Efficacy of real-time feedback exercise therapy in patients following total hip arthroplasty: a pilot cluster-randomized controlled trial
5 affiliations
- 1Department Health Sciences, University of Applied Sciences Campus Vienna, Favoritenstrasse 232, Vienna, 1100 Austria
- 2Paracelsus Medical University, Institute for Biomechanics, Strubergasse 21, Salzburg, 5020 Austria
- 3Orthopedic Hospital Vienna-Speising, 2nd Department, Speisinger Strasse 109, Vienna, 1130 Austria
- 4University of Vienna, Centre for Sport Science and University Sports, Neuromechanics Research Group, Auf Der Schmelz 6, Vienna, 1150 Austria
- 5BG-Unfallklinik Murnau, Institute for Biomechanics, Professor-Küntscher-Strasse 8, Murnau, 82418 Germany
Abstract
Background: The prevalence of hip osteoarthritis is increasing and frequently requires total hip arthroplasty (THA). However, a standardized rehabilitation protocol to ensure sustainable functional recovery from THA has yet to be established. Therefore, this study compared the effects of real-time feedback-assisted home-exercise versus standard written instructions on the functional performance of patients following unilateral THA.
Methods: This study was designed as a cluster-randomized controlled pilot trial with two parallel groups. Data from three-dimensional movement analysis, clinical examination, body-composition, activity monitoring and questionnaires were collected at baseline four weeks post-surgery, and follow-ups at three- and six-months post-surgery. Baseline measurements were followed by an eight-week supervised group exercise therapy. For home-exercise the control-group received printed instructions, whereas the intervention-group was provided a real-time feedback prototype.
Results: A total of 22 patients, aged 52 to 73 years (mean 62.9), participated in the study, 21 completed the intervention and thereof, 19 could be assessed at six-months post-surgery. No statistically significant differences were found for the primary outcomes frontal knee, pelvis and trunk range-of-motion during level walking, nor the secondary outcomes Harris Hip Score (HHS), SF-12 and IPAQ short form. Both groups improved their mean walking speed, cadence, step length, isometric knee flexion force of operated limb, SF-12 physical domain and HHS.
Conclusion: Real-time feedback assisted home-exercise after THA did not differ when compared to commonly used written instructions in improving function and quality of life. However, patients in the real-time feedback group reported greater motivation and self-confidence regarding exercise performance, which was not reflected in the recorded numbers of home-exercise sessions.
Trial registration: The study was prospectively registered on 7th December 2023 at ClinicalTrials.gov NCT06161194.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12891-026-10321-1.
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BibTeX
@article{widhalm2026efficacy,
title = {{Efficacy of real-time feedback exercise therapy in patients following total hip arthroplasty: a pilot cluster-randomized controlled trial}},
author = {Klaus Widhalm and Lukas Berger-Maul and Harald Penasso and Sebastian Durstberger and Peter Putz and Sebastian Leder-Berg and Hans Kainz and Peter Augat},
journal = {BMC Musculoskeletal Disorders},
year = {2026},
month = aug,
doi = {10.1186/s12891-026-10321-1},
url = {https://doi.org/10.1186/s12891-026-10321-1},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Efficacy of real-time feedback exercise therapy in patients following total hip arthroplasty: a pilot cluster-randomized controlled trial
AU - Klaus Widhalm
AU - Lukas Berger-Maul
AU - Harald Penasso
AU - Sebastian Durstberger
AU - Peter Putz
AU - Sebastian Leder-Berg
AU - Hans Kainz
AU - Peter Augat
PY - 2026
DA - 2026/08/04
JO - BMC Musculoskeletal Disorders
DO - 10.1186/s12891-026-10321-1
UR - https://doi.org/10.1186/s12891-026-10321-1
AB - Background: The prevalence of hip osteoarthritis is increasing and frequently requires total hip arthroplasty (THA). However, a standardized rehabilitation protocol to ensure sustainable functional recovery from THA has yet to be established. Therefore, this study compared the effects of real-time feedback-assisted home-exercise versus standard written instructions on the functional performance of patients following unilateral THA. Methods: This study was designed as a cluster-randomized controlled pilot trial with two parallel groups. Data from three-dimensional movement analysis, clinical examination, body-composition, activity monitoring and questionnaires were collected at baseline four weeks post-surgery, and follow-ups at three- and six-months post-surgery. Baseline measurements were followed by an eight-week supervised group exercise therapy. For home-exercise the control-group received printed instructions, whereas the intervention-group was provided a real-time feedback prototype. Results: A total of 22 patients, aged 52 to 73 years (mean 62.9), participated in the study, 21 completed the intervention and thereof, 19 could be assessed at six-months post-surgery. No statistically significant differences were found for the primary outcomes frontal knee, pelvis and trunk range-of-motion during level walking, nor the secondary outcomes Harris Hip Score (HHS), SF-12 and IPAQ short form. Both groups improved their mean walking speed, cadence, step length, isometric knee flexion force of operated limb, SF-12 physical domain and HHS. Conclusion: Real-time feedback assisted home-exercise after THA did not differ when compared to commonly used written instructions in improving function and quality of life. However, patients in the real-time feedback group reported greater motivation and self-confidence regarding exercise performance, which was not reflected in the recorded numbers of home-exercise sessions. Trial registration: The study was prospectively registered on 7th December 2023 at ClinicalTrials.gov NCT06161194. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12891-026-10321-1.
SN - 1471-2474
ER -