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An Occupational Therapy wellbeing guide for hip arthroscopy patients

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This guide has been part of a research project done at Physiocure in collaboration with Leeds Beckett University, carried out by MSc Occupational Therapy Students with the aim to enhance the recovery of Hip Arthroscopy Surgery patients. The guide can be used in the Pre-habilitation and Rehabilitation period.

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An Occupational Therapy wellbeing guide for hip arthroscopy patients

  1. 1. A post-operative occupational therapy well-being guide for hip arthroscopy patients and therapists. By Claire Burke BSc (Hons), MSPsS. & Victoria Emma Gleave LLB (Hons), MSc, MSPsS.
  2. 2. Contents •  Disclaimer Page 1 •  About the Authors Page 2-3 •  About this Guide Page 4 •  Key Points to Remember Page 5-6 •  What is an OccupaRon? Page 7 •  An IntroducRon to OccupaRonal Therapy Page 8-9 •  OccupaRonal Risk Factors and InjusRce Page 10 •  OccupaRonal Risk Factors aer a Hip Arthroscopy Page 11 •  OccupaRonal DeprivaRon Page 12 •  OccupaRonal AlienaRon Page 13 •  OccupaRonal Imbalance Page 14 •  The OccupaRonal Therapy Process Page 15 •  A Case Study Page 16-17
  3. 3. Contents •  OccupaRons Affected By a Hip Arthroscopy Page 18 •  Driving Page 19-21 •  Employment Page 22-23 •  Washing and Dressing Page 24-25 •  Housework Page 26-27 •  Food PreparaRon Page 28-30 •  Hobbies Page 31 •  Social IsolaRon Page 32 •  Sex Page 33-38 •  Equipment Page 39-40 •  Grading Page 41-42 •  Energy ConservaRon Page 43-45
  4. 4. Contents •  How to manage your mood Page 46-51 •  AcRvity Diary Page 52-53 •  Goal Seang Page 54-55 •  Self-Assessment Scale Page 56 •  SignposRng Page 57-59 •  References Page 60-67 •  Glossary Page 68-69
  5. 5. Disclaimer This occupa+onal therapy guide has been designed to provide you with informa+on on health and well-being, post opera+on; in order to promote independence in daily living. It is intended for educa+onal purposes only. You should not rely on this informa+on as a subs+tute for, nor does it replace, professional occupa+onal therapy advice, diagnosis, or treatment. 1
  6. 6. Victoria Emma Gleave LLB (Hons), MSc, MSPsS Claire Burke BSc (Hons), MSPsS About The Authors 2
  7. 7. About The Authors Claire Burke and Victoria Emma Gleave are final year OccupaRonal Therapy Masters students who are training at Leeds Becked University. Both Claire and Victoria have previous degrees in Psychology which are accredited by The BriRsh Psychological Society. They are both members of The Royal College of OccupaRonal Therapists and graduate members of The BriRsh Psychological Society, and together have experience in a wide variety health care fields including: •  Spinal injury Motor Neurone Disease •  Orthopaedics Stroke •  Paediatrics AuRsm •  Cerebral palsy Bipolar •  MulRple Sclerosis Schizophrenia •  Parkinson’s disease Personality Disorder This wellbeing booklet has been developed as the result of a six week role emerging placement at Physiocure. Role emerging placements allow students to go into a seang where there is no role of an occupaRonal therapist, and their aim is to promote occupaRonal therapy services within that seang1. 3
  8. 8. About This Guide •  The aim of this guide is to highlight how the occupaRonal therapy profession could support you during your recovery of a hip arthroscopy. •  The following guide is not comprehensive or extensive, for specialist informaRon please visit the Royal Collage of OccupaRonal Therapy website. •  This guide has been formulated as a result of the data collected via a Health Needs Assessment with paRents from the Physiocure pracRce. •  This guide is for educaRonal purposes only and should not replace the hospital guidelines and professional advice you have been given. The advice given is to be used in collaboraRon with other health professionals. 4
  9. 9. Key Points to Remember This guide will support you in implemen3ng the following occupa3onally focused messages into your daily life during your recovery from your hip arthroscopy. 5
  10. 10. Listen to your body.. Occupa3onal therapy can keep you well.. Break down ac3vi3es into small steps.. Meaningful occupa3ons can improve your health and well- being Conserve your energy..2 6
  11. 11. What Is An Occupation? An occupation is anything you do to occupy your time. Occupations can be classified into three separate categories3. Leisure Hobbies Socialising Things you do to relax Quiet recrea3on Spor3ng ac3vates Self-care Washing Grooming Toile3ng Dressing Cooking Produc3vity Paid employment Volunteering Sleep Sex Caring for others 7
  12. 12. An Introduction To Occupational Therapy What is occupa3onal therapy? OccupaRonal therapy is a health discipline in which the importance is placed on being able to independently parRcipate and engage in acRviRes of daily living through the use of occupaRon; thus encouraging health and well –being4. How do occupa3onal therapists work? OccupaRonal therapy pracRRoners work with communiRes and individuals to develop their ability to engage in the occupaRons they want and need to do. This is achieved by adapRng the environment or occupaRon to tailor their needs, in order to increase their occupaRonal engagement5. 8
