Intervention group
Participants in the intervention group will receive the
usual care program of rehabilitation. They will also receive
15 min of additional exercises at each physiotherapy session
(total time of 1 h, twice per day) designed specifically
to target strengthening of the hip abductor muscles.
The following exercises are unique to the hip strengthening
group and have been selected after a review of the
literature investigating the efficacy of various hip abductor
strengthening exercises (Table 2 and Additional file 1)
[18, 19, 24–27]. They will be performed in addition to
usual care received following TKA at the rehabilitation
hospital. The participants will initially perform non-weight
bearing antigravity hip strengthening exercises, such as
sidelying hip abduction, prone hip extension, standing abduction.
The exercises will be progressed to weight bearing,
gravity-resisted exercises such as sideways walking, and hip
abduction whilst standing on the operated leg. If the participant
receives hydrotherapy they will perform the same
additional hip strengthening exercises in the water, to
address the identical goals of the land based program.