Effects of progressive resistance training prior to total HIP arthroplasty – a secondary analysis of a randomized controlled trial

Abstract

To investigate 1-year postoperative effect of preoperative resistance training (RT) in patients undergoing total hip arthroplasty (THA) on patient-reported outcomes on activity and function and objective outcomes on muscle strength and physical performance. A 3-12 months follow-up of a randomized controlled trial. Patients scheduled for THA were randomized into: RT-group, twice a week for 10 weeks prior to THA, or 'care-as-usual' (CG). Primary endpoint of this sequel analysis is HOOS-ADL at 12 months follow-up. Secondary outcome measures are; other HOOS subscales, knee- and hip muscle strength plus function (gait, ascending/descending stairs, and sit-to-stand) at three and/or 12 months. CLINICALTRIALS.GOV: NCT01164111. Eighty patients (70% women, 70.4±7.6 years, BMI of 27.8±4.6) were randomized to RT (n=40) or CG (n=40); data from 85% were available at 12 months. No superior effects were observed at 12 months for HOOS ADL (between-group change score [95%CI]) (2.6 [-4.2; 9.8], P=0.44) or remaining subscales. However, ascending (1.3s [0.3; 2.3], P=0.01)) and descending stairs (1.6s [0.3; 2.9], P=0.01) demonstrated additional effects. At 3 months clinically relevant change-scores in favour of RT was observed on HOOS-Sport/Rec (10.5 points [1.4; 19.6], P=0.023), together with higher knee strength of the affected side (14.6 Nm [6.3; 22.9], P<0.001), and selected outcomes of physical function. At 12 months after surgery, there was no additional effect of preoperative RT compared with THA alone, but rehabilitation was accelerated at 3 months.