Rehabilitation after surgery
What do I need to know after surgery?
Post-operative rehabilitation concerns patients after surgery for orthopaedic conditions (lower limb fractures, multiple fractures, hip and knee arthroplasty) and neurosurgical conditions (spinal fractures, cauda equina).
The most common fractures are of the femur and occur in elderly patients.
After surgery, we focus in two directions at once:
A) investigate the real causes that caused the patient's fall, so that they can be treated and a new fall can be prevented in the future
- Did you know that after the first fall, the risk of falling again is multiplied?
- Do you know that the 70% of falls can be prevented? *1
B) after the surgery the patient is in need of care and hospitalisation but mainly from medical monitoring by a large scientific medical team that investigates and gives solutions to your man's problems.
- Rehabilitation doctors
- Pathologists
- Orthopaedic
- Neurologist
- Cardiologist
- Urologist
- Microbiologist
- Radiologist
The Rehabilitation Physicians are the specialized doctors who monitor the patient's post-operative course and in cooperation with the entire medical team give individualized instructions (rehabilitation program) to the physiotherapists, occupational therapists, psychologists and pool therapists, according to the needs and problems of each patient for postoperative pain, swelling, joint stiffness, stance, balance, gait and psycho-emotional state.
Our mission, at Wellness Rehabilitation Centre, is to help people regain their skills quickly and return to their families.
Key objective after surgery, it's not just walking but also walking or safe walking that will protect your man from unpleasant falls in the future.
For this reason, all patients are examined with specialized equipment to determine the risk of falling before they are discharged from the Wellness Rehabilitation Center.
The Recovery Stages after surgery
1ο Stadium: a bedridden patient is one who cannot get out of bed and turn on his side.
Usually, they are old*12, has dementia, sarcopenia*13, Acute Confusional State*2, which is a complication from the stress of surgery, infections with fever, poor general health with many diseases.
Is the patient belonging to the vulnerable groups*11
At this stage, general health support is needed, regulation of blood sugar and blood pressure that are deregulated by the stress of surgery, control of the ability to swallow, treatment of acute confusion, possible infections and prevention of bedsores, which can develop immediately, within a few hours, or if present, worsen.
The 1ο This stage is crucial for the patient's progression.
In addition to general health support, the programme includes treatments for:
- Maintaining good heart and lung condition
- The treatment of postoperative pain
- Maintaining the movement of the joints
- The treatment of postoperative edema
- The prevention of subsidence
- Facilitating the shedding of flakes
- The prevention of venous thrombosis due to stasis of blood flow in the veins of the legs
This stage is characterized by vigilance and alertness from all the staff of Wellness, medical, therapeutic and nursing.
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2ο Stage: the patient can sit down
Most patients, upon admission to the Wellness Rehabilitation Centre, have the option of sitting up.
Ο Rehabilitation Doctor of the ward (Physiatrist), determines the goals of treatment, according to the needs of each patient.
The initial examination includes measurements according to International rating scales for:
- The movement of the joints
- The power of the muscles in detail
- The postoperative swelling
- The intensity of the pain
- The patient's respiratory and cardiovascular capacity
Based on the measurements, the goals of the Rehabilitation Program are created in combination with the loading rate of the limb, according to the instructions of the attending physician who operated on the patient.
These measurements are repeated every week and the patient's needs and treatment goals are redefined.
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3ο Stage: Stimulation in the upright position
At this stage, the strength and coordination of the muscles, proprioception, pain intensity, swelling in the area of the operation play an important role, but the decisive parameter is the patient cooperation, the mood and the will. You need encouragement, motivation and determination.
This is aided by specialised medical rehabilitation machines that record the performance and problems in each treatment, so that experienced therapists can stick to specific points in the treatment and achieve safe static and dynamic balance, which is a prerequisite for the next stage. The Rehabilitation Program includes:
- Physiotherapy
- Occupational therapy
- Psychological support
- Biofeedback therapy
- Treatment in the pool
- Treatment of pain and postoperative swelling
Psychological Support
Η psycho-emotional mood is an important factor in achieving rehabilitation goals. Psychologists assess the situation and support the patient appropriately.
Biofeedback therapy
It is a therapy that helps to isolate something specific in the mind and deal with it. The general makes it specific. It gives feedback to the brain with visual and auditory stimuli, helping to retrain the patient in activities. Ex. the patient must load the leg 30% of body weight. Once the charge reaches 30%, an audible signal (auditory) is heard and the screen turns red (visual), so the patient stops loading the extra leg.
