Hip and knee endoprosthesis Movement Therapy

Patients with hip or knee endoprosthesis are transferred from acute to subacute or outpatient rehab at an ever earlier stage. In rehab, one of the major goals are the improvement of range of motion of the knee or hip. In addition to individual physiotherapy, it is inevitable that the patient participates in accompanying measures.

In the early stage of rehab, a motor splint is usually utilized. Further on in the rehab process, it is important that the patient starts to become active and to apply his/her own strength. Often, the transition from continuous passive motion with the motor splint to active training on an ergometer turns out to be problematic. Due to a small range of motion, pain or hematoma, the application of a cycle ergometer is not yet possible in many cases.

The motorized MovementTherapySystem MOTOmed is a suitable means to have the patients start early in the rehab process to begin to apply their own strength in fine doses from a chair or wheelchair. This is possible due to the advantageous seating position, the possibility of different pedal adjustments and the special functions such as the SmoothDriveSystem and ServoCycling.

Due to the integrated safety arrangements such as the MovementProtector and the SpasmControl with automatic direction change, patients get confident with the MOTOmed very quickly, even older individuals. The active assistive training with the MOTOmed ServoCycling is especially recommendable for orthopaedic patients. This function allows for a particularly gentle training and is considered to be an optimal measure for quick improvement in case of limited range of motion.

Training goals:

The following training goals can be expected from post surgery patients who do MOTOmed movement therapy training on a daily basis either at home or in rehab:

• Improvement of motor skills, cardiovascular conditions and strength
• Prevention of contractures (mobilization of joints, muscles and tendons)
• Prevention of thrombosis (improvement of the venous backflow from the legs)
• Rapid muscle build-up: Particularly in patients with a non-cemented endoprosthesis, who usually tend to have larger deficits in the area of quadriceps and gluteal muscles, enforced muscle gain can regularly be observed after additional training with the MOTOmed leg trainer.
• Early start of active training (less muscle loss, less stiffening). Particularly for weaker and older patients, the combination of passive-assistive and active training has proven to be of great value: In order to initiate movement, the legs are being moved and loosened up by the motor without any strain on the patient. After that, the patient can start cycling him/herself against a minimal resistance, even if putting in very little impulses. The motor supports the movement (assistive training). A further progression of the training is the active cycling against finely adjustable resistances.
• Improvement of circulation and therefore increased sensation of warmth
• Improvement of the general patient condition: Psychologically, a transition to an active form of training is of great importance for many patients. Thus, it can be quite valuable for post surgery patients to be able to perform movements without pain or tension after a long time of great pain and relieving postures.
• Support of the process to restore a correct gait pattern: Usually, physiotherapy training is only provided during the first two months after surgery. However, studies show that the largest increase of muscle strength only happens after those two months. Therefore, it is important that the patients continue with muscle strength training after the period of physiotherapy.