Functional Mobility on Discharge Day After Total Knee and Hip Replacement Surgery

Abstract

Purpose: To examine functional mobility status on discharge day after total knee and hip replacement surgery in post-acute care hospital setting.Methods: Eighty patients following total knee and hip replacement surgery were assessed with the de Morton Mobility Index (DEMMI), the Timed-Up-and-Go (TUG) and Five Times Sit to Stand Test, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) measurements of mobility-related activity on discharge day. Demographic information comprised age, body mass index, gender, type of surgery,length of hospital stay. Since the normality of distribution of the data was not confirmed, nonparametric Mann-Whitney-U test was used for analysis.Results: Forty patients (mean age: 66.83±7.39 years) underwent total knee replacement (TKR) and 40 patients (mean age: 62.63±11.95 years) underwent total hip replacement (THR). No statistical difference was found in age, body mass index and length of hospital stay between patients (p>0.05). TKR patients had better results in mean WOMAC total score, WOMAC Physical Functioning Score and mean DEMMI total score compared to THR patients (p<0.05). TUG and Five Times Sit to Stand Test time results showed a trend of deterioration in THR patients than TKR patients. The WOMAC pain, stiffness and total scores were similar between TKR and THR patients. Discussion: Results of this study indicated that functional mobility status at discharge would be better in patients with TKR than THR. Functional mobility evaluation following lower-extremity replacement surgery before discharge should be included in acute clinical physiotherapy practice to guide to physiotherapists to design effective intervention strategies to improve mobility

Keywords

• Osteoarthritis, arthroplasty, hip replacement, knee replacement, early ambulation

Total Diz ve Kalça Eklem Replasman Cerrahisi Sonrası Taburculuk Gününde Fonksiyonel Mobilite

Abstract

Amaç: Total diz ve kalça eklem replasman cerrahisi sonrası hastane post-akut bakımında taburculuk gününde fonksiyonel mobilite durumunu incelemektir.Yöntem: Total diz ve kalça replasman cerrahisi olan 80 hasta, taburculuk gününde mobiliteyle ilişkili aktivite ölçeklerinden De Morton Mobilite İndeksi (DEMMI), zamanlı kalk yürü testi (KYT), 5 tekrarlı sandalyeden ayağa kalkma testi ve Western Ontario McMaster Üniversitesi Osteoartrit Index (WOMAC) ile değerlendirildi. Demografik bilgiler,yaş, vücut kitle indeksi, cinsiyet, cerrahi tipi ve hastanede kalış süresidir. Veriler normal dağılım göstermediğinden nonparametrik testlerden Mann-Whitney U testi ile analiz edildi.Sonuçlar: Kırk hasta (yaş ort: 66.83±7.39 yıl) total diz replasmanı (TDR); 40 hasta (yaş ort: 62.63±11.95 yıl) total kalça replasmanı (TKR) cerrahisi geçirmişti. Yaş, vücut kitle indeksi ve hastanede kalış süresi açısından hastalar arasında istatistiksel farklılık yoktu (p>0.05). TDR hastalarının, ortalama WOMAC toplam ve WOMAC Fiziksel Fonksiyon skoru ile ortalama DEMMI total skoru TKR hastalarına göre daha iyiydi (p<0.05). KYT ve 5 tekrarlı sandalyeden ayağa kalkma testi zamanları TKR hastalarında TDR hastalarına oranla daha uzun olma eğilimindeydi. WOMAC ağrı, tutukluk ve toplam skorları TKR ve TDR hastalarında benzerdi.Tartışma: Bu çalışmanın sonuçları, taburculuk sırasındaki fonksiyonel mobilitenin TDR hastalarında TKR hastalarından daha iyi olduğunu göstermiştir. Alt ekstremite replasman cerrahisini takiben taburculuk öncesi fonksiyonel mobilitenin klinikte akut fizyoterapi uygulamalarında değerlendirilmesi, fizyoterapistlere mobiliteyi geliştirici etkili uygulama stratejilerini planlaması açısından yardımcı olacaktır

Keywords

• Osteoartrit, artroplasti, kalça replasmanı, diz replasmanı, erken ambülasyon

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