Plausibilité de l’effet d’un programme de télé-préréadaptation, supervisée ou en personne, comparés à un groupe témoin chez des participants en attente d’une arthroplastie totale de la hanche ou du genou : essai pilote randomisé en simple aveugle
INTRODUCTION: The accessibility to total hip (THA) and knee arthroplasty (TKA) often comes up against long wait lists. Prolonged wait times may have deleterious effects on patient functional status for the awaiting patients and telerehabilitation interventions can optimize the delivery of perioperative care. OBJECTIVES: This pilot single blind randomized controlled trial aims to evaluate the feasibility and the potential impact on pain and disability of a telerehabilitation prehabilitation program for patients awaiting a hip or knee TJA, compared to in-person prehabilitation or usual care during pre-surgical wait. METHODS: Thirty-four patients awaiting a total hip (THA) or knee arthroplasty (TKA) were recruited and randomly assigned to: 1—an in-person 12-week prehabilitation program, 2—a tele-prehabilitation program or 3—usual care. Feasibility, patients’ acceptance and compliance to the tele-prehabilitation program were assessed. Outcomes were the LEFS, the WOMAC, SF-36, the Self-Paces Walk (SPW), the Stair Test (ST), the Timed Up and Go (TUG) and a Global Rating of Change scale (GRC). Data was collected at baseline and after the prehabilitation program. RESULTS: Participants reported excellent satisfaction toward the tele-prehabilitation services and compliance with the prehabilitation program was high in the experimental groups. No significant differences between groups were found for self-reported outcomes after the prehabilitation program, but statistical power was low. Statistically significant improvements were, however, observed for the SPW and the ST among the participants in the experimental groups. DISCUSSION: This pilot study suggests that tele-prehabilitation can be feasible using commercially available mobile technologies with patients awaiting a THA or a TKA, and can generate good satisfaction with this population. This trial also suggests that rehabilitation can improve objective physical performance measures, such as walking speed or stair performance with those patients, but the objective functional improvement observed is not associated with reduction in pain or self-perceived functional improvements. The observations from this pilot project have to be interpreted with caution, as they need to be confirmed in a sufficiently powered larger trial.
Exercices Application mobile Prehabilitation Telerehabilitation Osteoarthritis Arthroplasty Hip Knee Physiotherapy Exercise Mobile applications Videoconference