Effects of rehabilitation treatment on thyroid function

Area of Science:

• Endocrinology
• Orthopedic Surgery
• Rehabilitation Medicine

Background:

• Thyroid metabolism can be significantly altered following orthopedic surgery.
• Nonthyroidal illness syndrome (NTIS) is a potential complication in post-surgical patients.
• The impact of rehabilitation intensity on thyroid function and NTIS is not fully understood.

Purpose of the Study:

• To assess the effects of intensive rehabilitation on thyroid metabolism in orthopedic patients.
• To investigate the relationship between patient disability and thyroid hormone levels.
• To determine the incidence of NTIS before and after rehabilitation.

Main Methods:

• A prospective clinical study involving 82 orthopedic surgery patients.
• Patients were divided into a walking group (WG) and a nonwalking group (NWG) based on mobility.
• Thyroid hormones (free T3, fT4, TSH, rT3) and disability (Barthel Index) were measured pre- and post-rehabilitation.

Main Results:

• Early mobilization (WG) led to the normalization of thyroid hormone levels post-rehabilitation.
• Non-ambulatory patients (NWG) showed persistent decreases in fT3/fT4 and elevated rT3, with 38% developing NTIS.
• A positive correlation between free T3 levels and disability scores (Barthel Index) was observed in the WG.

Conclusions:

• Intensive rehabilitation with early mobilization promotes thyroid function recovery.
• Physical activity during rehabilitation appears to prevent the occurrence of NTIS.
• Early patient mobilization is crucial for mitigating thyroid dysfunction and disability post-orthopedic surgery.