Project R-16620

The added value of MULTImodal biopsychosocial telePREhabilitation for individuals undergoing lower limb arthroPlasty: the MULTIPREP trial (Research)

Lower limb joint arthroplasties (TJA) are among the most performed elective surgeries (>50k/year in Belgium). Unfortunately, 13-30% of the patients ends up with moderate-severe persistent pain, which negatively impacts quality of life and induces high socio-economic burden. Moreover, in those experiencing favorable outcomes, the expected (re)uptake of physical activity often fails to materialize, illustrating that current (p)rehabilitation strategies do not effectively promote physical activity. Nevertheless, sufficient physical activity is desirable to improve surgical recovery and obtain general health and socio-economic benefits. Therefore, a shift in TJA care is warranted with a specific focus on improving psychosocial recovery mediators and facilitation of a behavioral shift towards a more active lifestyle. Based on the proof-of-concept delivered by our pilot trial and the literature, we propose multimodal biopsychosocial teleprehabilitation. This intervention constitutes optimal timing and a comprehensive design to achieve its intended goals, i.e., improved functional recovery post-TJA and general health, and decreased socio-economic burden. The scientific objectives are to assess if: 1) multimodal biopsychosocial teleprehabilitation on top of treatment as usual (TAU) is more effective than TAU alone to improve clinical outcomes at 12 months post-TJA; and 2) multimodal biopsychosocial teleprehabilitation + TAU is cost-effective as compared to TAU alone. P: 240 patients undergoing TJA I: Multimodal biopsychosocial teleprehabilitation ((pain science) education, physical activity promotion and stress management guided by motivational interviewing and solution-focused therapy principles) + TAU C: TAU O: Primary outcome: pain & functioning; Secondary outcomes: physical activity levels, cognitiveemotional outcomes, joint awareness, patient satisfaction, performance-based outcomes, quality of life; Tertiary outcomes: healthcare use, productivity loss.

01 January 2026 - 31 December 2029