Chest Expander Spring a Low Cost Home Physiotherapy-Based Exercise Rehabilitation after Total Hip Arthroplasty

Author(s): Bahaa Kornah, Saied K.Abdel-hameed, Abdel-hamid A. Atallah, Mohamed Ibrahem Abuelesoud, Tharwat Abdel ghany, Mohamed Abdelaziz, Mohamed Abdel-AAl, Nagi Saleem

Background: The demand for total hip arthroplasty (THA) is rising. Postoperative exercise rehabilitation helps patients recover normal joint functions by strengthening the muscles surrounding the replaced hip joint. In the face of rapidly increasing health care costs, ensuring widespread, cost-effective rehabilitation is a priority. However, the high cost of professionally supervised exercise rehabilitation programs limits access to program participation and, thus, to optimal recover of normal joint functions. Therefore, the development of an effective home-based, self-monitored exercise rehabilitation program is critical to promote the optimal recovery of THR patients.

Purpose: The aim of this study was to assess the feasibility, evaluate the effectiveness of a specific Progressive Resistance Exercise program for improving hip muscles strength, resorting hip joint mobility and address the functional needs of the patient treated with primary total hip arthroplasty. Additionally; spreading the idea of a low-cost post-operative rehabilitation program using chest expander spring.

Study Design: Prospective case series study.

Patients and Methods: This was a prospective single-center clinical study with a 12-week intervention program carried out in an outpatient clinic and in home based. 120 patients (84 males) had been enrolled in this study to which primary total hip arthroplasty had been done. Patients were evaluated preoperatively, at baseline, 2 weeks postoperative, one week following last visit of follow-up and at 6 months postoperatively. Clinical outcome measures involved: Harris Hip Score (HHS), Oxford Hip Score (OHS), WOMAC activity score, range of hip movements (ROM), Timed Get Up and GO Test and 6 Minutes walking test.

Results: The study included 120 patients (84 males). The mean age 65.3 years (range = 53-76 years). Results of clinical functional outcomes showed a progressive improvement at follow ups regarding : Harris Hip Score, Oxford Hip Score, WOMAC activity score ( related to pain, stiffness and physical functions), range of hip motions, time effect for Get up-and-go test and 6-minute walking distance test. The improvement is more achieved in last follow up visit and after 6 months postoperative.

Conclusions: The study demonstrates that this novel low-cost solution holds promise in rehabilitation after THA, ensuring better clinical outcomes than conventional rehabilitation while reducing dependence on human resources. Considering the low cost and convenience of a home-based resistance training program, health professionals should consider this and similar exercise programs when providing guidance to THR patients particularly in low-income countries.

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