Feasibility and preliminary effects of a tele-prehabilitation program and an in-person prehablitation program compared to usual care for total hip or knee arthroplasty candidates: a pilot randomized controlled trial

Abstract

Purpose: Prolonged wait times for total hip and knee arthroplasty have deleterious effects on functional status for the awaiting patients. Telerehabilitation interventions can optimize the delivery of perioperative care. This pilot single-blind randomized controlled trial evaluates the feasibility and the potential impact on pain and disability of a telerehabilitation prehabilitation program, compared to in-person prehabilitation or usual care.

Material and methods: Thirty-four patients awaiting a total hip or knee arthroplasty were randomly assigned to (1) an in-person 12-week prehabilitation program, (2) a tele-prehabilitation program or (3) usual care. Outcomes were feasibility, patients’ acceptance and compliance to the program, the LEFS, the WOMAC, SF-36, the Self-Pace Walk, the Stair Test, the Timed Up and Go, and a Global Rating of Change scale. Outcomes were collected at baseline and after 12 weeks.

Results: Participants reported excellent satisfaction toward tele-prehabilitation. Compliance with the programs was high. No significant differences between groups were found for self-reported outcomes after the prehabilitation program (p ≥ 0.05).

Conclusion: This pilot study suggests that tele-prehabilitation can be feasible using commercially available mobile technologies with patients awaiting total hip or knee arthroplasty, and can generate good satisfaction with this population. Further evaluation is warranted through a formal fully powered randomized controlled trial.

Trial registration: ClinicalTrials.gov #NCT02636751

Implications for Rehabilitation

• Prolonged wait times have deleterious effects on patients awaiting a total hip or knee arthroplasty.

• Prehabilitation interventions can optimize the delivery of perioperative care, but accessibility to such interventions can be limited by geographic situation, lack of transportation and financial issues.

• Using video conferencing mobile technologies can help overcome those obstacles.

• Tele-prehabilitation using mobile technology appears safe, feasible and generates good satisfaction with subjects awaiting a total hip or knee arthroplasty.

Keywords:

• Prehabilitation
• telerehabilitation
• osteoarthritis
• arthroplasty
• hip
• knee

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This project was financially supported by François Desmeules‘Fonds de recherche du Québec – Santé (FRQS) research scholar junior 1 fund [#31112] and by the Ordre professionnel de la physiothérapie du Québec’s master student grant [January 31, 2016 scholarship competition].