15:I[36083,["/_next/static/immutable/chunks/17aj78p4e3m5m.js","/_next/static/immutable/chunks/2a09gnc6jeu92.js","/_next/static/immutable/chunks/325-rr7592sd-.js"],"default"] 16:I[64571,["/_next/static/immutable/chunks/17aj78p4e3m5m.js","/_next/static/immutable/chunks/2a09gnc6jeu92.js","/_next/static/immutable/chunks/325-rr7592sd-.js"],"default"] 17:Tba0,ETM 01 Bewegungstherapie Therapeutische Inhalte Ziele gewichtet in Abhängigkeit von den individuellen Voraussetzungen: • Anbahnung, Übung und Training zur (Wieder-)Herstellung von physischen Funktionen, Belastbarkeit und Trainierbarkeit (z. B. Therapie zur Verbesserung von Gleichgewicht, Gangsicherheit und –symmetrie) • Stärkung physischer Ressourcen/Funktionen (insbesondere aerobe Ausdauer) und Vermittlung von Aktivitäten (z. B. ADL, sport- und berufsbezogene Bewegungskompetenzen) • Stärkung psychischer und sozialer Ressourcen durch positive und nachhaltig umsetzbare Bewegungserfahrungen, bewegungsbezogene Selbstwirksamkeitserfahrungen, Aufbau von Bewegungs- und Steuerungskompetenz zur Bindung an einen körperlich aktiven Lebensstil. Formale Ausgestaltung Mindestdauer pro Woche: Mindesthäufigkeit pro Woche: mind. 360 Minuten mind. 5 mal KTL- Leistungs- einheiten A011 Ausdauertraining mit Belastungsmonitoring Bereich 1 A012 Ausdauertraining ohne Belastungsmonitoring Bereich 1 A021 Muskelkrafttraining an Krafttrainingsgeräten Bereich 2 A029 Sonstiges Muskelkrafttraining Bereich 2 A031 Arbeitsplatzbezogenes Muskelkrafttraining Bereich 2 A041 Koordinationstraining Bereich 3 A051 Spielorientierte Sport- und Bewegungstherapie Bereich 3 A061 Spezifisch ausgerichtete Sport- und Bewegungstherapie orientiert an der Krankheit Bereich 3 A062 Spezifisch ausgerichtete Sport- und Bewegungstherapie orientiert an den Anforderungen des Arbeitsplatzes Bereich 3 A069 Spezifisch ausgerichtete Sport- und Bewegungstherapie orientiert an sonstigen Anforderungen Bereich 3 A071 Psychomotorische Therapie Bereich 3 A081 Sport- und Bewegungstherapie mit psychischer Zielsetzung Bereich 3 A091 Achtsamkeits- und wahrnehmungsorientierte Sport- und Bewegungstherapie Bereich 3 B011 Physiotherapeutische Behandlung Bereich 3 B012 Physiotherapeutische Behandlung erkrankungsspezifisch: Atemwegskrankheiten Bereich 3 B013 Physiotherapeutische Behandlung erkrankungsspezifisch: Herz-Kreislauf-Krankheiten Bereich 3 B014 Physiotherapeutische Behandlung erkrankungsspezifisch: Muskuloskelettale Krankheiten Bereich 3 B015 Physiotherapeutische Behandlung erkrankungsspezifisch: Onkologische Krankheiten Bereich 3 B016 Physiotherapeutische Behandlung erkrankungsspezifisch: Neurologische Krankheiten Bereich 3 B019 Physiotherapeutische Behandlung erkrankungsspezifisch: Sonstige Krankheiten Bereich 3 B021 Physiotherapeutische Behandlung im Bewegungsbad Bereich 3 B031 Hippotherapie Bereich 3 L011 Individualsportarten Bereich 3 L012 Mannschaftssportarten und Bewegungsspiele Bereich 3 L019 Sonstige Bewegung und Sport in der Freizeit Bereich 3 Mindestanteil entsprechend zu behandelnder Rehabilitand*innen mind. 90 % Weitere Hinweise Das ETM „Bewegungstherapie“ wird in drei Bereiche (1: Ausdauerorientierte Aktivitäten; 2: Muskelkräftigung und Funktionstraining; 3: Förderung der Bewegungsorientierung) unterteilt und eine Bedienung aller drei Bereiche gefordert.18:T9f7,ETM 02 Psychologische Interventionen Therapeutische Inhalte Klärung und Bearbeitung psychischer Belastungen und Problemkonstellationen sowie daraus resultierender Beanspruchungen im Berufs- und Alltagsleben, Aktivierung psychischer Ressourcen, Entwicklung einer realitätsangepassten, positiven Lebensperspektive, Akzeptanz und Umgang mit unabänderlichen bzw. langfristigen Krankheitsfolgen, Intervention bei begleitenden psychischen Störungen und Bahnung angemessener Weiterbehandlungsoptionen für die Zeit nach der Rehabilitation. Formale Ausgestaltung Mindestdauer pro Rehabilitation: mind. 60 Minuten KTL- Leistungs- einheiten F011 Psychologische Beratung in Konfliktsituationen F012 Psychologische Beratung bei berufsbezogenen Problemlagen F013 Psychologische Beratung zur Besprechung von Testergebnissen F014 Psychologische Beratung zu allgemeinen Problemstellungen F015 Orientierende psychologische Beratung F021 Psychologische Gruppenarbeit störungsspezifisch F031 Psychologische Gruppenarbeit problemorientiert: Stressbewältigung F032 Psychologische Gruppenarbeit problemorientiert: Schlaftraining F034 Psychologische Gruppenarbeit problemorientiert: Schmerzbewältigung