A specific inpatient aquatic physiotherapy program improves strength after total hip or knee replacement surgery: a randomized controlled trial. A targeted home- and center-based exercise program for people after total hip replacement: a randomized clinical trial. Intensive physical training in geriatric patients after severe falls and hip surgery. Early, intensified home-based exercise after total hip replacement--a pilot study. Physiotherapy after total hip replacement for primary arthrosis. Effectiveness of a physical exercise intervention program in improving functional mobility in older adults after hip fracture in later stage rehabilitation: protocol of a randomized clinical trial (REATIVE Study) Motor Imagery during Action Observation of Locomotor Tasks Improves Rehabilitation Outcome in Older Adults after Total Hip Arthroplasty Resistance training in the early postoperative phase reduces hospitalization and leads to muscle hypertrophy in elderly hip surgery patients--a controlled, randomized study. Treadmill training with partial body-weight support after total hip arthroplasty: a randomized controlled trial. Effects of extended outpatient rehabilitation after hip fracture: a randomized controlled trial. Randomised controlled trial to evaluate a physiotherapy-led functional exercise programme after total hip replacement. Effect of a video intervention on functional recovery following hip replacement and hip fracture repair. Effects on function and quality of life of postoperative home-based physical therapy for patients with hip fracture. Status of physiotherapy rehabilitation after total knee replacement in Australia. Independent home versus supervised rehabilitation following arthroscopic knee surgery--a prospective randomized trial. Rehabilitation following total hip arthroplasty evaluation over short follow-up time: randomized clinical trial. Task-oriented exercises and early full weight-bearing contribute to improving disability after total hip replacement: a randomized controlled trial
OBJECTIVE To evaluate the effect of inpatient aquatic physiotherapy in addition to usual ward physiotherapy on the recovery of strength , function , and gait speed after total hip or knee replacement surgery . DESIGN Pragmatic r and omized controlled trial with blinded 6-month follow-up . SETTING Acute-care private hospital . PARTICIPANTS People ( n=65 ) undergoing primary hip or knee arthroplasty ( average age , 69.6+/-8.2y ; 30 men ) . INTERVENTIONS Participants were r and omly assigned to receive supplementary inpatient physiotherapy , beginning on day 4 : aquatic physiotherapy , nonspecific water exercise , or additional ward physiotherapy . MAIN OUTCOME MEASURES Strength , gait speed , and functional ability at day 14 . RESULTS At day 14 , hip abductor strength was significantly greater after aquatic physiotherapy intervention than additional ward treatment ( P=.001 ) or water exercise ( P=.011 ) . No other outcome measures were significantly different at any time point in the trial , but relative differences favored the aquatic physiotherapy intervention at day 14 . No adverse events occurred with early aquatic intervention . CONCLUSIONS A specific inpatient aquatic physiotherapy program has a positive effect on early recovery of hip strength after joint replacement surgery . Further studies are required to confirm these findings . Our research indicates that aquatic physiotherapy can be safely considered in this early postoperative phase OBJECTIVE To examine the physical function , gait , and quality of life of patients after total hip replacement ( THR ) r and omly assigned to either a targeted home- or center-based exercise program . DESIGN R and omized controlled trial . SETTING Rehabilitation research center in Australia . PARTICIPANTS Twenty-three patients with unilateral THR were r and omly assigned to a supervised center-based exercise group ( n=11 ) or an unsupervised home-based exercise group ( n=12 ) . INTERVENTION The center-based group completed an 8-week targeted exercise program while under the direct supervision of a physiotherapist . After initial instruction , the home-based group completed the 8-week targeted exercise program at home without further supervision . MAIN OUTCOME MEASURES Quality of life , physical function , and spatiotemporal measures of gait . RESULTS No significant interaction ( group by time ) or main effects of grouping were found . Within each group , quality of life , and stair climbing improved significantly ( P<.05 ) as did Timed Up & Go test and 6-minute walk test performances ( P<.05 ) . Walking speed increased by 16 cm/s ( P<.01 ) , cadence by 8 steps/min ( P<.05 ) , step length by 4.7 cm ( P<.05 ) , and double-support time reduced by a factor of 16 % . Step length symmetry showed significant improvement ( P<.05 ) over time . Step length differential between the affected and unaffected limbs reduced from 4.0 to 2.7 cm . CONCLUSIONS The targeted strengthening program was effective for both the home- and center-based groups . No group differences were found in the majority of the outcome measures . This finding is