Randomized controlled trial to compare conventional physiotherapy with task-oriented exercises after total hip replacement

Abstract

BACKGROUND:

Different interventions are used during rehabilitation after hip replacement surgery, but it is unclear if task-oriented exercise is more effective than conventional physiotherapy.

OBJECTIVE:

This study compared the effectiveness of conventional physiotherapy (CPT) programme with task-oriented exercise (TOE) on hip pain, function, static and dynamic balance during the early rehabilitation stage after total hip replacement.

METHODS:

This randomized controlled parallel-group trial was executed in an inpatient physical medicine and rehabilitation centre. The study included 40 patients who were randomly classified into CPT and TOE groups ( $n=$ 20 in each). Hip pain (assessed by visual analogue scale), function in the operated leg (assessed by modified Harris Hip Score, mHHS), static balance (assessed by Abili Balance analyser system) and dynamic balance (assessed by Berg Balance Scale) were evaluated at baseline and after 18 days of rehabilitation. Cohen’s effect size ( $d$ ) was calculated.

RESULTS:

Greater pain reduction ( $p<$ 0.05; $d=$ 0.08) was observed after TOE (1.6 $\pm$ 0.68 scores) compared with the CPT programme (2.2 $\pm$ 0.83 scores). Hip function assessed by the modified mHHS improved more ( $p<$ 0.05; $d=$ 0.30) in the TOE group (73.45 $\pm$ 6.23 scores) than in the CPT group (54.90 $\pm$ 6.28 scores). Static balance improved significantly in both groups after the interventions but did not differ significantly between the groups. The improvement in dynamic balance was significantly greater ( $p<$ 0.05; $d=$ 0.45) after TOE (50.55 $\pm$ 1.57 scores) than after CPT (38.55 $\pm$ 3.43 scores).

CONCLUSION:

Both interventions reduced pain and improved function of the operated leg and static and dynamic balance. The effect on hip function was superior for TOE compared with CPT.