Influence of a motivational exercise counseling intervention on rehabilitation outcomes in individuals with arthritis who received total hip replacement.

摘要

Objectives. The purpose of this pilot study was to investigate differences in exercise activity and functional outcomes between older adults with osteoarthritis (OA) who had total hip replacement (THR) surgery and received an adjunct motivational exercise counseling intervention, and those who received usual care. The primary hypothesis held that an intervention that facilitated increased self-efficacy for exercise, perceptions of self-motivation, and reinforced coping skills would aid individuals in adhering to therapeutic exercise regimens beyond termination of physician-prescribed physical therapy sessions.;Design. Randomized clinical trial.;Setting. UPMC rehabilitation setting (outpatient physical therapy clinics).;Participants. Twenty-six (26) older adults with OA who received total hip replacement.;Intervention. Subjects were randomly assigned to either a treatment group that received a specialized Motivational Exercise Counseling intervention or to a control group that received usual care. Main Outcome Measures: Two-month Exercise Diary, Modified Activity Questionnaire, Gait Speed, Timed Chair Rise, WOMAC, MOS SF-36, Self-Efficacy for Exercise, and CES-D.;Analysis. Baseline analysis was performed to compare groups on dependent and demographic variables. Differences between groups were determined using two-way ANOVA (group X time).;Results. A significant interaction of group X time was present for the SF-36 mental health subscale, indicating that experimental subjects reported greater well-being at completion of the study. No significant difference between groups was evident for any of the remaining dependent variables, though differences between groups for exercise activity, performance-based and self-report physical function measures were in the predicted direction.;Conclusions. Small sample size and low statistical power prevent us from determining the effectiveness, or lack of effectiveness, that MEC may have on functional outcomes following rehabilitation after elective THR. Although differences between groups in exercise activity and functional outcomes were not significant, differences were in the predicted direction, warranting further study. Future studies using larger sample sizes are needed to further investigate the efficacy of MEC intervention.