Effects of tele-prehabilitation on clinical and muscular recovery in patients awaiting knee replacement: protocol of a randomised controlled trial

BMJ Open · 9 authors, 8 centres

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This publication describes the protocol for a randomised controlled trial investigating a home-based tele-prehabilitation program for male patients aged 65-80 awaiting total knee arthroplasty.

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This publication describes the protocol for a randomised controlled trial investigating a home-based tele-prehabilitation program for male patients aged 65-80 awaiting total knee arthroplasty. The primary outcome is the WOMAC score measured at the end of prehabilitation. A wide range of secondary outcomes, including other patient-reported measures, performance tests, and biomarkers, are planned.

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other

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surgery

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ORIGINAL PAPER

PMC10551960

Effects of tele-prehabilitation on clinical and muscular recovery in patients awaiting knee replacement: protocol of a randomised controlled trial

BMJ Open

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ABSTRACT

Abstract Background The increasing prevalence of knee osteoarthritis and total knee arthroplasty (TKA) impose a significant socioeconomic burden in developed and developing countries. Prehabilitation (rehabilitation in the weeks immediately before surgery) may be crucial to prepare patients for surgery improving outcomes and reducing assistance costs. Moreover, considering the progress of telemedicine, candidates for TKA could potentially benefit from a tele-prehabilitation programme. We aim to evaluate the effects of a home-based tele-prehabilitation program for patients waiting for total knee replacement. Methods and analysis Forty-eight male patients, aged 65–80, on a waiting list for TKA will be recruited and randomly assigned to the tele-prehabilitation intervention or control groups. Both groups will undergo the same 6-week exercise program (five sessions/week) and the same educational session (one per week). The tele-prehabilitation group will perform asynchronous sessions using a tablet, two accelerometers and a balance board (Khymeia, Padova, Italy), while the control group will use a booklet. The Western Ontario and McMaster Universities Osteoarthritis Index Questionnaire, at the end of the prehabilitation, will be the primary outcome. Secondary outcomes will include self-reported outcomes, performance tests and change in expressions of blood and muscle biomarkers. Ten healthy subjects, aged 18–30, will be also recruited for muscle and blood samples collection. They will not undergo any intervention and their data will be used as benchmarks for the intervention and control groups’ analyses. Ethics and dissemination This randomised controlled trial will be conducted in accordance with the ethical principles of the Declaration of Helsinki. This study has been approved by the Ethics Committee of Vita-Salute San Raffaele University (Milan, Italy. No. 50/INT/2022). The research results will be published in peer-reviewed publications. Trial registration number NCT05668312 . Keywords: Knee, REHABILITATION MEDICINE, Telemedicine, Orthopaedic & trauma surgery, Clinical Trial

CITATION EXPORT

Stefania Guida, Jacopo Vitale, Silvia Gianola et al.. Effects of tele-prehabilitation on clinical and muscular recovery in patients awaiting knee replacement: protocol of a randomised controlled trial. BMJ Open. (2023). https://doi.org/10.1136/bmjopen-2023-073163

AUTHORS

9 · 8 CENTRES

Stefania Guida, Jacopo Vitale, Silvia Gianola, Greta Castellini, Eva Swinnen, David Beckwée, Cecilia Gelfi, Enrica Torretta, Laura Mangiavini

1Unit of Clinical Epidemiology, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy
2Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium
3Spine Center, Schulthess Klinik, Zurich, Switzerland
4Rehabilitation Research Deparment, Vrije Universiteit Brussel, Brussel, Belgium
5Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerpen, Belgium
6Laboratory of Proteomics and Lipidomics, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy
7Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
8IRCCS Galeazzi Orthopaedic Institute, Milan, Italy