Jason Handschumacher – Restoring Balance & Function after Hip & Ankle Arthroplasty

Outline

Current options in total hip and total ankle arthroplasty

• Review surgical techniques and components
• Common Dx leading to THA and TAA
• Post-operative timelines and when to initiate balance training with each population

Gait and balance mechanics to maximize post-operative outcomes

• Review ankle and hip motions in “Normal” gait to understand which motions to emphasize
• Does the prosthesis limit range of motion and strength gain potential?
• Deficits at 6 months and 2 years post-operatively
• What is the role of proprioception and muscular response in balance and gait

Strategies for post-surgical balance

• The role of neuroplasticity in balance recovery
• Role of symmetry training and impacts on the contralateral limb
• Why surgery seems to have greater impact on ankle joint receptors than in the hip
• Greater muscle mass in the hip and which muscles are the keys in balance

The importance of balance and proprioceptive training following surgery

• Impact on patient perceived long-term outcome and how this can differ from the therapist
• Importance of patients regaining confidence and impact of fear of falling on actual falls
• How is the patient functioning long after discharge from formal therapy?

Post-operative exercises and activities demonstration

• Single limb stance and tandem stance activity early and late in rehabilitation
• Varying sensory inputs for progressions
• Effective strengthening exercises and proper dosing/overload principles