Beginning physical therapy within 24 hours of surgery can improve pain, range of joint motion, and muscle strength and cut hospital stays, according to new research in the journal Clinical Rehabilitation, published by Sage, Los Angeles.
Mindful of the trend toward discharging patients from the hospital more rapidly after surgery in recent years, physical therapy and public health researchers from Almeria, Malaga, and Granada in Spain set out to investigate whether an early start to physical therapy would improve recovery from knee arthroplasty surgery. They compared patients who began treatment within 24 hours of surgery with those who began 48 to 72 hours after their operation in a random, controlled clinical trial. Each group contained 150-plus patients aged 50 to 75.
The post-operative treatment began with a series of leg exercises, breathing exercises, and tips on posture. By the second day walking short distances with walking aids was added, and in subsequent days this was built up toward adapting to daily life activities, such as beginning to climb stairs on day four.
On average, those beginning treatment earlier stayed in the hospital two days less than the control group, and had five fewer rehabilitation sessions before they were discharged. An early start also lead to less pain, a greater range of joint motion both in leg flexion and extension, improved muscle strength, and higher scores in tests for gait and balance, the study reports.
Other benefits of early mobilization after this surgery are fewer complications such as deep vein thrombosis, pulmonary embolism, chest infection, and urinary retention, according to the study.
Benefits of starting rehabilitation within 24 hours of primary total knee arthroplasty: randomized clinical trial, by Nuria Sánchez Labraca, Adelaida Maria Castro-Sánchez, Guillermo A. Matarán-Peñarrocha, Manuel Arroyo-Morales, María del Mar Sánchez-Joya and Carmen Moreno-Lorenzo is published today, March 7, 2011, in Clinical Rehabilitation.