The effect of exercise on hip muscle strength, gait speed and cadence in patients with total hip arthroplasty: a randomized controlled study

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Abstract
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—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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