title: A feasibility randomised controlled trial of pre-operative occupational therapy to optimise recovery for patients undergoing primary total hip replacement for osteoarthritis (PROOF-THR).
abstract: OBJECTIVE
  To assess the feasibility of a pre-operative occupational therapy intervention for patients undergoing primary total hip replacement.
  
  
  METHODS
  Single blinded feasibility randomised controlled trial, with data collection prior to the intervention, and at 4, 12, and 26 weeks following surgery.
  
  
  METHODS
  Recruitment from two NHS orthopaedic outpatient centres in the West Midlands, UK.
  
  
  METHODS
  Patients awaiting primary total hip replacement due to osteoarthritis were recruited. Following pre-operative assessment, patients were individually randomised to intervention or control by a computer-generated block randomisation algorithm stratified by age and centre.
  
  
  METHODS
  The intervention group received a pre-surgery home visit by an occupational therapist who discussed expectations, assessed home safety, and provided appropriate adaptive equipment. The control group received treatment as usual.
  
  
  RESULTS
  The study assessed the feasibility of recruitment procedures, delivery of the intervention, appropriateness of outcome measures and data collection methods. Health related quality of life and resource use were recorded at 4, 12 and 26 weeks.
  
  
  RESULTS
  Forty-four participants were recruited, 21 were randomised to the occupational therapy intervention and 23 to usual care. Analysis of 26 week data included 18 participants in the intervention group and 21 in the control. The intervention was delivered successfully with no withdrawals or crossovers; 5/44 were lost to follow-up with further missing data for participation and resource use.
  
  
  CONCLUSIONS
  The feasibility study provided the information required to conduct a definitive trial. Burden of assessment would need to be addressed. A total of 219 patients would be required in an efficacy trial.
authors: School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, UK.
authors: Paul
authors: P
authors: Jepson
authors: CLAHRC-EM, School of Medicine, University of Nottingham, UK.
authors: Gina
authors: G
authors: Sands
authors: Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, UK.
authors: Andrew D
authors: AD
authors: Beswick
authors: The Royal Orthopaedic Hospital, NHS Foundation Trust, Birmingham, UK.
authors: Edward T
authors: ET
authors: Davis
authors: Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, UK.
authors: Ashley W
authors: AW
authors: Blom
authors: Faculty of Life Science and Medicine, King's College London, London, UK catherine.sackley@kcl.ac.uk.
authors: Catherine M
authors: CM
authors: Sackley
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000534:rehabilitation*; D005240:Feasibility Studies; D005260:Female; D006792:House Calls; D006801:Humans; D008297:Male; D009788:Occupational Therapy / Q000379:methods*; D015207:Osteoarthritis, Hip / Q000534:rehabilitation / Q000601:surgery*; D010044:Outpatient Clinics, Hospital; D011300:Preoperative Care / Q000379:methods*; D020127:Recovery of Function; D013222:State Medicine; D013997:Time Factors; D006113:United Kingdom
keywords: Activities of daily living; occupational therapy; osteoarthritis; pre-habilitation; prostheses