Rehabilitation following Total hip replacement tends to be less intense compared to total knee replacement. A home exercise regimen can accomplish most of the goals with periodic physiotherapist supervision and input.
Goals of rehabilitation following THR
- Observe hip precautions for 12 weeks (for posterior approach THR).
- Control pain and swelling.
- Regain normal gait and muscle control / strength.
- Restore proprioception, balance and coordination.
- Sit at edge of bed and out in chair.
- Begin transfers and short walks with walker for 5-10 minutes twice during the day.
- In bed static quadriceps, ankle pumps, hip abduction and gentle SLR as able.
- Progress with mobility. Aim for 50 m walk with walker by day 3.
- Progress with exercises in bed and in chair as advised by therapist.
- Sit out in chair most of the day by day 3. Aim for a single sitting session of 45-60 minutes. All meals sitting in a chair.
- Use toilet / bathroom with assistance for all toileting needs.
Days 3 to 14: After discharge home or rehabilitation centre
- Continue exercises as advised by therapist.
- Progress with walking distance with walker. Aim for 100 m.
- Sit out in chair for all meals and most of the day.
- Independent transfers into and out of bed.
- Perform HEP with assistance.
- Negotiate 4-6 stairs with assistance.
Weeks 2 to 6
- Continue home exercises. These aim to improve lower limb strength, proprioception and balance.
- Progress with walking distance
- Can start hydrotherapy if available
- Transition to straight cane or walking stick indoors as able.
Week 6 onwards
- Wean off stick indoors. Gradually progress to unaided ambulation as able and if safe.
- Progress with functional tasks within home environment and then in external environments.