Outpatient physiotherapy rehabilitation for total hip replacement: comparison of current practice with clinical evidence

Abstract

Background/Aims: Literature supports outpatient physiotherapy rehabilitation following total hip replacement. Current physiotherapy practice for this patient cohort is unknown. This study aimed to establish current physiotherapy practice for outpatient total hip replacement rehabilitation in Australia, and compare current practice with clinical evidence. Methods: An online self-administered questionnaire was designed to reveal current practice for physiotherapy rehabilitation following hospital discharge of total hip replacement patients. The questionnaire was distributed to 151 Australian physiotherapists involved in the care of total hip replacement patients. Findings: A response rate of 77% (116/151) was obtained. Current practice consists of: referral for outpatient physiotherapy, three to four sessions of physiotherapy at a frequency of one to two times a fortnight; commence within two weeks of hospital discharge and last five to six weeks. They include strengthening, education on hip precautions and exercise progression, gait retraining, stairs practice, range of motion exercises. Physiotherapy sessions are complemented by a home exercise programme. Conclusions: The high rate of referral for outpatient physiotherapy and provision of home exercise programmes are evidence-based. The infrequent use of resistance in strength training does not align with current evidence. There is insufficient literature regarding content, timing, frequency and duration to advise whether current practice regarding these aspects is evidence-based.