Are pre-operative exercise interventions for joint arthroplasty effective at improving peri‑operative outcomes: A systematic review and meta-analysis of randomized controlled trials.

IF 10.3 1区医学 Q1 HOSPITALITY, LEISURE, SPORT & TOURISM

Journal of Sport and Health Science Pub Date : 2025-08-31 DOI:10.1016/j.jshs.2025.101083

Natasha A Hares, James P Sanders, Dale W Esliger, Jonah J C Thomas, Beatrice Bourron, Heather J MacKinnon, Claire D Madigan

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引用次数: 0

Abstract

Background: Evidence on pre-operative physical activity before hip and knee arthroplasty is limited and heterogeneous. Intervention components and behavior change techniques remain underexplored. This review examined the effectiveness of pre-operative physical activity interventions on patient and surgical outcomes in elective hip and knee arthroplasty up to 12 weeks post-surgery.

Methods: A systematic search of eight databases up to August 8, 2024 identified randomized controlled trials of physical activity interventions before total hip and knee arthroplasty. Quality of evidence was evaluated with Grading of Recommendations, Assessment, Development and Evaluation framework. Random-effects models were used for meta-analyses. The Template for Intervention Description and Replication (TIDieR) was used for detailing the included interventions.

Results: Forty trials were included. Significant mean differences in favor of the intervention groups were found at pre- and post-surgery in four outcomes: health-related quality of life (Knee pre-surgery SMD = -0.5, 95 % CI: -0.1 to -0.1 and Hip and Knee post-surgery SMD = -0.4, 95 % CI: -0.6 to -0.1), pain (Hip and Knee pre-surgery SMD = -0.4, 95 % CI: -0.6 to -0.1 and Knee post-surgery SMD = -0.3, 95 % CI: -0.6 to -0.1), function (Hip and Knee pre-surgery SMD = -0.5, 95 % CI: -0.8 to -0.2 and Knee post-surgery SMD = -0.6, 95 % CI: -1 to -0.2), and timed-up-and-go (Hip and Knee MD = -1.2, 95 % CI: -2.0 to -0.3 and Hip and Knee MD = -1.3, 95 % CI: -1.7 to -0.8). Half of the interventions reported over 75 % of the TIDieR items, while behavior change techniques reporting was limited.

Conclusion: Pre-operative exercise improves health-related quality of life, pain, and function pre- and post-surgery in elective hip and knee arthroplasty. Standardized reporting is needed for establishing effective intervention components.

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关节置换术的术前运动干预对改善围手术期预后有效吗：随机对照试验的系统回顾和荟萃分析

背景：关于髋关节和膝关节置换术前运动的证据有限且不一致。干预成分和行为改变技术仍未得到充分探索。本综述研究了术前体育活动干预对择期髋关节和膝关节置换术后12周患者和手术结果的有效性。方法：系统检索截至2024年8月8日的8个数据库，确定了全髋关节和膝关节置换术前体育活动干预的随机对照试验。采用建议分级、评估、发展和评价框架评价证据质量。meta分析采用随机效应模型。干预描述和复制模板（TIDieR）用于详细描述所包括的干预措施。结果：共纳入40项试验。重要的意思是赞成干预组差异被发现在4的结果:预处理和对象与健康有关的生活质量(膝盖术前的SMD = -0.5,95%置信区间ci: -0.1 - -0.1,髋关节和膝关节对象SMD = -0.4,95%置信区间ci: -0.6 - -0.1),疼痛(髋关节和膝关节术前的SMD = -0.4,95%置信区间ci: -0.6 - -0.1和膝盖重新SMD = -0.3,95%置信区间ci: -0.6 - -0.1),函数(髋关节和膝关节术前的SMD = -0.5,95%置信区间ci: -0.8 - -0.2和膝盖重新SMD = -0.6,95%置信区间ci:-1至-0.2)，以及适时起跳（髋关节和膝关节MD = -1.2,95%CI为-2.0至-0.3，髋关节和膝关节MD = -1.3,95%CI为-1.7至-0.8）。一半的干预报告了超过75%的TIDieR项目，而行为改变技术报告有限。结论：术前锻炼可改善择期髋关节置换术前后与健康相关的生活质量、疼痛和功能。建立有效的干预成分需要标准化报告。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Sport and Health Science SPORT SCIENCES-

CiteScore

18.30

自引率

1.70%

发文量

101

审稿时长

22 weeks

期刊介绍： The Journal of Sport and Health Science (JSHS) is an international, multidisciplinary journal that aims to advance the fields of sport, exercise, physical activity, and health sciences. Published by Elsevier B.V. on behalf of Shanghai University of Sport, JSHS is dedicated to promoting original and impactful research, as well as topical reviews, editorials, opinions, and commentary papers. With a focus on physical and mental health, injury and disease prevention, traditional Chinese exercise, and human performance, JSHS offers a platform for scholars and researchers to share their findings and contribute to the advancement of these fields. Our journal is peer-reviewed, ensuring that all published works meet the highest academic standards. Supported by a carefully selected international editorial board, JSHS upholds impeccable integrity and provides an efficient publication platform. We invite submissions from scholars and researchers worldwide, and we are committed to disseminating insightful and influential research in the field of sport and health science.