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There were significant increases in both groups in all the measurements during the 12?weeks of exercises. All participants in the IG were satisfied or very satisfied with the exercises compared with 85% in the CG (P?=?0.095). In the IG, four participants (17.4%) had difficulties when performing the intensified exercises at home. Hip abduction strength was significantly weaker in the leg operated compared with the leg not operated on after the intervention in both groups (P?flupentixol supervision to perform intensified exercises. Copyright ? 2012 John Wiley & Sons, Ltd. The effect of total hip replacement (THR) is well documented; the majority of the patients experience significant pain relief and functional improvements (Ethgen et al. 2004; Kennedy et al. 2006; Roder et al. 2007). Nevertheless, research demonstrates deficits in muscle strength and physical function months and years after the operation (Jan et al. 2004; Jensen et al. 2011; Rasch et al. 2010; PFI-2 Sicard-Rosenbaum et al. 2002; Trudelle-Jackson and Smith 2004). Bhave et al. (2007) suggested that functional limitations after surgery are predominantly related to hip abductor weakness. The asymmetric gait pattern prior to THR has improved but not normalized within the first year after surgery (Foucher et al. 2007; Petersen et al. 2010). Several authors therefore suggested more intense training of muscle strength to improve strength and functional performance, and normalize the gait pattern (Foucher et al. 2007; Jan et al. 2004;Petersen et al. 2010; Rasch et al. 2010; Sicard-Rosenbaum et al. 2002; Trudelle-Jackson and Smith 2004). Maximal strength training in leg press and hip abduction is shown to be feasible 1?week after THR and effective in increasing muscle strength and work efficiency; however, no apparent effect was found on gait performance (Husby et al. 2009; Husby et al. 2010). Effect of supervised training (cardio/strength/range of motion) 8?weeks before and 9?weeks after THR on gait performance, muscle strength and self-perceived function is also documented (Gilbey et al. 2003; Wang et al. selleck products 1998). Suetta et al. (2004) found supervised resistance training of the quadriceps muscle to have a significant effect on the muscle size. The cross-sectional area of the quadriceps muscle in the resistance training group increased by 12% during 12?weeks of training, whereas that in the control group atrophied 9% in the same period. The resistance training group also showed improved muscle strength and sit-to-stand performance significantly compared with the group with standard rehabilitation.