Does an early home-based progressive resistance training program improve function following total hip replacement? Results of a randomized controlled study.
BACKGROUND
In-hospital progressive resistance training (PRT) has been shown to be an effective method of rehabilitation following hip surgery. The aim of this study was to assess whether a home-based PRT program would be beneficial in improving patients' muscle strength and physical function compared to standard rehabilitation.


METHODS
Subjects (n = 49) either received home-based PRT rehabilitation (n = 25) or standard rehabilitation (n = 24) in a prospective single blinded randomized trial carried out over a two-year period. The primary outcome measure was the maximal voluntary contraction of the operated leg quadriceps (MVCOLQ) with secondary measures of outcome being the sit to stand score (ST), timed up and go (TUG), stair climb performance (SCP), the 6 min walk test (6MWT), and lean mass of the operated leg (LM).


RESULTS
Twenty-six patients completed follow up at 1 year (n = 13 per group) for the final comparative analysis. All the outcome measures showed marked progressive improvements from the baseline measures at 9-12 months post op (Estimated effect (std error); p value)- MVCOLQ 26.50 (8.71) N p = 0.001; ST 1.37 (0.33) p = 0.0001; TUG -1.44 (0.45) s p =0.0001; SCP -3.41(0.80)s p = 0.0001; 6MWT 45.61 (6.10)m p = 0.0001; LM 20 (204)g p = 0.326) following surgery for both groups. Overall, there was no significant effect for participation in the exercise regime compared with standard care for all outcomes assessed.


CONCLUSIONS
Overall, this study demonstrated that there is no significant difference between the two groups for participation in the home-based PRT exercise programme when compared to standard care for all outcomes.


BACKGROUND
ISRCTN 1309951. Registered February 2011.
Department of Orthopaedics, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, Bangor, UK. tosanwumi@hotmail.com.|College of Medicine, Swansea University, Swansea, SA2 8PP, UK. tosanwumi@hotmail.com.
Tosan
T
Okoro
North Wales Organisation for Randomised Trials in Health (NWORTH), Bangor University, Bangor, UK.
Rhiannon
R
Whitaker
Department of Orthopaedics, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, Bangor, UK.
Andrew
A
Gardner
School of Sport Health and Exercise Science, Bangor University, Bangor, UK.
Peter
P
Maddison
Department of Orthopaedics, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, Bangor, UK.
John G
JG
Andrew
School of Sport Health and Exercise Science, Bangor University, Bangor, UK.
Andrew
A
Lemmey
D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D015207:Osteoarthritis, Hip / Q000175:diagnosis / Q000534:rehabilitation* / Q000601:surgery*; D026741:Physical Therapy Modalities; D010865:Pilot Projects; D011446:Prospective Studies; D055070:Resistance Training / Q000379:methods*; D016037:Single-Blind Method
Home based rehabilitation; Progressive resistance training; Total hip replacement