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Case Study of Physiotherapy Treatment of a Patient after total knee replacement surgery
Petrocheilos, Stavros ; Nováková, Tereza (advisor) ; Vomáčková, Helena (referee)
Title: Case study of physiotherapy treatment of a patient after total knee replacement surgery. Thesis aim: Thesis is divided into two parts, the first part is theoretical and has aim to show an overview of anatomy, kinesiology and biomechanics of the knee joint and to show general information about the osteoarthritis and the patient's surgery. The second part is the case study where aim is to show the examinations and treatments that were provided to the patient and analyse the results. Clinical findings: The patient was a 71 years old male with diagnosis of total knee replacement surgery, performed 7 days ago from the time we met. The patient had limited ROM in the operated leg into flexion and extension and the area around the knee was swollen and warm. Also, he had some weakness on the muscles of the operated leg. Procedures: All the procedures that used were based on my knowledge acquired from Charles University in Prague, Faculty of Physical Education and Sport. These were post isometric relaxation, joint mobilisation, strength and length tests and strengthening exercises based on my knowledge. Result: After 7 days of therapies the patient's operated leg had physiological mobility into flexion and extension, the muscles gained strength and oedema was reduced but not completely. Conclusion:...
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Differences in the care of patients after a complete knee and hip replacement from the standpoint of the nurse.
LUŇÁČKOVÁ, Jana
Complete knee and hip replacement are one of the most common surgical procedures in an orthopedic practice. The care of these patients places very high demands on the attending nurse and follows strict guidelines. The occurrence rate of indications for the knee/hip replacement has risen recently. The reason behind it is higher stress on the bearing joints due to alarming rise in obesity, arthritic changes in the joints etc. Surgical procedure can restore mobility and independence of the patient. Part of the successful postoperative care is a close cooperation with the physiotherapy specialist. Orthopedic nurses carry full responsibility for the patient's care and therefore should be informed on its specifics. The bachelor thesis is divided into two sections, theoretical and empirical. The theoretical section focuses on the anatomy of the knee and hip joint, history of the replacement procedure and its indications and contraindications. It also discusses the specifics of the care of the patient. The empirical section covers research. The objective of the thesis is to discover different aspects of nursing care of the patient after total hip replacement and knee replacement and to investigate whether nursing staff possesses the knowledge of these aspects. Three basic questions were formulated: 1. What are the differences in care between the total knee replacement and total hip replacement patients? 2. In what areas of patient care, according to the nurses' point of view, do these differences exist? 3. What areas of patient care after total knee/hip replacement do nurses find the most difficult? A qualitative research method has been used to accomplish results for this thesis. Data collection has been carried out through semi-structured interviews and assisted observations. The research has taken place at a single location, an orthopedic department of a hospital. The research was completely anonymous, interviews and observations took place from April 8th 2016 through May 31st 2016. A semi-structured interviews were used for the data collection. Nurses were given 14 basic questions (see Appendix) that were followed by additional sub-questions during the interviews. Then the interview results were sorted into groups by their category for better comprehension. An assisted observation was another technique used. The acquired data have been input into a prepared table (see Appendix). The interviews and observations were carried out with the same subjects/nurses. The data collected showed that the care of the total knee replacement patient does not fundamentally differ from that of a total hip replacement patient. The only differences found were those in positioning of the patient, utilization of compensation aids, rehabilitation care and, according to the nurses, also in prevention of possible complications. The most common problems occur in connection with the manipulation of the patient. Nurses seem to lack a clear guidance as to by who and how the patient should be informed prior to the replacement procedure. This bachelor thesis has been compiled in such a way as to outline basic overview of the patient care differences and to be used as an information source for the experienced as well as the inexperienced nursing staff. Practical aspect of this thesis is a proposal for a seminar (see Appendix) on the issue of patient care differences after a total knee/hip replacement.
