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J Physiother. 2013 Dec;59(4):219-26. doi: 10.1016/S1836-9553(13)70198-X.

Physiotherapist-directed rehabilitation exercises in the outpatient or home setting improve strength, gait speed and cadence after elective total hip replacement: a systematic review.

Author information

1
Australian National University Medical School, Australia; Physiotherapy Department, Canberra Hospital, Australia. Electronic address: corinne.coulter@act.gov.au.

Abstract

QUESTION:

In people who have been discharged from hospital after a total hip replacement, do rehabilitation exercises directed by a physiotherapist improve strength, gait, function and quality of life? Are these exercises as effective in an unsupervised home-based setting as they are in a supervised outpatient setting?

DESIGN:

Systematic review with meta-analysis of randomised trials.

PARTICIPANTS:

Adult patients after elective total hip replacement.

INTERVENTION:

Physiotherapist-directed rehabilitation exercises after discharge from hospital following total hip replacement.

OUTCOME MEASURES:

Hip and knee strength, gait parameters, functional measures, and quality of life.

RESULTS:

Five studies comprising 234 participants were included in the review. Sufficient data for meta-analysis were only obtained for hip and knee strength, gait speed and cadence. Physiotherapy rehabilitation improved hip abductor strength by a mean of 16Nm (95% CI 10 to 22), gait speed by 6 m/min (95% CI 1 to 11) and cadence by 20 steps/min (95% CI 8 to 32). Favourable but non-significant improvements in strength were noted for other muscle groups at the hip and knee. Function and quality of life could not be meta-analysed due to insufficient data and heterogeneity of measures, but functional measures tended to favour the physiotherapy rehabilitation group. Most outcomes were similar between outpatient and home-based exercise programs.

CONCLUSION:

Physiotherapy rehabilitation improves hip abductor strength, gait speed and cadence in people who have been discharged from hospital after total hip replacement. Physiotherapist-directed rehabilitation exercises appear to be similarly effective whether they are performed unsupervised at home or supervised by a physiotherapist in an outpatient setting.

KEYWORDS:

Exercise; Physical therapy; Physiotherapy; Rehabilitation; Total hip replacement

PMID:
24287215
DOI:
10.1016/S1836-9553(13)70198-X
[Indexed for MEDLINE]
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