scholarly journals Incorporating Specific Functional Strength Integration Techniques to Improve Functional Performance for Veterans After Total Hip Arthroplasty: Protocol for a Randomized Clinical Trial

2019 ◽  
Vol 99 (11) ◽  
pp. 1453-1460
Author(s):  
Dana L Judd ◽  
Victor A Cheuy ◽  
Jeri E Forster ◽  
Cory L Christiansen ◽  
Jennifer E Stevens-Lapsley
Keyword(s):  
Clinical Trial ◽  
Physical Therapy ◽  
Muscle Strength ◽  
Total Hip Arthroplasty ◽  
Resistance Exercise ◽  
Physical Function ◽  
Hip Arthroplasty ◽  
Functional Performance ◽  
Total Hip ◽  
Movement Compensation

Abstract Background Total hip arthroplasty (THA) is a common procedure, yet persistent deficits in functional performance exist after surgery. These deficits may be related to movement compensations observed after THA, which negatively affect quality of life and may increase morbidity and health care utilization, including in the veteran population. However, the best rehabilitative approach to remediating movement compensations and physical function deficits has not been determined. Objective The objective is to determine if a functional strength integration intervention (FSI), as part of a post-THA rehabilitation program, improves movement compensation, physical function, muscle strength, and self-reported outcome measures more than a control group (CON) undergoing a standard of care exercise program. Design This is a 2-arm randomized, controlled clinical trial. Setting The Veteran Affairs outpatient physical therapy clinics and academic research laboratory will be the settings. Participants One hundred veterans undergoing THA for hip osteoarthritis will be included in the study. Interventions Participants will be randomized to either the FSI or CON group and participate in visits of physical therapy over 8 weeks. The FSI protocol will include targeted exercise to improve muscular control and stability around the hip and trunk to minimize movement compensation during daily activity combined with progressive resistance exercise. The CON protocol will include patient education, flexibility activity, and low load resistance exercise. Measurements Functional performance, muscle strength and endurance, and self-reported outcomes will be measured at baseline (prior to surgery), midway through intervention (6 weeks after surgery), at the end of intervention (10 weeks after surgery), and 26 weeks after THA. Limitations The inability to blind treating therapists to study arm allocation is a limitation. Conclusions The proposed study aims to determine if targeted FSI can affect movement compensation to improve functional outcomes after THA more than traditional rehabilitation paradigms.

scholarly journals Abductor Muscle Force after Straight-Stem Compared to Short-Stem Total Hip Arthroplasty through a Modified Direct Lateral Approach: Functional Assessment of 70 Consecutive Patients of a Randomized Controlled Clinical Trial

2021 ◽  
Vol 10 (6) ◽  
pp. 1235
Author(s):  
Michael Fuchs ◽  
Marie-Anne Hein ◽  
Martin Faschingbauer ◽  
Mirco Sgroi ◽  
Ralf Bieger ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Muscle Strength ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Lateral Approach ◽  
Short Stem ◽  
Abductor Muscle ◽  
Total Hip ◽  
Straight Stem ◽  
Direct Lateral Approach

Because of preservation of proximal femoral bone stock and minimized soft tissue trauma, short-stem implants are becoming increasingly important in total hip arthroplasty (THA). The postulated advantage regarding the functional outcome has not been verified. We hypothesized an increased abductor muscle strength by the use of a short-stem design. Seventy consecutive patients of a randomized clinical trial were included. Of these, 67 patients met the inclusion criteria after 12 months. Thirty-five patients received a standard straight stem and 32 patients a short-stem femoral component. All surgeries were performed by a modified direct lateral approach. Isometric muscle strength of the hip abductors was evaluated preoperatively 3 and 12 months after surgery. Harris hip score (HHS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were evaluated. After three months, there were no differences between the two groups; the abductor force was comparable to the preoperative initial values. After 12 months, a significant increase in muscle strength for the short stem patient group compared to preoperative baseline values was measured (straight-stem THA, 0.09 Nm/kg ± 0.4, p = 0.32; short-stem THA, 0.2 Nm/kg ± 0.3, p = 0.004). Comparison of the 12-month postoperative total HHS and WOMAC revealed no significant differences between both groups. A significant increase in hip abductor muscle strength 12 months after short-stem THA compared to conventional-stem THA was observed.

scholarly journals Incorporating Neuromuscular Reeducation Techniques During Postoperative Rehabilitation Improves Functional Performance After Total Hip Arthroplasty: A Preliminary Study

2020 ◽  
pp. 1-9
Author(s):  
Dana Judd ◽  
Bradley S. Davidson ◽  
Dana Judd ◽  
Douglas A. Dennis ◽  
Jennifer E. Stevens-Lapsley ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Total Hip Arthroplasty ◽  
Postural Control ◽  
Hip Arthroplasty ◽  
Functional Performance ◽  
Preliminary Investigation ◽  
Outpatient Rehabilitation ◽  
Control Group ◽  
Total Hip ◽  
Minute Walk

