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Milestones – Physical Recovery

Everyone’s experience will be unique with respect to the severity of their particular situation. Therefore, defining the Milestones (phases) an individual will encounter on their physical road-to-recovery becomes somewhat artificial.

However, at Green Prosthetics & Orthotics, we understand that the fear of the unknown often times restricts us from taking control of our lives and shaping it to suit our needs. With that in mind, we offer the following milestones and their definitions. Our hope is that this provides a flow of what a patient might experience as they move from one phase to the next on their personal journey of recovery.

As can be seen by looking at the Milestones there are many healthcare professionals involved with each phase. This makes teamwork a cornerstone for success.

Phase I – Pre-Operative

Depending on the urgency of the situation, this is an opportunity to discuss various surgical levels, assess the overall physical condition of individual undergoing treatment, provide patient education, discus post-operative rehabilitation, and begin to formulate orthotic / prosthetic plans. At Green Prosthetics & Orthotics we offer free consultation to surgeons, as well as, patients in the pre-operative phase.

Phase II – Surgery

Key considerations are residual limb length determination, muscle closure options, nerve handling and reconstruction, and surgical dressing type (soft, semi-rigid, or rigid).

Phase III – Post-Operative

Activities include a focus on: wound healing, pain management, body motion analysis, residual limb shaping and shrinking, therapeutic exercising, increasing muscle strength, and regaining and restoring control sensations (often referred to as locus of control).

Phase IV – Pre-Orthotic / Prosthetic Goal Establishment

Very early on in the process it is important to establish both short-term and long-term recovery goals that are reachable in a reasonable amount of time. At Green Prosthetics & Orthotics we focus on this phase with our patients. Creating a set of goals and sharing them with the entire recovery team including your physicians, prosthetists, orthotists, and therapists becomes the GPS for living life to the fullest and overcoming perceived limitations.

Phase V – Comprehensive Post-Operative Assessment

With both short-term and long-term goals as the backdrop a comprehensive assessment of the patient needs is performed. This includes reviewing the patient prescription / referral, patient history, demographic characteristics, diagnosis, allergies, and current medications. Also at this time an examination that is specific to the patient’s diagnosis is performed. This includes such things as muscle testing, gait analysis, evaluation of sensory functions, range of motion and joint stability.

Phase VI – Formulate Treatment Plan

From the data collected in post-operative assessment the findings are evaluated and a goal based orthotic / prosthetic treatment plan is developed. Items such as stability, comfort, and aesthetics are reviewed. Options regarding the available technology, design, materials, and available components are discussed. Revisions to the original prescription may occur at this time. It is also at this time where responsible parties are informed of their financial responsibilities and insurance verification / authorization takes place.

Phase VII – Build & Fit Initial Prosthesis / Orthosis

Perform the necessary procedures to fabricate and fit an initial orthosis or prosthesis. Activities include: taking measurements, impressions, digitized scans, building a test socket, and selecting appropriate materials and components. It is important to recognize that in many instances the unit being assembled may not be the final device. Once the unit has been fabricated the device is tested with the patient for alignment, comfort, and functionality. A series of adjustments and design modifications may occur during this phase.

Phase VIII – Finalize Prosthesis / Orthosis

Once optimum fit and functionality is achieved, the temporary device is either replaced or is converted to a permanent orthosis or prosthesis. The patient or care provider is then educated on the overall device, provided maintenance instructions, wear schedules, and other necessary information to ensure a successful milestone is achieved.

During all phases, especially in Phase VII above and Phase VIII — extensive work with a physical / occupational therapist will be undertaken.

Phase IX – Continuous Care-for-Life Progress

Providing lifetime patient care and periodic evaluations to assure, maintain, and document optimal fit and function of the orthosis/prosthesis is essential. While much of the early focus is on wear schedules, comfort, proper usage, and functionality — this is also the time to ensure progress is being made on short and long term goals. During this time it is important to continue communications with the entire recovery team and where it’s appropriate adjust goals and expectations to be in a position to embrace life.