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Could Your Outcomes Improve With Pre-habilitation?

According to a recent study in the Journal of Bone and Joint Surgery, patients receiving preoperative physical therapy (knee replacement pre-habilitation) showed a 29 percent reduction in post-operative care use following a total knee replacement.

A big part of a physical therapy pre-habilitation session is about setting expectations and educating patients for the post-operative experience. They general consist of 1 or 2 sessions and cost in the range of $100. The study examined historical claims data from the Centers for Medicare & Medicaid Services  and found the following:

• 54.2 percent of the preoperative knee replacement physical therapy group required postoperative care services, compared to 79.7 percent of the patients who did not have preoperative therapy.
• The decline in postoperative care services resulted in an adjusted cost reduction of $1,215 per patient, due largely to lower costs for skilled nursing facility and home health agency care.

What does this mean for You?

Exercises may be prescribed to help maintain strength and promote range of motion of the knee joint itself prior to total knee replacement surgery. As a rule, the more you have (strength and range) going into the surgery,  the higher your starting point when you exit surgery.

Fifteen years ago, knee replacement candidates would wait as long as possible before submitting to the surgery. In doing so they would invariably lose strength and range in their knee from disuse, making the post surgical total knee replacement rehabilitation protocol  much more of an uphill climb.  An understandable problem because the surgery was and is a procedure of last resort.

Additionally, the pre-habilitation sessions often do not take place far enough in advance to allow for noticeable increases in strength and range and the limits of pain naturally hinder this development as well.

So what is driving the decrease utilization of total knee replacement rehabilitation services in this study? Education is the primary focus in a pre-habilitation session.

Becoming familiar with the principles and strategies of sound knee replacement recovery before your head is filled with narcotic pain medicine is an absolute game changer. If you get educated on what works, avoid pitfalls common to knee replacement patients and get your game plan down ahead of time, you will be well ahead of the crowd.

Nothing beats getting armed with solid insider information before you find yourself in the midst of a struggle. By all means take a pre-habilitation session or better yet grab my book on Amazon, get a cup of coffee, curl up on the sofa and do your pre-habilitation session right there. For the cost of a couple caramel macchiatos at Starbucks, you can get the information that will save you time, money and frustration.

Research Study on Pre-habilitation of Longer Duration

This is a study that included 4-8weeks of pre-habilitation which is not typical but was done for research purposes.


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Michelle, PT
Michelle, PT

Michelle Stiles called "the no nonsense" therapist, by her patients, created a company called Cowboy Up Recovery after recognizing the bankruptcy of the present medical model. Too many people regard conventional medical wisdom as gospel, ignoring the subversive influences of Big Pharma and Big Medicine. She believes, Americans in general are being trained from an early age to defer to experts in numerous areas of life and losing the impulses for self-responsibility and self-reliance in the process. Over-diagnosis and over-medicating has become endemic. While thankful for the best miracles of modern medicine, she encourages people of all persuasions to listen to their bodies and seek out answers to maintain not just an absence of disease but optimal health. Her advice is: Cowboy Up, no one cares more about your health than you do.

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