Total-Joint-Arthroplasty-Guidebooks-2020

Step 8 - Exercise

Essential Exercises Prehab Outpatient Phase – See page 32 • Instruction provided on home program to include isometrics, heel slides, ankle pumps and a 3 point straight leg raise (SLR). • Strengthening in Pre-Op physical therapy focuses on quadriceps and hip abductors. Hospital Phase • Focus is placed on control of swelling, pain control and positioning of operative limb with knee in full extension. • Exercises shared by patients with Total Knee Replacement (TKR) and Total Hip Replacements (THR) are isometrics, ankle pumps and heel slides in supine and sitting positions. • Patients with TKR will also perform 3-point SLR. • Patients with THR will also perform active assist hip abduction and SLRs if allowed by surgeon. Home Health Phase • Focus continues on control of swelling, pain control and positioning of the operative leg with knee in full extension. • Patients will continue with exercises received in the hospital independently. • Therapist will incorporate sitting and standing exercises for increasing joint range and quad/ abductor strengthening. • Some patients wil be able to attend outpatient therapy without the need for home health visits. Outpatient Clinic Phase • Focus is now on strengthening and maintaining/ increasing joint range per patient need. • Utilization of equipment in clinic, i.e. bicycle, calf weights, progressive resistive equipment. • All patients will continue with quad strengthening. • Patients with THR who have been limited by surgeon in active hip abduction will begin abductor strengthening once cleared by surgeon.

30 | Total Hip and Knee Replacement Surgery