Exercise Before Joint Replacement?
Workouts Before Surgery Helped Recovery Process for Hip and Knee Patients
Sept. 29, 2006 -- Getting a total knee or hip replacement? A sensible
exercise plan before surgery may help you recover after it.
That news appears in Arthritis & Rheumatism.
Researchers included Daniel Rooks, ScD, of Harvard Medical School, Boston's
New England Baptist Hospital, and Beth Israel Deaconess Medical Center.
Rook and colleagues studied 108 men and women scheduled for total hip or
replacementdue to severe osteoarthritisat
Boston's New England Baptist Hospital. Patients were typically in their late
50s to late 60s.
The researchers randomly split them into two groups.
Patients in one group followed a six-week exercise program before their
For comparison, the other patients weren't asked to exercise before
You might think exercise is the last thing someone should do if they need a
new hip or knee.
But getting stronger is often helpful, as long as the patient doesn't overdo
it and gets a doctor's approval first.
Rooks' team made sure the patients' workouts, done three times weekly for
six weeks, were sensible.
For the first three weeks, patients in the exercise group worked out in a
pool; water workouts are easy on the joints.
The patients stood in chest-deep water, exercising their spine, shoulders,
elbows, wrists, hands, hips, ankles, and knees.
For the last three weeks, patients exercised in a gym on recumbent
stationary bikes or elliptical machines. Those workouts don't pound the
Patients also did strength training and stretches for flexibility during the
program's last three weeks.
A physical therapist supervised the workouts, which lasted 30-60 minutes and
were held at a community fitness facility.
Before anyone broke a sweat, all the patients rated their ability to do
normal chores and activities. They also took tests of their balance, mobility,
and leg strength.
They repeated those tests right before surgery, and again afterwards.
As expected, patients in the workout group got stronger while those in the
comparison group didn't.
Also, after surgery, the exercisers were much less likely than the
nonexercisers to need to go to an inpatient rehabilitation facility instead of
Sixty-five percent of the exercisers went straight home, compared to 44% of
the nonexercisers, the study shows.
Exercisers who got total hip replacement also showed a significant advantage
in their presurgery function -- based on their own ratings of their ability to
handle routine activities -- compared to the nonexercisers.
However, no such function benefit was seen in exercisers who had their knees
The reasons for that aren't clear, the researchers note, although they say
the difference may be related to the joint location. A longer period of
exercise may be needed to help knee function, the researchers write.
"Our findings show that an appropriately designed program of water and
land-based exercise involving cardiovascular, strength training, and
flexibility activities can be a safe, tolerable, and effective approach to
improving muscle strength in middle-aged and older adults with severe
osteoarthritis of the hip and knee," write Rooks and colleagues.