Patients who have just undergone a THA have all the "problems" we try and solve with water-based intervention. And yet, they are often prevented from entering the pool until they "fail" land-based therapy.
Truly, the problems post-op total hip patients have are tailor-made for the pool:
- They have lower extremity swelling (Solution: hydrostatic pressure)
- They have difficulty weight bearing (Solution: buoyancy)
- They have need of assistive device to ambulation (Solution: buoyancy)
- They have pain and muscle spasm (Solution: thermal shifts and buoyancy)
- They have balance deficits (Solution: viscosity and flow to challenge; buoyancy to protect in case of fall)
- They have proprioceptive deficits (Solution viscosity and flow)
- They have ROM restrictions (Solution: hydrostatic pressure to reduce swelling and buoyancy to ease motion)
- They have weakness (Solution: buoyancy and viscosity)
The pool is the perfect place to be for the first month after surgery. But many MDs are gun-shy about infection and/or dislocation potential and don't think pool. So they restrict one of the best options for rehab immediately post-op.
See what researchers found can be done when you allow these patients to get in the water and go!
**********************************************************- They have lower extremity swelling (Solution: hydrostatic pressure)
- Giaquinto S, Ciotola E, Dall'armi V, Margutti F. Hydrotherapy after total hip arthroplasty: A follow-up study. Arch Gerontol Geriatr. 2009 Mar 10. [Epub ahead of print}
IRCCS San Raffaele Pisana, Via della Pisana 235, I-00163 Rome, Italy.
The aim of the study was to evaluate the subjective functional outcome of total hip arthroplasty (THA) in patients who underwent hydrotherapy (HT) 6 months after discharge.
A prospective randomized study was performed on 70 elderly inpatients with recent THA, who completed a rehabilitation program.
After randomization, 33 of them were treated in conventional gyms (no-hydrotherapy group=NHTG) and 31 received HT (hydrotherapy group=HTG).
Interviews with the Western-Ontario MacMasters Universities Osteoarthritis Index (WOMAC) were performed at admission, at discharge and 6 months later. Kruskal-Wallis, Mann-Whitney and Wilcoxon tests were applied for statistical analysis.
Both groups improved. Pain, stiffness and function were all positively affected.
Statistical analysis indicated that WOMAC sub-scales were significantly lower for all patients treated with HT. The benefits at discharge still remained after 6 months. We conclude that HT is recommended after THA in a geriatric population.
Recent Comments