Patient and physical therapists’ views on physical rehabilitation exercise in the early phase after total hip arthroplasty: a qualitative interview study

PURPOSE: Physical rehabilitation exercises (PRE) are commonly prescribed early after total hip arthroplasty (THA), but the fundamental effectiveness of PRE has been questioned. As little is known about stakeholder perceptions of PRE, the aim was to explore patients' and physical therapists' perceptions of using PRE in the early period after THA. METHODS: A qualitative interview study was conducted. Using a semi-structured interview guide, a focus group interview with six physical therapists and individual phone interviews with 18 patients were completed. Data were transcribed verbatim and analyzed applying a reflexive thematic analysis. RESULTS: Four main themes were identified: "Regaining everyday life," "Sense of security - trusting the health professionals," "Seeing the whole person - one size does not fit all," and "A pathway without PRE is risky." CONCLUSIONS: PRE was perceived to play an essential role in the early postoperative phase and a stratified, individual approach was requested. PRE was considered a means to regain everyday life and improve mental and physical recovery as well as mitigate complications. Guidance from physical therapists providing PRE was highlighted to enhance the patients' sense of security. Both patients and physical therapists were concerned that a pathway without PRE would lead to poorer patient outcomes.