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Early maximal strength training is an efficient treatment for patients operated with total hip arthroplasty
Husby VS, Helgerud J, Bjorgen S, Husby OS, Benum P, Hoff J
Archives of Physical Medicine and Rehabilitation 2009 Oct;90(10):1658-1667
clinical trial
5/10 [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: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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 < 0.002) and in the operated leg separately (p < 0.002) in the STG compared with the CRG. 1RM abduction strength in the operated leg (p < 0.002) and the healthy leg (p < 0.002) increased in the STG compared with the CRG. RFD increased in the STG compared with the CRG (Pg = 0.030), followed by a trend towards increased peak force in the STG (Pg = 0.053) (Pg = probability for differences between groups). Work efficiency tended to improve in the STG compared with the CRG (p = 0.065). 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.

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