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Use of physiotherapy to restore function after total knee replacement
VORÁČKOVÁ, Marcela
The bachelor thesis deals with possibilities of early physiotherapy of patients after total knee replacement during hospitalization and explores its influence on improvement of the movement of the joint and muscular strength, healing of the surrounding tissues, increasing mobility and independence of the patient. It is divided into a theoretical and practical part. The theoretical part deals with the anatomy of the knee joint, its kinesiology and gonarthrosis. Further it contains information about total replacement, the actual surgery, and especially the description of a suitable therapy focused mainly on the postoperative phase during hospitalization and also after the discharge into the home care. The physical therapy and care abroad is also mentioned. The practical part consists of qualitative research. The aim was to compile patient case reports after this surgery and propose a rehabilitation plan for them. During the research, I cooperated with three patients. Each case report includes a medical history, an initial and a final examination with a suggestion of a short-term rehabilitation plan and its description. Moreover, there is an evaluation of the therapy and a draft for a long-term rehabilitation plan. The therapy was conducted every weekday during the hospitalization and the contribution of physiotherapy was evaluated on the basis of the comparison of the initial and final examinations results. All patients experienced a significant improvement in the flexion of the operated joint, gait and independence, increased muscle strength of the limb, decreased swelling and pain, and the pathological barrier of the tissues of the operated limb. However, the elasticity of the scar and tissues around the patella, trigger points and shortened muscle groups were not affected within the time allowed. Physiotherapy have proved to be highly beneficial to all these patients, but during the short time there has been no improvement or restoration of all the aspects observed. Therefore, it is important to continue with regular care even after leaving hospital. This work can be used by students as well as patients, who are about to undergo a surgery of this kind, and other health care staff.
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Case study of patient after Total Knee Replacement on left side
Alqarni, Mohammed Abdullah A ; Malá, Jitka (advisor) ; Mahr, Edwin (referee)
Title of the thesis: Case study of patient after Total Knee Replacement on left side Author: Mohammed Abdullah Al Qarni Work placement: Centrum léčby pohybového aparátu Mediterra Summary In the bachelor thesis, which was written by myself, it is divided in two parts, theoretical part and case study. The theoretical part explains anatomy of Knee joint, it's bones, muscles, ligaments, nerves and blood supply and surgical and non-surgical approaches of therapy of the knee joint and Rehabilitation after surgery. Information about biomechanical and kinesiological point of view were discussed as well. In the practical part I analyzed procedures I have done with the patient, all examinations, conclusions, therapies and results. Last part of the bachelor thesis it contains list of literature that used in the bachelor thesis, it contains list of tables and figures used in the thesis, abbreviations and the ethics committee. Keywords: Knee joint, knee arthoplasty, total knee replacement, patella, knee exercises.
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Case Study of Physiotherapy Treatment of a Patient with the Diagnose Psoriatic Arthritis and Total Knee Replacement
Stiksrud, Tor-Erik ; Pavlů, Dagmar (advisor) ; Špiritović, Maja (referee)
Title: EN: Case study of physiotherapy treatment of a patient with the diagnose psoriatic arthritis and total knee replacement CZ: Kazuistika fyzioterapeuticke léčby pacienta s diagnózu psoriatic arthritis a totální endoproteza kolenniho kloubu Work placement: Revmatologický ústav, Prague, Na slupi 450/4, 128 00 Praha 2- Nové Město Summary The objective of this thesis is to illustrate a case study of a patient with the diagnosis psoriatic arthritis and physiotherapy after a total knee replacement. It is discussed in two parts, one theoretical that will focus on anatomy, kinesiology, and biomechanics of the knee, and also focus on the psoriatic arthritis and osteoarthritis of the knee.. The second part, the special part, of the thesis will focus on the patients rehabilitation, describing the examination, the day to day therapy, the final examinations and conclusion. Keywords: Psoriatic arthritis, total knee replacement, osteoarthritis physiotherapy, rehabilitation.
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Case report on physiotherapeutic care of a patient with total left knee replacement on the left side caused by the gonarthrosis
Hábová, Tereza ; Nováková, Tereza (advisor) ; Coufalová, Jitka (referee)
Title: Case report on physiotherapeutic care of a patient with total left knee replacement on the left side caused by the gonarthrosis. Summary: This thesis focuses on case report of a patient after total left knee replacement. The work contains two parts - the general part and the specialized part. The general part deals with structure, kinesiology and biomechanics of the knee joint, general definition of gonarthrosis, its cause, clinical symptoms and its treatment. It also describes the gonarthrosis, indications and the types of total knee replacement prosthesis. The most important topics of the general part contain descriptions of therapeutic methods and procedures, focused on improving patient's health in the post- operation phase. The specialized part constitutes the main part of this thesis. It is processed via case report form and describes the physiotherapeutic treatment of a specific patient, who underwent a total knee replacement surgery. In the conclusion of the specialized part of the thesis, I evaluate the effects of the theraphy. Key words: knee joint, total knee replacement, gonartrosis, rehabilitation Diagnosis: St.p. total left knee replacement caused by gonarthrosis
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Case study of physiotherapy treatment of a patient with the diagnosis
Jorlo, Johanne Marie ; Maršáková, Kateřina (advisor) ; Zemlerová, Hana (referee)
Title: Case study of physiotherapy treatment of a patient following total knee replacement Abstract: The aim of the thesis is to present the physiotherapy given to a patient with stiffness after an atypical total knee replacement procedure. The work consists of a general part and a special part. The general part aims to explain this particular case of total knee replacement from a theoretical point of view. The goal of the special part is to present physiotherapy as treatment, it's conduction and results. Method: One female patient (b. 1958) with chronic stiffness following total knee replacement was selected and gave consent to take part in the case study. A copy of the form of consent can be found in the appendix at the end of this thesis. Clinical examination, therapy and progress evaluation took place at Rehabilitation Clinic Malvazinky from 21.01.14 to 31.01.14 under the supervision of Mgr. Hana Zemlerová. Utilities used in examination and treatment included treatment table, measuring tape, neurologic hammer, goniometer, overball, big balls, bosu balls, spiked balls, supportive pillows, stationary bicycle and mats. Therapeutic methods and principles used was PIR, soft tissue techniques, joint manipulation and posture correction. The general part was based on theory learned through the bachelor...
