Abstract
Background: Home-based rehabilitation exercise following Total Hip Arthroplasty (THA) shows similar outcomes compared to supervised outpatient rehabilitation exercise. Little is known about patients' experiences with home-based rehabilitation, and this study aimed to investigate how patients perceived home-based rehabilitation exercise and general physical activity after THA, focusing on facilitators and barriers. Methods: Semi-structured interviews of qualitative design were conducted with 22 patients who had undergone THA and who had performed home-based rehabilitation exercise. The study took place in a regional hospital in Denmark between January 2018 and May 2019. Data were analyzed using an interpretive thematic analysis approach, with theoretical underpinning from the concept ‘conduct of everyday life’. The study is embedded within the Pragmatic Home-Based Exercise Therapy after Total Hip Arthroplasty-Silkeborg trial (PHETHAS-1). Results: The main theme, ‘wishing to return to the well-known everyday life’, and the subtheme ‘general physical activity versus rehabilitation exercise’ were identified. Generally, participants found the home-based rehabilitation exercise boring but were motivated by the goal of returning to their well-known everyday life and performing their usual general physical activities. Participants enrolled in the PHETHAS-1 study used the enrollment as part of their motivation for doing the exercises. Both pain and the absence of pain were identified as barriers for doing home-based rehabilitation exercise. Pain could cause insecurity about possible medical complications, while the absence of pain could lead to the rehabilitation exercise being perceived as pointless. Conclusions: The overall goal of returning to the well-known everyday life served as a facilitator for undertaking home-based rehabilitation exercise after THA along with the flexibility regarding time and place for performing exercises. Boring exercises as well as both pain and no pain were identified as barriers to the performance of home-based rehabilitation exercise. Participants were motivated towards performing general physical activities which were part of their everyday life.
Highlights
Total hip arthroplasty (THA) is a common surgical intervention in Western countries
The analysis of the data resulted in the identification of the main theme, ‘wishing to return to the well-known everyday life’, which is expanded on below, including the subtheme ‘general physical activity versus rehabilitation exercise’
Based on analysis of 22 interviews with participants who had undergone Total Hip Arthroplasty (THA) surgery we found that participants had a goal of returning to their habitual conduct of everyday life after their THA surgery, and this goal served as a main facilitator for performing the home-based rehabilitation exercise program
Summary
Total hip arthroplasty (THA) is a common surgical intervention in Western countries. It is often performed as fast-track surgery and the number of THAs has been rising.[1,2] Fast-track surgery has proven to be effective in terms of reducing costs, length of hospital stay, morbidity, and convalescence.[3,4] In Denmark alone, 11,000 THAs are performed every year,[5] with patients routinely being discharged from the hospital within two days of surgery.[6]Rehabilitation exercise is a customary part of the postoperative program for patients undergoing THA, in the expectation that it will reduce pain and increase mobility.[7]. Total hip arthroplasty (THA) is a common surgical intervention in Western countries. It is often performed as fast-track surgery and the number of THAs has been rising.[1,2] Fast-track surgery has proven to be effective in terms of reducing costs, length of hospital stay, morbidity, and convalescence.[3,4] In Denmark alone, 11,000 THAs are performed every year,[5] with patients routinely being discharged from the hospital within two days of surgery.[6]. Participants found the home-based rehabilitation exercise boring but were motivated by the goal of returning to their well-known everyday life and performing their usual general physical activities. Participants enrolled in the PHETHAS-1 study used the enrollment as part of their motivation for version 2
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