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2016;14(1):174-209

The effectiveness of inpatient physical therapy compared to outpatient physical therapy in older adults after total hip replacement in the post-discharge period: a systematic review

Jitka Klugarova1 Miloslav Klugar1 Jana Mareckova1 Jiri Gallo1 Zuzana Kelnarova1

1. The Czech Republic (Middle European) Centre for Evidence-Based Health Care: an Affiliate Center of the Joanna Briggs Institute; Department of Social Medicine and Public Health, Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czech Republic Corresponding author: Miloslav Klugar [email protected]

Executive summary Background Total hip replacement is the most effective and safest method for treating severe degenerative, traumatic and other diseases of the hip joint. Total hip replacement can reliably relieve pain and improve function in the majority of patients for a period of 15 to 20 years or more postoperatively. Physical therapy follows each total hip replacement surgery. Physical therapy protocols after total hip replacement in the post-discharge period vary widely in terms of setting (inpatient, outpatient), content (the particular set of exercises used), and frequency (e.g. daily versus twice a week). In current literature, there is no systematic review which has compared the effectiveness of inpatient and outpatient physical therapy in patients after total hip replacement in the post-discharge period. Objectives The objective of this systematic review was to compare the effectiveness of inpatient physical therapy with outpatient physical therapy on the quality of life and gait measures in older adults after total hip replacement in the post-discharge period.

Klugarova et al.The effectiveness of inpatient physical therapy compared to outpatient physical therapy in older adults after total hip replacement in the post-discharge period: a systematic review © the authors 2016 doi: 10.11124/jbisrir-2016-2392 Page 174

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Inclusion criteria Types of participants This review considered studies that include older adults (over 65 years) who have had total hip replacement and are in the post-discharge period. Adults with bilateral or multiple simultaneous surgeries and also patients who have had hemiarthroplasty of the hip joint were excluded. Types of intervention This review considered studies that included any type of physical therapy delivered in inpatient settings provided by professionals with education in physical therapy. Inpatient physical therapy delivered at any frequency and over any duration was included. Types of comparator This review considered studies that included as a comparator any type of physical therapy delivered in outpatient settings provided by professionals with education in physical therapy or no physical therapy. Types of outcomes This review considered studies that included the following primary and secondary outcomes. The primary outcome was quality of life, assessed by any validated assessment tool. The secondary outcome was measures of gait assessed by any valid methods. Types of studies This review considered both experimental and observational study designs including randomized controlled trials, non-randomized controlled trials, quasi-experimental, before and after studies, prospective and retrospective cohort studies, case control studies and analytical cross sectional studies for inclusion. Search strategy The search strategy aimed to find both published and unpublished studies. A three-step search strategy was utilized in 12 databases. Studies published in all languages and any date were considered for inclusion in this review. Methodological quality Assessment of methodological quality was not conducted as no studies were identified that met the inclusion criteria. Data extraction and synthesis Data extraction and synthesis was not performed because no studies were included in this systematic review.

Klugarova et al.The effectiveness of inpatient physical therapy compared to outpatient physical therapy in older adults after total hip replacement in the post-discharge period: a systematic review © the authors 2016 doi: 10.11124/jbisrir-2016-2392 Page 175

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Results During to the three-step search strategy 4330 papers were identified. The primary and secondary reviewer independently retrieved 42 potentially relevant papers according to the inclusion criteria by title and abstract screening. Following assessment of full text all of the retrieved papers were excluded based on the inclusion criteria. Conclusions There is no scientific evidence comparing the effectiveness of inpatient physical therapy with outpatient physical therapy in older patients after total hip replacement in the post-discharge period. Implications for research This systematic review has identified gaps in the literature for comparing the effectiveness of inpatient physical therapy with and outpatient physical therapy on the quality of life and gait measures in older adults after total hip replacement in the post-discharge period. Prospective randomized double blind multicenter controlled trials are needed to answer this important clinical question. Keywords Total hip replacement; physical therapy; inpatient; outpatient; home-based; quality of life; gait; post-discharge period; older adults

Background Total hip replacement (THR) is the most effective and safest method for treating severe degenerative, traumatic and other diseases of the hip joint. In the period 2000 to 2010, the incidence of primary THR in the USA increased from 142.2/100,000 to 257/100,000 in patients aged 45 and over.1 A similar study in Denmark reported an increase in the incidence of THRs from 101/100,000 to 131/100,000 between 1996 and 2002.2 In Australia, an annual increase of 46.3% was observed from 2003 to 2013. 3 More importantly, modeled future projections predict a future increase in the need for THRs.4 Total hip replacement can reliably relieve pain and improve function in the majority of patients for a period of 15 to 20 years or more postoperatively. 5 This is applicable especially for the elder population but not for younger patients aged below 60 years. The Kaplan-Meier ten-year revision-free survival estimates for younger patients range from 72% (95% CI: 67-76) in Finland to 86% (95% CI: 84.5-88.2) in Sweden.6 Hence, 14% to 28% of such patients on average did not achieve a 10-year THR functioning without revision. On this basis, the expected time of service of THRs is insufficient and the number of revision surgeries would therefore increase in the future. To avoid this trend, new technologies have been introduced into the practice (e.g. highly cross-linked polyethylene, trabecular metal, new generation of ceramics). Currently, their true contribution to increased survivorship of THR is widely discussed.7 However, valid and reliable data with at least 15 years of follow-up for a group of younger patients are still not available. For the purpose of this review, the reviewers focused on THR only in the context of elder patients. Particularly, they aimed to compare the effectiveness of inpatient physical therapy with outpatient physical therapy in achieving and maintaining the long-term outcome of THR.

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An understanding of the baseline status of patients undergoing THR surgery is fundamental, especially elderly patients who have to face a continuously growing number of challenges closely related to aging, such as cognitive and sensory impairments, comorbidities that decrease aerobic functional capacity, increased risk for falls, progressively decreased muscle strength and loss of coordination, and psychological and social problems. The next key objective is related to examining the overall physical activities after the THR surgery. Decreased physical activity is one of the most important health problems worldwide, particularly in elderly people. Orthopedic surgeons believe that THR surgery leads to an increase in the overall level of physical activity. 8 However, to date there is only weak evidence supporting this expectation. A recent study revealed no difference in physical activity six months after the surgery despite self-reported improvements after THR in terms of pain relief, physical function and quality of life.9 The key task in this line is to determine the minimal level of daily exercise and physical activity required for long-term satisfactory function of THR. Physical therapy follows each THR surgery. Physical therapy protocols after THR in the post-discharge period vary widely in terms of setting (inpatient, outpatient), content (the particular set of exercises used), and frequency (e.g. daily versus twice a week). Inpatient physical therapy is provided in a rehabilitation department, a hospital unit or an inpatient rehabilitation center with daily frequency by professionals with education in physical therapy. The patient is also accommodated in this setting under the guidance of professionals with education in physical therapy. Outpatient physical therapy is provided in rehabilitation day centers or clinics twice per week (at a minimum) under the guidance of professionals with education in physical therapy. Outpatient physical therapy can be also home-based under the above conditions.10-13 However, a couple of important questions remain unanswered. For instance, how long postoperative physical therapy should be provided and whether it should be repeated in the post-discharge period (and if yes, when, etc.). On one hand, there is strong consensus that health professional-supervised functional programs that are provided regularly (starting immediately postoperatively) are more effective than those based on the unguided individual exercise platform with “body structure and function” (e.g. pain, joint proprioception, etc.) and “activity and participation” outcomes (e.g. gait, stability, etc.).14 Overall, there is no one universally accepted physiotherapeutic approach for older adults after THR in the post-discharge period. However, it is clear that even intermittent but regular institutional physical therapy for all elder patients after THR surgery is not affordable even for the most developed countries.15 In current literature, there is no high quality evidence from systematic reviews which has compared the effectiveness of inpatient physical therapy with outpatient physical therapy in patients after THR in the post-discharge period. Five systematic reviews dealing with general effectiveness of physical therapy after THR showed the overall effect of physical therapy after THR. 16-20 However, these systematic reviews included only controlled trials and their results were limited by lack of controlled trials in the literature. In 2005, an evidence-based analysis comparing inpatient and outpatient physical therapy was done in Canada.10 However, this study included not only patients after having undergone THR but also those who have undergone total knee replacement. Unfortunately, conclusions of comparisons between inpatient and outpatient physical therapy in groups after THR are very unclear. The JBI Database of Systematic Reviews and Implementation Reports, the Cochrane Library and the PROSPERO database for systematic reviews were searched and no existing or currently underway systematic reviews relevant to review question were found. This systematic review includes not only

