Supervised vs. unsupervised exercise regimens after primary total hip arthroplasty

Location

Philadelphia, PA

Start Date

11-5-2022 1:00 PM

End Date

11-5-2022 4:00 PM

Description

INTRODUCTION

Historically, postoperative exercise and physical therapy (PT) has been viewed as crucial to a successful outcome following primary total hip arthroplasty (THA). This systematic review and meta-analysis aimed to assess differences in both short- and long-term objective and self-reported measures between primary THA patients with formal supervised PT versus unsupervised home exercises after discharge.

METHODS

We searched six electronic databases from inception to 12/14/2020 for randomized controlled trials comparing changes from baseline in lower extremity strength, aerobic capacity, and self-reported physical function and quality of life between supervised and unsupervised PT/exercise regimens following primary THA. Outcomes were separated into short- (<6 months from surgery, closest to 3 months) and long-term (≥6 months from surgery, closest to 12 months) measures. Meta-analyses were performed when possible and reported in standardized mean differences (SMDs) with 95% confidence intervals (CI).

RESULTS

Seven studies (N=398) were included for review. No significant differences were observed with regards to lower extremity strength (p=0.85), aerobic capacity (p=0.98), or short-term quality of life scores (p=0.18). Although patients in supervised PT demonstrated improved short-term self-reported outcomes compared to those performing unsupervised exercises, this was represented by a small effect size (SMD 0.23 [95% CI, 0.02-0.44]; p=0.04). No differences were observed between groups regarding long-term lower extremity strength (p=0.24), physical outcome scores (p=0.37), or quality of life (p=0.14).

DISCUSSION

Supervised PT provides no clinically significant benefit over unsupervised exercises following primary THA. These results suggest that providers should reconsider the routine use of supervised PT after discharge.

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COinS
 
May 11th, 1:00 PM May 11th, 4:00 PM

Supervised vs. unsupervised exercise regimens after primary total hip arthroplasty

Philadelphia, PA

INTRODUCTION

Historically, postoperative exercise and physical therapy (PT) has been viewed as crucial to a successful outcome following primary total hip arthroplasty (THA). This systematic review and meta-analysis aimed to assess differences in both short- and long-term objective and self-reported measures between primary THA patients with formal supervised PT versus unsupervised home exercises after discharge.

METHODS

We searched six electronic databases from inception to 12/14/2020 for randomized controlled trials comparing changes from baseline in lower extremity strength, aerobic capacity, and self-reported physical function and quality of life between supervised and unsupervised PT/exercise regimens following primary THA. Outcomes were separated into short- (<6 months from>surgery, closest to 3 months) and long-term (≥6 months from surgery, closest to 12 months) measures. Meta-analyses were performed when possible and reported in standardized mean differences (SMDs) with 95% confidence intervals (CI).

RESULTS

Seven studies (N=398) were included for review. No significant differences were observed with regards to lower extremity strength (p=0.85), aerobic capacity (p=0.98), or short-term quality of life scores (p=0.18). Although patients in supervised PT demonstrated improved short-term self-reported outcomes compared to those performing unsupervised exercises, this was represented by a small effect size (SMD 0.23 [95% CI, 0.02-0.44]; p=0.04). No differences were observed between groups regarding long-term lower extremity strength (p=0.24), physical outcome scores (p=0.37), or quality of life (p=0.14).

DISCUSSION

Supervised PT provides no clinically significant benefit over unsupervised exercises following primary THA. These results suggest that providers should reconsider the routine use of supervised PT after discharge.