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Post Surgery Rehabilitation Tips

9 Tips for Rehabilitation After A Knee Surgery

Dr. Vishwas Virmani 90% (22667 ratings)
MPT, BPT
Physiotherapist, Noida
9 Tips for Rehabilitation After A Knee Surgery

Rehabilitation following arthroscopic meniscectomy can be divided into four phases: protection, moderate protection, early functional and late functional.The word guideline is used instead of the protocol as it allows for individualization. 

The immediate postoperative phase is characterized by soft tissue bleeding and effusion, pain and quadriceps inhibition. Prior to discharge from the hospital, the patient’s involved extremity is placed in a jobs cryo temp in an elevated position for 20 minutes. By utilizing the intermittent compression device, RICE (rest, ice, compression, and elevation) is quickly applied. 

The patient is then instructed in a series of home therapeutic exercises, which include quadriceps setting, straight leg raises (SLR) in multiple planes and an active- assisted range of motion exercise. The patient is fitted with crutches and instructed in ambulation training weight bearing as tolerated on all surfaces. 

The patient is encouraged to follow the RICE principle and to curtail any excessive walking throughout this first phase, which usually lasts 5 to 7 days postoperatively. Non-steroidal anti-inflammatory drugs are prescribed, as they have been shown to decrease pain and effusion throughout the postoperative period following arthroscopic meniscectomy.  

MODERATE PROTECTION PHASE

The moderate protection phase is characterized by decreased pain, mild effusion, the range of motion greater than or equal to 90 degrees, and weakness.At the beginning of this phase, approximately 1 week postoperatively, the patient begins rehabilitation. History, measurements, and tests consistent with an initial evaluation are taken.  

9 Important points for the rehabilitation or physiotherapy following an Arthroscopic Meniscectomy aka Knee Surgery:

  1. The patient is allowed to discontinue using crutches upon demonstrating a normal gait pattern. The patient is reminded that‘every step is therapy’ as normal gait will help facilitate a normal range of motion. Using cuff weights, multiple planes SLR are continued in a progressive resisted exercise manner.
  2. The leg lift in the supine position should be performed with the involved knee in a slightly flexed position to improve the effectiveness of the exercise on the vastus muscle group. 
  3. Proximal (hip) musculature and hamstring isotonic exercises are added to the program, utilizing various progressive resisted machines. In keeping with the concept of total leg strength, calf raises off a step is begun. Submaximal multiple angle quadriceps isometrics are performed to improve static muscular strength without causing further joint irritation. 
  4. Strength gains are angle specific, and physiological overflow is about 20 degrees in either direction. This exercise is useful in strengthening the vastus medialis oblique, as it has been found to have maximal output in the 60-70 degree range of motion. 
  5. Electrical stimulation or biofeedback is used in conjunction with the isometric exercise for the patient with advanced quadriceps inhibition. A stationary cycle is initiated to improve range of motion and build muscle strength and endurance. 
  6. Ergometric cycling has been shown to be an excellent mode of rehabilitation since tibiofemoral compressive forces during induced during cycling approach only 1.2 times body weight. this is significantly lower than activities of daily living such as walking( two to four times body weight)or stair climbing( three to seven times body weight). Seat height should be kept high because of pattelo femoral joint compressive force increase with decreased seat height. 
  7. When the range of motion is limited to less than 100 degrees, a short crank ergometer is employed, decreasing the arc of motion necessary to cycle.This gives the patient a psychological boost because it allows for aerobic exercise. 
  8. Flexibility exercises (in the form of hamstring and calf stretching) are started, preferably after cycling since increased tissue temperature promotes a more effective stretch.Cold application is continued for its analgesic and anti-inflammatory effects. 
  9. Transcutaneous electrical nerve stimulation (TENS) is used for patients with increased pain. The patient’s home program is expanded to include cuff weight PRE, stationary bike, and stretching. The patient is also provided with a theraband for standing hip extension, abduction, adduction and seated knee flexion. 

SAANS Cardiac Rehabilitation Program

Physiotherapist, Delhi
SAANS Cardiac Rehabilitation Program

Cardiac Rehabilitation 
Cardiac rehabilitation (rehab) is a medically supervised program that helps improve the health and well-being of people who have heart problems. Rehab programs include exercise training, education on the heart and healthy living, and counselling to reduce stress and help you return to an active life.

