Question

62 year old client has recently recovered from a left hip fracture and is expressing a desire to start an exercise regimen. As you prepare your education session with her, consider the following questions:

Please answer these questions;

1. What type of exercise program would you recommend for her? Be specific and provide a rationale for your answer.
2. What health benefits do you plan to point out to her in support of your program and why? (provide evidence-based rationale)
3. How would you address any excuses she may offer? Explain and support your reasons with evidence-based rationale.
4. What incentives would you provide for her to promote adherence to the program? Why would those incentives be effective?
5. What precautions and safety measures would you emphasize? (be specific and comprehensive)

Answer 1

The faster you do the exercise the quicker you will get the strength and movement back as there are chances for the muscles to become stiff. Primary goal for every activity is to improve mobility and balance.

Exercise:

1) Chair exercise :

* ask the client to get relaxed on a chair and then ask her to raise the toe and then the heel. Repeat this for 2 - 3 times, because its always better to start from the bottom to avoid pain.

* Then slight slide the affected ( left) leg forward and back ward along the floor which enhance the flexion of the leg. Repeat it for 2 -3 times.

* Then straighten your leg straight as if the foot lift on the floor and ask them to hold it for 5 seconds . This improves both extension as well as the balance

2) Climbing exercise:

In this exercise you need 2 standing board ( one should be smaller than the other).

Promote the client to stand on it for a second with one leg and then the other . Repeat it daily in order to improve the balance . Initially it wont be must easy but later it improve the strength and mobility. Please not that it is not done in an over foot fashion.

this exercise can be done with the help of stairs ( make sure that their is handrails ) . Also make sure that the client bring the unaffected leg first and then the other.

3) Gluteal exercise :

In this exercise the client need lie down on the bed and and need to apply pressure on the buttock region , hold it for 4 -5 seconds. Repeat it for 3 times. Make sure that breath is not hold. By doing so your hip region muscles will get strengthen and reduces pains.

Health Benefits:

After a hip fracture the muscles will be poor and weak and chances for fall are more due to poor balance. so by performing exercise they ,

• Improve their ability to move around without any aid/assistance.
• Prevent falls.
• Improve their health within 6 months.

Excuses that can be expressed:

* Pain on the affected region -

• the pain will not subside without movement as it is affected on the bones,
• it will become more stiff and rigid.
• affect mobility
• after 2-3 change can be experienced.
• improve their balance and strength.
• move around independently.

How to convince the client :

• Be with the client and develop a trust worthy relationship initially.
• Demonstrate physically initially and the explain its benefits how it work, then encourage the client to do so.
• Have a open discussion with the client about it like sharing the opinion and experience.
• Share any evidence from the clinical setting its self.

Precaution and Safety measures:

• it is practiced in a clean and firm surface
• removal of sharp and tiny objects
• the quality of the equipment used ( chair, stand)
• need of walking stick.
• ensure that the client is aware about what exactly going to do.
• discourage vigorous activities and exercises.