Doctoral defence: Monika Mets "Effect of a preoperative home exercise program on motor function in women with severe knee osteoarthritis scheduled for total arthroplasty"

On October 10th Monika Mets will defend her thesis "Effect of a preoperative home exercise program on motor function in women with severe knee osteoarthritis scheduled for total arthroplasty".

Supervisors:
Helena Gapeyeva, University of Tartu and East Tallinn Central Hospital
Professor emeritus Tiit Haviko, University of Tartu

Oponent:
Professor emeritus Ari Heinonen, University of Jyväskylä (Finland)

Summary
Therapeutic exercise is a key part of treating knee osteoarthritis. Many studies have focused on people with earlier stages of the disease or on recovery after joint replacement surgery, but there is a lack of information regarding preoperative home exercise programs in severe knee osteoarthritis.

This study aimed to investigate the effect of a preoperative home exercise program on motor function, functional mobility and perceived health status in women with severe knee osteoarthritis scheduled for total knee arthroplasty. Women with knee osteoarthritis performed a preoperative home exercise program daily for 8 weeks. The program included 15 exercises to increase mobility, balance, coordination and lower limb muscle strength.

After the 8-week home exercise program, women demonstrated improved gait function, better balance under unstable conditions, enhanced thigh muscle activation and coordination during standing up from a chair, stronger lower limb muscles with less strength difference between limbs, and increased knee joint range of motion. They also completed functional tasks faster and reported an improvement in their perceived health status. A quarter of the participants postponed their planned knee surgery after completing the program. In women with severe knee osteoarthritis, characteristics of balance, gait, and perceived health status were associated with leg extensor muscle strength, knee pain, and range of motion characteristics. In some gait and muscle activation characteristics, the patients’ data did not differ compared to age- and gender-matched peers after the exercise program. These findings suggest that preoperative home exercise programs benefit individuals with severe knee osteoarthritis and are a valuable alternative when access to outpatient physiotherapy is limited.