What is the duration of this program?

As per the requirement of the patient, the program duration can vary from 6 to 8 weeks to lifelong.

What can one achieve through this program?

The goal of this program is to prevent and limit the physiological and psychological effects of cardiac illness and to improve the overall cardiovascular fitness and health of the patient. This is accomplished by developing individualised program which cover exercise, education and lifestyle modification, tailored to the individual needs and abilities of the patients.

Who requires Cardiac Rehabilitation?

People with the following cardiac diseases require cardiac rehabilitation:

·Myocardial Infarction

·Coronary Artery Bypass Surgery

·Angioplasty

·Stable Angina Pectoris

·Two Or More Documented Classical Risk Factors For Coronary Heart Disease

·Stable Chronic Heart Failure

·Peripheral Vascular Disease

·Diabetes Mellitus (Type II)

·Valvular Heart Disease

What are the facilities for Cardiac Rehabilitation at SAANS?

SAANS Foundation has a dedicated cardiac rehab facility, complete with exercise equipment, i.e., treadmills, ergocycles, steppers and cross trainers; a gymnasium for pre-class warm-up and resistance training classes; Human Performance Labs for fitness testing; and a dedicated area for patient education.

The cardiac rehabilitation team

Phase I (Initial Phase)

This is an inpatient program. It begins with pre-procedure counselling and continues immediately after coronary artery grafting or stenting and post-angina or myocardial infarction. Its aim is to initiate early mobilisation (out of the bed) to reduce the effects of de-conditioning, along with patient education about heart disease. This is continued with a walking and exercise program at home or till the patient returns back to the hospital for Phase II.

Phase II (Conditioning Phase)

This consists of a comprehensive program to modify the risk factors for heart disease and consists of exercise, stress management, smoking cessation, behaviour modification, nutritional advice and patient education about the risk factors of heart disease. The aerobic exercise program can begin as early as 2 weeks after an uncomplicated infarction, angina and stenting or 4 weeks after a complicated infarction or bypass grafting. This is conducted in the form of group sessions or classes consisting of the three steps of initial stretching exercises, conditioning phase of aerobic training on the treadmill, ergo cycle, stepper or cross trainer (along with strengthening exercises) followed by the cool down phase. One session usually lasts for 60 to 90 minutes. It takes a frequency of 3 to 5 times a week to complete 20 sessions. Initial sessions are conducted with electrocardiographic monitoring. The behaviour management and nutritional component runs along with the exercise program. All sessions are physician monitored and are conducted by trained staff.

Phase III (Maintenance Phase)

This aims at continuing the benefits gained by patients during the second phase. It consists of the continuation of the aerobic exercise program but at a lesser frequency of about 2 to 3 times a week at home/in a gymnasium/at a hospital.

Prosthodontic Rehabilitation!

Dr. Unjum Bashir 87% (25 ratings)
MDS - Prosthodontics and Implantology
Dentist, Srinagar
Prosthodontic Rehabilitation!

Patient having only upper front 6 teeth treated with crowns and cast partial denture.

Introduction To Saans Rehabilitation Program

Physiotherapist, Delhi
Introduction To Saans Rehabilitation Program

What Is Rehabilitation?

A comprehensive intervention for patients with chronic diseases who are symptomatic and often have decreased daily activities.

It is designed to

  • Reduce symptoms

  • Optimize functional status

  • Increase participation

  • Reduces health care costs

  • Stabilises or reversing systemic manifestations of the disease

  • Address morbidities and their consequences through education and exercise 

Why Rehabilitation is the Need of Hour

  • Chronic Disease Era

  • Associated Mental Health Concerns with Chronic Diseases.

  • Deconditioning Effects

  • Continuity in Healthcare delivery system

Who Can Benefit?

  • Chronic respiratory disease symptomatic with optimum drug therapy

  • Chronic cardiovascular diseases with breathlessness despite optimum intervention and drug therapy

  • Chronic neurological diseases

  • Chronic orthopedic diseases, pre & post operative conditions

  • Lifestyle disorders like Stress, Sleep, Obesity, Diabetes, Hypertension etc. 

  • Special children

  • Pre Natal and Post Natal Conditions

  • Oncological Condition

  • Chronic and Acute pain conditions

  • Alcohol Deaddiction & Smoking Cessation

What are Consequences of advanced chronic disease?

