OBJECTIVE: To evaluate the effect of home versus in-hospital exercise (under supervision) programmes on hip strength, gait speed and cadence in patients with total hip arthroplasty at least one year after operation. SETTING: Physical therapy and rehabilitation department. SUBJECTS: Twenty-six patients who had had a total hip arthroplasty operation 12 to 24 months prior to the study were enrolled. INTERVENTIONS: The patients were randomized into three groups: group 1 patients were assigned a home exercise programme, group 2 patients exercised under physiotherapist supervision in hospital, and group 3 served as the control group, with no specific intervention. The study duration was six weeks. MAIN MEASURES: Maximum isometric abduction torque of operated hip muscle, gait speed and cadence were measured before and after the study. RESULTS: Maximum isometric abduction torques of the hip abductor muscles improved in groups 1 and 2, but not in group 3 (30 +/- 12 to 38 +/- 11 ft.lb in group 1, 18 +/- 10 to 30 +/- 9.8 ft.lb in group 2). Gait speed improved from 67.8 +/- 23 to 74.35 +/- 24 m/min in group 1, from 48.53 +/- 4 to 56.7 +/- 5 m/min in group 2 and from 58.01 +/- 12 to 59.8 +/- 14 m/min in group 3. Cadence also improved, from 97.7 +/- 18 to 111 +/- 17 steps/min in group 1, from 90.75 +/- 6 to 104.75 +/- 7 steps/min in group 2, and from 87 +/- 16 to 88.22 +/- 16 steps/min in group 3. When the three groups were compared, group 2 showed the best improvement (p = 0.006) only in maximum isometric abduction torque. CONCLUSION: Our findings suggest that both home and supervised exercise programmes are effective one year after total hip arthroplasty. Home exercise programmes with close follow-up could be recommended.

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