Abstrakt til fysioterapeut Ruth Bitterlis kandidatafhandling "Pre-operative, sensory-motor training for patients undergoing Total Hip Replacement: a Randomised Controlled Trial"
Læs hele afhandlingen bragt i International Journal of Sports Medicine 2011/05/31 (engelsk)
Læs hele afhandlingen i "Physikalische Medizin Rehabilitationsmedizin Kurortmedizin 4/2009 (tysk)
Kontakt Ruth Bitterli
"Pre-operative, sensory-motor training for patients undergoing Total Hip Replacement: a Randomised Controlled Trial"
af J. Sieben, M. Hartmann, E. de Bruin og Ruth Bitterli, PT, MScPT, Physiotherapy Science Studies, Department of Rheumatology and Institute of Physical Medicine, University Hospital Zurich, Switzerland, and Faculty of Health, Medicine and Life Sciences, Maastricht University, 2009
Background
Studies to pre-operative force and endurance training programmes show unclear effect.
Objektive
The aim of this study was to investigate whether pre-operative, sensory-motor movement training results in improved Physical Function, Quality of Life and Sensory-Motor Function as well as reduced Disability in patients undergoing Total Hip Replacement.
Methods
80 subjects awaiting Total Hip Replacement (mean age 66.8 ±10.3; 31 women) were recruited 2004-2007. The intervention group undertook a pre-operative 2-6 week home exercise training programme, the control group received no therapy. The Primary Outcome Measure was Physical Function, secondary Outcome Measures were Quality of Life, Disability and Sensory-Motor Function.
Outcomes were measured using patient administered generic (SF-36) and disease-specific (WOMAC) questionnaires as well as objectively assessed balance ability (Biodex Balance System). Measurements were taken one day before operation and 10 days, 4 and 12 months following. Treatment effect was determined pre-operatively with t-test and post-operatively with analysis of variance as well as effect size.
Results
The intervention improved Quality of Life (subscale pain; p<0.05) and Sensory-Motor Function (balance ability; p<0.05) compared to no intervention before operation. These effects were lost following surgery. The intervention group estimated Disability (p=0.055) at 4 months more negatively than the control group. At one year follow-up group-membership influenced Quality of Life score (subscales vitality and mental health; p<0.05) different depending on the measurement time point.
Conclusions
No useful effect was identified for a short-term pre-operative sensory-motor training programme for this study subjects. The intervention appears to have initiated a psychosomatic process. Further studies are needed to assess whether a personalized, ability specific home programme would be more effective. The psychological aspects following Total Hip Replacement need to be considered in such a training programme in order to facilitate coping strategies, reduce unrealistic expectations and increase satisfaction.
Key words
Total Hip Replacement, Functional Ability, Health Related Quality of Life, Pre-Operative Training
Redigeret af : Mette Winsløw, 23.08.2011
Til top