Technological rehabilitation versus conventional rehabilitation following hip replacement: A prospective controlled study

Article type: Research Article

Authors: Aprile, Irene^a | Iacovelli, Chiara^{a; *} | Cruciani, Arianna^a | Simbolotti, Chiara^b | Loreti, Simona^c | Galli, Giulia^a | Vulpiani, Maria Chiara^c | Padua, Luca^{b; d}

Affiliations: [a] IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy | [b] Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy | [c] Physical Medicine and Rehabilitation Unit, Sant’Andrea Hospital, University of Rome – “La Sapienza”, Rome, Italy | [d] Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy

Correspondence: [*] Corresponding author: Chiara Iacovelli, IRCCS Fondazione Don Carlo Gnocchi, P.le Rodolfo Morandi, 6, 20121, Milan, Italy. Tel.: +39 6 33 08 65 54; Fax: +39 6 30 97 77 2; E-mail: ciacovelli@dongnocchi.it.

Abstract: BACKGROUND: Among new technological rehabilitation systems, there are proprioceptive platforms. These could be useful to improve static and dynamic balance. OBJECTIVE: To evaluate technological proprioceptive rehabilitation compared to conventional rehabilitation in patients after total hip arthroplasty (THA). METHODS: Sixty-four patients after THA were divided in two groups: a conventional group (CG) and a technological group (TG) treated with proprioceptive platforms. Before (T0) and after 20 sessions (T1), we recorded static and dynamic balance. Clinical and disability scales (Modified Harris Hip Score, Barthel Index, Deambulation Index), pain scales (ID-PAIN, DN4, VAS) and QoL scale (SF-36) were administered to patients during T0 and T1. Mann-Whitney U test was used for stabilometric and dynamic assessments to detect differences between groups of patients and healthy subjects. The Wilcoxon signed-rank test was used for the within-group analysis and the ANCOVA test for the analysis between groups of patients. RESULTS: All scales improved significantly in both groups after treatment (p< 0.05). Static balance improved in both groups, but there were greater improvements in the TG than in the CG. All dynamic balance indexes showed significant improvements only in the TG after treatment. CONCLUSIONS: Both treatments improved the clinical, disability, pain, and QoL scales, as well as static balance, but only proprioceptive technological rehabilitation improved dynamic balance. Rehabilitation through proprioceptive platforms can indeed improve static and dynamic balance, which are both crucial for the patient’s safety and autonomy.

Keywords: Total hip arthroplasty (THA), technological rehabilitation, proprioceptive conventional rehabilitation, static balance, dynamic balance

DOI: 10.3233/BMR-181211

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 4, pp. 561-568, 2020