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Physiotherapeutic procedures in the healing of the scars after orthopaedic surgery
MIXOVÁ, Pavlína
This bachelor´s thesis titled Physiotherapeutic Procedures in the Healing of the Scars after Orthopaedic Surgery discusses a new approach to scar healing after total knee and hip replacement. Due to the disruption of epidermis, subcutaneous tissue, fascia, muscle, bone and joint during the surgery, it is important to promote healing of the tissue both from nursing as well as physical therapy perspective. Wound healing following these procedures is extensive and can be affected by many negative and positive factors. The role of medical personnel caring for these patients is to eliminate the negative factors and promote positive ones. Newly created scars do not share the same properties with healthy skin tissuethey tend to be fragile and more liable to pathological processes. In some cases, the newly formed scar tissue can become activated and lead to referred pain. My thesis consists of two areas: theory and practice. The theory part was compiled to reflect current data in the following fields: skin anatomy and physiology; skeletal muscle anatomy; wound healing; scar definition and treatment; total hip and knee replacement; and physical therapy plans. The practice part of my thesis consists of qualitative research conducted with six patients after total hip or knee replacements. Physical therapy treatment was documented through case studies, including anamnesis, kinesiologic examination pre- and post-intervention, and actual treatment. Patient education was provided regarding appropriate scar care and scar massage. Patient teaching occurred individually. Patients were then provided with a handout on home instructions. Patients were regularly followed outpatient and had another examination two months after their procedure. My thesis concludes that implementing scar massage as part of post-operative plan led to improved perception of the scar by the patient as well as to improved healing of the tissue. Patients rated their experience overall as positive. Based on these findings, I firmly believe that patient education regarding appropriate scar care should be included in all discharge planning following orthopaedic surgery. These findings can be useful not only for physical therapists, but also for allied personnel, e.g., physical therapy students and nursing.
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Case Study of physiotherapy treatment of a patient with total knee replacement
Benýšková, Veronika ; Maršáková, Kateřina (advisor) ; Hlavičková, Růžena (referee)
Autor: Veronika Benýšková Title: Case Study of physiotherapy treatment of a patient with total knee replacement This bachelor thesis is focused on the issues and physiotherapeutic care of a patient after implantation of total knee replacement. Its general part informs about basic knowledge of knee, about the most common diseases and physiotherapeutical approaches which are being used for patiens with total knee replacement. Special part of this thesis describes case study of a patient with total knee replacement. This case study was worked out during special practice in ÚVN in Prague, Střešovice since 13th January 2011 to 3rd Ferbruary 2011.
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Case report of physiotherapeutic care of a patient after total knee replacement
Vášková, Mariana ; Dudová, Agnieszka (advisor) ; Hlavičková, Růžena (referee)
This bachelor's dissertation discusses a case report of physiotherapeutic care of a patient after total knee replacement. In the first, theoretical, part, anatomic structures, biomechanics of the knee, and knee replacement are described as well as the typology of operations and physiotherapeutic ap- proaches to patients after total knee replacement. In the second part, a case report is described. It contains anamnesis, initial kinesiologic examination, course of the therapy, final kinesiologic examination and evaluation of the therapy. The results of physiotherapeutic care of the patient are: increased range of motion of the knee, enhanced muscle strength in lower extremities, removal of some reflexive changes, and improved mobility of patella of the operated limb. As a result of physioterapeutic care, the overall condition of the patient has improved.
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