A. Considerations for rehabilitation exercise
(1) Element confidence: rehabilitation exercise is hard, especially at the beginning, must be full of confidence in themselves.
Persistence: Rehabilitation exercises are not a temporary activity for post-arthroplasty patients, 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 needs to be taken when getting up early after surgery and must be accompanied to complete it.
(2) Precautions should be taken to use your artificial joint properly so that it can 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.
Do not sit on a low stool (about 20cm), including squatting; avoid jumping from high places; avoid strenuous exercise; avoid falling; do not rotate your hip joint outward when lying down or walking; do not lie on your side when lying on your side. Do not lie on your side.
Second, the rehabilitation exercise of artificial hip joint replacement
Rehabilitation exercises for the operation period: mainly during the post-operative hospitalization, according to the recovery of the body after surgery can be divided into several stages.
1.1-3 days after surgery
As the first day after surgery, the patient is usually weak due to blood loss during surgery, wound pain is also more obvious, the gastrointestinal function caused by anesthesia has not yet recovered, and thus cannot eat, while the accumulated blood 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 lasts 3 seconds immediately after surgery until you are fully recovered.
(2) Ankle rotation: Rotate your ankle joint from the inside out, 3-4 times a day, repeating 5 times 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, one set of 30 reps every 2 hours, each set lasting 10-15 seconds.
Through this phase of exercise, should achieve.
Basically eliminate the swelling of the affected limb; the affected thigh and calf muscles can coordinate to make muscle stretching and contracting actions.
2.Day 4-7 after surgery
During this period, patients can eat normally, their strength gradually recovers, wound pain is reduced, blood and fluid in the joint have been drained out, drainage tubes have been removed, swelling of the affected limb gradually subsides, 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) Flexion of the hip and knee joint contact: As shown in the figure, patients can flex and extend the hip and knee joint on their own so that your heel slides towards the hip and then straightens, taking care not to make the knee joint 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 horizontal 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 muscle tense, try to straighten the knee joint, raise the lower limb (10cm from the bed), hold for 5-10 seconds, slowly put down, repeat the exercise, you will feel the thigh muscle 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. Most patients can partially weight-bearing the artificial hip joint during this period (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 floor Place the walker next to the leg on the operated side and move your body toward 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 around and stand with the walker.
(2) How to sit down Before sitting down, prepare well, need a chair with backrest and armrests, add a cushion, back up slowly, watch the position, hold it steady with both hands, and then sit down slowly. Hip flexion can 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 at your side to assist, know that you have enough strength to stand on their own. When you do standing exercises, you must hold 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 recover it, stretch the hip abductor and adductor muscles, 2-3 times each time.
(4) How to step and walk with a walker First walk with the aid of a walker, 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.
At first, walk for 5-10 minutes 3-4 times a day, 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 reaches 90 degrees; you can partially walk with weight on your own with the help of a walker; non-cemented prosthesis should extend the weight-bearing walking time appropriately.
4.Stitch removal and after discharge
If the wound heals well and no serious surgical complications occur, the stitches are usually removed 10-14 days after surgery, and the patient’s physical condition is mostly recovered and he can be discharged from the hospital. At this time, your joint function has not reached the ideal level, so rehabilitation exercises should be continued after discharge. The hip joint is rich in muscles and recovers relatively faster than after knee replacement. Your exercises after discharge from the hospital should mainly focus on standing exercises and walking exercises. After the soft tissues have completely healed, your hip joint can generally move freely.
(1) Change from a walker to a double crutch for walking: first move one foot away from the double crutch, land on the affected leg, move your weight forward until your center of gravity crosses the line of the double crutch, and move your healthy foot forward 20-30 cm over the line of the double crutch, and so on alternately.
(2) Continue the stance exercises during hospitalization.
(3) Up and down stairs: In most cases, you will be able to walk up and down stairs five weeks after surgery, as the soft tissues around the hip joint will have largely healed by three weeks.
When you go up the stairs, you should first move your healthy leg to the step, then move your operated leg up the step, and when you go down the stairs, you should first move your crutches to the next step, then move your operated leg down the step, and finally move your healthy leg down the step.
Once you can use the crutches to go up and down the stairs, you can switch to using the unilateral crutches to perform activities and gradually adapt until you can completely discard the crutches.
III. Notes
Through this stage of exercise, your hip joint should have returned to the normal level, but in order to use your artificial joint better, there are some details that you need to pay attention to in your daily life in the future.
(1) What you need to prepare at home after surgery: install reliable handrails for your seat, toilet and stairs; prepare a comfortable cushion for your seat with a safe backrest and armrests, prepare a footstool for your affected limb to rest; raise the toilet; prepare reliable handrails and chairs in the shower room; remove all items that may cause you to fall in the activity area of your home, such as: movable carpets and telephone wires.
(2) Avoid squatting with your hips flexed more than 90 degrees, straighten your chest and lower back while squatting, and do not bend your torso too far forward.
(3) When wearing shoes and socks, in order to avoid affecting the surgical result, you should lie on the bed with your feet on the bed and bend your hips to wear shoes and socks, and you should avoid crossing your lower limbs, such as stretched legs.
(4) We recommend not to drive a car for 6 weeks after the surgery, because some surveys have shown that the weakened muscle response in the early post-surgery period has an impact on driving safety.
(5) The prosthesis in your body will cause you to sound an alarm when passing through airport security. You can explain the situation to the airport security personnel, or you can ask your surgeon to issue a certificate for you.