A Water Rehabilitation Program in Patients with Hip Osteoarthritis Before and After Total Hip Replacement
Marek Łyp, Ryszard Kaczor, Anna Cabak, Piotr Tederko, Ewa Włostowska, Iwona Stanisławska, Jan Szypuła, Wiesław Tomaszewski
Department of Physiotherapy, Rehabilitation College in Warsaw, Warsaw, Poland
Med Sci Monit 2016; 22:2635-2642
Pain associated with coxarthrosis, typically occurring in middle-aged and elderly patients, very commonly causes considerable limitation of motor fitness and dependence on pharmacotherapy. This article provides an assessment of a rehabilitation program with tailored water exercises in patients with osteoarthritis before and after total hip replacement.
MATERIAL AND METHODS: A total of 192 patients (the mean age 61.03±10.89) suffering from hip osteoarthritis (OA) were evaluated before and after total hip replacement (THR). The clinical study covered measurements of hip active ranges of motion (HAROM) and the forces generated by pelvis stabilizer muscles. Pain intensity was assessed according to analogue-visual scale of pain (VAS) and according to the Modified Laitinen Questionnaire. The patients were divided into 6 groups (4 treatment and 2 control). We compared 2 rehabilitation programs using kinesitherapy and low-frequency magnetic field. One of them also had specially designed exercises in the water. Statistical analysis was carried out at the significance level α=0.05. This was a cross-sectional study.
RESULTS: A positive effect of water exercises on a number of parameters was found in patients with OA both before and after total hip replacement surgery. We noted a significant reduction of pain (p<0.001), increased ranges of motion and muscle strength, and reduced use of medicines (NASAIDs) (p<0.001). A correlation was found between the degree of degenerative deforming lesions and the effects of the treatment process (p<0.01).
CONCLUSIONS: 1. The rehabilitation program including water exercises most significantly reduced pain in patients with OA before and after total hip replacement surgery. 2. Inclusion of water exercises in a rehabilitation program can reduce the use of medicines in patient with OA and after THR.
Keywords: Arthroplasty, Replacement, Hip - rehabilitation, Aged, 80 and over, Cross-Sectional Studies, Exercise Therapy - methods, Muscle Strength - physiology, Osteoarthritis, Hip - surgery, Pain - etiology, Pain Measurement