Surgery-Induced Changes and Early Recovery of Hip-Muscle Strength, Leg-Press Power, and Functional Performance after Fast-Track Total Hip Arthroplasty: A Prospective Cohort StudyReportar como inadecuado




Surgery-Induced Changes and Early Recovery of Hip-Muscle Strength, Leg-Press Power, and Functional Performance after Fast-Track Total Hip Arthroplasty: A Prospective Cohort Study - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Background

By measuring very early changes in muscle strength and functional performance after fast-track total hip arthroplasty THA, post-operative rehabilitation, introduced soon after surgery, can be designed to specifically target identified deficits.

Objectives

Firstly, to quantify changes compared to pre-operative values in hip muscle strength, leg-press power, and functional performance in the first week after THA, and secondly, to explore relationships between the muscle strength changes, and changes in hip pain, systemic inflammation, and thigh swelling.

Design

Prospective, cohort study.

Setting

Convenience sample of patients receiving a THA at Copenhagen University Hospital, Hvidovre, Denmark, between March and December 2011.

Participants

Thirty-five patients 65.9±7.2 years undergoing THA.

Main outcome measures

Hip muscle strength, leg-press power, performance-based function, and self-reported disability were determined prior to, and 2 and 8 days after, THA Day 2 and 8, respectively. Hip pain, thigh swelling, and C-Reactive Protein were also determined.

Results

Five patients were lost to follow-up. Hip muscle strength and leg press power were substantially reduced at Day 2 range of reductions: 41–58%, P<0.001, but less pronounced at Day 8 range of reductions: 23–31%, P<0.017. Self-reported symptoms and function HOOS: Pain, Symptoms, and ADL improved at Day 8 P<0.014. Changes in hip pain, C-Reactive Protein, and thigh swelling were not related to the muscle strength and power losses.

Conclusions

Hip muscle strength and leg-press power decreased substantially in the first week after THA – especially at Day 2 – with some recovery at Day 8. The muscle strength loss and power loss were not related to changes in hip pain, systemic inflammation, or thigh swelling. In contrast, self-reported symptoms and function improved. These data on surgery-induced changes in muscle strength may help design impairment-directed, post-operative rehabilitation to be introduced soon after surgery.

Trial Registration

ClinicalTrials.gov NCT01246674.



Autor: Bente Holm, Kristian Thorborg, Henrik Husted, Henrik Kehlet, Thomas Bandholm

Fuente: http://plos.srce.hr/



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