Perioperative Exercise Programs Improve Early Return of Ambulatory Function After Total Hip Arthroplasty

Abstract

The study indicates that perioperative customized exercise program are well tolerated in the elderly patient with endstage hip arthritis and are effective in improving the rate of recovery in ambulatory function in the first 6 mo after total hip arthroplasty.

Factors Influencing Early Rehabilitation After THA: A Systematic Review

“…Although preoperative education seems useful for patients [19], few studies examine the effect of preoperative physiotherapy on early rehabilitation after THA. Preoperative physiotherapy reportedly improves muscle strength and gait, allowing early return to ambulatory function [18,55,62]. However, limitations of the studies on preoperative physiotherapy include small numbers of patients, variability in outcome measures, and lack of the cost-benefit analysis.…”

“…The subjects in the study were, in general, younger patients with less medical comorbidities. The functional outcome assessment in this study was limited to gait and stamina rather than activities of daily living or functional scores [62]. Gilbey et al [18] performed a prospective randomized study of 76 patients that examined the effectiveness of preoperative exercise programs.…”

“…Gilbey et al [18] performed a prospective randomized study of 76 patients that examined the effectiveness of preoperative exercise programs. They measured the outcomes at intervals similar to those of Wang et al [62] and measured strength of thigh flexors, extensors and abductors, and range of motion of the hip. The results were based on 57 patients: 32 in the exercise group and 25 in the control group.…”

Methods for Optimising Patient Function After Total Hip Arthroplasty

“…A systematic review by Ackerman and Bennell (Ackerman & Bennell 2004) found that only two randomised controlled trials involving patients undergoing THR surgery demonstrated a benefit of performing pre-operative exercise. Both Wang et al (Wang, Gilbey & Ackland 2002) and Gilbey et al (Gilbey et al 2003) used pre-operative stationary bikes, resistance training of the lower limb and hydrotherapy with post-operative hydrotherapy, progressive strengthening exercises and aerobic activity. Wang et al (Wang, Gilbey & Ackland 2002) reported a significantly higher mean gait velocity for the exercise group from three to 24 weeks post-operatively, and a greater mean distance walked by the exercise group at 24 weeks post-operatively.…”

“…The average age of patients undergoing a primary total hip replacement is 66.7 years (SD 13.1) with females slightly older than males (average 68.4 years (SD12.4) vs. 65.8 years (SD 12.24) respectively) (National Joint Registry for England and Wales 2010). As technology and surgical techniques for total hip replacement (THR) improve, patient expectations have also increased, including for an early return to normal physical function and activities (Wang, Gilbey & Ackland 2002). A reduced time between surgery and mobilisation has been found to have an influence in reducing length of stay and increasing patient satisfaction (Husted et al 2008).…”