The guidelines outlined by the New York State Workers Compensation Board aim to assist healthcare professionals in pre- and post-operative rehabilitation, encompassing procedures such as Hip Arthroplasty and addressing Hip Fractures. These directives are intended to support physicians and healthcare practitioners in determining suitable rehabilitation approaches for individuals undergoing hip-related surgeries.
Healthcare professionals specializing in pre- and post-operative rehabilitation, especially in the context of Hip Arthroplasty and Hip Fractures, can rely on the provided guidance from the Workers Compensation Board to make well-informed decisions regarding the most appropriate rehabilitation plans for their patients.
It is crucial to emphasize that these guidelines are not intended to replace clinical judgment or professional expertise. The ultimate decision regarding rehabilitation should involve collaboration between the patient and their healthcare provider.
Pre- and Post-Operative Rehabilitation, Including Hip Arthroplasty and Hip Fractures
While there may be some overlap in the characteristics and requirements of arthroplasty patients, the mobilization and exercises post-hip fracture are likely to differ somewhat. These aspects will be discussed separately below.
Treatments
Rehabilitation
Rehabilitation for work-related injuries should be centered on restoring the functional abilities necessary for the individual to meet their daily and work activities, aiming for a return to work and striving to bring the injured worker back to their pre-injury state to the extent possible.
Active therapy involves the patient’s internal effort to complete specific exercises or tasks, while passive therapy relies on interventions delivered by a therapist without the patient’s exertion of effort.
Generally, passive interventions are seen as a means to support progress in an active therapy program, leading to objective functional gains. It is important to prioritize active interventions over passive ones. Patients are advised to continue both active and passive therapies at home as an extension of the treatment process to sustain improvement levels.
The incorporation of assistive devices into the rehabilitation plan may be considered as an adjunctive measure to facilitate functional gains.
Post-Operative Exercise and Rehabilitation Program
Suggested – Implement a post-operative exercise and rehabilitation program specifically designed for hip fracture patients.
Indications: This recommendation applies to all hip fracture patients. The programs should be tailored to each individual, taking into account factors such as preoperative condition, bone quality, immediate surgical results, contraindications, and other medical conditions.
Frequency/Dose/Duration: The total number of visits may range from as few as two to three for patients with mild functional deficits to as many as 12 to 15 for those with more severe deficits, provided there is documentation of ongoing objective functional improvement. If ongoing functional deficits persist, more than 12 to 15 visits may be warranted, particularly if there is documentation of improvement toward specific objective functional goals (e.g., range of motion, advancing ability to perform work activities). As part of the rehabilitation plan, a home exercise program should be developed and performed in conjunction with the therapy.
