scholarly journals Standardizing Postoperative Rehabilitation Protocols for the Tri-Service: A Consensus Meeting Hosted by the Musculoskeletal Injury Rehabilitation Research for Operational Readiness Organization

2020 ◽  
Vol 185 (11-12) ◽  
pp. 480-483
Author(s):  
Brad Isaacson ◽  
Mae Miranda ◽  
Nelson Hager ◽  
Linzie Wagner ◽  
Sydney West ◽  
...  
Keyword(s):  
Musculoskeletal Injury ◽  
Consensus Meeting ◽  
Postoperative Rehabilitation ◽  
Injury Rehabilitation ◽  
Rehabilitation Research ◽  
Rehabilitation Protocols ◽  
Operational Readiness

scholarly journals Features of using accelerated rehabilitation protocols in obstetrics: literature review

2021 ◽  
Vol 37 (5) ◽  
pp. 61-78
Author(s):  
A. S. Benyan ◽  
M. V. Nechaeva ◽  
O. B. Kalinkina ◽  
Yu. V. Tezikov ◽  
O. R. Aravina ◽  
...  
Keyword(s):  
Health Care ◽  
Bowel Function ◽  
Economic Benefits ◽  
Obstetrics And Gynecology ◽  
Postoperative Rehabilitation ◽  
Accelerated Rehabilitation ◽  
Rehabilitation Protocols ◽  
The World ◽  
The Russian Federation ◽  
Abdominal Delivery

Accelerated postoperative rehabilitation and reduction of hospitalization periods and faster recovery are modern principles of surgical treatment that are widely implemented in practical healthcare. This approach is especially relevant in obstetrics and gynecology, where the share of abdominal delivery reaches up to 80% in some countries of the world. The advantages of accelerated rehabilitation protocols to reduce the number of days of hospital stay, reduce postoperative pain, and need for analgesia, rapid recovery of bowel function, fewer complications, increased patient satisfaction. This approach has direct economic benefits for health care institutions and is carried out in the interests of the child. The article is a review of the available literature on accelerated rehabilitation and recovery of patients in the world practice, as well as the experience of implementation in some healthcare institutions of the Russian Federation.

scholarly journals Variability of United States Online Rehabilitation Protocols for Proximal Hamstring Tendon Repair

2018 ◽  
Vol 6 (2) ◽  
pp. 232596711875511 ◽  
Author(s):  
Harry M. Lightsey ◽  
David E. Kantrowitz ◽  
Hasani W. Swindell ◽  
David P. Trofa ◽  
Christopher S. Ahmad ◽  
...  
Keyword(s):  
United States ◽  
Range Of Motion ◽  
Tendon Repair ◽  
Hamstring Tendon ◽  
Search Term ◽  
Postoperative Rehabilitation ◽  
Professional Literature ◽  
Rehabilitation Protocol ◽  
Rehabilitation Protocols ◽  
Proximal Hamstring

Background: The optimal postoperative rehabilitation protocol following repair of complete proximal hamstring tendon ruptures is the subject of ongoing investigation, with a need for more standardized regimens and evidence-based modalities. Purpose: To assess the variability across proximal hamstring tendon repair rehabilitation protocols published online by United States (US) orthopaedic teaching programs. Study Design: Cross-sectional study. Methods: Online proximal hamstring physical therapy protocols from US academic orthopaedic programs were reviewed. A web-based search using the search term complete proximal hamstring repair rehabilitation protocol provided an additional 14 protocols. A comprehensive scoring rubric was developed after review of all protocols and was used to assess each protocol for both the presence of various rehabilitation components and the point at which those components were introduced. Results: Of 50 rehabilitation protocols identified, 35 satisfied inclusion criteria and were analyzed. Twenty-five protocols (71%) recommended immediate postoperative bracing: 12 (34%) prescribed knee bracing, 8 (23%) prescribed hip bracing, and 5 (14%) did not specify the type of brace recommended. Fourteen protocols (40%) advised immediate nonweightbearing with crutches, while 16 protocols (46%) permitted immediate toe-touch weightbearing. Advancement to full weightbearing was allowed at a mean of 7.1 weeks (range, 4-12 weeks). Most protocols (80%) recommended gentle knee and hip passive range of motion and active range of motion, starting at a mean 1.4 weeks (range, 0-3 weeks) and 4.0 weeks (range, 0-6 weeks), respectively. However, only 6 protocols (17%) provided specific time points to initiate full hip and knee range of motion: a mean 8.0 weeks (range, 4-12 weeks) and 7.8 weeks (range, 0-12 weeks), respectively. Considerable variability was noted in the inclusion and timing of strengthening, stretching, proprioception, and cardiovascular exercises. Fifteen protocols (43%) required completion of specific return-to-sport criteria before resuming training. Conclusion: Marked variability is found in both the composition and timing of rehabilitation components across the various complete proximal hamstring repair rehabilitation protocols published online. This finding mirrors the variability of proposed rehabilitation protocols in the professional literature and represents an opportunity to improve patient care.

