ENU researchers design prehab service to revolutionise pre-surgery patient care

The waiting time for hip and knee replacement increased from 12 weeks to 18 months because of Covid and the backlog it created for the NHS.

Such a long period can considerably decrease the quality of life and the chance of quick post-surgery recovery for the patient. The good news: a group of ENU researchers may have just found the perfect solution.

Patients waiting for hip or knee replacements live with severe pain symptoms caused by damaged joint surfaces. The constant soreness and discomfort reduce people’s mobility and fitness, increasing their chances for gaining weight and extending the likely time of post-surgery recovery.

According to Edinburgh Napier’s Professor Anna Campbell, “Evidence is emerging that providing virtual exercise, nutritional and emotional support to people waiting for operations – or during treatment – has the potential to significantly improve their physical and psychological wellbeing and quality of life.”

The hip and knee (HAK) prehab intervention is a pilot service designed by ENU lecturers and researchers – Dr Kostas Kaliarntas, Professor Anna Campbell, and Dr Amanda Pitkethly from the School of Applied Sciences; and Dr David Hamilton, Dr Coral Hanson and Professor Lis Neubeck from the School of Health and Social Care. They worked in collaboration with orthopaedic surgeon Dr Nick Clement and anaesthetist Dr Elizabeth Brun Lacey, from NHS Lothian.

The service is now being funded by NHS Lothian for approximately 18 months. Its function is to provide virtual lifestyle behaviour change programmes that will increase the fitness and wellbeing of patients waiting for hip and knee replacement. These include individual online exercise sessions, dietary advice, and emotional support; all provided by clinical exercise physiologists.

Similar services developed by ENU researchers have been successfully delivered to cancer and cardiac patients, such as the ongoing Safefit trial led by Professor Anna Campbell and her team.

The new HAK prehab intervention follows the Safefit protocol and researchers aim to recruit 126 hip and knee replacement patients, supplying each of them with a 6-month virtual prehabilitation service.

The clinical exercise physiologists will monitor behavioural changes and measure outcomes by conducting interviews and exploring service users’ experiences. If the pilot proves beneficial for patients, and feasible for the NHS, it could revolutionise pre-surgery healthcare.

Dr Kostas Kaliarntas added, “This project gives us exciting opportunities for further collaborations with NHS, placement opportunities for our MSc Clinical Exercise Science and Physical Activity & Health undergraduate students, and potential follow up external funding applications.”

To find out more about becoming a clinical exercise physiologist by studying BSc (Hons) Physical Activity & Health or MSc Clinical Exercise Science at Edinburgh Napier University, click the links.

BSc (Hons) Physical Activity & Health Undergraduate Full-time

MSc Clinical Exercise Science Postgraduate Full-time