Pain treatment
Depending on the patient's condition, pain treatments are selected:
- Treatment of trigger points
- Myoperitoneal release
- Intramuscular irritation
- Acupuncture
- Treatment with radiofrequencies
- TENS
- TVPS*10
- Interlink treatment*3
Treatment of postoperative edema
Similarly, to reduce swelling, we choose
- Intermittent pressure devices
- Intermittent pressure devices with cold water flow
- Treatment with radiofrequencies
- Interlink treatment*3
Pre-existing health problems, such as Parkinson's disease, dementia, old stroke, make it difficult for the patient in both Stage 3 and Stage 4.
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4ο Stage: Safe walking
The patient is trained in the walking process with the help of assistive systems, such as: a suspension system, designed to reduce body weight and safely support the patient, a walking aid, a walker, an elbow or armpit brace or a simple brace
The patient learns the walking back and forth and side steps, distance steps, change of direction and walking with obstacles.
It is assessed by specialised measurements (gait analysis), all the elements are recorded in detail in each phase of gait (foot supported phase, airborne phase) and the gait training programme is adapted to achieve safe gait.
Step length, time, deviations from the vertical axis, etc. are measured.
Measurements of the patient's functional ability, such as the time it takes to get up from the chair, walk 10 steps and sit down again, are also assessed.
The conclusions from these measurements are important for advice and instructions to the patient.
5ο Stage: Up and down stairs
The patient is trained in the safe way to climb and descend stairs on his/her own, so that he/she is fully independent.
Why is rehabilitation after surgery necessary?
Older people belong to vulnerable groups*11 and are prone to complications (such as acute confusional state*2, pulmonary embolism, respiratory and urinary tract infections, bedsores - i.e. wounds on the body which are usually created in the coccyx, heels, ankles, back - contamination of the wound, etc.) or have conditions that complicate the patient's recovery (Parkinson's disease, old stroke, rheumatoid arthritis, people taking immunosuppressive treatment, kidney failure, etc.).
For these reasons, internationally, Rehabilitation Centres, which are specialised healthcare facilities, were created to meet the needs of medical care, nursing care and rehabilitation of patients with conditions such as post-surgery for safe recovery.
Import procedure at the Euxia rehabilitation centre
The procedure includes:
- Examination of the patient by a Medical Pathologist and informing the responsible relative
- Examination by the Rehabilitation Physician (Physiatrist) in charge of the ward and informing the responsible relative
- Laboratory tests: blood and biochemical tests, urine tests. Electrocardiogram, recording of the patient's vital signs
- Information from the Nurse Manager on how the Wellness Room operates, on the room's facilities and the patient's needs
- At the Wellness Rehabilitation Center, you have your Personal Advisor to solve your questions, answer your queries, and adjust your needs.
It is the link between your family and Euxia
It is your man in the Wellness.
Advice after discharge from the Wellness Rehabilitation Centre
1) The patient needs to continue the Rehabilitation Program
Rehabilitation processes in the body take time to heal the trauma and allow the joint to function properly.
Recovery time varies for each patient.
Discharge does not mean full completion of rehabilitation.
It means that you no longer need to stay at the Rehabilitation Centre or that the EOPYY no longer provides rehabilitation treatments with hospitalisation - accommodation.
However, it provides continuation of the program in a Day Care Rehabilitation Center, without accommodation and without financial charge.
That is, the patient follows the treatment and returns home.
After discharge, the therapeutic goals is to maintain and increase the ability to move safely.
They include 3 steps:
2) Vigilance is needed from the family,
because the risk of falling is not negligible, especially when there are concomitant conditions, such as Parkinson's disease or Parkinsonism, dementia, old stroke, which cause disturbances in balance and gait.
In the home, modifications are needed, such as thinning the furniture, removing carpets, placing chairs with armrests to facilitate lifting from the seat, modifying the bathroom, raising the bed if it is low, etc., in order to reduce the risk of falling.
An important chapter is proper nutrition.
Anti-inflammatory diet is recommended*12 and perhaps nutritional supplements, always according to medical instructions.
3) Medical monitoring is recommended
Falls with unpleasant consequences can occur in situations of hypoglycaemia, arrhythmia, dehydration, anaemia, etc.
At Euxia, after discharge we are by your side. There are outpatient clinics with appointments with the medical specialists you need, for monitoring and advice to keep you healthy.
