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In the United Kingdom, physiotherapy provisions have been reduced following the need for definitive proof of how they benefit patients. Total hip replacement surgery is an effective tool against end-stage arthritis and significantly improves the quality of life. Post-operation physiotherapy is a vital part of recovery; however, patients have complained about levels of function during that time. Researchers created a randomized controlled trial study to gain enough evidence of the efficacy of this process. Since patient dissatisfaction was one of the study’s main motivators, they tested for outcomes such as physical functioning, stiffness, and pain levels.
The study design split the participants into two groups; the functional exercise intervention and the usual care group, which operates as a control unit. Researchers specifically assessed patients in the 12 to 18 weeks post-operation recovery period (Monaghan et al., 2017). Three community-based health sites were utilized, and three physiotherapists supervised the former group in a practical workshop class with illustrated manuals. The physiotherapists taught 12 exercises and recorded the form and intensity of the patients in an exercise log book (Monaghan et al., 2017). The latter group followed the usual care path, which demands postoperative exercises during the hospital stay beginning at six weeks. The orthopedic supervises exercises such as hip abduction, ankle pumps, and static quadriceps through a combination of daily walks while under admission and no further restrictions on exercises when discharged. Most patients had undergone total hip replacement surgery and were above 50 years.
The patients were randomized during the study using a computer-generated number table and allocated by a physiotherapy manager. The measurements focused on patient performance and the primary outcomes determined by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire (Monaghan et al., 2017). Secondary outcomes such as walking speed, strength assessment, and mental health scores helped to establish the other relevant scopes of the study. Hip abduction strength was related to the strength assessment test and was tested by a dynamometer. The functional group additionally had follow-up rehabilitation sessions at distinct community health centers.
The sample size allowed the researchers to observe and record their results easily. Of 72 patients, 63 completed the study, with 32 people in the functional group and 31 in the usual care group (Monaghan et al., 2017). At the 12-week mark, there was no difference between the two regarding parametric and non-parametric exercises. However, the WOMAC questionnaire revealed an improvement in the functional group at the 18-week point, with significant improvements in distance walking and physical scores. However, stiffness and pain levels remained similar like the patient’s mental health scores in both groups.
Physiotherapy is more beneficial to total hip replacement surgery patients than regular care. However, randomization revealed no differences in hip abductor strength between the two, which was a controversial result of previous studies in the field. Ultimately, the study was limited by time since it was tested in real-world conditions, which only allowed for a longer examination of the patients. Furthermore, control group exercises require more structure to produce dependable results to satisfy the WOMAC questionnaire.
In conclusion, total hip replacement patients with arthritis require physical rehabilitation to regain full use of their bodies. Using two groups, a functional exercise one, and a control group, researchers were able to randomize a test assessing primary and secondary health outcomes. These outcomes included mobility, pain levels, and stiffness, whereby there was a significant difference in the functional group due to the physiotherapy treatment received. Increasing the time scope of the study would improve the results generated and aid patients recovering from such surgeries in regaining their normal functioning.
Reference
Monaghan, B., Cunningham, P., Harrington, P., Hing, W., Blake, C., O’ Dohertya, D., & Cusack, T. (2017). Randomised controlled trial to evaluate a physiotherapy-led functional exercise programme after total hip replacement. Physiotherapy, 103(3), 283–288. Web.
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