Clinical trial NCT03483519: Efficacy of Preoperative Muscle Training on Postoperative Orthopaedic Surgery Recovery
Official title: Efficacy of Preoperative Muscle Training on Postoperative Recovery and Function in Patients Undergoing Total Hip or Knee Replacement
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Arthroplasty
Osteoarthritis
Lead sponsor: Ottawa Hospital Research Institute
Sponsor class: OTHER
Collaborators: name: The Ottawa Hospital Academic Medical Association
First posted: 2018-03-30
Enrollment: 55
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to assess the effectiveness of a preoperative muscle training program on hip or knee TJA (Total Joint Arthroplasty). It aims to improve hospital discharge readiness and functional capacity in both the short and long-term. One of the key factors affecting recovery after TJA is how well the patient functions before their surgery. Thus, interventions addressing preoperative function are expected to be beneficial.

Detailed description: Although total hip or knee joint replacement is beneficial in treating severe hip or knee osteoarthritis, a significant number of patients take longer to recover in the hospital or have a non-optimal quality of life after the surgery. These patients often have difficulties in accomplishing basic essential everyday tasks such as walking and stair climbing, both shortly and long after surgery. It has been previously shown through research that difficulties to do basic tasks before surgery delays recovery and negatively affects long-term function. It has also been shown that these difficulties are associated with reduced strength in hip or knee muscles present before surgery, caused by lack of activity of patients. This study will determine if a hip or knee muscle strengthening exercise program accomplished before surgery can improve hospital recovery, capacity to accomplish basic activities, and quality of life two days, six weeks and six months after joint replacement surgery. If this exercise program is shown to be beneficial, it will be easily used by patients when waiting for their surgery.

Eligibility criteria: Inclusion Criteria:

* Patients aged 18 and older undergoing unilateral total hip or knee arthroplasty due to osteoarthritis;
* WOMAC functional subscale less than 66.5/100.

Exclusion Criteria:

* Patients under 18 years of age;
* Patients undergoing joint revision on the affected side;
* patients under the same day discharge protocol;
* Patients undergoing bilateral arthroplasty;
* Patients suffering from other previously diagnosed lower-limb problems limiting their capacity to accomplish the exercise program;
* Patients having surgery in less than 16 weeks after verbal consent;
* Patients unable or unwilling to commit to required study follow-ups;
* Patients with no fixed address;
* Patients with a cognitive impairment that may preclude questionnaire completion;
* Pregnant or suspected pregnant women as dual-energy x-ray (DXA) used in this study may be harmful to a fetus.

Primary outcomes:
measure: HOOS or KOOS Questionnaire to assess self-reported pain
timeFrame: 12 months
Secondary outcomes:
measure: Timed-Up-and-Go (TUG)
timeFrame: 12 months
measure: Timed Stair Test
timeFrame: 12 months
measure: Length of hospital stay
timeFrame: 1 month
measure: Post-surgical Complications
timeFrame: 30 days
measure: Hip or Knee Muscle Strength
timeFrame: 12 months
measure: Muscle Mass measured with dual-energy x-ray absorptiometry
timeFrame: 12 months
measure: Generic Health Status measured by the Questionnaire EQ-5D-5L
timeFrame: 12 months
Other outcomes:
Locations:
city: Ottawa
country: Canada
facility: The Ottawa Hospital
state: Ontario
Study officials:
affiliation: Ottawa Hospital
name: Paul Beaule, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Sled EA, Khoja L, Deluzio KJ, Olney SJ, Culham EG. Effect of a home program of hip abductor exercises on knee joint loading, strength, function, and pain in people with knee osteoarthritis: a clinical trial. Phys Ther. 2010 Jun;90(6):895-904. doi: 10.2522/ptj.20090294. Epub 2010 Apr 8.
citation: Pacheco-Brousseau L, Dobransky J, Jane A, Beaule PE, Poitras S. Feasibility of a preoperative strengthening exercise program on postoperative function in patients undergoing hip or knee arthroplasty: a pilot randomized controlled trial. Pilot Feasibility Stud. 2022 Jul 30;8(1):162. doi: 10.1186/s40814-022-01126-9.