Recovery after total hip joint arthroplasty in elderly patients with osteoarthritis: positive effect of upper limb interval-training.

OBJECTIVE: To evaluate the influence of an interval training program for the upper limbs on cardiorespiratory fitness and walking ability in elderly patients after total hip joint arthroplasty. DESIGN: A randomized controlled trial. After surgery, control and training groups started general rehabilitation. Training group combined it with an arm-interval exercise program (3 sessions of 30 minutes per week, for 6 weeks). SUBJECTS: Patients were assigned randomly to control (n = 7) and training groups (n = 7). METHODS: Incremental exercise tests were carried out until exhaustion on an arm crank ergometer 1 month before and 2 months after surgery. A 6-minute walk test was also performed 2 months after surgery. RESULTS: VO2 peak increased significantly in the training group (p = 0.0424) and did not change in the control group. The difference in VO2 peak change between the groups was significant (p = 0.0362, +19.2% in the training group and -3.5% in the control group). In the walking test the training group covered a significantly longer distance than did the control group (p = 0.0055, 396.4 metres and 268.1 metres, respectively). CONCLUSION: These results stress the importance of physical training in a rehabilitation program after total hip joint arthroplasty and this should be considered for improving the current practices in rehabilitation.

A specific arm-interval exercise program could improve the health status and walking ability of elderly patients after total hip arthroplasty: a pilot study.

OBJECTIVE: To investigate the influence of an arm-interval exercise program for the upper limbs on health status and walking ability in elderly patients after total hip arthroplasty. DESIGN: A randomized controlled investigation. After surgery, a control group started a general rehabilitation program, and a training group combined it with an arm-interval exercise program. SUBJECTS: Fourteen patients (age 75.1 +/- 4.8 years) were randomly assigned to the control group (n = 7) and the training group (n = 7). METHODS: A Western Ontario and MacMaster University (WOMAC) Osteoarthritis Index was completed and an incremental exercise test on an arm crank ergometer was also performed 1 month before (T(-1)) and 2 months after surgery (T2). Moreover, a 6-minute walk test was performed at T2. RESULTS: Both groups significantly improved all dimensions of WOMAC, except in WOMAC physical function subscale in the control group. The training group covered a significantly longer distance in the walking test than the control group and also presented significantly higher VO2 peak value at T2. Correlation analyses indicate that VO2 peak value and the distance covered in the 6-minute walking test were significantly associated with functional status. After calculating the ratio distance covered/score at WOMAC physical function, we observed a significantly higher ratio value in the training group than in the control group. CONCLUSION: Preliminary results indicate that the improvement in physical fitness and functional status of the training group seems to be associated with better health status.

Influence of a 6-week arm exercise program on walking ability and health status after hip arthroplasty: a 1-year follow-up pilot study.

The influence of an upper-limb interval-training program after total hip arthroplasty (THA) in elderly patients was studied during a 1 yr follow-up on health status and walking ability. After surgery, 14 patients were randomly assigned to the control group that started a 6 wk general rehabilitation program or the training group that combined it with an interval exercise program on an arm ergometer. A Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index was completed 1 mo before and 2 mo and 1 yr after surgery. A 6 min walking test was performed at 2 mo and 1 yr after surgery. The training group covered a significantly longer distance than the control group in the 6 min walk test and obtained significantly lower WOMAC scores both at 2 mo and 1 yr after surgery. However, both groups significantly improved in WOMAC and in their performance during the survey. Endurance-type upper-body aerobic training in a rehabilitation program might be important after THA.