Feasibility and efficacy of an 8-week progressive home-based strengthening exercise program in patients with osteoarthritis of the hip and/or total hip joint replacement: a preliminary trial.

The feasibility and efficacy of an additional progressive home-based strengthening exercise program (PHSEP) on subjects that already attended supervised institutional exercise therapy was investigated. Thirty-six hip patients with hip osteoarthritis (OA) and/or total hip replacement in at least one hip joint were randomly assigned to an intervention group (IG) or a control group (CG). IG (18 patients, mean age 64.9, standard deviation (SD) 7.5) followed an 8-week PHSEP in addition to their weekly institutional exercise therapy, while CG (18 patients, mean age 64.7, SD 9) solely continued the weekly institutional exercise sessions. Before and after the intervention period, strength of hip muscles was quantified applying isokinetic concentric and isometric measurements, and health-related quality of life was monitored using the SF36 questionnaire. Adherence to the exercise program was evaluated using exercise logs. The PHSEP was feasible for all subjects in IG with an adherence of 99%. Exercise logs reported that pain resulting from the PHSEP was low. Increased strength in isokinetic concentric hip adduction (13%) and isometric hip abduction (9%), adduction (12%), and flexion (7%) was found in IG in comparison to CG. The results of the SF36 did not change during the intervention period. Consequently, supervised institutional exercise therapy supplemented by a PHSEP could increase hip muscle strength in patients with hip OA and/or total hip replacement. However, further research should evaluate the optimal frequency and duration of such supplementary sessions and their potential to increase physical function and reduce pain.

Effects of a sensory-motor exercise program for older adults with osteoarthritis or prosthesis of the hip using measurements made by the Posturomed oscillatory platform.

OBJECTIVES: To assess changes in balance capacities after a 12-week sensory-motor training program for older adults with osteoarthritis or prosthesis of the hip. BACKGROUND: Sensory-motor training is recommended to help aging adults with osteoarthritis maintain activity, avoid injurious falls, and improve functioning. Up to now, however, there has been no standard training protocol for sensory-motor training. METHODS AND MEASURES: Thirty-five participants in a hip exercise group who had a mean age of 58 years (SD 12) were quasi-randomized into a training group (TG) and a control group (CG) by the month they applied for the Hip School program. The TG performed balance exercises using balance pads and received Hip School training once a week. The CG did not receive any training intervention. Balance was measured by recording center-of-pressure excursion while participants were in 1-legged stance on the oscillatory Posturomed platform. Outcome measures were the total path of center of pressure on the platform during balance recovery and the percentage of failed attempts. RESULTS: The TG had a lower percentage of failed attempts (TG 5%, CG 18%, P = .001) and required fewer balance recovery movements to maintain balance (TG: mean [SD] measurement is 59 [36] mm; CG: 96 [68] mm, P = .036] after completing the 12-week training program. After the training period, participants in the TG compensated better for perturbations in the nondisplaced medial-lateral (ML) direction (pretest [SD] measurement was 48 [18] mm; posttest, 36 [14] mm; P= .001]. CONCLUSIONS: Participants could successfully cope with more disturbances and improved their reactions to sudden displacements after training intervention. This exercise setting improves balance abilities and should be included in Hip School programs for patients with osteoarthritis.