Introduction.The usually occurring pain associated with osteoarthritis causes a significant reduction in mobility. This article presents the need to personalize the rehabilitation of patients after hip arthroplasty taking into account age and weight. Material and Methods. The study included 158 patients who were patients of the orthopedic clinic of the SPSK4 Polyclinic in Lublin. All respondents were subjected to partial or total plastic surgery and were asked to complete the questionnaire during follow-up visits. The questionnaire included questions about the course of the post-operative rehabilitation process and its results, as well as the assessment of pre-and post-operative pain scale in the form of the VAS scale. The statistical calculations were made using the Statistica 13 program, where the result at p <0.05 was considered statistically significant. In the study, frequency and descriptive statistics as well as comparative analysis for dependent samples based on the Student's t test were used in both measurements. Results. Patients asked for pre-operative and postoperative pain assessment using the VAS scale indicated a significant reduction in symptoms. The mean pain before surgery was 8.9 (± 1.2), and after surgery 2.7 (± 1.8). The average improvement for the whole group was 6.2 (± 1.8). Conclusions. The results of own research and analysis of the literature on the subject indicate that postoperative rehabilitation of patients undergoing operative treatment of cortherapy requires consideration of age, BMI and the presence of diabetes as factors requiring modification and personalization of the rehabilitation process. This will allow you to optimize the rehabilitation process, reduce pain symptoms as much as possible, and return functional efficiency to a more effective level.
Authors' contribution Wkład autorów: A. Study design/planning zaplanowanie badań B. Data collection/entry zebranie danych C. Data analysis/statistics dane-analiza i statystyki D. Data interpretation interpretacja danych E. Preparation of manuscript przygotowanie artykułu F. literature analysis/search wyszukiwanie i analiza literatury G. Funds collection zebranie funduszy Summary Due to aging of the population and the desire of people to maintain the best possible mobility, the demand for hip replacement is increasing. As a result, personalization of physical therapy after surgery is needed to achieve the best possible outcomes. However, patients undergoing hip replacement surgery often have additional factors, such as advanced age and obesity, which may hinder the process of rehabilitation. The aim of this study was to review the need and recommendations for personalized physical therapy before and after hip replacement surgery in patients with co-morbid factors such as advanced age and obesity. The research literature emphasizes the importance of effective recovery following hip replacement surgery. Older patients may require prolonged postoperative rehabilitation due to the type of surgery, muscle weakness or cognitive dysfunction. Proprioception and balance disorders may benefit from training on an unstable surface aimed at learning safe falling and getting up after a fall. Weakened gluteal muscles which may be present in the elderly and obese may benefit from strength training in the preoperative period. Excessive exposure of the elderly and obese to thromboembolic complications necessitate the inclusion in rehabilitation programs of exercises based on active ankle movement.
Introduction. Total hip replacement is a common and succesful treatment of the osteoarthritis of the hip. Material and Methods. During the work on this article, an analysis of scientific articles on corticosis and hip arthroplasty has been made, with particular emphasis on studies investigating the influence of age and body weight on the obtained results of treatment. The second method of collecting research material was the analysis of medical records of patients operated on in Independent Public University Hospital 4 in Lublin. The analysis included 150 patients undergoing total hip replacement surgery at the Independent Public Clinical Hospital No. 4 in Lublin in 2017. Among the respondents there were 54% (n = 81) men and 46% (n = 69) women. The most common diagnosis was primary cortherapy (M16)-68.7% (n = 103), followed by other primary cortherosters (M16.1)-14.7% (n = 22), other post-traumatic cortherapy and other secondary bilateral cortherapy (M16. 5 and M16.6)-after 3.3% (n = 5), another secondary cortherapy (M16.7)-2.7% (n = 4). Other diagnoses included cases of bilateral corticosis resulting from dysplasia (M16.2), other dysplastic coxartrosis (M16.3), unspecified coxartosis (M16.9) and congenital hip deformity (Q65.0). During 90.7% (n = 136), post-lateral access was used, in 8% (n = 12) anterolateral access was used, back and front access was used in 1 case (0.7%). Results. The average length of the procedure in the study group was 55 minutes (± 23 min), the minimum duration was 30 minutes and the maximum duration was 150 minutes. Among the respondents there were 4% (n = 6) operated in the early adulthood (18-34 years), 8.7% (n = 13) in middle adulthood (35-49 years), and later in adulthood (50-64 years) there were 36% (n = 54) of the subjects, in the elderly (65-74 years) there were 28% (n = 42), and in senile age (75-89) was 23.3% (n = 35). Among the respondents, there were 77 people aged over 65 years, which is 51.3%. The obtained results coincides with the data obtained in the report commissioned by the Ministry of Health, according to which in 2015 the most operational interventions were performed among patients aged 60-69 and 70-79, which accounted for 58% of all endoprosthetic surgery. Conclusions. Based on the analysis of research literature, older age, overweight and obesity as well as diabetes are factors that significantly affect the pre-operative and post-operative rehabilitation process in the case of arthroplasty. At the same time, there is a growing tendency to personalize the improvement process, which is associated with the need to improve the quality of life of patients undergoing surgery. In the case of people over 65 years of age and obese people, it is indicated not only for a specific post-operative approach, but also for a high value of preoperative improvement. The work done in the form of re-education and improvement of the gait function and increased mobility of the hip joint pays a faster return to the peak of functional efficiency after the procedure. In the case of diabetes...
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