A systematic review and meta-analysis of the effect of preoperative exercise intervention on rehabilitation after total knee arthroplasty
Bibliographic record
Abstract
BACKGROUND: A number of researches indicated preoperative functional exercise may improve the rehabilitation progress. This study aimed to investigate the effect of preoperative exercise intervention on rehabilitation before total knee arthroplasty (TKA) by literature retrieval and meta-analysis. METHODS: Embase, Cochrane library, PubMed, Ovid, and ClinicalTrials.gov were selected as the search database platforms. All published English articles related to preoperative exercise of TKA from January 2000 to January 2021 were searched with the following keyword strategy: ("preoperative functional exercise" or "prehabilitation exercise") AND ("TKA" or "total knee arthroplasty"). After literature screened according to the inclusion and exclusion criteria, the risk of bias and quality of the included articles were evaluated. RevMan 5.3.5 software was used for analysis to obtain the forest plot and funnel plot. RESULTS: A total of 911 articles were preliminarily searched in this study, and 12 were finally included for the quantitative analysis, comprising 889 patients; the result showed after intervention, the experimental group patients had wider ROM flexion than the control group patients [mean difference (MD) =4.28; 95% CI: 2.28 to 6.28; Z=4.19; P<0.0001]; the experimental group patients were with higher quadriceps strength value than the control group (MD =1.86, 95% CI: 0.58-3.15; Z=2.84, P=0.005); the WOMAC score (The Western Ontario and McMaster Universities Osteoarthritis Index), were higher for the experimental group patients (MD =-10.59; 95% CI: -11.88 to -9.29; Z=16.03; P<0.00001); and the standing and walking test index are higher (MD =-1.29, 95% CI: -1.90 to -0.67; Z=4.08; P<0.001); the quality of life score were higher too for the experimental group patients (MD =1.66; 95% CI: 1.13-2.20; Z=6.08; P<0.00001). DISCUSSION: Preoperative exercise intervention before TKA can improve knee flexion and flexibility, reduce inflammatory pain and stiffness, improve muscle strength, improve joint function, and thus improve the quality of life of patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.024 | 0.058 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.023 | 0.040 |
| Bibliometrics | 0.010 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".