important because it shows that THR patients can achieve significant improvements through a targeted strengthening program delivered at a center or at home BACKGROUND Intensive exercise training can lead to improvement in strength and functional performance in older people living at home and nursing home residents . There is little information whether intensive physical exercise may be applicable and effective in elderly patients suffering from the acute sequelae of injurious falls or hip surgery . OBJECTIVE To assess the feasibility , safety and efficacy of intensive , progressive physical training in rehabilitation after hip surgery . DESIGN Prospect i ve , r and omised , placebo-controlled intervention study of a 3-months training intervention and a 3-months ' follow-up . SETTING Physical training 6 - 8 weeks after hip surgery . SUBJECTS Twenty-eight ( 15 intervention , 13 control ) elderly patients with a history of injurious falls admitted to acute care or inpatient rehabilitation because of acute fall-related hip fracture or elective hip replacement . METHODS Progressive resistance and functional training to improve strength and functional performance . RESULTS No training-related medical problems occurred in the study group . Twenty-four patients ( 86 % ) completed all assessment s during the intervention and follow-up period . Adherence was excellent in both groups ( intervention : 93 , 0+/-13 , 5 % versus control : 96 , 7+/-6 , 2 % ) . Training significantly increased strength , functional motor performance and balance and reduced fall-related behavioural and emotional problems . Some improvements in strength persisted during 3-months follow-up while other strength variables and functional performances were lost after cessation of training . Patients in the control group showed no change in strength , functional performance and emotional state during intervention and follow-up . CONCLUSIONS Progressive resistance training and progressive functional training are safe and effective methods to increase strength and functional performance during rehabilitation in patients after hip surgery and a history of injurious falls . Because part of the training improvements were lost after stopping the training , a continuing training regime should be established BACKGROUND AND PURPOSE Despite a successful surgical procedure , deficits in muscle strength and physical function are documented 1 - 2 years after total hip replacement ( THR ) . There is a lack of evidence concerning which rehabilitation strategy is the most effective after THR . The purpose of this pilot study was to investigate the feasibility of an early-initiated intensified , home-based training regime and to form the basis of future studies with regard to exercises , outcome measures and power calculations . METHODS The trial is a single-blinded , cluster-r and omized controlled trial performed at an orthopaedic physiotherapy department in a public hospital in Denmark . A consecutive sample of 46 patients undergoing primary THR surgery for osteoarthritis between September 2008 and January 2009 was included . Forty-four patients completed the trial ( 96 % follow-up ) . Participants were r and omly assigned to an intervention group ( IG , n = 23 ) receiving 12 weeks of intensified exercises ( e.g. rubber b and resistance ) or a control group ( CG , n = 21 ) receiving st and ard rehabilitation exercises without external resistance . The outcome measurements were maximal gait speed , isometric hip abductor muscle strength , one-legged stance , health-related quality of life ( EuroQol-5 Dimensions ) , patient satisfaction , and patient-evaluated function , stiffness and pain ( Western and Ontario McMasters University Osteoarthritis Index ) . RESULTS There were significant increases in both groups in all the measurements during the 12 weeks of exercises . All participants in the IG were satisfied or very satisfied with the exercises compared with 85 % in the CG ( P = 0.095 ) . In the IG , four participants ( 17.4 % ) had difficulties when performing the intensified exercises at home . Hip abduction strength was significantly weaker in the leg operated compared with the leg not operated on after the intervention in both groups ( P < 0.01 ) . CONCLUSION This pilot study indicates that the majority of THR patients tolerated early-initiated intensified exercises without additional pain and with high patient satisfaction . It seems that some of the patients need supervision to perform intensified exercises Organized physiotherapy starting two months after uncomplicated total hip replacements for primary arthrosis did not improve the rehabilitation . Six months after surgery there were no significant differences between 14 patients with and 16 patients without physiotherapy regarding improvement of passive hip motion , or hip or knee muscle strength of the operated limb . Neither were there any differences in walking ability or activities of daily living Background Hip fractures result ing from falls increase substantially with advancing age and less than half of older hip fracture survivors regain their former