Author Archive: aenriquez

The Continuing Relationship Between Physical Therapy and Regenerative Medicine

In regenerative medicine, stem cells are used to treat damaged or destroyed tissues and organs. These stem cells come from the patient themselves and are a “blank state” which can be turned into several different variations of cells including bone, ligament, tendon or muscle.

Given that the main goal of both regenerative medicine and physical therapy is to restore the normal functioning of a diseased or injured tissue it is only appropriate that the two therapies – physical therapy and regenerative medicine – combine forces.Regenerative medicine aims to help the body heal itself more effectively. The study of using a tissue, cellular, organ and medicine substitutes to restore biological function lost as a result of injury, disease, congenital abnormalities or age has brought together a variety of scientists – many with overlapping backgrounds – in the field of regenerative medicine.

Once the regenerative medicine is administered via injection or other procedure, patients are often encouraged to continue physical therapy – as the strength gained from the stem cell therapy enhances their ability to complete physical therapy.

Furthermore, in cases such as artificial organs and medical devices, the relationship between the two fields is also important. A major problem with organ transplant is that there is no way to know if the body will reject the organ or not, and unfortunately, there is no way to prevent it either. However, the great benefit to regenerative medicine, and specifically stem cell therapy and the like, is that the materials used to aid in the healing process are taken directly from the patient – via their blood, bone marrow, or other appropriate sample collected for the needed materials.

However, following the introduction of a new organ or a medical device – even if the organ is one grown from the own patient – physical therapy is still a vital part of the rehabilitation process. Physical therapy has the strong power to enhance the healing potential. As a result of physical therapy, the body can maximize the functional interaction between the host and the donor object – rather it is an organ or a medical device. Following a form of regenerative medicine treatment, physical therapy should be appropriately positioned so that it can optimize the patient’s post-transplant recovery.

Oftentimes, regenerative medicine treatment options are also used for problems such as back pain, knee pain, and other debilitating chronic pain. Typically, the patient was probably receiving physical therapy prior to regenerative medicine treatment options – or had at least tried it as an option. However, to continue to increase the mobility and give the stem cells the best chance at being successful, physical therapy should continue to be an important part of the patient’s regimen.

As the two fields continue to work in close contact with one another, it is also imperative that scientists and rehabilitation specialists continue to work to develop clinically relevant protocols.

When combined, physical therapy and regenerative medicine can continue to optimize the quality of life for those patients suffering from chronic pain or other ailments which have previously inhibited them from doing things.

Total Hip Replacement Rehabilitation

Total hip replacement surgery involves removing damaged cartilage and bone from a painful hip and replacing this with prosthetic components. The hip is a ball-and-socket joint, with the ball being the head of the femur (thigh bone) and the socket being a portion of the pelvic bone. Also called total hip arthroplasty (THA), hip replacement is typically done because of damage from arthritis. The main part of the hip replacement process is rehabilitation.

Before Surgery

Rehabilitation begins before your total hip arthroplasty. A physical therapist teaches you about what to expect from the surgery and gives you exercises to precondition your body. Flexibility and strengthening maneuvers are used to make your recovery easier. The therapist may do a home visit to advise you on how to make your environment safe for your recovery.

Immediately after Surgery

Right after a total hip replacement, you will have some weakness, numbness, itching, soreness, pain, and stiffness of the hip and leg. Postoperative pain can continue for up to 6 weeks. However, this is managed using a variety of techniques and medications. Right after surgery, you are monitored in the recovery area for 1-2 hours before being moved to a hospital room.

Rehabilitation continues after surgery. A physical therapist will teach you how to put weight on the affected leg, how to use an assistive device (crutches, walker, cane), and how to move from bed to chair, and up from a chair. The therapist will not allow you to turn the leg inward, cross your legs, or bend forward more than 90 degrees.

Hospital Care

While in the hospital, your physical therapist will visit you 2 times each day and help restore function and prevent injury to your new hip. The therapist continues to work with you to learn how to turn in bed, how to walk with the assistive device, and how to perform a range of motion and strengthening exercises.

Subacute Recovery

Whether you are moved to a skilled nursing facility or return home, physical therapy continues. You progress to walking, climbing stairs, transferring from a car, increasing balance, and full movement of the new hip. Specific muscle strengthening exercises are used to improve standing and walking ability.

Once your new hip is strong, you are encouraged to fully bear weight on the hip and walk more. The physical therapy sessions continue to focus on stretching, mobility, and strength. The therapist aims to return you to your pre-surgery functional status and improve your quality of life. After 6 weeks, you may be allowed to climb ladders, lightly job, pull carts, and lift objects.

Normal Activities

As soon as the orthopedic surgeon gives you the go-ahead, you can return to usual and normal activities. This means you can walk as much as you wish, swim after sutures are removed, and participate in golf, cycling, and household chores. Return to driving, sexual activity, and air travel will depend on your rehabilitation success.

You are permitted from doing some things after a total hip replacement. To ensure proper healing and prevent hip dislocation, don’t:

  • Try to pick something from the floor while sitting.
  • Cross legs at the knees for at least 8 weeks.
  • Lean forward while sitting.
  • Bend at the waist beyond 90 degrees.
  • Reach down and pull up blankets when lying in bed.
  • Turn feet inward when you bend down.

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