The Effects of Resisted Hip Abductor Strengthening in Initial Phase in Patients with Hip Arthroplasty

Abstract

Although hip arthroplasty (HA) is done to effectively reduce pain and improve mobility and hence quality of life (QOL), this may not effec-tively restore biomechanics and improve gait as strength of hip muscles have been reported to remain weaker when assessed after 1 year of HA. Several studies done for assessing effects of strengthening exer-cises for varying periods at follow-ups of different intervals have been reported. This study was done to assess the effects of resisted hip ab-ductors program given in initial phase following total hip arthoplasty (THA). Consecutive patients of HA referred for physiotherapy satisfying inclusion criteria were recruited (N=15). Patients were divided in 2 groups. Control group (N=7) given conventional therapy and experi-mental (N=8) given conventional therapy and resisted isometric hip ab-ductor strengthening. Harris hip score (HHS) and strength measure-ment with modified sphygmomanometer (MoS) was recorded in each group, on the 3rd and 8th post-operative day (POD). Normal individuals (N=30) with comparable age and gender were studied to estimate the hip abductor strength with MoS. 11 of total cases were following hip fracture, 4 were AVN. On 3rd POD both groups were similar for age, gender, strength and HHS. Both groups on 3rd day had mean strength 31.87±4.57 (mean of normal 101.4±12.80) mm of Hg. Strength and HHS within groups improved significantly (p<0.001) on 8th POD. How-ever, mean difference in strength was statistically significant in experi-mental group compared to control group (p=0.016), no significant dif-ference seen in HHS (p=0.70). The study concludes that resisted iso-metric hip abductor strengthening exercises started early along with conventional physiotherapy are beneficial.