With the widespread implementation of artificial hip arthroplasty, postoperative rehabilitation is becoming increasingly important. The most delicate surgery can only be combined with perfect rehabilitation exercises to obtain ideal results. Correct rehabilitation exercises can help patients recover physical strength, enhance muscle strength, increase joint mobility and restore coordination of daily life movements, effectively reduce post-operative complications of hip replacement and promote early recovery of limb function.
The first stage of functional exercise (1~3 days after surgery)
Static muscle contraction exercise and distal joint exercise are the main exercises to promote blood circulation in the lower limbs.
Isometric contraction exercise of quadriceps muscle: supine position, lower limb straight without leaving the bed, active contraction of quadriceps muscle pulling the patella proximally, slow movement. Each time for 5-10 seconds, then rest for 5 minutes, about 90 times a day.
Ankle exercises: supine position, toe extension and flexion exercises, plantar flexion and dorsiflexion of the ankle joint. Hold each movement for 10 seconds, then relax, about 90 times a day.
Hip contraction exercise: supine position, straighten the leg, upper limbs on both sides of the body, contract the hip muscles, hold for 10 seconds, and then relax. About 60 times a day.
Patellar nudge exercise: supine position, the escort gently pushed the patient’s patella, up and down and left and right activities, about 30 times a day.
The second phase of functional exercise (4-10 days after surgery)
The main purpose is to strengthen the isotonic contraction of muscles and joint movements.
Straight leg raising exercise: supine position, lower limb straightening and raising, requiring the heel to be 20 cm from the bed, pausing in the air for 2-3 seconds, and then gradually increasing the pausing time, about 90 times a day.
Hip flexion and knee flexion exercise: supine position, one hand under the patient’s knee, one hand on the heel, without causing pain, hip flexion and knee flexion exercise. However, the hip flexion angle should not be large, less than 45°, about 30 times a day.
The third stage of functional exercise (11 days to 1 month after surgery)
Prone abduction: supine position, lower limb extension and abduction, about 120 times a day.
Recumbent to sitting training: support the affected limb with both hands, and move the affected limb to the bedside with the support of both hands and the healthy leg, about 30 times a day.
Sitting to standing, crutch training: the patient moves to the bedside, the healthy leg touches the ground first, the affected limb touches the ground after, crutches, using the healthy leg and crutch support to stand. At the beginning, training standing for 2 minutes is enough to prevent postural hypotension, and then gradually increase.
Standing to walking with crutches training: the affected limb is not weight-bearing, walking with crutches must be protected by a chaperone to avoid accidents. Generally not more than 15 minutes each time, 3 times a day.
Phase IV functional exercise (1 month after surgery)
Hip flexion exercise: stand in a standing position, hold the crutches or walker with both hands, stand on one leg on the healthy side, keep the body perpendicular to the ground. Flex the hip and knee on the affected side, with hip flexion limited to 90°, to strengthen the iliopsoas muscle strength.
Knee extension exercise: standing position, hands on crutches or walker, the healthy side standing on one leg, body kept perpendicular to the ground. The lower limb of the affected side is elevated straight leg to strengthen the quadriceps muscle.
Hip abduction exercises: in the same position as above, abduct the hip joint on the affected side to 40°, and strengthen the hip abductor muscle strength.
Phase 5 functional exercise (after 2 months postoperatively)
Stationary bicycle exercise: This method helps to enhance the coordination of lower limb muscles and hip activities. When you start pedaling, pedal backward first, and then pedal forward when you feel that the backward movement is easy and comfortable. When the action is consistent, then increase the number and frequency. The frequency should be 15 minutes twice a day and gradually increased to 20-30 minutes three times a day.
The sixth stage of functional exercise (3 months after surgery)
During this period, the affected limb can gradually bear weight, gradually from double crutches, single crutches to abandon crutches. When the body balance has been established, you can hold the double crutch or single crutch to walk more skillfully. Three times a day, 10-15 minutes each time. When the body balance has been adjusted to a better state, the crutches can be abandoned to walk 3 to 4 times a day at a normal pace for 20 to 30 minutes each time.
Special tips Patients with hip arthroplasty should not lie on their sides but only lie flat for 3 months, and avoid heavy physical labor and strenuous sports activities. After 6 months, you can choose to walk for daily exercise, but not hiking, high legged running, fast running or long distance walking.