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randomized controlled trials but also lower levels of evidence, including non-randomized controlled trials, quasi-experimental studies, before and after studies, prospective and retrospective cohort studies, case control studies and analytical cross sectional studies. This review aimed to compare the effectiveness of inpatient physical therapy with outpatient physical therapy after THR based on quality of life and gait measures. Evaluation of quality of life was included in most of the medical studies which assessed the effectiveness of indicated therapy and allowed for both physical and psychological aspects of health to be examined. Additionally, this systematic review focused on the influence of physical therapy after THR on gait performance because gait is the basic function characterizing the human locomotion. Biomechanical gait analysis can contribute to complex information on the influences of the chosen therapy on the most natural human motion behavior. Objectives, inclusion criteria and methods of analysis for this review were specified in advance and documented in a protocol.21

Review question What is the effectiveness of inpatient physical therapy compared to outpatient physical therapy on the quality of life and gait measures in older adults after total hip replacement in the post-discharge period?

Inclusion criteria Types of participants This review considered studies that include older adults (over 65 years) who have had total hip replacement and are in the post-discharge period. Adults with bilateral or multiple simultaneous surgeries and also patients who have had hemiarthroplasty of the hip joint were excluded. Types of intervention This review considered studies that include any type of physical therapy delivered in inpatient settings provided by professionals with education in physical therapy. Inpatient physical therapy delivered at any frequency and over any duration was included. Types of comparator This review considered studies that include as a comparator any type of physical therapy delivered in outpatient settings provided by professionals with education in physical therapy or no physical therapy. Types of outcomes This review considered studies that include the following primary and secondary outcomes. Primary outcomes included quality of life, assessed by any validated assessment tool (such as SF-36, WHOQOL, AQoL, etc.). Secondary outcomes included gait measures assessed by any valid methods (such as kinematics analysis, dynamic analysis, EMG, etc.). Types of studies This review considered both experimental and observational study designs including randomized controlled trials, non-randomized controlled trials, quasi-experimental, before and after studies,

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prospective and retrospective cohort studies, case control studies and analytical cross sectional studies for inclusion.

Search strategy The search strategy aimed to find both published and unpublished studies. A three-step search strategy was utilized in this review. This was followed by the title, abstract and index term of each article that was analyzed. An initial limited search of MEDLINE, Embase and CINAHL used keywords, such as "hip”, ”replacement", ”arthroplasty”, etc. A second search using all identified keywords and index terms was undertaken in the following databases: Medline (Ovid MEDLINE(R) 1946 to current), CINAHL (CINAHL® Plus with Full Text 1935 to current), Embase (1974 to current), Cochrane Library, Web of Science, Nursing Ovid and Pedro. The search for unpublished studies included: grey literature (ClinicalTrials.gov, Current Controlled Trials, Cos Conference Papers Index, Grey Literature Report, Mednar), dissertation theses (ProQuest), etc. Thirdly, the reference lists of all identified reports and articles were searched for additional studies. Studies published in all languages were considered for inclusion in this review if they contained an abstract written in English. Studies published in any date were considered for inclusion in this review. Initial keywords to be used were: 1. hip OR hips 2. arthroplasty OR implantation OR endoprosthesis OR replacement 3. rehabilitation OR kinesiotherapy OR physiotherapy OR physical therapy OR physical training OR physical exercise OR resistance training OR aquatic therapy OR pool exercise OR hydrotherapy OR musculoskeletal manipulation OR exercise therapy OR kinesiology OR manual therapy OR therapeutic exercise 4. inpatient OR outpatient OR home-based OR center-based 5. 1 AND 2 AND 3 AND 4

Method of the review Paper retrieval All identified papers were downloaded into software EndNote X7. A two-phase paper retrieval was done independently by the primary and secondary reviewer according to the inclusion criteria. Firstly, the relevancy of all identified primary studies was assessed by title and abstract analysis. Secondly, the full texts of the potentially relevant primary studies (retrieved during first phase of paper retrieval) were searched and their relevancy assessed according to full text analysis. Both phases of paper retrieval were followed by a comparison of the list of excluded and included studies done by both the primary and secondary reviewer. Any disagreement between primary and secondary reviewer was solved by discussion between them or with the associated reviewer. This situation did not happen; however the

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associated reviewer was invited to assess the relevancy of 10 studies which were the closest to the review question and inclusion criteria in order to increase the rigor of this selection process.

Assessment of methodological quality The reviewers had planned to use the Joanna Briggs Institute approach to assessing methodological quality. However, assessment of methodological quality was not done because no studies were retrieved during the two-phase paper retrieval.

Data extraction and synthesis Data extraction and synthesis was not done because no study was included in this systematic review.

Results Description of studies According to the three step search strategy, 4330 papers were found: 251 in MEDLINE, 424 in Embase, 133 in CINAHL, 596 in Web of Science, 323 in Pedro, 55 in NursingOvid, 110 in the Cochrane Library, 680 in ProQuest, six in ProQuest Dissertation and Theses, seven in COS, 198 in Clinical Trials, 147 in current controlled trials and 1546 in Mednar. There were 1287 duplicates identified and removed using citation manager EndNote X7. The primary and secondary reviewers independently retrieved 42 potentially relevant papers (from the initial 3043 papers) according to the inclusion criteria by title and abstract screening (see Figure 1). Following assessment of full text all of the retrieved papers were excluded with a reason according to the inclusion criteria (see Appendix IV).

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Eligibility

Screening

Identification

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Papers identified through systematic searching (n = 4330)

Papers screened on the basis of title and abstract (n = 3043)

Papers after duplicates removed (n = 1287)

Non-relevant papers excluded (n = 3001)

Full-text assessed for

Non-relevant papers

eligibility accordint to

excluded (n = 42)

inclusion criteria (n = 42)

Studies included in critical

Included

appraisal (n = 0)

Papers included in quantitative synthesis (meta-analysis) (n = 0)

From: Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6(6): e1000097. doi:10.1371/journal.pmed1000097

Figure 1. Flow Diagram of search and study selection (modified according to Moher, Liberati, Tetzlaff, Altman and Group22)

Discussion No experimental or observational studies were identified that compared the effectiveness of inpatient physical therapy versus outpatient physical therapy or no physical therapy in older patients after hip replacement in the post discharge period on gait performance or quality of life. In the current literature, there are some primary studies comparing different types of physical therapy according to setting in patients after THR in post-discharge period such as inpatient and outpatient physical therapy. 23-27 However, they were excluded during the second stage of paper retrieval because in three of them the experimental and control group included adults in all ages.23,25,26 In two of them, the reviewers also found a difference in the range of ages between the experimental and control groups.26,28 Importantly, in

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terms of quality of life, there were generally significant differences in the quality of life among different age categories.29,30 There were also age-related factors that influence recovery, e.g. in terms of wound healing after major surgery.31-34 In one excluded study, the authors analyzed patients after hip replacement together with patients after knee replacement but unfortunately did not perform subgroup analysis.25 Another issue with most of the primary studies dealing with physical therapy after THR was unclear description of the procedures which formed the tested rehabilitation protocol,18 particularly, information on the type of rehabilitation setting and supervision of rehabilitation by professional with education in physical therapy was really unclear.

