THE PHYSIO KNEE GYM: WHERE THE MAGIC HAPPENS October 4, 2021 Louis and Joanne Babineau at their home in Dieppe. Louis had his left knee replaced in April of 2021 and has been working at physio in the Knee Gym at Horizon’s The Moncton Hospital since. A total knee replacement is a common surgery requiring hard work from a patient to get their life back. The physiotherapy team at Horizon’s The Moncton Hospital (TMH) works with patients to come up with a plan to get them back to doing what they love, whether it’s a sport, a hobby, going back to work or for a lot of people, being present and there for their grandchildren. Following a knee replacement, patients are encouraged to get up and walk as soon as possible after the surgery. This can be daunting, but with the proper education and preparation from the physiotherapy team, it gets great results. Tara Mann, manager of Physiotherapy Services in the Moncton area, said patients who mobilize the day of surgery can see shortened lengths of stay and expedited recovery times – which means they can get back to doing the things they love. “It reduces their potential for post-operative complications and gives them the assurance they can walk with their new knee,” Tara said. “Most patients are fearful of the unknown, however the physiotherapy team is there to help ease their fears, encourage them, and teach them how to get up and move with confidence.” Tara Mann, manager of Physiotherapy Services in the Moncton area. Tara said part of a patient’s success is due to the dedication of the physiotherapy team on the orthopedic floor who work longer days to ensure patients are mobilized on the day of surgery. Take it from Louis Babineau, 66, of Dieppe, who had a knee replaced on April 27, 2021 at TMH. Going into surgery, the team prepared him – he was going to get up and walk as soon as possible, post-surgery. The sooner he walked, the sooner he could be discharged and begin to heal at home. “I couldn’t wait, I was ready for it, I wondered how hard it would be, but I did it,” Louis said. “And I was home the next day.” While not everyone is home the next day, Louis considers himself lucky and encourages others to trust the team when they tell you you can do it. It was about a year-and-a-half from the time he was told he needed the total joint replacement to the day of his surgery. “I was miserable. It was painful, very painful. Getting in and out of the car, going up and down the stairs, carrying anything. Doing anything was very hard,” Louis said. For years, Louis worked for Coca-Cola, which involved a lot of heavy lifting. He worked in construction, he worked in recreation maintaining ice for skating in the winter, and baseball fields in the summer, and he played baseball – a catcher. The pain meant Louis was unable to do any of the things he loved. No fishing, golfing, canoeing, or working on projects at the cottage. He wasn’t able to do chores around the house and for that, leaned on his wife Joanne. “She’s my best friend, I couldn’t have done anything without her,” he said. “When they gave me my surgery date, I thought ‘Finally,’ I was very happy, what a relief.” It’s hard to measure magic… you have to see it Since his knee replacement, Louis has attended physiotherapy in the Knee Gym at TMH. “It’s getting better, better every day,” he said. “Physio is tough, but they know what they’re doing.” Justin Saulnier, physiotherapy supervisor who works in the Knee Gym, said a knee replacement is a common surgery, and often times, patients hear from friends and family how it changed their lives. “People don’t realize all the parts involved in their rehab. People are quick to forget the challenges they overcame, or issues that had to be corrected for them to get back to where they want to be.” Justin Saulnier, physiotherapy supervisor who works in the Knee Gym. Justin said in the Knee Gym, at the first point of contact, they establish realistic expectations. “We know right from the start, you’re not going to be golfing next week, you’re not going to be doing your grocery shopping for an hour,” Justin said. “We work with patients to ensure they achieve their goals; it might just be a little longer than they anticipated.” Justin said the physio team challenges patients to achieve their best results. “We are honest with people. We encourage them when it’s time to be encouraged, and we will give guidance when it’s time to do that,” he said. “We try to create a fun, positive environment, because this kind of rehab can be challenging.” Carla Chadwick, who has had her second knee replaced warms up in the Knee Gym with Physiotherapist Justin Saulnier’s guidance. The first few visits are the most difficult because patients are not themselves. “They’re struggling with pain, they’re not sleeping or eating, and they’re going through something with expectations of where they think they should be and they are not necessarily aligning, so they’re lost,” Justin said. “We’re able to give them a bit more clarity. When we see them struggling, we try to have a little fun.” Physiotherapist Justin Saulnier makes an adjustment to the pulleys as Carla Chadwick works on her range of motion. The physiotherapy work is, at times strenuous, and the group-based rehabilitation allows patients who have had a total knee replacement to exercise together – at varying levels of recovery. “The camaraderie and motivation the staff and environment create is excellent,” said Tara. Justin said they often listen to music in the gym, and there are always a lot of laughs. “But we don’t always have laughs in here. People do have tough times, there are times where people are having issues and struggling, and potentially crying,” Justin said. “You want to respect everybody and respect what they’re going through and try to be there for whatever they need.” But the good news is, they see a lot of success worth celebrating in the gym. “Certain things we take for granted, a simple thing like putting your socks on by yourself in the morning, when that finally happens, it’s huge,” Justin said. “They commiserate their setbacks together and they celebrate their successful milestones together, and when they reach those goals – it’s hard to measure magic… you have to see it. The atmosphere is incredible,” said Tara. The physiotherapy team is there to keep patients motivated through their rehabilitation and ensure they don’t lose sight of their goals. “I always say the goal is, once we’re all done and you’re fully recovered, that people can’t tell that you had this (surgery) done,” Justin said. “So you can return to wherever you were before, and you can function without any issues in terms of strength or movement.” Getting back to that to-do list Louis and Joanne both agreed – the orthopedics team, and the physiotherapy team provided an excellent service. “Unbelievable. Unbelievable. Fantastic. You could not ask for better,” Louis said. “They were 200 per cent the best. The physiotherapists, the surgical team, everyone,” Joanne said. “Our physiotherapy staff lead and motivate patients through their rehabilitation,” said Tara. “Our patients put their trust in their expertise, and it shows with the results they receive. They also have fun doing it, there is always a lot of laughter.” With the surgery behind him, Louis is looking forward to checking things off his (and Joanne’s) to-do list, working on projects around their cottage on the Kouchibouguac River, and spending time with their grandchildren. Louis and Joanne Babineau in their backyard. Louis is so happy to have had his knee replaced so he can get back to doing the things he loves, including mowing his lawn and taking care of his yard. “I just want to get back to working and fixing things,” he said. “We went to the cottage and I saw all these things that needed to be fixed and I am not ready yet, but soon, I’ll get there.” But for now, he’s taking it one day at a time, knowing if he keeps doing his physio, he can keep working away at his to-do list. Reducing wait times An objective in Horizon’s Strategic Plan 2021-2026 is to reduce wait times throughout our system. A fundamental aspect of providing quality care is ensuring patients and clients have access to the health care services they need within a reasonable timeframe. The team in the physiotherapy gym are helping patients reduce the amount of time spent in hospital, after a knee replacement, and helping them get back to their regular activities.