The main goal of Physical Therapy is to bring you as close as possible to being independent in everyday life.
IMPORTANCE OF MOBILITY AND EXERCISE
Osteosarcoma is primarily treated at large medical centers in which a multi-disciplinary team including physical therapists, occupational therapists, pediatricians, surgeons, psychologists and nursing staff help to manage patient care. Both inpatient and outpatient facilities can treat and manage their patient’s musculoskeletal, neuromuscular, integumentary and cardiopulmonary rehabilitation needs as well as educate the patient and family on the importance of exercise mobility and functional independence
Physical therapy interventions will consist of early post-surgical mobility training, strength and endurance restoration, pain control, and patient and family and/or caregiver education for helping patients with limited mobility.
Physical therapists will help to correct balance and coordination impairments, make recommendations for home modifications that will enhance the patient’s independence; as well as educate and train the family members to assist and enable the patient to function independently. If you choose to have an amputation, physical therapists will train the patient in residual limb management and training with the prostheses. Whether you are undergoing a limb sparing surgery or amputation, physical therapy will help you retrain the muscles needed for improving strength, endurance, balance and range of motion to help return you to your normal daily activities. Patient education plays a crucial role in physical therapy to help you understand the appropriate rehab protocol and the negative consequences of overworking yourself after a limb-sparing procedure. It takes time for your body to heal, so be very cautious about returning to recreational activities without consulting your doctor or physical therapist first. |
A general Rehab Program following Limb Sparing Surgery is described below:1. A knee immobilizer is used for 3–6 weeks or until the soft tissues are healed and the quadriceps muscle is strong enough to stabilize the knee while walking. In other words, until you are not at risk of falling due to the knee buckling when you take a step 2. ROM: knee flexion with a Continuous Passive Motion machine is started approximately 5–7 days after surgery, if the wound is healed. Then, you are able to start performing assisted active and active flexion exercises. 3. Muscle strengthening: knee extension (quadriceps) and flexion (hamstrings, gastrocnemius) are supported by static contraction, assisted active, and active exercises (e.g. open- and closed-chain exercises). 4. Ambulation: the goals in terms of activities of daily living include: independence in transfers (e.g. bed to chair, on/off toilet); splints may be needed if nerve involvement occurred during the surgery; If a cemented endoprosthesis is used, walking with weightbearing using crutches is permitted. If the custom prosthesis is not cemented, weightbearing should be deferred for at least 6 weeks. |
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Physical Therapy in the Outpatient Environment
When you go to an Outpatient Physical Therapy Clinic, you should expect the following.
Day 1 will consist of a full evaluation including assessment of pain, strength, walking, balance, transfers, limitations in everyday life, and most importantly your own personal goals. The Physical Therapist will also discuss a home exercise program, as well as, different modalities you will receive in the subsequent visits. Depending on your current level of function and surgical or non-surgical approach, these may vary.
Day 1 will consist of a full evaluation including assessment of pain, strength, walking, balance, transfers, limitations in everyday life, and most importantly your own personal goals. The Physical Therapist will also discuss a home exercise program, as well as, different modalities you will receive in the subsequent visits. Depending on your current level of function and surgical or non-surgical approach, these may vary.
STRENGTHENING EXERCISES
First few weeks will include lower extremity exercises while laying down or sitting; Progress towards more advanced exercises in standing GAIT TRAINING Use of Crutches or other Assistive Device on level surfaces and stairs; progressing towards increasing weight-bearing status on involved lower extremity about 6 weeks after surgery This video provides detailed instructions on the proper safe and effective use of crutches |
PAIN RELIEF TECHNIQUES
These include electrotherapy, ice, heat, massage, hydrotherapy, joint movements, and mobilization. SCAR MASSAGE (if applicable): After surgery, long and deep scars develop that may cause adhesions to the skin and soft tissue. These can cause pain and limit range of motion. Scar massage will help keep the scar mobile and prevent these complications. A good guideline to follow is that your scar should move like a wrinkle in your skin. BALANCE TRAINING Once you are cleared for full weight bearing, these activities will help facilitate reaching outside your comfort level and reducing risk of falls AQUATIC THERAPY Once wounds are healed, aquatic therapy is a great option to have. The buoyancy and gravity-reduced environment will make it easier to perform every day movements, such as walking and exercises, while the water resistance will also facilitate muscle strengthening. |
Please view the slideshow below for a quick and easy guide to know what to expect during rehab after limb sparing surgery
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