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Effektivitat eines zusatzlichen ubungsprogramms in der ersten postoperativen woche nach implantation einer hufttotalendoprothese nach der OCM-methode (modifizierter anterior-lateraler zugangsweg) (Effectiveness of an adjunct training programme in the first post-surgical week following the implantation of a total hip arthroplasty using the OCM technique (modified anterolateral approach)) [German; with consumer summary]
Matheis C, Stoggl T
Physioscience 2016 Jun;12(2):47-54
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Among other things the development of a harmonic gait pattern is an important aim after a total hip arthroplasty (THA). Minimally invasive surgery techniques allow immediate full weight-bearing and serve as a good basis for minimizing post-surgical atrophy. OBJECTIVE: Improvement of the hip function using an additional selective mobilisation and strengthening exercise of the hip-surrounding muscles in order to ensure pelvic stability at full weight-bearing one week post-surgery. METHOD: The 13 patients after THA according to the OCM technique (modified anterolateral access) of this pilot study with a systematic block-randomised design with repeated measurements were allocated to an intervention group (n = 6) and a control group (n = 7). The control group performed standard physiotherapy and the intervention group completed an additional exercise programme focussing on coordination, stability and strengthening the gluteus muscles. The symmetrical performing of the one-leg stand on the affected side was tested. RESULTS: Within the intervention group the one-leg stand improved (p < 0.05), within the control group it tended to deteriorate (p < 0.1; interaction effect: time x group p < 0.05). CONCLUSION: An additional intensive exercise programme at full weight-bearing starting a few days after THR implantation according to the OCM surgery technique improves the one-leg stand already after one week compared to standard physiotherapy. The programme is therefore considered to be a reasonable and purposeful post-treatment intervention.

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