Arthroplasty for the frail person:
technology-supported home prehabilitation

published in July - December 2022 - in Il Fisioterapista - issue n.2
Luca Marin, Nicola Lovecchio, Dario Silvestri, Emilio Romanini, Massimiliano Febbi

The World Health Organization predicts a 56 percent growth in people aged 60 and older by 2030. One of the most common age-related issues is frailty. In orthopedic surgery, several studies have found a direct association between frailty status and postoperative outcomes. There is evidence that, if diagnosed early and properly treated, frailty status is reversible or otherwise amendable. Therefore, it is of interest to investigate the effects of prehabilitation on the outcomes of orthopedic surgery, particularly hip and knee arthroplasty, on frail people. The effectiveness of the use of technology in rehabilitation, particularly telerehabilitation, is demonstrated by numerous studies. Many of these have used exercise supported by visual biofeedback, either direct or with gamification, in both outpatient and home settings; others have used indirect electrostimulation. Considering the physical commitment and difficulties that the frail person might encounter for transfers, the needs of caregiver and adequate transportation, it was decided to administer the prehabilitation program at home, combining the use of tools that have been shown to be effective for other populations.