Self-administered home exercise program shows comparable results to outpatient therapy

LAS VEGAS — A new study shows similar outcomes between patients who followed a novel self-administered home exercise program and those who had conventional outpatient physical therapy services following total hip arthroplasty.

In a prospective, multicenter trial presented at the American Academy of Orthopaedic Surgeons 76th Annual Meeting, Nelson V. Greidanus, MD, and colleagues studied 102 patients who underwent conventional primary total hip arthroplasty (THA) and were randomized at the time of hospital discharge to a home exercise program or outpatient physical therapy services. Patients in the outpatient physical therapy group received standardized physical therapy services, while tthose in the self-administered home exercise program received detailed modules of self-administered exercises that were developed by expert rehabilitation professionals.

The investigators found that the groups had similar baseline demographics such as age, gender and comorbidity. They also discovered that the groups had a similar proportion of patients who had one of two surgical approaches for THA. In addition, the groups showed no significant differences regarding preoperative WOMAC scores and timed up-and-go (TUG) results.

Follow-up at 4 months revealed no significant differences between the groups regarding WOMAC scores and TUG results. At 12 months, the investigators also reported similar outcomes between the groups for WOMAC and TUG tests. In addition, they discovered that the home exercise group showed a recovery curve similar to that of the outpatient physical therapy group.

“The self-administered home exercise program did not show inferiority to the outpatient physical therapy,” Greidanus said during his presentation. “There were similar recovery rates, similar outcomes and satisfaction rates as reported by patients, as well as similar objective gait performance [results] such as with the timed-up-and-go procedure.”

MANOVA analyses comparing recovery curves were quite similar as well, he said.

“The self-administered program may serve as an adjunct to outpatient physical therapy services. Or, it can serve as a standalone alternative in geographic locations where patients may not be able to get to outpatient services,” he said.

Reference:
Greidanus NV, Backman C, Liang, et al. Clinical effectiveness of a self-administered rehabilitation program following primary THA. Paper #546. Presented at the American Academy of Orthopaedic Surgeons 76th Annual Meeting. Feb. 25-28, 2009. Las Vegas.