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BMC Musculoskeletal Disorders
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Open Access 01-12-2024 | Hip-TEP | Research

Hip strengthening exercise dosage is not associated with clinical improvements after total hip arthroplasty – a prospective cohort study (the PHETHAS-1 study)

Authors: Merete Nørgaard Madsen, Lone Ramer Mikkelsen, Michael Skovdal Rathleff, Kristian Thorborg, Thomas Kallemose, Thomas Bandholm

Published in: BMC Musculoskeletal Disorders | Issue 1/2024

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Abstract

Background

Postoperative rehabilitation exercise is commonly prescribed after total hip arthroplasty (THA), but its efficacy compared to no or minimal rehabilitation exercise has been questioned. Preliminary efficacy would be indicated if a dose-response relationship exists between performed exercise dose and degree of postoperative recovery. The objective was to evaluate the preliminary efficacy of home-based rehabilitation using elastic band exercise on performance-based function after THA, based on the association between performed exercise dose and change in performance-based function (gait speed) from 3 (start of intervention) to 10 weeks (end of intervention) after surgery.

Methods

A prospective cohort study was conducted. Following primary THA, patients were prescribed home-based rehabilitation exercise using elastic bands. Performed exercise dose (repetitions/week) was objectively measured using attached sensor technology. Primary outcome was change in gait speed (40 m fast-paced walk test). Secondary outcomes included patient-reported hip disability. In the primary analysis, a linear regression model was used.

Results

Ninety-four patients (39 women) with a median age of 66.5 years performed a median of 339 exercise repetitions/week (1st-3rd quartile: 209–549). Across outcomes, participants significantly improved from 3 to 10-week follow-up. The association between performed exercise dose and change in mean gait speed was 0.01 m/s [95% CI: -0.01; 0.02] per 100 repetitions.

Conclusions

We found no indication of preliminary efficacy of home-based rehabilitation exercise using elastic bands, as no significant and clinically relevant associations between performed exercise dose and changes in outcomes were present. Trials comparing postoperative rehabilitation exercise with no exercise early after THA are warranted.

Trial registration

Pre-registered: ClinicalTrials.gov (Identifier: NCT03109821, 12/04/2017).
Appendix
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Metadata
Title
Hip strengthening exercise dosage is not associated with clinical improvements after total hip arthroplasty – a prospective cohort study (the PHETHAS-1 study)
Authors
Merete Nørgaard Madsen
Lone Ramer Mikkelsen
Michael Skovdal Rathleff
Kristian Thorborg
Thomas Kallemose
Thomas Bandholm
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2024
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-024-08057-x

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