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

Monaghan, Brenda; Cunningham, Patricia M.; Harrington, Paul; Hing, Wayne; Blake, Catherine; Dohertya, D. O’; Cusack, Tara

doi:10.1016/j.physio.2016.01.003

Cited by 26 publications

(40 citation statements)

References 24 publications

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“…For joint and muscle function, hip muscle strength and hip ROM were the most evaluated outcomes. Hip muscle strength was measured in the following units of measurement: kilogram (kg) [ 27 , 28 , 45 ], Newton meter [ 29 , 33 ], Watts/kg body mass [ 30 ], Newton meter/kg body mass [ 30 , 31 ], Newton [ 32 , 42 ], pounds of force [ 36 ], pounds (lbs) [ 43 ] and Kendall’s criteria for manual muscle testing [ 46 ]. Hip ROM was displayed in degrees and was measured during active movement [ 40 , 41 ] or passive movement [ 31 , 42 ].…”

Section: Resultsmentioning

confidence: 99%

“…In the functional performance category, the 6-minute walk test (6MWT) [ 32 , 36 , 38 , 40 , 41 , 43 ] and stair-climbing performance [ 30 , 32 , 33 , 38 , 40 , 41 ] were the most evaluated functional tests. In addition, maximal walking speed [ 29 , 33 , 36 , 42 ], ten-meter walking speed [ 30 ], one-legged stance [ 29 ], chair rise performance [ 30 , 32 , 33 ], the timed up-and-go test [ 31 , 32 , 38 ], the figure-of-eight test [ 40 ] and the index of muscle function [ 40 ] were used in the included articles to evaluate functional performance.…”

Section: Resultsmentioning

confidence: 99%

“…For self-reported outcomes, both disease-specific and generic questionnaires were used. The most commonly used disease-specific questionnaire was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC): it was used in eight of the included articles to measure patient-reported pain, stiffness and/or physical function [ 29 , 34 – 36 , 38 , 39 , 43 , 44 ]. In addition, the Harris Hip Score [ 37 , 40 ], a tool that consists of both patient-reported outcomes (80% of the total score) and observations by a clinician (20% of the total score), and the Hip Disability and Osteoarthritis Outcome Score (HOOS) [ 30 , 40 , 41 ] were used.…”

Section: Resultsmentioning

confidence: 99%

“…Lastly, one article reported the outcomes of the Japanese Orthopedic Association hip score (only the pain subcategory) [ 31 ]. The following generic questionnaires were used to assess health status: the 12-item or 36-item Short Form Health Survey (SF-12 or SF-36) [ 27 , 28 , 43 , 44 , 46 ], the Rand 36-item Health Survey (RAND-36) [ 36 ] and the EuroQol five dimensions questionnaire [ 29 ]. Patient-reported pain was assessed using the Visual Analogue Scale [ 29 , 43 ] and the numeric rating scale [ 44 ].…”

Section: Resultsmentioning

confidence: 99%

“…Some of the articles in our review assessed both joint and muscle function and functional performance [ 29 – 33 , 36 , 40 – 43 ]. Results of these articles show that improvements in one category do not necessarily correspond with improvements in the other category and vice versa [ 30 – 33 , 40 , 43 ]. This is also described in the ICF model, which shows that an individual’s functioning can be defined at different levels and is the result of complex interactions between health condition and contextual factors [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

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The therapeutic validity and effectiveness of physiotherapeutic exercise following total hip arthroplasty for osteoarthritis: A systematic review

et al. 2018

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ObjectiveTo assess the therapeutic validity and effectiveness of physiotherapeutic exercise interventions following total hip arthroplasty (THA) for osteoarthritis.Data sourcesThe databases Embase, MEDLINE, Cochrane Library, CINAHL and AMED were searched from inception up to February 2017.Eligibility criteriaArticles reporting results of randomized controlled trials in which physiotherapeutic exercise was compared with usual care or with a different type of physiotherapeutic exercise were included, with the applied interventions starting within six months after THA. Only articles written in English, German or Dutch were included.Study appraisalTherapeutic validity (using the CONTENT scale) and risk of bias (using both the PEDro scale and the Cochrane Collaboration’s tool) were assessed by two researchers independently. Characteristics of the physiotherapeutic exercise interventions and results about joint and muscle function, functional performance and self-reported outcomes were extracted.ResultsOf the 1124 unique records retrieved, twenty articles were included. Only one article was considered to be of high therapeutic validity. Description and adequacy of patient selection were the least reported items. The majority of the articles was considered as having potentially high risk of bias, according to both assessment tools. The level of therapeutic validity did not correspond with the risk of bias scores. Because of the wide variety in characteristics of the physiotherapeutic exercise and control interventions, follow-up length and outcome measures, limited evidence was found on the effectiveness of physiotherapeutic exercise following THA.ConclusionThe insufficient therapeutic validity and potentially high risk of bias in studies involving physiotherapeutic exercise interventions limit the ability to assess the effectiveness of these interventions following THA. Researchers are advised to take both quality scores into account when developing and reporting studies involving physiotherapeutic exercise. Uniformity in intervention characteristics and outcome measures is necessary to enhance the comparability of clinical outcomes between trials.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The therapeutic validity and effectiveness of physiotherapeutic exercise following total hip arthroplasty for osteoarthritis: A systematic review

