The effect of supervised versus unsupervised (home-based) physiotherapy on functional and quality of life outcomes in the early phase following total hip arthroplasty

BackhroundsTotal hip arthroplasty (THA) is among the most common orthopedic surgeries whichexpected to grow with aging and its concomitant increase in the prevalence of hiposteoarthritis in the elderly populations.MethodsRehabilitation program can take place in a clinic (in the form of supervised physiotherapyprogram) or at home (in the form of unsupervised, pamphlet-based program).Physiotherapy programs are generally including the range of motion and strengtheningexercises combined with some functional tasks such as gait training and stair climbing toimprove balance and mobility in these patients.ResultsIn this regard, several systematic reviewshave attempted to compare the supervised and unsupervised home programs physiotherapy in the late stage rehabilitation following THA(i.e. more than 8 weeks) in terms of functional and quality of life outcomes. Overall, theirresults indicated that supervised physiotherapy seems to equally effective in functional andquality of life terms as compared with home physiotherapy program.ConclusionsBesides, there are several randomized controlled trials (RCT) examined patients in the earlystage of rehabilitation (i.e. the first 8 weeks following THA). In this respect, while in someRCTs, both the supervised and unsupervised home programs were equally effective inrecovering functional and quality of life outcomes, in the others, a greater improvementwere found for unsupervised home physiotherapy compared with supervised program.Therefore, it is yet unclear which physiotherapy program routeis superior in terms offunctional and quality of lifeoutcomes in the early stage of rehabilitation in patients withTHA. A computer literature search of PubMed, Scopus, Web of Science, CINAHL andCochrane Central was conducted using relevant keywords. Two authors extracted the dataindependently using an online data extraction form. All data were assessed and pooledto final deduction . Surprisingly ,this study found no significant difference in importantmeasured parameters between the functional exercise groups and the control groups.