Evidence library

Science and clinical backing, written plainly.

Explore the research, guidance, and plain-language summaries behind Habilis programmes.

How Habilis evaluates evidence

We prioritise current clinical guidance and systematic reviews, then connect each source to the programme topics it supports.

SourceSummaryControls

Guideline

2020

clinical-guidanceNICE NG157

Joint replacement: care before, during and after surgery

NICE recommends clear information, preoperative rehabilitation advice and rehabilitation support around planned hip and knee replacement.

Who it applies to

Adults preparing for or recovering from planned primary hip or knee replacement.

Practical meaning

Education, preparation and rehabilitation should be understandable and connected to the person’s own clinical pathway.

National Institute for Health and Care Excellence

Source

Guideline

2022

clinical-guidanceNICE QS206

Preoperative rehabilitation advice for hip and knee replacement

Adults listed for hip or knee replacement should receive tailored, understandable advice about preparation, exercise, lifestyle and recovery expectations.

Who it applies to

People listed for elective hip or knee replacement.

Practical meaning

Prehab is broader than exercise and includes preparation, independence and knowing what to expect.

National Institute for Health and Care Excellence

Source

Guideline

2024

clinical-guidanceWHO rehabilitation fact sheet

Rehabilitation supports function and independence

WHO defines rehabilitation as interventions that optimize functioning and reduce disability in interaction with a person’s environment.

Who it applies to

General rehabilitation education across conditions and recovery stages.

Practical meaning

Useful rehabilitation may include movement, education, environmental changes and self-management support.

World Health Organization

Source

Guideline

2023

clinical-guidanceWHO guideline

Non-surgical management of chronic primary low back pain

WHO supports person-centred combinations of education, exercise and other appropriate care rather than isolated, one-size-fits-all interventions.

Who it applies to

Adults with chronic primary low back pain; principles may inform general spine education.

Practical meaning

Activity and education are usually considered within a broader person-centred plan.

World Health Organization

Source

Review

2024

emergingDisability and Rehabilitation

Prehabilitation before total knee and hip arthroplasty

The review found some potentially relevant improvements, especially around knee arthroplasty, but heterogeneity and risk of bias prevent firm conclusions.

Who it applies to

Adults awaiting total knee or hip arthroplasty for osteoarthritis.

Practical meaning

Prehab may help preparation, but benefits vary and should not be promised.

Adebero T et al.

DOI Source

Review

2017

moderateJBJS

Preoperative exercise and education before hip and knee arthroplasty

Small-to-moderate pooled effects were reported for selected outcomes, while interventions and reporting varied substantially.

Who it applies to

Adults preparing for total hip or knee arthroplasty.

Practical meaning

Exercise and education can form part of preparation, with expectations kept proportionate to the evidence.

Moyer R et al.

DOI Source

Guideline

2020

clinical-guidanceActa Orthopaedica

Enhanced recovery recommendations for hip and knee replacement

The consensus supports preoperative education, multimodal perioperative care and early mobilization within coordinated pathways.

Who it applies to

Perioperative total hip and knee replacement care.

Practical meaning

Recovery works best as a coordinated pathway rather than one isolated exercise or intervention.

Wainwright TW et al.

DOI Source

Review

2017

moderateAmerican Journal of Physical Medicine & Rehabilitation

Home- versus hospital-based rehabilitation after knee arthroplasty

Pooled trials reported broadly comparable outcomes between home- and hospital-based rehabilitation for selected patients.

Who it applies to

People after primary total knee arthroplasty who are suitable for home rehabilitation.

Practical meaning

Home rehabilitation can be reasonable when supported by appropriate assessment and escalation routes.

Buhagiar MA et al.

DOI Source

Review

2023

emergingCureus

Supervised therapy versus home exercise after knee arthroplasty

The review found that some patients may achieve similar outcomes with structured home exercise, while supervision remains important when needs are greater.

Who it applies to

Post-discharge primary knee arthroplasty rehabilitation.

Practical meaning

Support intensity should reflect safety, confidence, function and individual needs.

Chaudhry YP et al.

DOI Source

Review

2024

moderateJournal of Telemedicine and Telecare

Telerehabilitation after total knee replacement

Randomized-trial evidence suggests remote rehabilitation can support pain and function outcomes for selected patients compared with conventional care.

Who it applies to

People after knee replacement with suitable technology, support and clinical oversight.

Practical meaning

Digital guidance can improve access but should include clear support and escalation routes.

Tsang MP et al.

DOI Source

Review

2024

emergingEFORT Open Reviews

Preoperative expectations and outcomes after hip or knee arthroplasty

Expectations may relate to some outcomes, but the evidence is inconsistent and often at moderate or high risk of bias.

Who it applies to

People preparing for total hip or knee arthroplasty.

Practical meaning

Specific, realistic conversations are preferable to broad promises about recovery.

Mooiweer Y et al.

DOI Source

Review

2025

emergingPubMed-indexed systematic review

Preoperative education and anxiety before hip or knee arthroplasty

The review reported small improvements in anxiety, knowledge and pain, while calling for better-described and more reproducible interventions.

Who it applies to

Adults receiving structured education before elective hip or knee arthroplasty.

Practical meaning

Clear education may help people feel informed, but it is one part of preparation.

Systematic review authors

Source

Review

2021

emergingJournal of Orthopaedic & Sports Physical Therapy

Prehabilitation before lumbar spine surgery: 2021 review

Very-low- to low-certainty evidence showed no clear additional benefit for CBT programmes, and exercise evidence was too limited for firm conclusions.

Who it applies to

Adults preparing for lumbar surgery for degenerative conditions.

Practical meaning

Preparation may still support understanding and readiness, but outcome claims must remain cautious.

Janssen ER et al.

DOI Source

Review

2025

emergingBritish Journal of Pain

Prehabilitation before elective lumbar spine surgery: 2025 review

Some small benefits were reported, but heterogeneous diagnoses, interventions and small samples left the overall estimates very uncertain.

Who it applies to

Adults preparing for elective lumbar spine surgery.

Practical meaning

Evidence is evolving; preparation should follow the surgical team rather than a universal programme.

Oliveira LA et al.

DOI Source

Guideline

2024

clinical-guidanceCDC patient safety guidance

Surgical-site infection signs and when to contact care

CDC advises contacting a healthcare provider for infection symptoms such as increasing redness or pain, cloudy drainage or fever.

Who it applies to

General postoperative wound-safety education.

Practical meaning

New or worsening wound concerns should be escalated rather than managed through an exercise video.

Centers for Disease Control and Prevention

Source

Review

2024

emergingJournal of Orthopaedics

Digital technology in rehabilitation after knee arthroplasty

The review describes growing use of digital guidance and remote monitoring, with promising but varied evidence across technologies.

Who it applies to

Digital support after total knee arthroplasty.

Practical meaning

Digital tools can support continuity when they complement—not replace—appropriate clinical care.

Raje S et al.

DOI Source

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