Dataset Information

Effects of home-based interval walking training on thigh muscle strength and aerobic capacity in female total hip arthroplasty patients: a randomized, controlled pilot study.

ABSTRACT:

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Due to the reduced physical activity of patients who have undergone total hip arthroplasty (THA), there are no home-based exercise training regimens for preventing muscle atrophy and aerobic capacity impairment in these patients. We examined whether interval walking training (IWT) could prevented these issues. Twenty-eight female patients (?60 years of age) who had undergone THA more than 2 months prior were randomly divided into IWT (n?=?14) and control (CNT, n?=?14) groups. The IWT subjects trained at a target of 60 min of fast walking at >70% peak aerobic capacity for walking (VO?peak) per wk for 12 wk, while those in the CNT maintained their previous sedentary life during the same period. We measured the energy expenditure of the daily physical activity, except during sleeping and bathing, every minute and every day during the intervention. We also measured the isometric knee extension (FEXT) and flexion (FFLX) forces, VO?peak, and anaerobic threshold during the graded cycling exercise (VO?AT) before and after the intervention. All subjects, except for one in IWT, completed the protocol. FFLX increased by 23% on the operated side (P?=?0.003) and 14% on the non-operated side of IWT (P?=?0.006), while it only increased on the operated side of CNT (P?=?0.03). The VO?peak and VO?AT in IWT increased by 8% (P?=?0.08) and 13% (P?=?0.002), respectively, and these changes were significantly higher in the IWT than in CNT group (both, P<0.05). In conclusion, IWT might be an effective home-based training regimen for preventing the muscle atrophy from reduced daily physical activity in THA patients.

Trial registration

UMIN-CTR UMIN000013172.

SUBMITTER: Morishima Y

PROVIDER: S-EPMC4182539 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Effects of home-based interval walking training on thigh muscle strength and aerobic capacity in female total hip arthroplasty patients: a randomized, controlled pilot study.

Morishima Yutaka Y Mizushima Takashi T Yamauchi Katsuya K Morikawa Mayuko M Masuki Shizue S Nose Hiroshi H

PloS one 20140930 9

<h4>Unlabelled</h4>Due to the reduced physical activity of patients who have undergone total hip arthroplasty (THA), there are no home-based exercise training regimens for preventing muscle atrophy and aerobic capacity impairment in these patients. We examined whether interval walking training (IWT) could prevented these issues. Twenty-eight female patients (∼60 years of age) who had undergone THA more than 2 months prior were randomly divided into IWT (n = 14) and control (CNT, n = 14) groups. ...[more]

PMID: 25268505

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Project description:Background and purpose - Gait analysis performed under increased physical demand may detect differences in gait between total (THA) versus resurfacing hip arthroplasty (RHA), which are not measured at normal walking speed. We hypothesized that patients after RHA would reach higher walking speeds and inclines compared with THA. Additionally, an RHA would enable a more natural gait when comparing the operated with the healthy contralateral hip. Patients and methods - From a randomized controlled trial comparing THA with RHA with at least 5 years' follow-up patients with a UCLA score of more than 3 points (n = 34) were included for an instrumented treadmill gait analysis. 25 patients with a unilateral implant (primary analysis-16 THA versus 9 RHA) and 9 patients with a bilateral implant (sub-analysis-n = 5 RHA + THA; n = 4 THA + THA). Spatiotemporal parameters, ground reaction forces, and range of motion were recorded at increasing walking speeds and inclines. Functional outcome scores were obtained. Results - At a normal walking speed of 1.1 m/s and at increasing inclines no differences were recorded in gait between the 2 groups with a unilateral hip implant. With increasing walking speed the RHA group reached a higher top walking speed (TWS) (adjusted difference 0.07 m/s, 95% CI -0.11 to 0.25) compared with THA. Additionally, RHA patients tolerated more weight on the operated side at TWS (155 N, CI 49-261) and as such weight-bearing approached the unaffected contralateral side. For the RHA group a "between leg difference" of 8 N (CI 3-245) was measured versus -129 N (CI -138 to -29) for THA (adjusted difference 144 N, CI 20-261). Hip flexion of the operated side at TWS was higher after RHA compared with THA (adjusted difference 8°, CI 1.7-14). Interpretation - In this study RHA patients reached a higher walking speed, and preserved a more normal weight acceptance and a greater range of hip flexion against their contralateral healthy leg as compared with patients with a THA.

