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.
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.