Abstract
Background: With the continuing increase in the number of total knee replacements, the importance of prehabilitation combined with a more intense and patient specific rehabilitation is growing. The research on the combination of a comprehensive prehabilitation and higher intensity patient specific rehabilitation is lacking. Methods: A case patient undergoing bilateral knee replacement was seen from the initiation of a prehabilitation program through the surgery and into a more intensive and patient specific rehabilitation. Baseline data was collected prior to beginning prehabilitation using a LEFS (lower extremity functional scale), strength measures, and patient reported pain levels. This data was then compared to prior to the surgery, post-op, and after a 2 months of rehabilitation before transitioning into a personal training program. Results: The patient was able to decrease their pain levels along with increasing standing tolerance and overall strength following prehabilitation prior to surgery. The patient was able to be discharged from traditional therapy in minimal time before returning to a personal training program to go beyond his baseline measures. Discussion: The case patient was able to show a statistically significant improvement in their LEFS prior to surgery after completing the prehabilitation program. His overall strength, both upper and lower body, had increased significantly. He was able to decrease pain levels and increase standing tolerance in order to return to normal daily activities and hobbies. Following surgery, the patient required only 3 traditional therapy visits prior to being discharged in order to return to Naples Personal Training to continue a more intense and patient specific rehabilitation to return to healthy aged matched activity level and beyond.