RSS-Feed abonnieren
DOI: 10.1055/s-0031-1271696
© Georg Thieme Verlag KG Stuttgart · New York
Pre-Surgical Sensorimotor Training for Patients Undergoing Total Hip Replacement: A Randomised Controlled Trial
Publikationsverlauf
accepted after revision January 13, 2011
Publikationsdatum:
31. Mai 2011 (online)
Abstract
The aim of this study was to investigate whether pre-operative, sensorimotor training results in improved physical function, quality of life, sensorimotor function and reduced disability in total hip replacement patients. 80 subjects awaiting total hip replacement at a Swiss hospital were recruited for this randomised controlled trial. The intervention group participated in a pre-operative home exercise sensorimotor training programme; the control group received no therapy. Primary outcome measure was physical function, secondary outcome measures were quality of life, disability and sensorimotor function. Outcomes were measured using generic and disease-specific questionnaires as well as objectively assessed balance ability. Measurements were taken one day before surgery and 10 days, 4 and 12 months after surgery. The intervention showed improved quality of life and sensorimotor function before surgery. These effects were lost following surgery. The intervention group experienced more disability at 4 months than the control group. At one year follow-up group-membership influenced quality of life scores depending on the measurement-time-point. It can be concluded that no useful effect was identified for a pre-operative sensory-motor training-programme. The psychological aspects following total hip replacement need to be considered in order to facilitate coping-strategies, reduce unrealistic expectations and increase satisfaction.
Key words
total hip endoprosthesis - osteoarthritis - physical therapy - orthopaedics - rehabilitation
References
- 1 Bundesamt für Statistik (BFS) .Krankenhausbehandlung – Detaillierte Daten. 2008. Neuchatel, Switzerland; http://www.bfs.admin.ch/bfs/portal/de/index/themen/14/04/01/data/01.html
- 2 Ackerman IN, Bennell KL. Does pre-operative physiotherapy improve outcomes from lower limb joint replacement surgery? A systematic review. Aust J Physiother. 2004; 50 25-30
- 3 Angst F, Aeschlimann A, Stucki G. Smallest detectable and minimal clinically important differences of rehabilitation intervention with their implications for required sample sizes using WOMAC and SF-36 quality of life measurement instruments in patients with osteoarthritis of the lower extremities. Arthritis Rheum. 2001; 45 384-391
- 4 Arnold BL, Schmitz RJ. Examination of balance measures produced by the biodex stability system. J Athl Train. 1998; 33 323-327
- 5 Bachmeier CJ, March LM, Cross MJ, Lapsley HM, Tribe KL, Courtenay BG, Brooks PM. A comparison of outcomes in osteoarthritis patients undergoing total hip and knee replacement surgery. Osteoarthritis Cartilage. 2001; 9 137-146
- 6 Boardman DL, Dorey F, Thomas BJ, Lieberman JR. The accuracy of assessing total hip arthroplasty outcomes: a prospective correlation study of walking ability and 2 validated measurement devices. J Arthroplasty. 2000; 15 200-204
- 7 Bullinger M, Kirchberger I. SF-36 Fragebogen zum Gesundheitszustand Handanweisung. Götingen: Hogrefe Verlag für Psychologie; 1998
- 8 Butler GS, Hurley CA, Buchanan KL, Smith-VanHorne J. Prehospital education: effectiveness with total hip replacement surgery patients. Patient Educ Couns. 1996; 29 189-197
- 9 Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd edition Hillsdale, NJ: Lawrence Erlbaum Associates; 1988
- 10 Crowe J, Henderson J. Pre-arthroplasty rehabilitation is effective in reducing hospital stay. Can J Occup Ther. 2003; 70 88-96
- 11 Fagerson T. The Hip Handbook. Boston: Butterworth-Heinemann; 1998
- 12 Finch E, Brooks D, Stratford P, Mayo N. Physical Rehabilitation Outcome Measures – A Guide to Enhanced Clinical Decision Making. (2nd edition) Hamilton: BC Decker Inc.; 2002
- 13 Finn J, Alvarez M, Jett R, Axtell R, Kemler D. Stability performance assessment among subjects of disparate balancing abilities. Med Sci Sports Exerc. 1999; 31 S252
- 14 Fisher R, Yates F. Statistical Tables for Biological, Agricultural and Medical Research. Darien: Hafner Publishing Company; 1970
- 15 Gammon J, Mulholland CW. Effect of preparatory information prior to elective total hip replacement on post-operative physical coping outcomes. Int J Nurs Stud. 1996; 33 589-604
- 16 Gammon J, Mulholland CW. Effect of preparatory information prior to elective total hip replacement on psychological coping outcomes. J Adv Nurs. 1996; 24 303-308
