Early Rehabilitation After Total Hip Replacement

Study Overview
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Brief Summary
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The purpose of this study is to determine whether supervised progressive resistance training is effective in the early phase after Total Hip Replacement. The investigators hypothesise that 10 weeks of supervised, progressive resistance training immediately after discharge will lead to increased functional performance, muscle strength and muscle power compared to standard rehabilitation consisting of home-based exercise.

Detailed Description
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After total hip replacement (THR) surgery there is a documented deficit in muscle strength and functional performance. There is a lack of evidence concerning the effectiveness of postoperative physiotherapy and training, however a few small studies have shown promising effect of resistance training. The present study will provide new and important knowledge concerning the effect of different rehabilitation strategies after THR. This might lead to a change in the rehabilitation regimes and faster and better recovery after THR surgery.

Official Title
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Early Rehabilitation After Toal Hip Replacement. -Effect of Supervised Progressive Resistance Training

Conditions
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Osteoarthritis, Hip

Intervention / Treatment
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* Other: Supervised progressive resistance training
* Other: Control group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Total hip replacement for osteoarthrosis Living within 30 km from the hospital Motivated to attend training 2 times/week in 10 weeks Reduced functional ability measured as: HOOS score < 67 written informed consent Exclusion Criteria: Comorbidities such as cancer, neuromuscular diseases, heart diseases etc. Cognitive impairment Body mass index > 35 Resurfacing prosthesis Scheduled additional prosthetic surgery in lower extremity within 6 months

Ages Eligible for Study
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Minimum Age: 18 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

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Control group<br>Standard rehabilitation | Other: Control group<br>* Standard rehabilitation consisting of home-based exercises with 2 postoperative instructions by a physiotherapist.<br>|
| Experimental: Resistance training<br>10 weeks of supervised progressive resistance training initiated within the first week after total hip replacement. | Other: Supervised progressive resistance training<br>* Resistance training 2 times/week initiated within the first week after total hip replacement. The training is supervised by physiotherapists and individually progressed.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Leg extension power | The power in leg extension is measured using the Nottingham leg extension power rig. Data is provided in watt and adjusted for bodyweight (watt/kg) | 10 weeks postoperative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Walking speed | Maximal walking speed measured over 20 m. | 4 weeks postoperative | 
| Sit-to-stand | The maximal number of rises from a chair within 30 seconds | 10 weeks postoperative | 
| Stair test | The time taken to ascend 18 steps as fast as possible | 10 weeks postoperative | 
| Hip Osteoarthritis Outcome Score (HOOS) | Questionnaire. A disease-specific patient reported outcome measure of function, pain, sport/recreation and quality of life related to the hip. | 6 months postoperative | 
| Walking speed | Maximal walking speed measured over 20 m. | 10 weeks | 
| Walking speed | Maximal walking speed measured over 20 m. | 6 months postoperative | 
| Leg extension power | The power in leg extension is measured using the Nottingham leg extension power rig. Data is provided in watt and adjusted for bodyweight (watt/kg) | 6 months postoperative | 
| Sit-to-stand | The maximal number of rises from a chair within 30 seconds | 6 months postoperative | 
| Stair test | The time taken to ascend 18 steps as fast as possible | 6 months postoperative | 
| Hip Osteoarthritis Outcome Score (HOOS) | Questionnaire. A disease-specific patient reported outcome measure of function, pain, sport/recreation and quality of life related to the hip. | 2 weeks postoperative | 
| Hip Osteoarthritis Outcome Score (HOOS) | Questionnaire. A disease-specific patient reported outcome measure of function, pain, sport/recreation and quality of life related to the hip. | 4 weeks postoperative | 
| Hip Osteoarthritis Outcome Score (HOOS) | Questionnaire. A disease-specific patient reported outcome measure of function, pain, sport/recreation and quality of life related to the hip. | 6 weeks postoperative | 
| Isometric muscle strength | Test of isometric muscle strength in hip abduction and hip flexion using hand-held dynamometry | 4 weeks postoperative | 
| Isometric muscle strength | Test of isometric muscle strength in hip abduction and hip flexion using hand-held dynamometry | 10 weeks postoperative | 
| Isometric muscle strength | Test of isometric muscle strength in hip abduction and hip flexion using hand-held dynamometry | 6 months postoperative | 
| Gait quality | Instrumented gait analysis using a combined accelerometer and gyro-sensor in 20 meter walk test and stair climb test. The purpose is to measure asymmetry between limps during walking and stair climbing and compare the two groups according to these variables. This outcome measure is performed on a subgroup of participants (n=26, 13 in each group) | 10 weeks postoperative | 
| Gait quality | Instrumented gait analysis using a combined accelerometer and gyro-sensor in 20 meter walk test and stair climb test. The purpose is to measure asymmetry between limps during walking and stair climbing and compare the two groups according to these variables. This outcome measure is performed on a subgroup of participants (n=26, 13 in each group) | 6 months postoperative | 
| Hip Osteoarthritis Outcome Score (HOOS) | Questionnaire. A disease-specific patient reported outcome measure of function, pain, sport/recreation and quality of life related to the hip. | 10 weeks postoperative | 
| Hip Osteoarthritis Outcome Score (HOOS) | Questionnaire. A disease-specific patient reported outcome measure of function, pain, sport/recreation and quality of life related to the hip. | 1 year postoperative | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Total Hip Replacement, Rehabilitation, Resistance training