Aim of the study Strategies for rehabilitation following arthroplasty have been well described. However, these methods are not fully suitable for patients with rheumatologic diseases. We at the Institute of Rheumatology have worked out and practice principles of rehabilitation tailored to the special needs of these patients.
Subject and methods An optimal rehabilitation plan includes pre-operative and post-operative care. We recommend that rehabilitation treatment be commenced early in post-operative care. Care should be taken to accommodate differences typical of these patients: e.g., anatomical changes in joint systems, neurophysiological changes in muscles, deformities, changes in psychological area, general weakness, less tolerance for loading, changed pain threshold, and long-term pharmacotherapy.
Patients in the study ranged in age from 21 to 70 years old. Their average time of hospitalisation was 17 days. Rehabilitation therapy was administered two times per day.
Patient evaluations were performed at the beginning and end of the therapy regime. The pre-therapy evaluation was essential to prescribing an effective a comprehensive rehabilitation program. The physiatricst obtained functional and vocational information (including activities typical of the patient’s daily life) and evaluated the patient’s range of motion, muscle strength, short muscles, weak muscles, and basic movement stereotypes.
Results The knowledge of these differences leads as to specification rehabilitation technique. We changed conditions: length exercises, loading intensity, and daily time. The rehabilitation treatment in principle reduces insufficiency causes of arthroplasties.
Conclusions A comparison of the pre- versus post-therapy evaluations indicates that our modified technique can be successfully employed with rheumatology patients following arthroplasty of load bearing joints. Objective confirmation of this thesis is found in two different venues: the length of acute hospital stay is materially shorter and the occurrence of admissions for re-treatment after surgery is materially less frequent.
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