F035 Psychologische Gruppenarbeit problemorientiert: Umgang mit Angst und Traurigkeit F039 Sonstige Gruppenarbeit problemorientiert F041 Psychoedukative Gruppenarbeit G011 Psychotherapie G012 Psychotherapeutische Krisenintervention G013 Themenspezifische Psychotherapie: Körperzentrierte Therapie G014 Themenspezifische Psychotherapie: Expositionstraining G015 Themenspezifische Psychotherapie: Training sozialer Kompetenzen G016 Themenspezifische Psychotherapie: Problemlösetraining G017 Themenspezifische Psychotherapie: Arbeitswelt G019 Themenspezifische Psychotherapie: Sonstige Themen G021 Psychotherapie als indikative Gruppe: Abhängigkeitsproblematik G022 Psychotherapie als indikative Gruppe: Affektive Störungen G023 Psychotherapie als indikative Gruppe: Ängste G024 Psychotherapie als indikative Gruppe: Zwänge G025 Psychotherapie als indikative Gruppe: Somatoforme Störungen G026 Psychotherapie als indikative Gruppe: Schmerz G027 Psychotherapie als indikative Gruppe: Essstörungen G028 Psychotherapie als indikative Gruppe: Persönlichkeitsstörungen G029 Sonstige Psychotherapie als indikative Gruppe G051 Angehörigengespräch psychotherapeutisch orientiert G061 Angehörigenseminar psychotherapeutisch orientiert G071 Paartherapie bzw. Familientherapie Mindestanteil entsprechend zu behandelnder Rehabilitand*innen mind. 30 % Weitere Hinweise19:T551,ETM 03 Schulung Therapeutische Inhalte Bio-psycho-sozial ausgerichtete Schulungsangebote, mit Schwerpunkten auf der Hauptindikation und/ oder relevanten Komorbiditäten. Die Schulungen sollten Krankheits- und Behandlungswissen sowie den Umgang mit Krankheit(-sfolgen) im Beruf und Alltag umfassen und die Krankheitsbewältigung unterstützen. Die Schulungsangebote sollten zudem die Motivation zur Mitwirkung und Eigenverantwortlichkeit fördern und möglichst aktivierende Methoden beinhalten, beispielsweise Strategien zur Zielsetzung, Planung und Selbstbeobachtung sowie die Anwendung von Feedbackverfahren und motivierender Gesprächsführung. Formale Ausgestaltung Mindestdauer pro Rehabilitation: mind. 90 Minuten KTL- Leistungs- einheiten C101 aktive Rückenschule C111 Schulung bei Endoprothesen-Versorgung C119 Schulung bei sonstigen Krankheiten des Haltungs- und Bewegungsapparats C121 Schulung bei chronischem Schmerz C131 Schulung bei Diabetes Typ I C132 Schulung bei Diabetes Typ II C133 Schulung bei Adipositas C141 Schulung bei Hypertonie C241 Schulung bei depressiven Störungen C242 Schulung bei Angststörungen C243 Schulung bei Abhängigkeitskrankheiten C249 Schulung bei sonstigen psychischen und Verhaltensstörungen C251 Schulung zu Erziehungsfragen Mindestanteil entsprechend zu behandelnder Rehabilitand*innen mind. 70 % Weitere Hinweise1a:T5f1,ETM 04 Gesundheitsbildung Therapeutische Inhalte Bedeutung der Lebensstilfaktoren soll in Seminaren zu gesundheitsbezogenen Themen verdeutlicht werden. Das Ziel ist Informationen zu modifizierbaren Risikofaktoren zu geben und Motivation z. B. durch Förderung der Eigeninitiative zu stärken. Ergänzend können Beratung, Anleitung und Vortrag genutzt werden, um vorteilhaftes Gesundheitsverhalten zu fördern. Formale Ausgestaltung Mindestdauer pro Rehabilitation: mind. 75 Minuten KTL- Leistungs- einheiten C012 Ärztliche Beratung zu Krankheit und Therapie C021 Angehörigengespräch krankheitsbezogen C041 Vortrag: Schutz- und Risikofaktoren C042 Vortrag: Gesunde Ernährung C043 Vortrag: Bewegung und körperliches Training C044 Vortrag: Stress und Stressbewältigung C051 Vortrag: Krankheitsspezifische Information C062 Vortrag: Medizinisch-beruflich orientierte Rehabilitation (MBOR) C063 Vortrag: Verhaltensorientierte Rehabilitation (VOR) C065 Vortrag: Sonstige Rehabilitationskonzepte C071 Seminar: Motivationsförderung und Selbstmanagement C081 Seminar: Schutz- und Risikofaktoren C083 Seminar: Bewegung und körperliches Training C084 Seminar: Stress und Stressbewältigung C089 Seminar: Sonstige Gesundheitsinformation und -förderung Mindestanteil entsprechend zu behandelnder Rehabilitand*innen mind. 70 % Weitere Hinweise Maximal ein Vortrag (30 Minuten) geht in die Erfüllung des ETM „Gesundheitsbildung“ ein. Reha-Therapiestandards Hüft- und Knie-TEP Evidenzbasierte Therapiemodule (ETM) KTL 20251b:T60b,ETM 06 Funktionelle und arbeitsweltbezogene Therapien Therapeutische Inhalte Auf individuellen Bedarf, Ressourcen, Kontextfaktoren, Motivationslage und Leistungsgrenzen abgestimmte Interventionen v.a. zum Training von Fertigkeiten, Selbstwirksamkeit und