Orthopaedic rehabilitation

The goal of rehabilitation is to restore a patient to the fullest medical, physical, mental, emotional, social, and vocational potential possible. Rehabilitation in the orthopaedic field of practice aims to facilitate optimal independence for patients with complex orthopaedic dysfunction, for example after hip or knee replacement surgery, or multiple orthopaedic trauma, all of which could potentially lead to significant disability. Orthopaedic dysfunction can successfully be addressed by means of focused rehabilitation, and Life Rehabilitation offers specific expertise in this field. Short term rehabilitative intervention is essential in view of the high risk of complications post-surgery in the absence of dedicated and intensive rehabilitation. Successful rehabilitation results in reduced healthcare costs and burden of care.

Orthopaedic rehabilitation

Patients are usually discharged from hospital within three to seven days after hip or knee replacement surgery. However, it is important for optimum long term outcome that discharged patients don’t face undue risk during the recovery phase, and are able to safely perform activities of daily living once they return home, such as getting into and out of bed, chairs and a car, using the bathroom, and preparing food. If, after surgery, patients are not progressing to the point that they can safely return to their home environment, an assessment for inpatient rehabilitation is recommended. This facilitates the required therapeutic interventions while the patients still enjoy 24 hour medical and nursing care.

Benefits of orthopaedic rehabilitation

The benefits of the orthopaedic programme offered by Life Rehabilitation include the following:

• Prevention of prolonged stay in an inappropriate, acute environment
• All necessary rehabilitation services, medical and nursing care is offered under one roof
• Significantly decreased risk of complications during recovery phase post-operatively
• Greatly improved patient outcomes over a shorter period
• Interdisciplinary team approach, addressing all issues comprehensively
• Patient centered, outcomes driven rehabilitation
• Simulation of a home environment, where the patient has the opportunity to practice tasks under supervision with increasing confidence
• Focused and appropriate caregiver training on all aspects of home care

Case management

Case management is carried out according to the Life Rehabilitation standard process, which includes a personal pre-admission patient assessment within 24 hours of the referral, to establish the potential benefits of rehabilitation and to optimise appropriate admissions with regards to timing and patient condition. The funder will receive an authorisation request, to be reviewed if necessary. Admission, progress and discharge reports will be sent to the funder and referring specialists. When ready to refer a patient, the specialist should contact the closest Life Rehabilitation unit and the rehabilitation admissions consultant will personally visit the patient to assess him or her and discuss the admission and any queries with the referring specialist, the patient and his or her family.

Admission criteria

The criteria for orthopaedic rehabilitation admissions include the following:

• Post-operative patients with hip, knee and other joint replacements
• Multiple orthopaedic trauma
• Patients must be over 12 years (unless dedicated paediatric facilities are available)
• Medically stabilised, with all surgical orthopaedic interventions completed
• Ability to benefit from rehabilitation and tolerate a comprehensive and intensive rehabilitation programme

Orthopaedic rehabilitation programme

The orthopaedic rehabilitation programme is focused on providing time limited, patient centered, outcomes based intervention early in the recovery process; thereby ensuring that all medical, physical and psychosocial needs are addressed. The holistic and interdisciplinary programme includes both individual and group sessions. Therapy and other interventions by the interdisciplinary team, are structured in accordance with the needs identified in the initial internationally recognised assessments, which measure functioning across all functional areas. Appropriate referrals are made after discharge and resources are provided. A follow-up assessment will be arranged to ensure maintenance of improved health status.

Service overview

The service includes the following:

• Stabilisation of medical co-morbidities
• Patient and family education on the correct and safe performance of activities of daily living, movement and exercise in order to minimise the risk of complications
• Mobility and independence retraining with self-care tasks in an adapted environment
• Recommendations on home adaptations and assistive devices
• Addressing psychosocial needs of adjustment and coping
• Training of caregivers, if required

Outcomes

Outcomes of orthopaedic rehabilitation in patients after joint replacement show the following benefits:

• Increased muscle strength
• Improved mobility
• Enhanced joint flexibility
• Reduced swelling and pain
• Safety in ambulation
• Strengthening and conditioning of the entire kinetic chain

Tariff

The cost effective, comprehensive tariff is inclusive of all professional services. Only medication and assistive devices (if necessary) are additional to the tariff.