医学
物理疗法
随机对照试验
定时启动测试
患者满意度
关节置换术
置信区间
康复
日常生活活动
不利影响
物理医学与康复
平衡(能力)
外科
内科学
作者
Ellen Oosting,M.M.E. Jans,Jaap Dronkers,Roelfrieke H. Naber,Christa M. Dronkers-Landman,Suzan M. Appelman-de Vries,Nico L. van Meeteren
标识
DOI:10.1016/j.apmr.2011.11.006
摘要
To investigate the feasibility and preliminary effectiveness of a home-based intensive exercise program to improve physical health of frail elderly patients scheduled for elective total hip arthroplasty (THA).Single-blind pilot randomized controlled trial.Patients' homes and a general hospital in The Netherlands.Frail patients (N=30) older than 65 years.A preoperative, home-based program supervised by an experienced physical therapist to train functional activities and walking capacity. The control group received usual care consisting of 1 session of instructions.Feasibility was determined on the basis of adherence to treatment, patient satisfaction, adverse events, walking distance (measured with a pedometer), and intensity of exercise (evaluated with the Borg scale). Preliminary pre- and postoperative effectiveness was determined by the Timed Up & Go (TUG) test, 6-minute walk test (6MWT), Chair Rise Time, and self-reported measures of functions, activities, and participation.Patient satisfaction and adherence to the training were good (median=5 on a 5-point Likert scale) and no serious adverse events occurred. The Borg score during training was 14 (range, 13-16). Preoperative clinical relevant differences on the TUG test (2.9 s; 95% confidence interval [CI], -0.9 to 6.6) and significant differences on the 6MWT (41 m; 95% CI, 8 to 74) were found between groups.Intensive preoperative training at home is feasible for frail elderly patients waiting for THA and produces relevant changes in functional health. A larger multicenter randomized controlled trial is in progress to investigate the (cost-)effectiveness of preoperative training.
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