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Abstract
Background: Recently the shift towards reductions in the length of stay following total hip replacement (THA) has caused a shift in rehabilitation to community services. Functional limitations of patients post-surgery have continued to be reported.
Objective: To evaluate the evidence for the effectiveness of delayed rehabilitation programmes in patients following THR.
Methods: Published research was identified by searching The Cochrane Central Register of Controlled Trials, PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Sports Discus, Web of Science, and PEDro databases. Randomised controlled trials and controlled clinical trials published up to 1 January 2013 were included, which evaluated delayed rehabilitation programmes after THR.
Two review authors independently assessed the methodological quality of the included trials using a descriptive approach as advocated by the Cochrane Musculoskeletal group.
Results: Six studies met the criteria for review. The quality of studies was low: five of the six studies were categorized as having a high level of bias with regard to either allocation concealment or sequence generation. Owing to the poor quality of the included trials and the substantial heterogeneity, it was decided that it was not appropriate to pool the data for meta-analysis. Analyses of the outcome data for individual studies using weighted mean difference (WMD) are presented where data was available.
Conclusions: There is limited low grade evidence that delayed rehabilitation post THR may improve gait speed and hip abductor strength. This highlights the need for further high quality randomised controlled trials to investigate this area of rehabilitation.
Acknowledgements
The authors gratefully acknowledge funding support from the Irish Health Research Board Research Training Fellowship for Healthcare Professionals 2011.