Randomised controlled trial to evaluate a physiotherapy-led functional exercise programme after total hip replacement

B. Monaghan, P. Cunningham, P. Harrington, W. Hing, C. Blake, D. O' Dohertya, T. Cusack

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4 Citations (Scopus)

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 21.9. 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 trail registration number: NCT01683201.

Original languageEnglish
Pages (from-to)283-288
Number of pages6
JournalPhysiotherapy
Volume103
Issue number3
Early online date15 Feb 2016
DOIs
Publication statusPublished - 1 Sep 2017

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Hip Replacement Arthroplasties
Randomized Controlled Trials
Exercise
Control Groups
Hip
Confidence Intervals
Ontario
Pain Measurement
Osteoarthritis
Mental Health

Cite this

Monaghan, B. ; Cunningham, P. ; Harrington, P. ; Hing, W. ; Blake, C. ; O' Dohertya, D. ; Cusack, T. / Randomised controlled trial to evaluate a physiotherapy-led functional exercise programme after total hip replacement. In: Physiotherapy. 2017 ; Vol. 103, No. 3. pp. 283-288.
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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 21.9. 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 trail registration number: NCT01683201.",
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Randomised controlled trial to evaluate a physiotherapy-led functional exercise programme after total hip replacement. / Monaghan, B.; Cunningham, P.; Harrington, P.; Hing, W.; Blake, C.; O' Dohertya, D.; Cusack, T.

In: Physiotherapy, Vol. 103, No. 3, 01.09.2017, p. 283-288.

Research output: Contribution to journalArticleResearchpeer-review

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AU - Monaghan, B.

AU - Cunningham, P.

AU - Harrington, P.

AU - Hing, W.

AU - Blake, C.

AU - O' Dohertya, D.

AU - Cusack, T.

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N2 - 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 21.9. 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 trail registration number: NCT01683201.

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