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Project Type: Externally Funded
Project Title: The Effects of Aquatic Prehabilitation in Knee OA Patients on Knee Arthroplasty Outcomes (Aquatic Prehab)
Principal Investigator: Sunghye Kim, MD
  Other Key Investigator (1): Leanne Groban, MD
  Other Key Investigator (2): Jeff Williamson, MD
  Other Key Investigator (3): Stephen Messier, PhD
  Other Key Investigator (4): Jason Lang, MD
Project Start Date: 09/01/2015
Projected End Date: 05/31/2017
Associated Center: Wake Forest University
Associated Core(s): RC1 (Clinical Research Core)
RC3 (Integrative Biology Core)
Brief Description: We hypothesize breaking this vicious cycle before surgery, by prehabilitation using individualized aquatic exercise, may result in better postoperative outcomes. Patients with KOA who are undergoing knee replacement surgery invariably experience pain, instability, muscle weakness, and fear of falling. Land-based exercise for prehabilitation might not be well accepted by these patients, resulting in poor compliance. Aquatic exercise is a valuable alternative to land based exercise. Aquatic exercise in a heated pool is known to be the most comfortable way to exercise for people with osteoarthritis. The resistance of water strengthens muscle and increase energy expenditure, at the same time the buoyancy of water provides an “environment” where joints are not weight bearing. Aquatic exercise in patients with OA has been extensively studied. However, it has not been studied in the preoperative setting as a tool of prehabilitation. Reported benefits of aquatic exercise include reduced pain, stiffness, physical function, decreased body fat proportions and improved inflammatory profile. We hypothesize that preoperative aquatic exercise will improve mobility, body composition and inflammatory profile in older patients with advanced OA. These improved preoperative mobility, body composition, and inflammatory status will in turn, lead to better postoperative outcomes and recovery. In designing a prehabilitation protocol, it was suggested the protocol should be tailored to participant’s ability for maximum effect. We will use an individualized aquatic exercise per each participant’s ability and tolerance to increase the benefit of exercise and adherence to the exercise protocol: participants with better exercise capacity will be challenged with higher intensity exercise while participants with lower exercise capacity will start with low intensity exercise. In summary, we will screen subjects on their mobility using an innovative tool, MAT-sf and enroll subjects who are most likely to benefit from preoperative aquatic exercise. We will use individualized aquatic exercise as a prehabilitation tool, which is the most comfortable way to exercise in patients with osteoarthritis but has never been tried as a prehabilitation tool. If our study shows promising results, it would open a door for a new intervention in this population. The proposed prospective randomized pilot study will recruit participants aged 50 years and older who are scheduled for primary total knee replacement surgery (TKA).
Project Keywords: Physical Function
Stored Blood/Tissue
Obesity/Weight Loss
Physical Function
Knee OA

Registered By: Abby Archer
Registered On: 08/15/2016
Project Status: Active