# Molecular Indicators of Isometric Exercise Efficacy in Early Rehabilitation of Older Adults After Total Hip Arthroplasty

## TL;DR

This study explores how isometric exercises improve early rehabilitation after hip surgery by analyzing molecular and genetic changes in muscle tissue and blood markers.

## Contribution

The study introduces blood cytokine levels and muscle transcriptome analysis as novel molecular indicators for evaluating early rehabilitation efficacy after hip surgery.

## Key findings

- Adding isometric exercises accelerated the normalization of IL6, IL8, and IL1β blood levels in older patients after hip surgery.
- Transcriptome analysis revealed enhanced inflammation resolution and vascular-related gene activation in the experimental group.
- Muscle biopsies from the operated leg revealed molecular indicators of regenerative processes after total hip arthroplasty.

## Abstract

Developing molecular methods for assessing the effectiveness of physical rehabilitation remains a pressing task. Our pilot study aimed to assess the utility of the transcriptome analysis of muscle biopsies in evaluating the efficacy of the isometric exercises (IEs) added to the standard protocol in the early rehabilitation of older patients during the initial two weeks post total hip arthroplasty (THA). Blood concentrations of total leukocytes, neutrophils, IL6, IL8, IL1β, myoglobin, etc. were measured, and transcriptome analysis of rectus femoris biopsies from the operated leg was performed before and after (1 and 12 days) THA in women aged 73–77 years. The additional IEs in the experimental rehabilitation group led to a significant acceleration in the recovery of IL6, IL8, and IL1β blood levels to the normal ranges compared to the control group, as confirmed by a Fisher’s exact test for this cytokine combination. The results of Gene Set Enrichment Analysis and Differentially Expressed Gene Analyses for the muscle biopsies point to accelerated resolution of inflammation, along with enhanced activation of genes associated with angiogenesis, lymphangiogenesis, vasodilation, and vasoconstriction in the experimental rehabilitation group compared to the control group. Thus, IL6, IL8, and IL1β blood levels can serve in combination as molecular indicators of the efficacy of early rehabilitation after THA, and transcriptome analysis of the rectus femoris biopsies of the operated leg allows for the revelation of the molecular indicators of regenerative processes in muscle tissue near the surgery area after THA.