Objective

To assess the therapeutic validity and effectiveness of physiotherapeutic exercise interventions following total hip arthroplasty (THA) for osteoarthritis.

Data sources

The databases Embase, MEDLINE, Cochrane Library, CINAHL and AMED were searched from inception up to February 2017.

Eligibility criteria

Articles reporting results of randomized controlled trials in which physiotherapeutic exercise was compared with usual care or with a different type of physiotherapeutic exercise were included, with the applied interventions starting within six months after THA. Only articles written in English, German or Dutch were included.

Study appraisal

Therapeutic validity (using the CONTENT scale) and risk of bias (using both the PEDro scale and the Cochrane Collaboration’s tool) were assessed by two researchers independently. Characteristics of the physiotherapeutic exercise interventions and results about joint and muscle function, functional performance and self-reported outcomes were extracted.

Results

Of the 1124 unique records retrieved, twenty articles were included. Only one article was considered to be of high therapeutic validity. Description and adequacy of patient selection were the least reported items. The majority of the articles was considered as having potentially high risk of bias, according to both assessment tools. The level of therapeutic validity did not correspond with the risk of bias scores. Because of the wide variety in characteristics of the physiotherapeutic exercise and control interventions, follow-up length and outcome measures, limited evidence was found on the effectiveness of physiotherapeutic exercise following THA.

Conclusion

The insufficient therapeutic validity and potentially high risk of bias in studies involving physiotherapeutic exercise interventions limit the ability to assess the effectiveness of these interventions following THA. Researchers are advised to take both quality scores into account when developing and reporting studies involving physiotherapeutic exercise. Uniformity in intervention characteristics and outcome measures is necessary to enhance the comparability of clinical outcomes between trials.

中文翻译：

---

全髋关节置换术治疗骨关节炎的物理疗法的治疗有效性和有效性：系统评价

客观的

评估全髋关节置换术（THA）对骨关节炎进行理疗运动干预的疗效和有效性。

数据源

从开始到2017年2月，都搜索了Embase，MEDLINE，Cochrane库，CINAHL和AMED数据库。

资格标准

包括报告随机对照试验结果的文章，其中将理疗锻炼与常规护理或不同类型的理疗锻炼进行了比较，所应用的干预措施于THA后六个月内开始。仅包括用英语，德语或荷兰语撰写的文章。

学习评估

两名研究人员分别评估了治疗有效性（使用CONTENT量表）和偏倚风险（使用PEDro量表和Cochrane协作工具）。提取物理疗法运动干预的特征以及有关关节和肌肉功能，功能表现和自我报告结果的结果。

结果

在检索到的1124条独特记录中，包括了20篇文章。仅一篇文章被认为具有很高的治疗效果。病人选择的描述和充分性是报道最少的项目。根据这两种评估工具，大多数文章被认为具有潜在的偏见风险。治疗有效性的水平与偏倚评分的风险不符。由于理疗运动和控制干预，随访时间和结果指标的特点多种多样，因此在THA后发现理疗运动的有效性的证据有限。

结论

在涉及物理治疗运动干预的研究中，治疗有效性不足和偏倚的潜在高风险限制了THA后评估这些干预措施有效性的能力。建议研究人员在制定和报告涉及理疗锻炼的研究时，应同时考虑两个质量得分。干预特征和结果指标的一致性对于增强试验之间临床结果的可比性是必要的。