levels of mobility . There is increasing evidence that rehabilitation interventions with exercises that goes beyond the sub-acute phase or even in a later stage of care have a positive impact on various functional abilities . The purpose of this study is to determine if exercise program training for people who have suffered a fall-related hip fracture will improve functional mobility when compared with usual care . Methods A r and omized controlled trial with blinded assessors and intention-to-treat analysis will be undertaken . We will recruit 82 older adults , 60 years or over who have suffered a hip fracture due to a fall in the previous 6 to 24 months . Participants r and omized to the Intervention Group ( IG ) will undertake a physical exercise program involving progressive and challenging balance training and neuromuscular and functional training of the lower limbs , conducted at home by physiotherapists , once a week , lasting about one hour , in the first , second and third month after r and omization and will be taught to perform exercises at home , twice a week , using a booklet . Visits to monitor and progress the home exercise program will be conducted once a month , from the fourth to the sixth month and each 2 months until the end of the follow up at the 12th month , i.e. , a total of 18 sessions . Participants will receive monthly phone calls to encourage exercise adherence . The control group will receive usual care . The primary outcome will be mobility-related disability and participants will be assessed at baseline , and at 3 months , 6 and 12 months . Participants will receive monthly phone calls to ask about falls and exercise adherence . Adverse effects will be monitored . Discussion This study proposes a home-based exercise program , which may in part overcome some barriers for rehabilitation , such as difficulties with public transportation and lack of a caregiver to accompany older patients to sessions . If a positive effect is observed this program has the potential to be incorporated into the public health system and contribute to building a pathway of care for older people with hip fracture . Trial registration Clinical trials.gov Identifier : NCT02295527 This study aim ed at determining whether the combination of action observation and motor imagery ( AO + MI ) of locomotor tasks could positively affect rehabilitation outcome  after hip replacement surgery . Of initially 405 screened participants , 21 were r and omly split into  intervention group ( N = 10 ; mean age = 64 y ; AO + MI of locomotor tasks : 30 min/day in the hospital , then 3 × /week in their homes for two months ) and  control group ( N = 11 , mean age = 63 y , active controls ) . The functional outcomes ( Timed Up and Go , TUG ; Four Step Square Test , FSST ; and single- and dual-task gait and postural control ) were measured before ( PRE ) and 2 months after surgery ( POST ) . Significant interactions indicated better rehabilitation outcome for the intervention group as compared to the control group : at POST , the intervention group revealed faster TUG ( p = 0.042 ) , FSST ( p = 0.004 ) , and dual-task fast-paced gait speed ( p = 0.022 ) , reduced swing-time variability ( p = 0.005 ) , and enhanced cognitive performance during dual tasks while walking or balancing ( p < 0.05 ) . In contrast , no changes were observed for body sway parameters ( p ≥ 0.229 ) . These results demonstrate that AO + MI is efficient to improve motor-cognitive performance after hip surgery . Moreover , only parameters associated with locomotor activities improved whereas balance skills that were not part of the AO + MI intervention were not affected , demonstrating the specificity of training intervention . Overall , utilizing AO + MI during rehabilitation is advised , especially when physical practice is limited OBJECTIVES To better underst and how immobilization and surgery affect muscle size and function in the elderly and to identify effective training regimes . DESIGN A prospect i ve r and omized , controlled study . SETTING Bispebjerg University Hospital , Copenhagen , Denmark . PARTICIPANTS Thirty-six patients ( aged 60 - 86 ) scheduled for unilateral hip replacement due to primary hip osteoarthrosis . INTERVENTION Patients were  r and omized to st and ard home-based rehabilitation ( 1 h/d x 12 weeks ) , unilateral neuromuscular electrical stimulation of the operated side ( 1 h/d x 12 weeks ) , or unilateral resistance training of the operated side ( 3/wk x 12 weeks ) . MEASUREMENTS Hospital length of stay ( LOS ) , quadriceps muscle cross-sectional area ( CSA ) , isokinetic muscle strength , and functional performance . Patients were tested presurgery and 5 and 12 weeks postsurgery . RESULTS Mean+/-st and ard error LOS was shorter for the resistance training group ( 10.0+/-2.4 days , P<.05 ) than for the st and ard rehabilitation group ( 16.0+/-7.2 days ) . Resistance training , but not electrical stimulation or st and ard rehabilitation , result ed in increased CSA ( 12 % , P<.05 ) and muscle strength ( 22 - 28 % , P<.05 ) . Functional muscle performance increased after resistance