When Kaki Koran required a hip replacement in April, she opted for presurgical physical therapy.

Two months after the hip replacement, Koran is driving, cooking, traveling and gardening. She credits her quick rebound to the presurgical PT, also called prehab.

Prehab is becoming a popular concept for patients prepping for surgery nationwide.

The Arthritis Foundation reports that knee and hip-replacement surgery patients who participated in strength training, aerobic and flexibility exercises for six weeks before their surgeries reduced their odds of needing inpatient rehab by 73 percent.

Physical therapist Carol Risdall isn't surprised by the numbers.

The owner of In-Home Therapy Services in Rapid City, Risdall offers prehab services for people preparing for a surgical procedure. She strongly believes in its advantages. Koran is a perfect example of why, she said.

About three years ago, Koran retired from her 20-year career as a registered nurse. Always active, Koran continued as an avid gardener and scuba diver. She met Risdall in a local scuba diving club.

Koran said that while she continued her active lifestyle after

retirement, she began experiencing more pain in her back. She had been diagnosed earlier with spinal stenosis, a narrowing in the spine that can put pressure on nerves. The pressure may cause pain, numbness and cramping. She assumed her symptoms arose from that.

As the pain and numbness increased, she began walking with bent-over posture, often requiring a cane.

Koran tried improving her condition with strengthening exercises and stretching.

"I realized then I had lost a lot of my function in my left leg," she said.

When a doctor did a more thorough examination, Koran learned that her left hip was a major part of the problem. The cartilage in the hip had drastically deteriorated.Very little was left to buffer between the joint bones. Her doctor recommended a hip replacement.

Koran and Risdall worked together in Koran's home before the surgery. Not only did Risdall work on strengthening Koran's body, she helped her arrange her home. She helped Koran purchase the appropriate shower stool, develop methods for tackling the stairs and post notes at various spots in the home to remind Koran to bend correctly.

After surgery, Koran's daughters lived with her for several weeks and Risdall continued working with her. Risdall said she realized just how much the prehab had helped when she visited Koran five days after surgery and discovered her doing laundry.

Risdall finished her post-surgical physical therapy with Koran last week, and Koran is back to her previously active lifestyle. It's a result that continues to amaze even Risdall.

"I've never worked with someone who has gotten a total hip that has gotten this advantage," she said. "She recovered extremely fast."

Preventive physical therapy might help elderly

While presurgical physical therapy is one way to improve the outcome for surgical patients, physical therapist Carol Risdall believes prehabilitative physical therapy also can help keep elderly people in their own homes.

Risdall, owner of In-Home Therapy Services, said a study released in the New England Journal of Medicine found that home-based therapy could reduce and prevent the decline of frail elderly patients. Risdall said too often, families of the elderly wait until there is an injury or problem before seeking physical therapy. By implementing physical therapy before, they may be able to prevent the injury to begin with and possibly keep their elderly parent out of a home, she said.

Risdall offers free senior fitness testing at Rapid City senior centers and is developing a balance class for seniors. To find out more about the testing, call In-Home Therapy Services at 348-2722.

Contact Lynn Taylor Rick at 394-8414 or lynn.taylorrick@rapidcityjournal.com.