Durchhaltevermögen mit Bezug zu individuell relevanten Tätigkeiten im Bereich Beruf (z. B. konkrete körperliche Anforderungen) und/oder Alltag (z. B. ADL, Gehfähigkeit). Stufenweise Heranführung an die Grundanforderungen des Alltags- und Arbeitslebens, Konsolidierung basaler Arbeitsfähigkeiten und je nach Berufsfeld, Arbeitsplatz und Arbeitssituation Stärkung der beruflichen Handlungskompetenz. Formale Ausgestaltung Mindestdauer pro Woche: mind. 60 Minuten KTL- Leistungs- einheiten E011 Arbeitstherapie berufsfeldspezifisch E012 Arbeitstherapie berufsfeldübergreifend E021 Arbeitsplatztraining E031 Verhaltensbeobachtung zur arbeitsbezogenen Leistungsbeurteilung E041 Interne Belastungserprobung E042 Externe Belastungserprobung E051 Bilanzierungsgespräch bei externem Arbeitsplatzpraktikum E061 Ergotherapeutische Behandlung: psychisch-funktionell, psychosozial E062 Ergotherapeutische Behandlung: sensomotorisch-perzeptiv E063 Ergotherapeutische Behandlung: motorisch-funktionell E069 Sonstige ergotherapeutische Behandlung E071 Ergotherapeutische Behandlung produktorientiert E082 Arbeitsplatzbesuch E111 Projektgruppe H271 Berufsbezogene Qualifizierungsangebote H272 Bewerbungstraining Mindestanteil entsprechend zu behandelnder Rehabilitand*innen mind. 50 % Weitere Hinweise1c:T57b,ETM 09 Leistungen zur sozialen und beruflichen Integration Therapeutische Inhalte Beratung zu sozialen, beruflichen und sozialrechtlichen Themen sowie Angebote zur Unterstützung bei sozialen oder beruflichen Problemlagen inkl. Abgleich von beruflichen und arbeitsbezogenen Anforderungen und aktuellem Fähigkeitsprofil, Förderung der Eingliederung ins Erwerbsleben Formale Ausgestaltung Mindestdauer pro Rehabilitation: mind. 45 Minuten KTL- Leistungs- einheiten C011 Ärztliche sozialmedizinische Beratung C031 Gespräche mit Rehabilitand und Betriebsangehörigen D011 Psychosoziale Beratung D012 Sozialrechtliche Beratung D013 Orientierende Sozialberatung D021 Beratung zu Leistungen zur Teilhabe am Arbeitsleben D022 Beratung zur stufenweisen Wiedereingliederung D023 Beratung zu beruflichen Perspektiven und Berufsklärung D029 Sonstige Beratung zur beruflichen Integration D041 Soziale Arbeit: Umgang mit beruflichen Belastungen und Konflikten am Arbeitsplatz D043 Soziale Arbeit: Berufliche Orientierung und berufliche Integration D045 Soziale Arbeit: Sozialrechtliche Fragen D046 Soziale Arbeit: Training der sozialen Kompetenz D049 Sonstige soziale Arbeit D051 Angehörigengespräch psychosozial Mindestanteil entsprechend zu behandelnder Rehabilitand*innen mind. 70 % Weitere Hinweise z. B. Fragen zu wirtschaftlicher Sicherung, Rentenfragen, Klärung sozialrechtlicher Fragen, Wohnungsfragen1d:T4aa,ETM 10 Beratung nachgehender Leistungen Therapeutische Inhalte Beratung zu geeigneten nach- und weitergehenden Maßnahmen zur Stabilisierung des Behandlungserfolgs; Informationsvermittlung zu Angeboten der Reha-Nachsorge und des Fallmanagements, sowie mögliche individuelle oder organisierte Aktivitäten und Selbsthilfemöglichkeiten, die Lebensstiländerungen und Krankheitsbewältigung unterstützen sowie Anbahnung von Kontaktgesprächen zu Vor- und Nachbehandler*innen. Formale Ausgestaltung Mindestdauer pro Rehabilitation: mind. 30 Minuten KTL- Leistungs- einheiten D031 Beratung zu ambulanten bzw. stationären Hilfen und Pflege D032 Abstimmung zu Kontakt- und Informationsgesprächen mit Vor- und Nachbehandlern D033 Beratung zu Nachsorgeangeboten, Selbsthilfegruppen und externen Beratungsstellen D039 Sonstige Beratung zu Nachsorge und weitergehenden Maßnahmen D044 Soziale Arbeit: Nachsorge und weitergehende Maßnahmen Mindestanteil entsprechend zu behandelnder Rehabilitand*innen mind. 80 % Weitere Hinweise Jede Abstimmung oder Anleitung geht maximal einmal in die Erfüllung der RTS ein. Reha-Therapiestandards Hüft- und Knie-TEP Evidenzbasierte Therapiemodule (ETM) KTL 20251e:T43e,ETM 11 Alltagstraining Therapeutische Inhalte Gezieltes Training zur Verbesserung der Alltagsaktivitäten, Wiederherstellung/ Verbesserung oder Erhalt der körperlichen Selbstversorgung oder der eigenständigen Lebensführung. Lernen, mit Hilfsmitteln und Einschränkungen umzugehen und die Krankheit/Behinderung in das Leben zu integrieren. Formale Ausgestaltung Mindestdauer pro Woche: mind. 30 Minuten KTL- Leistungs- einheiten E081 Hausbesuch E091 Training der Aktivitäten des täglichen Lebens E101 Hilfsmittelanpassung und -versorgung E102 Hilfsmittelberatung E103 Hilfsmitteltraining E109 Sonstige hilfsmittelbezogene