Rehabilitation Strategies for Elderly Post-Operative Patients Clinical Trial
Official title:
Muscle Function in the Elderly After Hip-Replacement Surgery - Effects of Long Term Disuse and Physical Training
During the last decades there has been an increase in the relative proportion and life
expectancy of elderly people in the industrialised countries. Consequently the amount of
elderly with diseases and disabilities related to aging has increased. It therefore appears
paramount to gain a better understanding of how disuse and immobilisation affects
neuromuscular properties in the elderly, as well as to identify training regimes that
ensures an effective rehabilitation.The population of interest in the present study was
elderly individuals with long term hip-osteoarthritis undergoing a hip-replacement
operation. The study was divided in two parts, a cross-sectional study and an intervention
study.
The cross-sectional study investigated muscle size, maximal muscle strength, specific force,
neural drive and explosive muscle force characteristics in elderly individuals who were
affected by unilateral prolonged disuse due to hip-osteoarthritis. The data clearly
indicated that the side with hip-osteoarthritis was affected by a marked decrease in muscle
mass, maximal muscle strength, neural drive and explosive muscle force characteristics
compared to the unaffected side.
The intervention study investigated if elderly patients that undergo hip-replacement surgery
could benefit from additional training in the early postoperative phase. The data clearly
demonstrated that resistance training was an effective and safe way to increase muscle mass,
maximal muscle strength, neuromuscular activity, functional performance and decrease the
hospitalisation period compared to regimes of conventional rehabilitation regimen or
electrical muscle stimulation. Additionally the intervention study demonstrated that
resistance training effectively induced marked increases in explosive muscle force
characteristics in elderly subjects compared to rehabilitation regimes using electrical
muscle stimulation or conventional rehabilitation. Furthermore, the gains in maximal muscle
strength and explosive muscle force characteristics were accompanied by significant
increases in EMG amplitudes. Furthermore, the demonstration that explosive muscle force
capacity of the neuromuscular system remains trainable in elderly recovering from prolonged
limb disuse and major surgery may have important implications for future rehabilitation
programs, especially when considering the importance of rapid muscle force capacity on
postural balance, maximal walking speed and other tasks of daily life actions.
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Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment