**Author details**

On the grounds of the two-year research efficacy of the therapy based on the ACT principles, i.e. therapy in a closed kinetic chain, was assessed. In order to get long-term results the time

The first time the patients filled in the questionnaires was standard, i.e. 1 day before surgery, next after termination of the managed rehabilitation in the department of orthopedics and traumatology of SMN Přerov (6 therapies on average) and the last time was 4 months after hip joint replacement, i.e. within a regular orthopedic check-up. The patients were observed from the beginning of 2015 until the end of 2016. During this period 168 patients who underwent total hip joint replacement went through the therapy based on the ACT principles. The measured values were entered into a table (see **Table 6**). Before surgery the patients had 43.3 points of Harris Hip Score, after termination of the managed rehabilitation they reached 74.3 points on average. After leaving the department of orthopedics and traumatology of SMN Přerov the patients started subsequent rehabilitation treatment, they followed up the existing therapy and went on improving their functional and conditional skills. Within the regular orthopedic check-up, i.e. during the fourth month after surgery, the patients reached on aver-

The benefit of the therapy applied in a CKC consists mainly in relatively easy performance and understanding of exercises which can be modified according to the skills and needs of an individual. The therapy based on the ACT principles helps to reduce subjective perception of pain and to improve motor skills in patients. Patient satisfaction with surgery depends on improvement of the quality of their life, i.e. on reduction or elimination of pain and renewal

The results of this study show that the managed rehabilitation in a closed kinetic chain has demonstrably better results compared to the therapy conducted in an open kinetic chain. The similarity principle, which integrates functional movement patterns into patients´ activities of daily living, is considered the key element. The patients agree that if the movement therapy is aimed at improvement of specific motion skills applicable in ADL, their motivation to perform the exercises is higher. Correctly set up CKC therapy leads to reduction of subjective perception of pain, which has already been proved in various studies. The results of our study show not only significant improvement of functional skills of patients in ADL but also significant reduction of a number of postural errors concerning standing positions and locomotion.

during which the patients filled in the questionnaire was modified.

**Table 6.** Harris Hip Score results of two-year observation.

178 Total Hip Replacement - An Overview

age 94 points in the Harris Hip Score questionnaire.

**4. Conclusion**

of motor skills they could do with a healthy hip joint [25–29].

Jan Vagner<sup>1</sup> \*, Ingrid Palaščáková Špringrová<sup>2</sup> , Pavel Přikryl<sup>3</sup> , Šárka Tomková<sup>4</sup> and Rafi Moheb<sup>5</sup>

\*Address all correspondence to: mgrjanvagner@gmail.com

1 Rehabilitation Department, Středomoravská nemocniční a.s, Přerov Hospital, Czech Republic

2 ACT centrum s.r.o., Postgraduate Education Centre, establishment accredited by the Ministry of Health of the Czech Republic, Praha, Czech Republic

3 Department of Orthopaedics and Traumatology, Středomoravská nemocniční a.s, Přerov Hospital, Czech Republic

4 Faculty of Health in Bánska Bystrica, St Elizabeth College of Health and Social Work in Bratislava, Slovak Medical University in Bratislava, Slovakia

5 Department of Orthopaedics, Kroměříž Hospital, Czech Republic
