Suggested Home Maintenance for the Postsurgical Patient 24-1

Suggested Home Maintenance for the Postsurgical Patient 24-1

Maxey: Rehabilitation for the Postsurgical Orthopedic

Chapter 24: Meniscectomy and Meniscal Repair

Suggested Home Maintenance for the Postsurgical Patient

Weeks 1 to 2

GOALS FOR THE PERIOD: Manage pain and swelling, increase ROM and strength, increase weight-bearing activities

1. Heel slides—10 repetitions to be held 30 seconds; pressure within patient’s tolerance

1. Ankle pumps—20 to 30 repetitions

1. Isometric muscle contractions—quadriceps, hamstring (if appropriate), adductor, and gluteal isometric contractions (10 to 20 repetitions to be held 10 seconds)

1. Cryotherapy with elevation to be performed as needed throughout the day for 10 to 15 minutes

1. Additional compression garment or wrapping may be helpful

Weeks 3 to 4

GOALS FOR THE PERIOD: Manage pain and swelling, increase ROM and strength, increase weight-bearing activities

1. Supine wall slides or passive heel slides, 10 repetitions to be held 30 seconds; pressure within patient’s tolerance

1. Cocontraction isometrics of the quadriceps and hamstrings, 10 to 20 repetitions to be held 10 seconds (depending on the repair site)

1. Isometric quadriceps, adductor, and hamstring contractions, 10 to 20 repetitions to be held 10 seconds

1. Flexibility exercises for the hamstring and gastrocnemius-soleus; stretches should be held at least 30 seconds and repeated 5 to 10 times

1. Four-quad program, two to three sets of 10 repetitions, weight added distally as tolerated

1. Elastic tubing exercises (dorsiflexion, plantar flexion, inversion and eversion, and hip PNF patterns), two to three sets of 10 repetitions

1. Low-resistance, moderate-speed stationary cycling

1. Home aquatic therapy (performing AROM exercises of the hip, knee, and ankle in chest-high water)

1. Continued cryotherapy with elevation to be performed as needed throughout the day for 10 to 15 minutes

Weeks 5 to 11

GOALS FOR THE PERIOD: Gain full ROM and 90% to 100% strength, progress functional activities, progress to gym program

1. Continued open-chain exercise program, four-quads, short arc quadriceps, and PNF patterns with tubing

1. Hamstring, gastrocnemius-soleus, quadriceps, and iliopsoas stretching, 5 to 10 repetitions to be held at least 30 seconds

1. Heel raises, two to three sets of 10 repetitions; lateral step-ups and forward step up and down (using 2-inch height progressions), two to three sets of 10 repetitions; wall squats, knee flexion at 45° advanced to 60°, two sets of 10 repetitions to be held 10 seconds; minisquats, partial lunges, and progression in knee flexion ROM (add tubing or weight to progress resistance as tolerated), two to three sets of 10 repetitions to be held 5 to 10 seconds

1. Balance activities (bilateral progressed as tolerated to unilateral)—balance board, trampoline (side-to-side and forward-to-back steps), two sets of 1 minute each

1. Exercise cords activity, T kicks, two to three sets of 10 repetitions

1. Stationary cycling, modifying the workload parameters of speed, resistance, and duration based on the response to the activity

1. Stair-stepping machine, cross-country ski machine, or treadmill, with workload progression based on patient response and tolerance

Weeks 12 to 18

GOALS FOR THE PERIOD: Return to sport or preinjury activities, establish an ongoing training program

1. Progression of strength and endurance training

1. Functional or sport-specific drills

1. Agility, sprinting, and track running

Copyright © 2013, 2007, 2001 by Mosby, Inc., an affiliate of Elsevier Inc.