  13. 13. An Introduction To Occupational Therapy Who do we work with? OccupaRonal therapists work with and alongside a wide variety of health professionals including but not limited to; nurses, doctors, clinical psychologists and physiotherapists. When collaboraRng with other health professions, this enables occupaRonal therapists to deliver beder care, treatment and outcome rate for service users6. 9
  14. 14. Occupational Risk Factors And Injustice Regardless of physical and mental difficulRes, you have the right to choose what meaningful acRviRes you engage in day-to-day that will promote your health and well-being. This is what is referred to as occupa&onal jus&ce7. When the right to engage in your meaningful occupaRons is challenged, this is called occupa&onal injus&ce8. Having a hip operaRon puts you at risk for experiencing occupaRonal injusRce. There are several different types of occupaRonal injusRces however, we are going to focus on the main three injusRces that you may face: •  Occupa3onal depriva3on •  Occupa3onal aliena3on •  Occupa3onal imbalance 10
  15. 15. Occupational Risk Factors After a Hip Arthroscopy OCCUPATIONAL DEPRIVATION OCCUPATIONAL ALIENATION OCCUPATIONAL IMBALANCE When you are unable to do the occupaRons you want to because your recovery from your hip operaRon deprives you from doing them9. When there is an absence of meaningful occupaRon in your life. ResulRng in feelings of disconnectedness, isolaRon, empRness and lack of sense of idenRty10. When you do not have an equal balance between self-care, leisure and producRvity occupaRons11. 11
  16. 16. Occupational Deprivation “I felt isolated due to not being able to conRnue with my career”. “I was unable to independently wash and dress myself and relied upon my parents, sister and boyfriend to do this for me”. Following your opera+on, you will have a reduced choice of occupa+ons that you can take part in, due to the decreased mobility that you now have, and the pain you will be in. Therefore, you may feel deprived from engaging in ac+vi+es that you normally take part in. Below are some examples of how previous hip arthroscopy pa+ents experienced occupa+onal depriva+on12. 12
  17. 17. Occupational Alienation “I can no longer spend quality Rme with my family and hug my children”. “I can no longer train for my marathon with my running club”. “I am going to cinema with my children later, can’t wait!” “Sounds fun! I’m going rock climbing with my husband at the weekend!” During your recovery you may find that you are unable to engage in occupa+ons which are meaningful or purposeful to you due to your limited mobility and pain. Below are some examples how previous hip arthroscopy pa+ents have experienced occupa+onal aliena+on13. 13
  18. 18. Occupational Imbalance Too much Not enough Going to work Looking aer your children Socialising Social isolaRon Washing and dressing APer your opera+on, you may find that you are spending more +me engaging in certain occupa+ons than others, for example spending more +me on self-care occupa+ons due the increased +me they now take, reducing the +me you may have to socialise14. 14
  19. 19. The OccupaRonal Therapy Process The occupa+onal therapy process, is a term used by occupa+onal therapists to refer to the complete interac+on between client and therapist, from point of contact to discharge - and all steps in between15. 15
  20. 20. Case Study Below is an example of how an occupational therapist can support you post operatively. I feel socially isolated due to limited mobility I cannot access kitchen utensils and food I need 3me off work for recovery Sally has just undergone a right hip arthroscopy and has highlighted the following self care, leisure and produc&vity occupa+ons as an issue for her post opera+on. 16
  21. 21. Occupational Therapy Solutions Graded ac3vi3es back into work Move utensils and food items into accessible areas in the kitchen Invite friends over/ keep in touch over the internet Below the recommenda+ons collabora+vely made by the occupa+onal therapist to address these issues. 17
  22. 22. Occupations Affected By a Hip Arthroscopy “In occupaRonal therapy, occupa&ons refer to the everyday acRviRes that people do as individuals, in families and with communiRes to occupy Rme and bring meaning and purpose to life. Occupa&ons include things people need to, want to and are expected to do16”. Driving [CATEGORY NAME] [CATEGORY NAME] Hobbies Housework Socialising Sex Food Prepara3on Employment Washing and Dressing Hobbies Leisure Produc3vity Self-care 18
  23. 23. The following secRon of this guide will provide you with informaRon on how to engage and parRcipate in acRviRes of daily living, aer your hip arthroscopy operaRon.
