Functional exercise after hip arthroplasty

  Postoperative functional exercise can promote the absorption of hematoma in the affected limb, prevent muscle nerve adhesions, enhance muscle strength and prevent muscle atrophy.  The specific steps of functional exercise methods are as follows: 1. Postoperative muscle strength training is an important element of postoperative functional exercise after arthroplasty. Resting contraction of the quadriceps, dorsiflexion and plantarflexion of the ankle joint should be started immediately after surgery.  2. On the 2nd and 3rd day after surgery, hip abduction and increase hip and knee flexion and extension training, and you can start practicing straight leg raising exercises. At the beginning, the patient may not be able to complete the above movements, so a soft pillow can be placed under the affected limb.  3. For cemented total hip prosthesis fixation, complete fixation can be achieved within 24 hours after surgery. Therefore, for such patients, standing training can be started on the first day after surgery. When the patient conducts standing training, each side of the limb is straightened to practice toe and rear root elevation off the ground, and the surgical side is gradually partially weight-bearing, practicing quadriceps and gluteus contraction and diastole, and straightening the hip and knee joints.  4, lower limb joint passive motion machine (CPM machine) auxiliary training: passive exercise training after hip replacement is often done with the aid of CPM machine. Its range of motion can be adjusted at any time and gradually increased. Generally, the maximum angle of movement of the CPM machine is 40 degrees at the beginning, and the range of movement of the hip joint is 25 to 45 degrees at this time, and increases by 5 to 10 degrees every day thereafter. By about 1 week after surgery, the maximum activity angle of the CPM machine is 90 degrees, and the range of motion of the hip joint is 25 to 50 degrees, after which the CPM machine can be gradually discontinued and active activity is the main focus.  5.Sitting training: instruct and collaborate with the patient to move the affected limb closer to the bedside, put it down near the edge of the bed and sit up, support the hands backward when sitting up, and hip flexion should not exceed 80 degrees. Since the sitting position is the most likely position for hip dislocation and subluxation, patients should mainly lie, stand or walk in the early postoperative period, and the sitting time should not exceed half an hour. The exercises in sitting position include hip extension exercises, hip flexion exercises and hip flexion internal and external rotation exercises.  6.Training of walking aid and crutches.  Note: Patients undergoing total hip replacement should be educated to avoid exceeding the limits of their prosthesis during functional exercises. In order to maintain the femoral head in the acetabulum and prevent joint injury, the following points should be noted: (1) Hip flexion should not exceed 90, and the upper body should not bend forward more than 90 degrees; (2) The hip joint should not be internalized beyond the midline, and the knee or ankle joint should not be crossed; (3) The hip joint should not be externally rotated, and the affected leg should be kept in the external booth when lying down and turning over, and should not be bent to the affected side when sitting.