24,35

Previous systematic reviews addressing the effectiveness of physical therapy after THR also highlighted the lack of primary studies (specifically RCTs), sparse results and no detailed evidence based protocols.16,18,20 Minns Lowe, Barker, Dewey and Sackley20 assessed generally the effectiveness of physical therapy after hip replacement in post-discharge period and synthesized eight RCTs. However, because of the poor methodological quality of the included studies and also the diversity of their results, they were not able to draw exact conclusions.20 Di Monaco and Castiglioni 18 attempted to find out which type and/or timing of exercise therapy was effective following THR and synthesized nine RCTs. They found sparse results and no detailed evidence-based protocols on the type and timing of exercise therapy after THR. However, the authors concluded that the most robust evidence corroborates ergometer cycling and resistance strength training in the early postoperative phase, and weight bearing exercise in the late phase.18 Coulter, Scarvell, Neeman and Smith

16

synthesized two

RCTs and compared the effectiveness between outpatient supervised physiotherapy with unsupervised home based physiotherapy and did not find any significant difference between these two in relation to walking speed, walking cadence and quality of life.16 Potential biases and errors in the review process This systematic review is the first that considered not only RCTs like the previous published reviews but all experimental and observational study designs. A comprehensive three-step systematic search in 13 databases including published and unpublished studies was performed. The systematic search strategy was very sensitive and was undertaken by an experienced librarian (see Appendix I). This minimized the risk of missing potentially relevant primary studies during the search process. Paper retrieval was done in two phases independently by two experienced reviewers (certified JBI trainers trained in the by in “comprehensive systematic review training program”). Any disagreement was resolved by discussion between the primary and secondary reviewers or with associated reviewer. Therefore, we also minimized the risk of missing potentially relevant primary study during paper retrieval.

Conclusion Although the risks of errors and biases were minimized during this review process and the study design, language or date were not limited, it can be concluded that there is no scientific evidence comparing the effectiveness of inpatient physical therapy without patient physical therapy in older patients after total hip replacement in the post-discharge period.

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Implications for practice No conclusions regarding if inpatient physical therapy is more effective than outpatient therapy in older patients after hip replacement in the post discharge period in terms of gait performance and quality of life due to the lack of evidence. Implications for research Generally, one of the main problems of many experimental or observational studies dealing with effectiveness of different types of physical therapy after hip replacement was the heterogeneity of age in patients.23,25,26,28,36 Another issue was that in some studies, the authors analyzed patients after knee replacement together with patients after hip replacement.25 Unfortunately, in many studies clear and specific description of tested rehabilitation protocol was missing. This systematic review identified gaps in the comparison of the effectiveness of inpatient and outpatient physical therapy on the quality of life and gait measures in older adults after total hip replacement in the post-discharge period. Prospective randomized double blind multicenter controlled trials are needed to answer this important clinical question.

Conflict of interest The reviewers declare that there were no conflicts of interest.

Acknowledgement This review was supported by grant of European Social Funds "Support of Human Resources in Science and Research in Non-medical Healthcare at the Faculty of Health Sciences at Palacký University Olomouc" (CZ.1.07/2.3.00/20.0163).

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References 1. Wolford ML, Palso K, Bercovitz A. Hospitalization for total hip replacement among inpatients aged 45 and over: United States, 2000-2010. NCHS data brief. 2015 (186):1-8. 2. Pedersen AB, Johnsen SP, Overgaard S, Soballe K, Sorensen HT, Lucht U. Total hip arthroplasty in Denmark: incidence of primary operations and revisions during 1996-2002 and estimated future demands. Acta Orthop. 2005;76(2):182-9. 3. Graves SE, Davidson D, Ingerson L, Ryan P, Griffith EC, McDermott BF, et al. The Australian Orthopaedic Association National Joint Replacement Registry. Med J Aust. 2004;180(5 Suppl):S31-4. 4. Bashinskaya B, Zimmerman RM, Walcott BP, Antoci V. Arthroplasty Utilization in the United States is Predicted by Age-Specific Population Groups. ISRN Orthop. 2012;2012. 5. Gallo J, Lostak J, Langova K. Long-term survival of the uncemented Balgrist total hip replacement cup. Int Orthop. 2013;37(8):1449-56. 6. Corbett KL, Losina E, Nti AA, Prokopetz JJ, Katz JN. Population-based rates of revision of primary total hip arthroplasty: a systematic review. PLoS One. 2010;5(10):e13520. 7. Chana R, Facek M, Tilley S, Walter WK, Zicat B, Walter WL. Ceramic-on-ceramic bearings in young patients: outcomes and activity levels at minimum ten-year follow-up. Bone Joint J. 2013 ;95-B(12):1603-9. 8. Learmonth ID, Young C, Rorabeck C. The operation of the century: total hip replacement. Lancet. 2007;370(9597):1508-19. 9. Harding P, Holland AE, Delany C, Hinman RS. Do Activity Levels Increase After Total Hip and Knee Arthroplasty? Clin Orthop Relat Res. 2013;472(5):1502-1511. 10. Health Quality O. Physiotherapy rehabilitation after total knee or hip replacement: an evidence-based analysis. Ont Health Technol Assess Ser. 2005;5(8):1-91. 11. Unify. Total hip replacement. [Clinical Guideline]. In: Guideline of Physiotherapy recommended by Union of Physiotherapists of the Czech Republic., 2004. Czech Republic: Union of Physiotherapists of the Czech Republic. 12. GMC. In: Inpatient Rehabilitation Facilities. 2014. Baltimore, US: Medicare. 13. GMC. In: Comprehensive Outpatient Rehabilitation Facilities. 2014. Baltimore, US: Medicare. 14. Westby MD, Brittain A, Backman CL. Expert consensus on best practices for post-acute rehabilitation after total hip and knee arthroplasty: a Canada and United States Delphi study. Arthritis Care Res (Hoboken). 2014;66(3):411-23. 15. Tian W, DeJong G, Horn SD, Putman K, Hsieh CH, DaVanzo JE. Efficient rehabilitation care for joint replacement patients: skilled nursing facility or inpatient rehabilitation facility? Med Decis Making. 2012;32(1):176-87. 16. Coulter CL, Scarvell JM, Neeman TM, Smith PN. Physiotherapist-directed rehabilitation exercises in the outpatient or home setting improve strength, gait speed and cadence after elective total hip replacement: a systematic review. J Physiother. 2013;59(4):219-26. 17. Alviar MJ, Olver J, Brand C, Tropea J, Hale T, Pirpiris M, et al. Do patient-reported outcome measures in hip and knee arthroplasty rehabilitation have robust measurement attributes? A systematic review. J Rehabil Med. 2011;43(7):572-83. 18. Di Monaco M, Castiglioni C. Which type of exercise therapy is effective after hip arthroplasty? A systematic review of randomized controlled trials. quiz 921-3. Eur J Phys Rehabil Med. 2013 ;49(6):893-907, 19. Minns Lowe CJ, Davies L, Sackley CM, Barker KL. Effectiveness of land-based physiotherapy exercise following hospital discharge following hip arthroplasty for osteoarthritis: an updated systematic review. Physiotherapy. 2015;101(3):252-65.

