TOTBİD Dergisi

TOTBİD Dergisi

2013, Cilt 12, Sayı, 3     (Sayfalar: 292-308)

Total hip arthroplasty, rehabilitation

Filiz Can 1

1 Hacettepe Üniversitesi, Sağlık Bilimleri Fakültesi, Fizyoterapi ve Rehabilitasyon Bölümü, Ankara

DOI: 10.14292/totbid.dergisi.2013.37
Görüntüleme: 787
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İndirme : 7944

The patients after total hip arthroplasty mostly show some impairments and functional limitations in the absence of pain. Muscle weakness and atrophy around hip joint can persist. Hip abductor weakness is the most common problem which results with Trandelenburg gait and asymmetric limb loading in functional activities. Dysfunction can lead to reduced mobility, physical activity levels and independence in daily life. Thus, rehabilitation of the patient after surgery is important. Rehabilitation for total hip arthroplasty must begin with a preoperative assessment, education and rehabilitation. Earlier initiated and intensive postoperative rehabilitation program must be used to reduce the early loss of muscle strength and function after total hip arthroplasty. Rehabilitation program after surgery comprises of prevention of complications, muscle re-education, flexibility and strengthening exercises, gait and balance training, functional exercises and home exercises. Dislocation position must be taught immediately after surgery and precautions must be emphasized during transfers. Physical therapy program in early term includes ankle pumps, gait training, low-intensity isometrics and isotonic exercises of the hip abductors, extensors and knee extensors. Early full weight bearing with crutches is allowed for cemented THA. Protected weight bearing for six weeks is appropriate for uncemented THA and this is progressed to 12 weeks. Aquatic therapy to facilitate early progression, low-frequency electric muscle stimulation for strengthening of the weak muscles, biofeedback for altering load distribution give additional beneficial effects. Exercise program in late term consisted of eight exercises focused on functional tasks, daily living tasks, balance, strength, endurance and cardiovascular fitness. Sports and physical activities which avoid impact loading of the hip should be encouraged to maintain cardiovascular fitness.

Anahtar Kelimeler : hip; arthroplasty; rehabilitation; physical therapy techniques