Factors Influencing Recovery Trajectory of Post-Operative Hip Replacement Patients on Their Functional Capacity

Tuesday, 13 July 2010: 11:10 AM

Ching-Fen Chang, RN, MSN
Tsae-Jyy Wang, PhD, RN
Department of Nursing, National Taipei College of Nursing, Taipei, Taiwan

Learning Objective 1: The Learner will be able to describe the functional capacity of elderly who undertaken hip replacement.

Learning Objective 2: The Learner will be able to describe factors influencing recovery trajectory of post-operative hip replacement patients on their rehabilitation activities.

Purpose: The purposes of the study were to describe factors influencing recovery trajectory of post-operative hip replacement patients on their functional capacity.Methods: This study is a structured observational design. 65 pre-operative hip replacement patients were recruited from two medical centers. Patients’ ability to perform 12 functional activities was assessed daily from the operation day until discharged. The Survival-Cox Regressions were used to analyze the duration for 50% of the patients to reach the target behavior in each of the 12 activities measured.

Results: The the mean time for 50% of the patients to be able to raise the leg straightly to 15°and to 30° were 6.6 days and 9.2 days, respectively. To perform leg abduction to 15° and to 30° were 5.8 and 7.6 days, respectively. The average duration for setting on the edge of bed for 5 minutes was 3.4 days and for double-limb stance by using a walker or crutches was 4.6 days. Waking with aid (walker or crutches) for 5 meters, for 10 meters, and for 20 meters were 5.4 days, 6.5 days, and 8.5 days, respectively. The average time for getting out of bed was 5.9 days and getting into bed was 6.6 days. On an average 6.7 days, the patients were able to using aid sitting and rising from a chair. Wound pain, limb weakness, and orthostatic intolerance were reasons for terminating rehabilitation activities. Non-obey in-bed leg muscle training was the most important factor for delaying the time to be able to perform these target activities.

Conclusion: The majority of the patients were able to perform most of the activities within a week. Nurses should address the potential barriers and encourage patients to do in bed leg muscle training as early as possible to facilitate their recovery.