Case Report: Combined Chain Exercises for Functional Recovery After Total Hip Replacement

Rizanah Agustina; Yeni Tri Nur Hayati; Dimas Arya Nugraha

doi:10.24843/

Authors

Rizanah Agustina Diploma Program in Physiotherapy, Faculty of Health Sciences, Universitas Muhammadiyah Lamongan, Lamongan, East Java, Indonesia Author
Yeni Tri Nur Hayati Department of Physiotherapy, Faculty of Health Sciences, Universitas Muhammadiyah Lamongan, Lamongan, East Java, Indonesia Author
Dimas Arya Nugraha Diploma Program in Physiotherapy, Faculty of Health Sciences, Universitas Muhammadiyah Lamongan, Lamongan, East Java, Indonesia Author

DOI:

https://doi.org/10.24843/

Keywords:

Arthroplasty, Replacement, Hip, Rehabilitation, Exercise Therapy, Resistance Training, Weight-Bearing

Abstract

Introduction: The hip joint is a major weight-bearing joint that is vulnerable to degeneration and injury. Severe hip pathology may cause pain, restricted mobility, and limitations in daily activities. Total Hip Replacement (THR) aims to relieve pain and restore function; however, postoperative pain, muscle spasm, limited range of motion (ROM), and muscle weakness may delay recovery. Combined open kinetic chain (OKC) and closed kinetic chain (CKC) exercises may enhance functional outcomes during post-THR rehabilitation.
Objective: This case report aimed to evaluate the effectiveness of combined OKC and CKC exercises in reducing pain and improving ROM, muscle strength, and functional ability following THR.
Methods: A post-THR patient underwent a physiotherapy program consisting of combined OKC and CKC exercises for six treatment sessions. Outcome measures included pain intensity using the Numeric Rating Scale (NRS), ROM, muscle strength assessed by Manual Muscle Testing (MMT), and functional ability evaluated using the Harris Hip Score (HHS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).
Results: After six sessions, pain decreased from 5/10 to 2/10 on palpation and from 7/10 to 3/10 during movement. Improvements were observed in hip flexion, adduction, and endorotation ROM. Muscle strength of the hip and knee increased. Functional outcomes improved, with HHS increasing from 43.9% to 70.75% and WOMAC decreasing from 44.7% to 23.95%.
Conclusion: Combined OKC and CKC exercises were effective in reducing pain, improving ROM, enhancing muscle strength, and restoring functional ability in a post-THR patient. This approach may serve as an adjunct to standard postoperative rehabilitation.