Joint replacement (arthroplasty) is a common treatment for severe osteoarthritis of the knee or hip. Physicians often prescribe exercise therapy to treat arthritis or promote rehabilitation after arthroplasty, but little is known about the effect of exercise on end-stage osteoarthritis and shortly before joint surgery.

Researchers at Harvard Medical School, New England Baptist Hospital and several other facilities studied 108 patients scheduled to have a knee or hip replacement. Half the patients were assigned to a thrice-weekly exercise program for the six weeks before their operation. They underwent individually tailored strengthening, aerobic and flexibility exercises, including aquatics, in a physical therapy group. The other 54 patients were given educational materials.

The exercisers were 73 percent less likely than the others to require discharge to an inpatient rehab center. In addition, they were more likely to be able to walk more than 50 feet before leaving the hospital.

The researchers noted that the program included only three weeks (nine sessions) of strength training, far less than the generally recommended amount, and suggested that the knee patients in particular would likely benefit from additional pre-operative strengthening. They concluded that a well-designed exercise program could enhance function and strength in middle-age and elderly patients with severely osteoarthritic hips or knees.

The study was published this month in Arthritis Care & Research.

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