A Targeted Strengthening Program Following Total Hip Replacement.

Study Overview
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Brief Summary
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Total Hip Replacement (THR) is a common surgical procedure performed in people with hip osteoarthritis and appears to be effective in relieving pain and improving function. However significant wasting and weakness of the hip and knee muscles persists post-operatively. Although relief of pain and improvement of function are important outcomes following THR, weakness of the hip and knee muscles reduces a person's ability to manage stairs, slopes, public transport and results in persistent gait abnormalities. Since lower limb weakness is one of the risk factors for falls, it is important that patients undergo a strengthening program post-operatively. The hypothesis is that lower limb strength and function will be better in patients who undergo a strengthening program post-operatively than in those who have usual care.

Detailed Description
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Total Hip Replacement (THR) is a common surgical procedure performed in people with hip osteoarthritis and appears to be effective in relieving pain and improving function. However significant quadriceps atrophy and weakness persist post-operatively. Although relief of pain and improvement of function are important outcomes following THR, weakness of the hip and knee muscles reduces a person's ability to manage stairs, slopes, public transport and results in persistent gait abnormalities. Since lower limb weakness is one of the risk factors for falls, it is important that this is appropriately addressed. The study examines the effect of an eight-week task-specific strengthening program on lower limb function in patients following THR in a randomized controlled trial. The experimental program is being conducted as a circuit in a gymnasium environment. Changes on specific measures of physical function of patients in the Experimental Group will be compared with those of patients in a Control Group who will continue with the standard care program provided at Austin Health. Outcome measures include:lower limb muscle strength using a step test, pain, stiffness, and function as reported on the WOMAC questionnaire, quality of life using the AQoL questionnaire, the Timed Up-and-Go test. Walking tests will also be conducted. These include: Walking pattern, recorded on an instrumented mat Walking endurance measured by the 6-minute walk test. Analysis of hip joint torques using 3-D motion analysis.

Official Title
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A Targeted Strengthening Program Following Total Hip Replacement.

Conditions
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Total Hip Joint Replacement

Intervention / Treatment
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* Behavioral: Strength training program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: primary uncomplicated total hip joint replacement 6-8 weeks prior to enrolment. able to walk 45m independently with or without walking aid. able to comprehend instructions prior joint replacement on the other side at least 12 months previously Exclusion Criteria: unable to fully weight-bear on affected limb pre-existing neurological or orthopaedic condition affecting gait revision surgery post-operative complications, e.g. wound infection uncontrolled systemic disease

Ages Eligible for Study
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Minimum Age: 0 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Intervention/Treatment |
| --- |
|Behavioral: Strength training program|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Lower limb strength using a step test |  |  | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain, stiffness and function using the WOMAC questionnaire. |  |  | 
| Function using the Timed Up-and-Go Test. |  |  | 
| Quality of life using the AQoL |  |  | 
| Spatiotemporal measures of walking using an instrumented mat. |  |  | 
| Hip joint torques using 3-D motion analysis. |  |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Total hip replacement, Strength training, Gait analysis