A targeted home- and center-based exercise program for people after total hip replacement: a randomized clinical trial

Arch Phys Med Rehabil. 2008 Aug;89(8):1442-7. doi: 10.1016/j.apmr.2007.11.058. Epub 2008 Jun 30.


Objective: To examine the physical function, gait, and quality of life of patients after total hip replacement (THR) randomly assigned to either a targeted home- or center-based exercise program.

Design: Randomized controlled trial.

Setting: Rehabilitation research center in Australia.

Participants: Twenty-three patients with unilateral THR were randomly assigned to a supervised center-based exercise group (n=11) or an unsupervised home-based exercise group (n=12).

Intervention: The center-based group completed an 8-week targeted exercise program while under the direct supervision of a physiotherapist. After initial instruction, the home-based group completed the 8-week targeted exercise program at home without further supervision.

Main outcome measures: Quality of life, physical function, and spatiotemporal measures of gait.

Results: No significant interaction (group by time) or main effects of grouping were found. Within each group, quality of life, and stair climbing improved significantly (P<.05) as did Timed Up & Go test and 6-minute walk test performances (P<.05). Walking speed increased by 16 cm/s (P<.01), cadence by 8 steps/min (P<.05), step length by 4.7 cm (P<.05), and double-support time reduced by a factor of 16%. Step length symmetry showed significant improvement (P<.05) over time. Step length differential between the affected and unaffected limbs reduced from 4.0 to 2.7 cm.

Conclusions: The targeted strengthening program was effective for both the home- and center-based groups. No group differences were found in the majority of the outcome measures. This finding is important because it shows that THR patients can achieve significant improvements through a targeted strengthening program delivered at a center or at home.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Analysis of Variance
  • Arthroplasty, Replacement, Hip / rehabilitation*
  • Exercise Therapy / organization & administration*
  • Female
  • Gait*
  • Hip Fractures / complications
  • Hip Fractures / surgery
  • Home Care Services / organization & administration*
  • Humans
  • Length of Stay
  • Male
  • Muscle Strength
  • Muscle Weakness / etiology
  • Muscle Weakness / rehabilitation
  • Osteoarthritis / complications
  • Pain / etiology
  • Pain / prevention & control
  • Physical Endurance
  • Physical Fitness
  • Quality of Life*
  • Self Care
  • Treatment Outcome