Does walking the day of total hip arthroplasty speed up functional independence? A non-randomized controlled study.
Federico Temporiti, Isabella Draghici, Stefano Fusi and 4 others
PMID 32346488WHAT IT FOUND
Patients who walked the day after hip replacement had higher functional independence scores at 3 days than those who started walking the next day.
By 7 days only self-care remained higher, and pain and quality of life were similar.
Key findings
01Walking the day of surgery was associated with higher total and motor Functional Independence Measure scores at 3 days than walking the next day.
02At 7 days, the self-care subscale remained higher in the walking-day group.
03Pain and quality of life did not differ between groups.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Patients were assigned to groups by surgery time and recovery from anesthesia, not randomly, so pre-existing differences cannot be ruled out. The study had no a priori sample size calculation, so the findings may be underpowered. The groups differed in age, and age was adjusted statistically rather than balanced by randomization. The walking-day group had more rehabilitation sessions by day 3 than the control group, so the extra contact may explain part of the difference. No minimum clinically important difference was established for the Functional Independence Measure in the first week after hip replacement, so the small numerical differences may not be clinically meaningful. Quality of life was measured only while patients were in hospital, and pain during the walking-day intervention was not assessed. Kinesiophobia and other psychological factors that may affect early recovery were not measured.
The easy way to misread this
Do not conclude that walking the day of surgery caused the faster independence scores. Patients were assigned by surgery time and recovery from anesthesia, not randomly, the walking-day group had more rehabilitation sessions by day 3, and no minimum clinically important difference was established for this outcome.