Exercise Intervention Targeting Hip Strengthening Compared to Usual Care in Patients Undergoing Revision Hip Replacement

Summary

There is sparse evidence on revision total hip replacement (THR), regarding the effectiveness on pain and function, and no consensus exists on optimal rehabilitation after revision THR. Further, patients undergoing revision THR achieve worse clinical outcomes on hip pain and function compared to patients undergoing primary THR. The primary aim of this randomized controlled trial is to compare the clinical effectiveness of a partly tele-delivered exercise intervention targeting hip strengthening with the standard community-based rehabilitation (usual care) in patients undergoing revision THR. The investigators will test the hypothesis that the exercise intervention targeting hip strengthening is superior to standard community-based rehabilitation in improving physical function measured with the 30-second Chair Stand Test at 16-week follow-up.

Conditions

• Revision Total Hip Arthroplasty

Interventions

OTHER

Exercise Intervention Targeting Hip Strengthening

An initial 16-week exercise intervention of 45 minutes of training 3 times a week in the patient's own home or at a rehabilitation center. Patients will be instructed by a physiotherapist during the first 3 sessions, in order to be able to perform the exercises at home. Subsequently, there are physiotherapist-supervised sessions once every second week. The delivery of the supervised sessions is based on the patient's preferences, either by physical attendance or remotely in the patient's home. The intervention will consist of 4 exercises adapted from the NEMEX program targeting lower extremity muscle strength, stability, postural function, and postural orientation. Progression is made when an exercise is performed with good sensorimotor control and good performance quality and with minimal exertion and adequate movement control. Progression is primarily provided by 3 levels of difficulty and secondly by varying the number of repetitions or where possible, by increasing the weight load.

OTHER

Usual Care

The intervention will consist of a rehabilitation intervention corresponding to standard care in the participating municipalities (i.e. content and duration of intervention). The intervention will be delivered individually or as group training, based on a clinical assessment of the individual patients' needs. The intervention can be supported by home-based exercises following instruction from a physiotherapist, supplemented by the provision of written information or access to a virtual training program. The intervention occurs in either the rehabilitation center's gym or the patient's home. The training sessions may consist of some of the following parameters: Strength training, stretching, functional training e.g. walking and stair climbing, stability training, balance training, endurance training, and gait correction.

Sponsors & Collaborators

• Aarhus University Hospital

  collaborator OTHER

• Vejle Hospital

  collaborator OTHER

• Regionshospitalet Silkeborg

  collaborator OTHER

• Gødstrup Hospital

  collaborator OTHER

• Viborg Regional Hospital

  collaborator OTHER

• Odense University Hospital

  collaborator OTHER

• Bispebjerg Hospital

  collaborator OTHER

• University Hospital, Gentofte, Copenhagen

  collaborator OTHER

• University of Aarhus

  lead OTHER

Principal Investigators

• Martin B Stisen, MSc · Aarhus University Hospital and Aarhus University

• Inger Mechlenburg, Prof. · Aarhus University Hospital and Aarhus University

• Alma B Pedersen, Prof. · Aarhus University Hospital and Aarhus University

• Troels Kjeldsen, MSc · Aarhus University Hospital and Aarhus University

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2022-11-25

Primary Completion

2024-12-03

Completion

2027-12-01

Countries

• Denmark

Study Locations