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 persist 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 care is needed when starting early after surgery and must be accompanied by someone to complete. (2) Precautions The proper use of your artificial joint will enable it to serve you better and longer. The following actions should be avoided as much as possible, otherwise the chance of your artificial hip joint loosening will be greatly increased. 1.Forbid to “stilt” in the morning after surgery, and don’t apply pressure while stilt; 2.Forbid to sit on a low stool (about 20cm), including squatting; 3.Forbid to jump from a high place; 4.Avoid to do strenuous exercise; 5.Avoid to fall; 6.Don’t rotate your hip joint outward when lying down or walking; 7 7. Do not lie on the side of your hip when you are in the lateral position. Second, the rehabilitation exercises of 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’s body is usually weak due to blood loss during surgery, and the wound pain is obvious. 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 have fully recovered. (2) Ankle rotation: rotate your ankle joint from the inside out, 3-4 times a day, 5 repetitions each time. (3) Exercises for 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 1 set of 30 reps every 2 hours, each set lasting 10-15 seconds. Through this stage of exercise, the following should be achieved: basically eliminate the swelling of the affected limb; the muscles of the affected thigh and calf can make muscle stretching and contracting movements with coordinated force. 2. 4-7 days after surgery During this period, the patient can eat and drink normally, physical strength is gradually recovered, wound pain is reduced, blood and fluid have been drained out of the joint, drainage tubes have been removed, and swelling of the affected limb has gradually subsided, so you can start to perform some lying hip activities to restore muscle strength and gradually increase the mobility of the hip joint. Repeat the following three exercises 10 times 3-4 times a day: (1) Hip and knee flexion contact: As shown in the figure, patients can flex and extend the hip and knee on their own so that your heel slides towards the hip and then straighten it, taking care not to make the knee swing 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 flat position to spread it to the sides as far as possible, then recover 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 a little fatigue of thigh muscles. (6) Hip straightening exercises: active straightening action of the hip joint on the operated side or a pillow under the hip, which can stretch the flexor muscles and the anterior 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 movement and increase muscle strength at the same time. Most patients can partially weight-bearing the artificial hip joint at this time (patients with non-cemented prosthesis should delay the weight-bearing time appropriately, please follow your doctor’s instruction for the specific method), and perform the following rehabilitation exercises: (1) How to get down to the floor Place the walker next to the operated leg and move your body towards the bedside. 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 well, you need a chair with 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, to sit in a higher chair. (3) Standing exercises At the beginning you will feel dizzy, so be sure to have someone around to assist, know that you have enough strength to stand on their 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 lower limb straighten and lift outwards and slowly retract, stretch the hip abductor and adductor muscles, 2-3 times each time. During this period, the patient can eat normally, physical strength gradually recovers, wound pain is reduced, blood and fluid in the joint have been drained, drainage tubes have been removed, and swelling of the affected limb gradually subsides, so you can start to perform some prone hip activities to restore muscle strength and gradually increase the mobility of the hip joint. Repeat the following three exercises 10 times 3-4 times a day: 1. Flexion of the hip and knee joint contact: As shown in the picture, patients can flex and extend the hip and knee joint on their own so that your heel slides towards the hip and then straighten it, taking care not to make the knee joint swing to both sides. 2.Hip contraction exercise: Lie flat so that the hip muscles are kept tight for 5 seconds. 3.Abduction contact: straighten your legs in the flat position to separate to the sides as far as possible, and then recover, taking care not to bring them completely together. 4, quadriceps contraction exercises: keep the muscles in front of your thighs tense, by pressing down, try to straighten the knee joint, hold for 10-15 seconds, practice 10 times every 10 minutes, until you feel a little fatigue of the thigh muscles. 5, straight leg raise exercise: your thigh front muscle tense, try to straighten the knee joint, raise the lower limb (10cm from the bed), hold 5-10 seconds, slowly put down, repeat the exercise, you will feel a little fatigue of thigh muscles. 6, hip straightening exercises: the operation side of the hip joint active straightening action or under the hip pillow, which can stretch the flexor muscle and the front of the joint capsule. Third, how to step and walk with a walker First use a walker to assist in 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: 1. active hip flexion up to 90 degrees 2. you can partially walk with weight on your own with the help of a walker 3. non-cemented prosthesis should extend the weight-bearing walking time appropriately 4. the knee joint should not exceed the waist and you should practice 2-3 times each time.