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Total Knee Replacement – Remote Therapy

28/07/2020
Physiotherapy
KNEE PAIN 2

Currently, standard rehabilitation following Total Knee Replacement (TKR) consists of guided exercise therapy for up to 12 weeks after surgery, including inpatient, outpatient and home therapy.1 With the current COVID-19 situation preventing normal consultations from occuring, let’s take a look at how you can assist your patient rehabilitate through TKR from the comfort of their own home.

Early Stage Rehabilitation

Early stage rehab focuses on pain control, ROM and muscle activation.

For pain relief, adding TENS during rehabilitation exercises in conjunction to routine pharmacological analgesics has been shown to reduce movement pain during the immediate post-operative period.2 Cold therapy is also an important tool in ensuring that knee ROM begins in the early post-operative period.3

For strengthening, early NMES used adjunctively to therapy after TKR has been shown to alleviate quadricep muscle activation deficits, improving quadricep strength, knee range of motion and function.1

Kate Holtham from Beatty Park Physio explains combining NMES with active exercise in the video below.

Later Stage Rehabilitation

During this stage, strengthening will include weight bearing exercises with or without NMES and exercises that focus on control.  Traditional face-to-face physio sessions allow the pratitioner to go through exercises specific to the progression of the rehab and recovery, to make sure the techniques are correct. The major challenge in at-home rehab is the inability to review rehab exercise techniques. Online video platforms can assist your patient with this by demonstrating the appropriate exercises for them to perform, such as the example videos shown below by RehabMyPatient.com and Emerge Ortho.

How can DJO help you?

While many practices have been busy researching telehealth options, you might find that you still need to provide additional material to aid in exercise prescription following your consultation. To assist with this, DJO has just introduced a Video Gallery for you and your patients during this unprecedented and difficult time. You can access this library by clicking here.

The DJO team are also providing remote product support via video for clinicians or patients. We offer a range of exercise and rehabilitation consumables, TENS and NMES units and Cold Therapy products to assist your patient complete their rehabilitation from home.

Get in touch with your sales representative today to see how they can assist you.

References:
1 Neuromuscular Electrical Stimulation (NMES) for Improving Outcomes Following Total Knee Arthroplasty (TKA) – Full Text View – ClinicalTrials.gov. Clinicaltrials.gov. (2020). Retrieved 17 April 2020, from https://clinicaltrials.gov/ct2/show/NCT03044028.
Rakel, B. A., Zimmerman, M. B., Geasland, K., Embree, J., Clark, C. R., Noiseux, N. O., Callaghan, J. J., Herr, K., Walsh, D., & Sluka, K. A. (2014). Transcutaneous electrical nerve stimulation for the control of pain during rehabilitation after total knee arthroplasty: A randomized, blinded, placebo-controlled trial. Pain155(12), 2599–2611. https://doi.org/10.1016/j.pain.2014.09.025
3 Kuyucu, E., Bülbül, M., Kara, A., Koçyiğit, F., & Erdil, M. (2015). Is cold therapy really efficient after knee arthroplasty?. Annals of medicine and surgery (2012)4(4), 475–478. https://doi.org/10.1016/j.amsu.2015.10.019