Land-Based Versus Pool-Based Exercise for People Awaiting Joint Replacement Surgery of the Hip or Knee: Results of a Randomized Controlled Trial

• Published in: Archives of physical medicine and rehabilitation Vol. 90; no. 3; pp. 388 - 394
• Main Authors: Gill, Stephen D., BPhty, McBurney, Helen, PhD, Schulz, Debra L., DPhysio
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-03-2009; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Arthroplasty; Arthroplasty, Replacement, Hip - rehabilitation; Arthroplasty, Replacement, Knee - rehabilitation; Biological and medical sciences; Diseases of the osteoarticular system; Exercise; Exercise Therapy - classification; Female; Humans; Male; Medical sciences; Middle Aged; Miscellaneous; Occupational therapy; Occupational Therapy - methods; Orthopedic surgery; Pain - prevention & control; Physical Medicine and Rehabilitation; Preoperative Care - classification; Preoperative Care - methods; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Rehabilitation; Single-Blind Method; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Swimming; Treatment Outcome; body mass index; osteoarthritis; GAC; Western Ontario and McMaster Universities Osteoarthritis Index; Arthroplasty; global assessment of change; Medical Outcomes Study 36-Item Short-Form Health Survey; ES; SF-36; ANCOVA; OA; Exercise; analysis of variance; ANOVA; WOMAC; Occupational therapy; Rehabilitation; effect size; MCS; mental component score; analysis of covariance; BMI; Physical exercise; Knee; Prosthesis; Hip; Reeducation; Treatment; Surgery; Orthopedics; Comparative study
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1016/j.apmr.2008.09.561

Abstract Gill SD, McBurney H, Schulz DL. Land-based versus pool-based exercise for people awaiting joint replacement surgery of the hip or knee: results of a randomized controlled trial. Objective To compare the preoperative effects of multidimensional land-based and pool-based exercise programs for people awaiting joint replacement surgery of the hip or knee. Design Randomized, single-blind, before-after trial. Setting Physiotherapy gymnasium and hydrotherapy pool. Participants Patients awaiting elective hip or knee joint replacement surgery. Interventions Land-based (n=40) or pool-based exercise program (n=42). Each 6-week program included an education session, twice-weekly exercise classes, and an occupational therapy home assessment. Main Outcome Measures Participants were assessed immediately before and after the 6-week intervention, then 8 weeks later. Primary outcomes were pain and self-reported function (Western Ontario and McMaster Universities Osteoarthritis Index) and patient global assessment. Secondary outcomes were performance-based measures (timed walk and chair stand) and psychosocial status (Medical Outcomes Study 36-Item Short-Form Health Survey mental component score). Pain was also measured before and after each exercise class on a 7-point verbal rating scale. Results Although both interventions were effective in reducing pain and improving function, there were no postintervention differences between the groups for the primary and secondary outcomes. However, the pool-based group had less pain immediately after the exercise classes. Conclusions While our multidimensional exercise-based interventions appeared to be effective in reducing disability in those awaiting joint replacement surgery of the hip or knee, there were no large differences in the postintervention effects of the interventions. However, pool-based exercise appeared to have a more favorable effect on pain immediately after the exercise classes.