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Volume 90, Issue 10, Pages 1658-1667 (October 2009)


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Early Maximal Strength Training Is an Efficient Treatment for Patients Operated With Total Hip Arthroplasty

Vigdis S. Husby, MScabdCorresponding Author Informationemail address, Jan Helgerud, PhDbe, Siri Bjørgen, MScb, Otto S. Husby, PhD, MDabd, Pål Benum, PhD, MDd, Jan Hoff, PhDbc

Abstract 

Husby VS, Helgerud J, Bjørgen S, Husby OS, Benum P, Hoff J. Early maximal strength training is an efficient treatment for patients operated with total hip arthroplasty.

Objective

To compare muscle strength, work efficiency, gait patterns, and quality of life in patients undergoing total hip arthroplasty (THA) randomly assigned to either maximal strength training or a conventional rehabilitation program.

Design

A randomized controlled study.

Setting

Research laboratory, rehabilitation center, and physical therapy clinic.

Participants

Patients (N=24) with osteoarthritis as the main reason for THA were randomly assigned to perform maximal strength training (n=12) or conventional rehabilitation (n=12).

Interventions

The maximal strength training group (STG) performed maximal strength training in leg press and abduction with the operated leg only 5 times a week for 4 weeks in addition to the conventional rehabilitation program. The conventional rehabilitation group (CRG) received supervised physical therapy 3 to 5 times a week for 4 weeks.

Main Outcome Measures

1-repetition maximum (1RM) leg press strength, 1RM abduction strength, rate of force development (RFD), work efficiency, gait patterns, and quality of life.

Results

1RM increased in the bilateral leg press (P<.002) and in the operated leg separately (P<.002) in the STG compared with the CRG. 1RM abduction strength in the operated leg (P<.002) and the healthy leg (P<.002) increased in the STG compared with the CRG. RFD increased in the STG compared with the CRG (Pg=.030), followed by a trend towards increased peak force in the STG (Pg=.053) (Pg = probability for differences between groups). Work efficiency tended to improve in the STG compared with the CRG (P=.065). No differences in gait patterns were revealed between the groups after the training intervention.

Conclusions

Early maximal strength training 1 week postoperatively is feasible and an efficient treatment to regain muscular strength for patients who have undergone THA, demonstrated by a significantly larger increase in muscular strength and a trend towards a better work efficiency in the STG compared with the CRG.

a Faculty of Health Education and Social Work, Sør-Trøndelag University College, Trondheim, Norway

b Faculty of Medicine, Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway

c Department of Physical Medicine and Rehabilitation, St. Olav‘s University Hospital, Trondheim, Norway

d Department of Orthopaedics, St. Olav's University Hospital, Trondheim, Norway

e Hokksund Medical Rehabilitation Centre, Hokksund, Norway

Corresponding Author InformationReprint requests to Vigdis S. Husby, MSc, Sør-Trøndelag University College, Ranheimsveien 10, NO-7004, Trondheim, Norway

 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.

 Clinical Trials ID: 00638417.

PII: S0003-9993(09)00400-6

doi:10.1016/j.apmr.2009.04.018


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