Rehabilitation program
after osseointegration

leren lopen na amputatie bij revalidatiecentrum in Doorn

Start of the osseointegration (click) prosthesis rehabilitation

AOFE clinics works together with the Military Rehabilitation Center in Doorn. Rehabilitation starts 3-6 weeks after surgery, depending on bone quality and ingrowth. It is possible that it is advised to start rehabilitation later than has been discussed with you prior to the operation. This will be individually coordinated with you.

Muscle pain

Muscle pain is an important limiting factor for progress in rehabilitation. Particularly in people with an osseointegration prosthesis in the thigh, the gluteal and buttock muscles are severely weakened after years of socket use. When walking with an osseointegrator prosthesis, the stump muscles must be fit and strong to stabilize the leg prosthesis. This muscle building during rehabilitation can be accompanied by a lot of 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 reduced. Sometimes it is necessary to take a rehabilitation break when pain is a limiting factor for gait training without walking aids.

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.

Stoma care instructions

The experience expert of the AOFE Clinics osseointegration team will go through the instructions for stoma cleaning with you and give you 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 rehabilitation

For Dutch patients, the rehabilitation lasts approximately six weeks with a lower leg osseointegration (click) prosthesis and 12 weeks with an upper leg osseointegrated (click) prosthesis. The rehabilitation doctor will discuss the progress with you and the team in interim evaluations and tailor the rehabilitation content and duration with you. Non-Dutch patients undergo four weeks of rehabilitation with a lower leg osseointegration prosthesis and six weeks with an upper leg osseointegrator prosthesis. Additional rehabilitation will be prescribed if required in the respective home country.

Thigh osseointegration (click) prosthesis rehabilitation protocol (standard)

Week 1: Building up prosthesis load.

  1. Apply and align a leg prosthesis including connector instructions.
  2. Constructive load on the leg prosthesis using a scale to 100% of the body weight.
  3. Exercises for hip mobility, strength, training, for trunk, buttock and buttock muscles.
  4. Stoma care instructions and pain management instructions.

Weeks 2 and 3: Walk in the bridge.

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

Week 4 to 6: Gait training with crutches.

  1. Basic gait training with crutches in 3-point gait and 2-point gait.
  2. Stairs
  3. Gait training on uneven surfaces.

Weeks 7 to 11: Advanced Gait Training (optional).

  1. Gait training without walking aid.
  2. Gait training with ramps, obstacles, dual tasks.

Thigh osseointegration (click) prosthesis rehabilitation protocol (adapted).
Indication for modified protocol is on surgeon’s advice

Week 1-6 : Building up prosthesis load up to a maximum of 50% of the body weight.

  1. Apply and align a leg prosthesis including connector instructions
  2. Constructive load on the leg prosthesis using a scale to 50% of the body weight.
  3. Standing and balance training.
  4. Walk in the bridge and walk with crutches in 3-point gait.
  5. Exercises for hip mobility, strength training for core and butt muscles.
  6. Stoma care instructions and pain management instructions.

Week 7-9: Building up prosthetic leg load to 100% of body weight.

  1. Constructive load on the leg prosthesis using a scale to 100% of the body weight.
  2. Standing and balance training.
  3. Walk in the bridge and walk with crutches in 3-point gait.
  4. Gait training: different gait patterns (sideways, backwards, stop, turn).

Weeks 10 to 12: Gait training with crutches.

  1. Basic gait training with crutches in 3-point gait and 2-point gait.
  2. Stairs.
  3. Gait training.
  4. Gait training on uneven surfaces.

Week 13-17: Advanced Gait Training.

  1. Gait training without aids.
  2. Gait training with ramps, obstacles, dual tasks.

Lower leg osseointegration (click) prosthesis rehabilitation protocol

Week 1: Building up leg prosthesis load.

  1. Apply and align a leg prosthesis including connector connection.
  2. Constructive load with a leg prosthesis using a scale to 100% of the body weight.
  3. Exercises for hip mobility, strength training for core, buttock and buttock muscles.
  4. Stoma care instructions and pain management instructions.

Week 2: Walk in the bridge.

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

Week 3: Gait training with crutches.

  1. Basic gait training with crutches in 3-point gait and 2-point gait.
  2. Stairs.
  3. Gait training on uneven surfaces.

Week 4: advanced gait training.

  1. Gait training without aids.
  2. Gait training with ramps, obstacles, dual tasks.

Dicky de Best ervaringsdeskundige

Do you have any questions or do
you want to sign up?

You can register directly for an intake interview. Do you still have questions? Then look through the frequently asked questions or ask your question to one of our specialists.