A Targeted Home- and Center-Based Exercise Program for People After Total Hip Replacement: A Randomized Clinical Trial

Galea MP, Levinger P, Lythgo N, Cimoli C, Weller R, Tully E, McMeeken J, Westh R. A targeted home- and center-based exercise program for people after total hip replacement: a randomized clinical trial.ObjectiveTo examine the physical function, gait, and quality of life of patients after total hip replacement (THR) randomly assigned to either a targeted home- or center-based exercise program.DesignRandomized controlled trial.SettingRehabilitation research center in Australia.ParticipantsTwenty-three patients with unilateral THR were randomly assigned to a supervised center-based exercise group (n=11) or an unsupervised home-based exercise group (n=12).InterventionThe center-based group completed an 8-week targeted exercise program while under the direct supervision of a physiotherapist. After initial instruction, the home-based group completed the 8-week targeted exercise program at home without further supervision.Main Outcome MeasuresQuality of life, physical function, and spatiotemporal measures of gait.ResultsNo significant interaction (group by time) or main effects of grouping were found. Within each group, quality of life, and stair climbing improved significantly (P<.05) as did Timed Up & Go test and 6-minute walk test performances (P<.05). Walking speed increased by 16cm/s (P<.01), cadence by 8 steps/min (P<.05), step length by 4.7cm (P<.05), and double-support time reduced by a factor of 16%. Step length symmetry showed significant improvement (P<.05) over time. Step length differential between the affected and unaffected limbs reduced from 4.0 to 2.7cm.ConclusionsThe targeted strengthening program was effective for both the home- and center-based groups. No group differences were found in the majority of the outcome measures. This finding is important because it shows that THR patients can achieve significant improvements through a targeted strengthening program delivered at a center or at home.