Hip strengthening exercise dosage is not associated with clinical improvements after total hip arthroplasty - a prospective cohort study (the PHETHAS-1 study)

Merete Nørgaard Madsen; Lone Ramer Mikkelsen; Michael Skovdal Rathleff; Kristian Thorborg; Thomas Kallemose; Thomas Bandholm

Hip strengthening exercise dosage is not associated with clinical improvements after total hip arthroplasty - a prospective cohort study (the PHETHAS-1 study)

Merete Nørgaard Madsen, Lone Ramer Mikkelsen, Michael Skovdal Rathleff, Kristian Thorborg, Thomas Kallemose, Thomas Bandholm

Abstract

BACKGROUND: Postoperative rehabilitation exercise is commonly prescribed after total hip arthroplasty (THA), but its efficacy compared to no or minimal rehabilitation exercise has been questioned. Preliminary efficacy would be indicated if a dose-response relationship exists between performed exercise dose and degree of postoperative recovery. The objective was to evaluate the preliminary efficacy of home-based rehabilitation using elastic band exercise on performance-based function after THA, based on the association between performed exercise dose and change in performance-based function (gait speed) from 3 (start of intervention) to 10 weeks (end of intervention) after surgery.

METHODS: A prospective cohort study was conducted. Following primary THA, patients were prescribed home-based rehabilitation exercise using elastic bands. Performed exercise dose (repetitions/week) was objectively measured using attached sensor technology. Primary outcome was change in gait speed (40 m fast-paced walk test). Secondary outcomes included patient-reported hip disability. In the primary analysis, a linear regression model was used.

RESULTS: Ninety-four patients (39 women) with a median age of 66.5 years performed a median of 339 exercise repetitions/week (1st-3rd quartile: 209-549). Across outcomes, participants significantly improved from 3 to 10-week follow-up. The association between performed exercise dose and change in mean gait speed was 0.01 m/s [95% CI: -0.01; 0.02] per 100 repetitions.

CONCLUSIONS: We found no indication of preliminary efficacy of home-based rehabilitation exercise using elastic bands, as no significant and clinically relevant associations between performed exercise dose and changes in outcomes were present. Trials comparing postoperative rehabilitation exercise with no exercise early after THA are warranted.

TRIAL REGISTRATION: Pre-registered: ClinicalTrials.gov (Identifier: NCT03109821, 12/04/2017).

Original language	English
Article number	928
Journal	BMC Musculoskeletal Disorders
Volume	25
Issue number	1
Pages (from-to)	928
ISSN	1471-2474
Publication status	Published - 19 Nov 2024

Keywords

Humans
Arthroplasty, Replacement, Hip/rehabilitation
Female
Prospective Studies
Male
Aged
Middle Aged
Exercise Therapy/methods
Treatment Outcome
Recovery of Function
Walking Speed/physiology
Muscle Strength/physiology
Hip Joint/surgery
Compliance
Hip arthroplasty
Exercise therapy
Dose-response
Rehabilitation

Cite this

Hip strengthening exercise dosage is not associated with clinical improvements after total hip arthroplasty - a prospective cohort study (the PHETHAS-1 study). / Madsen, Merete Nørgaard; Mikkelsen, Lone Ramer; Rathleff, Michael Skovdal et al.
In: BMC Musculoskeletal Disorders, Vol. 25, No. 1, 928, 19.11.2024, p. 928.

Research output: Contribution to journal › Journal article › Research › peer-review

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title = "Hip strengthening exercise dosage is not associated with clinical improvements after total hip arthroplasty - a prospective cohort study (the PHETHAS-1 study)",

abstract = "BACKGROUND: Postoperative rehabilitation exercise is commonly prescribed after total hip arthroplasty (THA), but its efficacy compared to no or minimal rehabilitation exercise has been questioned. Preliminary efficacy would be indicated if a dose-response relationship exists between performed exercise dose and degree of postoperative recovery. The objective was to evaluate the preliminary efficacy of home-based rehabilitation using elastic band exercise on performance-based function after THA, based on the association between performed exercise dose and change in performance-based function (gait speed) from 3 (start of intervention) to 10 weeks (end of intervention) after surgery.METHODS: A prospective cohort study was conducted. Following primary THA, patients were prescribed home-based rehabilitation exercise using elastic bands. Performed exercise dose (repetitions/week) was objectively measured using attached sensor technology. Primary outcome was change in gait speed (40 m fast-paced walk test). Secondary outcomes included patient-reported hip disability. In the primary analysis, a linear regression model was used.RESULTS: Ninety-four patients (39 women) with a median age of 66.5 years performed a median of 339 exercise repetitions/week (1st-3rd quartile: 209-549). Across outcomes, participants significantly improved from 3 to 10-week follow-up. The association between performed exercise dose and change in mean gait speed was 0.01 m/s [95\% CI: -0.01; 0.02] per 100 repetitions.CONCLUSIONS: We found no indication of preliminary efficacy of home-based rehabilitation exercise using elastic bands, as no significant and clinically relevant associations between performed exercise dose and changes in outcomes were present. Trials comparing postoperative rehabilitation exercise with no exercise early after THA are warranted.TRIAL REGISTRATION: Pre-registered: ClinicalTrials.gov (Identifier: NCT03109821, 12/04/2017).",

keywords = "Humans, Arthroplasty, Replacement, Hip/rehabilitation, Female, Prospective Studies, Male, Aged, Middle Aged, Exercise Therapy/methods, Treatment Outcome, Recovery of Function, Walking Speed/physiology, Muscle Strength/physiology, Hip Joint/surgery, Compliance, Hip arthroplasty, Exercise therapy, Dose-response, Rehabilitation",

author = "Madsen, \{Merete N{\o}rgaard\} and Mikkelsen, \{Lone Ramer\} and Rathleff, \{Michael Skovdal\} and Kristian Thorborg and Thomas Kallemose and Thomas Bandholm",