Therapie H021 Anleitung zu Aktivitäten des täglichen Lebens H049 Anleitung zur Durchführung sonstiger physikalischer Therapieverfahren H081 Anleitung zur Wundversorgung oder Narbenpflege H201 Supportives Gespräch L031 Gestalterisch-kreative Therapie L041 Gemeinsames Kochen und Genuss Mindestanteil entsprechend zu behandelnder Rehabilitand*innen mind. 50 % Weitere Hinweise Jede Abstimmung oder Anleitung geht maximal einmal in die Erfüllung der RTS ein.1f:T458,ETM 12 Physikalische Therapie Therapeutische Inhalte Physikalisch-therapeutische Behandlung von Haut, Bindegewebe und Muskeln durch Druck- und Zugreize mit dem Ziel der Detonisierung, Verbesserung von Sensibilitätsstörungen, Schmerzlinderung, Schmerzprävention und neuroreflektiver Fernwirkungen. Anwendung in Kombination mit aktivierenden Maßnahmen. Formale Ausgestaltung Mindestdauer pro Woche: mind. 80 Minuten KTL- Leistungs- einheiten H041 Anleitung zur Elektrostimulation H151 Topische Therapie K011 Ganzkörper-Kältetherapie K021 Lokale Kältebehandlung K022 Lokale Wärmebehandlung K051 Elektrotherapie K052 Ultraschalltherapie K081 Klassische Massage K092 Bindegewebsmassage K099 Sonstige Reflexzonenmassage K101 Unterwasser-Druckstrahlmassage K131 Manuelle Lymphdrainage mit Bandagierung K132 Manuelle Lymphdrainage ohne Bandagierung K141 Apparative Lymphdrainage K151 Gerätegestützte Mobilisation K173 Kompressionstherapie Mindestanteil entsprechend zu behandelnder Rehabilitand*innen mind. 50 % Weitere Hinweise Jede Abstimmung oder Anleitung geht maximal einmal in die Erfüllung der RTS ein.20:T43c,CPM ab 0–60°, wöchentlich um 10° bis 90° steigern; Narbenmassage; passiver Bewegungsumfang bei vollständiger Entspannung von Adduktoren, Iliopsoas und TFL; partnerassistierter Bewegungsumfang zu Hause 2× täglich je 15 Minuten: je 5 Minuten Zirkumduktion im und gegen den Uhrzeigersinn bei 30° Hüftflexion sowie Log Rolls in voller Extension; therapeutisch assistierte Zirkumduktion 10 Minuten in beide Richtungen bei 70° Flexion; tägliche Längstraktion; ab Woche 2 Quadrizeps-, Gluteal- und Transversus-abdominis-Anspannungen mit Therapeut und zu Hause 2× täglich; Gewichtsverlagerung 50 %, 75 % und 100 % in den Wochen 1–3 ohne Beckensenkung; Hüftextension in Rückenlage beidbeinig in Woche 1–2 und einbeinig ab Woche 3; Clamshells und Abduktion im Stand ohne Beckensenkung; tägliche Weichteilmobilisation, Piriformis- und Rectus-femoris-Dehnung, Quadruped Rocking sowie Thomas-Dehnung ab Woche 3; Wassertherapie mit Fersen-Zehen-Gang 15 Minuten, Progression der Wassertiefe, Rückwärtsgehen ab Woche 2, kurzen Kniebeugen bis 30° und Abduktion 3×20 je Bein.21:T413,CPM from 0-60°, increasing 10° each week to 90°; scar massage; passive range of motion with complete relaxation of the adductors, iliopsoas and TFL; partner-assisted home range of motion twice daily for 15 minutes: 5 minutes each of clockwise and counterclockwise circumduction at 30° hip flexion and log rolls in full extension; therapist-assisted circumduction for 10 minutes in both directions at 70° flexion; daily straight-leg distraction; from week 2, quadriceps, gluteal and transverse-abdominis sets with the therapist and at home twice daily; weight transfer of 50%, 75% and 100% in weeks 1-3 without pelvic drop; supine hip extension with both feet in weeks 1-2 and single-leg from week 3; clamshells and standing abduction without pelvic drop; daily soft-tissue mobilization, piriformis and rectus-femoris stretching, quadruped rocking and Thomas stretch from week 3; aquatic therapy with heel-to-toe gait for 15 minutes, water-depth progression, backward walking from week 2, short squats to 30° and abduction 3×20 each leg.22:T485,CPM od 0–60°, zwiększając o 10° tygodniowo do 90°; masaż blizny; bierny zakres ruchu przy pełnym rozluźnieniu przywodzicieli, mięśnia biodrowo-lędźwiowego i TFL; wspomagany przez partnera ROM w domu 2× dziennie po 15 minut: po 5 minut krążenia zgodnie i przeciwnie do ruchu wskazówek zegara przy zgięciu biodra 30° oraz log roll w pełnym wyproście; terapeuta wykonuje 10 minut krążenia w obu kierunkach przy zgięciu 70°; codzienna trakcja w osi kończyny; od 2. tygodnia napięcia mięśnia czworogłowego, pośladkowych i poprzecznego brzucha z terapeutą i w domu 2× dziennie; transfer ciężaru 50%, 75% i 100% odpowiednio w tygodniach 1–3 bez opadania miednicy; wyprost biodra w leżeniu tyłem obunóż w tygodniach 1–2 i jednonóż od tygodnia 3; clamshell i odwodzenie w staniu bez opadania miednicy; codzienna mobilizacja