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Effectiveness of a Home-Based Video-Guided Hip Muscle Exercise Program in Elderly Patients Following Bipolar
Chawarat Sripon1, Atiporn Therdyothin1, Tanawat Amphansap1
1Department of Orthopedics, Police General Hospital, Bangkok, THA.
Background:
Physical therapy after a femoral neck fracture is essential but is limited by poor compliance and incorrect exercise. To improve this, we developed the home-based video-guided music program (HBW-MV) program. We hypothesize that this program will improve functional outcome.
Study Design And Methods:
This was a randomized controlled trial from 2023 to 2024 on elderly patients with cementless bipolar hemiarthroplasty after femoral neck fracture. Thirty patients were equally allocated into the intervention group and the control group. Both received pre-discharge physical therapy instructions from an orthopedic trainee. Functional outcomes were assessed using Harris Hip Score (HHS) from two to 12 weeks. Hip strength was measured by a handheld dynamometer. Anxiety and pain were assessed using a visual analog scale. Compliance was assessed by a record table.
Results:
Both groups showed an increase in HHS at two, six, and 12 weeks postoperatively. The intervention group demonstrated significantly higher HHS compared with the control group at all time points, with mean scores of 49.40±6.10, 65.20±6.09, and 82.30±5.85 versus 39.73±7.80, 53.53±5.84, and 67.67±6.33, respectively (p<0.05). At the 12-week follow-up, significantly higher hip muscle strength in abduction, adduction, and flexion was observed in the intervention group relative to the control group (p < 0.05), whereas hip extension strength, although improved in both groups, did not show a statistically significant between-group difference. At both six and 12 weeks postoperatively, anxiety scores were significantly reduced in the intervention group relative to the control group (six weeks: 2.87±0.91 vs 3.47±0.64, p=0.023; 12 weeks: 1.47±0.51 vs 2.27±0.96, p=0.004). Postoperative pain scores were also significantly lower in the intervention group at 12 weeks (1.20±0.41 vs 1.93±0.88, p=0.004). Patient compliance with the rehabilitation program was significantly higher in the intervention group at six and 12 weeks.
Conclusions:
This research shows the HBW-MV program significantly improved functional outcomes, hip strength, and compliance. Additionally, it reduced anxiety and postoperative pain effectively.