Rehabilitation starts 3-6 weeks after the operation , depending on bone quality and ingrowth. It is possible that it is advised to start later than has been discussed with your prior to the operation. This will be individually coordinated with you.
Muscle pain
Muscle pain is an important limiting factor for progress in rehabilitation but also a necessity to make progress ('no pain no gain'). Particularly in people with an above knee osseointegration prosthesis, the gluteal and buttock muscles are severely weakened after years of socket use. When walking with an osseointegration prosthesis, the stump muscles must be fit and strong to stabilize the leg prosthesis. This muscle building during rehabilitation can be accompanied by severe muscle pain. The rehabilitation team will guide you in this and, if necessary, prescribe painkillers or adjust the rehabilitation pace. Muscle pain in the stump mainly occurs when the crutches are tapered off. Sometimes it is necessary to take a rehabilitation break when pain is a limiting factor for gait training without walking aids.
Artificial Leg Prosthesis – Alignment and Adjustment
Leg prosthesis adjustment is an important aspect of rehabilitation and depends on the rehabilitation phase. AOFE clinics works together with the prosthesis maker of the Military Rehabilitation Center in Doorn (www.defensie.nl search MRC Aardenburg).
Stoma care instructions
The experience expert of the AOFE Clinics osseointegration team will go through the instructions for stoma cleaning with you and provide tips for the materials and devices that you can use. The rehabilitation doctor is present at the rehabilitation session every week and can prescribe stoma products if necessary in case of stoma irritation.
Duration of the rehabilitation
For Dutch patients, the rehabilitation takes about six weeks with a below knee osseointegration (click) prosthesis and 12 weeks with an above knee osseointegration (click) prosthesis. The rehabilitation doctor will discuss the progress with you and the team during interim evaluations and tailor the rehabilitation content and duration with you. Non-Dutch patients undergo rehabilitation for four weeks with a below knee osseointegration prosthesis and six weeks with an above knee osseointegration prosthesis. Additional rehabilitation will be prescribed if required in the respective home country.
Week 1: Increasing prosthesis load
Week 2 and 3: Walk in the bridge.
Weeks 4 to 6: Gait training with crutches.
Weeks 7 to 11: Advanced gait training (optional).
Indication for modified protocol is on surgeon's advice depending on bone quality and length of stump
Week 1: Increasing prosthesis load
Week 2: Walk in the bridge
Week 3: Gait training with crutches
Week 4: Advanced gait training.