tkanek miękkich, rozciąganie gruszkowatego i prostego uda, quadruped rocking oraz rozciąganie Thomasa od 3. tygodnia; terapia w wodzie: chód pięta–palce 15 minut, progresja głębokości wody, chód tyłem od tygodnia 2, krótkie przysiady do 30° i odwodzenie 3×20 na każdą kończynę.23:T413,CPM from 0-60°, increasing 10° each week to 90°; scar massage; passive range of motion with complete relaxation of the adductors, iliopsoas and TFL; partner-assisted home range of motion twice daily for 15 minutes: 5 minutes each of clockwise and counterclockwise circumduction at 30° hip flexion and log rolls in full extension; therapist-assisted circumduction for 10 minutes in both directions at 70° flexion; daily straight-leg distraction; from week 2, quadriceps, gluteal and transverse-abdominis sets with the therapist and at home twice daily; weight transfer of 50%, 75% and 100% in weeks 1-3 without pelvic drop; supine hip extension with both feet in weeks 1-2 and single-leg from week 3; clamshells and standing abduction without pelvic drop; daily soft-tissue mobilization, piriformis and rectus-femoris stretching, quadruped rocking and Thomas stretch from week 3; aquatic therapy with heel-to-toe gait for 15 minutes, water-depth progression, backward walking from week 2, short squats to 30° and abduction 3×20 each leg.24:T4e8,Gelenkorthese mit eingeschränkter Extension: Woche 2: 90° bis vollständige Flexion; Woche 3: 45° bis vollständige Flexion; Woche 4: 30° bis vollständige Flexion; Woche 5: 20° bis vollständige Flexion; Woche 6: Gelenkorthese absetzen; Schwellungsmanagement: Eis, Kompression und Hochlagerung, Kältetherapie mit dem Arzt abstimmen; retrograde Massage; Woche 2: Ellenbogenflexions/-extensions-PROM innerhalb der Orthese; Unterarmpronations/-supinations-PROM bei 90° Ellenbogenflexion in der Orthese; bei Bedarf Schulter-AROM ohne Hyperextension; AROM von Handgelenk und Hand; Woche 3: Ellenbogen- und Unterarm-PROM wie oben; Woche 4: Ellenbogenflexions/-extensions-AROM in schwerkraftreduzierter Ebene sowie Unterarmpronations/-supinations-AROM bei 90° Flexion mit Unterarmstütze; Woche 5: Ellenbogenflexions-AROM in schwerkraftreduzierter Ebene und anschließend gegen die Schwerkraft, Orthese für AROM abnehmen, wenn der Bewegungsumfang vollständig und schmerzfrei ist, sowie Unterarmpronations/-supinations-AROM ohne Stütze; Progressionskriterien: ausreichende Kontrolle von Schmerzen und Ödem sowie vollständige AROM von Ellenbogen und Pronation/Supination gegen die Schwerkraft ohne Orthese und ohne Zunahme von Schmerz oder Schwellung.25:T55f,Hinged elbow brace set locked to allow restricted extension ROM: 2nd week: 90 degrees to full flexion; 3rd week: 45 degrees to full flexion; 4th week: 30 degrees to full flexion; 5th week: 20 degrees to full flexion; 6th week: discharge hinged elbow brace; swelling management: ice, compression, elevation, check with MD regarding cold therapy; retrograde massage; Week 2: elbow flexion/extension PROM within confines of hinged elbow brace; forearm pronation/supination PROM with elbow at 90 degrees in hinged elbow brace; shoulder AROM as needed, avoiding hyper-extension; wrist and hand AROM; Week 3: elbow flexion/extension PROM within confines of hinged brace and forearm pronation/supination PROM with elbow at 90 degrees flexion in hinged elbow brace; Week 4: elbow flexion/extension AROM in gravity-eliminated plane and forearm pronation/supination AROM with elbow at 90 degrees flexion and forearm supported; Week 5: elbow flexion AROM in gravity-eliminated plane progressing to against gravity, removing brace for AROM if full and painless against gravity, and forearm pronation/supination AROM with elbow at 90 degrees flexion without support; progression criteria: adequate maintenance of post-operative pain and edema control and full elbow flexion AROM and forearm pronation/supination AROM against gravity, without brace, and without increased pain or swelling.26:T43d,Orteza zawiasowa ustawiona z ograniczonym wyprostem: tydzień 2: 90° do pełnego zgięcia; tydzień 3: 45° do pełnego zgięcia; tydzień 4: 30° do pełnego zgięcia; tydzień 5: 20° do pełnego zgięcia; tydzień 6: odstawienie ortezy zawiasowej; kontrola obrzęku: lód, kompresja i elewacja, po konsultacji z lekarzem w sprawie zimna; masaż retrogradacyjny; tydzień 2: PROM zgięcia/wyprostu łokcia w ortezie; PROM pronacji/supinacji przedramienia przy łokciu 90° w ortezie; AROM barku w razie potrzeby bez nadmiernego wyprostu; AROM nadgarstka