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
| Autor: | Jaap Dronkers, Suzan M. Appelman-de Vries, E. Oosting, M.P. Jans, Nico L. U. van Meeteren, Roelfrieke H. Naber, Christa M. Dronkers-Landman |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Arthroplasty Replacement Hip Frail Elderly medicine.medical_treatment Pilot Projects Physical Therapy Sports Therapy and Rehabilitation Statistics Nonparametric law.invention Disability Evaluation Postoperative Complications Physical medicine and rehabilitation Patient satisfaction Randomized controlled trial law Preoperative Care Humans Medicine Adverse effect Physical Therapy Modalities Aged Aged 80 and over Motivation Rehabilitation business.industry Home Care Services Arthroplasty Confidence interval Test (assessment) Treatment Outcome Patient Satisfaction Pedometer Linear Models Physical therapy Feasibility Studies Patient Compliance Female business human activities |
| Zdroj: | Archives of Physical Medicine and Rehabilitation. 93:610-616 |
| ISSN: | 0003-9993 |
| DOI: | 10.1016/j.apmr.2011.11.006 |
| Popis: | 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. 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. © 2012 by the American Congress of Rehabilitation Medicine. |
| Databáze: | OpenAIRE |
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