Article

OBJECTIVE: To determine whether patients do better with unsupervised (home-based)
physiotherapy or in an outpatient setting. SETTING: Acute care public hospital in
the region, supporting a population of approximately 540,000. DESIGN:
Single-blind randomized controlled trial. PARTICIPANTS: Adult patients (N=98)
after unilateral elective total hip replacement (THR) were randomly assigned to a
supervised (center-based) exercise (n=56) or a unsupervised (home-based) exercise
(n=42) program and followed for 6 months postsurgery. INTERVENTIONS: The
supervised group attended a 4-week outpatient rehabilitation program supervised
by a physiotherapist. The unsupervised group was given written and pictorial
instructions to perform rehabilitation independently at home. MAIN OUTCOME
MEASURES: Western Ontario and McMaster Universities Osteoarthritis Index;
Short-Form 36-item Health Questionnaire (SF-36) mental and physical component
summary measures; University of California, Los Angeles activity scale; and timed
Up and Go test. RESULTS: There were no differences between the groups for any
measure. The overall differences between the adjusted means were as follows:
Western Ontario and McMaster Universities Osteoarthritis Index, 0.50 (95%
confidence interval [CI], -6.8 to 5.7); SF-36 physical component summary, 0.8
(95% CI, -6.5 to 8.1); SF-36 mental component summary, 1.7 (95% CI, -4.1 to 7.4);
University of California, Los Angeles activity scale, 0.3 (95% CI, 5.2 to 6.1);
and timed Up and Go test, 0 seconds (95% CI, -1.4 to 1.3s). CONCLUSIONS: The
results demonstrated that outcomes in response to rehabilitation after THR are
clinically and statistically similar whether the program was supervised or not.
The results suggest that early rehabilitation programs can be effectively
delivered unsupervised in the home to low-risk patients discharged home after
THR. However, the relative effect of late-stage rehabilitation was not tested.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS