A pilot study developing an effective home-based exercise strategy for patients with a total hip arthroplasty

Osteoarthritis is one of the most common chronic diseases of the
musculoskeletal system in elderly. Patients with osteoarthritis experience
pain, stiffness and loss of mobility. As a result of the ageing in the coming
decades the number of elderly with osteoarthritis will progressively increase.
Osteoarthritis is a common indicator for a Total Hip Arthroplasty (THA). A hip
replacement is one of the most successful orthopedic surgeries. However, with
regard to the postoperative rehabilitation a lot can be improved. The current
situation after a THA is that physical therapy is not prescribed by default.
Patients are resigned from the hospital and receive home exercises. However, it
is not clear whether patients actually carry out these exercises and whether
they perform the exercises correctly.

The main objective of this pilot study is the development and application of a
home-based exercise strategy that helps patients to return faster to their
functional level of before the surgery. At first, practical feasibilty of the
exercise strategy will be investigated and secondary the potential clinical
effectiveness. For the determination of clinical effectiveness, newly developed
possibilities of motion sensors will be used to evaluate mobility.

The pilot study is an intervention study with four measurements.

An eight-week home-based exercise strategy will be offered to patients after
their discharge from the hospital. This home-based exercise strategy will
consist of specified exercise instructions for improving muscle strength,
balance and functional movements.

Participants will be measured four times; before the surgery, at the beginning
and at the end of the eight-week intervention and a follow-up six months after
the operation. During these measurements participants fill in some
questionnaires and perform some activities of daily living (e.g. standing,
sitting, walking) while they are wearing a motion sensor.
In addition, a participant will perform an eight week home-based exercise
strategy in order to train muscle strength, balance and functional movements.
The exercises will take about 30 minutes a day. Furthermore, once a week there
is an appointment with a physiotherapist of 30 minutes.
The first time exercises are performed under the supervision of a
physiotherapist. The exercises consist of the usual exercises that are provided
after a THA and therefore there is no additional risk for participants. There
is also no risk in wearing of the motion sensor in the home situation and test
situations. The sensor is small and light and can be worn as a necklace without
constrictions. The objective measurements of mobility consist of acitivities of
daily living and in that sense there is again no additional risk for
participants.