Rehabilitation Protocols After Isolated Meniscal Repair: A Systematic Review

2016 ◽  
Vol 45 (7) ◽  
pp. 1687-1697 ◽  
Author(s):  
Kevin O’Donnell ◽  
Kevin B. Freedman ◽  
Fotios P. Tjoumakaris
Keyword(s):  
Systematic Review ◽  
Range Of Motion ◽  
Significant Variation ◽  
Clinical Success ◽  
Meniscal Repair ◽  
Postoperative Rehabilitation ◽  
Treatment Groups ◽  
Rehabilitation Protocols ◽  
Outcome Scores ◽  
The Ideal

Background: Current postoperative rehabilitation protocols after isolated meniscal repair vary widely. No consensus exists with regard to the optimal amount of weightbearing, range of motion, or speed at which the patient progresses through the rehabilitation phases. Confounding factors including concomitant ligamentous or cartilaginous injuries have made studying isolated meniscal tears problematic. Purpose: To systematically review and evaluate the influence of range of motion and weightbearing status during the postoperative rehabilitation period after isolated meniscal repair on clinical efficacy and outcome scores. Study Design: Systematic review. Methods: A search of PubMed, Scopus, and Cochrane Central Register of Controlled Trials was conducted. The selection criteria for inclusion were English-language in vivo clinical studies reporting on isolated meniscal repairs utilizing an arthroscopically assisted technique that outlined the postoperative rehabilitation protocol and included at least a 2-year follow-up. Titles, abstracts, and articles were reviewed, and data concerning patient demographics, tear type, repair technique, postoperative protocol details, clinical failures, and outcome scores were extracted from the eligible studies. Rehabilitation protocols were divided into “accelerated,” “motion restricted,” “weight restricted,” and “dual restricted” according to the limitations placed on the treatment groups. Results: Fifteen studies, containing 17 different treatment groups, met the inclusion criteria. The 2 accelerated groups, 2 motion-restricted groups, 4 weight-restricted groups, and 9 dual-restricted groups showed similar efficacy in terms of clinical success and postoperative outcome scores. Early range of motion and weightbearing status showed no influence over clinical outcomes. Of the 17 groups, 13 reported a greater than 70% clinical success rate with significant variation in the tear type, fixation technique, and postoperative restrictions. Conclusion: Early range of motion and immediate postoperative weightbearing appear to have no detrimental effect on the chances for clinical success after isolated meniscal repair. Significant variation exists between postoperative protocols, with no current consensus on the ideal parameters for weightbearing and range of motion. Studies reporting outcomes regarding isolated meniscal repair are limited. Future research should include determining the ideal combination of weightbearing and range of motion for specific tear types.

scholarly journals Risk Factors for Shoulder Stiffness: Current Concepts

Joints ◽  
2017 ◽  
Vol 05 (04) ◽  
pp. 217-223 ◽  
Author(s):  
Davide Cucchi ◽  
Antongiulio Marmotti ◽  
Silvana De Giorgi ◽  
Alberto Costa ◽  
Rocco D'Apolito ◽  
...  
Keyword(s):  
Risk Factors ◽  
Molecular Biology ◽  
Range Of Motion ◽  
Metabolic Factors ◽  
Postoperative Rehabilitation ◽  
Shoulder Stiffness ◽  
Medical Disorders ◽  
Rehabilitation Protocols ◽  
Postoperative Shoulder

AbstractShoulder stiffness is a condition of painful restriction of the glenohumeral range of motion. Numerous risk factors for primary and postoperative shoulder stiffness have been described. This article summarizes the known aspects of the pathophysiology of shoulder stiffness, with special attention to elements of molecular biology and genetics, which could influence the risk of developing shoulder stiffness. Furthermore, the role of hormonal and metabolic factors, medical disorders, drugs, and of other published risk factors for primary and postoperative shoulder stiffness is reviewed and discussed. Finally, aspects related to shoulder surgery and postoperative rehabilitation protocols, which could influence the development of postoperative stiffness are presented.

