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Health professions need to prepare for the large increase in the number of older people with OA requiring health services including TJA surgery. Older age and poor physical function influences the postoperative prognosis of TJA. At discharge from hospital after TJA, studies have shown that gait speed can be severely impaired among older patients.
The investigators hypothesize that an exercise program of 6-12 weeks will be beneficial for patients that are undergoing TJA.
More than 300.000 Norwegians above 20 years of age have osteoarthritis (OA) . There has been a significant increase in the prevalence of OA over the decades. In the United States knee OA affects 19% of adults aged 45 years or older. OA is associated with an extensive high economic and personal burden, largely attributable to the effects of disability, comorbid disease, and the expense of treatment.
Given the aging population, the number of total joint arthroplasty procedures (TJA) for hip and knee is likely to increase substantially. In light of poor physical function prior to surgery among older patients and the likelihood of an added decrease during hospitalization and risk of poorer outcome after surgery, it is hypothesised that prehabilitation (preoperative exercise) would improve outcomes after surgery, however evidence for its efficacy is still lacking
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention group | Active Comparator | Exercise interventions for 6-12 weeks. Adherence is monitored with day journals |
|
| Control group | No Intervention | Care as usual |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Exercise | Behavioral | Exercises in group and/or individually |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in gait speed | 40 meters Fast-Paced Walk test | Change measure: Baseline, within one week after intervention, 6 weeks after intervention, 3 months after intervention, 6 months after intervention and 12 months after intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Change in physical function | 30 second sit-to stand test | Change measure: Baseline, within one week after intervention, 6 weeks after intervention, 3 months after intervention, 6 months after intervention and 12 months after intervention |
| Change in aerobic capacity |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Odd-Einar Svinøy, MSc | OsloMet | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| OsloMet | Oslo | 0130 | Norway |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | Slatkowsky-Christensen B, Grotle M. Artrose i Norge. Norsk Epidemiologi 2008;18(1) | ||
| 28808025 | Background | Wallace IJ, Worthington S, Felson DT, Jurmain RD, Wren KT, Maijanen H, Woods RJ, Lieberman DE. Knee osteoarthritis has doubled in prevalence since the mid-20th century. Proc Natl Acad Sci U S A. 2017 Aug 29;114(35):9332-9336. doi: 10.1073/pnas.1703856114. Epub 2017 Aug 14. | |
| 19817509 |
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| ID | Term |
|---|---|
| D009043 | Motor Activity |
| D001168 | Arthritis |
| D010003 | Osteoarthritis |
| ID | Term |
|---|---|
| D001519 | Behavior |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D012216 | Rheumatic Diseases |
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| ID | Term |
|---|---|
| D015444 | Exercise |
| ID | Term |
|---|---|
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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6 min walk test |
| 1 week before intervention, directly after intervention as well as 6 and 12 weeks after TJA-surgery |
| Change in transitional ambulation | Timed-up and go Test (TUG) | Change measure: Baseline, within one week after intervention, 6 weeks after intervention, 3 months after intervention, 6 months after intervention and 12 months after intervention |
| Change in pain measured with numeric rating scale (NRS) | NRS - Single score, low score indicates low pain, high score indicated high levels of pain | Change measure: Baseline, within one week after intervention, 6 weeks after intervention and 3 months after intervention |
| Length of stay in hospital | Number of days | From date of hospital admission until the date of hospital discharge, assessed up to 12 months |
| Change in the ability to climb stairs | Stair-climb test. Timed performance from start to stop | Change measure: Baseline, within one week after intervention, 6 weeks after intervention, 3 months after intervention, 6 months after intervention and 12 months after intervention |
| Change in Health Status measured with EuroQol-5 dimensions (EQ-5D) | EQ-5D, five dimensions of health scored from 1-5, with 1 being no problem and 2-5 indicate increasing problem (higher score = increase in problem) | Change measure: Baseline, within one week after intervention, 6 weeks after intervention, 3 months after intervention, 6 months after intervention and 12 months after intervention |
| Background |
| Bitton R. The economic burden of osteoarthritis. Am J Manag Care. 2009 Sep;15(8 Suppl):S230-5. |
| 40050814 | Derived | Svinoy OE, Nordbo JV, Pripp AH, Risberg MA, Bergland A, Borgen PO, Hilde G. The effect of prehabilitation for older patients awaiting total hip replacement. A randomized controlled trial with long-term follow up. BMC Musculoskelet Disord. 2025 Mar 6;26(1):227. doi: 10.1186/s12891-025-08468-4. |
| 31892650 | Derived | Svinoy OE, Bergland A, Risberg MA, Pripp AH, Hilde G. Better before-better after: efficacy of prehabilitation for older patients with osteoarthritis awaiting total hip replacement-a study protocol for a randomised controlled trial in South-Eastern Norway. BMJ Open. 2019 Dec 30;9(12):e031626. doi: 10.1136/bmjopen-2019-031626. |