The Effect of Preoperative Exercise, Article Critique Example

The purpose of the study was to compare the impact of preoperative physical therapy workouts with the normal method of no preoperative physical therapy on three control groups of patients who undergo a primary total knee replacement. During the study, thirty patients were assigned to one of the three distinct groups.  The first group composed of ten patients was assigned as the control group, and the second group undertook physical therapy to strengthen the upper and lower limbs and increase knee motion range. Lastly, the third group partook in a cardiovascular training exercise. All these participants were then evaluated preoperatively and postoperatively using the Quality of Well Being Instrument, Arthritis Impact Measurement Scale, and the Hospital for Special Surgery Knee Rating (D’Lima et al., 1996). The study concludes that preoperative exercises are ineffective in improving patient outcomes or shortening the hospital length of stay for patients who have undergone total knee replacement.

One of the strengths of this research study is that it employs control groups subjected to different study constraints. Control groups are vital in enabling the gathering of detailed information on the effects of the preoperative physical therapy exercises on the three distinct groups, hence leading to the formulation of a credible and reliable conclusion.  The research was further conducted in an extensive period: six weeks preoperative and forty-eight weeks postoperative. The extensive period allowed the researchers to examine the impact of the preoperative physical exercises on the different groups before reaching meaningful conclusions on the efficacy of the preoperative exercises. Another important strength is the use of the objective and quantitative criteria (Hospital for Special Surgery Knee Rating), which enables the accurate evaluation of the patient results, making the findings generalizable to some extent.

Unfortunately, the research article fails to demonstrate comparability of the patients in treatment groups with their control groups. The patients within the control group and the group receiving the exercise regimen need to have similar baseline characteristics, thus influencing the outcome of the intervention being studied (D’Lima et al., 1996).  The researchers do not mention if the patients possess similar characteristics and the extent of exercises administered to them.

The use of the two scales (Quality of Well Being Instrument and the Arthritis Impact Measurement Scale), which are subjective in nature, is another limitation since these scales are prone to cognitive biases where the accuracy of the responses given by the participants is hard to verify. Therefore, the arrived conclusion might be misleading, making the findings not generalizable for a wider population. Lastly, there is a poorly described patient population where the eligibility of the patient’s inclusion in the study is unclear, thus making the findings unreliable.

References

D’Lima, D. D., Colwell, C. W., Morris, B. A., Hardwick, M. E., & Kozin, F. (1996). The effect of preoperative exercise on total knee replacement outcomes. Clinical Orthopaedics and Related Research®, 326, 174-182.