Patient education and rehabilitation after hip arthroplasty in an Italian spa center: a pilot study on its feasibility

Abstract

Nowadays, some spa centers are suitable for providing rehabilitative and preventive treatment in association with traditional spa therapy. This study aims to evaluate the feasibility and the effectiveness of an intensive rehabilitation program after hip arthroplasty in an Italian spa center. Early after total hip arthroplasty for severe osteoarthritis (≤ 10 days after the intervention), 12 consecutive patients (5 males and 7 females) aged between 50 and 85 years were enrolled for this study. All the patients performed a 2-week thermal multimodal rehabilitation program, which consisted of education and physical rehabilitative measures. Patients had 2-h and half/day session of land-based and hydrokinesitherapy (aquatic therapy) consisted in active and passive joint mobilization, respiratory and functional re-education exercises, gait and balance training, resistance exercise, and power training mainly for the upper limb associated to physical therapy modalities (electrotherapy and low-level laser therapy). An educational program was performed to both patients and families. Both before and after the rehabilitation treatment, patients underwent clinical evaluation, hip flexion/abduction range of motion, and Numeric Pain Rating Scale. Harris Hip Score (HHS) and SF-12 questionnaires (physical-PCS-12-and mental health component-MCS-12) were also administered. After the 2-week thermal spa treatment, hip flexion/abduction improved significantly (p < 0.05), but there was no statistically significant reduction in pain (p = 0.350). The HHS score improved significantly from 62.6 ± 12.8 to 82.15 ± 12.7 (p < 0.05), and the PCS-12 score from 36.37 ± 8.4 to 43.61 ± 8.95 (p < 0.05). There was no adverse event during spa treatment. After total hip arthroplasty, patients who underwent an intensive post-acute multimodal rehabilitation program showed an improvement in motor and functional recovery and a positive impact on quality of life. Therefore, we believe that the thermal setting is a suitable place for providing intensive rehabilitative treatment in orthopedic musculoskeletal disability.

Does aquatic thermal therapy improve quality of life after total hip replacement? A retrospective preliminary pilot study

“…Our results support the role of aquatic thermal therapy in the rehabilitation process of this population. Thermal hydrokinesitherapy may improve mood, anxiety and stress management, reduce fatigue and pain and thus facilitate rehabilitation (Oláh et al 2011;Musumeci et al 2018) without no reported side effects. Stress has a direct association with fatigue, which relates to pain (Rapolienė et al 2016).…”

“…Treatment consisted of six sessions/week for 2 consecutive weeks of two and half hours of land-based (1 hour and a half) and hydrokinesitherapy (1 hour) with active and passive joint mobilization, respiratory and functional re-education exercises, gait and balance training, resistance exercise, and power training associated with physical therapy (electrotherapy and low-level-laser therapy). An educational program was provided to participants and families (Musumeci et al 2018). All subjects were evaluated the day of admission (T0) and at the end of treatment (T1); after 3 months (T2) and 6 months after the end of the treatment (T3) scales scores were collected by telephone interview.…”

Adult Measures of General Health and Health‐Related Quality of Life

“…The SF‐12 has also been shown to be able to discriminate between patients with rheumatoid arthritis of the hands/wrists who have high pain and those with low pain (PCS ES = 0.81 and MCS ES = 0.33) . In addition, the responsiveness of the SF‐12 to a wide range of treatments and programs for musculoskeletal conditions has been reported .…”

Wearable Biofeedback Suit to Promote and Monitor Aquatic Exercises: A Feasibility Study

“…The applications of this system potentially range from rehabilitation to athletic training and research in the field of aquatic kinematics. Given that biofeedback allows faster and more effective recovery, with a pronounced proprioceptive nuance, the applications of wearable biofeedback suit in human rehabilitation can be envisaged in: orthopedic and rheumatic diseases [38], accompanied by general symptomatology -subacute and chronic pain syndromes, reduction of ROM, post-lesion recovery of soft tissue or bone and postoperative recovery [39]; scoliosis and pain management, especially in back pain; sports traumatology and spine trauma. With neurological diseases -where both biofeedback and the microgravity condition of water immersion (which allows movement even in the presence of significant deficits of motor units recruitment) find precise indications, wearable biofeedback suit would, for example, allow biofeedback-assisted aquatic step training in post-stroke [40] and hemiplegic patients [41], in para and tetraplegia and in Parkinson's disease [42], [43].…”