- 17 Gilbey HJ, Ackland TR, Wang AW, Morton AR, Trouchet T, Tapper J. Exercise improves early functional recovery after total hip arthroplasty. Clin Orthop. 2003; 193-200
- 18 Gocen Z, Sen A, Unver B, Karatosun V, Gunal I. The effect of preoperative physiotherapy and education on the outcome of total hip replacement: a prospective randomized controlled trial. Clin Rehabil. 2004; 18 353-358
- 19 Granacher U, Gollhofer A. Neuromuskuläre Leistungsfähigkeit im Alter – Ein Überblick. Zeitschrift für Physiotherapeuten. 2005; 57 1316-1328
- 20 Harriss DJ, Atkinson G. International Journal of Sports Medicine – Ethical Standards in Sport and Exercise Science Research. Int J Sports Med. 2009; 30 701-702
- 21 Hinman M. Factors affecting reliability of the Biodex Balance System: a summary of four studies. J Sport Rehabil. 2000; 9 240-252
- 22 Illyés À, Holnapy G, Szendröï M, Kiss R. Importance of proprioception after total hip replacement. In: Austria: International Association of Science and Technology for Development; 2006: 379-383
- 23 Ishii Y, Tojo T, Terajima K, Terashima S, Bechtold JE. Intracapsular components do not change hip proprioception. J Bone Joint Surg Br. 1999; 81 345-348
- 24 Lephart S, Fu F. Proprioception and Neuromuscular Control in Joint Stability. Leeds: Human Kinetics; 2000
- 25 Lieberman JR, Dorey F, Shekelle P, Schumacher L, Thomas BJ, Kilgus DJ, Finerman GA. Differences between patients’ and physicians’ evaluations of outcome after total hip arthroplasty. J Bone Joint Surg Am. 1996; 78 835-838
- 26 Mancuso CA, Salvati EA, Johanson NA, Peterson MG, Charlson ME. Patients’ expectations and satisfaction with total hip arthroplasty. J Arthroplasty. 1997; 12 387-396
- 27 Mancuso CA, Sculco TP, Salvati EA. Patients with poor preoperative functional status have high expectations of total hip arthroplasty. J Arthroplasty. 2003; 18 872-878
- 28 McGrath RE, Meyer GJ. When effect sizes disagree: the case of r and d. Psychol Methods. 2006; 11 386-401
- 29 Moseley GL. Do training diaries affect and reflect adherence to home programs?. Arthritis Rheum. 2006; 55 662-664
- 30 Nakagawa S, Cuthill IC. Effect size, confidence interval and statistical significance: a practical guide for biologists. Biol Rev Camb Philos Soc. 2007; 82 591-605
- 31 Nallegowda M, Singh U, Bhan S, Wadhwa S, Handa G, Dwivedi SN. Balance and gait in total hip replacement: a pilot study. Am J Phys Med Rehabil. 2003; 82 669-677
- 32 Nilsdotter AK, Roos EM, Westerlund JP, Roos HP, Lohmander LS. Comparative responsiveness of measures of pain and function after total hip replacement. Arthritis Rheum. 2001; 45 258-262
- 33 Pincivero D, Lephart S, Henry T. Learning effects and reliability of the Biodex Stability System. J Athl Train. 1995; 30 S48
- 34 Rooks DS, Huang J, Bierbaum BE, Bolus SA, Rubano J, Connolly CE, Alpert S, Iversen MD, Katz JN. Effect of preoperative exercise on measures of functional status in men and women undergoing total hip and knee arthroplasty. Arthritis Rheum. 2006; 55 700-708
- 35 Schmitz R, Arnold B. Intertester and intratester reliability of a dynamic balance protocol using the Biodex Stability System. J Sport Rehabil. 1998; 7 95-101
- 36 Siggeirsdottir K, Olafsson O, Jonsson H, Iwarsson S, Gudnason V, Jonsson BY. Short hospital stay augmented with education and home-based rehabilitation improves function and quality of life after hip replacement: randomized study of 50 patients with 6 months of follow-up. Acta Orthop. 2005; 76 555-562
- 37 Soderman P, Malchau H, Herberts P. Outcome of total hip replacement: a comparison of different measurement methods. Clin Orthop. 2001; 163-172
- 38 Stucki G, Meier D, Stucki S, Michel BA, Tyndall AG, Dick W, Theiler R. Evaluation einer deutschen Version des WOMAC (Western Ontario und McMaster Universities) Arthroseindex. Z Rheumatol. 1996; 55 40-49
- 39 van Baar ME, Dekker J, Oostendorp RA, Bijl D, Voorn TB, Lemmens JA, Bijlsma JW. The effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee: a randomized clinical trial. J Rheumatol. 1998; 25 2432-2439
- 40 Wang AW, Gilbey HJ, Ackland TR. Perioperative exercise programs improve early return of ambulatory function after total hip arthroplasty: a randomized, controlled trial. Am J Phys Med Rehabil. 2002; 81 801-806
- 41 Weineck J. Sportbiologie. Balingen: Spitta Verlag GmbH; 2000
- 42 Weitbrecht WU, Rice C, Schafer W. Phantomsensationen und peripher induzierter Neglect nach Hufttotalendoprothese. Fortschr Neurol Psychiatr. 2004; 72 93-97
Correspondence
Dr. Judith M. SiebenPhD
Department of Anatomy &
Embryology
Maastricht University
P.O. Box 616
6200 MD Maastricht
The Netherlands
Telefon: +31/433/88 1056
Fax: +31/433/88 4134
eMail: j.sieben@maastrichtuniversity.nl