The therapeutic validity and effectiveness of physiotherapeutic exercise following total hip arthroplasty for osteoarthritis: A systematic review

Annet Wijnen, Sjoukje E Bouma, Gesine H Seeber, Lucas H V van der Woude, Sjoerd K Bulstra, Djordje Lazovic, Martin Stevens, Inge van den Akker-Scheek, Annet Wijnen, Sjoukje E Bouma, Gesine H Seeber, Lucas H V van der Woude, Sjoerd K Bulstra, Djordje Lazovic, Martin Stevens, Inge van den Akker-Scheek

Abstract

Objective: To assess the therapeutic validity and effectiveness of physiotherapeutic exercise interventions following total hip arthroplasty (THA) for osteoarthritis.

Data sources: The databases Embase, MEDLINE, Cochrane Library, CINAHL and AMED were searched from inception up to February 2017.

Eligibility criteria: Articles reporting results of randomized controlled trials in which physiotherapeutic exercise was compared with usual care or with a different type of physiotherapeutic exercise were included, with the applied interventions starting within six months after THA. Only articles written in English, German or Dutch were included.

Study appraisal: Therapeutic validity (using the CONTENT scale) and risk of bias (using both the PEDro scale and the Cochrane Collaboration's tool) were assessed by two researchers independently. Characteristics of the physiotherapeutic exercise interventions and results about joint and muscle function, functional performance and self-reported outcomes were extracted.

Results: Of the 1124 unique records retrieved, twenty articles were included. Only one article was considered to be of high therapeutic validity. Description and adequacy of patient selection were the least reported items. The majority of the articles was considered as having potentially high risk of bias, according to both assessment tools. The level of therapeutic validity did not correspond with the risk of bias scores. Because of the wide variety in characteristics of the physiotherapeutic exercise and control interventions, follow-up length and outcome measures, limited evidence was found on the effectiveness of physiotherapeutic exercise following THA.

Conclusion: The insufficient therapeutic validity and potentially high risk of bias in studies involving physiotherapeutic exercise interventions limit the ability to assess the effectiveness of these interventions following THA. Researchers are advised to take both quality scores into account when developing and reporting studies involving physiotherapeutic exercise. Uniformity in intervention characteristics and outcome measures is necessary to enhance the comparability of clinical outcomes between trials.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. The International Classification of Function,…
Fig 1. The International Classification of Function, Disability and Health (ICF) model [13].
Fig 2. Flow diagram of the article…
Fig 2. Flow diagram of the article selection process.
THA: total hip arthroplasty; OA: osteoarthritis; RCT: randomized controlled trial.

