Better Before - Better After: Prehabilitation Program for Older Patients Awaiting Total Hip Replacement
- Conditions
- Arthritis of Hip
- Interventions
- Behavioral: Exercise
- Registration Number
- NCT03602105
- Lead Sponsor
- Oslo Metropolitan University
- Brief Summary
Health professions need to prepare for the large increase in the number of older people with OA requiring health services including TJA surgery. Older age and poor physical function influences the postoperative prognosis of TJA. At discharge from hospital after TJA, studies have shown that gait speed can be severely impaired among older patients.
The investigators hypothesize that an exercise program of 6-12 weeks will be beneficial for patients that are undergoing TJA.
- Detailed Description
More than 300.000 Norwegians above 20 years of age have osteoarthritis (OA) . There has been a significant increase in the prevalence of OA over the decades. In the United States knee OA affects 19% of adults aged 45 years or older. OA is associated with an extensive high economic and personal burden, largely attributable to the effects of disability, comorbid disease, and the expense of treatment.
Given the aging population, the number of total joint arthroplasty procedures (TJA) for hip and knee is likely to increase substantially. In light of poor physical function prior to surgery among older patients and the likelihood of an added decrease during hospitalization and risk of poorer outcome after surgery, it is hypothesised that prehabilitation (preoperative exercise) would improve outcomes after surgery, however evidence for its efficacy is still lacking
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 103
- Participants 70 years or older living at home with residential address in the county of Oslo or Akershus scheduled for elective primary total hip replacement due to end-stage osteoarthritis.
- Harris Hip Score >60.
- Participants must also be capable in Norwegian and be able to follow exercise sessions.
- Patients with known rheumatoid arthritis or medical contraindications or those who are scheduled for revision of hip arthroplasty
- Unable to speak and understand the Norwegian language.
- Patients with neurological disorders affecting gait
- Medical contraindications for exercise
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Intervention group Exercise Exercise interventions for 6-12 weeks. Adherence is monitored with day journals
- Primary Outcome Measures
Name Time Method Change in gait speed Change measure: Baseline, within one week after intervention, 6 weeks after intervention, 3 months after intervention, 6 months after intervention and 12 months after intervention 40 meters Fast-Paced Walk test
- Secondary Outcome Measures
Name Time Method Change in physical function Change measure: Baseline, within one week after intervention, 6 weeks after intervention, 3 months after intervention, 6 months after intervention and 12 months after intervention 30 second sit-to stand test
Length of stay in hospital From date of hospital admission until the date of hospital discharge, assessed up to 12 months Number of days
Change in transitional ambulation Change measure: Baseline, within one week after intervention, 6 weeks after intervention, 3 months after intervention, 6 months after intervention and 12 months after intervention Timed-up and go Test (TUG)
Change in pain measured with numeric rating scale (NRS) Change measure: Baseline, within one week after intervention, 6 weeks after intervention and 3 months after intervention NRS - Single score, low score indicates low pain, high score indicated high levels of pain
Change in aerobic capacity 1 week before intervention, directly after intervention as well as 6 and 12 weeks after TJA-surgery 6 min walk test
Change in the ability to climb stairs Change measure: Baseline, within one week after intervention, 6 weeks after intervention, 3 months after intervention, 6 months after intervention and 12 months after intervention Stair-climb test. Timed performance from start to stop
Change in Health Status measured with EuroQol-5 dimensions (EQ-5D) Change measure: Baseline, within one week after intervention, 6 weeks after intervention, 3 months after intervention, 6 months after intervention and 12 months after intervention EQ-5D, five dimensions of health scored from 1-5, with 1 being no problem and 2-5 indicate increasing problem (higher score = increase in problem)
Trial Locations
- Locations (1)
OsloMet
🇳🇴Oslo, Norway