Basic Principles of Rehabilitation: Common Mistakes and the Right Approach
Rehabilitation is a long-term process of recovery after illness, injury, or surgery. Many mistakenly see it as a short course, but in reality it is work on oneself that can last months or even years. In this article, I will discuss the main mistakes and misconceptions I encounter as a doctor.
Who Is Not Suitable for Rehabilitation?
Not all patients can undergo rehabilitation. It is not indicated if a person:
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cannot perform even simple instructions (due to dementia, severe illness, coma);
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does not want to engage (depression, personality traits, demotivation).
Women aged 60–75 often refuse, saying: «Leave me alone, let me die in peace,» even though they are not actually dying.
Mistake 1: Rehabilitation Is a Short Course
Many think a month in a centre is enough. This is not true. Rehabilitation lasts until the goal is achieved – restoration of full life – or until the patient stops (due to old age or loss of motivation).
Mistake 2: Complex Equipment Is Needed
This is a myth. For adults, bodyweight exercises are sufficient, like Shaolin monks. The exception is children with an unformed walking pattern – they need special devices.
Mistake 3: Intensive Rehabilitation Is the Key to Success
Intensity is dangerous. In people over 50, it can cause a hypertensive crisis and adaptation breakdown. Example: my mother went to a sanatorium, and after 7 days an ambulance met her due to a crisis from intensive procedures.
Regularity is key, not intensity. Optimal: 2 sessions with an instructor per week + 5 days of self-work (or with relatives). Sessions must follow a strict schedule, not «when I feel like it.»
Mistake 4: Sequence Is Broken
You cannot stand a bedridden patient up and force them to walk. Recovery must be step-by-step. Sample plan after prolonged bed rest:
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Adaptation to load – light exercises lying down (10–14 days).
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More intense exercises – turning, verticalisation (raising the head of the bed), 10–14 days.
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Sitting with support – legs dangling (10 days).
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Sitting without support – maintaining balance (10 days).
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Learning to walk – with a walker, gradually.
Specifics After Hip Replacement
Surgery is only 10% of success; the other 90% is rehabilitation. You should not operate on someone who barely walked before the fracture. Example: an 85-year-old woman was persuaded to have surgery, but afterwards she did not want to get up, and recovery failed.
Conclusion
Rehabilitation is work on oneself. It requires patience, regularity, and support from loved ones. Do not chase intensity – consistency and motivation are more important. And remember: without the patient’s desire, even the best methods will not work.