  • Peripheral Muscle dysfunction

  • Respiratory muscle dysfunction

  • Nutritional abnormalities

  • Cardiac impairment

  • Skeletal disease

  • Sensory defects

  • Neurocognitive dysfunction

  • Psychosocial dysfunction

What are the components of Rehabilitation program?

  • Proper education of Disease process

  • Exercise Training

  • Psychosocial/behavioral intervention/CBT

  • Nutrition assessment

  • Breathing and Relaxation techniques

  • Medications, devices & specific therapy

  • Outcome Assessment

What are the Possible Benefits?

  • Improved Exercise Capacity

  • Reduced perceived intensity of dyspnoea and stress

  • Improve health-related QOL

  • Reduced hospitalization

  • Reduced anxiety and depression

  • Improved limb function and ADL’s

  • Benefits extend well beyond immediate period of training 

Rehab Team 

For a successful rehabilitation program, it requires an efficient coordination and teamwork of medical professionals, which includes:

  • Doctors

  • Physiotherapists

  • Nurses

  • Nursing Attendants and health care workers

  • Wellness Coach and Psychologists

  • Nutritionists

  • Education Providers

2 people found this helpful

Saans Pulmonary Rehabilitation Program

Physiotherapist, Delhi
Saans Pulmonary Rehabilitation Program

What is Pulmonary Rehabilitation?

Pulmonary Rehabilitation (Rehab) is a medically supervised program that helps to improve the health and well being of people who have pulmonary problems.

Rehab programs include endurance training, chest therapy, education on lung hygiene and healthy living, counseling to reduce stress & trigger factors and smoking cessation thus helping you return to an active and healthy lifestyle.

Who requires Pulmonary Rehabilitation?

People with following diseases require Pulmonary Rehabilitation:

What are the facilities for Pulmonary Rehabilitation at SAANS?

SAANS Foundation has a dedicated Pulmonary Rehab facility with separate areas for postural drainage, oxygen therapy and Non Invasive Ventilation, nebulisation and telemetric ECG monitored exercise systems i.e. ergo cycles, stepper and cross trainer; a gymnasium for pre-class warm-up and resistance training classes; Lung function testing labs; and a dedicated area for patient education.

The Pulmonary Rehab team

A multi-disciplinary team consisting of

  • Physiatrists (rehab physician)

  • Pulmonologists

  • Nurses

  • Exercise Physiologists

  •  Physical and Occupational Therapists

  • Psychologists and Wellness Coach

  • Nutritionists

What is the duration of the program?

As per patient requirement, the program duration can vary from 4-6 weeks to lifelong.

What can one achieve through this program?

The goal of this program is to prevent and limit the physiological and psychological effects of pulmonary illness and to improve overall cardio-pulmonary status and health. This is accomplished by developing individualized programs of exercise, education and lifestyle modification that are tailored to individual needs and abilities.

Three phase program

Phase I (Initial)

This is an inpatient program which starts at the time of hospitalization. It aims to initiate early mobilization to reduce the effects of de-conditioning. It consists of oxygen therapy, chest wall manipulation, nebulization, postural drainage, breathing exercises and incentive spirometry to improve oxygenation. This is continued with a walking and exercise program at home or till patient return back to the hospital for Phase II.

Phase II (Conditioning Phase)

This consists of a comprehensive program to modify the aggravating factors for lung disease along with endurance training. This consists of chest care, aerobic exercise, stress management, smoking cessation, behavior modification, nutritional advice and patient and family education. The Phase II can begin after stabilization of the early symptoms. This is conducted in the form of group sessions or classes, one session usually last for 60-90 minutes. Frequency is 3-5 times a week to complete a total of about 20 sessions. Initial sessions of aerobic training are conducted with electrocardiographic monitoring. All sessions are physician monitored conducted by trained staff.

Phase III (Maintenance Phase)

This aims to continue the benefits gained by patients during Phase II. It consists of continuation of the aerobic exercise program but at a lesser frequency of 3 times a week at home/in a gymnasium/at a hospital.

1 person found this helpful

Saans Musculoskeletal Rehabilitation Program

Physiotherapist, Delhi
Saans Musculoskeletal Rehabilitation Program

What is Musculoskeletal Rehabilitation?

