To illustrate the meaning of these findings, Dr. Fenton said that “reducing sedentary behavior by around one hour per day and replacing it with light physical activity may contribute to around a 6% reduction in long-term risk of cardiovascular disease.”
Sex-Specific Treatment after Total Hip Arthroplasty
If early results hold up with further study, rehabilitation after total hip arthroplasty (THA) tailored specifically to the sex of the patient may offer improved clinical outcomes. In particular, preliminary evidence from a study presented by J. Heather Brunner, graduate student, Physical Therapy, University of Illinois at Chicago, suggests that clinical outcomes in women may be improved by focusing more on hip abductor rehabilitation.
The study included 124 patients, 64 of whom were female, who underwent rehabilitation after THA. Ms. Brunner presented a secondary analysis of this patient cohort aimed at testing the hypothesis that abductor strength and pain or function would differ by sex in patients who undergo rehabilitation after THA. To test this hypothesis, investigators analyzed clinical outcomes separately for men and women based on assessment of hip abductor strength and function and pain scores around one year after THA.
The study found no association between improved function and gait or strength in men. However, in women, the study found a significant relationship between improved function and increased hip range of motion, peak adduction and external rotation moments, and abductor strength. The study also found that improvements in pain differed between men and women, with increased range of motion and decreased peak adduction moment related to pain reduction in men, whereas pain reduction in women was associated with increased external rotation moment.
“Research suggests that women are at higher risk for poorer clinical outcomes after total hip arthroplasty, but we do not yet know how to improve these outcomes,” said Kharma C. Foucher, MD, PhD, assistant professor, Department of Kinesiology and Nutrition, University of Illinois at Chicago, and advisor to Ms. Brunner. “The main finding of our study was that we found that women who had the most gains in both abductor strength and the most improvements in gait mechanics after total hip arthroplasty also had the most functional improvement.”
Mary Beth Nierengarten is a freelance medical journalist based in Minneapolis.
