How to rehabilitate after hip replacement?

With the widespread development of artificial hip arthroplasty, post-operative rehabilitation exercises are gaining more and more attention. A more delicate surgery can only obtain ideal results if combined with perfect rehabilitation exercises. Correct rehabilitation exercises can help patients recover physical strength, enhance muscle strength, increase joint mobility and restore the coordination of daily life movements, and effectively reduce post-operative complications of hip replacement and promote early recovery of limb function. 1, the first stage of functional exercise (1 to 3 days after surgery): mainly focus on static muscle contraction exercise and distal joint exercise, the purpose is to promote blood circulation in the lower limbs, which is very important to prevent thrombosis. ①Quadriceps isometric contraction exercise: supine position, lower limb straight without leaving the bed, active contraction of quadriceps muscle pulling the patella proximally, slow movement, each time lasting 5-10 seconds, then rest for 5 minutes, about 90 times a day. ②Ankle exercise: supine position, active toe extension and flexion exercise, ankle plantar flexion and dorsiflexion, hold each movement for 10 seconds, then relax, about 90 times a day. ③Gluteal muscle contraction exercise: the patient straightens the leg in the supine position, the upper limbs are comfortably placed on both sides of the body, contract the gluteal muscles, hold for 10 seconds, and then relax, about 60 times a day. ④Patellar nudge exercise: supine position, chaperones gently push the patella up, down, left and right activities, about 30 times a day. 2, the second stage of functional exercise (4-10 days after surgery): mainly to strengthen the isotonic contraction of muscles and joint movements. ①Straight leg raising exercise: supine position, lower limb straightening and raising, requiring the heel to be 20 cm from the bed, pause in the air for 2 to 3 seconds, and then gradually increase the pause time, about 90 times a day. ② Hip flexion and knee flexion exercise: supine position, one hand under the patient’s knee, one hand holding the heel, and perform hip flexion and knee flexion exercise without causing pain, but the hip flexion angle should not be large, it should be less than 45°, about 30 times a day. 3, the third stage of functional exercise (11 days to 1 month after surgery): at this time, the patient’s pain has been reduced or disappeared, the muscles and ligaments around the prosthesis began to repair, to leave the bed training. However, training for patients with non-cemented prosthesis should be carried out after 15 days. ①Reclining abduction: supine position, lower limb extension and abduction, about 120 times a day. ②Reclining to sitting training: support with both hands, abduct the affected limb, and move the affected limb to the bedside with the support of both hands and the healthy leg, about 30 times a day. ③Sitting to standing, crutch training: the patient moved to the bedside, the healthy leg first, the affected limb after touching the ground, crutches, using the healthy leg and crutch support to stand, the beginning of training to stand for 2 minutes to prevent postural hypotension, and then gradually increase. ④Standing to walking with crutches training: the affected limb is not weight-bearing, walking with crutches must be protected by a chaperone to avoid accidents, the time depends on the patient’s physical strength, generally no more than 15 minutes each time, 3 times a day. 4, the fourth stage of functional exercise (1 month after surgery): ① hip flexion exercises: standing position, hands on crutches or walkers, the healthy side of the single-leg stand, the body to maintain vertical with the ground. The affected side flexes the hip and knee, and the hip flexion is limited to 90 degrees to strengthen the iliopsoas muscle strength. Knee extension exercise: standing position, hands on crutches or walker, the healthy side standing on one leg, the body kept perpendicular to the ground. Straight leg elevation of the lower limb on the affected side to strengthen the quadriceps muscles. ③ Hip abduction exercise: in the same position as above, abduct the hip joint on the affected side to 40 degrees, and strengthen the hip abductor muscle strength. 5, the fifth stage of functional exercise (2 months after surgery): can use stationary bicycle exercise: this method helps lower limb muscles and hip activity coordination to enhance. When you start pedaling, pedal backward first, and then pedal forward when you feel that the backward movement is easy and comfortable. When the movement is consistent, then increase the number and frequency of pedaling, 2 times a day, 15 minutes each time, and gradually increase to 3 times a day, 20 to 30 minutes each time. 6, the sixth stage of functional exercise (3 months after surgery): this period can gradually weight-bearing affected limbs, gradually from double crutches a single crutch a abandon crutches. Because the body balance has been established, can hold double or single crutches more proficient walking, 3 times a day, 10 ~ 15 minutes each time. When the body balance has been adjusted to full proficiency, the crutches can be abandoned to walk at a normal pace 3 to 4 times a day for 20 to 30 minutes each time, so that you can eventually return to a normal walking state. In addition, patients with hip arthroplasty should not lie on their sides for 3 months, lie flat in bed, and avoid heavy physical labor and strenuous sports activities. Do not squat with your hip flexed, do not cross your legs, do not sit on a low bench, and do not stilt your legs. After 6 months, you can choose to take a walk for daily exercise, but not hiking, high legged running, fast running and long distance walking.