Early Maximal Strength Training Is an Efficient Treatment for Patients Operated With Total Hip Arthroplasty

Husby, Vigdis Schnell; Helgerud, Jan; Bjørgen, Siri; Husby, Otto Schnell; Benum, Pål; Hoff, Jan

doi:10.1016/j.apmr.2009.04.018

Cited by 84 publications

(140 citation statements)

References 47 publications

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“…Initiation of strength training as soon as possible after surgery is of great importance to decrease the influence of postsurgery immobilization on the impairment of muscle mass [36], as recommended by the present study. The current study demonstrated significant positive results in the improvement of muscle strength force in the intervention group compared with the nonintervention group, and these findings were similarly highlighted by Husby et al [33] in another randomized study. Even with good outcomes in the muscle strength force as measured by Kendall's criteria [22], this method may be imprecise when compared with a previously described method using a dynamometer, an instrument that is thought to have higher measurement accuracy [26,28,37].…”

Section: Discussionsupporting

confidence: 87%

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Rehabilitation following total hip arthroplasty evaluation over short follow-up time: Randomized clinical trial

Umpierres¹,

Ribeiro²,

Marchisio³

et al. 2014

J Rehabil Res Dev

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Abstract-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 randomized double-blind trial was performed between July 2009 and October 2011 to compare over 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. Greater improvements were also observed for the THAPCP group than 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: ClinicalTrials.gov; NCT01491048, "Evaluation of functional rehabilitation in patients undergoing physiotherapy after total hip arthroplasty (arthrosis)"; https://clinicaltrials.gov/ct2/show/NCT01491048

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Section: Discussionsupporting

confidence: 87%

“…Muscle strength declines 3-4 percent each day during the first week of immobilization [31], and patients who receive THA commonly experience a period of inactivity ahead of surgery [32], possibly due to the presence of pain [33]. This negative effect on muscle mass has been reported previously [31,34].…”

Section: Discussionmentioning

confidence: 86%

Rehabilitation following total hip arthroplasty evaluation over short follow-up time: Randomized clinical trial

Umpierres¹,

Ribeiro²,

Marchisio³

et al. 2014

J Rehabil Res Dev

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“…Sample size estimates were based on previous work examining lower extremity muscle strength before and 5 weeks after THA [16]. Estimates from the nonsurgical leg were used to represent healthy control subjects.…”

Section: Methodsmentioning

confidence: 99%

Muscle Strength and Functional Recovery During the First Year After THA

Judd¹,

Dennis

Thomas³

et al. 2013

Clin Orthop Relat Res

146

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Background Patients undergoing total hip arthroplasty (THA) often are satisfied with the decrease in pain and improvement in function they achieve after surgery. Even so, strength and functional performance deficits persist after recovery, but these remain poorly characterized; knowledge about any ongoing strength or functional deficits may allow therapists to design rehabilitation programs to optimize recovery after THA. Questions/purposes The purposes of this study were to (1) evaluate postoperative muscle strength, function, and quality of life during the first year after THA; and (2) compare strength and function in patients 1 year after THA with a cohort of healthy peers. Methods Twenty-six patients undergoing THA were assessed 1, 3, 6, and 12 months postoperatively, and 19 adults with no hip pathology were tested as a control group. Isometric muscle strength (hip flexors, extensors, abductors, knee extensors, and flexors), functional performance (stair climbing, five times sit-to-stand, timed-up-and-go, 6-minute walk, and single-limb stance tests), and selfreported function (Hip Disability and Osteoarthritis Score, SF-36, and UCLA activity score) were compared. Results One month after THA, patients had 15% less hip flexor and extensor torque, 26% less abductor torque, 14% less knee extensor and flexor torque, and worse performance on the stair climbing, timed-up-and-go, single-limb stance, and 6-minute walk. Compared with healthy adults, patients 12 months after THA had 17% less knee extensor and 23% less knee flexor torque; however, the functional testing (including stair climbing, five times sit-to-stand, and the 6-minute walk) showed no significant differences with the patient numbers available between individuals undergoing THA and healthy control subjects. SF-36 Physical Component Scores, although significantly improved from preoperative levels, were significantly worse than healthy adults 1 year after THA (p \ 0.01).

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“…A leg press strength difference of 20 kg or more was previously regarded as clinically relevant (Husby et al 2009), and this was used as a reference when calculating the number of patients needed. In all, 20 patients were to be included in each group, selecting a significance level of 5% and a power level of 80%.…”

Section: Methodsmentioning

confidence: 99%

Muscular strength after total hip arthroplasty

et al. 2015

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Background and purposeMinimizing the decrease in muscular strength after total hip arthroplasty (THA) might allow patients to recover faster. We evaluated muscular strength in patients who were operated on using 3 surgical approaches.Patients and methodsIn a prospective cohort study, 60 patients scheduled for primary THA were allocated to the direct lateral, posterior, or anterior approach. Leg press and abduction strength were evaluated 2 weeks or less preoperatively, 2 and 8 days postoperatively, and at 6-week and 3-month follow-up.ResultsDifferences in maximal strength change were greatest after 2 and 8 days. The posterior and anterior approaches produced less decrease in muscular strength than the direct lateral approach. 6 weeks postoperatively, the posterior approach produced greater increase in muscular strength than the direct lateral approach, and resulted in a greater increase in abduction strength than the anterior approach. At 3-month follow-up, no statistically significant differences between the groups were found. The operated legs were 18% weaker in leg press and 15% weaker in abduction than the unoperated legs, and the results were similar between groups.InterpretationThe posterior and anterior approaches appeared to have the least negative effect on abduction and leg press muscular strength in the first postoperative week; the posterior approach had the least negative effect, even up to 6 weeks postoperatively. THA patients have reduced muscle strength in the operated leg (compared to the unoperated leg) 3 months after surgery.

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Early Maximal Strength Training Is an Efficient Treatment for Patients Operated With Total Hip Arthroplasty

Cited by 84 publications

References 47 publications

Rehabilitation following total hip arthroplasty evaluation over short follow-up time: Randomized clinical trial

Rehabilitation following total hip arthroplasty evaluation over short follow-up time: Randomized clinical trial

Muscle Strength and Functional Recovery During the First Year After THA

Muscular strength after total hip arthroplasty

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