Home exercise program yielded similar improvements as formal therapy after hip arthroscopy
Click Here to Manage Email Alerts
Key takeaways:
- A home exercise program yielded similar outcomes as formal physical therapy at 1 year after hip arthroscopy.
- Both home exercise and formal therapy yielded significant improvements in outcome scores.
Published results showed a home exercise program yielded similar improvements as formal physical therapy at 1 year after hip arthroscopy for femoroacetabular impingement.
Taylor E. Hobson, MD, and colleagues from the University of Utah analyzed outcomes of patients who underwent either a home-based exercise program (n = 62) or formal physical therapy (n = 46) after hip arthroscopy for femoroacetabular impingement syndrome between October 2020 and October 2021. According to the study, patients self-selected their rehabilitation modality.
Researchers analyzed single assessment numeric evaluation (SANE) scores, VAS pain scores, 12-item International Hip outcome Tool (iHOT-12) scores, Patient-Reported Outcomes Measurement Information System–physical function (PROMIS-PF) scores and patient satisfaction preoperatively and at 1 month, 3 months, 6 months and 1 year postoperatively.
Overall, researchers found both cohorts had significantly improved outcomes with no significant differences for any outcome measures at 1-year follow-up.
At 1 year after surgery, SANE scores were 82.6 for the formal therapy cohort and 81.6 for the home exercise cohort, while VAS pain scores at rest were 1.3 for the formal therapy cohort and 1.1 for the home exercise cohort. In addition, iHOT-12 scores were 69.6 for the formal therapy cohort and 72.5 for the home exercise cohort, while PROMIS-PF scores were 50.7 for the formal therapy cohort and 51.4 for the home exercise cohort. Patient satisfaction scores were also similar between the cohorts at 1 year postoperatively.
“These findings suggest that a structured [home exercise program] HEP may be a viable alternative to [formal physical therapy] FPT after hip arthroscopic surgery in patients who prefer a self-directed rehabilitation program,” the researchers wrote in the study.
Perspective
Back to Top
In my practice, rehabilitation following hip arthroscopy is extremely important and, in many cases, the key to a successful outcome. Particularly important is the strengthening of the core musculature and the gluteus medius and minimus muscles . In addition, mobilization of the hip joint and internal rotation of the hip is a critical factor. At Hospital for Special Surgery, we have developed a protocol that focuses on these aspects and published studies showing that strengthening of the gluteus medius is directly correlated with a successful outcome, particularly with return to sport.
In the study by Taylor E. Hobson, MD, MBA, and colleagues, patients who felt they would do well with a home exercise program chose that route. This may be a limitation.
During the pandemic, we learned more could be done to create structured home therapy programs. New devices allow patients to effectively strengthen the aforementioned parts of the body and also provide the care team with feedback on the patient’s progress.
I strongly feel, in most cases, a supervised physical therapy program, particularly for those patients trying to return to sports, is critical. However, it is extremely important to accommodate patients who are unable to travel to a facility to ensure the home therapy program protocols are clearly defined, carefully monitored and the goals of the exercises are understood.
Collapse
Read more about
Click Here to Manage Email Alerts