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I am in rehab for a total hip replacement. I confess I'm a type A person. Even though I try not to compare myself to others, I always end up checking to see how I'm doing based on how others are doing. What should I really be using to gauge my progress?

You'll be relieved to know that the most common question patients have after hip replacement surgery is: "How am I doing compared to everyone else?" This seems to be the result of a natural human tendency not necessarily based on how competitive you are. Most patients ask their surgeon or physical therapist this question sometime during the postoperative period. With information from a new study on recovery following a total hip replacement, there are some ballpark answers to this question. For example, it appears there are two phases to recovery. The first occurs during the 12 to 15 weeks following the procedure. Rapid change occurs in the first three months and then starts to slow between 15 and 20 weeks. By the end of four months, most patients have been discharged from treatment. They are well on their way to resuming all physical activities and exercise they are interested in. Thirty (30) weeks (seven and a half months) later, patients experience another leveling out as they are now able to walk again at a normal pace. Physical function involving the legs continues to improve though at a much slower pace than early on. Balance and postural stability seem to take longer to recover. If you continue to follow the exercise program prescribed by your physical therapist, then by the end of 12 months (one full year), you should be fully recovered. At that point, hip muscle strength, joint motion, and leg function should test within normal limits for your age. Patients who quit doing their exercises too soon often have muscle weakness and report falls two years after hip replacement. The therapist can use several tools to measure how you are doing. A popular (valid and reliable) test of physical activity is the six minute walk test (6MWT). In this test, how far you can walk (and how fast) in six-minutes is measured. For both men and women after total hip replacement, the peak distance walked occurs around that 30-week postoperative timeframe. Women don't walk as far as men and their early recovery time is a little slower but in the end (a year later), walking ability evens out between the sexes. Other measures may include whether or not you still need a walking aid (e.g., walking sticks or cane), your pain level, and how much medication you are still taking for pain. How well you can go up and down stairs is a functional skill of importance. Your ability to carry out daily activities may also be examined closely. You can use these known guidelines to establish your own goals and check your recovery against the average. More physical therapy with a supervised rehab program may still be needed if you have not experienced good improvement or the results you expected. Setting too high of expectations can discourage you -- especially in those early weeks of recovery. Just compete against yourself rather than against others who may be ahead or behind you for specific (individual) reasons. Adopt a "can do" attitude, follow your therapist's and surgeon's advice, and give yourself the time you need to recover.

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