Title
Preoperative home-based physical therapy versus usual care to improve functional health of frail older adults scheduled for elective total hip arthroplasty: A pilot randomized controlled trial
Author
Oosting, E.
Jans, M.P.
Dronkers, J.J.
Naber, R.H.
Dronkers-Landman, C.M.
Appelman-De Vries, S.M.
van Meeteren, N.L.
Publication year
2012
Abstract
Preoperative home-based physical therapy versus usual care to improve functional health of frail older adults scheduled for elective total hip arthroplasty: a pilot randomized controlled trial. 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, 1316). Preoperative clinical relevant differences on the TUG test (2.9s; 95% confidence interval [CI], -0.9 to 6.6) and significant differences on the 6MWT (41m; 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. © 2012 by the American Congress of Rehabilitation Medicine.
Subject
Healthy Living
HL - Healthy for Life
Themalijn
Healthy for Life
Health
Healthy Living
Arthroplasty
Feasibility studies
Frail elderly
hip
Osteoarthritis
Rehabilitation
replacement
To reference this document use:
http://resolver.tudelft.nl/uuid:47216f7e-3748-47c0-92fa-1c19270e0974
DOI
https://doi.org/10.1016/j.apmr.2011.11.006
TNO identifier
448197
ISSN
0003-9993
Source
Archives of Physical Medicine and Rehabilitation, 93 (4), 610-616
Document type
article