Woman in water aqua therapy with Fish and Field Biokineticists offer pre and post-operative rehabilitation through hydrotherapy in Bryanston, Johannesburg

The Importance of Pre- and Post-Operative Rehabilitation

Posted on Posted in Rehabilitation

Pre- and Post-Operative Rehabilitation

Postoperative rehabilitation is well known, recommended by surgeons and practised by most individuals after undergoing surgery.  Unfortunately, preoperative rehabilitation is often overlooked or not even suggested to the individual going for surgery.

Preoperative Therapy

Exercise therapy could be initiated long before (or even a few weeks) surgery to reduce the risk of unsatisfactory surgical outcomes.  The aim/goals for preoperative rehabilitation would include:  reducing pain, shortening the length of the hospital stay, reduce the need for in-hospital rehabilitation and reduce recovery time.

Depending on the type of surgery, the preoperative rehabilitation program would focus on certain aspects.  Should a person be undergoing major joint surgery (i.e. total hip replacement), the preoperative therapy will focus on range of motion, joint stability and strength.  The focus would change slightly to cardiovascular training, breathing exercises, exercises that would assist in blood circulation and muscle strengthening, should the person undergo cardiac surgery.

There are many studies suggesting the benefits of preoperative rehabilitation but even more so combining preoperative and post-operative rehabilitation.

Combining Pre- and Post-Operative Rehabilitation

One study looked at how pre- and post-operative rehabilitation would influence the outcome of an ACL reconstruction 2 years after surgery.  The results showed superior preoperative patient-reported knee function as well as 2 years post-surgery with 86 – 94% of patients scoring within the normative range in different Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales.  Another study suggested a shorter length of stay at a clinic or hospital and reduced medical expenditure, and another showed reduced post-operative complications.

Floating devices in water with Fish and Field Biokineticists offer pre and post-operative rehabilitation through aqua therapy for pre- and postoperative surgery in Bryanston, Johannesburg

Including Aqua-Therapy as part of your Rehabilitation

When looking more into the modality of treatment for pre- and post-operative rehabilitation, aqua therapy seemed to prove even more beneficial.  Since aqua therapy provides a low to no impact and safe environment, many people are still capable of doing rehab (pre- or post) in the water when unable to do land rehabilitation.  The use of aqua therapy for preoperative rehabilitation have shown reduced pain immediately after exercise.  One study showed that performing a rehabilitation program that included aqua therapy most significantly influenced the reduction of pain in patients with osteoarthritis and after total hip replacement surgery.  Increased ranges of motion and muscle strength, as well as reduced use of anti-inflammatory medicines were also noted.  And when aqua therapy was used as a post-operative (knee replacement) rehabilitation modality it resulted in increased mobility, increased knee extensor and flexor power and tightening muscle strength in the affected leg.  The recovery of strength, function and gait speed all measured better 14 days after total knee arthroplasty in another group that was doing aqua therapy as part of their rehabilitation program. Over and above the physical benefits aqua therapy provide, it also positively influenced mood and socialisation.

The research carries on and on, one study after the other proving the benefits of pre- and post-operative rehabilitation programs.   So next time you know you need to go for surgery, do yourself a favour and start your rehabilitation program early, you will be happy you did when your recovery process is easier and quicker.

Author: Jenna-Lee Field

References:

  1. viha.ca/NR/rdonlyres/C803C6F6-F3E9-4763-A531-C255CA261EBF/0/heart.surgery_210.pdf
  2. Grindem, PT, PhD, L.P. Grancin, MD, PhD, M.A. Risberg, PT, PhD, L. Engebretsen, MD, PhD, L. Snyder-Mackler, PT, ScD, SCS, ATC, FAPTA, and Z. Eitzen, PT, PhD., How does a combined pre-operative and post-operative rehabilitation program influence the outcome of ACL Reconstruction 2 years after surgery? A comparison between patients in the Delaware-Oslo ACL Cohort and the Norwegian Knee Ligament Registry, accessed 21 July 2017.
  3. -W.Huang, P.-H.Chen, and Y.-H.Chou, Effects of a preoperative simplified home rehabilitation education program on length of stay of total knee arthroplasty patients, accessed 21 July 2017.
  4. Karin ValkenetIngrid GL van de PortJaap J DronkersWouter R de VriesEline LindemanFrank JG Backx, The effects of preoperative exercise therapy on postoperative outcome: a systematic review, accessed 21 July 2017.
  5. Marek ŁypRyszard KaczorAnna CabakPiotr TederkoEwa WłostowskaIwona StanisławskaJan Szypuła, and Wiesław Tomaszewski, A Water Rehabilitation Program in Patients with Hip Osteoarthritis Before and After Total Hip Replacement, accessed 21 July 2017
  6. Alessandro Bistolfi, Anna Maria Federico, Irene Carnino, Cecilia Gaido, Ilaria Da Rold, Ernesta Magistroni, Maria Vittoria Actis, Alessandro Aprato and Giuseppe Massazza, Rehabilitation and Physical Therapy before and after Total Knee Arthroplasty: A Literature Review and Unanswered Questions, accessed on 21 July 2017

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