References

    1. Litwic A, Edwards MH, Dennison EM, Cooper C. Epidemiology and burden of osteoarthritis. Br Med Bull. 2013;105: 185–199. doi:
    1. Bennell KL, Hinman RS. A review of the clinical evidence for exercise in osteoarthritis of the hip and knee. J Sci Med Sport. 2011;14: 4–9. doi:
    1. Bijlsma JW, Berenbaum F, Lafeber FP. Osteoarthritis: an update with relevance for clinical practice. Lancet. 2011;377: 2115–2126. doi:
    1. Katz JN. Total joint replacement in osteoarthritis. Best Pract Res Clin Rheumatol. 2006;20: 145–153. doi:
    1. Otten R, van Roermund PM, Picavet HS. Trends in the number of knee and hip arthroplasties: considerably more knee and hip prostheses due to osteoarthritis in 2030. Ned Tijdschr Geneeskd. 2010;154: A1534
    1. Landelijke Registratie Orthopedische Implantaten (LROI). Online LROI-Rapportage 2015: Blik op Uitkomsten. 2016. Available from: . Cited 22 May 2017.
    1. Statistisches Bundesamt. Fallpauschalenbezogene Krankenhausstatistik (DRG-Statistik) Operationen und Prozeduren der vollstationären Patientinnen und Patienten in Krankenhäusern—Ausführliche Darstellung. 2015. Available from: . Cited 6 June 2017.
    1. Ostendorf M, Johnell O, Malchau H, Dhert WJ, Schrijvers AJ, Verbout AJ. The epidemiology of total hip replacement in The Netherlands and Sweden: present status and future needs. Acta Orthop Scand. 2002;73: 282–286. doi:
    1. Bandholm T, Kehlet H. Physiotherapy Exercise After Fast-Track Total Hip and Knee Arthroplasty: Time for Reconsideration? Arch Phys Med Rehabil. 2012;93: 1292–1294. doi:
    1. DeJong G, Tian W, Smout RJ, Horn SD, Putman K, Smith P, et al. Use of rehabilitation and other health care services by patients with joint replacement after discharge from skilled nursing and inpatient rehabilitation facilities. Arch Phys Med Rehabil. 2009;90: 1297–1305. doi:
    1. Brown CK, Southerst D, Cote P, Shearer HM, Randhawa K, Wong JJ, et al. The Effectiveness of Exercise on Recovery and Clinical Outcomes in Patients With Soft Tissue Injuries of the Hip, Thigh, or Knee: A Systematic Review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. J Manipulative Physiol Ther. 2016;39: 110–120.e1. doi:
    1. Bijlsma JW, Dekker J. A step forward for exercise in the management of osteoarthritis. Rheumatology. 2005;44: 5–6. doi:
    1. World Health Organization. The International Classification of Functioning, Disability and Health (ICF). Geneva; 2001.
    1. Rasch A, Dalen N, Berg HE. Muscle strength, gait, and balance in 20 patients with hip osteoarthritis followed for 2 years after THA. Acta Orthop. 2010;81: 183–188. doi:
    1. Sicard-Rosenbaum L, Light KE, Behrman AL. Gait, lower extremity strength, and self-assessed mobility after hip arthroplasty. J Gerontol A Biol Sci Med Sci. 2002;57: M47–M51.
    1. Trudelle-Jackson E, Emerson R, Smith S. Outcomes of total hip arthroplasty: a study of patients one year postsurgery. J Orthop Sports Phys Ther. 2002;32: 260–267. doi:
    1. Herbert RD, Bo K. Analysis of quality of interventions in systematic reviews. BMJ. 2005;331: 507–509. doi:
    1. Hoogeboom TJ, Oosting E, Vriezekolk JE, Veenhof C, Siemonsma PC, de Bie RA, et al. Therapeutic validity and effectiveness of preoperative exercise on functional recovery after joint replacement: a systematic review and meta-analysis. PLoS One. 2012;7: e38031 doi:
    1. Snoek JA, van Berkel S, van Meeteren N, Backx FJ, Daanen HA. Effect of aerobic training on heart rate recovery in patients with established heart disease; a systematic review. PLoS One. 2013;8: e83907 doi:
    1. Vooijs M, Siemonsma PC, Heus I, Sont JK, Rovekamp TA, van Meeteren NL. Therapeutic validity and effectiveness of supervised physical exercise training on exercise capacity in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. Clin Rehabil. 2016;30: 1037–1048. doi:
