The Effectiveness of Specific Exercise Approach or Modifiable Heel Lift in the Treatment of Functional Leg Length Discrepancy in Early Post-surgery Inpatients after Total Hip Arthroplasty: A Randomised Controlled Trial with a PROBE design

by MASS4D® Prescription Orthotics July 26, 2017

The purpose of this study was to determine whether the addition of an exercise approach or heel lift to the early postoperative rehabilitation programme could improve functional leg length discrepancy (LLD), patient-perceived LLD, and other functional outcomes more than standard rehabilitation alone in the short term after total hip arthroplasty (THA).

The study design was a two-intervention, three parallel groups, randomised controlled trial with a PROBE (prospective, randomised, open, blinded-endpoint) design.

The subject population included one-week postoperative patients who underwent primary unilateral THA with diagnosed osteoarthritis of the hip at a general hospital in Japan.

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Within one week of the surgery, patients were checked for inclusion and exclusion criteria by a physical therapist and asked to sign an informed consent form by a research manager.

There were 2 intervention groups: the specific exercise approach (SEA) group and the modifiable heel lift (MHL) group.

SEA consisted of semi-structured techniques to treat contractures that resulted in functional LLD.

The control group received normal postoperative care, comprising standard rehabilitation after THA.

Patients in the MHL group were given an insole-type heel lift to correct the functional LLD, made of a thermo plastic rubber of 5-mm thickness to put inside the shoe of the “shorter” leg.

Early postoperative SEA was found to be clinically effective in improving functional LLD and patient-perceived LLD and MHL was effective in improving functional LLD compared with a standard rehabilitation program in the short term in patients with these LLDs after THA.

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References:

1. Nakanowatari, T., Suzukamo, Y., Izumi, S. (2016) The Effectiveness of Specific Exercise Approach or Modifiable Heel Lift in the Treatment of Functional Leg Length Discrepancy in Early Post-surgery Inpatients after Total Hip Arthroplasty: A Randomized Controlled Trial with a PROBE Design. Physical Therapy Research: November 2016, Vol. 19, No. 1, pp. 39-49.

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