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Clin Rehabil. 2013 Sep;27(9):771-84. doi: 10.1177/0269215513478437. Epub 2013 Apr 10.

Recovery of function following hip resurfacing arthroplasty: a randomized controlled trial comparing an accelerated versus standard physiotherapy rehabilitation programme.

Author information

1
Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, UK. Karen.Barker@ouh.nhs.uk

Abstract

OBJECTIVE:

To identify if a tailored rehabilitation programme is more effective than standard practice at improving function in patients undergoing metal-on-metal hip resurfacing arthroplasty.

DESIGN:

Randomized controlled trial.

SETTING:

Specialist orthopaedic hospital.

SUBJECTS:

80 men with a median age of 56 years.

INTERVENTIONS:

Tailored post-operative physiotherapy programme compared with standard physiotherapy.

MAIN OUTCOMES:

Primary outcome - Oxford Hip Score (OHS), Secondary outcomes: Hip disability and Osteoarthritis Outcome Score (HOOS), EuroQol (EQ-5D-3L) and UCLA activity score. Hip range of motion, hip muscle strength and patient selected goals were also assessed.

RESULTS:

At one year the mean (SD) Oxford Hip Score of the intervention group was higher, 45.1 (5.3), than the control group, 39.6 (8.8). This was supported by a linear regression model, which detected a 5.8 unit change in Oxford Hip Score (p < 0.001), effect size 0.76. There was a statistically significant increase in Hip disability and Osteoarthritis Outcome Score of 12.4% (p < 0.0005), effect size 0.76; UCLA activity score differed by 0.66 points (p < 0.019), effect size 0.43; EQ 5D showed an improvement of 0.85 (p < 0.0005), effect size 0.76. A total of 80% (32 of 40) of the intervention group fully met their self-selected goal compared with 55% (22 of 40) of the control group. Hip range of motion increased significantly; hip flexion by a mean difference 17.9 degrees (p < 0.0005), hip extension by 5.7 degrees (p < 0.004) and abduction by 4 degrees (p < 0.05). Muscle strength improved more in the intervention group but was not statistically significant.

CONCLUSIONS:

A tailored physiotherapy programme improved self-reported functional outcomes and hip range of motion in patients undergoing hip resurfacing.

KEYWORDS:

Arthroplasty; physiotherapy; randomized controlled trial; range of motion

PMID:
23576032
DOI:
10.1177/0269215513478437
[Indexed for MEDLINE]

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