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20. Minns Lowe CJ, Barker KL, Dewey ME, Sackley CM. Effectiveness of physiotherapy exercise following hip arthroplasty for osteoarthritis: a systematic review of clinical trials. BMC Musculoskelet Disord. 2009;10(98):1-14. 21. Klugarova J, Klugar M, Gallo J, Mareckova J, Kelnarova Z. The effectiveness of inpatient physical therapy compared to outpatient physical therapy in older adults after total hip replacement in the post-discharge period: a systematic review protocol. JBI Database System Rev Implement Reports. 2015;13(7):4-12. 22. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009 Jul 21;6(7):e1000097. 23. Krummenauer F, Gunther KP, Witzleb WC. The incremental cost effectiveness of in-patient versus out-patient rehabilitation after total hip arthroplasty - Results of a pilot investigation. European Journal of Medical Research. 2008;13(6):267-274. 24. Maager M, Scherak O, eL Shohoumi M, Wottawa A. Rehabilitation after total hip replacement. International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation. 1995;18(3):266-9. 25. Mahomed NN, Davis AM, Hawker G, Badley E, Davey JR, Syed KA, et al. Inpatient compared with home-based rehabilitation following primary unilateral total hip or knee replacement: a randomized controlled trial. J Bone Joint Surg Am, American Volume. 2008;90(8):1673-1680. 26. Siggeirsdottir K, Olafsson O, Jonsson H, Iwarsson S, Gudnason V, Jonsson BY. Short hospital stay augmented with education and home-based rehabilitation improves function and quality of life after hip replacement - Randomized study of 50 patients with 6 months of follow-up. Acta Orthopaedica. 2005;76(4):555-562. 27. Unlu E, Eksioglu E, Aydog E, Aydod ST, Atay G. The effect of exercise on hip muscle strength, gait speed and cadence in patients with total hip arthroplasty: a randomized controlled study. Clinical Rehabilitation. 2007;21(8):706-711. 28. Tribe KL, Lapsley HM, Cross MJ, Courtenay BG, Brooks PM, March LM. Selection of patients for inpatient rehabilitation or direct home discharge following total joint replacement surgery: a comparison of health status and out-of-pocket expenditure of patients undergoing hip and knee arthroplasty for osteoarthritis. Chronic Illn. 2005;1(4):289‐302. 29. Rustoen T, Wahl AK, Hanestad BR, Lerdal A, Paul S, Miaskowski C. Age and the experience of chronic pain: differences in health and quality of life among younger, middle-aged, and older adults. Clin J Pain. 2005;21(6):513-23. 30. SF-36. In: U.S. Population Norms. 1998 A community for measuring health outcomes using SF tools. Medical Outcomes Trust. 31. Gosain A, DiPietro LA. Aging and wound healing. World J Surg. 2004;28(3):321-6. 32. Thomas DR. Age-related changes in wound healing. Drugs Aging. 2001;18(8):607-20. 33. Van de Kerkhof PC, Van Bergen B, Spruijt K, Kuiper JP. Age-related changes in wound healing. Clin Exp Dermatol. 1994;19(5):369-74. 34. Gerstein AD, Phillips TJ, Rogers GS, Gilchrest BA. Wound healing and aging. Dermatol Clin. 1993;11(4):749-57. 35. Okoro T, Morrison V, Maddison P, Lemmey AB, Andrew JG. An assessment of the impact of behavioural cognitions on function in patients partaking in a trial of early home-based progressive resistance training after total hip replacement surgery. Disabil. Rehabil. 2013;35(23):2000-2007. 36. Bak R, Strohbach H, Venbrocks RA, Smolenski U. Generic and specific health-related quality of life at short-term follow-up after total hip arthroplasty and inpatient rehabilitation program. Physikalische Medizin Rehabilitationsmedizin Kurortmedizin. 2001;11(4):129-132.

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Appendix I: Search strategy

MEDLINE (1946 to 2nd week in January 2015)

Results

1

hip*.mp

273879

2

arthroplast*.mp

50771

3

implantation.mp

164067

4

endoprosthes*.mp

4991

5

replacement.mp

203198

6

2 OR 3 OR 4 OR 5

368514

7

rehabilitation*.mp

112731

8

kinesiotherap*.mp

107

9

physiotherap*.mp

14391

10

physical therap*.mp

37112

11

physical training*.mp

4307

12

physical exercise*.mp

9873

13

resistance training*.mp

5568

14

aquatic therap*.mp

56

15

pool exercise*.mp

26

16

hydrotherap*.mp

2390

17

musculoskeletal manipulation*.mp

953

18

exercise therap*.mp

27163

19

kinesiolog*.mp

800

20

manual therap*.mp

1086

21

therapeutic exercise*.mp

777

22

7 OR 8 OR 9 OR 10 OR 11 OR 12 OR 13 OR 14 OR 15 OR 16 OR 17 OR 18 OR

186309

19 OR 20 OR 21 23

inpatient*.mp

68178

24

outpatient*.mp

117891

25

home based.mp

4711

26

centre based.mp

222

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27

home programme*.mp

75

28

home program*.mp

449

29

hospital based.mp

17205

30

institutional.mp

59513

31

rehabilitation unit*.mp

1971

32

rehabilitation center*.mp

8672

33

23 OR 24 OR 25 OR 26 OR 27 OR 28 OR 29 OR 30 OR 31 OR 32

255725

34

1 AND 6 AND 22 AND 33

251

Embase (1974 to 2015 Week 03)

Results

1

hip*.mp

373163

2

arthroplast*.mp

61595

3

implantation.mp

202182

4

endoprosthes*.mp

16415

5

replacement.mp

288716

6

2 OR 3 OR 4 OR 5

522844

7

rehabilitation*.mp

196763

8

kinesiotherap*.mp

23863

9

physiotherap*.mp

71843

10

physical therap*.mp

21080

11

physical training*.mp

6393

12

physical exercise*.mp

15059

13

resistance training*.mp

8970

14

aquatic therap*.mp

127

15

pool exercise*.mp

36

16

hydrotherap*.mp

3844

17

musculoskeletal manipulation*.mp

110

18

exercise therap*.mp

3368

19

kinesiolog*.mp

2383

20

manual therap*.mp

2069

Klugarova et al.The effectiveness of inpatient physical therapy compared to outpatient physical therapy in older adults after total hip replacement in the post-discharge period: a systematic review © the authors 2016 doi: 10.11124/jbisrir-2016-2392 Page 187

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21

therapeutic exercise*.mp

1279

22

7 OR 8 OR 9 OR 10 OR 11 OR 12 OR 13 OR 14 OR 15 OR 16 OR 17 OR 18

304174

OR 19 OR 20 OR 21 23

inpatient*.mp

98476

24

outpatient*.mp

206765

25

home based.mp

7059

26

centre based.mp

405

27

home programme*.mp

115

28

home program*.mp

705

29

hospital based.mp

22975

30

institutional.mp

68004

31

rehabilitation unit*.mp

3437

32

rehabilitation center*.mp

12043

33

23 OR 24 OR 25 OR 26 OR 27 OR 28 OR 29 OR 30 OR 31 OR 32

384045

34

1 AND 6 AND 22 AND 33

424

CINAHL (18. 1. 2015)

Results

1

hip* Ti/Ab

31340

2

arthroplast* Ti/Ab

11790

3

implantation Ti/Ab

10727

4

endoprosthes* Ti/Ab

280

5

replacement Ti/Ab

20094

6

2 OR 3 OR 4 OR 5

40841

7

rehabilitation* Ti/Ab

51665

8

kinesiotherap* Ti/Ab

61

9

physiotherap* Ti/Ab

11485

10

physical therap* Ti/Ab

12878

11

physical training* Ti/Ab

1983

12

physical exercise* Ti/Ab

4547

13

resistance training* Ti/Ab

2648

14

aquatic therap* Ti/Ab

251

Klugarova et al.The effectiveness of inpatient physical therapy compared to outpatient physical therapy in older adults after total hip replacement in the post-discharge period: a systematic review © the authors 2016 doi: 10.11124/jbisrir-2016-2392 Page 188

