Orthopedic and Surgical Rehabilitation Notes

Orthopedic Rehabilitation

Focuses on the musculoskeletal system: muscles, bones, ligaments, and tendons.
Addresses injuries and conditions affecting these structures.
Includes arthritis, carpal tunnel syndrome, sports injuries, broken bones, joint replacements, ACL tears, and more.
Therapeutic approach to correct musculoskeletal limitations and alleviate pain from trauma, illness, or surgery.
Rehabilitation helps regain limb use and incorporates assistive devices.

Examples of Orthopedic Injuries and Conditions Requiring Rehab

Carpal tunnel syndrome
Arthritis
Osteoporosis
ACL and meniscus tears
Fractures
Hip, knee, or shoulder replacement
Stroke
Sciatica
Amputation
Tendon injuries

Levels of Orthopedic Rehabilitation

Inpatient Therapy
- Multiple Trauma:
  - Patients have complex injuries requiring specialized care.
  - Recovery can be slow and challenging.
  - Physiotherapy helps regain independent function.
- Joint Replacement/Fracture:
  - Physical therapy helps regain strength, mobility, and confidence.
Outpatient Therapy
- Centers specialize in returning patients to their normal lives.
- Addresses sports injuries, work injuries, and other orthopedic conditions.
- Utilizes appropriate physiotherapy rehabilitation.
Home Health Services
- Rehabilitation provided in the patient's home.

Stages/Phases of Complete Rehabilitation

The Recovery Stage / Rest and Protect the Injury
- Goal: Allow the body to begin the healing process.
- Rest and prevent aggravating the injury.
- May involve keeping weight off the injured area or using a cast/sling.
- Treating inflammation, controlling pain and swelling are important.
- Methods: ice/heat, over-the-counter pain relief (NSAIDs), or prescription medications.
The Repair Stage / Recover the Motion
- Goal: Improve Range of Motion and/or Flexibility, start recovering movement and mobility.
- Gently ease the body back to pre-injury levels of range-of-motion (ROM).
- Soft tissue and gentle range-of-motion exercises are important.
- Flexibility exercises help prevent long-term effects of decreased ROM or function.
- Small weights may be used if safe, but intensive strength training is discouraged.
The Strength Stage / Recover the Strength
- Goal: Restore strength & begin Proprioception/Balance Training.
- Address muscular atrophy or wasting that leads to weakness and loss of endurance.
- Work back to pre-injury levels of muscular and cardiovascular endurance.
- Weight machines allow for safe and precise strength training.
The Function Stage / Recover the Function
- Goal: Restore function to pre-injury levels.
- Address higher-level capabilities to reduce the risk of re-injury.
- Identify deficiencies in coordination, proprioception, balance, speed, and agility.
Recovery of daily activities or sports specific skills
- Goal: recovery of the normal physical skills of active life and for the athlete, the recovery of the technical-specific sport skills and advancing from basic to complex sport- specific skills
- Takes place on the field and is aimed at all types of patients
- The field rehabilitation program is not predefined but can be changed from day to day by the rehabilitation specialist in consultation with the doctor and in relation to the individual patient’s responses.
Selection of Right Treatment
- Correct diagnosis and effective treatment plan.
- Custom-suited care plans, considering lifestyle, behaviors, and variables that could lead to accident/reinjury.

Types of Therapy in Orthopedic Rehabilitation

Multidisciplinary Team: Physical therapists, occupational therapists, nurses, doctors, and other specialists.
Physical Therapy
- Restores strength, flexibility, mobility, and overall function.
- Uses manual therapies, stretches, exercises, and other techniques in gradual progression.
Occupational Therapy
- Helps regain the ability to perform everyday activities: bathing, cooking, driving, and working.
- Provides adaptive tools for activities that are difficult to perform.
- Focuses on fine motor skills, hand-eye coordination, movement adaptation, and balance training.
Hand Therapy
- Subspecialty of occupational therapy dedicated to restoring the use of arms and hands.
- Provides techniques, information, and tools to use hands efficiently and work around deficiencies.

Benefits of Orthopedic Rehabilitation

Promotes circulation, limiting blood clot risk
Reduces pain and the need for pain medication
Prevent further injury and fall risk
Improves memory and cognition
Re-establishing the ability to perform favorite activities
Regain function as quickly and effectively as possible

What is Surgical Rehabilitation?

Deals with stiffness and weakness caused after surgery.
Treatment given through physiotherapy, hydrotherapy, or exercise therapy.
Helps in optimizing the pain of patients.

Why Physical Therapy is Important After Surgery

Helps patients regain mobility and recover faster.
Ensures that replacements or repairs heal properly.
Manages pain and helps patients avoid or limit opioid medications.

Benefits of Surgical Rehabilitation

Helps with circulation after surgery, preventing blood clots.
Posture, balance, and coordination improvement and training.
Gait analysis and training.
Self-care training.
Manual therapy techniques.
Home exercise instruction.
Pain control and management.
Improves flexibility.
Reduced risk for postoperative pulmonary complications (PCCs).

Types of Therapy in Surgical Rehabilitation

Pre-Operative Rehabilitation
- Program designed to help patients prior to surgery for a great outcome.
- Includes:
  - Mentally prepare for surgery
  - Reduce pain and inflammation
  - Restore range of motion
  - Improving muscular control of the injured joint
  - Normalizing movement patterns prior to your surgery
  - Improved overall well-being and fitness
  - Gain a good understanding of the exercises that you will perform immediately after surgery
  - restore joint mobility, flexibility and strength.
Post-Operative Rehabilitation
- Includes:
  - minimize the adverse effects of surgery such as pain and swelling as well as to restore normal movement, flexibility and function.
  - resuming normal activities of daily living and preventing an injury from recurring
  - exercises to restore range of motion, stability, and strength
  - return the patient to a pre-injury activity level
  - Strategies for pain reduction including modalities such as ice, heat, and electrical stimulation
  - Manual therapy techniques
  - Flexibility exercises to improve range of motion
  - Exercises to strengthen muscles
  - Posture, balance, and coordination training
  - Gait analysis and training
  - Self-care training
  - Home exercise instruction