i dłoni; tydzień 3: PROM łokcia i przedramienia jak wyżej; tydzień 4: AROM zgięcia/wyprostu łokcia w płaszczyźnie odciążonej grawitacyjnie oraz AROM pronacji/supinacji z podparciem; tydzień 5: zgięcie łokcia AROM od płaszczyzny odciążonej do przeciwgrawitacyjnej, z usunięciem ortezy przy pełnym i bezbolesnym ruchu oraz AROM pronacji/supinacji bez podparcia; kryteria progresji: prawidłowa kontrola bólu i obrzęku oraz pełny AROM łokcia i pronacji/supinacji bez ortezy, bez nasilenia bólu lub obrzęku.27:T52c,2nd week: 90 degrees to full flexion; 3rd week: 45 degrees to full flexion; 4th week: 30 degrees to full flexion; 5th week: 20 degrees to full flexion; 6th week: discharge hinged elbow brace; Ice, compression, elevation (check with MD re: cold therapy); Retrograde massage; Week 2: Elbow flexion/extension PROM within confines of hinged elbow brace; Forearm pronation/supination PROM with elbow at 90 degrees, in hinged elbow brace; Shoulder AROM as needed, avoiding hyper-extension; Wrist and hand AROM; Week 3: Elbow flexion/extension PROM within confines of hinged brace; Forearm pronation/supination PROM with elbow at 90 degrees flexion in hinged elbow brace; Week 4: Elbow flexion/extension AROM in gravity-eliminated plane in hinged elbow brace; Forearm pronation/supination AROM with elbow at 90 degrees flexion and forearm supported; Week 5: Elbow flexion AROM in gravity-eliminated plane in hinged elbow brace, progressing to against gravity in hinged elbow brace, with removal of brace for AROM if full and painless against gravity; Forearm pronation/supination AROM with elbow at 90 degrees flexion without support; Adequate maintenance of post-operative pain and edema control; Full elbow flexion AROM and forearm pronation/supination AROM against gravity, without brace, and without increased pain or swelling.28:T44d,Woche 1: aktiver Bewegungsumfang von Hand, Handgelenk, Ellenbogen und Halswirbelsäule; Griff- und Handgelenkkräftigung; sehr vorsichtiger passiver Bewegungsumfang in Rückenlage: Flexion bis 90° und Außenrotation bis 30°; physikalische Maßnahmen nach Bedarf. Woche 2: Wärmepackungen vor den Übungen; Pendelübungen mit Kreisen nach innen und außen beginnen; Weichteilmobilisation; Außenrotation in Rückenlage mit Stab bis 30°, Ellenbogen auf einem gefalteten Handtuch und Schulter in 15° Abduktion unterstützt; Skapulastabilisation: Scapular Clocks und Skapularetraktion ohne Schulterextension. Wochen 3–5: aktiv-assistierte Bewegungen beginnen, wenn Schmerzen und Unsicherheit abnehmen; alle bisherigen Übungen fortsetzen; bei stabiler klinischer Situation vorsichtige aktiv-assistierte Flexion bis 140° in Rückenlage mit Stab, Unterstützung des Physiotherapeuten oder verschränkten Händen beginnen; Seilzugübung für Flexion nach Verträglichkeit; submaximale Isometrie für Außenrotation und Flexion; Flexion und Abduktion auf dem Gleitbrett zum Tisch nach Verträglichkeit.29:T468,Tydzień 1: czynny zakres ruchu ręki, nadgarstka, łokcia i odcinka szyjnego; wzmacnianie chwytu i nadgarstka; bardzo delikatny bierny zakres ruchu w leżeniu tyłem: zgięcie do 90° i rotacja zewnętrzna do 30°; fizykoterapia według potrzeb. Tydzień 2: ciepłe okłady przed ćwiczeniami; rozpocząć ćwiczenia wahadłowe z krążeniem do wewnątrz i na zewnątrz; mobilizacja tkanek miękkich; rotacja zewnętrzna w leżeniu tyłem z laską do 30°, z łokciem podpartym na złożonym ręczniku i barkiem odwiedzionym do 15°; stabilizacja łopatki: zegar łopatkowy i retrakcja łopatki bez wyprostu barku. Tygodnie 3–5: rozpocząć czynny wspomagany zakres ruchu po zmniejszeniu bólu i obawy pacjenta; kontynuować wcześniejsze ćwiczenia; przy stabilnej sytuacji klinicznej rozpocząć delikatne czynne wspomagane zgięcie do 140° w leżeniu tyłem z laską, pomocą fizjoterapeuty lub splecionymi dłońmi; rozpocząć ćwiczenia z bloczkiem dla zgięcia w granicach tolerancji; submaksymalna izometria rotacji zewnętrznej i zgięcia; zgięcie i odwodzenie po desce ślizgowej do stołu w granicach tolerancji.c:["$","main",null,{"className":"app-container py-8 sm:py-10","children":[["$","$L15",null,{}],["$","$L16",null,{"protocols":[{"id":"02380220-76d1-5289-be83-b0956922e077","slug":"us-jared-lee-21-total-knee-arthroplasty","title_pl":"Protokół rehabilitacji po całkowitej endoprotezoplastyce stawu kolanowego","title_de":"Rehabilitationsprotokoll nach Knie-Totalendoprothese","title_en":"Total Knee Arthroplasty Rehabilitation Protocol","title_original":"TKA Rehabilitation","summary_pl":"Trzyfazowy protokół po całkowitej endoprotezoplastyce stawu kolanowego, obejmujący odzyskanie zakresu ruchu, normalizację chodu i progresję funkcjonalną.","summary_de":"Dreiphasiges Protokoll nach Knie-Totalendoprothese zur Wiederherstellung des Bewegungsumfangs, Normalisierung des Gangbilds und funktionellen Progression.","summary_en":"Three-phase protocol after total knee arthroplasty covering range-of-motion restoration, gait normalization and functional progression.