training ( 30 % , P<.001 ) and electrical stimulation ( 15 % , P<.05 ) but not after st and ard rehabilitation . CONCLUSION Postoperative resistance training effectively increased maximal muscle strength , muscle mass , and muscle function more than a st and ard rehabilitation regime . Furthermore , it markedly reduced LOS in elderly postoperative patients OBJECTIVE To compare treadmill training with partial body-weight support ( TT-BWS ) and conventional physical therapy ( PT ) in ambulatory patients with hip arthroplasty . DESIGN R and omized controlled trial . SETTING Rehabilitation center . PARTICIPANTS Eighty patients with a fully loadable implant who could walk independently with crutches after unilateral total hip arthroplasty were r and omized to receive either TT-BWS ( treatment group ) or conventional PT ( controls ) , for 10 working days . INTERVENTIONS Each patient received 45 minutes of individualized PT , either treadmill training plus PT in the experimental or PT alone in the control group . MAIN OUTCOME MEASURES The Harris score , recorded by blind assessors , served as the primary outcome measure . Secondary outcome measures were the hip extension deficit , gait velocity , gait symmetry , affected hip abductor power ; hip abductor amplitude of electromyographic activation ; and the interval from surgery to ab and oning crutches . RESULTS At the end of training , the treatment group 's Harris score was 13.6 points higher ( P<.0001 ) than the control group 's score . Further , hip extension deficit was 6.8 degrees less ( P<.0001 ) , gait symmetry was 10 % greater ( P=.001 ) , affected hip abductor was stronger ( Medical Research Council grade s 4.24 vs 3.73 ; P<.0001 ) , and the amplitude of gluteus medius activity was 41.5 % greater ( P=.001 ) than those measures for controls . Gait velocity did not differ in the 2 groups . These significant differences in favor of the treatment group persisted at 3 and 12 months . The treatment group ab and oned crutches sooner than the control group ( 3 vs 8wk ) . In the treatment group , 39 patients finished treatment , 35 appeared at 3 , and 26 at 12 months for follow-up . In the control group , the corresponding numbers were 40 , 35 , and 24 patients , respectively . CONCLUSION TT-BWS is more effective than conventional PT at restoring symmetrical independent walking after hip replacement CONTEXT Hip fractures are common in the elderly , and despite st and ard rehabilitation , many patients fail to regain their prefracture ambulatory or functional status . OBJECTIVE To determine whether extended outpatient rehabilitation that includes progressive resistance training improves physical function and reduces disability compared with low-intensity home exercise among physically frail elderly patients with hip fracture . DESIGN , SETTING , AND PATIENTS R and omized controlled trial conducted between August 1998 and May 2003 among 90 community-dwelling women and men aged 65 years or older who had had surgical repair of a proximal femur fracture no more than 16 weeks prior and had completed st and ard physical therapy .  INTERVENTION Participants were r and omly assigned to 6 months of either supervised physical therapy and exercise training ( n = 46 ) or home exercise ( control condition ; n = 44 ) . MAIN OUTCOME MEASURES Primary outcome measures were total scores on a modified Physical Performance Test ( PPT ) , the Functional Status Question naire physical function subscale ( FSQ ) , and activities of daily living scales . Secondary outcome measures were st and ardized measures of skeletal muscle strength , gait , balance , quality of life , and body composition . Participants were evaluated at baseline , 3 months , and 6 months . RESULTS Changes over time in the PPT and FSQ scores favored the physical therapy group ( P = .003 and P = .01 , respectively ) . Mean change ( SD ) in PPT score for physical therapy was + 6.5 ( 5.5 ) points ( 95 % confidence interval [ CI ] , 4.6 - 8.3 ) , and for the control condition was + 2.5 ( 3.7 ) points ( 95 % CI , 1.4 - 3.6 points ) . Mean change ( SD ) in FSQ score for physical therapy was + 5.2 ( 5.4 ) points ( 95 % CI , 3.5 - 6.9 ) and for the control condition was + 2.9 ( 3.8 ) points ( 95 % CI , 1.7 - 4.0 ) . Physical therapy also had significantly greater improvements than the control condition in measures of muscle strength , walking speed , balance , and perceived health but not bone mineral density or fat-free mass . CONCLUSION In community-dwelling frail elderly patients with hip fracture , 6 months of extended outpatient rehabilitation that includes progressive resistance training can improve physical function and quality of life and reduce disability compared with low-intensity home exercise 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 dem and in patients . DESIGN Adequately powered assessor-blinded r and omised controlled trial . SETTING Patients were recruited at a pre-operative assessment clinic and r and omised following surgery . PARTICIPANTS Sixty-three subjects were r and omised 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 ) question naire , 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 21.9 m , 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 Although much research has documented the functional outcomes in hip repair surgery , few studies have identified effective interventions to improve functional outcomes . The purpose of this study was to test the use of generic and individualized videos on patients ' return to preoperative levels of independent functioning , increased physical performance , improved coping ability , and enhanced perception of ability to care for self .  