Community-based prehabilitation program: a pilot study exploring the impact of exercise and education programs on functional mobility pre-surgery and on length of stay post-total joint arthroplasty

Abstract

The effect of implementing a community-based prehabilitation program prior to total joint arthroplasty (TJA) on mobility and length of stay (LOS) in hospital post-TJA in obese patients was investigated in this quantitative pilot study. Changes in mobility measures from baseline, at 6 weeks and 12-weeks pre-surgery and post-surgery were assessed using: Lower Extremity Functional Scale (LEFS), Visual Analogue Scale (VAS), Timed Up and Go (TUG), Self-Paced Walk Test (SPWT), and Stair Test (ST). A prehabilitation group attended education sessions and underwent a 12-week land and pool-based exercise program before TJA, whereas the control group received the usual preoperative standard of care. The prehabilitation group experienced improved mobility before and after surgery whereas the control group only saw improvements post-surgery. The LOS for the prehabilitation group was marginally lower (0.3 days) than the control group. In conclusion, there is evidence that a prehabilitation program prior to TJA may reduce hospital LOS resulting in potential cost savings and improved patient mobility measures both prior to and post-surgery.