DOI QR코드

DOI QR Code

Effect of Adding Ankle-Joint-Pumping Exercise to Gluteal-Muscle-Strengthening Exercise on Thigh Swelling, Gait ability and Pain level in Patients With Total Hip Arthroplasty

볼기근 근력강화 운동과 병행한 발목관절 펌핑 운동이 엉덩관절 전치환술 환자의 허벅지 둘레, 보행능력, 통증 수준에 미치는 영향

  • Hyun-gook Lee (Department of Physical Therapy, Graduate School of Health and Medicine, Daejeon University) ;
  • Suhn-yeop Kim (Department of Physical Therapy, College of Health and Medical Science, Daejeon University)
  • 이현국 (대전대학교 보건의료대학원 물리치료학과) ;
  • 김선엽 (대전대학교 보건의료과학대학 물리치료학과)
  • Received : 2023.11.11
  • Accepted : 2023.12.09
  • Published : 2024.05.31

Abstract

PURPOSE: This study was conducted to investigate the effect of gluteal muscle strengthening exercises (GMSE) with ankle joint pumping exercises (AJPE) on thigh swelling, gait ability, and pain level in patients who underwent total hip arthroplasty. METHODS: A total of 38 patients who had undergone total hip replacement surgery >1 week prior participated in this study. Participants were randomly assigned to a group that performed only GMSE (CG; n = 19) and a group that performed GMSE and AJPE (EG; n = 19). The CG group performed GMSE for 30 min, and the EG group performed GMSE for 30 min followed by AJPE for 15 min. Exercises were performed five times a week, for a total of 20 times over 4 weeks in both groups. Thigh swelling (thigh size), 10 m walking test (10MWT) and timed up and go test (TUG) results, pain level (visual analogue scale, VAS) scores, Short Form 36 health survey (SF-36), and hip outcome scale (HOS) scores were evaluated before and after the intervention. RESULTS: After 4 weeks of intervention, significant differences were observed in the thigh size, 10MWT, TUG, VAS, SF-36, HOS before and after intervention in both groups (p < . 05). However, only thigh size showed a significant interaction between group and measurement time (p < . 05). CONCLUSION: GMSE combined with AJPE might be effective in improving the gait ability and pain level in patients with total hip arthroplasty, and GMSE may be more effective in improving thigh swelling and gait ability than GMSE without AJPE.

