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Activity progression for TKRs

Discussion in 'Post-surgery information (knees)' started by Josephine, Jul 25, 2017.

  1. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator
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    For TKRs.

    Activities of Daily Living 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.
    Don't be despondent if you have to go back once in a while in the early days.

    Week 1
    Just walking around the house - trips to the bathroom and kitchen are included!
    Be up on your feet several times a day as you need to but don't get obsessive about it
    A 5-6 minute walk every 3-4 hours is plenty
    Spend most of your time resting and elevating

    Week 2 -
    add this to previous instructions in Week 1
    Start on a plan of walks around the house 3-4 times a day for about 5 minutes but don't
    a) get obsessive about it
    b) get into too much pain and
    c) get too tired. Stop before you get to that point.​


    Week 3 -
    add to all the previous
    Lengthen the walks to about 5-10 minutes as before
    Activity: prepare yourself a small meal or a snack


    Weeks 4 and 5 - add to all the previous
    Increase walks to out in the garden or street; to 20mins or longer if you feel up to it bt don't forget that means 10mins there and 10mins back!

    Additionally activity:
    Gather a little bit of laundry OR put it in the machine OR take it out but not all of it
    Now you can do a little dusting and tidying;
    Do a little meal prep (for yourself not the entire family!)

    Weeks 6 and onward
    - add to all the previous
    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: a very little 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!!

    Week 10 add to all the previous
    Bed making and changing sheets, cleaning bedrooms etc., can wait now by which time, all things being well, you should pretty much start getting back to normal but don't rush it. If you start getting pain and stiffness in your knee, that's a sign your knee doesn't like what you're doing, that you're rushing ahead too fast. Slow down, right down, and start again. This stage might last until week 14 or even 16 but if it takes a even longer, don''t worry about it.

    Returning to work
    It's becoming the norm for knee 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 knee and cause tendinitis in various places. But in essence, I would advise that 6 weeks is far too early and 10-12 weeks would be a more sensible target!
     
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