Two rehabilitation units in separate acute care facilities were used to recruit subjects . Data were collected on 82 participants on admission to the study , on discharge from rehabilitation , 1 week after discharge , and 3 months post discharge . The results indicate that video intervention has some benefit to persons recovering from hip repair surgery . The benefits were realized in physical performance as evidence d by a significant difference in the distance walked and time walked of participants in the treatment group OBJECTIVE To evaluate the effects of a 3-month home-based physical therapy ( PT ) program for patients with hip fracture after surgery . DESIGN R and omized controlled trial . SETTING Home . PARTICIPANTS Twenty-five patients recently discharged from an acute orthopedic department . INTERVENTIONS Patients were r and omized to the home-based PT group ( n=13 ) , where they received home-based PT 8 times from discharge to month 3 postdischarge , or to the control group ( n=12 ) . The home-based PT program included exercises for muscle strengthening , range of motion ( ROM ) , balance , and functional training . Patients in the control group were instructed to practice the exercise program given at bedside before discharge . MAIN OUTCOME MEASURES Patients were evaluated for hip ROM , strength , walking velocity , Harris hip score , and health-related quality of life ( HRQOL ) at the week of discharge and at 1 , 3 , and 6 months after discharge . RESULTS The baseline characteristics showed no difference between the 2 groups . Harris score of the home-based PT group progressed from 58.6+/-8.5 to 90.1+/-5.4 at month 3 , whereas Harris score of the control group progressed from 54.6+/-14.5 to 77.4+/-10.0 ( P<.01 ) . Scores of the psychologic domain of HRQOL for the home-based PT group were significantly better at month 1 ( P<.05 ) and month 3 ( P<.01 ) after discharge . Moreover , the physical domain score of the home-based PT group was also significantly better ( P<.05 ) at 3 months after discharge . CONCLUSIONS Home-based PT programs could help patients regain function and HRQOL earlier BACKGROUND AND PURPOSE Owing to a scarcity of clinical research , evidence -based clinical guidelines are not available to guide physiotherapy rehabilitation after total knee replacement surgery . This is despite the fact that , annually , over 20000 patients in Australia , over 300 000 patients in North America and 36 000 patients in the UK potentially require rehabilitation at this time to regain functional independence and to resume recreational and work-related physical activities . This survey of clinicians aim ed to describe st and ard ( usual ) care after total knee replacement in Australia and to provide possible explanations for practice variance , if such variation exists . METHOD A nationwide postal survey involving public and privately funded hospital physiotherapy departments was conducted . Purposive sampling was used to r and omly select hospitals from the National Joint Replacement Registry . A series of closed and open-ended protocol -based questions were asked . RESULTS A response rate of 65 % ( 65/100 ) was obtained . Elements of consistency and diversity across the acute and post-acute phases were evident . Consistent findings included the provision of gait retraining and exercise prescription in the acute period , the requirement for independent ambulation as a criterion for discharge from acute care and the routine referral to ongoing outpatient or community-based physiotherapy . Less consistency was reported for the use of continuous passive motion and cryotherapy  in the acute phase , the modes of ongoing rehabilitation , discharge from rehabilitation criteria and the tools for measuring outcomes . Both institutional and non-institutional factors appeared to explain the demonstrated practice variation . CONCLUSIONS In order to propagate evidence -based practice guidelines and uniformity in care , well- design ed clinical trials are required to identify cost-effective rehabilitation programmes after total knee replacement This prospect i ve study compared 30 patients r and omly assigned to either a home exercise program or supervised outpatient physical therapy following arthroscopic partial medial meniscectomy . Their knee functions were assessed at 2 , 4 , and 8 weeks postoperatively using isokinetic analysis and subjective question naires . At each evaluation , the home exercise group performed as well or better than the supervised physical therapy group . There were no statistically