Post Operative Rehabilitation Stage-1 Hospital

Patient Name Date /./ .. Therapist Name After you have been in the hospital, you need to try to get back to normal activities as soon as possible. You will need extra rest, but it is best to be out of bed for every meal and sit up at least 1-2 hours twice a day. Normal activities usually include walking often, so try to walk every 1 to 2 hours during the day. Eat a healthy diet, drink plenty of fluids and take your medicines as ordered. Report any problems to your doctor, home health nurse, therapist or aide. If you have had surgery or lung problems, practice deep breathing exercises or use the incentive spirometer you received at the hospital. It is easy to combine these with the exercises described below. Day 0 Operative Day 1 Chest PT No CPT/Huffi ng and assisted coughing Yes Inflation tech if haemodynamically stable -IS/DBE 1S/Deep breathing exercise/AROM Functional activity PROM/AROM AROM, Bed sitting Chair sitting/Room walking (if Hemodynamically stable) Mobilization outside room & reorientation programme Same + diet advise/Mob. to ward Make the patient to walk inside hospital500m- Extended walking Stair climbing Home exercise advice Exercise intensity 1 MET 1 - 2 MET

Cont+ Chest expansion / Segmental ex. Same Same

2 3 MET

3 4

Yes Yes

3 - 4 MET 4 - 5 MET

5 6

Yes

Continue

> 5.5 MET

Follow these steps to use your incentive spirometer:

Inhale normally. Relax and breathe out. Place your lips tightly around the mouthpiece. Make sure the device is upright and not tilted. Breathe in slowly and deeply. Fill your lungs with as much air as you can. If you inhale too quickly, the spirometer may make a noise. If you hear this noise, inhale more slowly. Hold your breath long enough to keep the balls (or disk) raised for at least 3 seconds. Perform this exercise every hour while youre awake or as often as your doctor instructs. If you were also taught coughing exercises, perform them regularly as instructed.

Stage-2- Limb Physio for Hospital &Home Program

1. Arm Raises Lift arms up as high as you can. Breathe in as you lift up and breathe out as your arms come down. Repeat _____ times, _____ times/day

2. Single Arm Raises Hold theraband in both hands. Stretch one arm up and out. Repeat______times, ______times/day

3. W - Exercises Hold hands in front of chest with elbows bent. Moved hands out to side and squeeze shoulder blades together. Repeat _____ times, _____ times/day Advanced - use weights in hands or stretch theraband. Both of these exercises are good for osteoporosis and posture.

4. Chair Push-Ups Place hands on arm rests of chair. Lift buttocks off the chair by pushing with your arms.

Repeat _____ times, _____ times/day

5. Knee Extension Kick your foot up - then lower foot. Repeat _____ times, _____ times/day Advanced Knee Extension - Kick your foot up and move foot out. Move foot back in. Lower foot. Repeat _____ times, _____ times/day More advanced - add weight to ankle

6. Ankle Pumps Move feet up, down and around in circles Repeat _____ times, _____ times/day This exercise is good for circulation. Good ankle movement is necessary for standing and balance.

Standing Exercises Do these while standing next to the kitchen counter. Hold on with 1 or both hands. Do not do these while standing with a walker.

1. Knee flexion Hold on to the counter. Lift one foot as shown in the picture. Do 10 times. Repeat 10 times with your other foot.

2. Hip Abduction Hold on to the counter. Lift one leg out to the side 10 times. Repeat 10 times with your other leg.

3. Hip Extension Hold onto counter. Kick leg behind you 10 times. Repeat 10 times with other leg. Repeat _____ sets/day

4. Glute Sets (for posture) Squeeze buttocks together. Hold___seconds. Gently arch back. Repeat 5 times

5.

Toe Rises

Hold on to the counter. Rise up on your toes and rock back on your heels. Repeat ____ times, _____ times/day

6. Mini-Knee Bends Hold on to the counter. Bend your knees and stand straight again. Do not bend so far that your knees hurt. Repeat _____ times, _____ times/day 7. Heel-Toe Standing (for balance) Stand beside counter. Hold on and look ahead. Place one foot directly in front of the other foot so they are in a straight line. Hold position for 10 seconds. Change position so other foot is in front. Hold for 10 seconds.

8. Sideways Walking Hold on to the counter. Take 10 side steps to the right. Take 10 side steps to the left. Then side step back. Repeat _____ times, _____ sets/day

As you get stronger - add weights to ankles and hands. Do the arm exercises in a standing position. Add a walking program 3-5 times a week. The goal is to get back to doing what you want to do and prevent falls.

Stage-3- Supervise Exercise Program