Prehabilitation interventions for patient undergoing Primary Replacement Arthroplasty: Protocol for scoping review
Abstract BackgroundOsteoarthritis ranks fifth among all forms of disability worldwide 1 and it is estimated that 30.8 million adults have osteoarthritis 2. Primary replacement arthroplasty is the surgical treatment of choice to decrease pain and improve quality of life in late-stage OA 5. The current situation in South Africa, which is a lower- and middle-income countries LMICs, is that the waiting lists for arthroplasty is extensive with steep costs involved in the management of these patients in public sector hospitals which serves most of the population 7. Physiotherapist can have an impact on this situation by implementing measures to reduce length of stay postoperatively in the hospital by prehabilitation (Prehab). Hence a need to conduct a scoping review to identify the trends in literature regarding the content as well as the gaps.MethodsThe methodology will involve a literature search as described by Arksey and O’Malley19. The scoping review methods will adopt the framework proposed by the Joanna Briggs Institute guidelines. Literature searches will be conducted in the following electronic databases PubMed/MEDLINE, Cochrane Library, and Google Scholar and peer-reviewed journal papers will be included based on predetermined inclusion criteria. Quantitative, qualitative, and mixed-method studies will be included to consider different aspects of measuring the effects of physical activity and exercise. Two reviewers will screen all citations and full-text articles and the main reviewer will abstract data, organize them into themes and sub-themes, summarize them, and report the results using a narrative synthesis. The study methodological quality will be appraised using a Mixed Methods Appraisal Tool.DiscussionThe proposed scoping review will map the breadth of knowledge available on topic of Prehab interventions in patients scheduled to undergo joint arthroplasty in terms of exercise prescription principles and other ways to implement pre-operative optimisation. The scoping review is the first part of a study that aims to design a prehab program suitable for a resource constrained LMICs health care system wherein the demographic and physical characteristics of its health users are unique and independent to the context. Systematic review registration: Open Science Framework https://osf.io/9fdsh/