1. Experiences and perceptions of patients participating in prehabilitation and early rehabilitation for hip and knee arthroplasty : a systematic review and narrative synthesis of qualitative evidenceManca Zupančič Opara, Žiga Kozinc, Stefan Loefler, Karl Miedler, Nejc Šarabon, 2026, review article Abstract: Objective: To synthesize qualitative evidence on patients’ experiences and perceptions of prehabilitation and early rehabilitation in the context of hip and knee arthroplasty. Methods: A systematic review was conducted across PubMed, Scopus, and Web of Science, with the databases searched from inception to March 2026. Eligible studies included individuals referred for or undergoing total hip or knee arthroplasty and reporting qualitative data on experiences with prehabilitation or early rehabilitation. Titles, abstracts, and full texts were screened by one reviewer and independently checked by a second reviewer, while data extraction was performed independently by two reviewers. Methodological quality was assessed using the Critical Appraisal Skills Programme qualitative checklist. Findings were synthesized using a primarily descriptive narrative approach with thematic organization into facilitators and barriers; a formal qualitative meta-synthesis was not conducted. The review protocol was not registered. Results: Twelve studies were included: 11 focused on prehabilitation and two on early postoperative rehabilitation. The included studies involved patients undergoing total hip arthroplasty, total knee arthroplasty, or both procedures. Patient experiences were grouped into five thematic domains: symptoms and physical condition, understanding and information, behavior, psychological well-being, and intervention delivery. Reported facilitators included improved symptoms and physical function, greater understanding and preparedness for surgery, better pain coping, improved psychological well-being, and positive experiences with different delivery formats. Reported barriers included increased pain, information overload, language barriers, limited individualization, restricted interaction, and varying delivery preferences. The evidence base was heterogeneous in terms of intervention content, delivery mode, patient populations, and depth of qualitative reporting. Conclusion: Prehabilitation and early rehabilitation were generally perceived positively, but several barriers were identified. The findings highlight the importance of symptom monitoring, individualized exercise prescription, clear tailored education, and flexible delivery formats. However, the findings should be interpreted cautiously because the synthesis was primarily descriptive, the included studies were heterogeneous, and the evidence was substantially stronger for prehabilitation than for early rehabilitation.
Keywords: prehabilitation, early rehabilitation, hip arthroplasty, knee arthroplasty, patient experience, qualitative research
Published in RUP: 30.08.2026; Views: 225; Downloads: 1
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2. The effects of resistance exercise with blood flow restriction on muscle performance, muscle mass, and function in older adults : a systematic reviewMatic Jelen, Manca Zupančič Opara, Nejc Šarabon, 2026, review article Keywords: aging, strength, power, endurance, frailty, hypertrophy, BFR, ischemia
Published in RUP: 24.07.2026; Views: 336; Downloads: 9
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4. Early rehabilitation after total hip or knee joint replacement : a narrative reviewManca Zupančič Opara, Žiga Kozinc, Helmut Kern, Klaus Müller-Hohenstein, Stefan Loefler, Nejc Šarabon, 2026, original scientific article Abstract: When conservative treatment of osteoarthritis is not effective, patients may undergo total joint replacement. Postoperative rehabilitation is a crucial component of recovery, and early rehabilitation plays a particularly important role in optimizing outcomes, with the aim of enabling patients to return to independence and work as soon as possible. The aim of this paper is to summarize the role of early rehabilitation after total knee and hip joint replacement, including its main goals, key components, optimal timing, potential risks, and the evidence comparing early with delayed rehabilitation. Current evidence indicates that early inpatient rehabilitation contributes to faster recovery of mobility, improved joint range of motion and muscle strength, fewer postoperative complications, and shorter hospital stays. Early outpatient rehabilitation initiated soon after discharge may further support recovery by increasing daily physical activity, improving joint mobility, and reducing rehabilitation costs. Although some studies report similar clinical outcomes between early and delayed physiotherapy, earlier initiation may allow patients to achieve comparable functional recovery sooner. Overall, early rehabilitation represents a safe and effective approach that should be integrated into standard postoperative care pathways
Keywords: knee, hip, rehabilitation
Published in RUP: 07.06.2026; Views: 436; Downloads: 16
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5. Body ownership illusions in immersive virtual reality : a implications for musculoskeletal rehabilitationManca Zupančič Opara, Nejc Šarabon, 2026, review article Keywords: avatar, embodiment, musculoskeletal pain, predictive coding, Proteus effect, psychosocial barriers, VR
Published in RUP: 26.04.2026; Views: 690; Downloads: 16
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6. Disease severity affects knee range of motion but not strength deficits in knee osteoarthritis : a systematic review and meta-analysisManca Zupančič Opara, Nejc Šarabon, 2026, review article Abstract: Objectives: To compare knee range of motion and muscle strength between individuals with symptomatic knee osteoarthritis and healthy controls, and to assess how Kellgren–Lawrence grade and measurement protocols affect these outcomes.Methods: A systematic search of PubMed, Scopus, and Web of Science identified studies comparing knee flexion/extension range of motion or flexor/extensor strength between patients with knee osteoarthritis and controls. Risk of bias was assessed with Joanna Briggs Institute tools. Pooled mean and standardized mean differences with 95% confidence intervals were calculated using random-effects meta-analyses.Results: Thirty studies were included. Compared with healthy controls, individuals with knee osteoarthritis showed significantly reduced knee flexion [MD = 16.30°, 95%CI (11.40, 21.21)] and extension [MD = 4.25°, 95%CI (2.30, 6.19)], with greater flexion loss in advanced KL grades. Knee osteoarthritis participants also demonstrated significantly lower strength across all contraction types: isometric [extensors: SMD = 0.86, 95%CI (0.57, 1.14); flexors: SMD = 0.52, 95%CI (0.30, 0.74)], concentric [extensors: SMD = 1.07, 95%CI (0.65, 1.50); flexors: SMD = 0.77, 95%CI (0.43, 1.12)], and eccentric extensor strength. Strength deficits were consistent across Kellgren–Lawrence grades, knee joint angles, and angular velocities during testing.Conclusions: Individuals with symptomatic knee osteoarthritis present with marked reductions in knee range of motion and strength. While range of motion impairments worsen with disease severity, strength deficits are stable across Kellgren–Lawrence grades and measurement protocols. Given the very low to low certainty of evidence, results should be interpreted with caution. 1 Introduction
Keywords: osteoarthritis, knee, arthritis, risk factors, rehabilitation
Published in RUP: 18.02.2026; Views: 694; Downloads: 7
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