  24. 24. Driving Although you are allowed to resume driving 2 weeks aPer having a hip arthroscopy, the general rule is that you are able to make an emergency stop if required, without damaging the operated hip17. The following points are to be considered aPer your opera+on… The side you had operated If the operated side is the right side or you don’t have an automaRc vehicle, it is advisable that you wait for up to 2 weeks before driving; due to increased movement in the affected side. The car you drive If you have an automaRc vehicle, and it is your le side that has been operated on, you may be able to drive earlier, however you should discuss this with your surgeon. Your insurance policy Please check your insurance policy, as some insurance companies will not insure you for a number of weeks aer your operaRon. 19
  25. 25. Driving: Being A Passenger Geang in and out of a vehicle can be challenging aer having a hip arthroscopy. Repeatedly geang in and out of your vehicle can risk straining the hip and stretching Rssues. Please think carefully before you make a journey. If you do decide that you do have to make a journey in your vehicle as a passenger, please make sure the passenger seat is reclined and pushed fully back, as this will maximise your legroom. To make the journey a smooth one, you can use a pillow to higher the seat to your level. This means that you do not have to bend down onto the seat when geang in the car. Travelling as a passenger is permiWed 1 week post opera+vely, however if you do have a journey to make, please consider the following points, and do not force any hip movements18. 20
  26. 26. Driving Prac+ce Run! Aer 2 weeks, subject to the stage you are at during recovery, you might want to test your fitness to drive. Do this in a safe place without puang the keys in the igniRon: simply sit in the driving seat and pracRse puang firm pressure on the pedals. If you feel pain, you are not yet ready to drive. If you feel sore aerwards, you may need to wait a day or two and try again. Only when you can put enough pressure on the pedals to do an emergency stop - should you think about driving again. UlRmately, it is your responsibility to ensure that you are in control of your vehicle at all Rmes and to feel confident that you would be able to demonstrate this if asked. 21
  27. 27. Employment Engagement in occupa+on contributes not only to health and well-being, but also social inclusion and personal development, and employment is a part of this. Therefore, it is important that you go back to work in a safe and controlled manner19. Workplace evaluaRon and job analysis Goal seang and intervenRon planning Workplace modificaRons Injury prevenRon Mental Wellbeing An occupaRonal therapist can help you in the following areas: 22
  28. 28. Employment You need to be pa3ent with yourself You have just undergone a major trauma3c surgery, it is important that you are kind to yourself during this period. Your employer should not expect too much too soon You will have been given post-opera3ve advice by your surgeon, please follow this. You will not have the same range of mo3on pre opera3on. You may be able to aZend work however, your performance may be slower due to pain, but remember this is ok, take your 3me. See grading sec3on. You are trying your best You know your body beZer than anybody else, listen to it and only do what you can manage. Set realis3c goals for yourself. See goal se[ng sec3on. Going back to work aPer a trauma+c surgery can be a daun+ng experience, it is important to remember to look aPer yourself during this +me, both mentally and physically20. It is essen+al to make your employer aware of the following: 23
  29. 29. Washing & Dressing Body Washing Hair Washing You may not be able to independently wash and dress yourself for the first few weeks following on from your opera+on21. Therefore, the following +ps are designed to enable you to carry out this occupa+on as self-sufficiently as possible. In order to protect your operated hip, it is important that you do not step into the bath or shower for the first 2 weeks, or un3l your surgeon advices that you can do this safely. During the first 2 weeks it is strongly advised that you strip -wash or use a walk-in shower when you are discharged home. Please see equipment sec3on for adap3ve equipment. It is advised that you wash your hair in a shower or a sink. 24
