Incorporating Neuromuscular Reeducation Techniques During Postoperative Rehabilitation Improves Functional Performance After Total Hip Arthroplasty: A Preliminary Study

Author Info

Bradley S. Davidson Dana Judd Douglas A. Dennis Jennifer E. Stevens-Lapsley Joshua D. Winters Margaret Schenkman

Corresponding Author

Dana Judd
Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, USA

A B S T R A C T

Introduction: Total hip arthroplasty is a common procedure in end-stage hip osteoarthritis. Yet, following hip arthroplasty, deficits in functional performance, possibly due to movement compensations, persist. The purposes of this study are to provide conceptual basis for improving functional performance following hip arthroplasty by addressing movement compensation, present a unique rehabilitation protocol developed from this conceptual framework, and present findings from a preliminary investigation. Methods: This study was a prospective, randomized, controlled preliminary trial with concealed allocation and intention-to-treat analysis. Twenty participants undergoing primary, posterior approach THA were randomized into a neuromuscular reeducation and a control group. The neuromuscular reeducation group completed an 8-week, outpatient rehabilitation program after total hip arthroplasty utilizing neuromuscular reeducation techniques to promote pelvic stability and strength to improve movement quality. The control group was supervised by the study therapist weekly for 8 weeks after surgery but did not attend outpatient rehabilitation. Outcomes, assessed before and after surgery, included stair climb test, gait speed, 6-minute walk test, assessments of postural control and pelvic stability, muscle strength, and self-reported function. Results: Following the intervention, the neuromuscular reeducation group demonstrated statistically and clinically significant improvements in the stair climb test, 4-meter walk, 6-minute walk, postural control, and in some patient-reported outcomes. Further, there were trends toward improvement in pelvic stability during functional tasks and muscle strength, but these improvements were not statistically significant. Conclusions: Findings of this preliminary investigation support the use of neuromuscular reeducation techniques to improve functional performance after total hip arthroplasty, yet more information may be needed to determine efficacy. Therefore, this preliminary work has set the stage for future investigations to explore whether neuromuscular reeducation training after total hip arthroplasty should be considered in clinical practice.

Article Info

Article Type

Research Article

Publication history

Received: Wed 12, Feb 2020
Accepted: Mon 02, Mar 2020
Published: Mon 16, Mar 2020

Copyright

© 2023 Dana Judd. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.JSR.2020.01.02