B Monaghan1, P Cunningham2, P Harrington3, W Hing4, C Blake5, D O' Dohertya6, T Cusack5. 1. Department of Physiotherapy, Our Lady's Hospital, Navan, Co Meath, Ireland. Electronic address: brenda.monaghan@hse.ie. 2. Department of Radiology, Our Lady's Hospital, Navan, Co Meath, Ireland. 3. Department of Orthopaedics, Our Lady's Hospital, Navan, Co Meath, Ireland. 4. Faculty of Health and Sciences and Medicine, Bond University, Robina, QLD, Australia. 5. School of Public Health, Physiotherapy and Population Science, University College Dublin, Belfield, Dublin, Ireland. 6. Department of Physiotherapy, Our Lady's Hospital, Navan, Co Meath, Ireland.
Abstract
BACKGROUND: At present, there is an insufficient evidence base to evaluate the effectiveness of physiotherapy following total hip replacement (THR). This study evaluated the effectiveness of a physiotherapy-supervised functional exercise programme between 12 and 18 weeks following THR. These time-points coincide with increased functional demand in patients. DESIGN: Adequately powered assessor-blinded randomised controlled trial. SETTING:Patients were recruited at a pre-operative assessment clinic and randomised following surgery. PARTICIPANTS: Sixty-three subjects were randomised to either the usual care group (control, n=31) or the functional exercise+usual care group (n=32). INTERVENTIONS: Patients in the functional exercise group attended a physiotherapy-supervised functional exercise class twice weekly from 12 to 18 weeks following THR. Patients in the control group followed the usual care protocol with no exercise intervention. MAIN OUTCOME MEASUREMENT: The main outcome measurement tool was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire, and the secondary outcomes included walking speed, hip abduction dynamometry, Short Form 12 physical and mental health scores, and visual analogue pain scale score. RESULTS: At 18 weeks post surgery, WOMAC function and walking speed improved significantly more in the functional exercise group [mean difference -4.0, 95% confidence interval (CI) -7.0 to 1.0 (P<0.01); mean difference 21.9m, 95% CI 0.60 to 43.3 (P<0.04)] than the control group, but there was no significant difference in hip abductor strength. CONCLUSION: This study demonstrated that patients who undertake aphysiotherapy-led functional exercise programme between 12 and 18 weeks after THR may gain significant functional improvement compared with patients receiving usual care. Clinical trial registration number NCT01683201.
RCT Entities:
BACKGROUND: At present, there is an insufficient evidence base to evaluate the effectiveness of physiotherapy following total hip replacement (THR). This study evaluated the effectiveness of a physiotherapy-supervised functional exercise programme between 12 and 18 weeks following THR. These time-points coincide with increased functional demand in patients. DESIGN: Adequately powered assessor-blinded randomised controlled trial. SETTING:Patients were recruited at a pre-operative assessment clinic and randomised following surgery. PARTICIPANTS: Sixty-three subjects were randomised to either the usual care group (control, n=31) or the functional exercise+usual care group (n=32). INTERVENTIONS:Patients in the functional exercise group attended a physiotherapy-supervised functional exercise class twice weekly from 12 to 18 weeks following THR. Patients in the control group followed the usual care protocol with no exercise intervention. MAIN OUTCOME MEASUREMENT: The main outcome measurement tool was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire, and the secondary outcomes included walking speed, hip abduction dynamometry, Short Form 12 physical and mental health scores, and visual analogue pain scale score. RESULTS: At 18 weeks post surgery, WOMAC function and walking speed improved significantly more in the functional exercise group [mean difference -4.0, 95% confidence interval (CI) -7.0 to 1.0 (P<0.01); mean difference 21.9m, 95% CI 0.60 to 43.3 (P<0.04)] than the control group, but there was no significant difference in hip abductor strength. CONCLUSION: This study demonstrated that patients who undertake a physiotherapy-led functional exercise programme between 12 and 18 weeks after THR may gain significant functional improvement compared with patients receiving usual care. Clinical trial registration number NCT01683201.
Authors: Eric Röhner; Anke Mayfarth; Christian Sternitzke; Frank Layher; Andrea Scheidig; Horst-Michael Groß; Georg Matziolis; Sabrina Böhle; Klaus Sander Journal: J Clin Med Date: 2021-05-29 Impact factor: 4.241
Authors: Annet Wijnen; Sjoukje E Bouma; Gesine H Seeber; Lucas H V van der Woude; Sjoerd K Bulstra; Djordje Lazovic; Martin Stevens; Inge van den Akker-Scheek Journal: PLoS One Date: 2018-03-16 Impact factor: 3.240