Does rapid mobilisation as part of an enhanced recovery pathway improve length of stay, return to function and patient experience post primary total hip replacement? A randomised controlled trial feasibility study
Does rapid mobilisation as part of an enhanced recovery pathway improve length of stay, return to function and patient experience post primary total hip replacement? A randomised controlled trial feasibility study
Purpose: Day-zero ambulation may enable patients to recover and leave hospital quicker following total hip replacement (THR). The present randomised control feasibility study investigated the efficacy of day-zero ambulation as a physiotherapeutic intervention. Methods: Thirty-six non-blinded adults aged 44–85 (Mean 67.1; SD 9.6 years) undergoing primary, uncomplicated THR were block randomized to either a control group (n = 18) with standard post-operative physiotherapy or an intervention group (n = 18) incorporating walking on the same day as the operation. Outcomes were length of hospital stay (LOS), time to reach functional milestones and achieve all physiotherapy discharge criteria, post-operative pain scores, complications and patient experience. Results: Participants treated with day-zero ambulation had reduced median hospital LOS of 1 day (p =.096), and median reduced times to reaching functional milestones of 39.7 h quicker to transfer to a chair (p <.001), 24.5 h quicker to walk 10 m (p =.009) and 26.4 h quicker to independently ascend and descend stairs (p =.01). Participants in the intervention group were deemed physiotherapy ready to leave hospital significantly earlier than control group (1.04 days, p =.015). Conclusions: Day-zero ambulation appears safe and may have clinically relevant effects in speeding patient functional recovery and facilitating earlier discharge from hospital.Implications for Rehabilitation Day-zero ambulation following total hip replacement (THR) appears safe. Preliminary data suggest that day-zero mobilisation following THR could be efficacious and support the need for a fully powered randomised controlled trial. There may be a clinically relevant effect in speeding patient functional recovery and facilitating an earlier discharge from hospital.
Total hip replacement, accelerated, ambulation, day-zero, mobilization, total hip arthroplasty
1-7
Efford, Christopher M.
82f1ad3d-d2d4-4ea2-b3c2-3e4383c8299f
Samuel, Dinesh
03b00738-9b9c-4c0a-a85a-cf43fc0932fc
Efford, Christopher M.
82f1ad3d-d2d4-4ea2-b3c2-3e4383c8299f
Samuel, Dinesh
03b00738-9b9c-4c0a-a85a-cf43fc0932fc
Efford, Christopher M. and Samuel, Dinesh
(2022)
Does rapid mobilisation as part of an enhanced recovery pathway improve length of stay, return to function and patient experience post primary total hip replacement? A randomised controlled trial feasibility study.
Disability and Rehabilitation, .
(doi:10.1080/09638288.2022.2148298).
Abstract
Purpose: Day-zero ambulation may enable patients to recover and leave hospital quicker following total hip replacement (THR). The present randomised control feasibility study investigated the efficacy of day-zero ambulation as a physiotherapeutic intervention. Methods: Thirty-six non-blinded adults aged 44–85 (Mean 67.1; SD 9.6 years) undergoing primary, uncomplicated THR were block randomized to either a control group (n = 18) with standard post-operative physiotherapy or an intervention group (n = 18) incorporating walking on the same day as the operation. Outcomes were length of hospital stay (LOS), time to reach functional milestones and achieve all physiotherapy discharge criteria, post-operative pain scores, complications and patient experience. Results: Participants treated with day-zero ambulation had reduced median hospital LOS of 1 day (p =.096), and median reduced times to reaching functional milestones of 39.7 h quicker to transfer to a chair (p <.001), 24.5 h quicker to walk 10 m (p =.009) and 26.4 h quicker to independently ascend and descend stairs (p =.01). Participants in the intervention group were deemed physiotherapy ready to leave hospital significantly earlier than control group (1.04 days, p =.015). Conclusions: Day-zero ambulation appears safe and may have clinically relevant effects in speeding patient functional recovery and facilitating earlier discharge from hospital.Implications for Rehabilitation Day-zero ambulation following total hip replacement (THR) appears safe. Preliminary data suggest that day-zero mobilisation following THR could be efficacious and support the need for a fully powered randomised controlled trial. There may be a clinically relevant effect in speeding patient functional recovery and facilitating an earlier discharge from hospital.
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Efford_Samuel 2022 Feasibility Study Manuscript Accepted
- Accepted Manuscript
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Does rapid mobilisation as part of an enhanced recovery pathway improve length of stay return to function and patient experience post primary total
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Accepted/In Press date: 12 November 2022
e-pub ahead of print date: 22 November 2022
Additional Information:
Funding Information:
The authors would like to thank study participants, clinical orthopaedic staff at the Royal Bournemouth Hospital and acknowledge support from the Faculty of Environmental and Life Sciences, University of Southampton.
Publisher Copyright:
© 2022 Informa UK Limited, trading as Taylor & Francis Group.
Keywords:
Total hip replacement, accelerated, ambulation, day-zero, mobilization, total hip arthroplasty
Identifiers
Local EPrints ID: 473253
URI: http://eprints.soton.ac.uk/id/eprint/473253
ISSN: 0963-8288
PURE UUID: 2685d586-4ad8-4c87-8732-dc72db879fe2
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Date deposited: 12 Jan 2023 18:25
Last modified: 17 Apr 2024 01:39
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Author:
Christopher M. Efford
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