Project description:BackgroundTotal hip arthroplasty (THA) is very effective in alleviating pain, but functional deficits persist up to a year following surgery. Regardless of standard physiotherapy programs, significant additional muscular atrophy and weakness occur. Deficits in strength have serious adverse consequences for these patients with respect to physical function, the maintenance of independence, and the requirement for revision surgery. Progressive resistance training in rehabilitation following THA has been shown to significantly enhance muscle strength and function. The fundamental principle is to progressively overload the exercised muscle as it becomes stronger. Different strength training protocols have been used at different times in the postoperative phase, in group or individual practices, with major differences being in center-based and home-based programs with or without supervision. The primary objective of our study is to evaluate whether an early postoperative home-based strength training protocol can improve patient functional outcomes at 3 months and 1 year following surgery. Secondary objectives are the feasibility of the presented protocol for all elective THA patients and its safety.Methods/designThis study is a prospective multicenter randomized clinical trial to be conducted in the orthopedic departments of two Slovenian hospitals. In each hospital, 124 patients aged 60 or older with unilateral osteoarthritis, an ASA score between 1 and 3, a signed informed consent form, and no terminal illness disabling rehabilitation participation will be randomly assigned to the intervention or control group. THA with an anterior approach will be performed. All patients will receive current standard physiotherapy during hospitalization. Patients in the intervention group will also learn strength and sensory-motor training exercises. Upon discharge, all will receive USB drives with exercise videos, written exercise instructions, and a training diary. Physiotherapists will perform the assessments (physical tests and the maximal voluntary isometric contraction assessment), and patients will fill out outcome assessment questionnaires (the Harris Hip Score and 36-Item Short Form Health Survey) at baseline and 1, 3, and 12 months after surgery.DiscussionThe main purpose of our study is to design a new standardized rehabilitation protocol with videos that will be effective, safe, and accessible to all Slovenian THA patients.Trial registrationClinicalTrials.gov NCT04061993 . Registered on 07 November 2019. Protocol ID: PRT_PhD. Version 1.

Project description:To study function outcomes and their predictors after primary total hip arthroplasty (THA).Prospective cohort study.Mayo Clinic.All patients who underwent primary THA at the Mayo Clinic between 1993 and 2005 and were alive at the time of follow-up.Whether sex, age, body mass index (BMI), comorbidity, anxiety, and depression predict moderate to severe activity limitation (limitation in ?3 activities) and complete dependence on waling aids 2 and 5 years after primary THA was examined. Multivariable logistic regression adjusted for operative diagnosis, American Society of Anesthesiologists score, implant type, and distance from medical center.At 2 years, 30.3% of participants reported moderate to severe activity limitation; at 5 years, 35% of participants reported moderate to severe activity limitation. Significant predictors of moderate to severe activity limitations at 2-year follow-up were female sex (odds ratio (OR)=1.2, 95% confidence interval (CI)=1.1-1.4), aged 71 to 80 (OR=2.0, 95% CI=1.6-2.5), aged 80 and older (OR=4.5, 95% CI=3.4-6.0), depression (OR=2.1, 95% CI=1.6-2.7), and BMI greater than 30.0. At 5-year follow-up, significant predictors were aged 71 to 80 (OR=1.7, 95% CI=1.3-2.2), older than 80 (OR=4.3, 95% CI=2.8-6.6), depression (OR=2.3, 95% CI=1.6-3.4), and BMI greater than 30.0.Significant predictors of complete dependence on walking aids at 2 years were female sex (OR=2.0, 95% CI=1.4-2.7), aged 71 to 80 (OR=2.4, 95% CI=1.4-4.2), older than 80 (OR=11.4, 95% CI=6.0-21.9), higher Deyo-Charlson score (OR=1.5, 95% CI=(1.1-1.2) for 5-point increase, depression (OR=2.0, 95% CI=1.2-3.4), and BMI greater than 35.0. Each of these factors also significantly predicted complete dependence on walking at 5-year follow-up, with similar odds ratios, except that BMI of 30.0 to 34.9 was not significantly associated.Higher BMI, depression, older age, and female sex predict activity limitation and complete dependence on walking aids 2 and 5 years after primary THA.

Dataset Information

Effects of home-based interval walking training on thigh muscle strength and aerobic capacity in female total hip arthroplasty patients: a randomized, controlled pilot study.

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Trial registration

Publications

Effects of home-based interval walking training on thigh muscle strength and aerobic capacity in female total hip arthroplasty patients: a randomized, controlled pilot study.

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