Post Surgeries Rehabilitation

Every surgery that involves the muscles, joints, or bones requires rehabilitation post the surgery. Some such common surgeries are:

1. Neurological And Spinal Surgery: Repair of the disc, spinal fusion, replacement of the disc, surgery of the brain are included in this surgery.
2. Orthopedic Surgery: Replacements of the muscles, bones, and joints come under this.
3. Gynecological Surgery And Obstetric: Hysterectomy, postnatal, and gynecological repairs fall under this category.
4. Thoracic Surgery: When internal organs are operated on, such as the heart, liver, lungs, and other internal organs, then the operation is known as thoracic surgery.
5. Surgery of the Breast: Operating the breast for cysts and other issues fall under this procedure.
6. Urological Surgery: Operating the prostate and bladder are known as Urological surgery.

Now that we know the types of surgeries that require post-surgery rehabilitation, you can now be clear on the fact that if you need to go through such a process or not.

Role of Post-Surgery Rehabilitation

As per recent studies, it shows that post-surgery rehab plays a very important role in the healing of the muscles, joints, as well as internal organs as well. Studies have also shown that pre-surgery exercises are also beneficial to prepare well for the operation.
Elderly individuals are the ones who undergo such major surgeries. To cope with the entire mechanism and after-effects of surgery, an exercise, as well as a physiotherapy routine, is a must.

Below is a simple, step-by-step flowchart that explains what happens if the patient does not receive rehab post-surgery:

Step 1:

Pre-Operative Functional Status
Before undergoing major surgery, the body and the mind are already under stress. To overcome the same, a pre-surgery exercise must take place; however, there still is some leftover functional status before a major operation.

Step 2:
Major Surgery
After one prepare himself for the surgery, step 2 includes undergoing the same.

Step 3:
Surgical stress & Physical Activity Level
The reduced physical activity after surgery leads to post-surgical stress. If a post-surgery rehab does not initiate soon after the surgery, the can suffer physical collapse.

Step 4:
Deconditioning
When on a bed for a long-time, after major surgeries, the mind begins to decondition. It leads to mental issues, such as anxiety and depression. We must also remember that deconditioning is also a part of surgical stress.

Step 5:
Functional Decline
This also comes under surgical stress and is known to be the after-effects of deconditioning. When the post-surgery patient does not stay in rehabilitation after the operation, one can see a considerable decline in physical activities too.
Also, participation in social activities is reduced, which leads to a further decline in the function of the brain.

Step 6:
Post-Operative Complications
All of the above steps combine to form post-operative complications. In such cases, the patient does not completely recover from the surgery, either mentally, or physically or even both.

To avoid Post-Operative Complications, A Post-Surgery Rehabilitation is a must.

Effect of Long-Term Care Facility

Doctors deduce the effects of any facility or care via predictive algorithms. When such a technique helps to determine the effect of the long-term facility for patient’s post-surgery, below were the findings:

1. The analysis showed that above 80% of patients who undergo major surgeries are concerned about their quality of life in the future.
2. As per stats, after surgery and on discharge, the report shows that more than 80% of patients went home after discharge. 7.5% chose a skilled nursing facility, 3.7% went to rehab, and around 4.5% chose Long-term Care Facilities.
3. The above analysis does not apply to patients who are on dialysis or have right heart failure and have a severe lung disease.
4. Out of the 4.5% of patients who chose Long-term care facilities saw a significant improvement in their quality of life. At least 30.7% of the patients had a healthy and longer life.
5. Out of the 80% of patients, who chose to go home, the majority of the patients saw a significant increase in hospital re-admission. It does not include the ones who chose the Long-term care facility at home.

Types of Long-Term Care Facilities are there?

Organized Providers: 

This includes providers such as certain institutions, residential care by certain communities that works towards long-term care of patients, services that also work towards servicing the community, such as NGO’s.

Nursing Homes

include hospitals, clinics, and health facilities that allow post-surgical patients to remain in hospital to receive long-term care post-surgery.

Community-Based Residential care

These do not work as organized providers because they are smaller than an NGO.

HCBS (Home and Community-Based Services)

These services offer waivers on such long-term care services based on factors such as age, type of disability, mental illness, type of chronic diseases such as AIDS, and injury in the brain.

Individual Caregivers

Individual caretakers work for in-house and in-hospital care. Post-surgery rehabilitation can take place very smoothly; by such individual caregivers too as they are trained and well-equipped to carry out such practices.