et al. 2018

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Evaluation of Exercise Interventions and Outcomes After Hip Arthroplasty

Saueressig¹,

Owen

Zebisch³

et al. 2021

JAMA Netw Open

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IMPORTANCE Preoperative and postoperative exercise interventions are commonly used in patients with total hip arthroplasty despite a lack of established efficacy. OBJECTIVE To explore clinical outcomes associated with exercise training before and after hip arthroplasty. DATA SOURCES PubMed, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, EMBASE, and Google Scholar were searched from their inception to March 2020. Reference lists of included trials and related reviews were also searched. STUDY SELECTION Randomized clinical trials of land-based exercise interventions before or after total hip arthroplasty were included. DATA EXTRACTION AND SYNTHESIS This systematic review and meta-analysis is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Data extraction was independently performed in duplicate. Random-effects meta-analyses with restricted maximum likelihood were performed for pooling the data. MAIN OUTCOMES AND MEASURES The primary prespecified outcome was self-reported physical function. Secondary prespecified outcomes were self-reported pain intensity, quality of life, gait speed, lower body muscle strength, lower body flexibility, anxiety, hospital length of stay, and adverse events. RESULTS A total of 32 randomized clinical trials with 1753 patients were included in the qualitative synthesis, and 26 studies with 1004 patients were included in the meta-analysis. Compared with usual care or no or minimal intervention, postoperative exercise training was not associated with improved self-reported physical function, with a moderate level of certainty, at 4 weeks

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Clinical and cost-effectiveness of physiotherapy interventions following total hip replacement: a systematic review and meta-analysis

2020

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To examine the reported clinical and cost-effectiveness of physiotherapy interventions following total hip replacement (THR). A systematic review was completed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). MEDLINE, CINAHL, AMED, Scopus, DARE, HTA, and NHS EED databases were searched for studies on clinical and cost-effectiveness of physiotherapy in adults with THR published up to March 2020. Studies meeting the inclusion criteria were identified and key data were extracted. Risk of bias was assessed using the Cochrane Risk of Bias Tool and a Consolidated Health Economic Evaluation Reporting Standards (CHEERS). Data were summarised and combined using random-effect meta-analysis. A total of 1263 studies related to the aim of the review were identified, from which 20 studies met the inclusion criteria and were included in the review. These studies were conducted in Australia ( n = 3), Brazil ( n = 1), United States of America (USA) ( n = 2), France ( n = 2), Italy ( n = 2), Germany ( n = 3), Ireland ( n = 1), Norway ( n = 2), Canada ( n = 1), Japan ( n = 1), Denmark ( n = 1), and United Kingdom (UK) ( n = 1). The duration of follow-up of the included studies was ranged from 2 weeks to 12 months. Physiotherapy interventions were found to be clinically effective for functional performance, hip muscle strength, pain, and range of motion flexion. From the National Health Service perspective, an accelerated physiotherapy programme following THR was cost-effective. The findings of the review suggest that physiotherapy interventions were clinically effective for people with THR. However, questions remain on the pooled cost-effectiveness of physiotherapy interventions, and further research is required to examine this in patients with THR. Future studies are required to examine the cost-effectiveness of these interventions from patients, caregivers, and societal perspectives. Registration Prospero (ID: CRD42018096524).

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

Cited by 26 publications

References 24 publications

The therapeutic validity and effectiveness of physiotherapeutic exercise following total hip arthroplasty for osteoarthritis: A systematic review

The therapeutic validity and effectiveness of physiotherapeutic exercise following total hip arthroplasty for osteoarthritis: A systematic review

Evaluation of Exercise Interventions and Outcomes After Hip Arthroplasty

Clinical and cost-effectiveness of physiotherapy interventions following total hip replacement: a systematic review and meta-analysis

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