scholarly journals Postoperative Rehabilitation After Rotator Cuff Repair

2017 ◽  
Vol 5 (1) ◽  
pp. 232596711668477 ◽  
Author(s):  
Scott Mollison ◽  
Jason J. Shin ◽  
Alexander Glogau ◽  
R. Cole Beavis
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Demographic Data ◽  
Average Response Rate ◽  
Postoperative Rehabilitation ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Shoulder Range Of Motion ◽  
Rehabilitation Protocols ◽  
Cuff Repair

Background: Postoperative rehabilitation after arthroscopic rotator cuff repair (ARCR) remains controversial and suffers from limited high-quality evidence. Therefore, appropriate use criteria must partially depend on expert opinion. Hypothesis/Purpose: The purpose of the study was to determine and report on the standard and modified rehabilitation protocols after ARCR used by member orthopaedic surgeons of the American Orthopaedic Society for Sports Medicine (AOSSM) and the Arthroscopy Association of North America (AANA). We hypothesized that there will exist a high degree of variability among rehabilitation protocols. We also predict that surgeons will be prescribing accelerated rehabilitation. Study Design: Cross-sectional study; Level of evidence, 4. Methods: A 29-question survey in English language was sent to all 3106 associate and active members of the AOSSM and the AANA. The questionnaire consisted of 4 categories: standard postoperative protocol, modification to postoperative rehabilitation, operative technique, and surgeon demographic data. Via email, the survey was sent on September 4, 2013. Results: The average response rate per question was 22.7%, representing an average of 704 total responses per question. The most common immobilization device was an abduction pillow sling with the arm in neutral or slight internal rotation (70%). Surgeons tended toward later unrestricted passive shoulder range of motion at 6 to 7 weeks (35%). Strengthening exercises were most commonly prescribed between 6 weeks and 3 months (56%). Unrestricted return to activities was most commonly allowed at 5 to 6 months. The majority of the respondents agreed that they would change their protocol based on differences expressed in this survey. Conclusion: There is tremendous variability in postoperative rehabilitation protocols after ARCR. Five of 10 questions regarding standard rehabilitation reached a consensus statement. Contrary to our hypothesis, there was a trend toward later mobilization.

scholarly journals Return-to-Play Guidelines After Patellar Instability Surgery Requiring Bony Realignment: A Systematic Review

2020 ◽  
Vol 8 (12) ◽  
pp. 232596712096613
Author(s):  
Rishi Chatterji ◽  
Alex E. White ◽  
Christopher J. Hadley ◽  
Steven B. Cohen ◽  
Kevin B. Freedman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
Patellar Instability ◽  
Return To Play ◽  
Patient Comfort ◽  
Tibial Tubercle ◽  
Soft Tissue Reconstruction ◽  
Postoperative Rehabilitation ◽  
Rehabilitation Protocols ◽  
Tissue Reconstruction

Background: Recurrent patellar instability can be treated nonoperatively or surgically, and surgical management may vary based on the causative pathology in the structures surrounding the patella. Although isolated soft tissue reconstruction is among the most common operative treatments, certain patient populations require bony realignment for adequate stabilization. Purpose: To evaluate postoperative guidelines, including return to play and rehabilitation, after bony procedures involving the tibial tubercle for patellar instability. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review on return-to-play guidelines was conducted with studies published from 1997 to 2019 that detailed procedures involving bony realignment by tibial tubercle osteotomies and tibial tubercle transfers with or without soft tissue reconstruction. Exclusion criteria included animal or cadaveric studies, basic science articles, nonsurgical rehabilitation protocols, and patients with mean age <18 years. Studies were assessed for return-to-play criteria, rehabilitation protocols, and bias. Results: Included in the review were 39 studies with a total of 1477 patients and 1598 knees. Mean patient age ranged from 17.5 to 34.0 years, and mean follow-up ranged from 23 to 161 months. All 39 studies described postoperative rehabilitation; however, only 16 studies specifically outlined return-to-play criteria. The most commonly cited return-to-play criterion was quadriceps strength (62.5%). Range of motion (50.0%), physical therapy protocols (18.8%), and radiographic evidence of healing (18.8%) were other cited objective criteria for return-to-play. Four of 16 (25.0%) studies described subjective criteria for return to play, including pain, swelling, and patient comfort and confidence. Of the 11 studies that described a timeline for return to play, the range was between 2 and 6 months. Conclusion: The results revealed that 100% of papers evaluated lacked adequate return-to-play guidelines. Moreover, timelines significantly varied among studies. More clearly defined return-to-play guidelines after tibial tubercle transfer for patellar instability are required.

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