REHABILITATION - POST PROCEDURE PLANNING
Generally speaking, most of us have heard of the term “rehabilitation”, whether it be in the physical, mental or substance abuse context. In this article we will discuss research based best practice guidelines to help you understand and get the most out of your physical rehabilitation program. We also explore why education and exercise are so important in any physical rehabilitation program.
All too often we hear of clientele having a major procedure performed, such as a Coronary Artery Bypass Graft (CABG), a Total Knee or Hip replacement (TKR, THR) and following on from these procedures there is very little, if any, ongoing support/rehabilitation provided. In some instances the surgeon themselves will have an extensive post-operative plan in place or, alternatively, the hospital will provide an in-house 4-12 week rehabilitation program. However, in a high percentage of cases, clients are shown the door and left to their own care!
Hopefully you have seen the previous part of this article series relating to ‘pre-habilitation’ - actively preparing for your procedure by performing some form of training to improve one’s functional capacity. Clearly the saying “what you put in, you get out,” comes to mind, as we ask the patient to actively participate and perform extra amounts of work to get the most out of their procedure. Although the need for surgery is mostly out of your control, there is a lot you can do before and after an operation to optimise the outcomes and speed up your recovery.
A long-term study in the European Journal of Preventative Cardiology found that ten years after a CABG procedure those who completed a comprehensive cardiac rehabilitation program reduced their total mortality rate by 12%. Significant improvements were noted in the prognosis of the patient as well as a reduction in the need for hospital care.
The two areas of rehabilitation that offer the most benefits are education and guided exercise. We look at these in further detail below.
This has been found to be a huge part of any rehabilitation program. Below are just a few of the reasons:
The more you know as a client the better informed your choices will be.
Increased knowledge and understanding of the recent procedure means you are more likely to actively take part in the process. This includes knowledge of the recovery required and a rough timeline to full health
Learning how to reduce the risk factors for any such procedure happening again will ultimately improve your health and reduce stress about the topic.
This could start in hospital itself, the day you leave hospital, or you may be advised to rest for up to 4-6 weeks. For some procedures rest allows body tissue to heal appropriately before they are stressed through exercise. Regardless, it has been shown that starting an exercise program 4-6 weeks after a lumbar disc surgery leads to faster improvements in pain and disability when compared to no exercise treatment at all.
No difference was found in the type of exercise, whether it was independently performed home based exercise or face-to-face treatment within a post-op rehabilitation centre. Improved outcomes (pain, disability and total mortality) rely heavily on patient adherence.
Here are our top tips for getting the best out of your post-op rehabilitation exercise program:
Ask your surgeon and hospital for as much information as possible. In particular, is there a recommended rest time? Activities to avoid? A timeline to full recovery?
See an Accredited Exercise Physiologist. More often than not a referral can be provided through your GP or you could book in privately. The benefits of an exercise physiologist include:
Having support and guidance through what can be a daunting exercise program.
Having the ability to report pain levels and modify exercises accordingly.
Finding ways to make difficult activities easier to perform
You will help you feel supported and have improved quality of life during a difficult time.
Stick to it! It may seem frustrating when initial pain and disability is still present, but the body has an amazing capacity to adapt. So long as you work within your limits and have solid ‘SMART’ goals set by yourself and supporting team, you will be able to come out the other side with greatly improved outcomes!
Please use these tips as a guide and hopefully they can help you make positive decisions about your future, or contact us if you would like to know how our team of allied health professionals can assist you in bouncing back after major surgery.
This article was written by Wian van Heerden, one of our qualified Exercise Physiologists based on the Sunshine Coast.
Hedback, B., Perk, J., Hornblad, M. and Ohlsson, U., 2001. Cardiac Rehabilitation after Coronary Artery Bypass Surgery: 10-Year Results on Mortality, Morbidity and Readmissions to Hospital. European Journal of Cardiovascular Prevention & Rehabilitation, 8(3), pp.153-158.
Oosterhuis, T., Costa, L., Maher, C., de Vet, H., van Tulder, M. and Ostelo, R., 2014. Rehabilitation after lumbar disc surgery. Cochrane Database of Systematic Reviews.
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Sunshine and Cooloola Coasts
Wian van Heerden