Keywords

References

  1. Wengler A, Nimptsch U, Mansky T, et al. Hip and knee replacement in Germany and the USA. : Analysis of individual inpatient data from German and US hospitals for the years 2005 to 2011. Dtsch Arztebl Int. 2014;111(23-24):407-16. 
  2. Smith-Petersen MN. Evolution of mould arthroplasty of the hip joint. The Journal of Bone and Joint Surgery. 1930;3157(I996):747-56. 
  3. Malchau H, Herberts P, Eisler T, et al. The Swedish total hip replacement register. J Bone Jt Surgery. 2002;84-A(1):2-20. 
  4. Anakwe RE, Jenkins PJ, Matthew M. Predicting dissatisfaction after total hip arthroplasty: A study of 850 patients. J Arthroplasty. 2011;26(2):209-13. 
  5. Agostini V, Ganio D, Facchin K, et al. Gait parameters and muscle activation patterns at 3, 6 and 12 months after total hip arthroplasty. J Arthroplasty. 2014;29(6):1265-72. 
  6. Skinner HB. Pathokinesiology and total joint arthroplasty. Clinical Orthopeadics and Related Research. 1993;3(1):282. 
  7. Neelapala RYV, Moily K. Relationship between gluteal muscle strength and balance in individuals with chronic ankle instability. Physiotherapy Practice Research. 2016;38(1):1-5. 
  8. Shin HJ, Jung JH, Kim SH, et al. A comparison of the transient effect of complex and core stability exercises on static balance ability and muscle activation during static standing in healthy male adults. Healthcare. 2020;8(4):375. 
  9. Fuentes J, Armijo-Olivo S, Magee DJ, et al. A preliminary investigation into the effects of active interferential current therapy and placebo on pressure pain sensitivity: A random crossover placebo controlled study. Physiotherapy. 2011;97(4):291-301. 
  10. Jan MH. Hung JY, Lin JHC, et al. Effects of a home program on strength, walking speed, and function after total hip replacement. Arch Phys Med Rehabil. 2004;85(12):1943-51. 
  11. Vaz MD, Kramer JF, Rorabeck CH, et al. Isometric hip abductor strength following total hip replacement and its relationship to functional assessments. J Orthop Sports Phys Ther. 1993;18(4):526-31. 
  12. Janda V. Muscle Function Testing. Elsevier; 1983. 1-260p. 
  13. Inacio M, Ryan AS, Bair WN, et al. Gluteal muscle composition differentiates fallers from non-fallers in community dwelling older adults. BMC Geriatr. 2014;14(1):37. 
  14. Reiman MP, Bolgla LA, Loudon JK, et al. A literature review of studies evaluating gluteus maximus and gluteus medius activation during rehabilitation exercises. Physiother Theory Pract. 2012;28(4):257-68. 
  15. Howe TE. Exercise for osteoarthritis of the hip and knee. Annu Rev Gerontol Geriatr. 2016;36(1):155-68. 
  16. Zhang W, Nuki G, Moskowitz RW, et al. Oarsi recommendations for the management of hip and knee osteoarthritis. Osteoarthr Cartil. 2010;18(4):476-99. 
  17. Maharem TAS, Shehata AM, Khalil BM, et al. Effect of ankle pump exercise on fatigue sensation, comfort, and lower limb hemodynamics among deep vein thrombosis p atients. Int J Health Sci (Qassim). 2022;(March 2022):4945-57. 
  18. Macrae WA. Chronic post-surgical pain: 10 years on. Br J Anaesth. 2008;101(1):77-86. 
  19. Wylde V, Hewlett S, Learmonth ID, et al. Persistent pain after joint replacement: prevalence, sensory qualities, and postoperative determinants. Pain. 2011;152(3):566-72. 
  20. Pacault-Legendre V, Anract P, Mathieu M, et al. Pain after total hip arthroplasty: A psychiatric point of view. Int Orthop. 2009;33(1):65-9. 
  21. Ng CY, Ballantyne JA, Brenkel IJ. Quality of life and functional outcome after primary total hip replacement: A five-year follow-up. J Bone Jt Surg. 2007;89(7):868-73. 
  22. Kemp JL, Makdissi M, Schache AG, et al. Hip chondropathy at arthroscopy: Prevalence and relationship to labral pathology, femoroacetabular impingement and patient-reported outcomes. Br J Sports Med. 2014;48(14):1102-7. 
  23. Kemp J, Moore K, Fransen M, et al. A pilot randomised clinical trial of physiotherapy (manual therapy, exercise, and education) for early-onset hip osteoarthritis post-hip arthroscopy. Pilot Feasibility Stud. 2018;4(1):16. 
  24. Badura-Brzoza K, Zajac P, Brzoza Z, et al. Psychological and psychiatric factors related to health-related quality of life after total hip replacement - preliminary report. Eur Psychiatry. 2009;24(2):119-24. 
  25. Satoh M, Masuhara K, Goldhahn S, et al. Cross-cultural adaptation and validation reliability, validity of the Japanese version of the Hip disability and Osteoarthritis Outcome Score (hoos) in patients with hip osteoarthritis. Osteoarthr Cartil. 2013;21(4):570-3. 
