I. Considerations for rehabilitation exercise
(1) Elements
Confidence: Rehabilitation exercise is hard, especially at the beginning, you must be confident in yourself.
Persistence: Rehabilitation exercises are not a temporary activity for patients after artificial joint replacement, but need to be persistent for a long time, so be persistent.
Caution: Safety is very important, and falling can sometimes have very serious consequences and undo all previous efforts. Therefore, you need to be careful when performing any rehabilitation exercises. Particular attention needs to be paid to getting up early after surgery, and someone must accompany you to complete it.
(2) Precautions
The proper use of your artificial joint will help it to serve you better and longer.
The following actions should be avoided as much as possible, otherwise the chance of loosening of your artificial hip joint will be greatly increased.
◆ Don’t stagger in the morning after surgery, and don’t apply pressure while stagger.
Prohibit sitting on a low stool (about 20cm), including squatting.
Prohibit jumping from high places.
◆ Avoid doing strenuous exercise.
◆ Avoid falling to.
◆ Do not rotate your hip joint outward when lying down or walking.
Do not lie on your side when you are in the lateral position.
Rehabilitation exercises for artificial hip joint replacement
Perioperative rehabilitation exercises: mainly during the postoperative hospitalization, according to the recovery of the body after surgery can be divided into the following stages.
1.1-3 days after surgery
On the first day after surgery, the patient is usually weak due to blood loss during surgery, and the wound pain is also obvious. The gastrointestinal function caused by anesthesia has not yet recovered, so he cannot eat, and the blood accumulated in the joint still needs to be drained out through the reserved drainage tube. Therefore, the rehabilitation training at this time is aimed at restoring muscle strength and promoting blood circulation in the lower limbs to prevent and control thrombosis. The reason for not moving the hip joint is that the contraction of the lower limb muscles is like a pump that continuously squeezes blood back to the heart. The complete lack of activity of the affected limb after surgery may cause blood stasis and swelling in the lower limb, resulting in deep vein thrombosis, which may cause life-threatening pulmonary and cerebral root blockage if the thrombus is dislodged, while the complete lack of activity of the lower limb may cause the muscles and joints to lose elasticity and affect the recovery of limb and joint functions after surgery. Therefore, the lower limbs should be slightly elevated on the 1st to 3rd days after surgery to promote blood return to the lower limbs.
(1) Flexion and extension of the ankle joint: slowly hook the toe upward and then extend it farther, so that the surface of the foot is taut. 5-10 times every hour, each movement lasting 3 seconds, immediately after surgery until you are fully recovered.
(2) Rotation of the ankle joint: Rotate your ankle joint from the inside out, 3-4 times a day, repeating 5 times each time.
(3) Exercises on the healthy side of the limb: contract the muscles of the healthy side of the lower limb by flexing the hip and knee, and practice one set of 30 repetitions every 2 hours for 10-15 seconds each time.
Through this phase of exercise, the following should be achieved.
◆ Basic elimination of swelling of the affected limb.
◆ Affected side thigh and calf muscles can make muscle stretching and contraction movements with coordinated force.
2.Day 4-7 after surgery
During this period, the patient can eat normally, physical strength is gradually recovered, wound pain is reduced, blood and fluid in the joint have been drained out, drainage tubes have been removed, swelling of the affected limb has gradually subsided, and some lying hip activities can be started to restore muscle strength and gradually increase the mobility of the hip joint.
Repeat the following three exercises 3-4 times a day for 10 times each time.
(1) Hip flexion and knee contact: As shown in the diagram, the patient can flex and extend the hip and knee on your own so that your heel slides towards the hip and then straightens, taking care not to swing the knee to the sides.
(2) Hip contraction exercise: Lie flat so that the hip muscles are held tightly for 5 seconds.
(3) Abduction contact: straighten the leg in the horizontal position and spread it out to the sides as far as possible, then retract it, taking care not to bring it completely together.
(4) quadriceps contraction exercises: keep the muscles in front of your thigh taut by pressing down and straightening the knee joint as much as possible, hold for 10-15 seconds, practice 10 times every 10 minutes until you feel a little fatigue in your thigh muscles.
(5) straight leg raise exercise: your front thigh muscles tense, try to straighten the knee joint, raise the lower limb (10cm from the bed), hold for 5-10 seconds, slowly lower, repeat the exercise, you will feel the thigh muscles a little fatigue.
(6) Hip straightening exercises: active straightening action of the hip joint on the operation side or pillow under the hip, which can stretch the hip flexors and the front part of the joint capsule.
3.Day 8-14 after surgery
Continue the previous phase of exercises according to the recovery situation, and further increase the exercises in sitting and standing positions to restore normal hip joint activities and increase muscle strength at the same time. The artificial hip joint of most patients at this period can already be partially weight-bearing (patients using non-cemented prosthesis should delay the weight-bearing time appropriately, please follow your doctor’s instruction for the specific method), and carry out the following rehabilitation training contents.
(1) How to get down to the ground
Place the walker next to the operated leg and move your body toward the bed.
Move the operated side leg under the bed to prevent external rotation of the operated side hip.
Move the able-bodied leg under the bed, turn the body and stand with the walker.
(2) How to sit down
Before sitting down, prepare yourself with a chair with a backrest and armrests, add a cushion, back up slowly, watch the position, hold your hands steady, and then sit down slowly. Hip flexion should not exceed 90 degrees, and sit in a higher chair.
(3) Standing exercises
At the beginning you will feel dizzy, so be sure to have someone around to help you know you have enough strength to stand on your own. When doing standing exercises, you must hold on to the side of the bed or the handrail on the wall, and practice 3-4 times a day.
Standing leg lifts: Hold the handrail with both hands and lift your affected leg, being careful not to lift the knee above the waist.
Standing back extension and abduction exercises: slowly extend the affected limb backwards, lift your head and chest, stretch the hip capsule and hip flexors, pay attention to keep your upper body upright, 2-3 times each time, then straighten the lower limb and lift it outwards and slowly retract it, stretch the hip abductor and adductor muscles, 2-3 times each time.
(4) How to walk with a walker
First use a walker to assist walking, keep the center stable and switch to a bilateral axillary cane. First place the walker 20 cm in front of the body, step the art side leg first, then the healthy side leg to follow, and so on.
In the beginning, walk for 5-10 minutes 3-4 times a day, and then increase to 20-30 minutes 2-3 times a day as you get used to it. After full recovery, you should keep walking 3-4 times a day for 20-30 minutes each time. Walking helps you maintain muscle strength around the hip joint.
Through this phase of exercise you should achieve.
◆ Active flexion of the hip joint to 90 degrees
Walk with partial weight bearing with the help of a walker
◆ The duration of weight-bearing should be extended for non-cemented prosthesis