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2016;14(1):174-209

15

pool exercise* Ti/Ab

55

16

hydrotherap* Ti/Ab

327

17

musculoskeletal manipulation* Ti/Ab

13

18

exercise therap* Ti/Ab

2774

19

kinesiolog* Ti/Ab

407

20

manual therap* Ti/Ab

1838

21

therapeutic exercise* Ti/Ab

800

22

7 OR 8 OR 9 OR 10 OR 11 OR 12 OR 13 OR 14 OR 15 OR 16 OR 17 OR 18

82070

OR 19 OR 20 OR 21 23

inpatient* Ti/Ab

21907

24

outpatient* Ti/Ab

27269

25

home based Ti/Ab

4818

26

home-based Ti/Ab

3013

27

centre based Ti/Ab

495

28

centre-based Ti/Ab

86

29

home programme* Ti/Ab

636

30

home program* Ti/Ab

4289

31

hospital based Ti/Ab

7470

32

hospital-based Ti/Ab

5053

33

institutional Ti/Ab

11310

34

rehabilitation unit* Ti/Ab

2102

35

23 OR 24 OR 25 OR 26 OR 27 OR 28 OR 29 OR 30 OR 31 OR 32 OR 33 OR

71527

34 36

1 AND 6 AND 22 AND 35

133

Web of Science (18. 1. 2015)

Results

1

hip* Ti/Topic

314934

2

arthroplast* Ti/Topic

46902

3

implantation Ti/Topic

164727

4

endoprosthes* Ti/Topic

4885

5

replacement Ti/Topic

273824

Klugarova et al.The effectiveness of inpatient physical therapy compared to outpatient physical therapy in older adults after total hip replacement in the post-discharge period: a systematic review © the authors 2016 doi: 10.11124/jbisrir-2016-2392 Page 189

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6

2 OR 3 OR 4 OR 5

454823

7

rehabilitation* Ti/Topic

123701

8

kinesiotherap* Ti/Topic

70

9

physiotherap* Ti/Topic

14078

10

physical therap* Ti/Topic

55825

11

physical training* Ti/Topic

28654

12

physical exercise* Ti/Topic

59769

13

resistance training* Ti/Topic

13055

14

aquatic therap* Ti/Topic

695

15

pool exercise* Ti/Topic

2815

16

hydrotherap* Ti/Topic

656

17

musculoskeletal manipulation* Ti/Topic

450

18

exercise therap* Ti/Topic

31119

19

kinesiolog* Ti/Topic

1037

20

manual therap* Ti/Topic

8944

21

therapeutic exercise* Ti/Topic

7042

22

7 OR 8 OR 9 OR 10 OR 11 OR 12 OR 13 OR 14 OR 15 OR 16 OR 17 OR 18

276973

OR 19 OR 20 OR 21 23

inpatient* Ti/Topic

65583

24

outpatient* Ti/Topic

103086

25

home based Ti/Topic

53982

26

centre based Ti/Topic

225291

27

home programme* Ti/Topic

5121

28

home program* Ti/Topic

26657

29

hospital based Ti/Topic

96513

30

institutional Ti/Topic

98865

31

rehabilitation unit* Ti/Topic

9215

32

rehabilitation center* Ti/Topic

8042

33

23 OR 24 OR 25 OR 26 OR 27 OR 28 OR 29 OR 30 OR 31 OR 32

613382

34

1 AND 6 AND 22 AND 33

596

Klugarova et al.The effectiveness of inpatient physical therapy compared to outpatient physical therapy in older adults after total hip replacement in the post-discharge period: a systematic review © the authors 2016 doi: 10.11124/jbisrir-2016-2392 Page 190

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Pedro (18.1.2015)

Results

1

total hip replacement Ti/Ab

88

2

hip replacement Ti/Ab

110

3

implantation AND hip* Ti/Ab

2

4

therap* AND hip* Ti/Ab

322

5

celkem staženo záznamů (překrývaly se)

323

Nursing Ovid (1946 to January Week 2 2015)

Results

1

hip*.mp

6796

2

arthroplast*.mp

1839

3

implantation.mp

1463

4

endoprosthes*.mp

29

5

replacement.mp

5630

6

2 OR 3 OR 4 OR 5

7418

7

rehabilitation*.mp

17718

8

kinesiotherap*.mp

4

9

physiotherap*.mp

2563

10

physical therap*.mp

6130

11

physical training*.mp

412

12

physical exercise*.mp

709

13

resistance training*.mp

2651

14

aquatic therap*.mp

28

15

pool exercise*.mp

5

16

hydrotherap*.mp

251

17

musculoskeletal manipulation*.mp

61

18

exercise therap*.mp

3696

19

kinesiolog*.mp

104

20

manual therap*.mp

149

21

therapeutic exercise*.mp

3822

22

7 OR 8 OR 9 OR 10 OR 11 OR 12 OR 13 OR 14 OR 15 OR 16 OR 17 OR 18 OR

29578

19 OR 20 OR 21

Klugarova et al.The effectiveness of inpatient physical therapy compared to outpatient physical therapy in older adults after total hip replacement in the post-discharge period: a systematic review © the authors 2016 doi: 10.11124/jbisrir-2016-2392 Page 191

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23

inpatient*.mp

12464

24

outpatient*.mp

9330

25

home based.mp

909

26

centre based.mp

25

27

home programme*.mp

26

28

home program*.mp

132

29

hospital based.mp

2041

30

institutional.mp

9498

31

rehabilitation unit*.mp

536

32

rehabilitation center*.mp

2519

33

23 OR 24 OR 25 OR 26 OR 27 OR 28 OR 29 OR 30 OR 31 OR 32

33977

34

1 AND 6 AND 22 AND 33

55

Cochrane library (19. 1. 2015)

Results

1

hip* Ti/Ab/Key

12034

2

arthroplast* Ti/Ab/Key

5498

3

implantation Ti/Ab/Key

9237

4

endoprosthes* Ti/Ab/Key

187

5

replacement Ti/Ab/Key

15947

6

2 OR 3 OR 4 OR 5

26028

7

rehabilitation* Ti/Ab/Key

13205

8

kinesiotherap* Ti/Ab/Key

718

9

physiotherap* Ti/Ab/Key

4530

10

physical therap* Ti/Ab/Key

15255

11

physical training* Ti/Ab/Key

7573

12

physical exercise* Ti/Ab/Key

15166

13

resistance training* Ti/Ab/Key

3704

14

aquatic therap* Ti/Ab/Key

119

15

pool exercise* Ti/Ab/Key

528

16

hydrotherap* Ti/Ab/Key

257

Klugarova et al.The effectiveness of inpatient physical therapy compared to outpatient physical therapy in older adults after total hip replacement in the post-discharge period: a systematic review © the authors 2016 doi: 10.11124/jbisrir-2016-2392 Page 192

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17

musculoskeletal manipulation* Ti/Ab/Key

295

18

exercise therap* Ti/Ab/Key

16035

19

kinesiolog* Ti/Ab/Key

89

20

manual therap* Ti/Ab/Key

2838

21

therapeutic exercise* Ti/Ab/Key

1758

22

7 OR 8 OR 9 OR 10 OR 11 OR 12 OR 13 OR 14 OR 15 OR 16 OR 17 OR 18 OR

51091

19 OR 20 OR 21 23

inpatient* Ti/Ab/Key

6937

24

outpatient* Ti/Ab/Key

18286

25

home based Ti/Ab/Key

5162

26

home-based Ti/Ab/Key

2035

27

centre based Ti/Ab/Key

8312

28

centre-based Ti/Ab/Key

175

29

home programme* Ti/Ab/Key

1165

30

home program* Ti/Ab/Key

4758

31

hospital based Ti/Ab/Key

9506

32

hospital-based Ti/Ab/Key

1390

33

institutional Ti/Ab/Key

2835

34

rehabilitation unit* Ti/Ab/Key

1035

35

rehabilitation center* Ti/Ab/Key

1189

36

23 OR 24 OR 25 OR 26 OR 27 OR 28 OR 29 OR 30 OR 31 OR 32 OR 33 OR 34

47167

OR 35 37

1 AND 6 AND 22 AND 36

110

ProQuest (19. 1.2015)

