Table 1. Characteristics of the Included Studies.
| Source | Intervention group/control group | Intervention group | Control group(s) | Startc | Follow-upd | Outcome measure | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Sample size, No. | Age, mean (SD), y | Women, % | Type of intervention | Settinga | Frequency | Volume and durationb | Type of intervention | Settinga | Frequency | Volume and durationb | ||||
| Preoperative studies | ||||||||||||||
| Bitterli et al,54 2011 | 41/39 | 65.4 (10.8)/68.4 (9.7) | 46/31 | Sensorimotor training | HB | 2×/d for 2-6 wk | 6 Exercises for 10 reps each/NR | None | NR | NR | NA | 2-6 wks BO | 4 mo and 1 y | SF-36, WOMAC, BBS |
| Doiron-Cadrin et al,46 2019 | 6/5/6 | 69.9 (9.1)/61.3 (8.1)/66.7 (9.2) for hip and knee combined | 64/83/73 | Telerehabilitation (resistance, mobility, and proprioceptive exercise) | HB | 2×/wk for 12 wk | 6 Exercise for 2 sets of 10 reps/NR | C1: rehabilitation C2: usual care | C1: S; C2: S | C1: exercise 2×/wk for 12 wk ; C2: 1 education session | C1: 6 exercise for 2 sets of 10 reps; C2: NA | NR | ≥12 wk | LEFS, WOMAC, SF-36, SPW, TST, TUG |
| Ferrara et al,47 2008 | 11/12 | 63.8 (9.0)/63.1 (6.9) | 64/58 | Group and individual exercise (resistance, flexibility, and cardiovascular exercise) | S | 5 d/wk for 4 wk | 3-4 Sets of 8-12 reps, 10-15 min cardiovascular exercise/40 min in groups, 20 min individual therapy | None | S | NR | NR | 1 mo BO | 3 mo | BMRC, WOMAC, SF-36, BI, VAS, hip-ROM |
| Gill et al,48 2009 | 40/42 | 71.6 (8.9)/69.2 (10.5) | 57/67 | Land-based group exercise + HB exercise (cardiovascular or other exercise) | S | 2 d/wk + 3 d HB exercise for 6 wk | 4 Exercises for 2 sets of 10 reps/1 h + 30 min HB exercise | Pool-based group exercise + HB exercise (cardiovascular or other exercise) | S and HB | S: 2 d/week + 3 d HB: 6 wk |
1.5 h HB exercise, 4 exercise for 2 sets of 10 reps | NR | 7 wk and 5 wk | WOMAC, 50FTW, 30CST, SF36 MCS |
| Gocen et al,49 2004 | 30/30 | 46.9 (11.5)/55.5 (14.4) | 43/27 | Lower body stretching + upper body strengthening | PS | 3×/d, duration NR | 1 Set of 10 reps/NR | None | NA | NA | NA | 8 wk BO | Discharge, 3 mo, and 2 y | HHS, VAS, hip-ROM |
| Holsgaard-Larsen et al,50 2020 | 40/40 | 70.0 (7.7)/70.8 (7.5) | 68/63 | Explosive resistance training for lower body | S | 2×/wk for 10 wk | 10-min warm-up; 4 exercise for 3 sets of 8-12 reps/1 h | Usual care | NA | NA | NA | NR | Postintervention (BO), 3 mo, 6 mo, 9 mo, and 12 mo | HOOS, gait speed, chair raise test, muscle strength, body composition |
| Oosting et al,51 2012 | 15/15 | 76.9 (6.3)/75.0 (6.3) | 93/67 | Functional exercise + walking capacity + encouragement for HB exercise | S | 2×/wk for 3-6 wk | NR/encouraged to walk ≤30 min/d | Usual care | NA | NA | NA | 3-6 wk BO | 6 wk | Feasibility, TUG, CRT, 6MWT, VAS, HOOS, LAPAQ |
| Vukomanović et al,53 2008 | 23/22 | 60.1 (11.0)/56.2 (18.5) | 70/80 | Functional exercise | S | 2 classes | NR/NR | None | NA | NA | NA | NR | Discharge and 15 mo | VAS, HHS, JOA |
