Article

OBJECTIVE: To determine whether intensity and duration of standard exercise
therapy are associated with changes in function after total hip arthroplasty
(THA) and total knee arthroplasty (TKA). DESIGN: Prospective cohort study.
SETTING: Orthopedic inpatient rehabilitation center. PARTICIPANTS: A total of 123
patients 2 weeks after THA
(n = 58; age, 62.5 +/- 10.4 years) and TKA (n = 65; age, 66.6 +/- 7.6 years). INTERVENTION: Standard rehabilitation (hands-on
physiotherapy, group exercise therapy, strength training, cycle ergometer
therapy, continuous passive motion therapy, and water exercise therapy). MAIN
OUTCOME MEASURES: The Western Ontario and McMaster Universities Arthritis Index
(WOMAC) and hip and knee range of motion (ROM) were assessed before and after
inpatient rehabilitation. RESULTS: The individual rehabilitation period varied
between 12-25 days and included 48.1 +/- 12.5 (THA) or 41.9 +/- 9.7 (TKA)
exercise interventions with intensities between 9.6 and 14.0 points on the Borg
Rate of Perceived Exertion Scale. WOMAC pain (P < .001), stiffness (P < .001),
and function (P < .001), as well as hip (P < .001) and knee (P < .001) ROM,
improved significantly in THA and TKA patients. Analysis of covariance showed
that these changes could not be explained by the total duration or mean intensity
of exercise therapy. CONCLUSIONS: The findings show a low dose-response
relationship between early postoperative exercise therapy and the improvements in
function or ROM after THA and TKA. Although the findings raise questions about
the efficacy of existing rehabilitation programs, the small sample size, single
setting, and geographic differences in postoperative treatment standards limit
the generalizability of findings.
CI - Copyright (c) 2015 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc.
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Langue : ANGLAIS