REHABILITATION STANDARDS - HIP JOINT
Standards for the provision of rehabilitation care following total hip arthroplasty (THA)
Pre-operative phase
- Initial physiotherapy assessment at the start of hospitalisation, focusing on musculoskeletal function.
- Psychological preparation (explanation of the course of physiotherapy after surgery).
- Respiratory physiotherapy, vascular gymnastics.
- Isometric exercise training (m. quadriceps femoris and gluteal muscles).
- Training of transfers from the bed to sitting and standing using a cushion between the knees (information on prohibited movements).
- Training of walking on crutches. Preparation of compensatory aids for walking after surgery.
- Training in independence and self-care.
Postoperative care after hip replacement / Days 0-14
Physiotherapy is initiated immediately after surgery in the ICU of the orthopaedic ward and subsequently in the standard room of the orthopaedic ward.
The basic prerequisite for physiotherapy is the patient's overall good health and cooperation. Throughout the rehabilitation period, we proceed with the therapy taking into account the individual needs of the client.
Day 0.
Prone positioning, operated lower limb in slight abduction, foam cushion between the knees, supported heels. Hip and knee in semiflexion. Respiratory physiotherapy.
Day 1.
Patient briefing on the appropriateness of exercise, independent movement regime without physiotherapist supervision and prohibited movements after TEP.
Supine positioning as day 0. Lateral position - foam square between the knees, supported on the belly. Sitting on the bed, standing at the bedside.
Respiratory physiotherapy, vascular gymnastics to prevent complications of immobilization.
General conditioning exercises with loose joints.
Active movement with assistance to flexion in the range of 40° in the operated hip joint.
Verticalization according to the condition - sitting, standing, walking.
Self-care, independence.
Day 2 and other days
Practice of independent positioning in supine and prone positioning, practice of self-care.
Respiratory physiotherapy, vascular gymnastics
Compensation of muscle imbalances - stretching, strengthening of the muscular system in the supine and seated positions - exercises of the lower limbs in open chains of movement with and without the assistance of a physiotherapist.
Centering, sensorimotor and proprioceptive exercises.
Verticalization training.
Stereotype gait, three-legged gait with relief of the operated limb. According to the patient's capabilities, the possibility of gradually increasing the load on the operated lower limb from 30 to 50% of the body weight.
Day 3 and the following days physiotherapy is gradually expanded to include:
Compensation of muscle imbalances - stretching, strengthening of the muscular system, sensorimotor and proprioceptive exercises on the bed, in sitting, standing at the support.
Training of independence in self-care and mobility - walking without the accompaniment of a physiotherapist, possibly nursing staff.
On days 5 and 6 until the end of hospitalization, physiotherapy is extended by:
Practice of independent positioning in the supine position.
Practice of walking on stairs and on the ground.
Use of exercise equipment in the exterior of the Dr. Pírka Clinic
Strengthening the muscles of the lower limbs on a horizontal exercise bike.
Scar care with the possibility of using laser and soft techniques to influence the swelling of the operated limb.
REHABILITATION STANDARDS - KNEE JOINT PULSE
Standards for the provision of rehabilitation care following total knee arthroplasty (TEP)
Preoperative phase
- Initial physiotherapy examination at the beginning of hospitalization, focusing on the musculoskeletal system.
- Psychological preparation (explanation of the course of physiotherapy after surgery).
- Respiratory physiotherapy, vascular gymnastics.
- Isometric exercise training (m. quadriceps femoris and gluteal muscles).
- Training of transfers from the bed to sitting and standing using a cushion between the knees (information on prohibited movements).
- Training of walking on crutches. Preparation of compensatory aids for walking after surgery.
- Training in independence and self-care.
Postoperative care after knee TEP / Postoperative days 0-7
Physiotherapy is initiated immediately after surgery in the ICU of the orthopaedic ward and subsequently in the standard room of the orthopaedic ward.
The basic entry condition for physiotherapy is mainly the patient's overall good health and cooperation. Throughout the rehabilitation period, we proceed with the therapy taking into account the individual needs of the client.
Day 0.
Prone positioning, operated lower limb in slight abduction, supported heels. Hip and knee joint in semiflexion, in mid-rotation position.
Respiratory physiotherapy.
Day 1.
Patient briefing on the appropriateness of exercise, independent movement regime without physiotherapist supervision and prohibited movements after TEP.
Supine positioning as Day 0. Lateral position - foam square between the knees, supported on the belly.
Respiratory physiotherapy, vascular gymnastics to prevent complications of immobilization.
General conditioning exercises with loose joints.
Active movement with assistance to flexion in the range of 40° in the operated knee joint.
Verticalization according to the condition - sitting, standing, walking.
Self-care, independence.
Day 2 and other days
Practice of independent positioning in supine and prone positioning, practice of self-care.
Respiratory physiotherapy, vascular gymnastics
Compensation of muscle imbalances - stretching, strengthening of the muscular system in the supine and seated positions - exercises of the lower limbs in open chains of movement with and without the assistance of a physiotherapist.
Centering, sensorimotor and proprioceptive exercises.
Verticalization training.
Stereotype gait, three-legged gait with relief of the operated limb. According to the patient's capabilities, the possibility of gradually increasing the load on the operated lower limb from 30 to 50% of the body weight.
Day 3 and the following days physiotherapy is gradually expanded to include:
Increasing the range of the operated joint by means of a motodlagy in the range of 0 to 90° every day, taking into account the individual approach of the surgeon.
Balancing of muscle imbalances - stretching, strengthening of the muscular system, sensomotor and proprioceptive exercises on the bed, in sitting, standing at the support.
Training of independence in self-care and mobility - walking without the accompaniment of a physiotherapist, possibly nursing staff.
On days 5 and 6 until the end of the hospitalization, physiotherapy is extended to include
Practice of independent positioning in the supine position.
Practice of walking on stairs and in the field.
Use of exercise equipment in the exterior of the Dr. Pírka Clinic accompanied by a physiotherapist.
Strengthening of lower limb muscles on a horizontal exercise bike.
Scar care with the possibility of using laser and soft techniques to influence the swelling of the operated limb.
Physiotherapy is started immediately after surgery.
Practice moving from bed to sitting and standing.
Exercise after total knee arthroplasty.
Practice walking on crutches.