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Rising to a standing position from a sitting position is one of the most important activities of daily life. We present a total-body analysis of rising from a chair as performed by nine healthy individuals under controlled conditions. We describe four phases of this activity. Phase I is a flexion-momentum phase used to generate the initial momentum for rising. Phase II begins as the individual leaves the chair seat and ends at maximal ankle dorsiflexion. Forward momentum of the upper body is transferred to forward and upward momentum of the total body. Phase III is an extension phase during which the body rises to its full upright position. Phase IV is a stabilization phase. Kinetics and kinematics of the phases are analyzed. The phases are differentiated in terms of momentum and stability characteristics. Clinical implications of the mechanics of rising are discussed.

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To assess the potential recovery rate of a minimally invasive total hip replacement technique with minimal soft tissue disruption, an accelerated rehabilitation protocol was implemented with weightbearing as tolerated on the day of surgery. One hundred consecutive patients were enrolled in this prospective study. Ninety-seven patients (97%) met all the inpatient physical therapy goals required for discharge to home on the day of surgery; 100% of patients achieved these goals within 23 hours of surgery. Outpatient therapy was initiated in 9% of patients immediately, 62% of patients by 1 week, and all patients by 2 weeks. The mean time to discontinued use of crutches, discontinued use of narcotic pain medications, and resumed driving was 6 days postoperatively. The mean time to return to work was 8 days, discontinued use of any assistive device was 9 days, and resumption of all activities of daily living was 10 days. The mean time to walk 1 ⁄2 mile was 16 days. Furthermore, there were no readmissions, no dislocations, and no reoperations. Therefore, a rapid rehabilitation protocol is safe and fulfills the potential benefits of a rapid recovery with minimally invasive total hip arthroplasty.

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