restore function

Last reviewed 01/2018

It is important to restore function as soon as possible. This should be directed at the whole person and not just the injury. The type of injury and the motivation of the patient will determine the most appropriate method. If neglected, oedema may develop, and muscle mass and function may be lost.

Elevation of the lower limb may easily be accomplished by raising the end of the bed or by resting the limb on stacked pillows. Upper limb injuries may be supported in a sling provided that the arm is exercised regularly.

Active movement stimulates the circulation, pumps away oedema fluid, prevents soft-tissue adhesion and promotes healing. Even a plaster is not a contra-indication to exercise since it permits static muscle contraction. Movements should never be forced and should be performed only to the point of pain.

Assisted movement may be accomplished with the aid of machines. Continuous passive motion - CPM - devices are motorised frames of various construction that provide continuous flexion and extension.

As the patient's condition improves and confidence is gained, increasing attention should be paid to functional activities such as walking, dressing, and eating.

Motivation is essential to adequate progress and must be explored in all cases of underperformance.