  26. de Groot IB, Reijman M, Terwee CB, et al. Validation of the Dutch version of the hip disability and osteoarthritis outcome score. Osteoarthr Cartil. 2007;15(1):104-9. 
  27. Toya K, Sasano K, Takasoh T, et al. Ankle positions and exercise intervals effect on the blood flow velocity in the common femoral vein during ankle pumping exercises. J Phys Ther Sci. 2016;28(2):685-8. 
  28. Charalambous C, Cleanthous S, Tryfonidis M, et al. Foot pump prophylaxis for deep venous thrombosis - Rate of effective usage following knee and hip arthroplasty. Int Orthop. 2003;27(4):208-10. 
  29. Ku MC, Tsai YH, Cheng PC, et al. After total knee arthroplasty, monitored active ankle pumping improves lower leg circulation more than unmonitored pumping: A pilot study. Appl Sci. 2022;12(18):9028. 
  30. Yun SC. Imputation of missing values. Jprew Medipubilc Heal. 2004;8(1):1-3. 
  31. Heerey J, Risberg MA, Magnus J, et al. Impairment-based rehabilitation following hip arthroscopy: Postoperative protocol for the HIP arthroscopy international randomized controlled trial. J Orthop Sports Phys Ther. 2018;48(4):336-42. 
  32. Zhuang Z, Ai D, Yao Y, et al. The changes of the calf-vein deformation and femoral vein peak velocity during ankle pump exercise with or without graduated compression stockings. BMC Musculoskelet Disord. 2022;23(1):435. 
  33. Yang J, Yang L, Tan JS, et al. Reduction of blood loss by Intra-articular Injection of tranexamic acid combined with knee and hip flexion at 45° during primary total knee arthroplasty: A randomized controlled trial. Orthop Surg. 2020;12(6):1835-42. 
  34. Kim K, Jeon K. Development of an efficient rehabilitation exercise program for functional recovery in chronic ankle instability. J Phys Ther Sci. 2016;28(5):1443-7. 
  35. Giles LS. Webster KE, Jodie A, et al. Can ultrasound measurements of muscle thickness be used to measure the size of individual quadriceps muscles in people with patellofemoral pain? Phys Ther Sport. 2015;16(1):45-52. 
  36. Rahman M, Thangamani Alagappan R. The test-retest reliability of 10 meter walk test in healthy young adults-a cross sectional study. IOSR J Sport Phys Educ (IOSR-JSPE. 2019;6(3):1-6. 
  37. Bohannon RW. Comfortable and maximum walking speed of adults aged 20-79 years: Reference values and determinants. Age Ageing. 1997;26(1):15-9. 
  38. Butland RJA, Pang J, Gross ER, et al. Two-, six-, and 12-minute walking tests in respiratory disease. BMJ. 1982;284(6329):1607-8. 
  39. Kear BM. Guck TP, Mcgaha AL, et al. Timed up and go (TUG) test. J Prim Care Community Health. 2017;8(1):9-13. 
  40. Berg U, W-Dahl A, Rolfson O, et al. Influence of fast-track programs on patient-reported outcomes in total hip and knee replacement (THR/TKR) at Swedish hospitals 2011-2015: An observational study including 51,169 THR and 8,393 TKR operations. Acta Orthop. 2020;91(3):306-12. 
  41. Ware JE. The mos 36-ltem short-form health survey (SF-36). Med Care. 1992;30(6):473-83 
  42. McHorney CA. Measuring and monitoring general health status in elderly persons: Practical and methodological Issues in using the SF-36 health survey. Gerontologist. 1996;36(5):571-83. 
  43. Nilsdotter AK, Lohmander LS, Klassbo M, et al. Hip disability and osteoarthritis outcome score (HOOS) - validity and responsiveness in total hip replacement. BMC Musculoskelet Disord. 2003;4(1):10. 
  44. Park SH, Joeng EY. The immediate effect of functional massage on pain, range of motion, balance ability and gait speed in patients with total hip replacemet. The J of kompt. 2022:28(1):9-17. 
  45. Kim SG, Kim WS. Effect of ankle range of motion (ROM) and lower-extremity muscle strength on static balance control ability in young adults: A regression analysis. Med Sci Monit. 2018;24(1):3168-75. 
  46. French HP, Gilsenan C, Cusack T. Gluteal muscle dysfunction and the role of specific strengthening in hip osteoarthritis: A review. Phys Ther Rev. 2008;13(5):333-44. 
  47. Monaghan B. Cunningham P, Harrington P, et al. Randomised controlled trial to evaluate a physiotherapy-led functional exercise programme after total hip replacement. Physiotherapy. 2017;103(3):283-8. 
  48. Jin YW. Lower limbs muscle comparative research for verification effect of rehabilitation training program of total hip arthroplasty. J of life science 2010;20(4):543-48. 
  49. Bitterli R, Sieben JM, Hartmann M, et al. Pre-surgical sensorimotor training for patients undergoing total hip replacement: A randomised controlled trial. Int J Sports Med. 2011;32(09):725-32.