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Does pre-operative physiotherapy improve outcomes from lower limb joint replacement surgery? A systematic review
Ilana N Ackerman1, Kim L Bennell
1School of Physiotherapy, University of Melbourne, Carlton, VIC, 3010, Australia. i.ackerman@pgrad.unimelb.edu.au
The Australian Journal of Physiotherapy
|February 28, 2004
Summary
Pre-operative physiotherapy does not improve outcomes for total knee replacement patients. Its effectiveness for total hip replacement patients remains undetermined due to confounding post-operative care.
Area of Science:
- Orthopedics
- Rehabilitation Medicine
- Evidence-Based Practice
Background:
- Lower limb joint replacement surgery is common.
- Pre-operative physiotherapy aims to optimize patient condition before surgery.
- The effectiveness of pre-operative physiotherapy requires rigorous evaluation.
Purpose of the Study:
- To systematically review randomized controlled trials evaluating pre-operative physiotherapy for lower limb joint replacement.
- To assess the impact of pre-operative physiotherapy on post-operative outcomes.
Main Methods:
- Systematic review of randomized controlled trials.
- Searched relevant key terms for suitable trials.
- Assessed methodological quality using the PEDro scale.
- Calculated treatment effect sizes and 95% confidence intervals.
Main Results:
- For total knee replacement, minimal differences were observed between pre-operative physiotherapy and control groups across all outcomes.
- For total hip replacement, improvements in WOMAC scores, strength, range of motion, and gait were noted in the intervention group.
- However, total hip replacement results were confounded by additional intensive post-operative physiotherapy.
Conclusions:
- Pre-operative physiotherapy programs do not demonstrate effectiveness in improving outcomes after total knee replacement.
- The impact of pre-operative physiotherapy on total hip replacement outcomes could not be definitively determined due to concurrent post-operative interventions.
