ArticleArchives of rehabilitation research and clinical translation2025
Feasibility of a Preoperative Exercise and Nutritional Intervention in Sarcopenic Obese Individuals Undergoing Hip or Knee Arthroplasty: A Pilot Randomized Controlled Trial.
Article in Archives of rehabilitation research and clinical translation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To evaluate the feasibility and preliminary effectiveness of a combined preoperative exercise and nutritional intervention in patients with sarcopenic obesity (SO) scheduled for total hip or knee arthroplasty. Design: A pilot randomized controlled trial was conducted (May 2021 to December 2022). Setting: A regional Dutch hospital. Participants: Patients (N=40) with obesity before total hip arthroplasty or total knee arthroplasty (73% women, age 65±10y, body mass index, 34±3kg/m Interventions: Exercise, a physiotherapist-supervised program of resistance and aerobic training twice weekly for 6 weeks, plus dietitian-guided nutritional advice to reach recommended protein intake within the habitual diet (n=21), compared with a control group receiving usual preoperative care and general dietary guidance (n=19). Main outcome measures: The main outcome was feasibility and acceptability, based on recruitment, adherence, and participant feedback. Secondary outcomes included physical function, self-reported health, body composition, and inflammation markers. Results: Of 40 randomized patients, 25 completed the intervention period, with many dropouts because of scheduling issues related to coronavirus disease 2019. Exercise adherence was 80%, and dietary adherence was high, with participants significantly increasing protein intake. The proportion of patients meeting the recommended protein intake (1.2g/kg) increased from 21% to 93% in the intervention group, whereas it remained at 18% in the control group. Intervention participants improved preoperative functional mobility, with the timed Up and Go test reduced by a clinically relevant difference of 2 seconds. Interviews indicated that participants continued the nutritional advice and exercise on their own initiative after surgery. Postoperative outcomes, measured by length of stay and self-reported physical functioning, were unchanged. Conclusions: Despite recruitment challenges and dropouts, the intervention was feasible and well-received, with short-term functional improvements. The preoperative period offers a valuable window for lifestyle changes, though no postoperative differences were observed. Longer or more personalized interventions may further enhance outcomes.
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