A Prospective Randomized Controlled Trial Assessing the Impact of Preoperative Combined with Postoperative Progressive Resistance Training on Muscle Strength, Gait, Balance and Function in Patients Undergoing Total Hip Arthroplasty

Guo Chen; Duoduo Yu; Yichen Wang; Zou Ma; Mengna Bi; Lisha Lu; Shangshang Zhang; Jiaxin Liu; Hu Chen; Hai Shen; Huiwu Zhang; Xiaobing Luo; Yan Si; Peng Zhang

doi:10.2147/CIA.S453117

A Prospective Randomized Controlled Trial Assessing the Impact of Preoperative Combined with Postoperative Progressive Resistance Training on Muscle Strength, Gait, Balance and Function in Patients Undergoing Total Hip Arthroplasty

Clin Interv Aging. 2024 May 8:19:745-760. doi: 10.2147/CIA.S453117. eCollection 2024.

Authors

Guo Chen¹, Duoduo Yu², Yichen Wang¹, Zou Ma¹, Mengna Bi¹, Lisha Lu¹, Shangshang Zhang¹, Jiaxin Liu¹, Hu Chen¹, Hai Shen², Huiwu Zhang², Xiaobing Luo², Yan Si¹, Peng Zhang¹

Affiliations

¹ Department of Geriatric Orthopedics(1), Sichuan Provincial Orthopedic Hospital, Chengdu, Sichuan, 610041, People's Republic of China.
² Sichuan Provincial Orthopedic Hospital, Chengdu, Sichuan, 610041, People's Republic of China.

Abstract

Purpose: The aim of this study is to investigate the effects of a preoperative combined with postoperative moderate-intensity progressive resistance training (PRT) of the operative side in patients with hip osteoarthritis (HOA) who are undergoing total hip arthroplasty (THA). The study seeks to evaluate the impact of this combined intervention on muscle strength, gait, balance, and hip joint function in a controlled, measurable, and objective manner. Additionally, the study aims to compare the outcomes of this combined intervention with those of preoperative or postoperative muscle strength training conducted in isolation.

Methods: A total of 90 patients with HOA scheduled for unilateral primary THA were randomly assigned to three groups: Pre group (preoperative PRT), Post group (postoperative PRT), and Pre& Post group (preoperative combined with postoperative PRT) focusing on hip flexion, extension, adduction, and abduction of operated side. Muscle strength, gait parameters, balance, and hip function were assessed at specific time points during a 12-month follow-up period.

Results: All three groups showed significant improvements in muscle strength, with the Pre& Post group demonstrating the most pronounced and sustained gains. Gait velocity and cadence were significantly improved in the Pre& Post group at 1-month and 3-month postoperative follow-ups compared to the other groups. Similarly, the Pre& Post group exhibited superior balance performance at 3-month and 12-month postoperative follow-ups. The Harris Hip Score also showed better outcomes in the Pre& Post group at all follow-up intervals.

Conclusion: Preoperative combined with postoperative moderate-intensity PRT in HOA patients undergoing THA led to superior improvements in muscle strength, gait, balance, and hip joint function compared to preoperative or postoperative PRT alone. This intervention shows significant promise in optimizing postoperative rehabilitation and enhancing patient outcomes following THA.

Keywords: exercise therapy; gait variability; muscle strength; progressive resistance training; total hip arthroplasty.

Publication types

Randomized Controlled Trial

MeSH terms

Aged
Arthroplasty, Replacement, Hip* / rehabilitation
Female
Gait*
Hip Joint / surgery
Humans
Male
Middle Aged
Muscle Strength*
Osteoarthritis, Hip* / surgery
Postoperative Period
Postural Balance*
Prospective Studies
Range of Motion, Articular
Resistance Training* / methods
Treatment Outcome

Grants and funding

This research was funded by Sichuan Provincial Health Commission Cadre Health Research Project (grant number CGY2020-606); Sichuan Medical Association Youth Innovation Scientific Research Project (grant number Q19011); Sichuan Provincial Orthopedic Hospital Scientific Research Project (grant number 20ZD01).