Effect of multi-modal exercises after hemiarthroplasty of hip joint in a 72 year old male Parkinson’s disease participant. A case report

P. Senthil 1, S. Parvathi 2, P. Senthil Selvam 1, R. Radhakrishnan 3

1 School of Physiotherapy, Vels Institute of Science Technology and Advanced Studies, Chennai, Tamilnadu, India; 2 Department of Applied Psychology and Behavioural Science, J.B.A.S. College for Women, Chennai, India; 3 Tamilnadu Physical Education and Sports University, Chennai, India

Background. Parkinson’s disease is a progressive and deteriorating disease which often affects the mobility of individuals of above 60 years. A fall is one of the risk factor and especially the neck of femur fracture was very common among them. In India, the physiotherapy intervention of Parkinson’s patient after hemiarthroplasty was poorly defined when compared to total hip arthroplasty. Thus, we have taken a single case study as an initiative with multi-modal exercise on physical function of Parkinson’s patient after the hemiarthroplasty. 

Case presentation. A 72-year-old man with symptom of Parkinson’s disease and stage 3 of Hoehn and Yahr classification for past 1 year had a fall and underwent hemiarthroplasty for the left sided neck of femur fracture. After post-operative check x-rays and vital signs are normal, we have started multi-modal exercise with initial bed mobility exercise, breathing exercise and chest percussion technique, balance training in sitting and standing with gutter crutch, proprioceptive training, psychological counselling, progress to resistance exercise to quadriceps and stretching the calf muscle for 12 weeks. We have gradually reduced the gutter crutch to walking stick and gradually without walking aids at the end of 12 week protocol. We have continued the exercise for the patient and follow-up at 24 week also to check the status of physical function of patient. We have assessed the patient at the baseline and post-12 week with post-24 week follow-up using sit to stand and timed up and go test performance as an outcome measures. The physical performance showed significant changes in the post-12 week of patient when compared at baseline values and even continued significance at post-24 week of multi-modal exercise also. 

Conclusions. Thus, the multi-modal exercises proved to be more beneficial on physical function for the Parkinson’s patient with hemiarthroplasty. Even, we have found that the earlier mobilization had promoted the confident of patient and active participation of progression is faster in this case study. 

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