Activity progression for THRs

Josephine

NURSE DIRECTOR EMERITUS
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For THRs.

Activities of Daily Living (ADLs) are assessed in hospital as a means of assessing your fitness to be discharged home. Your domestic circumstances will be taken into account as in if you are living alone, etc.

ADLs include:
~ Personal hygiene and grooming
~ Dressing and undressing
~ Functional transfers, e.g. Getting out of bed
~ Voluntarily controlling bladder and bowel elimination
~ Ambulation (Walking or using a wheelchair)
~ Housework
~ Meal Preparation
~ Care of pets
~ Meal preparation and cleanup

Walking and other activity
Walking is about the best exercise you can do but again, you need to moderate your time and distance.
Always use your walker, crutches or canes as appropriate, only moving from one to the other as you gain confidence. Actually, hips really don't need all that much exercising and have a perfectly good way of sorting things out for themselves if given half a chance.

Week 1
A little walking around the house. Trips to the bathroom and kitchen are included!
Being up on your feet several times a day as you need to but don't get obsessive about it.
A 5 minute walk every couple of hours is plenty.

Activity: for the first week nothing but rest, occasional trips to the kitchen to get a snack or a drink and to the bathroom for potty and showers!

Week 2
Start on a plan of walks around the house lasting longer than 5-10 minutes but don't a) get into too much pain and b) get too tired. Stop before you get to that point.

Activity: do some tidying up, a little bit of meal prep and maybe some washing up so long as someone else dries and puts it away!


Week 3
Lengthen the walks to about 15-20 minutes once a day, maybe twice a day if it doesn't cause your hip to be painful.

Activity: prepare yourself a meal or help prepare a family meal but not all of it. A little bit of laundry but not all of it.


Weeks 4 and 5
Increase walks around, to 30mins, longer if you feel up to it.

Activity: now you can do some dusting and push a vacuum round the middle of the living room; do a little meal prep (for yourself not the family!), maybe fill and empty the washing machine

Weeks 6 and 7
Start taking car trips to the shops but keep them short and sweet at the start, no longer than 15-20 minutes
Take at least one 5 minute rest while you are out.

Activity: ironing, washing, meal prep but get someone else to clear up after, wash up but someone else clears the table, brings you the dirty dishes, dries and puts them away after, not you!!

Weeks 8 and onward
Bed making and changing sheets, cleaning bedrooms etc., can wait until about now by which time, all things being well, you should pretty much start getting back to normal.

But if it takes a bit longer, don''t worry about it.

And a reminder
Hips actually don't need much exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

Returning to work
It's becoming the norm for hip patients to be pressured back to work after 6 weeks or so. This can be done but it is even more important one needs to try and negotiate a "Phased return to work" because going straight back to full time work can be very hard on the new hip and cause tendinitis in various places.
 

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