{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T10:40:25Z","timestamp":1758710425265,"version":"3.44.0"},"reference-count":40,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T00:00:00Z","timestamp":1746403200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Osseointegration (OI) has become an increasingly popular option for people with amputations around the world. However, limited information is available regarding the rehabilitation protocols before and after OI surgery, particularly for the civilian population who face several constraints.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the effectiveness of a civilian\u2010focused, goal\u2010directed rehabilitation protocol for patients with transfemoral amputation receiving a screw\u2010type OI prosthesis to optimize functional outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A retrospective cohort study of patients with transfemoral amputation who received OI surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>A national rehabilitation innovation center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Ten patients treated by the same orthopedic surgeon using the Osseoanchored Prostheses for the Rehabilitation of Amputees (OPRA) system were included in this study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prehabilitation and rehabilitation protocols for the civilian population were developed, which outlined week\u2010by\u2010week, progressive rehabilitation goals before and longitudinally after the OI surgery. After Stage 2 of the surgery, patient outcome was evaluated using outcome measures at 6\u2009months and 1\u2009year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>On average, the number of rehabilitation sessions received by the patients was 15.9\u2009\u00b1\u20094.5 at 6\u2009months, which increased to 26.7\u2009\u00b1\u200910.2 at 1\u2009year. There were significant improvements in the Amputee Mobility Predictor (37.9\u2009\u00b1\u20095.0 vs. 38.9\u2009\u00b1\u20094.8, <jats:italic>p<\/jats:italic>\u2009=\u2009.003), 6\u2010Minute Walk Test (225.3 \u00b1 118.5 vs. 264.0 \u00b1143.3 m, <jats:italic>p<\/jats:italic>\u2009=\u2009.02), and 10\u2009M fast walk (11.9\u2009\u00b1\u20093.5 vs. 9.3\u2009\u00b1\u20092.4\u2009seconds, <jats:italic>p<\/jats:italic>\u2009=\u2009.03). The 10\u2010M self\u2010paced walk test reduced from 19.5\u2009\u00b1\u20099.9\u2009seconds at 6\u2009months to 12.1\u2009\u00b1\u20094.7\u2009seconds at 1\u2009year, although the difference was insignificant (<jats:italic>p<\/jats:italic>\u2009=\u2009.20). At the conclusion of the study, all patients were walking post OI surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Given the constraints faced by civilians with transfemoral amputation, we proposed a rehabilitation protocol for the population who received OI prostheses. Critical clinical milestones were presented to guide rehabilitation progression. Initial results showed improvements in certain outcome measures between 6\u2009months and 12\u2009months following Stage 2 surgery. However, long\u2010term randomized control studies are needed to further validate its efficacy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pmrj.13385","type":"journal-article","created":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T09:43:45Z","timestamp":1746438225000},"page":"1026-1033","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A goal\u2010directed rehabilitation protocol for people with transfemoral amputation receiving osseointegration prostheses"],"prefix":"10.1002","volume":"17","author":[{"given":"Kristin","family":"Reeves","sequence":"first","affiliation":[{"name":"TIRR Memorial Hermann Hospital  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1311-0658","authenticated-orcid":false,"given":"Shuyang","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, McGovern Medical School University of 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