Article

OBJECTIVE: To investigate the feasibility and preliminary effectiveness of a
home-based intensive exercise program to improve physical health of frail elderly
patients scheduled for elective total hip arthroplasty (THA). DESIGN: Single-blind pilot randomized controlled trial. SETTING: Patients' homes and a
general hospital in The Netherlands. PARTICIPANTS: Frail patients (N=30) older
than 65 years. INTERVENTION: A preoperative, home-based program supervised by an
experienced physical therapist to train functional activities and walking
capacity. The control group received usual care consisting of 1 session of
instructions. MAIN OUTCOME MEASURES: Feasibility was determined on the basis of
adherence to treatment, patient satisfaction, adverse events, walking distance
(measured with a pedometer), and intensity of exercise (evaluated with the Borg
scale). Preliminary pre- and postoperative effectiveness was determined by the
Timed Up & Go (TUG) test, 6-minute walk test (6MWT), Chair Rise Time, and
self-reported measures of functions, activities, and participation. RESULTS:
Patient satisfaction and adherence to the training were good (median=5 on a
5-point Likert scale) and no serious adverse events occurred. The Borg score
during training was 14 (range, 13-16). Preoperative clinical relevant differences
on the TUG test (2.9 s; 95% confidence interval [CI], -0.9 to 6.6) and
significant differences on the 6MWT (41 m; 95% CI, 8 to 74) were found between
groups. CONCLUSIONS: Intensive preoperative training at home is feasible for
frail elderly patients waiting for THA and produces relevant changes in
functional health. A larger multicenter randomized controlled trial is in
progress to investigate the (cost-)effectiveness of preoperative training.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS