Effect of Multiple Physiotherapy Sessions on Functional Outcomes in the Initial Postoperative Period After Primary Total Hip Replacement: A Randomized Controlled Trial
Abstract
Stockton KA, Mengersen KA. Effect of multiple physiotherapy sessions on functional outcomes in the initial postoperative period after primary total hip replacement: a randomized controlled trial.
Objective
To determine whether increasing physiotherapy input from once to twice per day will result in earlier achievement of functional milestones (ie, independence in mobility and transfers) and decreased length of stay (LOS) in patients undergoing a primary total hip replacement.
Design
Randomized controlled trial.
Setting
Metropolitan private hospital.
Participants
Patients (N=57) with primary total hip replacement were randomly assigned to the twice daily (treatment, n=30) and once daily (control, n=27) groups. Patients who chose to attend hydrotherapy were excluded from the randomization process; however, they gave consent for outcome measures to be collected for comparison with the randomized groups.
Interventions
The control group received usual care, and the treatment group received twice-daily physiotherapy from day 1 after surgery to discharge.
Main Outcome Measures
The Iowa Level of Assistance at postoperative days 3 and 6 and LOS.
Results
This study demonstrates that patients who received twice-daily land-based physiotherapy after primary total hip replacement attained earlier achievement of functional milestones than patients that received once-daily physiotherapy. A statistically significant (P=.041) but not clinically significant difference was evident in the Iowa Level of Assistance score at day 3. There was no difference between the groups in Iowa Level of Assistance measures on day 6 or on LOS.
Conclusions
Patients who received twice-daily physiotherapy showed a trend toward earlier achievement of functional milestones; however, this finding did not translate to decreased LOS.
aPhysiotherapy Department, Wesley Hospital, Brisbane, Queensland, Australia
bArthritis Queensland, Brisbane, Queensland, Australia
cSchool of Mathematical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
Reprint requests to Kellie A. Stockton, BAppSc Physio, Grad Dip Physio, Arthritis Queensland, PO Box 2121, Windsor, Queensland 4030, Australia
Supported by the Wesley Research Institute (grant no. 2006/14) and ARC Linkage Project (grant no. LP0669670).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
ABSTRACT