Effectiveness of land-based physiotherapy exercise following hospital discharge following hip arthroplasty for osteoarthritis: an updated systematic review.
BACKGROUND
Existing review required updating.


OBJECTIVE
To evaluate the effectiveness of physiotherapy exercise after discharge from hospital on function, walking, range of motion, quality of life and muscle strength, for patients following elective primary total hip arthroplasty for osteoarthritis.


METHODS
Systematic review from January 2007 to November 2013.


METHODS
AMED, CINAHL, EMBASE, MEDLINE, Kingsfund Database, and PEDro. Cochrane CENTRAL, BioMed Central (BMC), The Department of Health National Research Register and Clinical Trials.gov register. Searches were overseen by a librarian. Authors were contacted for missing information. No language restrictions were applied.


METHODS
Trials comparing physiotherapy exercise vs usual/standard care, or comparing two types of relevant exercise physiotherapy, following discharge from hospital after elective primary total hip replacement for osteoarthritis were reviewed.


RESULTS
Functional activities of daily living, walking, quality of life, muscle strength and joint range of motion.


METHODS
Quality and risk of bias for studies were evaluated. Data were extracted and meta-analyses considered.


RESULTS
11 trials are included in the review. Trial quality was mixed. Newly included studies were assessed as having lower risk of bias than previous studies. Narrative review indicates that physiotherapy exercise after discharge following total hip replacement may potentially benefit patients in terms of function, walking and muscle strengthening.


CONCLUSIONS
The overall quality and quantity of trials, and their diversity, prevented meta-analyses.


CONCLUSIONS
Disappointingly, insufficient evidence still prevents the effectiveness of physiotherapy exercise following discharge to be determined for this patient group. High quality, adequately powered, trials with long term follow up are required.
Physiotherapy Research Unit, Oxford University Hospitals NHS Trust, Nuffield Orthopaedic Hospital, Windmill Road, Headington, Oxford, UK. Electronic address: catherine.minnslowe@ouh.nhs.uk.
Catherine J Minns
CJ
Lowe
Physiotherapy Research Unit, Oxford University Hospitals NHS Trust, Nuffield Orthopaedic Hospital, Windmill Road, Headington, Oxford, UK.
Linda
L
Davies
School of Rehabilitation Sciences, University of East Anglia, Norwich Research Park, Norwich, UK.
Catherine M
CM
Sackley
Physiotherapy Research Unit, Oxford University Hospitals NHS Trust, Nuffield Orthopaedic Hospital, Windmill Road, Headington, Oxford, UK; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford University Hospitals NHS Trust, Oxford, UK.
Karen L
KL
Barker
D000203:Activities of Daily Living; D019644:Arthroplasty, Replacement, Hip / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D053580:Muscle Strength; D015207:Osteoarthritis, Hip / Q000601:surgery; D011446:Prospective Studies; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D016059:Range of Motion, Articular; D016138:Walking
Exercise; Hip arthroplasty; Physiotherapy; Systematic review