  30. 30. Washing & Dressing Dressing . Keep your clothes in easy to reach places; you should organise this before your opera3on. It is advised that you wear comfortable, flowing clothing post opera3on, for ease of movement. When you get dressed, sit on the edge of your bed or chair with your clothes beside you, within easy reach Ensure you dress your operated side first. Use the grabber, for underwear and lower half dressing; and the sock aid and long shoe horn for your socks and shoes. For examples of helpful adap3ve equipment, please see the equipment sec3on. Comfortable, well fi[ng shoes are advisable which you can either slip on or are fiZed with elas3c shoelaces or Velcro straps 21. 25
  31. 31. Housework Use a rolling trolley to transport items with ease. Use long-handled grabber, mop, brush and dustpans to do light chores. Do not engage in acRviRes that involve bending, or twisRng for example; washing floors, dusRng low tables, or making beds. Place items you use oen above knee level or on the top shelf of your refrigerator, so that you do not have to bend down. Slide items along the kitchen counter and use a perching stool whilst preparing food. There is not set +meframe on when to engage in household ac+vi+es. It is always important to listen to your body21. However, if you do decide to carry out household task please adhere to the following precau+ons… 26
  32. 32. Housework Do not use heavy items such as a vacuum cleaner. Do not try and clean yourself if you cannot manage independently. Hiring a cleaner, is a safer alternaRve. Do not move heavy furniture. Do not reach to get highly placed items. . If you are going to par+cipate in housework, avoid doing the following21: 27
  33. 33. Pre-chopped fruit and vegetables will make cooking meals easier. A slow cooker is excellent for making healthy meals. Prepare your ingredients at night and switch on the cooker in the morning. If you have access to the internet, you can do your food shop online and have it delivered to your door. However, please note, if your kitchen is not on ground level, some supermarkets are not legally allowed to use internal stairs. Please check with the provider before making a purchase. Food Preparation APer your opera+on you may find preparing meals very challenging. The following +ps may help you overcome some obstacles you may face21! 28
  34. 34. Prior to your operaRon, you could cook large batches of food (e.g., lasagne), prepare them into daily porRons and freeze them. A perching stool is useful for when you are spending long periods of Rme in the kitchen. Siang on this will remove the weight from your operated hip. Ready meals, although not an ideal source of nutriRon require minimum effort to prepare21. There are various different companies who provide a service which deliver hot meals to your front door! Please see the signposRng secRon for more informaRon. Food Preparation 29
  35. 35. Food Preparation Do not carry heavy items you need to make a meal. Ask someone you live with to put them in a place you can reach without needing assistance. Refrain from cooking meals from scratch as this is a strenuous acRvity. Make sure you ask for help if you want to cook a meal from scratch. It is not advised that you carry hot liquids or hot food as you may be a lidle unsteady on your feet for a few weeks. If you find yourself wan+ng to prepare meals from scratch, please use cau+on and take into account the following21: 30
  36. 36. Hobbies . Adap3ng your hobby Watch TV programs related to your hobby. Watch online videos. Buy hobby related magazines. Listen to radio staRons that talk about your hobby. AZend social events related to your hobby Go watch your hobby e.g., football/ rugby matches. Start a new hobby Prior to your operaRon explore different hobbies you could do when you are in recovery e.g., learn a new language. Return to hobby When you feel ready to go back to your hobby, do not dive straight back into, start off small and listen to your body. Please see grading chapter for more informaRon. Having a hobby is important for your health and well-being. APer your opera+on you may not be able to par+cipate in your hobby for a long period of +me22. The following advice may help you to be able to s+ll engage in your hobby even if you cannot physically par+cipate in it. 31
  37. 37. Social Isolation Tips to prevent social isolaRon Invite your friends and family round for a night in! Plan acRviRes with friends and family where you know you will be able to rest breaks. Use Social media to keep in contact with your friends and family. Explore the internet for forums/blogs related to your operaRon. Before your operaRon, buy a diary and pencil in acRviRes you would like to do aer your operaRon. This will give you something to look forward to. Research has found that post opera+ve social support can counteract the nega+ve impact of physical disease or trauma. Therefore, please find some helpful +ps below on how to reduce social isola+on aPer your surgery23, 24. 32