Results

1

hip* Ti/Ab

1396296

2

arthroplast* Ti/Ab

69157

3

implantation Ti/Ab

273609

4

endoprosthes* Ti/Ab

8729

5

replacement Ti/Ab

1328741

6

2 OR 3 OR 4 OR 5

1651352

Klugarova et al.The effectiveness of inpatient physical therapy compared to outpatient physical therapy in older adults after total hip replacement in the post-discharge period: a systematic review © the authors 2016 doi: 10.11124/jbisrir-2016-2392 Page 193

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7

rehabilitation* Ti/Ab

659707

8

kinesiotherap* Ti/Ab

313

9

physiotherap* Ti/Ab

63730

10

physical therap* Ti/Ab

197095

11

physical training* Ti/Ab

101708

12

physical exercise* Ti/Ab

121298

13

resistance training* Ti/Ab

31553

14

aquatic therap* Ti/Ab

3003

15

pool exercise* Ti/Ab

19284

16

hydrotherap* Ti/Ab

6205

17

musculoskeletal manipulation* Ti/Ab

719

18

exercise therap* Ti/Ab

65946

19

kinesiolog* Ti/Ab

12937

20

manual therap* Ti/Ab

16008

21

therapeutic exercise* Ti/Ab

14446

22

7 OR 8 OR 9 OR 10 OR 11 OR 12 OR 13 OR 14 OR 15 OR 16 OR 17 OR 18 OR

1175933

19 OR 20 OR 21 23

inpatient* Ti/Ab

170031

24

outpatient* Ti/Ab

290662

25

home based Ti/Ab

362329

26

home-based Ti/Ab

48145

27

centre based Ti/Ab

892213

28

centre-based Ti/Ab

14305

29

home programme* Ti/Ab

78227

30

home program* Ti/Ab

780755

31

hospital based Ti/Ab

365452

32

hospital-based Ti/Ab

41079

33

institutional Ti/Ab

645221

34

rehabilitation unit* Ti/Ab

42557

35

rehabilitation center* Ti/Ab

112996

36

23 OR 24 OR 25 OR 26 OR 27 OR 28 OR 29 OR 30 OR 31 OR 32 OR 33 OR 34

3592343

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OR 35 37

1 AND 6 AND 22 AND 36

850

38

po automatickém odstranění duplicit

680

ProQuest Disserations & Theses (19. 1. 2015)

Results

1

hip* Ti/Ab

915

2

arthroplast* Ti/Ab

55

3

implantation Ti/Ab

354

4

endoprosthes* Ti/Ab

2

5

replacement Ti/Ab

1503

6

2 OR 3 OR 4 OR 5

1914

7

rehabilitation* Ti/Ab

1764

8

kinesiotherap* Ti/Ab

0

9

physiotherap* Ti/Ab

25

10

physical therap* Ti/Ab

882

11

physical training* Ti/Ab

665

12

physical exercise* Ti/Ab

601

13

resistance training* Ti/Ab

208

14

aquatic therap* Ti/Ab

7

15

pool exercise* Ti/Ab

24

16

hydrotherap* Ti/Ab

2

17

musculoskeletal manipulation* Ti/Ab

3

18

exercise therap* Ti/Ab

166

19

kinesiolog* Ti/Ab

12

20

manual therap* Ti/Ab

96

21

therapeutic exercise* Ti/Ab

64

22

7 OR 8 OR 9 OR 10 OR 11 OR 12 OR 13 OR 14 OR 15 OR 16 OR 17 OR 18 OR

4519

19 OR 20 OR 21 23

inpatient* Ti/Ab

1096

24

outpatient* Ti/Ab

1312

25

home based Ti/Ab

3185

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26

home-based Ti/Ab

305

27

centre based Ti/Ab

3752

28

centre-based Ti/Ab

87

29

home programme* Ti/Ab

38

30

home program* Ti/Ab

2582

31

hospital based Ti/Ab

2060

32

hospital-based Ti/Ab

287

33

institutional Ti/Ab

9016

34

rehabilitation unit* Ti/Ab

254

35

rehabilitation center* Ti/Ab

185

36

23 OR 24 OR 25 OR 26 OR 27 OR 28 OR 29 OR 30 OR 31 OR 32 OR 33 OR 34

24159

OR 35 37

1 AND 6 AND 22 AND 36

6

COS Papers (19.1.2015)

Results

1

hip* Ti/Ab

19389

2

arthroplast* Ti/Ab

2366

3

implantation Ti/Ab

10257

4

endoprosthes* Ti/Ab

195

5

replacement Ti/Ab

16326

6

2 OR 3 OR 4 OR 5

29144

7

rehabilitation* Ti/Ab

9524

8

kinesiotherap* Ti/Ab

1

9

physiotherap* Ti/Ab

624

10

physical therap* Ti/Ab

1347

11

physical training* Ti/Ab

1229

12

physical exercise* Ti/Ab

1046

13

resistance training* Ti/Ab

483

14

aquatic therap* Ti/Ab

32

15

pool exercise* Ti/Ab

27

16

hydrotherap* Ti/Ab

26

Klugarova et al.The effectiveness of inpatient physical therapy compared to outpatient physical therapy in older adults after total hip replacement in the post-discharge period: a systematic review © the authors 2016 doi: 10.11124/jbisrir-2016-2392 Page 196

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17

musculoskeletal manipulation* Ti/Ab

4

18

exercise therap* Ti/Ab

338

19

kinesiolog* Ti/Ab

51

20

manual therap* Ti/Ab

102

21

therapeutic exercise* Ti/Ab

63

22

7 OR 8 OR 9 OR 10 OR 11 OR 12 OR 13 OR 14 OR 15 OR 16 OR 17 OR 18 OR

14897

19 OR 20 OR 21 23

inpatient* Ti/Ab

1500

24

outpatient* Ti/Ab

2461

25

home based Ti/Ab

2531

26

home-based Ti/Ab

412

27

centre based Ti/Ab

14409

28

centre-based Ti/Ab

162

29

home programme* Ti/Ab

117

30

home program* Ti/Ab

1366

31

hospital based Ti/Ab

1703

32

hospital-based Ti/Ab

445

33

institutional Ti/Ab

7200

34

rehabilitation unit* Ti/Ab

323

35

rehabilitation center* Ti/Ab

280

36

23 OR 24 OR 25 OR 26 OR 27 OR 28 OR 29 OR 30 OR 31 OR 32 OR 33 OR 34

32909

OR 35 37

1 AND 6 AND 22 AND 36

7

Clinical trials (19.1.2015) total hip replacement = 198 z. (prohledáváno pole All fields) hip* AND therap* = 0 z. hip* AND rerhabiliation* = 0 z.

Current Controlled trials total hip replacement = 94 z. (prohledáváno pole Keyword)

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hip* AND therap* = 0 z. hip* AND rehabiliation* = 0 z.

Mednar total hip replacement = 781 z. (prohledáváno pole Keyword) hip* AND therap* = 375 z. (prohledáváno pole Keyword) hip* AND rehabilitation* = 390 z. (prohledáváno pole Keyword)

Grey Literature Report total hip replacement = 0 z. (prohledáváno pole All fields) hip* AND therap* = 0 z. (prohledáváno pole All fields) hip* AND rehabilitation* = 0 z. (prohledáváno pole All fields)

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Appendix II: Appraisal instruments MAStARI appraisal instrument

Klugarova et al.The effectiveness of inpatient physical therapy compared to outpatient physical therapy in older adults after total hip replacement in the post-discharge period: a systematic review © the authors 2016 doi: 10.11124/jbisrir-2016-2392 Page 199

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Appendix III: Data extraction instruments MAStARI data extraction instrument

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Appendix IV: Excluded studies 1.

