Prehabilitation” refers to exercise performed before surgery that helps reduce functional decline after surgery. The theory is that a higher level of function pre-operatively will provide a higher level of function post-operatively, thus shortening the rehabilitation process. Prehabilitation exercise has been shown effective at preventing functional decline in frail elderly individuals (Gill et al. 2002).

For the past 4 years , Dr. Robert Topp and his colleagues at the University of Louisville have been researching the effects of a “prehab” program for patients scheduled for total knee replacement surgery. Their exercise program features progressive Thera-Band resistance exercises performed over a period of 4 to 8 weeks before surgery. Last year, I featured Dr. Topp’s prehabilitation program in the Academy Blog after his publication in Archives of Physical Medicine and Rehabilitation.

Most recently, Dr. Topp’s colleague, Dr. Ann Swank was the lead author on a paper in the February 2011 issue of Journal of Strength and Conditioning Research. The article described the pre-operative outcomes of 71 patients with severe knee arthritis who had pain that didn’t respond to medication. The patients were randomly assigned to either a control group or a 4 to 8 week prehab exercise group prior to total knee replacement surgery.

Patients were tested before and after the program which included progressive Thera-Band resistance band training, light walking, stretching and step-up training three times per week in the clinic and at home. Download the Louisville Total Knee Replacement Prehabilitation Exercise Protocol here.

The exercise group improved their pain levels significantly more than the control group before surgery. They also significantly increased in leg strength and improved their performance on functional tasks before surgery, which the authors hypothesized will lead to better outcomes after surgery. The authors concluded that their short-term and “easily accessible” prehabilitation program was successful for patients with end-stage knee osteoarthritis and pain unresponsive to medication. Find more prehabilitation research articles using Thera-Band products here.

Dr. Topp noted, “The prehabilitation program we developed using Thera-Band resistance for total knee replacement patients reduces pain and improves function before surgery. It’s quite possible that this program can translate to savings in healthcare costs.”

REFERENCE: Swank AM, Kachelman JB, Bibeau W, Quesada PM, Nyland J, Malkani A, Topp RV. Prehabilitation before total knee arthroplasty increases strength and function in older adults with severe osteoarthritis. J Strength Cond Res. 2011 Feb;25(2):318-25.

Disclosure: Thera-Band Academy provided support for this study

Visit the Thera-Band Academy Total Knee Replacement Resource Center here

Read the University press release here

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