Gagnier, Joel Joseph and Wijnen, Annet and Bouma, Sjoukje E. and Seeber, Gesine H. and van der Woude, Lucas H. V. and Bulstra, Sjoerd K. and Lazovic, Djordje and Stevens, Martin and van den Akker-Scheek, Inge
(2018)
The therapeutic validity and effectiveness of physiotherapeutic exercise following total hip arthroplasty for osteoarthritis: A systematic review.
PLOS ONE, 13 (3).
e0194517.
ISSN 1932-6203
Abstract
To assess the therapeutic validity and effectiveness of physiotherapeutic exercise interventions
following total hip arthroplasty (THA) for osteoarthritis.
Data sources
The databases Embase, MEDLINE, Cochrane Library, CINAHL and AMED were searched
from inception up to February 2017.
Eligibility criteria
Articles reporting results of randomized controlled trials in which physiotherapeutic exercise
was compared with usual care or with a different type of physiotherapeutic exercise were
included, with the applied interventions starting within six months after THA. Only articles
written in English, German or Dutch were included.
Study appraisal
Therapeutic validity (using the CONTENT scale) and risk of bias (using both the PEDro
scale and the Cochrane Collaboration's tool) were assessed by two researchers independently.
Characteristics of the physiotherapeutic exercise interventions and results about
joint and muscle function, functional performance and self-reported outcomes were
extracted.
Results
Of the 1124 unique records retrieved, twenty articles were included. Only one article was
considered to be of high therapeutic validity. Description and adequacy of patient selection
were the least reported items. The majority of the articles was considered as having potentially
high risk of bias, according to both assessment tools. The level of therapeutic validity
did not correspond with the risk of bias scores. Because of the wide variety in characteristics
of the physiotherapeutic exercise and control interventions, follow-up length and outcome
measures, limited evidence was found on the effectiveness of physiotherapeutic exercise
following THA.
Conclusion
The insufficient therapeutic validity and potentially high risk of bias in studies involving physiotherapeutic
exercise interventions limit the ability to assess the effectiveness of these
interventions following THA. Researchers are advised to take both quality scores into
account when developing and reporting studies involving physiotherapeutic exercise. Uniformity
in intervention characteristics and outcome measures is necessary to enhance the
comparability of clinical outcomes between trials.
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