Rehabilitation with click prosthesis

AOFE clinics collaborates with the Military Rehabilitation Center in Doorn (www.defensie.nl search MRC Aardenburg).

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.

Above knee osseointegration (click) prosthesis rehabilitation protocol (standard protocol)

Week 1: Increasing prosthesis load

  • Fitting and aligning the leg prosthesis including connector instructions
  • Load the leg prosthesis gradually with the aid of a scale up to 100% of the body weight
  • Exercises for hip mobility, strength, training, for trunk, buttocks and butt muscles
  • Stoma care instructions and pain management instructions

Week 2 and 3: Walk in the bridge.

  • Standing and balance training
  • Gait training: different gait patterns (sideways, backwards, stop and turn)

Weeks 4 to 6: Gait training with crutches.

  • Basic gait training with crutches in 3-point gait and 2-point gait.
  • Climbing stairs
  • Gait training on uneven surfaces.

Weeks 7 to 11: Advanced gait training (optional).

  • Gait training without walking aid
  • Gait training with inclines, obstacles, dual tasks

Indication for modified protocol is on surgeon's advice depending on bone quality and length of stump

Below knee osseointegration (click) prosthesis rehabilitation protocol (standard protocol)

Week 1: Increasing prosthesis load

  • Fitting and aligning the leg prosthesis including connector instructions
  • Load the leg prosthesis gradually with the aid of a scale up to 100% of the body weight
  • Exercises for hip mobility, strength, training, for trunk, buttocks and butt muscles
  • Stoma care instructions and pain management instructions

Week 2: Walk in the bridge

  • Standing and balance training
  • Gait training: different gait patterns (sideways, backwards, stop and turn)

Week 3: Gait training with crutches

  • Basic gait training with crutches in 3-point gait and 2-point gait
  • Climbing stairs
  • Gait training on uneven surfaces

Week 4: Advanced gait training.

  • Gait training without aids
  • Gait training with inclines, obstacles, dual tasks