Biofeedback-assisted exercise in the rehabilitation of patients after total hip arthroplasty – effects on functional outcomes and quality of life

INTERVENTION: Intervention includes 21 day of inpatient postoperative rehabilitation after total hip arthroplasty (THA) according to standard protocol which consists of daily sessions of land‐based exercise therapy, application of physical agents (interferential current therapy and electrostimulation), group aquatic exercise and individual education. Each of 21 days of rehabilitation follows the same protocol, except Sundays when patients do not receive physiotherapy (there are three Sundays during the patients' stay at the hospital). There are 18 days of rehabilitation consisting of: 50 minutes of land‐based exercise, 30 minutes of aquatic exercise, 10 minutes of interferential current therapy, and 10 minutes of electrostimulation. All interventions are performed on a daily basis, except individual education. Programme of land‐based exercise consists of 20 exercises. Patients perform 7 variations of isometric exercises for thigh muscles and 13 dynamic exercises for lower limb which include pelvic lift exercise from lying supine position (exercise 1), active straight leg raise from lying supine position with and without elastic band around ankles for the resistance (exercises 2 & 3), hip abduction with the knee in extension from lying supine position with and without elastic band around ankles for the resistance (exercises 4 & 5), hip and knee flexion from lying supine position with and without elastic band around feet for the resistance (exercises 6 & 7), hip and knee flexion toward the patient’s chin in lying supine position with patient’s legs on Swiss ball (exercise 8), shifting extended leg from Swiss ball on the therapy bed and vice versa in lying supine position (exercise 9), hip abduction with extended knee from side lying position (exercise 10), hip flexion and extension CONDITION: Musculoskeletal ‐ Osteoarthritis Physical Medicine / Rehabilitation ‐ Physiotherapy Total hip arthroplasty; ; Total hip arthroplasty PRIMARY OUTCOME: Quality of life using EQ‐5D‐5L questionnaire [Day 1 of the rehabilitation, Day 21 of the rehabilitation.] Self‐reported functional status of the hip using Hip dysfunction and Osteoarthritis Outcome Score (HOOS)[Day 1 of the rehabilitation, Day 21 of the rehabilitation.] Self‐reported levels of pain using Numeric Rating Scale (NRS)[Day 1 of the rehabilitation, Day 21 of the rehabilitation.] SECONDARY OUTCOME: Patient's functional status of the lower extremity using 30s Chair Stand Test[Day 1 of the rehabilitation, Day 21 of the rehabilitation.] Patient's mobility using Timed up & Go Test[Day 1 of the rehabilitation, Day 21 of the rehabilitation.] Primary outcome. ; Quality of life using SF‐36 Health Survey [Day 1 of the rehabilitation, Day 21 of the rehabilitation.] INCLUSION CRITERIA: Patients admitted to inpatient postoperative rehabilitation after THA which consented to participate in the study.