What does standard rehabilitation practice after total hip replacement in the UK entail?

There is evidence of prolonged poor function in patients after total hip replacement (THR). Studies of progressive resistance training (PRT) interventions to improve function are often compared to ‘standard’ practice which is not well defined. This study aimed to investigate ‘standard’ rehabilitation care in the UK after total hip replacement (THR) as well as determine whether PRT was part of ‘standard’ care.  After ethical approval, questionnaire item development about rehabilitation practice was guided by a focus group interview (after informed consent) with physiotherapists (n = 4; >5 years post-qualification) who regularly treated THR patients. An online questionnaire investigating the exercises prescribed and rehabilitation practice following THR was developed and sent to physiotherapists working in hospitals in the UK. The survey was performed from January to May 2011. The survey results were analysed (frequency (%) of responses) focusing on the exercises the physiotherapists thought were important, in addition to their use of PRT in prescribed regimes.  106 responses were gathered from physiotherapists in the UK. The survey respondents considered that the most important muscles to target in all phases of rehabilitation were the hip abductors (62.2%), followed by the quadriceps (16.9%), and other muscles (21%). Exercise type prescribed revealed no consensus, with weight bearing (42%), functional (45%) and Bed-based/Bridging/Postural exercises (13%) favoured. 83.7% were able to define the basis of progressive resistance training (PRT), but only 33% prescribed it.

The authors found that standard physiotherapy rehabilitation in the UK after THR is variable, and appears to rarely include PRT. They concluded that this could be a factor in prolonged poor function in some patients after this common operation.

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Benenden Hospital

An interesting post, it is important that the correct care is taken to look after a patient has gone through THR. It is a big change for the patient so care does need to be taken in their rehabilitation.

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