The effectiveness of adding arm exercise programme following hip replacement in the elderly

INTERVENTION: Participants are randomised to one of two groups, and begin their physical rehabilitation one day post‐operatively. A randomization sequence is created using a computer‐generated list of random nubers block sizes of four. Control group: The standard rehabilitation programme lasts 30 minutes and consists of exercises to improve joint range of motion and muscle strength lower limbs, function, balance, coordination and gait with weight bearing from day one and was performed twice a day, five days a week, for two weeks in hospital, after that supervised in inpatient rehabilitation center ( for four weeks) and unsupervised at home (for six weeks). Intervention group: Participants also take part in the standard rehabilitation program but with additional upper limb and body exercises, adding 15 minutes to the sessions. The additional exercises involve additional physical chair exercises for arm and upper body, with/out resistance, in order to improve posture, flexibility and muscle strength and to implement regular, deep breathing. Participants are assessed at baseline (one day pre‐operatively), after the intervention (two weeks postoperatively) and at three months follow‐up (12 weeks postoperatively). The first two assessments are done while participants are in hospital and the last one is planned and scheduled as an outpatient check‐up. CONDITION: Hip osteoarthritis ; Musculoskeletal Diseases ; Hip osteoarthritis PRIMARY OUTCOME: Change in the hip function and physical performance of the lower limbs is measured using the Harris Hip score (HHS) at baseline, two weeks and three months postoperatively. SECONDARY OUTCOME: 1. Muscle strength measured by Hand grip strength (HGS) at baseline, two weeks and three months postoperatively; 2. Health‐related quality of life measured by Medical Outcomes Study 36‐item Short‐Form Health Survey (SF‐36) at baseline, two weeks and three months postoperatively; ; Added 19/12/2016:; 3. Functional status is assessed by the New Mobility Score Modified (NMSMod) at baseline, two weeks and three months postoperatively INCLUSION CRITERIA: 1. Aged 60 years and over 2. End stage hip osteoarthritis 3. Admitted to the surgery department of Zvezdara University Hospital