| Presurgical Exercise Improves Recovery After Hip or Knee Replacement |
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NEW YORK (Reuters Health) - Men and
women with end-stage osteoarthritis can safely participate in and
benefit from a program of cardiovascular fitness, strength training,
and flexibility exercise prior to total hip or total knee arthroplasty,
according to results of a prospective, randomized trial.
Little is known about the effects of exercise on patients with end-stage osteoarthritis or on the outcomes of joint replacement surgery, Dr. Daniel S. Rooks and his associates point out in their paper published in the October 15th issue of Arthritis and Rheumatism. Dr. Rooks, from Beth Israel Deaconess Medical School in Boston, and other members of his team recruited patients scheduled to undergo unilateral, primary arthroplasty of the hip or knee. Patients who completed the study had been randomly assigned to exercise (25 with hip arthritis and 14 with knee arthritis) or to education alone (24 and 15, respectively). The exercise protocol consisted of sessions 3 times a week for 6 weeks. For the first 3 weeks, the subjects performed light exercises in chest-deep water. During the next 3 weeks, strength training activities - such as the seated row, leg press, and biceps curls - were added to the water exercises, along with cardiovascular and flexibility exercises. Prior to hip surgery, patients who completed the exercise program experienced stabilized or improved pain and function, while the control subjects had gotten worse. In contrast, those undergoing knee replacement did not seem to benefit from the program. But no matter which joint was replaced, 65% of patients who were in the exercise group were discharged directly home after surgery, versus 44% of those in the control group. The odds ratio after adjustment for baseline function and age was 0.27. At 8 and 26 weeks after surgery, participants in the exercise program had improved more in physical function and pain, particularly patients who had knee replacement surgery. "Our findings suggest that men and women with severe arthritis can safely increase lower-extremity muscle strength through participation in a program of cardiovascular fitness, strength training, and flexibility exercise prior to total hip arthroplasty or total knee arthroplasty," the authors conclude. Reuters Health Information 2006. © 2006 Reuters Ltd. |
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