In an article published on MEDICINENET.COM Medical Author
Dr.William C. Shiel Jr., MD, FACP, FACR
reports about the importance of post hip replacement physical therapy.
What is involved in the rehabilitation process after total hip joint replacement?
After total hip joint replacement surgery, patients often start physical therapy immediately. On the first day after surgery, it is common to begin some minor physical therapy while sitting in a chair. Eventually, rehabilitation incorporates stepping, walking, and climbing. Initially, supportive devices such as a walker or crutches are used. Pain is monitored while exercise takes place. Some degree of discomfort is normal. It is often very gratifying for the patient to notice, even early on, substantial relief from the preoperative pain for which the total hip replacement was performed.
Physical therapy is extremely important in the overall outcome of any joint replacement surgery. The goals of physical therapy are to prevent contractures, improve patient education, and strengthen muscles around the hip joint through controlled exercises. Contractures result from scarring of the tissues around the joint. Contractures do not permit full range of motion and therefore impede mobility of the replaced joint. Patients are instructed not to strain the hip joint with heavy lifting or other unusual activities at home. Specific techniques of body posturing, sitting, and using an elevated toilet seat can be extremely helpful. Patients are instructed not to cross the operated lower extremity across the midline of the body (not crossing the leg over the other leg) because of the risk of dislocating the replaced joint. They are discouraged from bending at the waist and are instructed to use a pillow between the legs when lying on the nonoperated side in order to prevent the operated lower extremity from crossing over the midline. Patients are given home exercise programs to strengthen the muscles around the buttock and thigh. Most patients attend outpatient physical therapy for a period of time while incorporating home exercises regularly into their daily living.
Occupational therapists are also part of the rehabilitation process. These therapists review precautions with the patients related to everyday activities. They also educate the patients about the adaptive equipment that is available and the proper ways to do their “ADLs” or activities of daily living.
The newly developed LegTutor and 3DTutor can be very helpful and instrumental in physiotherapy following hip replacement.
The LegTutor™ system has been developed to allow for functional rehabilitation of the lower extremity. The system consists of an ergonomic wearable leg brace and dedicated rehabilitation software. The LegTutor™ system allows for a range of biomechanical evaluation including speed, passive and active range of motion and motion analysis of the lower extremity. Quantitative biomechanical data allow for objective evaluation and rehabilitation treatment follow up. The LegTutor™ rehabilitation concept is based on performing controlled exercise rehabilitation practice at a patient customized level with real time accurate feedback on the patient’s performance. The exercises are designed in the form of challenging games that are suitable for a wide variety of neurological and orthopedic injury and disease.The games challenge the patient to perform the exercise task to their best ability and to continue exercise practice.
The LegTutor™ allows for isolated and a combination of knee and three directional hip treatment. The system provides detailed exercise performance instructions and precise feedback on the patients exercise performance. Controlled exercise of multi joints within the normal movement pattern prevents the development of undesired and compensatory joint movement and ensures better performance of functional tasks.
The 3DTutor™ is a motion feedback device that can be positioned on various parts of the body and can be used in conjunction with the LegTutor for hip replacement therapy. For example, the 3DTutor™ provides motion feedback on the supination and pronation position of the forearm and the trunk movement position when positioned on the forearm and the trunk. When combined with the ArmTutor™ and the HandTutor™ the 3DTutor™ allows the Tutor system to evaluate and treat the whole upper extremity by providing multijoint virtual functional task exercises of the arm and feedback on the patient’s trunk position. When combined with the LegTutor™ and positioned on the ankle, the 3DTutor™ contributes to the complete lower extremity multijoint evaluation and virtual functional task exercises of the hip, knee and ankle.
The Tutor™ system is used by many leading rehabilitation centers worldwide and has full FDA and CE certification.
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