title: UK survey of occupational therapist's and physiotherapist's experiences and attitudes towards hip replacement precautions and equipment.
abstract: Total hip replacement (THR) is one of the most common orthopaedic procedures in the United Kingdom (UK). Historically, people following THR have been provided with hip precautions and equipment such as: raised toilet seats and furniture rises, in order to reduce the risks of dislocation post-operation. The purpose of this study was to determine current practices in the provision of these interventions in the UK for people following primary THR.
  
  
  
  A 27-question, self-administered online survey was developed and distributed to UK physiotherapists and occupational therapists involved in the management of people following primary THR (target respondents). The survey included questions regarding the current practices in the provision of equipment and hip precautions for THR patients, and physiotherapist's and occupational therapist's attitudes towards these practices. The survey was disseminated through print and web-based/social media channels.
  
  
  
  170 health professionals (87 physiotherapists and 83 occupational therapists), responded to the survey. Commonly prescribed equipment in respondent's health trusts were raised toilet seats (95 %), toilet frames and rails (88 %), furniture raises (79 %), helping hands/grabbers (77 %), perching stools (75 %) and long-handled shoe horns (75 %). Hip precautions were routinely prescribed by 97 % of respondents. Hip precautions were most frequently taught in a pre-operative group (52 % of respondents). Similarly equipment was most frequently provided pre-operatively (61 % respondents), and most commonly by occupational therapists (74 % respondents). There was variability in the advice provided on the duration of hip precautions and equipment from up to 6 weeks post-operatively to life-time usage.
  
  
  
  Current practice on hip precautions and provision of equipment is not full representative of clinician's perceptions of best care after THR. Future research is warranted to determine whether and to whom hip precautions and equipment should be prescribed post-THR as opposed to the current 'blanket' provision of equipment and movement restriction provided in UK practice.
authors.affiliation: School of Health Sciences, University of East Anglia, Queen's Building, School of Health Sciences, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK. toby.smith@uea.ac.uk.
authors.forename: T O
authors.initials: TO
authors.lastname: Smith
authors.affiliation: Division of Health and Social Care Research, King's College, London, UK.
authors.forename: C M
authors.initials: CM
authors.lastname: Sackley
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000534:rehabilitation; D001291:Attitude of Health Personnel; D007722:Health Knowledge, Attitudes, Practice; D006617:Hip Dislocation / Q000517:prevention & control*; D006801:Humans; D008875:Middle Aged; D000072087:Occupational Therapists / Q000523:psychology*; D010353:Patient Education as Topic; D059825:Physical Therapists / Q000523:psychology*; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods / Q000706:statistics & numerical data; D012656:Self-Help Devices / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D006113:United Kingdom
keywords: Dislocation; Equipment; Movement restriction; Rehabilitation; Total hip replacement