  38. 38. Sex Sex and emo+on aPer a hip arthroscopy Sexual acRvity with your partner is an important aspect of your relaRonship, which can help you to connect on both a physical and emoRonal level. The absence of sexual acRvity following on from a hip operaRon may prove to be an issue within you relaRonship25. Therefore, this chapter is designed to equip you with emoRonal and pracRcal advice to support you in having a safe and healthy sexual relaRonship following on from your hip arthroscopy. 33
  39. 39. Sex There is no definiRve answer for when you should first engage in sexual acRvity aer your hip operaRon. However, the main indicator of knowing when you are ready to engage in sexual acRvity is when you can balance independently without any aids or equipment. It is paramount that you listen to your body and are aware of your physical limits. If at any point you feel in pain, please refrain from conRnuing with this acRvity. It is important to remember that your confidence to engage in sexual acRvity may take Rme to return following on from your hip operaRon. This is normal! Please go at a pace that comfortable for you25. How soon can I engage in the occupa3on of sex? 34
  40. 40. Sex •  Do not try too much too soon. Know your limits! •  Ease slowly into a posiRon that is comfortable for you. •  Do not remain in the same posiRon for more than 20 min. •  Refrain from engaging in sexual acRvity on an unsafe surface. •  Don’t parRcipate in anything you feel pressured to do or you feel is out of your comfort zone. •  Engage in posiRons that are low impact. •  Relax! The sRffer your body becomes, the more prone you become to injury. •  Listen to your body! You know your limits beder than anyone else26. Being in+mate with your partner is an important part of your rela+onship and it is understandable that you will s+ll want to engage in this occupa+on. The following points will enable you to par+cipate safely in this ac+vity. 35
  41. 41. The following posi+ons demonstrated are a guide only. Please follow the advice of your surgeon. It is important to remember that you will recover at a pace that is comfortable for you, both mentally and physically, be pa+ent with yourself. Unwind, take your +me, take care, and enjoy yourself! Sex Comfortable posi+ons 36
  42. 42. Edge of bed Siang in a chair Woman on top 37
  43. 43. Spoon Standing Missionary 38
  44. 44. Equipment Shoe horn Bath board Long handle sponge Grabber To help you pick up objects you cannot bend down to reach. To help you reach those hard to reach areas e.g. toes. To help you with puang on your footwear. To help you enjoy a bath without stepping into the bath. You may find the following pieces of equipment helpful during your recovery. The following equipment allows you to maintain independence whilst adhering to your hip precau+ons. This list is not exhaus+ve, please find further informa+on on equipment providers in the sign pos+ng chapter. 39
  45. 45. Equipment Raised toilet seat Perching stool Shower chair To make sure the toilet is at the right height so you do not break your hip precauRons. So you can enjoy a shower whilst siang. So you can engage in acRviRes such as cooking whilst taking the weight off your hip. This is not a comprehensive list of equipment, please see the Signpos+ng sec+on for further specialised aids and adapta+ons. However, you may already have items around your home that may help you transport hot drinks and objects, for example a flask and a rucksack. 40
  46. 46. Grading Carrying out your day-today ac+vates will be a challenge during the first few weeks of your recovery. However, through simplifying your tasks, which is also known as grading this will enable you to take part in occupa+ons which are meaningful to you15. Aer your hip arthroscopy, your daily occupaRonal performance will be compromised. Therefore, it is recommended that you grade your occupaRons. Grading is a method that is used when you want to engage in an occupaRon, but your current situaRon does not permit this15. “Grading allows the individual to break down a task they wish to complete, into stages that become increasingly more difficult27”. By simplifying your tasks you will build up your confidence slowly, this will in turn increase your moRvaRon and self-efficacy; and you will be able to complete the task independently. working toward a specific goal15. 41
