WAYS TO RESTORE MOTOR ACTIVITY IN PATIENTS AFTER HIP JOINT REPLACEMENT SURGERY

Abstract

Rehabilitation after hip replacement is a set of measures aimed at strengthening the muscles that support the hip joint, restoring normal gait and joint mobility, and preventing complications, including contractures, edema, and thrombosis. Indications for hip replacement include rheumatoid arthritis, dysplastic and post-traumatic arthrosis (ankylosis), malignant and benign tumors, etc., but the main reason is deforming osteoarthritis of the III–IV degree, with painful clinical manifestations and destruction of joint elements. Rehabilitation after hip replacement consists of three main stages: early (0–6 weeks), middle (outpatient – from 6 weeks to 3–6 months), and long-term (supportive – from 3–6 months to a year). Ultimately, it is aimed at restoring walking with and without aids and returning to an active life. Purpose of the study: To develop and test a set of therapeutic exercises aimed at improving proprioception, i.e., the ability to maintain body position in space relative to gravity, which is lost after hip replacement surgery. Subject of the study: the effect of therapeutic exercises after hip replacement surgery. Research objective: to determine the walking speed of patients after hip replacement surgery during the recovery period using a 6-minute walk test. Research methods: Determination of the speed of movement of patients after hip replacement during the recovery period using a 6-minute walk test. Materials and methods: Twelve patients undergoing rehabilitation after hip replacement were included in the experimental study. Half of them (n=6), who constituted the control group, were treated and rehabilitated only according to the rehabilitation facility's program, while the other half (n=6) – the main group – additionally performed 20 minutes of therapeutic exercises aimed at restoring spatial awareness and balance while walking. Results obtained: The practical part of the experiment lasted for 1.5 months, during which patients in the control group underwent treatment according to the method approved by the rehabilitation facility, while those in the main group underwent treatment according to the experimental method. Two measurements were taken using a 6-minute walk test. In the first measurement, during the selection of patients for the experiment, the average distance covered in the control group was 235 m, which was 52.2% of the physiological norm (450 m), while in the main group it was 232 meters, or 51.5%, which confirmed the equivalence of the selected groups for the experiment. The second, final measurement gave the following result: in patients in the control group, the increase averaged 58 meters, or 293 meters (60.5% of the norm), and in the main group, it was 133 meters, or an increase to 365 m (80.1% of the norm). In percentage terms, the walking speed of patients in the main group increased by 19.6%. Conclusions. Recovery of full walking ability after hip replacement is divided into several stages and is a rather lengthy process. The patient must first move around with the help of a walker, gradually transitioning to crutches or a cane. Over time, with sufficient muscle strengthening through regular therapeutic exercises, it becomes possible to completely abandon the use of mobility aids. For effective restoration of walking after hip replacement, it is necessary to perform a set of therapeutic exercises to strengthen the muscular system, stabilize proprioceptive balance, and restore coordination and balance of motor activity. The coordinated implementation of these factors contributes to the restoration of walking, endurance and confidence when moving.