The objective of this study was to determine do patients do better with unsupervised home PT or in an outpatient setting Are the outcomes after a supervised (centre-based) and an independent (home-based) physical rehabilitation program delivered in the early post-discharge phase (<8weeks) equivalent in an adult THR population.
The participants included 98 adult post unilateral elective total hip replacement (THR) and they were randomly assigned to supervised/centre-based exercise (n=56) or unsupervised/home exercise (n=42) and followed 6 months post-surgery. The supervised group attended a 4 week outpatient rehabilitation program supervised by a physiotherapist. The unsupervised group was given written and pictorial instructions to perform rehabilitation independently at home.
The WOMAC, SF-36 mental and physical component scores(MCS and PCS) questionnaires, the UCLA activity rating and the Timed up and Go test (TUG). There were no differences between groups for any measure. Overall differences between the adjusted means were: WOMAC 0.5 [-6.75, 5.73], SF-36 PCS 0.8 [-6.5 – 8.1], SF-36 MCS 1.7 [-4.1 – 7.4], UCLA 0.3 [5.19, 6.10] and TUG 0 secs [-1.4 – 1.3].
Results demonstrated that outcomes in response to rehabilitation after THR are clinically and statistically similar whether the program was supervised or not. The results suggest that early rehabilitation programs can be effectively delivered unsupervised in the home to low-risk patients discharged home after THR. However, the relative effect of late stage rehabilitation was not tested.