  47. 47. Grading examples include: •  Increasing or decreasing the complexity. •  Increasing the difficulty of a task by changing the amount of steps required to complete it. •  The amount of Rme given to complete a task may be altered. •  The amount of cues or assistance given to the person may be changed15. Grading Ac+vi+es and occupa+ons can be graded in a variety of ways. 42
  48. 48. Energy Conservation Following on from your operaRon, you may find that you have a reduced amount of energy. Therefore, it is essenRal you have an occupaRonal balance; between doing your day to day acRviRes and resRng28. Energy conservaRon allows you to use your energy wisely to make the most of the energy your body has35. This chapter will explain how to implement energy conservaRon techniques into your daily life. Using the following techniques: -  Pacing -  Priori3sing 43
  49. 49. Spread your tasks throughout the day. Break a job down into stages and work out what is needed for the job. Doing things a lidle and oen can be more effecRve than trying to do a task in one go. Rest Breaks Make sure you make Rme for regular rest breaks. Have a nap if you need to. Finish the task before you become overRred. Think through each task carefully – what is involved in the task? Do you need to stand up or sit down for long periods of Rme? Plan Ahead Organise tasks and distribute heavier acRviRes throughout the week. Plan light acRviRes, for example dusRng, organising social acRviRes, to prevent social isolaRon. Don’t Do Too Much At Once Pacing28 44
  50. 50. Prioritising28 Organise Tasks In Terms Of Importance Think about whether everything needs to be done today or can some tasks wait unRl another day? Organise the Rming of acRviRes to avoid unnecessary trips, for example limit the need to go constantly up and down stairs. Ask For Help Ask yourself if you really do need something or can it wait for another day? Do not be afraid to ask for help. Set Achievable Goals Set yourself goals you know you can realisRcally achieve, and only complete the acRviRes that mean the most to you. 45
  51. 51. How To Manage Your Mood •  Your emoRons may be up and down aer surgery and you may have to take Rme off work to recover. •  Depending on how physical your occupaRons are, you may not be able to fully engage in them for a number of weeks. •  The following secRons on sleep and stress and anxiety have been designed to support you through this challenging and difficult Rme. Undergoing a trauma+c opera+on, can prove to be a challenging +me in a persons life, not only does it affect you physically, but emo+onally as well. The following chapter will address the emo+ons you may feel aPer your recovery and help you to manage them. 46
  52. 52. Sleep •  Do not drink any caffeinated products. For example, coffee and energy drinks. •  Refrain from consuming food or drink at least 2 hours before you go to bed. •  Limit your alcohol and nicoRne intake. •  Do not have long lie ins. •  Try have a bed Rme rouRne. For example, set bed Rmes. •  Try relax before going to bed. •  Aromatherapy and a hot bath can be helpful. •  Mindfulness can help you relax before bed. Please see sign posRng secRon for further informaRon29. Sleep is essen+al for mood and occupa+onal performance. Below are some +ps to op+mise your sleeping habits. 47
  53. 53. Anxiety and Pain Low mood can increase pain percepRon and can heighten your pain levels30. When you experience low mood, you may experience the following: Catastrophising- this involves dwelling on the worst possible outcomes. It is associated with pain severity. Hypervigilance – this occurs when there is an increased adendance to pain and decreased ability to distract yourself from pain. Fear avoidance- this is when you avoid movement or acRviRes based on fear of pain or re-injury. This is especially counterproducRve for physical rehabilitaRon and is termed ‘kinesophobia’. Research has found that anxiety can nega+vely affect your thoughts and behaviour, which has the poten+al to prolong your rehabilita+on. 48
  54. 54. Cycle of Worry Physical symptoms Worrying thoughts about symptoms High stress level APer the opera+on you may have thoughts that can lead you to feel anxious these thoughts can lead to anxiety which can then become out of control. It Is important to recognise this paWern in order to take control31. 49
  55. 55. How Can I Fight Low Mood? •  PracRcing relaxaRon and controlled breathing can help to reduce any physical symptoms you may be experiencing. •  Acknowledging any negaRve thoughts that you have and turning them into posiRve ones will help with your mood. •  When you get negaRve thoughts, try distracRng yourself! •  Grading yourself back into your daily roles and rouRnes. This will help you to have a posiRve impact on your behaviour31. Below are some +ps on how to manage when you are feeling low. 50
