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Odusanya O.F.1, Odole A.C.1
1University of Ibadan/University College Hospital, Physiotherapy Department, Ibadan, Nigeria
Background: Femoral neck fracture is a major cause of morbidity and mortality in elderly individuals. It is usually treated using hip hemi-arthroplasty to minimize the risk of non-union in the elderly. Post-surgical physiotherapy intervention is aimed at relieving pain and improving physical performance. However, prospective studies on effect of physiotherapy intervention on pain intensity and physical performance in elderly post hip hemi-arthroplasty are not readily available.
Purpose: This study was designed to investigate the effects of a 12-week physiotherapy intervention on pain intensity and physical performance in elderly individuals post hip hemi-arthroplasty secondary femoral neck fracture
Methods: This pre-test post-test quasi-experimental study involved 25 (14 females; 11 males) elderly individuals who had hip hemi-arthroplasty secondary to femoral neck fracture. They were consecutively selected from University College Hospital, Ibadan and National Orthopaedic Hospital, Igbobi, Lagos. They were placed on the same analgesics (Tramadol and Ibuprofen) post-surgery and commenced a post-arthroplasty physiotherapy protocol (range of motion exercises and strengthening exercises to hip abductors, hip extensors, hip flexors, knee extensors, knee flexors) not later than 72 hours post-surgery. They received physiotherapy three times in a week for 12 consecutive weeks. Participants Pain Intensity (PI) was assessed using numerical rating scale and physical performance was assessed using Timed-Up-and-Go (TUG) and 10-Meter Walk Test (10MWT). The outcomes were assessed at baseline,
4th week, 8th week and 12th week of intervention. Data were analyzed using paired t-test, repeated measure of ANOVA at α 0.05
Results: Participants were aged 73.1±8.4 years. Their mean height and weight was 1.60±0.1 m and 64.67±12.3 kg respectively. Their body mass index was averaged 25.13±4.0 kg/m². At baseline, participants pain intensity score was 4.9±2.1. Their physical performance on the TUG and 10MWT was 108.0±49.2 seconds and 111.9±69.5 seconds respectively at baseline. There was a significant reduction in PI (3.3±1.9; 2.1±1.5 and 1.3±1.0) and improvement in TUG (67.8±42.3 seconds; 55.7±34.3 seconds and 43.45±26.64 seconds) and 10MWT (53.7±31.3 seconds; 44.7±25.4 seconds and 41.6±24.0 seconds) at 4th, 8th and 12th weeks of intervention respectively. Post hoc analysis revealed significant improvement between each possible paired time point (baseline vs 4th week, baseline vs 12th week, baseline
vs 8th week, 4th week vs 12th week) in all outcomes of PI, TUG and 10MWT.
Conclusion(s): Twelve weeks of range of motion and strengthening exercises relieved pain and improved physical performance in elderly individuals post hip hemi-arthroplasty secondary to femoral neck fracture.
Implications: This post arthroplasty physiotherapy protocol of range of motion and strengthening exercises should be adopted in the management of elderly patients post hip hemi-arthroplasty secondary to femoral neck fracture. Performance-based measures of timed-up-and-go and 10-meter walk test should also be incorporated in the assessment of these patients.
Funding acknowledgements: Self sponsored
Topic: Orthopaedics
Ethics approval: Ethical approval for study was sought and obtained from the University of Ibadan/ University College Hospital Health Research Ethics Committee
All authors, affiliations and abstracts have been published as submitted.
