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The purpose of this study is to examine the feasibility, safety and outcomes of a study comparing a 6-week post-operative rehabilitation program to usual care in patients ≤60 years undergoing elective unilateral total hip arthroplasty (THA). Methods: A cohort of 24 THA patients were recruited during their 6-week postoperative visit to their surgeons. The community-based rehabilitation program, which was designed to improve function and increase activity, consisted of 12 structured exercise classes on land and water over 6 weeks. Physical activity was assessed using a Sense Wear Pro Armband (SWA). Participants completed the Hip Osteoarthritis Outcome Score (HOOS) and THA satisfaction questionnaire before and immediately after the intervention. Results: 14 participants received the augmented rehabilitation, and 10 participants were in the control group. All except one in the intervention group completed at least 80% of the sessions. The intervention group took significantly more steps/day (mean difference = 2440 steps/day, 95% CI = 1678, 4712) (p < 0.05), at the follow-up compared to baseline. The intervention group had a higher mean change of number of weekly PA bouts than the control group. Within the intervention group, all HOOS subscales were significantly higher at the follow-up compared to baseline. Conclusion: Findings provided pragmatic insight regarding the intervention and assessments of implementing an augmented rehabilitation program for elective THA. [ABSTRACT FROM AUTHOR]

This study aimed to determine the comparative effectiveness of interventions in treatment of sarcopenia. The primary outcome was the measure of treatment effect on muscle mass, and secondary outcomes were the treatment effect on muscle strength and physical performance. Systematic review and network meta-analysis (NMA). Participants with sarcopenia receiving interventions targeting sarcopenia in any setting. Data sources : Relevant RCTs were identified by a systematic search of several electronic databases, including CINAHL, Embase, MEDLINE, and the Cochrane Central Registry of Controlled Trials (CENTRAL) from January 1995 to July 2019. Duplicate title and abstract and full-text screening, data extraction, and risk of bias assessment were performed. Data extraction : All RCTs examining sarcopenia interventions [mixed exercise (combined aerobic and resistance exercise), aerobic exercise, resistance exercise, balance exercise, physical activity and protein or nutrition supplementation, acupuncture, whole-body vibration, protein supplement or interventions to increase protein intake, any nutritional intervention other than protein, and pharmacotherapy] were included. Comparators were standard care, placebo, or another intervention. Data synthesis : We performed Bayesian NMA; continuous outcome data were pooled using the standardized mean difference effect size. Interventions were ranked using the surface under the cumulative ranking curve (SUCRA) for each outcome. A total of 59 RCTs were included after screening of 4315 citations and 313 full-text articles. Network meta-analysis of muscle mass outcome (including 46 RCTs, 3649 participants, 11 interventions) suggested that mixed exercise were the most effective intervention (SUCRA = 93.94%) to increase muscle mass. Physical activity and protein or nutrition supplementation, and aerobic exercise were the most effective interventions to improve muscle strength and physical performance, respectively. Overall, mixed exercise is the most effective intervention in increasing muscle mass and was one of the 3 most effective interventions in increasing muscle strength and physical performance. Mixed exercise and physical activity with nutritional supplementation are the most effective sarcopenia interventions. Most of the included studies have a high risk of bias. More robust RCTs are needed to increase the confidence of our NMA results and the quality of evidence. [ABSTRACT FROM AUTHOR]