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T1 - Hip strengthening exercise dosage is not associated with clinical improvements after total hip arthroplasty - a prospective cohort study (the PHETHAS-1 study)

AU - Madsen, Merete Nørgaard

AU - Mikkelsen, Lone Ramer

AU - Rathleff, Michael Skovdal

AU - Thorborg, Kristian

AU - Kallemose, Thomas

AU - Bandholm, Thomas

PY - 2024/11/19

Y1 - 2024/11/19

N2 - BACKGROUND: Postoperative rehabilitation exercise is commonly prescribed after total hip arthroplasty (THA), but its efficacy compared to no or minimal rehabilitation exercise has been questioned. Preliminary efficacy would be indicated if a dose-response relationship exists between performed exercise dose and degree of postoperative recovery. The objective was to evaluate the preliminary efficacy of home-based rehabilitation using elastic band exercise on performance-based function after THA, based on the association between performed exercise dose and change in performance-based function (gait speed) from 3 (start of intervention) to 10 weeks (end of intervention) after surgery.METHODS: A prospective cohort study was conducted. Following primary THA, patients were prescribed home-based rehabilitation exercise using elastic bands. Performed exercise dose (repetitions/week) was objectively measured using attached sensor technology. Primary outcome was change in gait speed (40 m fast-paced walk test). Secondary outcomes included patient-reported hip disability. In the primary analysis, a linear regression model was used.RESULTS: Ninety-four patients (39 women) with a median age of 66.5 years performed a median of 339 exercise repetitions/week (1st-3rd quartile: 209-549). Across outcomes, participants significantly improved from 3 to 10-week follow-up. The association between performed exercise dose and change in mean gait speed was 0.01 m/s [95% CI: -0.01; 0.02] per 100 repetitions.CONCLUSIONS: We found no indication of preliminary efficacy of home-based rehabilitation exercise using elastic bands, as no significant and clinically relevant associations between performed exercise dose and changes in outcomes were present. Trials comparing postoperative rehabilitation exercise with no exercise early after THA are warranted.TRIAL REGISTRATION: Pre-registered: ClinicalTrials.gov (Identifier: NCT03109821, 12/04/2017).

AB - BACKGROUND: Postoperative rehabilitation exercise is commonly prescribed after total hip arthroplasty (THA), but its efficacy compared to no or minimal rehabilitation exercise has been questioned. Preliminary efficacy would be indicated if a dose-response relationship exists between performed exercise dose and degree of postoperative recovery. The objective was to evaluate the preliminary efficacy of home-based rehabilitation using elastic band exercise on performance-based function after THA, based on the association between performed exercise dose and change in performance-based function (gait speed) from 3 (start of intervention) to 10 weeks (end of intervention) after surgery.METHODS: A prospective cohort study was conducted. Following primary THA, patients were prescribed home-based rehabilitation exercise using elastic bands. Performed exercise dose (repetitions/week) was objectively measured using attached sensor technology. Primary outcome was change in gait speed (40 m fast-paced walk test). Secondary outcomes included patient-reported hip disability. In the primary analysis, a linear regression model was used.RESULTS: Ninety-four patients (39 women) with a median age of 66.5 years performed a median of 339 exercise repetitions/week (1st-3rd quartile: 209-549). Across outcomes, participants significantly improved from 3 to 10-week follow-up. The association between performed exercise dose and change in mean gait speed was 0.01 m/s [95% CI: -0.01; 0.02] per 100 repetitions.CONCLUSIONS: We found no indication of preliminary efficacy of home-based rehabilitation exercise using elastic bands, as no significant and clinically relevant associations between performed exercise dose and changes in outcomes were present. Trials comparing postoperative rehabilitation exercise with no exercise early after THA are warranted.TRIAL REGISTRATION: Pre-registered: ClinicalTrials.gov (Identifier: NCT03109821, 12/04/2017).

KW - Humans

KW - Arthroplasty, Replacement, Hip/rehabilitation

KW - Female

KW - Prospective Studies

KW - Male

KW - Aged

KW - Middle Aged

KW - Exercise Therapy/methods

KW - Treatment Outcome

KW - Recovery of Function

KW - Walking Speed/physiology

KW - Muscle Strength/physiology

KW - Hip Joint/surgery

KW - Compliance

KW - Hip arthroplasty

KW - Exercise therapy

KW - Dose-response

KW - Rehabilitation

UR - https://www.scopus.com/pages/publications/85209799056

M3 - Journal article

C2 - 39563311

SN - 1471-2474

VL - 25

SP - 928

JO - BMC Musculoskeletal Disorders

JF - BMC Musculoskeletal Disorders

IS - 1

M1 - 928

ER -

Hip strengthening exercise dosage is not associated with clinical improvements after total hip arthroplasty - a prospective cohort study (the PHETHAS-1 study)

Abstract

Keywords

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