfaction; 6) cost-effectiveness of this intervention. Total Enrollment: 230 patients If the intervention improves function prior to surgery, results will be clinically applicable for patients waiting for surgery

Official Title
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Impact of a Pre-operative Rehabilitation Exercise Program for Patients With Severe Dysfunction Awaiting Total Knee Arthroplasty

Conditions
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Osteoarthritis, Rheumatoid Arthritis

Intervention / Treatment
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* Other: Exercise
* Other: Usual care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: primary unilateral total knee arthroplasty poor functional status (WOMAC=50 or greater) 50 yrs or older reside within health region understands English Exclusion Criteria: unicompartmental total knee arthroplasty revision surgery

Ages Eligible for Study
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Minimum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Usual care<br>Usual care | Other: Usual care<br> <br> |
| Experimental: Exercise<br>Exercise | Other: Exercise<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Self-reported function | Self-reported function | 5 evaluations within 6 months after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quality of life, self-efficacy, ambulation, anxiety and patient satisfaction | Quality of life | 5 evaluations within 6 months after surgery | 
| self-efficacy | self-efficacy | 5 evaluations within 6 months after surgery | 
| ambulation, anxiety and patient satisfaction | ambulation | 5 evaluations within 6 months after surgery | 
| anxiety | anxiety | 5 evaluations within 6 months after surgery | 
| patient satisfaction | patient satisfaction | 5 evaluations within 6 months after surgery |