Bak P, Muller WD, Bocker B, Smolenski UC. Short-term patterns of recovery from total hip and knee

arthroplasty

after

multidisciplinary

inpatient

rehabilitation.

Physikalische

Medizin

Rehabilitationsmedizin Kurortmedizin 2008;18:11-8. Reason for exclusion: age of patients did not match inclusion criteria, missing comparison with control group. 2.

Bak R, Strohbach H, Venbrocks RA, Smolenski U. Generic and specific health-related quality of life at short-term follow-up after total hip arthroplasty and inpatient rehabilitation program. Physikalische Medizin Rehabilitationsmedizin Kurortmedizin 2001;11:129-32.

Reason for exclusion: age of patients did not match inclusion criteria, missing comparison with control group. 3.

Bindawas SM, Graham JE, Karmarkar AM, Chen N-W, Granger CV, Niewczyk P, et al. Trajectories in functional recovery for patients receiving inpatient rehabilitation for unilateral hip or knee replacement. Archives of Gerontology & Geriatrics. 2014;58(3):344-349.

Reason for exclusion: outcome of study did not match inclusion criteria. 4.

Cary MP, Jr. Inpatient Rehabilitation Outcomes in Medicare Hip Fracture Patients. ProQuest Dissertations and Theses. 2012:214-n/a. Available from: ProQuest Central; ProQuest Hospital Collection

Reason for exclusion: missing comparison of inpatient physical therapy with outpatient or home based physical therapy or no physical therapy, did not match inclusion criteria, outcomes of study also did not match inclusion criteria. 5.

Ciotola E, Dall'armi V, Margutti F. Hydrotherapy after total hip arthroplasty: a follow-up study. Archives of gerontology and geriatrics. 2010;50(1):92-5.

Reason for exclusion: this study comparing the effectiveness of two types of inpatient physical therapy did not match inclusion criteria, the outcome of this study also did not match inclusion criteria. 6.

Coulter CL, Weber JM, Scarvell JM. Group physiotherapy provides similar outcomes for participants after joint replacement surgery as 1-to-1 physiotherapy: a sequential cohort study. Archives of Physical Medicine & Rehabilitation. 2009;90(10):1727-1733.

Reason for exclusion: age of patients did not match inclusion criteria, intervention and comparison also did not match inclusion criteria. 7.

Dahl E, Stanghelle JK. [Rehabilitation after hip arthroplasty]. Rehabilitering av pasienter etter hofteplastikk. 1983;103(13):1052-4.

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Reason for exclusion: age of patients did not match inclusion criteria. 8.

David G. Murray MD, Renée SC, Kay Dickersin P, Pamela Woods Duncan PPT, Charles H. Epps Jr MD, Walter H. Ettinger Jr MD, et al. Total Hip Replacement. JAMA. 1995;273(24):1950-1956.

Reason for exclusion: just a review of literature. 9.

Galea MP. A Targeted Strengthening Program Following Total Hip Replacement. Australia: National Health and Medical Research Council University of Melbourne, Australia 2003.

Reason for exclusion: just a record of registration of clinical trial “11. Galea MP, et al. A targeted home- and center-based exercise program for people after total hip replacement: a randomized clinical trial…” (see reason for exclusion below). 10. Galea MP. Hip Replacements; New findings from University of Melbourne describe advances in hip replacements. Medical Devices & Surgical Technology Week. Atlanta: NewsRx 2008:192. Reason for exclusion: Just summary of results of the clinical trial “11. Galea MP, Levinger P, Lythgo N, Cimoli C, Weller R, Tully E, et al. A targeted home- and center-based exercise program for people after total hip replacement: a randomized clinical trial…” (see reason for exclusion below). 11. Galea MP, Levinger P, Lythgo N, Cimoli C, Weller R, Tully E, et al. A targeted home- and center-based exercise program for people after total hip replacement: a randomized clinical trial [corrected] [published erratum appears in ARCH PHYS MED REHABIL 2009 Dec;90(12):2162]. Archives of Physical Medicine & Rehabilitation. 2008;89(8):1442-1447. Reason for exclusion: intervention and comparison did not match inclusion criteria. 12. Gilbey HJ, Ackland TR, Wang AW, Morton AR, Trouchet T, Tapper J. Exercise improves early functional recovery after total hip arthroplasty. Clinical Orthopaedics and Related Research [clinical trial]. 2003 Mar (408):193-200. Reason for exclusion: intervention and comparison did not match inclusion criteria, outcomes also did not match inclusion criteria. 13. Greenberg K, Kroll T. Relationship Between Body Weight and the Length of Stay in Inpatient Rehabilitation After Total Hip Replacement. 133rd Annual Meeting and Exposition of the American Public Health Association. 2005. Reason for exclusion: the objective of this primary study did not match review objective. 14. Haase I, Albrecht C, Swoboda B, Kladny B. Long-term effects of rehabilitation following hip replacement. Physikalische Medizin Rehabilitationsmedizin Kurortmedizin. 2000;10(3):94-97. Reason for exclusion: age of patients did not match inclusion criteria, there was missing

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comparison with control group which did not match inclusion criteria. 15. Hansen TB, Jacobsen F, Larsen K. Cost effective interprofessional training: An evaluation of a training unit in Denmark. Journal of Interprofessional Care. 2009;23(3):234-241. Reason for exclusion: intervention and comparison did not match inclusion criteria. 16. Hauer K, Specht N, Schuler M, Bärtsch P, Oster P. Intensive physical training in geriatric patients after severe falls and hip surgery. Age & Ageing. 2002;31(1):49-57. Reason for exclusion: type of population did match inclusion criteria, intervention and also comparison did not match inclusion criteria. 17. Heiberg KE, Bruun-Olsen V, Ekeland A, Mengshoel AM. Effect of a walking skill training program in patients who have undergone total hip arthroplasty: Followup one year after surgery. Arthritis Care & Research. 2012 Mar;64(3):415-423. Reason for exclusion: intervention and comparison did not match inclusion criteria. 18. Ho EK, Harvey DT, Caldwell SK. Outcome measures of an inpatient rehabilitation unit in patients with fractured hip and hip replacement - Correlation between the quality of life survey and functional independence measure. 2000. Reason for exclusion: type of population did not match inclusion criteria, there was also missing comparison which did not match inclusion criteria. 19. Husby VS, Helgerud J, Bjorgen S, Husby OS, Benum P, Hoff J. Early Maximal Strength Training Is an Efficient Treatment for Patients Operated With Total Hip Arthroplasty. Archives of Physical Medicine and Rehabilitation 2009;90:1658-67. Reason for exclusion: age of patients, intervention and also comparison did not match inclusion criteria. 20. Jakovljevic M, Vauhnik R. Aquatic exercises versus land based exercises for elderly patients after a total hip replacement. Zdravniski Vestnik-Slovenian Medical Journal. 2011 Apr;80(4):240-245. Reason for exclusion: intervention and comparison did not match inclusion criteria, outcome also did not match inclusion criteria. 21. Jonsson B, Sigurdsson E, Siggeirsdottir K, Janssen H, Gudnason V, Matthasson T. Early discharge, education and home based rehabilitation reduces unit costs after total hip replacement: Results of a cost analysis in a randomised study. J Bone Joint Surg Am (Proceedings). 2006; 88-b(Supp_i): Reason for exclusion: specific information about population, intervention and comparison missing, outcome did not match inclusion criteria.

