Function and quality of life could not be meta-analysed due to insufficient data and heterogeneity of measures , but functional measures tended to favour the physiotherapy rehabilitation group .
Most outcomes were similar between outpatient and home-based exercise programs .
Physiotherapy rehabilitation improves hip abductor strength , gait speed and cadence in people who have been discharged from hospital after total hip replacement .
Physiotherapist-directed rehabilitation exercises appear to be similarly effective whether they are performed unsupervised at home or supervised by a physiotherapist in an outpatient setting
QUESTION In people who have been discharged from hospital after a total hip replacement , do rehabilitation exercises directed by a physiotherapist improve strength , gait , function and quality of life ?
Are these exercises as effective in an unsupervised home-based setting as they are in a supervised outpatient setting ?
Group physiotherapy provides similar outcomes for participants after joint replacement surgery as 1-to-1 physiotherapy: a sequential cohort study.
UNLABELLED Coulter CL , Weber JM , Scarvell JM . Group physiotherapy provides similar outcomes for participants after joint replacement surgery as 1-to-1 physiotherapy :  a sequential cohort study . OBJECTIVES To compare effectiveness and time efficiency of physiotherapy rehabilitation provided within a group with an individualized program provided at home for improving participants ' outcomes after total joint replacement surgery . DESIGN Quasiexperimental sequential cohort trial with 12-week follow-up . SETTING A tertiary acute care hospital . PARTICIPANTS Consecutive patients ( N=51 ) having hip or knee replacement surgery in an 8-month period and who were able to weight-bear postoperatively . INTERVENTIONS The first group admitted to the study entered the exercise group  , and patients in the following 4 months entered the home physiotherapy group . MAIN OUTCOME MEASURES Primary outcome measures included the Western Ontario McMaster 's University Osteoarthritis Index ( WOMAC ) , Medical Outcomes Study 36-Item Short-Form Health Survey ( SF-36 ) , Timed Up & Go ( TUG ) test , and knee range of motion ( ROM ) . Secondary measures included the 6-m walk test and a patient evaluation question naire . Staff time costs were recorded . Outcomes were recorded preoperatively or at hospital discharge , and 5 and 12 weeks postoperatively . RESULTS There was no difference between the 2 groups for either the WOMAC or SF-36 scores , 6-m walk test , TUG test , or ROM measures at 12 weeks ( P>.05 ) , although both groups of patients improved between hospital discharge and 12 weeks . The class group accessed more frequent physiotherapy than the home group ( mean , 7.5 and 3.96 visits , respectively ) . The physiotherapist 's time was less per patient per visit for the class group ( mean , 27min direct and 10min indirect ) than for the home visits ( mean , 38min direct and 26min indirect ) . CONCLUSIONS This trial suggests that the class-based exercise rehabilitation was the most efficient method of delivery of the physiotherapy service , without cost to patient outcomes
Function and quality of life could not be meta-analysed due to insufficient data and heterogeneity of measures , but functional measures tended to favour the physiotherapy rehabilitation group .
Most outcomes were similar between outpatient and home-based exercise programs .
Physiotherapy rehabilitation improves hip abductor strength , gait speed and cadence in people who have been discharged from hospital after total hip replacement .
Physiotherapist-directed rehabilitation exercises appear to be similarly effective whether they are performed unsupervised at home or supervised by a physiotherapist in an outpatient setting
QUESTION In people who have been discharged from hospital after a total hip replacement , do rehabilitation exercises directed by a physiotherapist improve strength , gait , function and quality of life ?
Are these exercises as effective in an unsupervised home-based setting as they are in a supervised outpatient setting ?