| Villadsen et al,52 2014 | 43/41 | 68.7 (8.4)/68.6 (7.1) | 51/51 | Neuromuscular exercise program | S | 2×/wk for 8 wk | 2-3 Sets of 10-15 reps/1 h | Preoperative education | NA | NA | NA | 8 wk BO | 4 wk and 12 wk | HOOS, EQ5D |
| Postoperative studies | ||||||||||||||
| Austin et al,55 2017 | 60/60 | 61.2 (8.4)/62.3 (12.7) | 38/52 | Physical therapy + HB exercise | S | 2× to 3×/wk for 10 wk | NR/NR | HB exercise with manual | HB | 10 wk | NR/NR | AO | 1 mo, and 6-12 mo | HHS, WOMAC, SF-36 |
| Beck et al,56 2019 | 80/80 | NR/NR | 53/64 | Sports therapy (resistance exercise, cardiovascular exercise, flexibility exercise) | S | 50 units | NR/45 min | None | NA | NA | NA | 6 wk AO | 6 (±1 mo), 12 (±3 mo) | Isokinetic strength of hip, postural stability, lactate threshold, WOMAC, HHS, EQ-5D |
| Bodén and Adolphson,57 2004 | 10/10 | 54 (NR)/55 (NR) | NR/NR | Full weight bearing (pressure sensor) and HB exercise | HB | NR | NA | Late weight-bearing | HB | NA | NA | AO | 2 y | HHS, bone density, bone remodeling, prostheses fixation |
| Coulter et al,58 2017 | 56/42 | 66 (NR)/63 (NR) | 64/50 | Physiotherapeutic exercise (resistance exercise + functional exercise) | S | 1×/wk for 4 wk + HB exercise | NR/NR | Manual of resistance exercise | HB | NR | NR/NR | AO | 5 wk, 12 wk, and 26 wk | WOMAC, SF-36, TUG, PSC, UCLA activity index |
| Galea et al,59 2008 | 11/12 | 68.6 (9.7)/66.6 (7.9) | 73/67 | Functional exercise + resistance exercise | S | 2×/wk for 8 wk | 7 Exercises/45 min | Functional exercise + resistance exercise | HB | 8 wk | NR | 8 wk AO | Postintervention | TUG, SCT, 6MWT, WOMAC, AQoL, gait parameters |
| Heiberg et al,60 2012 | 35/33 | 70.2 (66.5)/70.6 (68.4) | 35/33 | Functional exercise + resistance exercise | S | 2×/wk for 6 wk | NR/70 min | None | NA | NA | NA | 3 mo AO | 5 mo and 12 mo | SCT, 6MWT, hip-ROM, HOOS, HHS, self-efficacy, IMF |
| Husby et al, 200961 and 201062 | 12/12 | 58 (5)/56 (8) | 58/67 | Conventional rehabilitation + resistance exercise | S | 5 d/wk for 4 wk | Sling exercise + leg press and hip ABD/1 h and 10 min warmup and 4 sets of 5 reps | Conventional rehabilitation | S | 5 d/wk for 4 wk | Sling exercise /1 h/NR | 1 wk AO | 1 wk, 5 wk, 6 mo, and 12 mo | Strength, gait pattern, cardiovascular parameters, SF-36 |
| Jan et al,63 2004 | 13/13/27 | 58.8 (12.9)/59.3 (10.3)/57.0 (12.8) | 30/38/63 | Flexibility, resistance exercise, walking | HB | 7 d/wk for 12 wk | 6 Exercises for 2 sets of 10 reps/30 min walk | C1: same as I (low adherence); C2: No intervention | C1: S; C2: NA | C1: 7 d/wk for 12 wk; C2: NA | C1: 6 exercise for 2 sets of 10 reps/30 min walk; C2: NA | 1.5 y AO | 1 wk | Hip strength, gait speed, HHS |
| Johnsson et al,64 1988 | 14/16 | 70 (58-76)/66 (50-74) | NR | Resistance exercise, walking | NR | NR | NR/NR | None | NA | NA | 2 mo AO | 6 mo | Hip strength, hip ROM | |
