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Excerpt
The purpose of this study was to apply customised preoperative exercise training programs to patients scheduled for primary THR surgery and compare their rate of recovery to similar subjects who underwent the routine course of presurgery care. Subjects randomised to the exercise group (E) participated in a twice-weekly supervised strength and hydrotherapy program, and completed two unsupervised home-based sessions for a period of two months presurgery. Outcome measures, which included bi-lateral lower extremity muscle strength, active range of motion (AROM) of the hip and knee and subjective functional assessments (WOMAC, HHS), were tested in all patients on three occasions, at 8-weeks and 1-week prior to surgery and at week-3 postsurgery. The results revealed that at baseline (8-weeks presurgery) no differences were observed between the two groups for age, height, weight, all measures of thigh and leg strength and AROM of the hip and knee. However, at 1-week presurgery E showed significant improvement (p<.05) from baseline in all measures of thigh strength on the non-affected side and in leg extension, thigh extension, thigh abduction strength as well as AROM of the hip on the operative side compared to C. At week-3 postsurgery E were significantly stronger (p<.05) in measures of bi-lateral thigh abduction, AROM of the operative hip and leg extension on the non-operative side. The improved maintenance of bilateral thigh abductor strength and AROM of the operated hip may lead to the early restoration of normal gait and decreased reliance on walking aids.
