Occupational therapy treatment interventions for total hip arthroplasty: A rapid review of evidence

Abstract

Introduction: The demand for total hip arthroplasty is increasing in South Africa and globally. Occupational therapists provide rehabilitation to promote engagement in activities of daily living following total hip arthroplasty. This review aimed to identify evidence for occupational therapy intervention for total hip arthroplasty across care settings and ages.

Method: Rapid review methodology was used and the Cochrane Library and MEDLINE databases were searched for articles published between 1 January 2012 and 31 March 2023. Eleven articles were selected and analysed.

Results: Evidence from randomised controlled trials and systematic reviews reported interventions across care settings. Pre-operative occupational therapy emphasised education and training on adaptive devices, with tele-rehabilitation identified as a promising approach for pre-operative preparation. Post-operative interventions centred on exercises, safety, activities of daily living training, and standard occupational therapy rehabilitation primarily targeting lower limb function. The review highlights the disparity between occupational therapy evidence in high versus low- to middle-income countries, emphasising the importance of contextual interpretation.

Conclusion: While evidence largely aligns with South African occupational therapy practices, gaps exist in upper body strengthening, return to work interventions, and pain management. The need for tailored approaches and further exploration of tele-rehabilitation for optimised outcomes in resource constrained contexts are further noted.

Implications for practice

• Occupational therapists in South Africa need to plan total hip arthroplasty interventions based on local healthcare settings, resources, and patient priorities.


• Occupational therapists should strive for a comprehensive approach to intervention for total hip arthroplasty that includes attention to upper body strengthening, return to work, driving rehabilitation, and pain management.


• Pre-operative education-focused interventions by occupational therapists can enhance patient outcomes and show the use of occupational therapy communication skills in preparing patients for surgery and post-operative recovery after total hip arthroplasty.


• Occupational therapists should explore the use and feasibility of tele-rehabilitation in optimising outcomes for total hip arthroplasty patients in resource constrained contexts.