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

Corinne Coulter, Jennie SCARVELL, Teresa Neeman, Paul N. Smith

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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 16 Nm (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
Original languageEnglish
Pages (from-to)219-226
Number of pages8
JournalJournal of Physiotherapy
Volume59
Issue number4
DOIs
Publication statusPublished - 2013

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Exercise Therapy
Hip Replacement Arthroplasties
Physical Therapists
Hip
Outpatients
Knee
Rehabilitation
Quality of Life
Gait
Meta-Analysis
Exercise
Outcome Assessment (Health Care)
Walking Speed
Muscles

Cite this

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title = "Physiotherapist-directed rehabilitation exercises in the outpatient or home setting improve strength, gait speed and cadence after elective total hip replacement: a systematic review",
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 16 Nm (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 = "Physiotherapy, Rehabilitation, Exercise, Total hip replacement, Physical therapy",
author = "Corinne Coulter and Jennie SCARVELL and Teresa Neeman and Smith, {Paul N.}",
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T1 - Physiotherapist-directed rehabilitation exercises in the outpatient or home setting improve strength, gait speed and cadence after elective total hip replacement: a systematic review

AU - Coulter, Corinne

AU - SCARVELL, Jennie

AU - Neeman, Teresa

AU - Smith, Paul N.

PY - 2013

Y1 - 2013

N2 - 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 16 Nm (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

AB - 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 16 Nm (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

KW - Physiotherapy

KW - Rehabilitation

KW - Exercise

KW - Total hip replacement

KW - Physical therapy

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M3 - Article

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JF - Australian Journal of Physiotherapy

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ER -