Introduction: Total hip arthroplasty is a common procedure in end-stage hip osteoarthritis. Yet, following hip arthroplasty, deficits in functional performance, possibly due to movement compensations, persist. The purposes of this study are to provide conceptual basis for improving functional performance following hip arthroplasty by addressing movement compensation, present a unique rehabilitation protocol developed from this conceptual framework, and present findings from a preliminary investigation. Methods: This study was a prospective, randomized, controlled preliminary trial with concealed allocation and intention-to-treat analysis. Twenty participants undergoing primary, posterior approach THA were randomized into a neuromuscular reeducation and a control group. The neuromuscular reeducation group completed an 8-week, outpatient rehabilitation program after total hip arthroplasty utilizing neuromuscular reeducation techniques to promote pelvic stability and strength to improve movement quality. The control group was supervised by the study therapist weekly for 8 weeks after surgery but did not attend outpatient rehabilitation. Outcomes, assessed before and after surgery, included stair climb test, gait speed, 6-minute walk test, assessments of postural control and pelvic stability, muscle strength, and self-reported function. Results: Following the intervention, the neuromuscular reeducation group demonstrated statistically and clinically significant improvements in the stair climb test, 4-meter walk, 6-minute walk, postural control, and in some patient-reported outcomes. Further, there were trends toward improvement in pelvic stability during functional tasks and muscle strength, but these improvements were not statistically significant. Conclusions: Findings of this preliminary investigation support the use of neuromuscular reeducation techniques to improve functional performance after total hip arthroplasty, yet more information may be needed to determine efficacy. Therefore, this preliminary work has set the stage for future investigations to explore whether neuromuscular reeducation training after total hip arthroplasty should be considered in clinical practice.

scholarly journals Could the Evaluation of Muscle Strength Imbalances Be Used as a Predictor of Total Hip Arthroplasty?

2021 ◽  
Vol 18 (10) ◽  
pp. 5082
Author(s):  
Tomáš Vodička ◽  
Michal Bozděch ◽  
Marta Gimunová ◽  
Lenka Svobodová ◽  
Jiří Zháněl ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Clinical Predictor ◽  
Total Hip ◽  
Logistic Regressions

Loss of muscle strength characterizes the period before total hip arthroplasty (THA). Little is known about whether muscle strength imbalances caused by muscle strength decline could be considered another clinical predictor for THA. This study aimed to determine whether muscle imbalances may be used as a clinical predictor for THA surgery. Thirty-six participants were enrolled in the study. Eighteen patients had THA (THA group), while 18 were healthy elders (CON group). Ipsilateral (H/Q) and bilateral (% Def) muscle imbalances of the knee were assessed. THA patients showed impairment of the extensors on the affected extremity compared to those unaffected. A comparison between the groups proved there were weakened flexors in the THA group on both extremities. A comparison of the imbalances revealed a significant bilateral imbalance of the extensors and ipsilateral imbalance of both extremities in the THA group. We computed two logistic regressions using bilateral and ipsilateral imbalance as the predictors of THA surgery. We found that bilateral extensor imbalance may be used as a predictor for THA (Nagelkerke R2 = 0.22). A decrease of the bilateral extensors imbalance by 8% decreases the probability of THA by 8%. The most interesting finding is that the evaluation of the bilateral extensor imbalance may be used as another clinical predictor for THA.

scholarly journals Effects of rehabilitation and arthroplasty on the hip isometric muscle strength in patients with osteoarthritis of the hip

2009 ◽  
Vol 62 (5-6) ◽  
pp. 236-240 ◽  
Author(s):  
Slavica Jandric
Keyword(s):  
Muscle Strength ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Gluteus Medius ◽  
Treated Group ◽  
Early Rehabilitation ◽  
Control Group ◽  
Osteoarthritis Of The Hip ◽  
Total Hip ◽  
Tensor Fasciae Latae

Introduction Periarticular muscles have a significant role in keeping the mobility and integrity of the hip joint. The aim of this article was to investigate the effects of the total hip arthroplasty and early rehabilitation on the muscle strength. Patients Three groups of examined persons (matched in relation to musculosceletal conditions, sex, age and occupation) were included in the investigation. The first group (40 of the involved hip) and the second group (with 33 involved hips) were groups of patients with late-stage of osteoarthritis of the hip. The first group of patients was managed conservatively and the second group operatively (total cemented hip endoprosthesis was performed). The third group was control group with 123 healthy hips. Material and methods The maximal voluntary isometric strength was measured with dynamometer. The muscle strength was tested in all three groups: in the first group of patients at the beginning and at the end of the therapy and in patients of the second group 6?3 months postoperatively. Results A significant improvement of the muscle strength was noted for the flexors (t=2.45, p<0.05), musculus tensor fasciae latae (t=2.35, p<0.05), extensors (t=2.85, p<0.01), adductors (t=3.02, p<0.01), external rotators (t=3.1, p<0.01), m. gluteus medius (t=5.28, p<0.001) and internal rotators (t=5.77, p<0.001) after total hip arthroplasty and early rehabilitation in comparison to the conservatively treated group. Conclusion The muscle strength in the patients with osteoarthritis of the hip after arthroplasty was significantly higher than after rehabilitation for all hip muscles but did not reach values of the strength of the muscles in the corresponding control group.

A randomized clinical trial comparing six techniques of postoperative analgesia for elective total hip arthroplasty under subarachnoid anesthesia with opioids

2021 ◽  
Vol 87 (6) ◽  
Author(s):  
José R. ORTIZ-GÓMEZ ◽  
Marta PEREPÉREZ-CANDEL ◽  
Arantxa PAVÓN-BENITO ◽  
Berta TORRÓN-ABAD ◽  
María DORRONSORO-AUZMENDI ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Total Hip Arthroplasty ◽  
Randomized Clinical Trial ◽  
Hip Arthroplasty ◽  
Postoperative Analgesia ◽  
Total Hip

scholarly journals Changes in Hip and Knee Muscle Strength in Patients Following Total Hip Arthroplasty

2013 ◽  
Vol 16 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Yoshihiro FUKUMOTO ◽  
Koji OHATA ◽  
Rui TSUKAGOSHI ◽  
Keiich KAWANABE ◽  
Haruhiko AKIYAMA ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Knee Muscle ◽  
Knee Muscle Strength
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