Phase I (within 3 days)
1. Quadriceps training This is one of the first few exercises the patient can do in the supine position. Place a towel rolled into a column under the thigh and use the towel as a fulcrum to perform knee flexion exercises under the effect of gravity. Use a larger towel to further increase the knee flexion angle. Keep the thigh muscle contraction state for 10 seconds, relax, repeat 20 times / group, 3 to 4 groups.
2. Ankle dorsiflexion and dorsiextension exercises: active maximum flexion and extension of the ankle joint in the supine position and resistance training. The hemodynamic effect of ankle joint movement is significant and is one of the measures to prevent venous thrombosis. Hold each movement for 10 seconds, repeat 20 times/group, 3~4 groups/day.
3.Hip contraction exercise: supine leg extension position, upper limbs comfortably placed on the side of the body, contract the hip muscles to hold for 10 seconds, relax, brace your hands hard, do hip lifting and hold for 10 seconds, repeat 20 times/group, 2~3 groups/day.
Phase 2 (within 4-10 days)
1.Supine straight leg raise exercise (active mainly, passive as a supplement): hold time from 15 seconds gradually increase, 10 times / group, 2~3 groups / day.
2.Supine hip flexion and knee flexion exercise: the nurse can support the knee with one hand and the heel with the other hand, and flex the hip and knee without causing abnormal pain. 10 times/group. 2~3 groups/day.
3.Knee flexion at the bedside: the hip joint of the affected limb is abducted, the foot is placed outside the bed, and the knee joint is flexed with force, so that the knee flexion gradually increases.
4.Supine knee extension: The patient lies on his back and places a pillow or pillar-shaped towel under the ipsilateral ankle joint. This gradually extends the knee joint with the gravity of the lower limb. If knee extension is significantly limited, a sandbag should be pressed on the joint surface during early postoperative sleep at night.
5. Prone knee extension: The patient lies prone, and knee extension exercises are performed with the help of downward pressure of the foot.
6. Terminal knee extension exercises: The patient lies supine and places a pillow or towel under the knee joint as a fulcrum. The patient actively lifts the foot off the bed until the knee joint is completely straightened.
Phase 3 (2 to 3 weeks postoperatively)
The purpose of this phase is to strengthen the muscles and to maintain the acquired joint mobility.
1. Quadriceps resistance exercises
Sitting on the bedside and extending the knee, the affected ankle with sandbag to extend the calf, gradually increase from 1kg to 4.5kg, 50 times/return, 2 times/day.
2.N rope muscle resistance exercise
Caution
1. It should be understood that the rehabilitation training of any joint is for two purposes: 1) training of joint mobility; 2) training of muscle strength around the joint. For the knee joint, the early stage is based on joint mobility training, and the later stage is based on muscle strength recovery.
2, intensity: should vary from person to person, is the patient situation to increase the training content, but there should be a minimum limit and requirements.
3.Weight-bearing: if the wound is not painful, walk on the ground with the help of crutches, start with partial weight-bearing and gradually transition to full weight-bearing. At the latest one month after the gradual full weight-bearing.
4.Mobility: Knee mobility should reach 90 degrees when the stitches are removed from the hospital, and 120 degrees in 2 months, generally without CPM machine, but by the patient’s own exercise.
5. Crutches: early application, should be gradually removed after one month at the latest.
6.When climbing stairs, the contralateral limb should go up first, and the lower limb on the surgical side should go up later. “When going up the stairs, the good leg first; when going down the stairs, the bad leg first”.