Preoperative progressive explosive-type resistance training is feasible and effective in patients with hip osteoarthritis scheduled for total hip arthroplasty--a randomized controlled trial

A Hermann; A Holsgaard-Larsen; B Zerahn; S Mejdahl; S Overgaard

doi:10.1016/j.joca.2015.07.030

Preoperative progressive explosive-type resistance training is feasible and effective in patients with hip osteoarthritis scheduled for total hip arthroplasty--a randomized controlled trial

Osteoarthritis Cartilage. 2016 Jan;24(1):91-8. doi: 10.1016/j.joca.2015.07.030. Epub 2015 Aug 15.

Authors

A Hermann¹, A Holsgaard-Larsen², B Zerahn³, S Mejdahl⁴, S Overgaard⁵

Affiliations

¹ Orthopedic Research Unit, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Denmark; Department of Orthopedic Surgery, Herlev University Hospital, Denmark; Institute of Clinical Research, University of Southern Denmark, Denmark. Electronic address: ahermann@dadlnet.dk.
² Orthopedic Research Unit, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Denmark.
³ Department of Clinical Physiology and Nuclear Medicine, Herlev University Hospital, Denmark.
⁴ Department of Orthopedic Surgery, Herlev University Hospital, Denmark.
⁵ Orthopedic Research Unit, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Denmark; Institute of Clinical Research, University of Southern Denmark, Denmark.

PMID: 26285180
DOI: 10.1016/j.joca.2015.07.030

Abstract

Objective: To investigate the efficacy and feasibility of progressive explosive-type resistance training (RT) in patients with osteoarthritis (OA) of the hip scheduled for total hip arthroplasty (THA).

Method: Randomized controlled trial (1:1) in patients diagnosed with hip OA and scheduled for THA. The intervention group (IG) performed supervised preoperative progressive explosive-type RT twice a week for 10 weeks; four exercises (hip/thigh) performed in three series each (8-12 repetition maximum). The control group (CG) received 'care as usual'. Efficacy was reported as the between-group difference in the Hip Osteoarthritis Outcome Score (HOOS) (primary endpoint; ADL function), and leg muscle power at post intervention follow-up immediate before surgery. Intention-to-treat analyses were performed in a multilevel regression model adjusting for baseline, sex, age and weight. Feasibility was reported as adherence, exercise related pain and adverse effects. Post-surgical follow up will be reported separately. ClinicalTrials.gov registration: NCT01164111.

Results: Eighty patients (age 70.4 ± 7.6 years, BMI 27.8 ± 4.6, 52 females (65%) were included. Adherence was high (93%) with acceptable exercise related pain (VAS score ≤ 5) reported in 83% of sessions and no adverse events. Changes in HOOS 'function' was 10.0 points 95%CI [4.7; 15.3] higher in IG compared to CG (P < 0.001). For all the remaining HOOS subscales IG scored significantly better (P < 0.03) and had higher leg extension muscle power (P < 0.0001) compared to CG.

Conclusion: Progressive explosive-type RT was feasible in the included group of hip OA patients scheduled for THA and resulted in significant improvement in self-reported outcomes and increased leg muscle power.

Keywords: HOOS; Muscle power; Osteoarthrosis; Patient reported outcomes; Rehabilitation; Strength training; Total joint replacement.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Activities of Daily Living*
Aged
Arthroplasty, Replacement, Hip*
Feasibility Studies
Female
Humans
Male
Middle Aged
Multilevel Analysis
Muscle Strength
Osteoarthritis, Hip / physiopathology
Osteoarthritis, Hip / rehabilitation*
Osteoarthritis, Hip / surgery
Pain Measurement
Preoperative Care*
Regression Analysis
Resistance Training / methods*
Surveys and Questionnaires
Treatment Outcome

Associated data

ClinicalTrials.gov/NCT01164111