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Back in 2009, I wrote about the trend to move from passive rehabilitation to active rehabilitation — that instead of “RICE” (rest, ice, compression and elevation), we should think in terms of “MICE” (movement, ice, compression and elevation). In that light, I was interested to see a new Spanish study that tested when rehab should begin after knee replacement surgery. They took 300 patients and randomly assigned them to begin rehab either within 24 hours of surgery or 48 to 72 hours after surgery. The results were clear:
On average, those beginning treatment earlier stayed in hospital two days less than the control group and had five fewer rehabilitation sessions before they were discharged. An early start also lead to less pain, a greater range of joint motion both in leg flexion and extension, improved muscle strength and higher scores in tests for gait and balance.
Obviously they weren’t doing jumping jacks or anything like that on day one:
The post-operative treatment began with a series of leg exercises, breathing exercises, and tips on posture. By the second day walking short distances with walking aids was added, and in subsequent days this was built up towards adapting to daily life activities, such as beginning to climb stairs on day four.
Anyway, just thought it was an interesting data point — that even for something as major as a knee replacement, lying around and staying immobilized is no longer seen as the optimal way to promote healing.