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

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 (P_g=.030), followed by a trend towards increased peak force in the STG (P_g=.053) (P_g = 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.

Key Words: Arthroplasty, Hip, Rehabilitation

List of Abbreviations: ASA, American Society of Anesthesiologists, CRG, conventional rehabilitation group, MCS, mental component score, PCS, physical component score, PF, peak force, REE, resting energy expenditure, RFD, rate of force development, RM, repetition(s) maximum, SF-36, Medical Outcomes Study 36-Item Short-Form Health Survey, STG, strength training group, THA, total hip arthroplasty, Vo₂, oxygen consumption, V̇o₂max, maximum oxygen consumption