Musculoskeletal Rehabilitation involves maximising your function and potential so that you can return back to the community as soon as possible after any injury.

Who requires Musculoskeletal Rehabilitation?

People with following problems require Musculoskeletal Rehabilitation:

·Acute or chronic musculoskeletal pain

·Post fracture stiffness and reduced function

·Loss of a part of limb

·Chronic arthritis

·Chronic backache

·Repetitive strain injury

·Prolonged bed rest with generalised weakness (deconditioning syndrome)

Who Can Benefit?

Complex MSK Management

The Complex MSK Management specialises in treating patients who have significant functional mobility and movement impairments related to the musculoskeletal system such as, arthritis, osteoporosis, de-conditioning syndrome, post-operative complications and diabetes mellitus with associated neurological and cardiac conditions. Patients receive physical and occupational therapy, balance & gait training and education to improve their level of independence in daily living.

Multiple Trauma Management

Multiple Trauma Management provides rehab to people who have sustained multiple fractures and other injuries e.g. in a motor vehicle accident. The admission criteria are two or more active orthopedic medical conditions, multiple injuries / fractures as a result of trauma, physically ready to participate in the entire rehab process with cognitive ability to learn new activities and follow direction. These patients will be managed by a multi-disciplinary team taking care of post trauma stress disorder, pain management, mobility and activities of daily living. 

Sports Rehab

The Sports Rehab provides comprehensive care to people with shoulder joint and rotator cuff injuries, tennis and golfers elbow, hand injuries, anterior cruciate ligament tears, hamstring and ankle sprains who are engaged in outdoor sports like cricket, football, basketball, volleyball, etc. leading to significant pain, strength, movement & mobility impairments. The latest technology available at the centre - multi-joint dynamometer and gait and motion analysis gives significant input in managing these conditions allowing early return to the sporting activities.

Repetitive Strain Injury (RSI) Management

The RSI Management aims to manage patients who present with chief complaints of neck or back pain or any other cumulative trauma disorders due to overuse. Patients will be evaluated by an inter-disciplinary team and comprehensive rehabilitation activities will be provided with pharmacotherapy, electrotherapy, exercise programmes, ergonomic advice, behaviour and relaxation techniques, trigger point injection procedures and education.

Amputation Management

Amputation Management caters to the need of upper and lower limb amputation due to traumatic, ischemic, diabetic or other conditions. It offers comprehensive programme beginning with pre-amputation counselling, immediate post-operative pain reduction & temporary prosthesis, permanent prosthesis fitting & training and management of late early & late complications. The programme aims to reintegrate the person back into the society.

What is the duration of the Musculoskeletal Rehabilitation programme?

As per patient requirement, the programme duration can vary from 2-12 weeks.

1 person found this helpful

Rehabilitation Stages Patellar Tendinopathy

Dr. Shamik Bhattacharjee 91% (162 ratings)
MPTh/MPT, BPTh/BPT
Physiotherapist, Guwahati
Rehabilitation Stages Patellar Tendinopathy

Rehabilitation Stages Patellar Tendinopathy

Rehabilitation From Drug Abuse Ayurveda!

Dr. Abhishek Saxena 92% (811 ratings)
BAMS
Ayurveda, Bhopal
Rehabilitation From Drug Abuse Ayurveda!

Drug addiction is a condition, which is abnormal or pathological and occurs due to excess use of alcohol, drugs, smoking or other such addictive substances. The different effects of addiction are acute drug use, drug-seeking behavior, relapsing vulnerability, slow response to natural stimuli, and last but not the least, low motivation in life.

Drug addiction is regarded as a community disease as it leads to crimes, violence, failure in school, child-abuse, the loss of productivity and domestic violence. That is why it is very important to eradicate this problem from the society; especially the teens should be educated on the same.

Madatya in Ayurveda
In Ayurveda, the problems of drug addiction is dealt under the heading of Madatya, meaning ‘intoxication’. The state of individual occurs due to continuous use of drug, alcohol, tobacco or any substance of high intoxication. Madatya is relative to the third and fourth stage in the addiction process i.e., drug dependence and drug abuse. Madatya kills the will to live a happy and healthy life because it is a total opposite of ‘ojas’, which means a source of energy. Madatya and wellness can’t go hand-in-hand in a body.