| Maire et al, 2003,65 2004,66 and 200667 | 7/7 | 77 (NR)/77 (NR) | 86/86 | Traditional rehabilitation + arm interval ergometer | S | 3×/wk for 6 wk | Intervals 6 × 5 min (4 min base work 1 min peak work)/30 min | Traditional rehabilitation | S | NR | NR | 1 wk AO | 2 mo and 1 y | 6MWT, WOMAC, walking test distance |
| Mikkelsen et al,69 2012 | 25/21 | 67.7 (7)/66.8 (8) | 48/48 | Resistance + stretching exercise + mobility exercise | HB | 2×/d for 7 d/wk | 10 Reps per exercise/NR | Stretching + mobility exercise | H | 2×/d for 7×/wk | 10 Reps per exercise/NR | 1 d AO | 4 wk an 12 wk | Adherence, PAS, gait speed, hip strength, balance, WOMAC, EQ-5D |
| Mikkelsen et al,68 2014 | 32/30 | 64.8 (8)/65.1 (10) | 44/40 | Resistance exercise + HB exercise | S and HB | S:2×/wk; HB:5×/wk | 3 Sets with 10-12 reps (wk 1), 10 reps (wk 2-5), and 8 reps (wk 6-10)/35-50 min | Stretching + mobility exercise | H/ | 2×/d, 7 d/wk | 2 Sets of 10 reps/NR | 1 wk AO | 2 wk, 4 wk, 6 wk, 10 wk, 6 mo, and 12 mo | Leg extension power, 20MWT, 30CST, HOOS |
| Mitrovic et al,70 2016 | 35/35 | 69.2 (6.3)/68.1 (6.4) | 63/77 | Standard rehabilitation program (lower body exercise) + additional upper body exercise | PS and HB | PS: 2×/d for 5 d/wk for 6 wk; HB: 6 wk | NR/45 min | Standard rehabilitation program (lower body exercise) | PS and HB | 2×/d for 5 d/wk for 6 wk; HB: 6 wk exercise | NR/30 min | 1 d AO | 2 wk and 12 wk | HHS, Hand grip strength, SF-36, Program tolerance |
| Monhagan et al,71 2016 | 32/31 | 68 (8)/69 (9) | 37/26 | Functional exercise + usual care | S | 2×/wk for 6 wk | 12 Exercises for 15 reps/35 min | Usual care | S | 2×/wk for 6 wk | 15 Reps/exercise for 7 isometric exercise | 12 wk AO | 18 wk | WOMAC, VAS, 6MWT, SF-12 |
| Monticone et al,72 2014 | 50/50 | 69.5 (7.5)/68.8 (8.1) | 64/56 | Task oriented exercise + full weight bearing + ergometer cycling | S | 5×/wk for 3 wk | NR/90 min | Open chain exercise + partial weight bearing | S | 5×/wk for 3 wk | NR/90 min | 4-7 d AO | Posttreatment and 1 y | WOMAC, NRS, FIM, SF-36 |
| Morishima et al,73 2014 | 14/14 | 60.3 (7.4)/59.9 (5.4) | NR | Interval walking | HB | 60 min/wk of fast walking for 12 wk | ≥5 Sets of 2-3 min low intensity V̇o2 peak followed by 3 min high intensity | None | NA | NA | NA | 2 mo AO | 1 wk | Thigh muscle strength, V̇o2 peak, energy expenditure |
| Nanakaku et al,74 2016 | 14/14 | 60.5 (6.4)/60.8 (7.5) | 86/86 | Resistance exercise + hip external rotator strengthening | S | 5×/wk for 4 wk | 3 Sets of 8-12 reps/NR | Resistance exercise | S | 5×/wk for 4 wk | 3 Sets of 8-12 reps/NR | 3 d AO | Posttreatment | Hip pain, Hip muscle strength, Hip-ROM, TUG |
| Nelson et al,75 2019 | 35/35 | 62 (9)/67 (11) | 66/60 | Telerehabilitation (resistance exercise) | HB | 1× to 2×/wk for 30 min | NR/NR | In-person resistance exercise | S and HB | 3× for 30 min; HB: 6 wk exercise | NR/NR | 2 wk after discharge | 6 wk and 6 mo | HOOS, SF-12, EQ-5D |
