Necessity of Inclusion of Muscular Belt Training Exercises in the Complex Rehabilitation Programme of Osteoarthritic Patients after Total Hip Replacement (A Case Report)

Koleva I, Papathanassiou Y, Yoshinov B and Hadjiyanev C

Published on: 2020-04-15


Introduction: During last years, we observe an increase of the number of joint replacement in lower extremities, especially in geriatric osteoporotic population. The rehabilitation protocol after arthroplasty includes physiotherapy, oriented to training of muscles (around the joint) and to gait recovery. Nevertheless, in some cases, during this period a complication or comorbidity can occur. The goal of current study is to present a patient after hip replacement with unexpected low back pain and related clinical signs and symptoms; and the subsequent adaptation of our rehabilitation complex to this comorbidity.

Patient’s Presentation: The presented patient is a 74 years old male; transferred to our Department one week after left total hip replacement, with the objective of complex rehabilitation; for persistent clinical manifestations. At the moment of admission, the patient suffers from excessive pain in the hip region and muscles around it; low back pain and paravertebral stiffness, leg tingling; difficulties in standing-up, transfers and mobility; gait instability; altered autonomy in everyday life. Clinical exam before rehabilitation demonstrates Reduced and painful Range of Motion in the operated hip; vertebral (lumbar) syndrome and bilateral lumbo-sacral radicular syndrome (L5-S1). The imagery (X-ray, CT, and MRI) demonstrated lumbar osteochondrosis, spondylosis and spondylarthrosis. In the complex rehabilitation program we included exercises for hip mobility, muscle strength, gait training; and for spine mobility and muscular dysbalance. The algorithm of orthopedic rehabilitation is presented and explained in details. For improvement of the efficacy of the rehabilitation we must consider the kinesiological and pathokinesiological analysis of the typical posture and gait of every patient, especially after operation of one lower extremity. The adaptation of the complex rehabilitation programme to the individual case at the concrete moment of his condition is obligatory. The adapted rehabilitation stimulates the functional recovery of patients with orthopedic conditions, ameliorating their autonomy and quality of life.