Effect of early supervised progressive resistance training compared to unsupervised home-based exercise after fast-track total hip replacement applied to patients with preoperative functional limitations. A single-blinded randomised controlled trial.
Study Goal
The researchers aimed to compare the effectiveness of supervised progressive resistance training (PRT) combined with unsupervised home-based exercise versus unsupervised home-based exercise alone in improving leg-extension power and other functional outcomes in patients after total hip replacement (THR).
Results Summary
Both groups showed improved leg-extension power, with no significant difference between them. However, the intervention group (PRT + home exercise) demonstrated greater improvements in maximal walking speed and stair climb performance compared to the control group (home exercise alone).
Population
Patients with lower pre-operative function scheduled for total hip replacement (THR).
Effective Dosage
Intervention group: 5 days/week home-based exercise + 2 days/week PRT; Control group: 7 days/week home-based exercise.
Duration
10 weeks.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
2 weekly sessions of supervised progressive resistance training (PRT) in combination with 5 weekly sessions of unsupervised home-based exercise | no change | leg-extension power of the operated leg | patients with lower pre-operative function scheduled for total hip replacement (THR) | no between-group difference (P = 0.79) | was not superior to | #1 |
2 weekly sessions of supervised progressive resistance training (PRT) in combination with 5 weekly sessions of unsupervised home-based exercise | increase | maximal walking speed | patients with lower pre-operative function scheduled for total hip replacement (THR) | P = 0.008 | improved more in the IG compared to CG | #2 |
2 weekly sessions of supervised progressive resistance training (PRT) in combination with 5 weekly sessions of unsupervised home-based exercise | increase | stair climb performance | patients with lower pre-operative function scheduled for total hip replacement (THR) | P = 0.04 | improved more in the IG compared to CG | #3 |
2 weekly sessions of supervised progressive resistance training (PRT) in combination with 5 weekly sessions of unsupervised home-based exercise | increase | leg extension power | patients with lower pre-operative function scheduled for total hip replacement (THR) | mean [95% CI] IG: 0.29 [0.13; 0.45] W/kg | increased from baseline to the 10 week follow up | #4 |
7 weekly sessions of unsupervised home-based exercise | increase | leg extension power | patients with lower pre-operative function scheduled for total hip replacement (THR) | mean [95% CI] CG: 0.26 [0.10; 0.42] W/kg | increased from baseline to the 10 week follow up | #5 |
OBJECTIVE: To examine if 2 weekly sessions of supervised progressive resistance training (PRT) in combination with 5 weekly sessions of unsupervised home-based exercise is more effective than 7 weekly sessions of unsupervised home-based exercise in improving leg-extension power of the operated leg 10 weeks after total hip replacement (THR) in patients with lower pre-operative function. METHOD: A total of 73 patients scheduled for THR were randomised (1:1) to intervention group (IG, home based exercise 5 days/week and PRT 2 days/week) or control group (CG, home based exercise 7 days/week). The primary endpoint was change in leg extension power at 10 week follow up. Secondary outcomes were isometric hip muscle strength, sit-to-stand test, stair climb test, 20 m walking speed and patient-reported outcome (HOOS). RESULTS: Sixty-two completed the trial (85%). Leg extension power increased from baseline to the 10 week follow up in both groups; mean [95% CI] IG: 0.29 [0.13; 0.45] and CG: 0.26 [0.10; 0.42] W/kg, with no between-group difference (primary outcome) (P = 0.79). Maximal walking speed (P = 0.008) and stair climb performance (P = 0.04) improved more in the IG compared to CG, no other between-group differences existed. CONCLUSIONS: In this trial, supervised PRT twice a week in addition to 5 weekly sessions of unsupervised exercise for 10 weeks was not superior to 7 weekly sessions of unsupervised home-based exercise for 10 weeks in improving the primary outcome, leg-extension power of the operated leg, at the primary endpoint 10 weeks after surgery in THR patients with lower pre-operative function. TRIAL REGISTRATION: NCT01214954.