Optimization of physical functioning of patients before and after total hip arthroplasty

Vulnerable elderly people with poor physical fitness and comorbidity are at risk of delayed recovery from daily activities (transfers, walking, stair climbing) following a hip replacement and therefore spending longer in the hospital. Very few training programmes are geared towards this group of elderly people. Measuring physical fitness and muscle function before surgery can help to predict the patient's risk of delayed recovery and can also help determine the preventative measures to be implemented to prevent prolonged hospital stays and admission to a rehabilitation centre. This dissertation found that it's possible to offer vulnerable elderly people an intensive therapeutic training programme at home before surgery. Elderly people are more likely to participate in this programme if it is offered at home instead of in the hospital. The programme, which is tailored to the personal capabilities and needs of the patient, helps to prevent a further decline in physical fitness. Listening to patients and their families can shed light on the motivation, participation goals and relationships within the therapy process.