| After any major surgery such as total knee | | | | circulation, and that fact alone would improve the |
| replacement (total knee arthroplasty), one of the | | | | flow of nutrients to the wound site and the flow of |
| patient's prime concerns is regaining function and | | | | wastes away from it. What surprised the researchers |
| mobility. Exercise has been found to be beneficial for | | | | was that when they administered stress tests at the |
| wound healing and also for more complete and | | | | end of the study, the exercisers showed increased |
| quicker recovery of mobility and function. Exercise | | | | cortisol levels typical of younger adults. This increase |
| achieves these outcomes through several different | | | | in cortisol levels was a second mechanism that |
| methods. Some recent studies, written up in medical | | | | promoted improved healing. |
| journals, provide pointers for anyone wishing to have | | | | Exercise also plays a role beyond improvement in |
| a positive effect on their own rehabilitation after | | | | healing rates. Patients that undergo total knee |
| surgery. | | | | arthroplasty or hip replacements will be dependent on |
| One of the immediate results of almost all major | | | | walkers and canes for mobility during the early |
| surgery is reduced function and mobility. Reduced | | | | stages of their recovery. It is not uncommon for the |
| function and mobility immediately raises the stress | | | | increased exercise load on the upper body to lead to |
| level of the patient who is now confined an unable to | | | | soreness, pain, and decreased energy levels in those |
| provide complete care for themselves. This has the | | | | unaccustomed to doing this type of activity. |
| direct effect of increasing stress. | | | | In the 2007, May issue of Journal of Strength and |
| It has been demonstrated in numerous studies that | | | | Conditioning Research an article reported on the |
| stress slows the healing process. In | | | | results of a case study involving two TKA patients. |
| Neuroimmunomodulation, Vol 13, 2006, Glaser and | | | | One underwent 4 weeks of pre-habilitation exercises. |
| Christian write that "...stress can significantly slow | | | | (Pre-habilitation is physical therapy delivered before |
| wound healing: stressors ... impair healing in humans | | | | any surgical intervention). There were significant |
| and animals. For example, in humans...the relatively | | | | differences in both function and self-reported pain |
| brief stress of academic examinations impedes | | | | perception in the exercising case than in the |
| healing." They go on further to state "Recent | | | | non-exercising case. |
| evidence suggests that interventions designed to | | | | This supports the findings of a study reported in the |
| reduce stress and its concomitants (e.g., exercise, | | | | February 2002 issue of Applied Nursing Research that |
| social support) can prevent stress-induced | | | | compared preoperative exercise, anesthesia, or |
| impairments in healing." | | | | analgesia on the ability to walk after surgery. It was |
| A 2005 report in the Journals of Gerontology | | | | found that anesthesia, or analgesia had no effect. |
| describe a study on exercise and healing among older | | | | Subjects who exercised before surgery were able to |
| adults that was completed with some surprising | | | | walk significantly greater distances afterwards. |
| findings. The study followed the results of 28 adults, | | | | What does all this mean for people looking forward |
| with an average age of 61, who had not exercised in | | | | to surgery, whether total knee replacement or some |
| the previous 6 months. Half the group was started | | | | other major intervention? It's simple. Exercise can |
| on a program of 75 minutes of exercise activity for | | | | help you in four ways. |
| three times a week. The other half did nothing other | | | | 1. It will actually help speed healing of the wound site |
| than their normal routine. After four weeks of | | | | through improved circulation and the attendant |
| exercise, all the adults received small puncture | | | | improved flow of nutrients to your wound. |
| wounds on their upper arms and were then | | | | 2. It will help stimulate the proper regulation of |
| monitored for rate of healing. They also performed | | | | cortisol levels in your body, which will improve your |
| stress tests twice, at the beginning and at the end | | | | immune system function. |
| of the study. Their cortisol levels were measured | | | | 3. It will help strengthen your body, leading to |
| before and after each stress test. | | | | improved mobility, especially if you must use an |
| When they did the stress test before the study, the | | | | assistive device such as a walker or can after your |
| researchers found that neither group showed any | | | | operation. |
| increase in cortisol levels after the stress test. | | | | 4. And finally improved mobility will mean less stress |
| Exercise normally increases cortisol levels. The ability | | | | on the recovering patient. In addition, exercise is a |
| to produce cortisol diminishes with age. This is | | | | proven stress reducer in its own right. By reducing |
| significant because cortisol increases the efficiency of | | | | stress, you remove the ability of stress to slow |
| immune system function. This is a factor in the | | | | healing. |
| commonly observed increased time for wounds to | | | | The studies seem to be quite clear. If you know you |
| heal in older adults. | | | | are going to go for surgery, start exercising, even if |
| The results of the study were that the exercisers | | | | it is a limited program. Any exercise, done regularly, is |
| healed faster, typically within 29 days instead of 39 | | | | better than no exercise. And remember, discuss your |
| days for the non-exercisers. The researchers | | | | exercise program with your doctor. |
| expected this. They reasoned that exercise increases | | | | Good luck. |