Year of Publication

2009

Degree Name

Doctor of Philosophy (PhD)

Document Type

Dissertation

College

Health Sciences

Department

Rehabilitation Sciences

First Advisor

Dr. Carl G. Mattacola

Second Advisor

Dr. Gilson Capilouto

Abstract

The number of patients electing to undergo total hip arthroplasty (THA) in the United States has been projected to double by the year 2030, with a growing number of these patients below the age of 65 years. This cohort of patients not only desires to return to pain free daily activity, but wishes to participate in recreation and sporting activities. However, many of these patients report pain, impairments, and functional limitations following THA. The number one deficit observed for patients who fail conventional post-operative rehabilitation is persistent weakness of the hip abductor muscles. In order to safely progress these patients back to their desired activity level, appropriate postoperative rehabilitation programs need to be developed.

The primary objective of this dissertation was to examine the effectiveness of a hip abductor strengthening program on subjective and objective outcomes following THA. The secondary aims of this study were to document hip muscle activation and lower extremity movement patterns during functional exercises; and to compare shortterm subjective and objective clinical outcomes for subjects following THA compared to controls.

Several observations were made from our results. First, the lunge, single leg squat, and step-up and over exercises may be appropriate to include in post-operative rehabilitation programs to transition THA subjects from static strengthening exercises to dynamic activities. Second, subjects at 6- and 12-weeks following THA continue to exhibit strength and functional deficits, which contributes to decreases in activity level. Third, the addition of an exercise program targeting the hip abductor muscles following THA may help to improve subjective and objective outcomes compared to conventional post-operative rehabilitation. Finally, findings from our results are summarized and we propose a model to develop patient-specific rehabilitation programs.

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