Does an early home-based progressive resistance training program improve function following total hip replacement Results of a randomized controlled studyReportar como inadecuado




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BMC Musculoskeletal Disorders

, 17:173

Rehabilitation, physical therapy and occupational health

Abstract

BackgroundIn-hospital progressive resistance training PRT has been shown to be an effective method of rehabilitation following hip surgery. The aim of this study was to assess whether a home-based PRT program would be beneficial in improving patients’ muscle strength and physical function compared to standard rehabilitation.

MethodsSubjects n = 49 either received home-based PRT rehabilitation n = 25 or standard rehabilitation n = 24 in a prospective single blinded randomized trial carried out over a two-year period. The primary outcome measure was the maximal voluntary contraction of the operated leg quadriceps MVCOLQ with secondary measures of outcome being the sit to stand score ST, timed up and go TUG, stair climb performance SCP, the 6 min walk test 6MWT, and lean mass of the operated leg LM.

ResultsTwenty-six patients completed follow up at 1 year n = 13 per group for the final comparative analysis. All the outcome measures showed marked progressive improvements from the baseline measures at 9–12 months post op Estimated effect std error; p value- MVCOLQ 26.50 8.71 N p = 0.001; ST 1.37 0.33 p = 0.0001; TUG −1.44 0.45 s p =0.0001; SCP −3.410.80s p = 0.0001; 6MWT 45.61 6.10m p = 0.0001; LM 20 204g p = 0.326 following surgery for both groups. Overall, there was no significant effect for participation in the exercise regime compared with standard care for all outcomes assessed.

ConclusionsOverall, this study demonstrated that there is no significant difference between the two groups for participation in the home-based PRT exercise programme when compared to standard care for all outcomes.

Trial registrationISRCTN 1309951. Registered February 2011.

KeywordsProgressive resistance training Home based rehabilitation Total hip replacement Abbreviations6MWTsix minute walk test

ADLsactivities of daily living

ANOVAanalysis of variance

BMIbody mass index

CIconfidence interval

CONSORTconsolidated standards of reporting trials

DEXAdual energy X-ray absorptiometry

HTVPhigh training volume participants

ICCintra class correlation coefficient

LTVPlow training volume participants

MVCmaximal voluntary contraction

MVCOLQMaximal voluntary contraction of operated leg quadriceps

NNewtons

NFATnuclear factor of activated T cells

NHSnational health service

NICEnational institute for health and clinical excellence

NJRnational joint registry

NWORTHNorth Wales organisation for randomised trials in health

PRTprogressive resistance training

ROMrange of movement

RT-PCRreverse transcriptase polymerase chain reaction

SCPstair climb performance

SDstandard deviation

SRstandard rehabilitation

STsit to stand number of repetitions

THRtotal hip replacement

TOTosan Okoro, corresponding author

TUGtimed up and go test seconds

Electronic supplementary materialThe online version of this article doi:10.1186-s12891-016-1023-x contains supplementary material, which is available to authorized users.

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Autor: Tosan Okoro - Rhiannon Whitaker - Andrew Gardner - Peter Maddison - John G. Andrew - Andrew Lemmey

Fuente: https://link.springer.com/



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