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22. Krummenauer F, Gunther KP, Witzleb WC. The incremental cost effectiveness of in-patient versus out-patient rehabilitation after total hip arthroplasty - Results of a pilot investigation. European Journal of Medical Research 2008;13:267-74. Reason for exclusion: age of patients and also outcomes did not match inclusion criteria. 23. Larsen K, Hansen TB, Thomsen PB, Christiansen T, Soballe K. Cost-Effectiveness of Accelerated Perioperative Care and Rehabilitation After Total Hip and Knee Arthroplasty. J Bone Joint Surg Am. 2009 Apr;91A(4):761-772. Reason for exclusion: intervention and comparison did not match inclusion criteria. 24. Maager M, Scherak O, eL Shohoumi M, Wottawa A. Rehabilitation after total hip replacement. International

journal

of

rehabilitation

research

Internationale

Zeitschrift

fur

Rehabilitationsforschung Revue internationale de recherches de readaptation 1995;18:266-9. Reason for exclusion: outcomes did not match inclusion criteria, no information if control group had home-based physical therapy delivered by professionals with education in physical therapy. 25. Mahomed NN, Davis AM, Hawker G, et al. Inpatient compared with home-based rehabilitation following primary unilateral total hip or knee replacement: a randomized controlled trial. J Bone Joint Surg Am 2008;90:1673-80. Reason for exclusion: age of patients did not match inclusion criteria, they also analyzed patients after hip and knee total hip replacement together which did not match inclusion criteria. 26. Mahomed NN, Lin MJK, Levesque J, Lan S, Bogoch ER. Determinants and outcomes of inpatient versus home based rehabilitation following elective hip and knee replacement. J Rheumatol. 2000;27(7):1753-1758. Reason for exclusion: No limitation of age of the patients and no information about minimal age of the patients, just mean and standard deviation, patients younger than 65 years were included, which did not match inclusion criteria, home-based physical therapy was not supervised by physical therapist, which also did not match inclusion criteria. 27. Mallinson T, Deutsch A, Bateman J, Tseng H-Y, Manheim L, Almagor O, et al. Comparison of Discharge Functional Status After Rehabilitation in Skilled Nursing, Home Health, and Medical Rehabilitation Settings for Patients After Hip Fracture Repair. Archives of Physical Medicine & Rehabilitation. 2014;95(2):209-217. Reason for exclusion: outcome did not match inclusion criteria. 28. Marcu IR, Patru S, Bighea A, Popescu RS, Bumbea AM. Effect of hydrotherapy vs. Conventional land-based exercise in patients with hiparthroplasty for osteoarthritis. Osteoporosis International. 2014;25:S421.

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Reason for exclusion: intervention and comparison did not match inclusion criteria. 29. Messecar D. "Hospital at home" care was generally as effective as routine hospital care for older adults [commentary on Shepperd S, Harwood D, Jenkinson C, et al. Randomised controlled trial comparing hospital at home care with inpatient hospital care. I: three month follow up of health outcomes. BR MED J 1998;316(7147):1786-91 and Shepperd S, Harwood D, Gray A, et al. Randomised controlled trial comparing hospital at home care with inpatient hospital care. II: cost minimisation analysis. BR MED J 1998 Jun 13;316:1791-6]. Evidence Based Nursing. 1999;2(2):50-51. Reason for exclusion: intervention and comparison did not match inclusion criteria. 30. Munin MC, Glynn N, Rudy TE, Crossett LS, Rubash HE. Randomized controlled trial of early inpatient rehabilitation after elective hip and knee arthroplasty. 2000. Reason for exclusion: intervention and comparison did not match inclusion criteria, outcome also did not match inclusion criteria. 31. Munin MC, Rudy TE, Glynn NW, Crossett LS, Rubash HE. Early inpatient rehabilitation after elective hip and knee arthroplasty. JAMA: Journal of the American Medical Association. 1998;279(11):847-852. Reason for exclusion: intervention and comparison did not match inclusion criteria, outcome also did not match inclusion criteria. (the same study as previous one). 32. Okoro T, Morrison V, Maddison P, Lemmey AB, Andrew JG. An assessment of the impact of behavioural cognitions on function in patients partaking in a trial of early home-based progressive resistance training after total hip replacement surgery. Disability & Rehabilitation 2013;35:2000-7. Reason for exclusion: age of patients did not match inclusion criteria, intervention and also comparison did not match inclusion criteria, unclear setting in the case of control group. 33. R & D GJNH. Pedometer Based Intervention After Total Hip Replacement-A Pilot Study. Golden Jubilee National Hospital, Glasgow,Scotland, United Kingdom: Ben Stansfield 2013. Reason for exclusion: results of study not published and age of patients did not match inclusion criteria, intervention also did not match inclusion criteria. 34. Scherak O, Kolarz G, Wottawa A, Maager M, el Shohoumi M. Effect of inpatient rehabilitation measures on patients with total hip endoprostheses – evaluation 15 months after operation. Acta medica Austriaca. 1996;23(4):142-145. Reason for exclusion: the objective of this primary study did not match review objective. 35. Siggeirsdottir K, Olafsson O, Jonsson H, Iwarsson S, Gudnason V, Jonsson BY. Short hospital stay augmented with education and home-based rehabilitation improves function and quality of life after hip replacement - Randomized study of 50 patients with 6 months of follow-up. Acta Orthopaedica

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2005;76:555-62. Reason for exclusion: age of patients did not match inclusion, large difference in range of age between experimental group and control group. 36. Slaven E, Kotecki J, Dugan EL, Walker S. A national survey of physical therapists to determine outpatient practices following total hip arthroplasty... 2008 Combined Sections Meeting...Nashville, Tennessee, February 6-9, 2008. J Orthop Sports Phys Ther.. 2008;38(1):A42-3. Reason for exclusion: the objectives of this primary study did not match review objective. 37. Tribe KL, Lapsley HM, Cross MJ, Courtenay BG, Brooks PM, March LM. Selection of patients for inpatient rehabilitation or direct home discharge following total joint replacement surgery: a comparison of health status and out-of-pocket expenditure of patients undergoing hip and knee arthroplasty for osteoarthritis (Provisional abstract). Chronic Illness2005:289-302. Reason for exclusion: age of patients did not match inclusion criteria, not clear if outpatient home-based therapy was delivered by professionals with education in physical therapy, difference in range of age between experimental group and control group. 38. Unlu E, Eksioglu E, Aydog E, Aydod ST, Atay G. The effect of exercise on hip muscle strength, gait speed and cadence in patients with total hip arthroplasty: a randomized controlled study. Clinical Rehabilitation 2007;21:706-11. Reason for exclusion: age of patients, intervention and also comparison did not match inclusion criteria. 39. Vincent HK, Lee LW, Weng J, Alfano AP. Outcomes after inpatient rehabilitation of primary and revision

total

hip

arthroplasty.

Archives

of

physical

medicine

and

rehabilitation.

2006;87(8):1026-32. Reason for exclusion: the objective of this primary study did not match review objective. 40. Westby MD. Rehabilitation and Total Joint Arthroplasty. Clinics in Geriatric Medicine. 2012;28(3):489-508. Reason for exclusion: just a review of literature. 41. Yoslow W, Simeone J, Huestis D. Hip replacement rehabilitation. Archives of Physical Medicine and Rehabilitation. 1976;57(6):275-278. Reason for exclusion: age of patients did not match inclusion criteria, there was also missing comparison with control group. 42. Zuckerman JD. Inpatient rehabilitation after total joint replacement. JAMA. 1998;279(11):880. Reason for exclusion: just an editorial, not a primary study.

Klugarova et al.The effectiveness of inpatient physical therapy compared to outpatient physical therapy in older adults after total hip replacement in the post-discharge period: a systematic review © the authors 2016 doi: 10.11124/jbisrir-2016-2392 Page 209

The effectiveness of inpatient physical therapy compared to outpatient physical therapy in older adults after total hip replacement in the post-discharge period: a systematic review.

Total hip replacement is the most effective and safest method for treating severe degenerative, traumatic and other diseases of the hip joint. Total h...
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