Introduction
Orthopedic rehabilitation is a specialized form of therapy aimed at restoring function, mobility, and quality of life for individuals recovering from musculoskeletal injuries, surgeries, or chronic conditions. It’s commonly used after events like joint replacements, fractures, ligament repairs, or spinal surgeries.
Rehabilitation is needed by an increasing number of individuals with multiple chronic conditions because of its advantage of providing the ability to live a longer, productive life.
Definition
Orthopedic rehabilitation is a therapeutic strategy to recovery, the purpose of which is to rectify any musculoskeletal defects and alleviate pain due to trauma, illness, or operative procedures.
Goals
- Reduce pain and inflammation
- Improve joint mobility and muscle strength
- Restore functional independence
- Prevent complications like stiffness or muscle atrophy
Common Techniques Used
| Technique | Purpose |
|---|---|
| Therapeutic Exercises | Strengthen muscles, improve flexibility, and enhance balance |
| Manual Therapy | Hands-on techniques to mobilize joints and soft tissues |
| Modalities | Use of heat, cold, ultrasound, or electrical stimulation for pain relief |
| Gait Training | Relearning how to walk safely and efficiently |
| Assistive Devices | Training with walkers, canes, or braces to support mobility |
Settings for Rehabilitation
- Inpatient Rehabilitation – For complex cases needing intensive therapy (e.g., post-amputation)
- Outpatient Rehabilitation – For less severe injuries or post-op recovery (e.g., ACL tear)
Principles
- Promote adaptation: Rehabilitation should begin during the initial contact with the patient.
- Emphasis on abilities: The emphasis of rehabilitation is to restore the patient’s independence or pre-illness or pre-injury level of function in as short a time as possible.
- Rehabilitation enables time management.
- It is focused on patient-centered care.
- The patient must be an active participant.
- Rehabilitation motivates the patient and helps him or her to attain social independence.
Benefits
- Maximizes movement.
- Participates in recovery.
- Helps the patient avoid the need for opioids or surgery.
Types
Physical Therapy (Physiotherapy)
Hot/cold compression, application of splints transcutaneous electrical nerve stimulation (TENS), back care, acupuncture (also known as trigger-point dry needling), and electrotherapy.
Occupational Therapy
Educates the patients for daily activities (ADLs) and instrumental activities of daily living (IADLs) such as cooking, music therapy, and play time with families; taking a nutritious diet, and adequate sleep and rest; and hand therapy [range of motion exercises (also known as joint manipulations), muscle strengthening exercise (also known as joint mobilization)].
Sports Rehabilitation
Hockey, football, tennis, running or jogging, cricket, aerobic exercise (cycling, walking), deep breathing exercise, meditation, and ergometer exercise (fitness cycling).
Ultrasound/Electrical Stimulation (NMES)
Neuromuscular electrical stimulation (NMES) uses a device that sends electrical impulses to nerves to contract the muscles and increase the muscle strength.
Nursing Interventions
- Pain Management: Administer analgesics as prescribed; use non-pharmacologic methods (ice, positioning).
- Mobility Support: Assist with ambulation, encourage participation in physical therapy, use gait belts or walkers safely.
- Skin Care: Reposition every 2 hours, inspect skin daily, use pressure-relieving devices.
- Infection Prevention: Monitor surgical sites, maintain sterile technique during dressing changes.
- Patient Education: Teach about weight-bearing restrictions, home safety, signs of complications, and importance of adherence to rehab.
Special Considerations
- Make sure that the patient takes regular medication.
- Secure the assistive device for amputee patients.
- If the patient feels any pain during procedure, allow a short rest and continue after a few minutes.
- Make sure that vitals are stable and the saturation level is high.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884.
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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