The efficacy of exercise rehabilitation in restoring physical function following total hip replacement for osteoarthritis: A review

Introduction Standard physiotherapy rehabilitation fails to restore normal levels of muscle mass, strength and physical function in patients following elective total hip arthroplasty for osteoarthritis. Consequently, more intense forms of exercise rehabilitation have been advocated for these patients. The aim of this article was to review the controlled trials that have evaluated post-total-hip-arthroplasty exercise interventions aimed at improving function. Materials and methods The electronic databases MEDLINE and CINAHL were searched using the following terms: �total hip arthroplasty/replacement�, �exercise�, �rehabilitation� and �function�. This search was expanded by hand-checking the reference lists of the studies and reviews identified by electronic scanning. Results Thirteen appropriate studies (18 papers) were identified, comprising 8 �early� intervention studies (<5 weeks from surgery) and 5 �delayed� intervention studies. Conclusion The studies reviewed suggest that centre-based, but not home-based, exercise rehabilitation are effective in restoring muscle mass, strength and function in total hip arthroplasty patients during the immediate post-surgery phase, and that the efficacy of the centre-based interventions is most likely due to higher training intensity that is facilitated by supervision and access to specialised equipment and facilities. When commencement of training is delayed, however, both home- and centre-based training programs provide significant improvements in patient strength and function.