  56. 56. Breathing Strategies to Manage Stress and Anxiety Step 1 Begin by breathing out through your mouth, as far as you are able to do so. Releasing all tension around your stomach. Step 2 When you feel that your stomach is relaxed, take a deep breath in. Step 3 When you breathe in, make sure your stomach rises. This allows for deep breathing Step 4 Try holding the breath for a moment, releasing the breath slowly. Relax your shoulders. Step 5 Repeat this process three Rmes. You should noRce yourself feeling calmer and heavier. Step 6 To check that you are doing this technique correctly, place one hand on your stomach. You should noRce your hand rising up and down with the in and out breath29. 51
  57. 57. Activity Diary An acRvity diary can support you in planning your weeks and keeping you on track with your rehabilitaRon31. 52
  58. 58. Activity Diary MONDAY TUESDAY WEDNESDAY TURSDAY FRIDAY SATURDAY SUNDAY Wake- 9am 9am-10am 10am-11am 11am-12 noon 12 noon – 1pm 1pm-2pm 2pm-3pm 3pm-4pm 4pm-5pm 6pm-7pm 7pm-8pm 8pm-9pm 9pm-bed 53
  59. 59. Setting Your Goals Seang goals is important for your rehabilitaRon as they allow you do the things you want and need to do whilst, monitoring your progress; making changes accordingly. Goal seang can improve your self-efficacy, self-esteem and occupaRonal performance. Overall, supporRng your health and well-being15. 54
  60. 60. How to write a SMART goal A SMART goal is: Specific Measureable Adainable Reviewable Timed Sally will be able to walk to the corner shop at the top of her street in line with hospital precauRons. She will use her crutches, with support from a friend/family member, within two weeks of coming home from hospital. Sally’s progress will be self-monitored using a self assessment. Below is an example of a SMART goal. 55
  61. 61. Self Assessment: Setting Goals and Measuring My Progress My Goal (Overall goal, e.g. walk to the shop) SMART Goal (How I am going to achieve my goal) Have I achieved my goal Is the result what you expected? 1. 2. 3. Much beder Much beder Much beder Much beder Much beder Much beder A lidle beder A lidle beder A lidle beder A lidle beder A lidle beder A lidle beder Yes No As expected As expected As expected As expected As expected As expected No No Yes Yes 56
  62. 62. Signposting Carers Informa3on www.carersleeds.org.uk Counselling www.naRonalcounsellingsociety.org Hip Blogs www.myfaihippain.blogspot.co.uk Mindfulness www.headspace.com Meals on Wheels www.meals-on-wheels.com Occupa3onal Therapy Health Insurance www.bupa.co.uk 57
  63. 63. Signposting Physiotherapy www.physiocure.org.uk Bri3sh Psychological Society www1.bps.org.uk Royal College of Occupa3onal Therapy www.rcot.co.uk/OT services & advice Red Cross www.redcross.org.uk/en/What-we-do/Health-and-social-care/ Independent-living/Support-at-home 58
  64. 64. Signposting Self-help for Low Mood www.getseltelp.co.uk/index.html Surgery and Driving www.gov.uk/surgery-and-driving William MerriZ – Equipment Store www.wmdlc.org 59
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  66. 66. References 5.  The Royal College of OccupaRonal Therapists (2017) What is occupa3onal therapy? [Online]. Available from: <hdps:// www.rcot.co.uk/about-occupaRonal-therapy/what-is-occupaRonal- therapy> [Accessed 12th July 2017]. 6.  World FederaRon of OccupaRonal Therapists (2016) About occupa3onal therapy: where do OTs work? [Online]. Available from:<hdp:// www.wfot.org/AboutUs/AboutOccupaRonalTherapy/ WheredoOTswork.aspx > [Accessed 12th July 2017]. 7.  Wilcock, A. and Townsend, E. (2009) OccupaRonal JusRce. In: Crepeau, E. Cohn, E and Schell, B. eds. Willard and Spackmans occupa3onal therapy 11th ed. pp. 192-199. Philadelphia, PA. Lippincod Williams and Wilkins, pp. 192-199. 8.  Townsend, E. and Wilcock, A. (2004) OccupaRonal jusRce and client- centred pracRce: A dialogue in progress. Canadian Journal of Occupa3onal Therapy, 71 (2), pp. 75-87. 61
  67. 67. References 9.  Whiteford, G. (2000) OccupaRonal deprivaRon: Global challenge in the new millennium. Bri3sh Journal of Occupa3onal Therapy, 63 (5), pp. 200-204. 10.  Townsend, E. and Wilcock, A. (2004) OccupaRonal jusRce and client- centred pracRce: A dialogue in progress. Canadian Journal of Occupa3onal Therapy, 71 (2), pp. 75-87. 11.  Stadnyk, R. Townsend, E. and Wilcock, A. (2010) OccupaRonal jusRce. In: ChrisRansen, C. and Townsend, E. eds. Introduc3on to occupa3on: the art and science of living. 2nd ed. Englewood Cliffs: PrenRce Hall, pp. 329-358. 12.  Whiteford, G. (2010) When people cannot parRcipate: occupaRonal deprivaRon. In ChrisRansen, C.H. and Townsend, E.A (Eds.) Introduc3on to occupa3on: the art and science of living Second Edi3on. Upper Saddle Creek, NJ: PrenRce Hall. pp. 303-328. 62
