title: Effect of early supervised progressive resistance training compared to unsupervised home-based exercise after fast-track total hip replacement applied to patients with preoperative functional limitations. A single-blinded randomised controlled trial.
abstract: OBJECTIVE
  To examine if 2 weekly sessions of supervised progressive resistance training (PRT) in combination with 5 weekly sessions of unsupervised home-based exercise is more effective than 7 weekly sessions of unsupervised home-based exercise in improving leg-extension power of the operated leg 10 weeks after total hip replacement (THR) in patients with lower pre-operative function.
  
  
  METHODS
  A total of 73 patients scheduled for THR were randomised (1:1) to intervention group (IG, home based exercise 5 days/week and PRT 2 days/week) or control group (CG, home based exercise 7 days/week). The primary endpoint was change in leg extension power at 10 week follow up. Secondary outcomes were isometric hip muscle strength, sit-to-stand test, stair climb test, 20 m walking speed and patient-reported outcome (HOOS).
  
  
  RESULTS
  Sixty-two completed the trial (85%). Leg extension power increased from baseline to the 10 week follow up in both groups; mean [95% CI] IG: 0.29 [0.13; 0.45] and CG: 0.26 [0.10; 0.42] W/kg, with no between-group difference (primary outcome) (P = 0.79). Maximal walking speed (P = 0.008) and stair climb performance (P = 0.04) improved more in the IG compared to CG, no other between-group differences existed.
  
  
  CONCLUSIONS
  In this trial, supervised PRT twice a week in addition to 5 weekly sessions of unsupervised exercise for 10 weeks was not superior to 7 weekly sessions of unsupervised home-based exercise for 10 weeks in improving the primary outcome, leg-extension power of the operated leg, at the primary endpoint 10 weeks after surgery in THR patients with lower pre-operative function.
  
  
  BACKGROUND
  NCT01214954.
authors.affiliation: Interdisciplinary Research Unit, Elective Surgery Centre, Silkeborg Regional Hospital, Denmark; Lundbeck Centre for Fast-track Hip and Knee Arthroplasty, Denmark. Electronic address: lonemike@rm.dk.
authors.forename: L R
authors.initials: LR
authors.lastname: Mikkelsen
authors.affiliation: Department of Orthopaedic Surgery, Aarhus University Hospital, Denmark. Electronic address: inger.mechlenburg@ki.au.dk.
authors.forename: I
authors.initials: I
authors.lastname: Mechlenburg
authors.affiliation: Department of Orthopaedic Surgery, Aarhus University Hospital, Denmark. Electronic address: kjeld@soballe.com.
authors.forename: K
authors.initials: K
authors.lastname: Søballe
authors.affiliation: Interdisciplinary Research Unit, Elective Surgery Centre, Silkeborg Regional Hospital, Denmark; Institute of Clinical Medicine, Aarhus University, Denmark. Electronic address: lenejoer@rm.dk.
authors.forename: L B
authors.initials: LB
authors.lastname: Jørgensen
authors.affiliation: Interdisciplinary Research Unit, Elective Surgery Centre, Silkeborg Regional Hospital, Denmark. Electronic address: soermik@midt.rm.dk.
authors.forename: S
authors.initials: S
authors.lastname: Mikkelsen
authors.affiliation: Physical Medicine & Rehabilitation Research - Copenhagen (PMR-C), Department of Physiotherapy, Copenhagen University Hospital, Hvidovre, Denmark; Department of Orthopaedic Surgery and Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark. Electronic address: Thomas.Bandholm@hvh.regionh.dk.
authors.forename: T
authors.initials: T
authors.lastname: Bandholm
authors.affiliation: Department of Physiotherapy- and Occupational Therapy, Aarhus University Hospital, Denmark; Centre of Research in Rehabilitation (CORIR), Institute of Clinical Medicine, Aarhus University, Denmark. Electronic address: annempte@rm.dk.
authors.forename: A K
authors.initials: AK
authors.lastname: Petersen
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D055070:Resistance Training; D016037:Single-Blind Method; D016896:Treatment Outcome
keywords: Progressive resistance training; Randomised controlled trial; Rehabilitation; Total hip replacement