significant differences between the two groups . At 4 weeks postoperation , the mean percent deficit in torque ( strength ) between the affected and unaffected limbs was 22.1 % in the supervised rehabilitation group and 22.0 % in the home exercise . The percent deficit in terms of endurance was 7.7 % in the supervised group and 3.6 % in the home group . Similar results were noted with regard to the patients ' subjective evaluations of their knee function and ability to resume work and recreational activities . We conclude that a well-planned , unsupervised home exercise knee rehabilitation program can produce equally good postoperative recovery as compared to a supervised outpatient physical therapy regimen in properly selected patients following arthroscopic partial meniscectomy of the knee UNLABELLED Hip osteoarthritis ( OA ) is a degenerative disease , and total hip arthroplasty ( THA ) is one of the surgical procedures of choice to improve the OA patient 's quality of life . Without a rehabilitation program , THA patients will develop functional limitations . A r and omized double-blind trial was performed between July 2009 and October 2011 to compare in a short follow-up time two groups of patients who underwent THA for OA . The THA protocol ( THAP ) group received verbal instructions and physiotherapy exercise demonstrations , and the THA physiotherapy care protocol ( THAPCP ) group received the same verbal instructions and demonstrations associated with daily exercise practice guided by a physiotherapist . The outcomes that were assessed preoperatively and 15 d postoperatively in 106 patients were muscle strength force , goniometry , Medical Outcomes Study 36-Item Short Form Health Survey , and Merle d'Aubigné and Postel score . Higher muscle strength force scores and degrees in range of motion were found in the THAPCP group . Higher improvements were also observed for the THAPCP group compared with the THAP group in the Merle d'Aubigné and Postel score . At the end of the follow-up period , the intervention in the THAPCP group improved functional capacity , quality of life , mobility , muscle strength , goniometry , and pain . It appears to be a safe tool for accelerating recovery in THA patients . CLINICAL TRIAL REGISTRATION Clinical Trials.gov ; NCT01491048 Objective : To evaluate the efficacy of an in-hospital programme based on task-oriented exercises associated with early full weight-bearing in patients with multiple comorbidities undergoing total hip replacement . Design : R and omized controlled trial . Setting : Specialised rehabilitation centre . Subjects : A total of 100 patients ( mean age of 69 ( 8) years ; 40 males , 60 females ) . Interventions : The experimental group underwent task-oriented exercises and was encouraged to ab and on any walking aids by the end of their in-hospital stay . The control group underwent open chain kinetic exercises , and was recommended to use partial weight-bearing and walking aids until three months after surgery . Both groups individually followed programmes of 90-minute sessions five times a week for three weeks . Outcome measures : Western Ontario and McMaster Universities Osteoarthritis Index , Pain Numerical Rating Scale , Functional Independence Measure , and Short-Form Health Survey . The participants were evaluated before , after training , and after a further 12 months . Results : There were no significant between-group differences at baseline . After training , a between-group difference of 12 points was found for the Western Ontario and McMaster Universities Osteoarthritis Index – functional subscale , indicating a clinical ly tangible treatment effect on disability . The Functional Independence Measure increased by 31 and 15 points in the experimental and control group , respectively . A linear mixed model revealed significant effects of time , group , and time by group interaction on disability , pain , activities of daily living , and most of the physical quality of life domains . Conclusion : Task-oriented exercises associated with early full weight-bearing improve disability , pain , activities of daily living , and quality of life after total hip replacement
Function and quality of life could not be meta-analysed due to insufficient data and heterogeneity of measures , but functional measures tended to favour the physiotherapy rehabilitation group .
Most outcomes were similar between outpatient and home-based exercise programs .
Physiotherapy rehabilitation improves hip abductor strength , gait speed and cadence in people who have been discharged from hospital after total hip replacement .
Physiotherapist-directed rehabilitation exercises appear to be similarly effective whether they are performed unsupervised at home or supervised by a physiotherapist in an outpatient setting
QUESTION In people who have been discharged from hospital after a total hip replacement , do rehabilitation exercises directed by a physiotherapist improve strength , gait , function and quality of life ?
Are these exercises as effective in an unsupervised home-based setting as they are in a supervised outpatient setting ?