Hip Replacement Post-Surgery Rehabilitation

The conclusion that was drawn by another experiment conducted by BMC Health Services, in the case of hip replacement surgery was:

1. Patients who chose post-surgery rehabilitation and long-term care facilities found it easier to return to pre-existing functioning levels.
2. Above 70% of patients who did not choose IRF rehab showed hospital re-admission after six months of discharge.
3. Those surgical patients who chose hospital rehabilitation showed fewer signs of Dementia and any other cerebrovascular disease.
4. The study also showed that 20% of the patients who did not receive post-surgeries rehabilitation died within six months. Whereas in the other case, the mortality percentage amongst post-surgery rehab patients was:

• 15.4% for patients who chose in-hospital rehabilitation.
• 11.6% for patients who chose Long-term care Facility

It indicates that, in the case of hip surgery, it is quite essential to receive proper rehab care. One can either chose an in-hospital rehab, or in-house rehab, or even a long-term care facility, depending on what they require.

But due to the constriction of very fewer studies conducted in this field, it is not definite if post-surgeries rehabilitation increases one’s age. What is certain is the fact that this kind of rehab prevents any kind of Post-Operative Complications.

Knee Replacement Post-Surgery Rehabilitation

As per NCBI, the current studies determine the exact post-operative rehabilitation strategy that is most effective in the case of TKA (Total Knee Arthroplasty).

However, some studies show that patients who chose such rehab procedures show fewer chances of post-operative complications.

1. Rehabilitation procedures that aim at improving the strength of muscles, balance, and gait seem to cause better recovery in TKA patients.
2. Some of these procedures include contractions with high-velocity, tele rehabilitation, rehabilitation, and interventions.
3. The exercising techniques also improve conditions such as anxiety and depression after surgery.
4. As per a survey that was done by EMBASE, PubMed, and Cochrane Library databases, including the following results:

• CPM Procedure: Continuous passive motion was helpful in the healing of soft tissues. It would improve knee flexion if the patient continued to practice at least two hours of CPM, and three hours of regular exercise, every day.
• High Velocity & Intense Exercise: This routine improved muscular strength as well as power significantly.
• Outpatient Therapy: This includes tele rehabilitation, which provides intervention therapy using telecommunication devices. Virtual assistants in this procedure show the best improvement in patients who underwent TKA.
• Inpatient Rehabilitation: Inpatient rehab involves exercise and physiotherapy protocols followed by hospitals on TKA patients. Although this procedure did not show significant results as compared to home-based care services, it is one of the most widely used techniques for knee-surgery patients.
• Early Rehabilitation: This procedure takes place before the operation. In this procedure, patients go through bed mobility exercises so that they can overcome the effects of anesthesia after the surgery.

As mentioned earlier, irrespective of the above procedures, there is no definite study that confirms the role of post-surgery rehab in improving the condition of the patient drastically. It, however, helps in reducing post-operation complications.

Shoulder Post-Surgery Rehabilitation

For patients who undergo shoulder surgery, it is important to facilitate post-surgeries rehabilitation. It is carried out so that the patient can return to normal levels of functioning earlier.

Due to the criticality of the rotator cuff patients, they must remain in touch with doctors while undergoing such a rehab procedure.

What does the procedure include? And how effective is it? We will discuss these questions below:

1. Physiotherapy and exercises help in the repair of tendons.
2. Although the anatomy of the shoulder is quite complex, consulting with a physician during shoulder post-surgery rehabilitation helps in determining if the chosen care facility is helping or not.
3. The reduction of stress is significant due to the motion exercises implemented. When the body is in motion, patients gain confidence, hence, show faster recovery post-surgery.
4. One must remember not to apply excessive stress on the shoulder due to its complex anatomy and tenderness.
5. Activation of scapular muscles occurs due to such a rehab procedure. Followed by isotonic and isometric rotator cuff exercises.
6. For athletes, there is a special exercise routine known as plyometric training that is majorly responsible for their faster recovery and to maintain mental balance too.

Thus, we can conclude that in the case of shoulder surgery, it is critical to undergo post-surgery rehabilitation. Not only does this procedure lead to faster recovery, but it also is responsible for fewer complications.

For How Long Is Post-Surgery Rehabilitation Required?

It depends on the type of surgery that determines the timeline of post-surgery rehabilitation. Also, age plays a significant role in the same.
For children, the time limit ranges between 3 months to 6 months. Children show faster recovery in terms of muscle strengthening, as well as tissue repair. Hence, they do not require much time to recover from major surgeries.

For Adults, especially for athletes, the rehab procedure maybe a bit more complicated. They must choose Outpatient Long-term Care Facility so that they get professional care strictly. The suggested timeline for adults is somewhere between six months to one year.

For Elderly patients, one cannot recommend vigorous exercises. The best therapy for them is tele rehabilitation, as well as Outpatient care, which goes on for as long as they want.