Effect of a walking skill training program in patients who have undergone total hip arthroplasty: Followup one year after surgery

Objective To investigate the effect of a 12‐session walking skill training program of weight‐bearing activities on physical functioning and self‐efficacy initiated in patients 3 months after total hip arthroplasty (THA). Methods Sixty‐eight patients with THA, 35 women and 33 men, with a mean age of 66 years (95% confidence interval [95% CI] 64, 67 years), were randomized to a training group (n = 35) or a control group without physiotherapy (n = 33). Assessments were performed before the intervention at 3 months (pretest), at 5 months (posttest 1), and at 12 months (posttest 2) after surgery. The primary outcome was the 6‐minute walk test (6MWT). The secondary outcomes were the stair climbing test (ST); figure‐of‐eight test; Index of Muscle Function (IMF); active hip range of motion (ROM) in flexion, extension, and abduction; Harris Hip Score (HHS); self‐efficacy; and Hip Dysfunction and Osteoarthritis Outcome Score. Results The training group had larger improvements than the control group at posttest 1 on the 6MWT with an adjusted mean difference of 52 meters (95% CI 29, 74 meters; P < 0.001) and on the ST of −1 second (95% CI −2, 0 seconds; P = 0.01).There were also improvements on the figure‐of‐eight test ( P = 0.02), IMF ( P = 0.001), active hip ROM in extension ( P = 0.02), HHS ( P = 0.05), and self‐efficacy ( P = 0.04). The difference between the groups persisted at posttest 2 on the 6MWT of 52 meters (95% CI 24, 80 meters; P < 0.001) and on the ST of −1 second (95% CI −3, 0 seconds; P = 0.05). Conclusion The walking skill training program was effective, especially in improving walking both immediately after the intervention and 1 year after THA surgery.