life after joint replacement

Rehabilitation is an Essential Part of Successful Joint Replacement

By Charlie Edwards, IPMR Physical Therapist
otal joint replacement can make a dramatic difference in a persons level of pain and disability. Many people with various forms of arthritis and other conditions suffer from knee and hip pain that limits their ability to do everyday activities. Every person is unique, and their pains and activity limitations are unique as well. Likewise, the degree of pain and difficulty varies between individuals. One may have more difficulty with stairs while another person may have more pain with standing or after sitting for an extended period. Over time, these limitations may increase, causing many people to consider total joint replacement. Quality rehabilitation is a large component of surgical success and starts well before joint replacement. Rehabilitation addresses the pain, stiffness, weakness, disabilities, and functional limitations that are present as a result of a medical condition, disease, or injury. Physical and occupational therapists have knowledge and understanding of human movement that enables them to effectively improve function and ability

in persons with pain and disability, such as progressing arthritis of the hip or knee. Evaluation and treatment of other medical conditions that may be limiting health or function is an important step. A painful knee or hip is usually not the only condition affecting function, and diagnosing and treating the other conditions can result in overall improved health and mobility. The healthier an individual is going into surgery the more likely a successful outcome. Physical and/or occupational therapy should always be considered prior to joint replacement for many reasons. Evaluation by a physical or occupational therapist examines a patients overall function, and identifies specific limitations in movement, strength, posture, balance, and other areas. The therapist will then discuss the degree of limitation, how these limitations affect function, and how therapy can address these limitations. For some, their condition can be effectively managed by therapy alone. By increasing strength and mobility, and reducing

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Page 32 Healthy Cells Magazine Peoria December 2013

pain and inflammation, therapy may help an individual regain function and avoid surgery. For others, pre-operative therapy will focus on maximizing strength and function prior to surgery to result in a faster, fuller recovery after surgery. Post-surgical rehabilitation can be very challenging. Early mobilization and effective control of postoperative pain and swelling are keys to minimizing the recovery period. Avoiding the potential serious compli-

cations like infection and DVT (deep vein thrombosis, a blood clot that can form in an arm or leg and can have life-threatening consequences) is a main reason for pre-habilitation and post-surgical rehabilitation. Therapists often become a patients ally during the challenging postoperative period by ensuring that they avoid complications and continue to improve function. After a hospital stay patients begin the next phase of rehabilitation. For some, this could mean admission to a nursing facility or in-home care for additional nursing and therapy care. For others, outpatient rehabilitation immediately follows the hospital stay. Outpatient rehabilitation typically consists of therapy visits up to three times per week and lasts from one to three months. Physical condition prior to surgery, early stages of recovery, compliance with prescribed ice, medication, and activity, as well as personal goals and expectations may influence the length of a patients postoperative therapy. It is important to consider the frequency and duration of therapy after joint replacement, in order to plan accordingly and allow time for a full recovery. Patients must also consider transportation, and the fact that driving will be difficult if not impossible after surgery. Choosing a rehabilitation provider is as important as choosing a surgeon, so be proactive in finding the best in your area. A rehabilitation provider that performs outcomes research and shares results shows their intent to provide and maintain high quality care. The Institute of Physical Medicine and Rehabilitation, IPMR, provides physical medicine, physical therapy, occupational therapy, acupuncture, mental health, and nutrition services to improve function and quality of life before and after joint replacement. For appointments, call 309-692-8670. Visit ipmr.org.

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December 2013 Peoria Healthy Cells Magazine Page 33