Hip Replacement

[jake]

How safe and effective is vibration for someone with a hip replacement? I havent seen any research on this. If there is anybody that uses it for hip replacement, how soon after surgery do you start your patients on this. My practice is primarily orthopedic and post surgical in nature.I am hearing more and more about vibration exercise but not sold on it yet since I see it on infomercials which quite frankly makes it look like a gimmick

[dr_pt]

Jake

You sound like me 2 years ago! I was at the APTA show and thought it would be dangerous for my patients. unfortunately not all machines are made the same. You have to be careful with what you go with since they arent all designed the same. With hip replacements, i was told not to put someone on it unless they are post 1 year surgery. However i have got great results in my center and started using it much earlier than that. base it on clinical recovery. is the patient weight bearing? can they do wall squats? you can slowly start putting them on vibration and get feedback from your patient on how they feel. no brainer here. just the same as any other exercises you use. use your clinical judgment. with research, im not sure. i looked for hip replacement and vibration research but couldnt find any.

[Dr Jasper Sidhu]

Hi Jake,

With respect to research on hip replacements and vibration exercise, check out Dr. Maddalozzo's presentation at ACSM with the following link: http://www.medscape.com/viewarticle/703818

Clinically, hip and knee replacements have been listed as contraindications for vibration. However, its now a common consensus that they are more like 'precautions' rather than contraindications. Dr_pt is right. You should base your decision to integrate vibration into your hip replacement protocols just the same as you would any other conventional resistance or weight bearing exercise. We usually abide by the following rules:

- Initiate contralateral limb strengthening to get a good 'cross over effect' of treatment. We can bring in a patient after surgery and have them perform opposite leg stretches, strengthening exercises, etc. ANY form of exercise at the earliest possible time will provide a positive impact on long term recovery. Nobody wants to feel like an invalid and vibration can be a great 'early adoption' of exercise

- Initiate calf massage. If the patient is unable to weight bear or start weight bearing exercises, we usually start with deep tissue massage of the calves. One of the reasons is to keep circulation going considering most people fall into the sedentary vicious cycle

- We progress to sitting in a chair and placing the feet on the vibration platform. This limits any stresses to the hip joints as they patient is healing, but also provides some good distal stimulation. I've had conversations with physical therapists that feel that this distal stimulation by way of the Wolff's Law can actually signal increased bone formation in the earlier stages of recovery. That's why as dr_pt pointed out, therapists are starting to integrate vibration even earlier than the recommended 1 year.

I hope this helps in providing you with some more information on effects of vibration on hip replacements

[jake]

Drpt and dr sidhu. Thank you for that information. Thats more than i got from some of the companies I have talked to. As I see it, I can start a full body conditioning program a lot earlier by using vibration exercise. Is there any age limit? Also, I am seeing different types of machines out there. There is that alternating one and the vertical one. Which is better? What are the best frequencies? Which has research behind it?