Functional exercise after total hip replacement (FEATHER) a randomised control trial

Abstract

BackgroundProlonged physical impairments in range of movement, postural stability and walking speed are commonly reported following total hip replacement (THR). It is unclear from the current body of evidence what kind of exercises should be performed to maximize patient function and quality of life.Methods/designThis will be a single blind multi centre randomized control trial with two arms. Seventy subjects post primary total hip arthroplasty will be randomized into either an experimental group (n=35), or to a control group (n=35). The experimental group will attend a functional exercise class twice weekly for a six week period from week 12 to week 18 post surgery. The functional exercise group will follow a circuit based functional exercise class supervised by a chartered Physiotherapist. The control group will receive usual care. The principal investigator (BM) will perform blinded outcome assessments on all patients using validated measures for pain, stiffness, and function using the Western Ontario and Mc Master Universities Osteoarthritis index (WOMAC). This is the primary outcome measurement tool. Secondary outcome measurements include Quality of life (SF-36), 6 min walk test, Visual Analogue Scale, and the Berg Balance score. The WOMAC score will be collated on day five post surgery and repeated at week twelve and week eighteen. All other measurements will be taken at week 12 and repeated at week eighteen. In addition a blinded radiologist will measure gluteus medius cross sectional area using real time ultrasound for all subjects at week 12 and at week 18 to determine if the functional exercise programme has any effect on muscle size.DiscussionThis randomised controlled trial will add to the body of evidence on the relationship between muscle size, functional ability, balance, quality of life and time post surgery in patients following total hip arthroplasty. The CONSORT guidelines will be followed to throughout. Ethical approval has been gained from the Ethics committee Health Services Executive Dublin North East.Trial registrationThis trial is registered with ClinicalTrials.gov (a service of the United States National Institutes of Health) identifier NCT01683201

Early Unpleasant Postoperative Symptoms for Patients Undergoing Primary Hip versus Primary Knee Replacement: Patient Perception

“…Additionally, the present study indicated all patients had poor result after THR at the 4 th and 10 th postoperative day. These findings were supported by Monaghan, Grant, Hing, and Cusack (2012) who stated that THR patients experienced pain, physical impairment, reduced range of motion and reduced muscle strength persisting for one year [54] . The findings of the study also come in agreement with Singh and Lewallen (2010) who reported that patients had moderate to severe pain and activity limitation (defined as a limitation in 3 or more activities) following THR surgery [55] .…”

Rehabilitación domiciliaria en la prótesis total de cadera y rodilla

“…A continuación, en el cuadro 20.1, se describen distintos procedimientos o técni-cas indicadas en la fisioterapia de prótesis de cadera (Grotle et al, 2010;Monaghan et al, 2012).…”

A randomized controlled trial: Preoperative home-based combined Tai Chi and Strength Training (TCST) to improve balance and aerobic capacity in patients with total hip arthroplasty (THA)

“…However, postoperative residual dissatisfaction is linked to complications due to comorbitities, such as unbalanced (Giaquinto, Ciotola, & Margutti, 2007), muscle weakness (Bhave et al, 2007), limitations in activities (Singh & Lewallen, 2010) and maintain abnormal gait (Foucher et al, 2007). These functional limitations are associated with preoperative dysfunction and will be long-lasting persistence in patients after the surgery (Monaghan, Grant, Hing, & Cusack, 2012;van Dijk et al, 2010). Surgical approach and bedrest following an orthopedic surgery will compromise additional muscle weakness and decreasing aerobic capacity (Convertino, Bloomfield, & Greenleaf, 1997;Meneghini, Pagnano, Trousdale, & Hozack, 2006).…”

“…The further changes, that may cause balance and gait problems in THA patients, are damage to proprioceptors due to excise or capsule released from the hip, altered unequal leg length and weight bearing (Bohannon, 1995;Nallegowda et al, 2003). It is necessary to do physical rehabilitation exercise to re-train for balance, gait, and activities of daily living in postoperative care (Bhave et al, 2007;Monaghan et al, 2012;Nallegowda et al, 2003).…”