Het gebruik van kinesitherapie en van fysische geneeskunde ... - KCE

KCE Reports 87 Physiotherapy & Physical and Rehabilitation Medicine 61
Key points
Selection of rehabilitation episodes
The episodes selected answered to the following conditions:
° They are preceded by one single surgical operation of the list;
° No other major surgery is performed during the hospital stay and the
hospital stay is not abnormally long;
° Episode is not interrupted by readmission, except in a rehabilitation
service;
° The episode begins within a maximum delay after the surgical operation;
° The rehabilitation lasts less than 365 days.
The selected episodes accounted for 15 to 89% of all surgery procedures,
depending on the procedure.
For the following surgical procedures, more than 50% of procedures had no
rehabilitation: surgical treatment of urinary incontinence, of fractured collar
bone, of ruptured extensor tendons of the hand, and procedures for carpal
tunnel release.
For arthrodesis of the dorso-lumbar spine, hip prosthesis and plasty of the
cruciate knee ligaments, most surgical procedures had rehabilitation.
4.2 DESCRIPTION OF THE REHABILITATION EPISODES FOR
EACH SURGICAL INTERVENTION
4.2.1 Type of rehabilitation in first instance
The type of rehabilitation given in first instance varies, not only depending on the type
of surgery performed, but also according to whether or not the patient is hospitalised
(cf. Table 21).
Treatment often begins during hospitalisation, except for fractures of the forearm,
sutures of the extensor tendons of the hand, and procedures performed during “one
day hospitalisation” (carpal tunnel release and meniscectomy).
PT is the most common first intention treatment: it is performed during hospitalisation
in more than 2 patients out of 5, with the exception of fractures of forearm (17.5%) and
ankle (28%), cervical spine operation (36%), meniscectomy (34%) and shoulder
operations (major 35% and minor 24%).
PRM (mono or multi-disciplinary) is performed in first intention during hospitalisation in
more than one patient out of five, except in relation to fractures of the forearm (12%),
hallux valgus (19%), urinary incontinence (9%), mastectomy p (18%) and shoulder surgery
(19%). PRM is rare in first instance on an outpatient basis, except mono-disciplinary
PRM in relation to meniscectomy, carpal tunnel release and surgical treatment of
urinary incontinence.
Mono-disciplinary PRM is common on an outpatient basis for all inpatient procedures
(10 to 28%).
Multi-disciplinary PRM is the first instance treatment for more than one patient out of 3
following knee or hip arthroplasty. This type of treatment is also frequently observed
following fractures of the femur (more than 20% of patients) and arthrodesis of the
dorso-lumbar spine (13%).
p Mastectomy is the surgical removal of one or both breasts, partially or completely.