Exercise prescription following joint replacement Flashcards
Which are the most commun?
Knee & Hip replacement (around 1 million each)
Who is affected by those surgeries
- Women>Men <=> OA is higher in women
- <65 yo
Why is it important to do exercise post surgery?
- Pain reduction
- To minimize disability
- Restore ROM, function, strengh, mobility
- Encourage mvt & decrease risk of DVT
Rehabilitation phases
- Early phases
- Late phase
Early phase for THR
2-16 weeks
Early phase for TKR
3-16 weeks
Late phase for THR
12 weeks to 8 months
Late phase for TKR
12 weeks to 12 months
What’s the average hospital length of stay after surgery?
5 to 6.50 days (UK)
How to assess the pain during exercise?
Numeric pain rating scale
What are the reccommended post acute rehab interventions?
- Therapeutic & functional exercises
- Gait traaining
- CV training
- Electrical/thermal modalities
- Manual therapy
- Patient education topics
Dosage for exercises
Frq : 3-4 x/day
Reps : 8-12
Sets : 1-4
Rest : 2-3 min between sets
-> Incr. as rehab stages progress
Exercise prescription for TKR
- Activity based focused
- Early mobilization
- Standart physiotherapy
Early goals for TKR
- Control pain/swelling
- Gait w/ appropriate gait aid
- Prevent medical complication
- 90° flexion & full extension!!
Late goals for TKR
- Full active knee extension
- Knee flexion at least 110° (functional range?)
-Resume o f normal activities
Common strength deficits after a TKR
-quads/hamstrings
-hip flexors/add
-calf muscles (2ndary to long term gait deviation)
Which function are difficult after a TKR?
Sit-to-stand -> using hip flexors & extensors to compensate
How much time is needed to regain post-op strength? (TKR)
3-6 months (quads & hamstrings)
When to start rehabilitation after TKR?
Soon after surgery (early bed exercises for day 1 post op++)
Examples of exercises for early stage of rehab in TKR
- Ankle pumps
- Isometric quads
- AROM knee flexion
- Static hamstrings
- Inner range quads
- Passive knee extension
-Passive knee extension w/pt supine
Exemples of intermediate exercise in TKR
(2/3 weeks post op)
- Mini squats
- Heel raises
- AROM knee flexion standing
- Single leg stance balance
- Single heel raise
- Step ups/downs