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  69. 69. References 17.  Momaya, M. Stavrinos, D. McManus, B. Wiag, S. Emblom, B. and Estes, R. (2017) Return to driving aer hip arthroscopy. Clinical Journal of Sport Medicine. 18.  DiSilvestro, K. Santoro, A. Tjoumakaris, F. Levicoff, E. Freedman, K. (2016) When can I drive aer orthopaedic Surgery? A systemaRc review. Clinical Orthopaedics and Related Research, 474 (12), pp. 2557-2570. 19.  Ross, J. (2007) Occupa3onal therapy and voca3onal rehabilita3on. West Sussex: John Wiley & sons. 20.  Desiron, H. Drijk, A. Van Hoof, E. and Donceel, P. (2011) BMC public health occupaRonal therapy return to work: A systemic literature review. BioMed Central, 11 (615), pp. 1-15. 64
  70. 70. References 21.  Penrose, D. (1993). Occupa3onal therapy for orthopaedic condi3ons. England: Chapman and Hall. 22.  DeMadeo, R. Gross, M. and Mikenis, K. (2008) Leisure. In: Meriano, C. and Latella, D. ed. Occupa3onal therapy interven3ons: Func3on and occupa3ons. Thorofare, NJ: Slack, pp. 397-422. 23.  Santoro, D. Sobocinski, S. and Klippel-TancreR, C. (2008) Social parRcipaRon. In: Meriano, C. and Latella, D. ed. Occupa3onal therapy interven3ons: Func3on and occupa3ons. Thorofare, NJ: Slack, pp. 423-465. 24.  Terkelsen, A. Anderson, O. Molgaard, H. Hanson, J. and Jenson, T. (2004) Mental stress inhibits pain percepRon and heart rate variablility but not a nocicepRve withdrawal reflex. Acta Psychologica Journal 180 (4), pp. 405-414. 65
  71. 71. References 25.  Chesanow, N. (2015) Sex aer hip surgery: advice that paRents may not receive. Medscape, pp. 1-5. 26.  Raut, S. Daivanjna, S. and Khanduja, V. (2016) Labral tears in young sexually acRve women: an evaluaRon of paRent saRsfacRon aer hip arthroscopy. Journal of Hip Preserva3on Surgery, (3) 1, pp. 1-10. 27.  Finlay, L. (2004) The prac3ce of physiological occupa3onal therapy. Nelson. 28.  Guy’s and St Thomas’ NHS FoundaRon Trust (2017) Using your energy wisely: 3ps to help you conserve your energy [Online]. Available from: <hdp://www.guysandsdhomas.nhs.uk/resources/paRent-informaRon/ cardiovascular/using-your-energy-wisely.pdf>[Accessed 28th July 2017]. 66
  72. 72. References 29.  Thew, M. and McKenna, J. (2008) Lifestyle management in health and social care. West Sussex: Wiley–Blackwell. 30.  Vlaeyen, J. and Linton, S. (2000) Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Interna3onal Associa3on for the Study of Pain, (85) pp. 317-332. 67
  73. 73. Glossary Ac3vi3es of Daily Living A structures series of acRons or tasks which contribute to occupaRons. Grading AdapRng an acRvity so it becomes progressively more demanding as a persons skills improve or less demanding as an individuals funcRon deteriorates. Occupa3onal Aliena3on A sense that ones occupaRons are meaningless and unfulfilling, typically associated with feelings of powerlessness to alter the situaRon. Occupa3onal Depriva3on A state of prolonged preclusion in engagement in occupaRons of necessity or meaning due to factors out of the control of an individuals for example, geographic isolaRon, incarceraRon or disability. Occupa3onal Engagement A sense of involvement, choice and posiRve meaning and commitment while performing an occupaRon or acRvity. 68
  74. 74. Glossary Occupa3onal Injus3ce A consequence of restricted access to occupaRon for specific groups of people indicated by occupaRonal risk factors of alienaRon, apartheid, deprivaRon, imbalance and marginalisaRon. Occupa3onal Jus3ce The human right related to occupaRon for all groups of people. Occupa3onal Par3cipa3on ParRcipaRon is defined as the involvement in life situaRon. Occupa3on A group of acRviRes that have personal and sociocultural meaning. It is named within a culture and supports parRcipaRon within society. OccupaRons can be categorised as self-care, producRvity and leisure. 69
  • FienNyusulPawon

    Dec. 20, 2017
  • ShaunGardner9

    Aug. 27, 2017

This guide has been part of a research project done at Physiocure in collaboration with Leeds Beckett University, carried out by MSc Occupational Therapy Students with the aim to enhance the recovery of Hip Arthroscopy Surgery patients. The guide can be used in the Pre-habilitation and Rehabilitation period.

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