    1. Coulter CL, Scarvell JM, Neeman TM, Smith PN. Physiotherapist-directed rehabilitation exercises in the outpatient or home setting improve strength, gait speed and cadence after elective total hip replacement: a systematic review. J Physiother. 2013;59: 219–226. doi:
    1. Di Monaco M, Castiglioni C. Which type of exercise therapy is effective after hip arthroplasty? A systematic review of randomized controlled trials. Eur J Phys Rehabil Med. 2013;49: 893–907.
    1. Lowe CJ, Davies L, Sackley CM, Barker KL. Effectiveness of land-based physiotherapy exercise following hospital discharge following hip arthroplasty for osteoarthritis: an updated systematic review. Physiotherapy. 2015;101: 252–265. doi:
    1. Maher CG, Sherrington C, Herbert RD, Moseley AM, Elkins M. Reliability of the PEDro scale for rating quality of randomized controlled trials. Phys Ther. 2003;83: 713–721.
    1. Armijo-Olivo S, da Costa BR, Cummings GG, Ha C, Fuentes J, Saltaji H, et al. PEDro or Cochrane to Assess the Quality of Clinical Trials? A Meta-Epidemiological Study. PLoS One. 2015;10: e0132634 doi:
    1. Higgins JP, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ. 2011;343: d5928 doi:
    1. Husby VS, Helgerud J, Bjørgen S, Husby OS, Benum P, Hoff J. Early Maximal Strength Training Is an Efficient Treatment for Patients Operated With Total Hip Arthroplasty. Arch Phys Med Rehabil. 2009;90: 1658–1667. doi:
    1. Husby VS, Helgerud J, Bjørgen S, Husby OS, Benum P, Hoff J. Early postoperative maximal strength training improves work efficiency 6–12 months after osteoarthritis-induced total hip arthroplasty in patients younger than 60 years. Am J Phys Med Rehabil. 2010;89: 304–314. doi:
    1. Mikkelsen LR, Mikkelsen SS, Christensen FB. Early, intensified home-based exercise after total hip replacement—A pilot study. Physiother Res Int. 2012;17: 214–226. doi:
    1. Mikkelsen LR, Mechlenburg I, Søballe K, Jørgensen LB, Mikkelsen S, Bandholm T, et al. Effect of early supervised progressive resistance training compared to unsupervised home-based exercise after fast-track total hip replacement applied to patients with preoperative functional limitations. A single-blinded randomised controlled trial. Osteoarthritis Cartilage. 2014;22: 2051–2058. doi:
    1. Nankaku M, Ikeguchi R, Goto K, So K, Kuroda Y, Matsuda S. Hip external rotator exercise contributes to improving physical functions in the early stage after total hip arthroplasty using an anterolateral approach: a randomized controlled trial. Disabil Rehabil. 2016;38: 2178–2183. doi:
    1. Okoro T, Whitaker R, Gardner A, Maddison P, Andrew JG, Lemmey A. Does an early home-based progressive resistance training program improve function following total hip replacement? Results of a randomized controlled study. BMC Musculoskelet Disord. 2016;17: 173 doi:
    1. Suetta C, Magnusson SP, Rosted A, Aagaard P, Jakobsen AK, Larsen LH, et al. Resistance training in the early postoperative phase reduces hospitalization and leads to muscle hypertrophy in elderly hip surgery patients—A controlled, randomized study. J Am Geriatr Soc. 2004;52: 2016–2022. doi:
    1. Maire J, Faillenet-Maire AF, Grange C, Dugué B, Tordi N, Parratte B, et al. A specific arm-interval exercise program could improve the health status and walking ability of elderly patients after total hip arthroplasty: A pilot study. J Rehabil Med. 2004;36: 92–94.
    1. Maire J, Dugué B, Faillenet-Maire AF, Smolander J, Tordi N, Parratte B, et al. Influence of a 6-week arm exercise program on walking ability and health status after hip arthroplasty: A 1-year follow-up pilot study. J Rehabil Res Dev. 2006;43: 445–449.
    1. Beaupre LA, Masson ECO, Luckhurst BJ, Arafah O, O'Connor GJ. A randomized pilot study of a comprehensive postoperative exercise program compared with usual care following primary total hip arthroplasty in subjects less than 65 years of age: Feasibility, selection of outcome measures and timing of assessment. BMC Musculoskelet Disord. 2014;15: 192 doi:
