Protocol for physio post Total Hip Replacement (THR)

[JAW]

Just a quick reply. My advice would be to take things steady, and pay out to see an independent Physiotherapist, which will only cost you around £70 for an hour, and £35 for half an hour. So for less than the cost of a new pair of shoes and a handbag you can have a couple of one to ones without rush.

You want to get better thoroughly not quickly. If someone is young to have a THR, then its doubly important to ensure a really good outcome, and speed of rehabilitation is frankly nonsensical.
NHS THR costs are based on cover for average treatment, and not necessarily extra Physiotherapy sessions, so these would be funded as extra, which is why you aren't getting them as routine, it's all a question of whose budget the consultations come from, and if the consultant doesn't consider it necessary he wont fund from Orthopaedic budget, and your GP might not want to spend his scant resources this way either. Sad but accurate, everthing is about funding.

[arkesh_physio]

Hi
thanx charlize & jwilso for the informn..

[charlize29]

Hi Arkesh_physio,

No problem with that, but I have found this article which everyone was discussing about :

Treadmill training with partial body-weight support after total hip arthroplasty: a randomized controlled trial.
• Hesse S,
• Werner C,
• Seibel H,
• von Frankenberg S,
• Kappel EM,
• Kirker S,
• Kading M.
Department of Neurological Rehabilitation, Klinik Berlin, Kladower Damm 223, D-14089 Berlin, Germany. [email protected]
OBJECTIVE: To compare treadmill training with partial body-weight support (TT-BWS) and conventional physical therapy (PT) in ambulatory patients with hip arthroplasty. DESIGN: Randomized controlled trial. SETTING: Rehabilitation center. PARTICIPANTS: Eighty patients with a fully loadable implant who could walk independently with crutches after unilateral total hip arthroplasty were randomized to receive either TT-BWS (treatment group) or conventional PT (controls), for 10 working days. INTERVENTIONS: Each patient received 45 minutes of individualized PT, either treadmill training plus PT in the experimental or PT alone in the control group. MAIN OUTCOME MEASURES: The Harris score, recorded by blind assessors, served as the primary outcome measure. Secondary outcome measures were the hip extension deficit, gait velocity, gait symmetry, affected hip abductor power; hip abductor amplitude of electromyographic activation; and the interval from surgery to abandoning crutches. RESULTS: At the end of training, the treatment group's Harris score was 13.6 points higher (P<.0001) than the control group's score. Further, hip extension deficit was 6.8 degrees less (P<.0001), gait symmetry was 10% greater (P=.001), affected hip abductor was stronger (Medical Research Council grades 4.24 vs 3.73; P<.0001), and the amplitude of gluteus medius activity was 41.5% greater (P=.001) than those measures for controls. Gait velocity did not differ in the 2 groups. These significant differences in favor of the treatment group persisted at 3 and 12 months. The treatment group abandoned crutches sooner than the control group (3 vs 8wk). In the treatment group, 39 patients finished treatment, 35 appeared at 3, and 26 at 12 months for follow-up. In the control group, the corresponding numbers were 40, 35, and 24 patients, respectively. CONCLUSION: TT-BWS is more effective than conventional PT at restoring symmetrical independent walking after hip replacement.
PMID: 14669181 [PubMed - indexed for MEDLINE]

[charlize29]

Well, it depends on you guys whether you want to incorporate treadmill training after THR. Goodluck!!!