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"c8a9eec5-8931-5e40-a677-405f3bb741ce","condition_slug":"total-knee-arthroplasty","condition_name_pl":"Artroplastyka całkowita stawu kolanowego (TKA)","condition_name_de":"Totale Knieendoprothetik (TKA)","condition_name_en":"Total Knee Arthroplasty (TKA)","condition_name_original":"Total Knee Arthroplasty (TKA)","icd_codes":[],"category_key":"knee","category_pl":"Ortopedia","category_de":"Orthopädie","category_en":"Orthopedics","body_regions_pl":["kolano"],"body_regions_de":["Knie"],"body_regions_en":["knee"],"search_terms_pl":["TKA","wymiana stawu kolanowego","endoproteza kolana","rehabilitacja po TEP","TEP kolana"],"search_terms_de":["Knie-TEP","Kniegelenkersatz","TKA","Knieendoprothese","Knierehabilitation"],"search_terms_en":["TKA","total knee replacement","knee arthroplasty","post-op knee rehab"],"source_document_id":"34bcbd4f-3c27-5006-8a00-272e635ba1cd","source_title":"TKA Rehabilitation","issuer":"Jared Lee, MD","source_country_code":"US","jurisdiction_code":"US-CO","authority_level":"clinic","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_requires_review","official_url":"https://jaredleemd.com/wp-content/uploads/2025/06/TKA-Rehabilitation-Protocol.pdf","source_sha256":"1f73205f41abecf0cd3776b2eb0afdbac3fd73270117a0bc0568bbefc486cf38","authorization_required":true,"license_note":"All Rights Reserved. Authorization is required before final public release. Current development and staging remain allowed by the owner's decision.","modules":[{"id":"7d3e0411-bcb6-5fa8-b78a-7820ae3a6093","name_de":"Phase 1: Wochen 0–2","name_en":"Phase 1: Weeks 0-2","name_pl":"Faza 1: tygodnie 0–2","source_page":1,"module_number":1,"name_original":"Phase 1: Weeks 0-2","service_codes":[],"structured_content":{"de":{"goals":["Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, den schmerzfreien Bewegungsumfang verbessern, tiefe Venenthrombosen verhindern und selbstständiges Gehen erreichen."],"exercises":["Wiederherstellung des vollständigen Bewegungsumfangs, wobei die vollständige Extension bis zum 14. postoperativen Tag erreicht sein muss","isometrische Quadrizepskräftigung","Fersengleiten, SAQ, LAQ, Anheben des gestreckten Beins und Fußpumpen","Fahrradergometer für den Bewegungsumfang ohne Widerstand","Rumpfkräftigung"],"applies_when":["Wochen 0–2"],"restrictions":["Kein Autofahren bis zum Absetzen der Opioidanalgetika."],"progression_criteria":["Ziel: Bewegungsumfang 0–90° bis zum 14. postoperativen Tag, mit besonderem Fokus auf vollständige Extension."],"dosage_and_progression":["Belastung nach Verträglichkeit.","Gehhilfe nach Verträglichkeit schrittweise ablegen."],"physiotherapist_actions":["TED-Kompressionsstrümpfe durchgehend tragen.","Den Aquacel-Verband bis zum 14. Tag nicht entfernen, außer er ist beschädigt oder durchnässt.","Ödemkontrolle","neuromuskuläre Elektrostimulation","manuelle Mobilisation der Patella und des Tibiofemoralgelenks","physikalische Maßnahmen nach Bedarf."]},"en":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, improve pain-free range of motion, prevent deep-vein thrombosis and achieve independent ambulation."],"exercises":["restore full range of motion, with full extension required by postoperative day 14","isometric quadriceps strengthening","heel slides, SAQ, LAQ, straight-leg raises and ankle pumps","stationary cycling for range of motion without resistance","core strengthening","manual patellar and tibiofemoral mobility"],"applies_when":["Weeks 0-2"],"restrictions":["Do not remove the Aquacel dressing until day 14 unless compromised or saturated.","Do not drive until narcotic pain medication is discontinued."],"progression_criteria":["Goal: range of motion 0-90° by postoperative day 14, with emphasis on full extension."],"dosage_and_progression":["Weight-bearing as tolerated.","Wean from the assistive device as tolerated."],"physiotherapist_actions":["Wear TED compression stockings at all times.","Edema control","neuromuscular electrical stimulation","modalities as needed."]