PHYSICAL THERAPY & REHAB
Does an early home-based progressive resistance training program improve function following total hip replacement? Results of a randomized controlled study
This report has been verified
by one or more authors of the
original publication.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2016;4(14):23 BMC Musculoskelet Disord. 2016 Apr 21;17(1):17349 patients who had undergone total hip arthroplasty were randomized to either a 6-week home-based progressive resistance training (PRT) regimen or standard inpatient/outpatient physiotherapy without PRT exercises. The purpose of this study was to evaluate if the home-base PRT group demonstrated significantly better results regarding isokinetic quadriceps strength and functional performance measures compared to standard rehabilitation over 9-12 months follow-up. Results demonstrated no significant differences between groups in the change from baseline to 9-12 months postoperatively in either maximal isokinetic quadriceps strength, the sit-to-stand test, or the timed up-and-go test. Results also demonstrated significantly greater improvement in stair climb performance and the 6-minute walk test in the standard rehabilitation group compared to the home-based PRT group.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
はい = 1
不確実＝0.5
無関係 = 0
いいえ = 0
報告基準評価では、著者が出版物内で試験の方法論的特徴や試験特性を報告する際の透明性を評価します。評価は以下の5つのカテゴリーに分類されます。
1/4
Randomização
4/4
Medidas de resultado
4/4
Inclusão/Exclusão
3/4
Descrição do tratamento
3/4
Estatística
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
Fragility Indexは、重要な所見の解釈を助けるツールで、結果の強さの尺度を提供します。Fragility Indexは、その所見が有意でなくなるために、二項対立の結果に追加する必要がある連続した事象の数を表します。数値が小さいほど弱い所見を表し、数値が大きいほど強い所見を表します。
なぜ今この研究が必要なのですか？
Following total hip arthroplasty, the type of exercises performed, and the setting that they are performed in, may influence overall patient outcome. The idea of centre-based progressive resistance training programs has been popular more recently, though widespread application has been hindered due to the increased expense required by supervision. As an alternative, researchers have begun to investigate if home-based programs featuring PRT following an initial supervised session may demonstrate efficacy in patient rehabilitation. Therefore, a randomized controlled trial comparing a home-based PRT training program to conventional inpatient and outpatient rehabilitation, not including PRT, was needed.
主な研究課題は何ですか？
Following total hip arthroplasty, does a home-based progressive resistance training significantly improve muscle strength and physical strength compared to standard, inpatient/outpatient non-PRT exercise rehabilitation, assessed 9-12 months?
重要な知見は？
- No significant difference was observed in the increase in maximal isokinetic quadriceps strength from baseline to 9-12 months between the home-based PRT group (172.3+/-85.10N to 247.4+/-85.10N) and the standard inpatient/outpatient PT group (174.2+/-70.3N to 240.3+/-87.4N) (p=0.065).
- No significant differences were observed between the home-based PRT group and the standard inpatient/outpatient PT group in the increase in the 30-sec sit-to-stand test after 9-12 months (3.64+/-2.72 and 4.75+/-4.04, respectively; p=0.239), increase in lean mass of the operative limb after 9-12 months (200.15+/-800.58g and 194.08+/-586.98g, respectively; p=0.508), or decrease in the TUG test (-3.74+/-5.37s and -2.68+/-2.35s, respectively; p=0.972)
- The home-based PRT group demonstrated a significantly smaller decrease in stair climb performance compared to the standard inpatient/outpatient PT group (-6.69+/-5.08s vs. -7.71+/-6.99s, respectively; p=0.038), as well as a smaller increase in the 6MWT (84.52+/-52.41m vs. 120.91+/-88.59m, respectively; p=0.004).
- Time effects for all outcomes, with the exception of lean mass of the operative limb, were significant.
- Within the home-based PRT group, a significant effect of training volume on the primary outcome was observed, with an increase of 121N (+/-84.63) in maximal isokinetic quadriceps strength after 9-12 months observed in the high training volume cohort compared to decrease of 5.33N (+/-54.12) in the low training volume cohort (p=0.034).
最も覚えておくべきことは？
Following total hip arthroplasty, a 6-week program of home-based progressive resistance training did not significantly improve isokinetic quadriceps strength and functional performance scores after 9-12 months when compared to standard, non-PRT inpatient/outpatient physiotherapy.
それが私の患者ケアにどのように影響するか？
The results of this study suggest that home-based progressive resistance training may not hold any significant advantanges over standard inpatient/outpatient physiotherapy sessions when considering patient outcome within the first postoperative year, though improvement in outcomes of the study cohort as a whole was significant. Examination of the influence of training volume suggested that outcome may be improved with higher training volume. Therefore, additional studies should be conducted to determine if a greater emphasis on training volume and compliance of patients may further increase the efficacy of home-based PRT following total hip arthroplasty.
免責事項
このページに記載されている内容は、情報提供のみを目的としたものであり、専門的な医療アドバイス、診断、治療の代わりとなるものではありません。治療が必要な場合は、必ず医師の診断を仰ぐか、最寄りの救急外来を受診してください。このページに記載されている内容に関して個人が表明した意見、信念、見解は、OrthoEvidenceの意見、信念、見解を反映するものではありません。
0の4 月間無料記事のロック解除
