PhD Defence Pascale Doris Gränicher

Keywords: Prehabilitation, orthopedic surgery, total knee arthroplasty, spinal surgery
 

"Warm-up! Prehabilitation in orthopedic patients"

Many patients waiting for orthopedic surgery, such as knee replacement, experience reduced activity levels and increasing impairments during the waiting period before the procedure. This dissertation investigates whether a structured prehabilitation program – combining exercise and education – can help maintain function preoperatively and support recovery. A meta-analysis of existing studies showed short- and mid-term benefits of prehabilitation regarding knee functioning, though evidence remains limited. Based on these findings, a pilot study tested a new program, which proved safe, well accepted, and helped patients to stay active. Strength, pain and quality of life measures were assessed, and practical challenges for clinical use were identified. A scoping review on spinal surgery prehabilitation also suggests potential benefits and identified areas for future research. Overall, this dissertation highlights the promising value of prehabilitation for orthopedic patients, outlines current evidence gaps and limitations, and offers practical recommendations for its integration into everyday clinical care. 

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