Research Summary
Waiting for a Knee or Hip Replacement? Remote Prehab Programs All Improved Function in a Small Trial
People waiting for a knee or hip replacement improved their strength and mobility with four weeks of at-home "prehab," whether it used electrical muscle stimulation, live online sessions with a physiotherapist, or a simple exercise brochure. That is the finding of a randomized trial in BMC Musculoskeletal Disorders.
What was studied
Many patients on joint replacement waiting lists have weak muscles and limited mobility, which is linked to slower recovery after surgery. Prehabilitation means exercising before the operation to get stronger. Researchers in Italy compared three remote options.
In this three-arm randomized controlled trial, 60 patients scheduled for total knee or total hip replacement were split evenly into four-week programs of three 30-minute sessions a week: neuromuscular electrical stimulation (NMES) of the muscles, physiotherapist-supervised online exercise, or unsupervised home exercise guided by a brochure. Tests included the 30-second chair stand, the Timed Up and Go walking test, the Oxford Knee or Hip Score, a six-minute walk after surgery and length of hospital stay.
Key findings
- All three groups improved significantly on most measures.
- NMES improved the Timed Up and Go test more than both other programs, and did better than supervised online exercise on the six-minute walk and Oxford score.
- Brochure-guided home exercise was largely equal to NMES on most measures, and beat supervised online exercise on the six-minute walk.
What it means for people with knee pain
If you are waiting for a joint replacement, getting active beforehand appears worthwhile, and it may not require in-person visits. A structured home exercise plan or at-home muscle stimulation may be practical options to discuss with your surgeon or physical therapist.
Limitations
The study was small and had no usual-care or no-exercise group, so it shows how the programs compared with each other, not whether they beat doing nothing. It mixed knee and hip patients and followed them only to 10 days after surgery.
Frequently asked questions
- What is prehabilitation before knee replacement?
- Prehabilitation, or prehab, is exercise or muscle training done before surgery to build strength and mobility, with the aim of recovering faster afterward.
- Can I do prehab at home?
- In this trial, all three remote programs, including unsupervised exercise from a brochure, improved function over four weeks. Ask your surgeon or physical therapist which plan suits you.
- Is electrical muscle stimulation better than exercise before surgery?
- NMES did best on a timed walking test, but brochure-guided home exercise was about as good on most other measures. The study was small, so more research is needed.
Sudden severe pain, swelling, or can't bear weight? Seek medical care promptly. In an emergency call 911.