Published: 01/16/2014

Total Joint Replacement – Rehabilitation and Patient Motivation Set Course for Long-Term Success

The last thing on the mind of someone who has just had a joint replaced is to move that joint, but at Evangelical Community Hospital’s Joint Replacement Program, that’s exactly what happens within a day of surgery.
 
Evangelical’s orthopaedic surgeons have performed 3,450 replacements since the inception of the program in 2005. The program continues to flourish as more and more patients of all ages seek better mobility and function. In 2013 alone, the program saw a 13% increase in patients seeking total joint replacement.

For those receiving knee, hip, and shoulder replacements, mobility in the future relies on immediate and ongoing physical therapy after surgery. In charge of that recovery process, is Evangelical’s trained rehabilitation team consisting of physical and occupational therapists.
 
“Some people may feel asking a person to put weight on and move a new joint is unthinkable, but moving right away promotes better movement in the future,” said Kara Rothermel, Director of Rehabilitation Services at Evangelical Community Hospital.
 
Evangelical’s Joint Replacement Program focuses on patient and family education, including the awareness that therapy is integral to success. Part of the program is informative, pre-operative education through classes and consultation. The detailed sessions thoroughly prepare patients to go into surgery expecting to put in hard physical work to get the most out of their new joint.
 
Rothermel continued, “A patient’s motivation and commitment are huge factors in long-term outcomes. We ask patients to try their very best when taking part in the program. The surgeons give their best, the rehab team offers their best, and the patients are the final factor in the best outcome equation.”
 
The day after surgery patients are asked by therapists to be up and moving. This is true for knee, hip, and shoulder replacements. This starts with activities of daily living including using equipment to aid them in getting dressed, walkers to provide support, and instruction on how to properly move to get ready for their day.
 
In their rooms, joints are stretched and worked to prepare for movement and exercises are taught one-on-one to each patient. These exercises are the same ones that will be done at home on their own to promote the most success for the new joint.
 
Patients are encouraged to walk to the rehabilitation gym with the assistance of a therapist to guide and correct them in how they are moving on the new joint. On the way, they practice how to negotiate stairs and are spoken to about their individual home situation and setup. They are given instructions on how they might handle common tasks such as getting in and out of the car, maneuvering tight spaces in their home, and avoiding trips and falls.
 
Once in the rehabilitation gym, joint replacement patients join fellow replacement patients for group sessions where the education component is emphasized. They also go over the same exercises they’ve been taught individually, in order to increase their understanding and independence in the exercises for their home program. The sessions create a sense of camaraderie among the patients who are going through the same challenges. Patients are also introduced to real-life scenarios such as using the fully outfitted bathroom to practice maneuvering in and out of the bath tub and using the sink and toilet.
 
Another essential element is that of the coach. Each patient is encouraged to bring a coach to support them through the process of surgery and recovery. The coaches work with the patients during group sessions and learn how to motivate and guide them with the expectation that this same rehabilitation will happen at home without the direction of the trained therapists. Joint replacement patients have a short and meaningful hospital stay, generally going home on the third day. In-hospital therapy sessions, both group and individual, prepare them for the rehabilitation work that will continue after discharge. Most patients will then receive outpatient physical therapy, which is usually 2-3 times per week.
 
“Our program is grounded on solid basics in rehabilitation - restore motion, strength, and mobility. Our role is to provide the patient with the resources and knowledge to take their joint replacement success into their own hands. We are their instructor, their cheerleader, their greatest advocate. Our only goal is to give them the rehabilitation tools and a good foundation toward improving their quality of life,” said Rothermel.
 
For more information on Evangelical’s Joint Replacement Program and rehabilitation, call 1-888-447-6563.
 
Evangelical is a non-profit organization that employs approximately 1,460 people and has more than 170 employed and non-employed physicians on staff. The Hospital is licensed to accommodate 132 overnight patients, 12 acute rehab patients and 18 bassinets. The Hospital serves residents throughout the Central Susquehanna Valley, including those living in Snyder, Union, Northumberland, and Lycoming Counties.

Margaret Woodhead of Shamokin Dam puts on her shoes, an activity of daily living, after having a total hip replacement two days earlier. Assisting her in managing every day tasks with her new hip is Nicole Shovlin, MOTR/L, Occupational Therapist and a member of Evangelical’s team of rehabilitation experts.

 

Margaret Woodhead of Shamokin Dam is instructed by Nicole Shovlin, MOTR/L, Occupational Therapist, how to maneuver in and out of the bath tub in the fully outfitted bathroom in the rehabilitation gym of the Center for Orthopaedics at Evangelical Community Hospital. The bathroom was created solely to aid total joint replacement patients in learning how to properly move their new joints during every day activities. The education provided by therapists prepares them for their return to home and the therapy they will need to do after discharge from the Hospital.