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Titre : | Preoperative Home-Based Physical Therapy Versus Usual Care to Improve Functional Health of Frail Older Adults Scheduled for Elective Total Hip Arthroplasty: A Pilot Randomized Controlled Trial (2012) |
Auteurs : | E. Oosting ; M.P. Jans ; J.J. Dronkers |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (2012/4, 2012) |
Article en page(s) : | pp 610-616 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Arthrose ; Etudes de faisabilité ; Personne âgée fragile ; Rééducation et réadaptation |
Mots-clés: | Arthroplasty ; replacement ; hip ; Feasibility studies ; Frail elderly ; Osteoarthritis ; Arthroplastie prothétique de hanche |
Résumé : |
Objective To investigate the feasibility and preliminary effectiveness of a home-based intensive exercise program to improve physical health of frail elderly patients scheduled for elective total hip arthroplasty (THA). Design Single-blind pilot randomized controlled trial. Setting Patients' homes and a general hospital in The Netherlands. Participants Frail patients (N=30) older than 65 years. Intervention A preoperative, home-based program supervised by an experienced physical therapist to train functional activities and walking capacity. The control group received usual care consisting of 1 session of instructions. Main Outcome Measures Feasibility was determined on the basis of adherence to treatment, patient satisfaction, adverse events, walking distance (measured with a pedometer), and intensity of exercise (evaluated with the Borg scale). Preliminary pre- and postoperative effectiveness was determined by the Timed Up & Go (TUG) test, 6-minute walk test (6MWT), Chair Rise Time, and self-reported measures of functions, activities, and participation. Results Patient satisfaction and adherence to the training were good (median=5 on a 5-point Likert scale) and no serious adverse events occurred. The Borg score during training was 14 (range, 1316). Preoperative clinical relevant differences on the TUG test (2.9s; 95% confidence interval [CI], −0.9 to 6.6) and significant differences on the 6MWT (41m; 95% CI, 8 to 74) were found between groups. Conclusions Intensive preoperative training at home is feasible for frail elderly patients waiting for THA and produces relevant changes in functional health. A larger multicenter randomized controlled trial is in progress to investigate the (cost-)effectiveness of preoperative training. |
Disponible en ligne : | Oui |
En ligne : | http://www.archives-pmr.org/article/S0003-9993%2811%2900970-1/abstract |