Background Physiotherapy is a common practice after total hip arthroplasty (THA). The overall aim of physiotherapy is to optimize functional outcomes like walking and thereby enable patients to regain a physically active lifestyle.
Objectives The objectives of this long-term follow-up study five years after THA were 1) to examine whether the 1-year effects from a previous walking skill training program on walking and stair climbing still persist five years following total hip arthroplasty (THA), 2) to examine recovery of physical functioning from before surgery to five years, and 3) to identify predictors of physical activity five years after THA from preoperative measures.
Methods A 5-year follow-up of a randomized controlled trial (RCT) and a longitudinal study. Sixty participants with mean age 70 years (95% CI 68–72 years) were assessed. Outcome measures were the 6-minute walk test (6MWT), the stair climbing test (ST), hip range of motion (ROM), self-efficacy, Hip Dysfunction and Osteoarthritis Outcome Score (HOOS), and University of California, Los Angeles (UCLA) Activity Scale. Data were analyzed by Student t-tests, general linear model, and multivariate regression analyses.
Results The groups were approximately equal on outcome measures of physical functioning, pain, and self-efficacy at five years (P>0.05). In the total group, the recovery course was unchanged from one to five years (P>0.05), except 9% improvement in ROM (P<0.001) and 18% decline in ST (P=0.004). Preoperative 6MWT, HOOS pain, HOOS sport, and UCLA predicted UCLA score five years after THA (P≤0.03).
Conclusions At five years after THA the control group had caught up with the training group on physical functioning, and the participants lead an active lifestyle. Those with worse preoperative scores on pain, walking capacity, physical functioning in sport, and physical activity were at risk of being less physically active in the long term following THA.
Heiberg KE, Bruun-Olsen V, Ekeland A, Mengshoel AM. Effect of a walking skill training program in patients who have undergone total hip arthroplasty: Followup one year after surgery. Arthritis Care Res (Hoboken). 2012;64(3):415-23.
Heiberg KE, Ekeland A, Bruun-Olsen V, Mengshoel AM. Recovery and prediction of physical functioning outcomes during the first year after total hip arthroplasty. Arch Phys Med Rehabil. 2013;94(7):1352-9.
Disclosure of Interest None declared