Perioperative Exercise Programs Improve Early Return of Ambulatory Function After Total Hip Arthroplasty

Wang AW, Gilbey HJ, Ackland TR: Perioperative exercise programs improve early return of ambulatory function after total hip arthroplasty: A randomized, controlled trial. Am J Phys Med Rehabil 2002;81:801–806. Objective Patients with endstage hip arthritis have poor ambulatory function. The aim of this study was to determine if perioperative exercise programs are well tolerated by these elderly patients and if a customized program can achieve an earlier recovery of normal ambulatory function after total hip arthroplasty. Design Twenty-eight subjects scheduled for total hip arthroplasty were randomized to either the exercise group and received a perioperative customized exercise program or the control group and received the routine perioperative care. Ambulatory function was assessed by measurement of gait parameters during a 25-m walk test, and walking endurance was assessed by a 6-min walk test. Results Exercise group subjects attended 97.3% of scheduled exercise sessions with no training injuries. Exercise group subjects demonstrated greater stride length and gait velocity at 3 wk postsurgery. At 12 and 24 wk postsurgery, gait velocity was greater, and the 6-min walking distance was significantly greater than the control group. Conclusion The study indicates that perioperative customized exercise program are well tolerated in the elderly patient with endstage hip arthritis and are effective in improving the rate of recovery in ambulatory function in the first 6 mo after total hip arthroplasty.