Effects of ice compress combined with early walking training on postoperative rehabilitation in THA patients without drainage

Abstract

Objective To explore the effect and safety of ice compress combined with early walking training on postoperative rehabilitation in patients with total hip arthroplasty (THA) without drainage. Methods Totally 84 THA patients from Zhejiang Provincial People′s Hospital were recruited in this study during April 2015 to March 2016 by using purposive sampling method. According to the random number table (i.e. hospital ID) , the participants were divided into the intervention group (n=42) and the control group (n=42) . Patients in the control group received drainage tubes after THA, and started walking training after removing the tubes. However, patients in the intervention group didn′t receive drainage tubes after THA but received ice compress, and started walking training within 24 hours after surgery. The postoperative complications, the pain, swelling degree, hemoglobin change, time of recoving independent walking, activities of daily living (ADL) , and average inpatient days of patients in two groups were observed and compared. Results The pain scores within 24 hours and 25-48 hours after surgery for the intervention group were (2.38±1.13) and (1.90±1.06) , which were lower than the scores [ (3.26±1.38) and (2.41±1.0) ] for the control group (t=3.283, 2.487; P 0.05) . Similarly, there were no differences between two groups in wound swelling and hemoglobin change (t=-1.221, -0.294; P>0.05) . The ADL scores one week and two weeks after THA surgery for the intervention group were (70.12±9.96) and (75.00±7.89) , which were higher than the scores [ (64.52±9.9) and (70.21±9.3) ] for the control group (t=2.577, 2.588; P 0.05) . The time of recoving independent walking in the control group was longer than that in the intervention group [ (3.71±1.59) d vs (5.20±2.03) d; t= -3.848; P<0.05]. The average hospitalization time in the intervention group was shorter than that in the control group [ (9.29±4.03) d vs (11.07±3.28) d; (t=2.283; P<0.05) ]. No complications (e.g. dislocation, infection, and symptomatic deep venous thrombosis) were observed after three months′ follow-up. Conclusions The ice compress combined with early walking training is beneficial for postoperative rehabilitation in THA patients without drainage. It can improve patients′ independent walking function and self-care ability and can accelerate the rehabilitation process. Key words: Arthroplasty, replacement, hip; Drainage; Activities of daily living; Ice compress; Walking training