Assessment of relevance and effectiveness of remote rehabilitation methods in patients after total hip replacement

Abstract

Relevance: The effectiveness and validity of rehabilitation after endoprosthetics of the lower limb joints is beyond doubt. However, the workload of operating surgeons and the high demand for rehabilitation hospitals and outpatient care limit the possibility of rehabilitation treatment, which impairs the final result of the operation. Taking into account active development of technologies, the introduction of remote-controlled rehabilitation and online questionnaires to assess the effectiveness of postoperative recovery and the quality of life of patients can be considered a promising direction for the organization of a continuous approach to rehabilitation treatment. The aim of the study was to evaluate the effectiveness of the remote rehabilitation forms and the developed questionnaires to determine the routing of patients after hip replacement. Materials and methods: The retrospective study included 30 patients aged 40 to 75 years after total hip replacement surgery. In the surgical hospital, all patients were offered the opportunity to take a survey according to the questionnaire developed by us in order to determine the group and further routing after surgery. The patients of the main group (n=15) who had the technical capabilities to engage in rehabilitation remotely were offered a link to exercise therapy complexes and a video clip on the technique of performing these exercises; online classes with a physical therapy instructor were also conducted. The rehabilitation program started from the first day after surgery and lasted 90 days. The patients of the control group (n=15) underwent classical rehabilitation in a hospital lasting 10–14 days, after which they were discharged with recommendations for outpatient follow-up. To assess the dynamics and satisfaction with postoperative recovery, all patients underwent remote testing to evaluate the quality of life and psycho-emotional state, which was carried out on the second day and 3 months after surgery. Results. The use of remote rehabilitation methods for patients after hip replacement has a positive clinical effect and is characterized by high satisfaction with the outcomes of postoperative recovery. Remote monitoring of the recovery dynamics and the creation of a database contribute to assessing the effectiveness of the treatment. Conclusion. The developed online questionnaires allow determining further routing of patients for rehabilitation treatment after surgery and evaluating the effectiveness of rehabilitation, including by means of remote rehabilitation methods. In case of paramedical difficulties in conducting full-time rehabilitation, a model of using various forms of remote rehabilitation is proposed.