Effects of a home program on strength, walking speed, and function after total hip replacement.

OBJECTIVE

To assess the efficacy of a home exercise program in increasing hip muscle strength, walking speed, and function in patients more than 1.5 years after total hip replacement (THR).

DESIGN

Randomized controlled trial.

SETTING

Kinesiology laboratory.

PARTICIPANTS

Fifty-three patients with unilateral THR were randomly assigned to the training (n=26) and control (n=27) groups. Patients in the training group were further divided into exercise-high (n=13) and exercise-low (n=13) compliance groups according to their practice ratio (high, > or =50%).

INTERVENTION

The training group underwent a 12-week home program that included hip flexion range of motion exercises for both hip joints; strengthening exercises for bilateral hip flexors, extensors, and abductors; and a 30-minute walk every day. The control group did not receive any training.

MAIN OUTCOME MEASURES

Strength of bilateral hip muscles, free and fast walking speeds while walking over 3 different terrains, and functional performance were assessed by using a dynamometer, videotape analysis, and the functional activity part of the Harris Hip Score, respectively, before and after the 12-week period.

RESULTS

Subjects in the exercise-high compliance group showed significantly (P <.05) greater improvement in muscle strength for the operated hip, fast walking speed, and functional score than those in the exercise-low compliance and control groups.

CONCLUSIONS

The designed home program was effective in improving hip muscle strength, walking speed, and function in patients after THR who practiced the program at least 3 times a week, but adherence to this home program may be a problem.