    1. Bodén H, Adolphson P. No adverse effects of early weight bearing after uncemented total hip arthroplasty: a randomized study of 20 patients. Acta Orthop Scand. 2004;75: 21–29. doi:
    1. Galea MP, Levinger P, Lythgo N, Cimoli C, Weller R, Tully E, et al. A targeted home- and center-based exercise program for people after total hip replacement: A randomized clinical trial. Arch Phys Med Rehabil. 2008;89: 1442–1447. doi:
    1. Giaquinto S, Ciotola E, Dall'Armi V, Margutti F. Hydrotherapy after total hip arthroplasty: A follow-up study. Arch Gerontol Geriatr. 2010;50: 92–95. doi:
    1. Heiberg KE, Bruun-Olsen V, Ekeland A, Mengshoel AM. Effect of a walking skill training program in patients who have undergone total hip arthroplasty: Followup one year after surgery. Arthritis Care Res. 2012;64: 415–423.
    1. Heiberg KE, Figved W. Physical Functioning and Prediction of Physical Activity After Total Hip Arthroplasty: Five-Year Followup of a Randomized Controlled Trial. Arthritis Care Res. 2016;68: 454–462.
    1. Johnsson R, Melander A, Onnerfalt R. Physiotherapy after total hip replacement for primary arthrosis. Scand J Rehabil Med. 1988;20: 43–45.
    1. Monaghan B, Cunningham P, Harrington P, Hing W, Blake C, O'Dohertya D, et al. Randomised controlled trial to evaluate a physiotherapy-led functional exercise programme after total hip replacement. Physiotherapy. 2016, .
    1. Monticone M, Ambrosini E, Rocca B, Lorenzon C, Ferrante S, Zatti G. Task-oriented exercises and early full weight-bearing contribute to improving disability after total hip replacement: a randomized controlled trial. Clin Rehabil. 2014;28: 658–668. doi:
    1. Strom H, Huss K, Larsson S. Unrestricted weight bearing and intensive physiotherapy after uncemented total hip arthroplasty. Scand J Surg. 2006;95: 55–60. doi:
    1. Umpierres CS, Ribeiro TA, Marchisio ÂE, Galvão L, Borges ÍNK, Macedo CAS, et al. Rehabilitation following total hip arthroplasty evaluation over short follow-up time: Randomized clinical trial. J Rehabil Res Dev. 2014;51: 1567–1578. doi:
    1. Veenhof C, Van den Ende CH, Dekker J, Koke AJ, Oostendorp RA, Bijlsma JW. Which patients with osteoarthritis of hip and/or knee benefit most from behavioral graded activity? Int J Behav Med. 2007;14: 86–91.
    1. Wright AA, Cook CE, Flynn TW, Baxter GD, Abbott JH. Predictors of response to physical therapy intervention in patients with primary hip osteoarthritis. Phys Ther. 2011;91: 510–524. doi:
    1. Fitzgerald GK, Hinman RS, Zeni J Jr, Risberg MA, Snyder-Mackler L, Bennell KL. OARSI Clinical Trials Recommendations: Design and conduct of clinical trials of rehabilitation interventions for osteoarthritis. Osteoarthritis Cartilage. 2015;23: 803–814. doi:
    1. Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, et al. The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol. 2010;63: 737–745. doi:
    1. Jorgensen L, Paludan-Muller AS, Laursen DR, Savovic J, Boutron I, Sterne JA, et al. Evaluation of the Cochrane tool for assessing risk of bias in randomized clinical trials: overview of published comments and analysis of user practice in Cochrane and non-Cochrane reviews. Syst Rev. 2016;5: 80 doi:
    1. Dobson F, Bennell K, Hinman R, Haxby Abbott J, Roos E. Recommended performance-based tests to assess physical function in people diagnosed with hip or knee osteoarthritis. 2013. Available from: . Cited 1 February 2018. doi:
    1. van den Akker-Scheek I, Zijlstra W, Groothoff JW, Bulstra SK, Stevens M. Physical functioning before and after total hip arthroplasty: perception and performance. Phys Ther. 2008;88: 712–719. doi:

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