AUTHORS ' CONCLUSIONS Very low quality evidence is available from single trials , thus we are uncertain if hip pre caution s with or without the addition of equipment and functional restrictions are effective in preventing dislocation and improving outcomes after THA .
BACKGROUND Total hip arthroplasty ( THA ) is one of the most common orthopaedic operations performed worldwide .
Painful osteoarthritis of the hip is the primary indication for THA .
Following THA , people have conventionally been provided with equipment , such as raised toilet seats and chairs , and educated to avoid activities that could cause the hip joint to be in a position of flexion over 90 degrees , or adduction or rotation past the midline .
These aspects of occupational therapy have been advocated to reduce the risks of prosthesis dislocation .
However , the appropriateness of these recommendations has been question ed .
OBJECTIVES To assess the effects of provision of assistive devices , education on hip pre caution s , environmental modifications and training in activities of daily living ( ADL ) and extended ADL ( EADL ) for people undergoing THA .
Characterizing rehabilitation services for patients with knee and hip replacement in skilled nursing facilities and inpatient rehabilitation facilities.
OBJECTIVE To characterize rehabilitation services for patients with knee and hip replacement in 3 types of postacute facilities in the U.S. DESIGN Multi-site prospect i ve observational cohort study . SETTING Eight freest and ing skilled nursing facilities ( SNFs ) , 1 hospital-based SNF , and 11 inpatient rehabilitation facilities ( IRFs ) . PARTICIPANTS Patients ( N=2158 ) with knee or hip replacement . INTERVENTIONS No new interventions . MAIN OUTCOME MEASURES Length of stay ( LOS ) , amount and intensity of physical therapy ( PT ) and occupational therapy ( OT ) , types of therapy activities . RESULTS Average LOS was about 15 days for freest and ing SNF patients , and 9 to 10 days for hospital-based SNF and IRF patients . Freest and ing SNFs and IRFs provide about the same number of hours of PT and OT ; the hospital-based SNF provided 27 % fewer hours . Freest and ing SNFs and the hospital-based SNF provided fewer hours a day than did IRFs . Joint replacement patients across all 3 types of facilities spent , on average , 70 % to 75 % of their PT time in just 2 activities -- exercise and gait and spent 56 % to 66 % of their OT time in 3 activities -- exercise , functional mobility , and dressing lower body . CONCLUSIONS Both freest and ing SNFs and IRFs provided similar amounts of PT with a similar emphasis on exercise and gait activities . IRFs , however , provided more OT than freest and ing SNFs . IRFs had shorter LOSs and more intensive therapy services than freest and ing SNFs . Study freest and ing SNFs exhibited greater variation in LOS and intensity of therapy than IRFs
AUTHORS ' CONCLUSIONS Very low quality evidence is available from single trials , thus we are uncertain if hip pre caution s with or without the addition of equipment and functional restrictions are effective in preventing dislocation and improving outcomes after THA .
BACKGROUND Total hip arthroplasty ( THA ) is one of the most common orthopaedic operations performed worldwide .
Painful osteoarthritis of the hip is the primary indication for THA .
Following THA , people have conventionally been provided with equipment , such as raised toilet seats and chairs , and educated to avoid activities that could cause the hip joint to be in a position of flexion over 90 degrees , or adduction or rotation past the midline .
These aspects of occupational therapy have been advocated to reduce the risks of prosthesis dislocation .
However , the appropriateness of these recommendations has been question ed .
OBJECTIVES To assess the effects of provision of assistive devices , education on hip pre caution s , environmental modifications and training in activities of daily living ( ADL ) and extended ADL ( EADL ) for people undergoing THA .