Richard Haynes PTA/CPT - 8/18/2009

Question
Dear Doctor Haynes:

My mother is a 74 year old who had a double knee replacement about 9 years ago. (She is in good overall health, but is overweight -- perhaps by 20 to 30 lbs.) She has a great deal of difficulty arising from a seated position. At times, she is unable to get up herself, and has to be lifted in order to get to a standing position.

Is it possible that the use of some sort of leg/knee brace (or other device) could provide her with extra support, and thus make it easier for her to raise up from a seated position?

Unfortunately, her problem is curtailing her social activity to the point that she is almost totally homebound.

Is there anything that can help her?

Thank you for your kind help.


Answer
Hi Philip,

I just want to let you know right off top I am not a doctor. I work in the field of physical therapy and have done so for 14 years. Most of my experience however is joint replacement rehabilitation.

Now to get to your question, getting a brace or other device right now is not a good idea. Her problem appears to be weak quadriceps or thigh muscles in other words. Also the gluteal muscles or her backside and low back more then likely are weak as well.

Exercise will help her tremendously unless she is having a great deal of pain with her knees.
that you do not mention so I will assume its general weakness only.

You can do one of two things:
1. Go back to either her orthopedic doctor or general practitioner and ask one of them to write a prescription for in-home physical therapy due to her decrease in mobility. A therapist can give her hands on therapy and exercises that will get those muscles up to par and set her up on a written home exercise program to follow.
By having someone there instructing her that helps with a patients compliance and general understanding and following correct exercise technique etc...

2. I can provide you with some detailed exercises at my website if needed.

I feel the best bet is to get a PT in there and get her started on an exercise protocol.
A brace etc... will not improve her situation as I feel its strictly muscle weakness in the muscle groups  I have suggested above.

Let me know if I can be of any further help.

Regards
Richard Haynes PTA/CPT
Punta Gorda, Florida.
http://www.richardhaynes.com
http://www.rhaynes.blogspot.com