Patient Perspectives on Home-Based Rehabilitation Exercise and General Physical Activity after Total Hip Arthroplasty: A qualitative study (PHETHAS-2)

Abstract

AbstractObjectivesTo investigate patient-perceived facilitators and barriers to home-based rehabilitation exercise and general physical activity after THA.DesignUsing a qualitative design, twenty-two semi-structured interviews were conducted and analyzed using an interpretive thematic analysis approach, with theoretical underpinning from the concept conduct of everyday life. The study is embedded within the PHETHAS-1 trial, quantitatively investigating recovery outcomes after a home-based rehabilitation exercise program.SettingA regional hospital in Denmark between January 2018 and May 2019.ParticipantsTwenty-two patients who had undergone THA and performed home-based rehabilitation exercise.ResultsThe main theme “Wishing to return to the well-known everyday life” and the subtheme “General physical activity versus rehabilitation exercise” were identified. Generally, the participants found the home-based rehabilitation exercise boring but were motivated by the goal of returning to their habitual conduct of everyday life and perform their usual general physical activities. Participants enrolled in the PHETHAS-1 study used the enrollment as part of their motivation for doing the exercises.Both pain and no pain were identified as barriers for doing the home-based rehabilitation exercise. Pain could cause insecurity while no pain could cause the rehabilitation exercise to be perceived as pointless.ConclusionsThe overall goal for the THA patients was to return to their habitual everyday life. This goal served as a facilitator for undertaking home-based rehabilitation exercise. Being able to perform their usual activities paradoxically became a barrier for some of the participants, as they were more motivated towards general physical activity than the rehabilitation exercise.Contribution of paperKey messagesPatients undergoing total hip arthroplasty have goal of returning to their habitual everyday life doing their usual physical activities.Home-based rehabilitation exercise can be perceived as boring and time-consuming and the goal of returning to their habitual everyday life serves as a facilitator to perform the rehabilitation exercise.What this paper addsBoth pain and no pain can be a barrier to performing home-based rehabilitation exercise.Pain can cause uncertainty as to whether performing an exercise could be harmful, while no pain can cause the rehabilitation exercise to be perceived as pointless.Standard care patients tend to modify the rehabilitation program as they are gradually able to perform their usual general physical activities.Enrolment in clinical studies and contact with health professionals can facilitate adherence to home-based rehabilitation exercise.Trial identifierNCT03109821