70.
Feasibility of Early-Initiated Progressive Resistance Training after
Total Hip Replacement
Lone Ramer Mikkelsen, Inger Mechlenburg, Mette Krintel Petersen, Kjeld
Søballe, Søren Mikkelsen, Thomas Bandholm
Department of Orthopaedics Silkeborg Regional Hospital ; Department of
Orthopaedics, Aarhus University Hospital ; Department of Physiotherapy ,
Aarhus University Hospital; Department of Orthopaedics, Aarhus University
Hospital ; Department of Orthopaedics , Silkeborg Regional Hospital ;
Department of Orthopaedics and Physical Therapy , Copenhagen University
Hospital, Hvidovre
Background:
Muscle atrophy, reduced hip muscle strength and function are
documented within the first weeks after Total Hip Replacement (THR).
Purpose / Aim of Study:
The purpose of this study was to evaluate the
feasibility of early-initiated progressive resistance training (PRT) after THR.
Materials and Methods:
10
patients were followed 4 weeks post THR. The
PRT was initiated 2-5 days after surgery, and performed twice a week for 4
weeks. Unilateral exercises were performed in 4 training machines applying 3
sets of 10 repetitions at 10 RM (repetition maximum). Absolute loading (kg)
and pain during the exercises were measured at each training session.
Isometric muscle strength was measured before and 4 weeks after the THR.
Findings / Results:
Pain during exercises and resting pain before and after
each training session was unchanged or decreased during the 4 weeks of
training. Averaged across exercises pain during training decreased from 3.6
(
sd: 2.8) at the first session to 1.52 (sd: 1.8) VAS-mm at the last session,
p<0.001. The absolute training load increased progressively for all 4 exercises
during the 4 weeks of training. For example: 2nd, 5th and 8th training session.
Hip extension, mean (sd): 28.9 (8.5), 36.3 (7.5), 39.4 (8.4), kg, p=0.02. Hip
flexion, mean (sd): 32.4 (9.7), 43.8 (11.5), 53.6 (12.9), kg, p=0.001. Isometric
strength in Nm/kg: Preoperative, 4 weeks postoperative, p- value (diff): Hip
abduction, mean (sd): 0.86 (0.28), 0.85 (0.16) Nm/kg, p=0.94. Hip flexion,
mean (sd): 0.98 (0.26), 1.03 (0.29) Nm/kg, p=0.52.
Conclusions:
It seems feasible to commence PRT within the first week after
THR, as hip pain remained the same or decreased, while the training load
increased progressively. The included patients reached their preoperative hip-
strength levels after 4 weeks of training.