Addiction and doshas
The Ayurvedic states that the doshas are aggravated by the overdose of drugs into one’s body. They are Vata (Air), Kapha (Water), Pitta (Fire) or a combination of all three doshas termed as Tridosha.

Treatments in Ayurveda
In Madatya, Ayurveda balances the aggravated doshas. It first detects the doshas, and then treats them. Ayurveda uses herbal remedies to treat the symptoms, discards the toxins (ama) collected in the body and motivates and regenerates cells and tissues. There is a phase in the de-addiction process where the patient becomes confused because their intelligence level drops due to drug abuse. Ayurveda treats this problem with the use of herbs like Yashtimadhu (Glycyrrhizaglabra), Brahmi (Bacopamonnieri), Shankhpushpi (Convolvulus pluricaulis) and Guduchi (Tinosporacordifolia).

In Ayurveda, treatment of Sattva Guna, meaning the quality of goodness, is done to promote mental health. The patients are made to follow strict healthy practices like consumption of natural vegetarian food, practice Yoga, and meditation and follow a daily routine of less anxiety and stress. Activities like wearing neat and clean clothes, walking and spending time in natural flowery ambiance with good friends, listening to good music and all other forms of natural relaxants and entertainment are also a part of treatment. These will boost the soul and mind of the patients and make them grateful to God for their lives.

In case you have a concern or query you can always consult an expert & get answers to your questions!

3479 people found this helpful

Rehabilitation After Trauma To Front Tooth

Dr. Rajesh Ahal 89% (396 ratings)
A.C.C.I - Accredited and Certified Course in Implantology, MDS - Pediatric & Preventive Dentistry, BDS
Dentist, Jammu
Rehabilitation After Trauma To Front Tooth

Upper front right tooth fractured at middle level on being self hit by a t t bat. Reattached the fractured component - had to do a rct and restored finally with a metaless crown.

Patient immensely satisfied.

Pulmonary Rehabilitation - How Physiotherapy Can Help?

Xcell Physiocare 86% (22 ratings)
MSPT (Master of Physical Therapy)
Physiotherapist, Delhi
Pulmonary Rehabilitation - How Physiotherapy Can Help?

Seeing someone who used to do all their activities on their own turn to someone who needs help even with small things like going to the bathroom can be very difficult.

The lungs are vital organs in that they are essential to supply oxygen to the entire body. If the various organs do not receive adequate oxygen, their function can be impaired. Therefore, lung function needs to be maintained. Lung function can be impaired by chronic conditions like COPD and bronchiectasis. In both these, the overall ability of the lungs to take in adequate oxygen is reduced. Therefore, the lungs need to be rehabilitated so that they can improve their ability to function better. These exercises are aimed at the following:

  1. Improve ability to breathe effectively
  2. Reduce episodes of breathlessness
  3. Reduce the number of hospitalizations required to clear sputum and infections
  4. Improve ability to perform small, routine chores on their own
  5. Improve exercise tolerance over a period of time
  6. Improve overall quality of life
  7. Reduce morbidity and mortality rates

It has been proven beyond doubt that in addition to medications, physiotherapy plays a vital role in improving lung function over a period of time. Depending on the actual condition of the patient, a physiotherapy program is drawn up. Initially, the therapist will guide the patient and/or the caretaker with the various exercises. Over a period of time, the caretaker and the patient can do these on their own. The intent of these common exercises is to improve breathing efficiency, clear mucus, and improve overall lung function.

  1. Active breathing techniques (ABT) – We all know that breathing is involuntary; however, making an effort to consciously breathe can improve the efficiency. More oxygen is taken in and sent to the various organs, thereby rejuvenating the entire body.
  2. Postural drainage: With any chronic lung condition, sputum or mucus tends to accumulate in various parts of the lungs. If not drained, it can attract more bacteria and cause infection. The patient is made to lie in various positions so that different parts of the lungs are drained, aided by gravity. This is highly effective in clearing secretions.
  3. Pursed lip breathing: Inhaling through the nose and letting the air out through the mouth like how a candle is blown helps improve lung function.
  4. Forced coughing: A person is taught to induce coughing so that secretions are cleared out, thereby reducing chances of infection. Inhale as usual to the full capacity and exhale in coughing spurts.

It has been proven beyond doubt that with no side effects (unlike medications), physiotherapy improves the overall quality of life in people with COPD.

5534 people found this helpful
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