| Okoro et al,76 2016 | 25/24 | 65.2 (9.1)/66.3 (11.0) | 60/42 | Resistance exercise | HB | 5×/wk for 6 wk | 3-10 Reps/NR | Standard rehabilitation | S | NR | NR/NR | 4-7 d AO | 9-12 mo | Strength, CRT, TUG, TST, 6MWT, lean mass |
| Suetta et al,77 2004 | 13/12/11 | 69 (NR)/68 (NR)/69 (NR) | 46/58/55 | Resistance exercise | S | 3×/wk for 12 wk | 3-5 Sets with 8-20 reps | C1: NMES; C2: HB exercise | C1: HB; C2: HB | C1: 1 h/d; C2: NR | C1: 1 h; C2: NR | 7 d AO | 5 wk and 12 wk | Gait speed, CRT in 5 s, TST, muscle strength |
| Trudelle-Jackson et al,78 2004 | 18/16 | 59.4 (10.8)/59.6 (12.1) | 43/64 | Weight-bearing exercise | HB | 3× to 4×/wk for 8 wk | 1-2 Sets with 15-20 reps/NR | Isometric exercise, flexibility exercise | HB | 3× to 4×/wk for 8 wk | 1-2 Sets with 15-20 reps/NR | 4-12 mo AO | Posttreatment | Hip muscle strength, postural stability, fear of falling, HQ-12 |
| Unlu et al,79 2007 | 9/8/9 | 45.4 (8.7)/57.8 (7.5)/52.6 (10.3) | 78/75/56 | Exercise program (stretching + resistance exercise) | HB | 2×/d for 6 wk | NR/NR | C1: Inpatient therapy; C2: no intervention | C1: S; C2: NA | C1: NR; C2: NA | NR/NR | 12-24 mo AO | Posttreatment | Hip muscle strength, gait parameters |
| Winther et al,80 2018 | 31/29 | 61 (NR)/66 (NR) | 45/52 | Resistance exercise | S | 3×/wk for 3 mo | 2 Exercises with 4 sets with 5 reps/NR | Conventional rehabilitation | S | NR | NR/NR | After discharge | 3 mo, 6 mo, and 12 mo | 6MWT, hip strength, NRS, HHS, HOOS-PS |
Abbreviations: ABD, abduction; AO, after operation; AQoL, assessment of quality of life; BBS, Biodex Balance System; BI, Barthel Index; BMRC, British Medical Research Council; BO, before operation; C1, control group 1; C2, control group 2; CRT, chair rise time; 30CST, 30-second chair stand test; FIM, Functional Independence Measure; 50FTW, 50-foot timed walk; HB, home-based; HHS, Harris Hip Score; HOOS, Hip disability and Osteoarthritis Outcome Score; HOOS-PS, HOOS Physical Function Short Form; HQ-12, 12-Item Hip Questionnaire; LAPAQ, Longitudinal Aging Study Amsterdam Physical Activity Questionnaire; IMF, Index of Muscle Function; JOA, Japanese Orthopaedic Association; LEFS, Lower Extremity Functional Scale; MCS, Mental Component Score; 6MWT, 6 minute walk test; NA, not applicable; NMES, neuromuscular electrical stimulation; NR, not reported; NRS, Numerical Rating Scale; PAS, Physical Activity Scale; PS, partially supervised; PSC, patient-specific concerns; rep, repetition; ROM, range of motion; S, supervised; SCT, stair climb test; SF-12, Short Form 12 item; SF-36, 36-Item Short-Form Health Survey; SPW, self-paced walk; TST, timed stair tests; TUG, timed up-and-go; VAS, visual analog scale; V̇o2, oxygen consumption; WOMAC, Western Ontario McMaster Osteoarthritis Index.
a
Setting can be HB, S, or PS.
b
Number of sets and reps, duration in minutes.
c
Start of the intervention.
d
Shown as time since total hip arthroplasty.