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Marie D. Westby1 , Deborah Kennedy2 , Susan Carr1 , Victoria Brander3 , Mary Bell4, Catherine Backman5
1
Mary Pack Arthritis Program, Vancouver, Canada. 2 Department of Rehabilitation, Holland Orthopaedic and Arthritic Centre,
Toronto, Canada. 3 Northwestern Arthritis Institute, Chicago, IL, USA. 4 Department of Rheumatology, Sunnybrook Health Science
Center, North York, Canada. 5 Department of Occupational Science and Occupational Therapy, University of British Columbia,
Vancouver, Canada
Contact address: Marie D. Westby, Mary Pack Arthritis Program, 895 West 10th Ave, Vancouver, BC, V5Z 1L7, Canada.
marie.westby@vch.ca.
Citation: Westby MD, Kennedy D, Carr S, Brander V, Bell M, Backman C. Post-acute physiotherapy for primary total hip arthroplasty.
Cochrane Database of Systematic Reviews 2006, Issue 2. Art. No.: CD005957. DOI: 10.1002/14651858.CD005957.
Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
ABSTRACT
This is the protocol for a review and there is no abstract. The objectives are as follows:
The aim of this review is to determine the efficacy and effectiveness of post-acute physiotherapy (PT) on patients who have undergone
a primary THA for OA on patient-centred outcomes of pain, physical function and HRQOL. Various forms of PT and clinical settings
including inpatient rehabilitation, outpatient and home care programs will be compared to routine care, non-supervised or alternative
PT approaches. Post-acute PT will have been initiated within six-months post-surgery and completed within twelve-months post-
surgery.
• To examine the short-term and long-term effects of post-acute physiotherapy on patient centred outcomes of pain, physical
function and HRQOL
• To compare measures of effectiveness across different clinical settings, patient characteristics and treatment approaches
• To identify gaps in the published literature related to post-acute physiotherapy in the THA population
Secondary outcomes will examine: The grey literature search will be conducted using the following
• Body structure and function (hip ROM, lower extremity strategies to identify published and unpublished papers, reports
muscle strength and endurance, soft tissue flexibility, balance, and other documents:
proprioception, cardiopulmonary function/aerobic fitness, Conference proceedings and papers from congresses and sympo-
Trendelenburg sign, leg length discrepancy) siums will be searched through the databases PapersFirst and Pro-
• Activity (activities of daily living) ceedingsFirst.
• Participation (return to work, return to leisure activities, Hand searching conference proceedings (January 2000 - Septem-
driving, sexual activity) ber 2005)
• Patient satisfaction • American Academy of Orthopedic Surgeons Annual
• Surgical outcomes and complication rates (dislocation, Meeting
hospital readmission, radiographic prosthetic loosening, revision/ • American Academy of Physical Medicine and
survivorship of prosthesis) Rehabilitation Annual Assembly
• Adverse effects due to rehabilitation (such as increased pain, • American College of Rheumatology Annual Scientific
dislocation, falls) Meeting
REFERENCES
APPENDICES
CONTRIBUTIONS OF AUTHORS
Westby M - Project coordinator and main reviewer; conceived, designed and coordinated the review; developed the search strategy and
will oversee the undertaking of the searches, the screening and critical appraisal of papers; prepared the review protocol and will write
the review
Kennedy D - Co-reviewer; provided feedback on the screening and data extraction forms; will assist in screening and critically appraising
retrieved papers; will extract data from papers and help with the interpretation of data by providing a clinical perspective; will provide
feedback on the review
Carr S - Co-reviewer; provided feedback on the screening and data extraction forms; will assist in screening and critically appraising
retrieved papers; will extract data from papers and help with the interpretation of data by providing a clinical perspective; will provide
feedback on the review
Brander V - Co-reviewer; will provide feedback on screening and data abstraction forms and review protocol; will assist in screening
and critically appraising retrieved papers; will extract data from papers and help with the interpretation of data by providing a clinical
perspective; will provide feedback on the review
Backman C - Secondary (tie breaker) reviewer; assisted in the design of the review; provided feedback on the protocol; will assist
in critically appraising papers when consensus cannot be reached by primary reviewers; will help with the interpretation of data by
providing a methodological perspective; will assist in writing the review; secured funding for the review
Bell M - Secondary (tie breaker) reviewer; provided input and feedback on protocol; will assist in critically appraising papers when
consensus cannot be reached by primary reviewers; will help with the interpretation of data by providing a methodological perspective;
will provide general advice and feedback on the review
DECLARATIONS OF INTEREST
None. One secondary reviewer (CB) is a co-investigator on a current trial examining the effectiveness of out-patient physiotherapy
following THA compared to a minimally supervised home exercise program. The results of this trial will not be published during the
time frame of this systematic review.
SOURCES OF SUPPORT
External sources
• The John Insall Foundation for Orthopaedics, USA.
• Canadian Institutes of Health Research, Canada.