Effects of supervised exercise compared to non-supervised exercise early after total hip replacement on patient-reported function, pain, health-related quality of life and performance-based function - a systematic review and meta-analysis of randomized controlled trials
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Sebrina Hansen1, Jens Aaboe2, Inger Mechlenburg3
11 Center of Rehabilitation, Municipality of Slagelse, Slagelse, Denmark.
Background::
The rehabilitation after a total hip replacement varies in degree of supervision; however, it remains unknown whether supervised programmes are more effective than non-supervised.
Objective::
This study compared the effectiveness of supervised exercise compared to non-supervised home-based exercise after total hip replacement on patient-reported function, hip-pain, health-related quality of life and performance-based function.
Methods::
A systematic review and meta-analysis of randomized controlled trials investigating the effect of supervised exercise compared to non-supervised home-based exercise. An electronic search was performed in Medline, Embase and CINAHL on 14 March 2018. The methodological quality was assessed using the Cochrane Risk of Bias tool.
Results::
Seven studies were included with a total of 389 participants. A small and non-significant difference in favour of the supervised groups was found in patient-reported function (standardized mean difference (SMD) -0.22 (95% confidence interval (CI) -0.46 to 0.02)), hip-related pain (SMD -0.03 (95% CI -0.27 to 0.21)), health-related quality of life (mean difference (MD) -3.08 (95% CI -6.29 to 0.14)) and performance-based function (SMD -0.26 (95% CI -0.68 to 0.17)) at end of treatment and in patient-reported function (MD -1.31 (95% CI -3.79 to 1.16)) at the 6- to 12-month follow-up.
Limitations::
The literature search was systematic, but limited to three databases. The overall quality of evidence was downgraded to moderate due to lack of blinding in included studies.
Conclusion::
Supervised exercise was not significantly effective compared to non-supervised home-based exercise on patient-reported function, pain, health-related quality of life and performance-based function after primary total hip replacement.
Others::
PROSPERO registration number: CRD42017055604.
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