Rehabilitation program based on exercise prescription
nausea, chest pain, vomiting, peripatellar muscle, dizziness, adduction, hyperextension, forceful, abduction
BEND, CONTRACTION, PROGRESSION, COLD, COMPLICATIONS

The basic elements of the exercise prescription included Frequency, Intensity, Time, Type, Volume, and Progression, (FITT-VP) [
The main aim of preoperative exercise therapy is to maintain the cardiopulmonary capacity of the patients and prevent complications. The main exercises were moderate-intensity upper limb resistance training, respiratory training, ankle pump exercise, and lower limb isometric contraction training. Each training lasted for 15–30 min and was done every day preoperatively.The main aim of postoperative exercise therapy is to improve hip joint mobility and the muscle strength of the lower limbs. Weight-transfer training was conducted with the permission of the physician. The primary exercises were low-to-moderate intensity hip flexibility training, strength training, and balance coordination training, which were performed for 30 min per session and 5 times every week.The main aim of exercise therapy after discharge is to improve the ability of the patient to perform activities of daily living and continue to support the balance and coordination training of the lower limbs to decrease the onset of falls. Daily living training and balance training were conducted step by step with low-to-moderate intensity for 15–30 min each time and 3–5 times every week. The details are as follows:
1. Abdominal respiration: lie down or in a semi-recumbent position, inhale through the nose, and exhale through the mouth. The upper abdomen should bulge out when breathing in, and the abdomen should retract when breathing out. Breathing should be slow, fine, and even, 5–10 min/time, 2–5 times/day2. Abdominal massage: in the supine position, place the base of the palm on the abdomen and slowly and gently massage in a clockwise direction, 5–10 min/time, 2–5 times/day3. Ankle pump exercise: forceful, slow, full range of flexion and extension of the ankle joint, hook the foot to the end for 5 s and then tense the foot for 5 s, 10 sets/group, 1–3 sets/h4. Static contraction of quadriceps femoris: straighten the knee joint on the affected side, tighten anterior thigh muscles for 10 s, and then relax, 10 pieces/group, 2 or 3 groups/time, 2 times/day5. Single bridge exercise: in the supine position, bend the hip and knee to 90 degrees on the healthy side, raise the affected side and tighten and raise the hip, 10 times/group, 3?5 s between each time, 1 or 2 groups/day6. Double upper limb resistance group training: a. In the supine position or end sitting position, hold 0.5?2 kg dumbbells with both hands to do front and side lifting exercises. b. Hold 10–15 kg elastic band with both hands to do resistance group chest expansion exercise. c. Pull the rings with both hands, tighten the abdominal muscles, and raise the torso. The movements are required to be slow and even, 5–10 min/time, 2 times/dayTreatment can be combined with instruments: pneumatic, low-to-moderate frequency, magnetic therapy, infrared, etc. (use as appropriate)Continue to use the above exercises and add the following as appropriate:1. Strength exercises: strength training of the peripatellar muscle groups: do forward flexion, abduction, and back extension training of the hip joint in different positions, from passive—assisted—fully active. Note that the hip must not be internally rotated, hold for 5–10 s at the end of the activity, 10 sets/group, 2 or 3 groups/time, 2 times/day2. Balance training: a. Sitting balance training: according to the patient’s condition, perform sitting three-stage balance training with or without weight-bearing on the affected limb, 2–5 times/repetition, 2–3 times/day, and b. Standing balance training: according to the patient’s condition, perform progressive weight-bearing exercises on the affected limb using the assistive device, 2–5 times/repetition, 2–3 times/day3. Walking training with assistive devices: walking training with a walker: note that when turning around, you should first take a step to the side of the turn, move the walker, and then follow the other limb, 50–100 m/repetition, 2–3 times/dayTreatment can be combined with instruments: pneumatic, low-to-moderate frequency, magnetic therapy, infrared, etc. (use as appropriate)Selecting the above exercises, you can add the following:1. Walking training (10–15 min/time, 2 times/day): walking training with a walker: note that when turning around, you should first take a step to the side of the turn, move the walker, and then follow up with the other limb. If the patient is holding a double crutch, use four-point step training, 50–100 m/time, 2–3 times/day2. Daily living ability training (10–15 min/time, 2 times/day): a. Stair climbing training: climb up the stairs in the order of healthy side—affected side—abduction and walk down the stairs in the order of affected side—abduction—healthy side; b. Transfer training; and c. Alternate positions when putting on and taking off trousers, putting on and taking off shoes and socks, and picking up objects on the floor1. Perform low-to-moderate intensity training as the main focus and progress gradually2. Avoid holding your breath and combine the exercises with breathing exercises (abdominal breathing)3. After each exercise, apply cold compresses immediately for 10–15 min each time4. If the following conditions occur, the exercise should be stopped immediately:a. Feeling chest pain, difficulty in breathing, dizziness, nausea, and vomiting during exerciseb. Having a blood pressure of > 200/100 mmHg or a systolic blood pressure increase of > 30 mmHg or a decrease of 10 mmHg during exercisec. During exercise, the ST segment monitored by the electrocardiogram is shifted downward by ≥ 0.1 mV or increases by ≥ 0.2 mV5. After hip arthroplasty: a. if the posterior-lateral approach is used, avoid flexion of the hip beyond 90°, excessive rotation, and adduction; b. if the anterolateral approach is used, avoid hyperextension and external rotation of the hip