},"pl":{"goals":["zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, poprawa bezbolesnego zakresu ruchu, zapobieganie zakrzepicy żył głębokich i samodzielne chodzenie."],"exercises":["odtworzenie pełnego zakresu ruchu, z obowiązkowym uzyskaniem pełnego wyprostu do 14. dnia po zabiegu","izometryczne wzmacnianie mięśnia czworogłowego","ślizgi pięty, SAQ, LAQ, unoszenie wyprostowanej kończyny i pompki stopy","rower stacjonarny dla zakresu ruchu bez oporu","wzmacnianie centralne"],"applies_when":["tygodnie 0–2"],"restrictions":["Nie usuwać opatrunku Aquacel do 14. dnia, chyba że jest uszkodzony lub przesiąknięty.","Nie prowadzić pojazdów do odstawienia leków opioidowych."],"progression_criteria":["Cel: zakres ruchu 0–90° do 14. dnia po zabiegu, ze szczególnym naciskiem na pełny wyprost."],"dosage_and_progression":["Obciążanie według tolerancji.","Stopniowo odstawiać pomoc do chodzenia według tolerancji."],"physiotherapist_actions":["Pończochy uciskowe TED przez cały czas.","Kontrola obrzęku","elektrostymulacja nerwowo-mięśniowa","manualna mobilizacja rzepki i stawu piszczelowo-udowego","fizykoterapia według potrzeb."]},"original":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, improve pain-free range of motion, prevent deep-vein thrombosis and achieve independent ambulation."],"exercises":["restore full range of motion, with full extension required by postoperative day 14","isometric quadriceps strengthening","heel slides, SAQ, LAQ, straight-leg raises and ankle pumps","stationary cycling for range of motion without resistance","core strengthening","manual patellar and tibiofemoral mobility"],"applies_when":["Weeks 0-2"],"restrictions":["Do not remove the Aquacel dressing until day 14 unless compromised or saturated.","Do not drive until narcotic pain medication is discontinued."],"progression_criteria":["Goal: range of motion 0-90° by postoperative day 14, with emphasis on full extension."],"dosage_and_progression":["Weight-bearing as tolerated.","Wean from the assistive device as tolerated."],"physiotherapist_actions":["Wear TED compression stockings at all times.","Edema control","neuromuscular electrical stimulation","modalities as needed."]}},"additional_notes_de":"Ziele: Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, den schmerzfreien Bewegungsumfang verbessern, tiefe Venenthrombosen verhindern und selbstständiges Gehen erreichen.","additional_notes_en":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, improve pain-free range of motion, prevent deep-vein thrombosis and achieve independent ambulation.","additional_notes_pl":"Cele: zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, poprawa bezbolesnego zakresu ruchu, zapobieganie zakrzepicy żył głębokich i samodzielne chodzenie.","minimum_patient_share":null,"therapeutic_content_de":"Ödemkontrolle; Wiederherstellung des vollständigen Bewegungsumfangs, wobei die vollständige Extension bis zum 14. postoperativen Tag erreicht sein muss; neuromuskuläre Elektrostimulation; isometrische Quadrizepskräftigung; Fersengleiten, SAQ, LAQ, Anheben des gestreckten Beins und Fußpumpen; Fahrradergometer für den Bewegungsumfang ohne Widerstand; Rumpfkräftigung; manuelle Mobilisation der Patella und des Tibiofemoralgelenks; physikalische Maßnahmen nach Bedarf.","therapeutic_content_en":"Edema control; restore full range of motion, with full extension required by postoperative day 14; neuromuscular electrical stimulation; isometric quadriceps strengthening; heel slides, SAQ, LAQ, straight-leg raises and ankle pumps; stationary cycling for range of motion without resistance; core strengthening; manual patellar and tibiofemoral mobility; modalities as needed.","therapeutic_content_pl":"Kontrola obrzęku; odtworzenie pełnego zakresu ruchu, z obowiązkowym uzyskaniem pełnego wyprostu do 14. dnia po zabiegu; elektrostymulacja nerwowo-mięśniowa; izometryczne wzmacnianie mięśnia czworogłowego; ślizgi pięty, SAQ, LAQ, unoszenie wyprostowanej kończyny i pompki stopy; rower stacjonarny dla zakresu ruchu bez oporu; wzmacnianie centralne; manualna mobilizacja rzepki i stawu piszczelowo-udowego; fizykoterapia według potrzeb.","minimum_requirements_de":"Belastung nach Verträglichkeit. TED-Kompressionsstrümpfe durchgehend tragen. Den Aquacel-Verband bis zum 14. Tag nicht entfernen, außer er ist beschädigt oder durchnässt. Kein Autofahren bis zum Absetzen der Opioidanalgetika. Gehhilfe nach Verträglichkeit schrittweise ablegen. Ziel: Bewegungsumfang 0–90° bis zum 14. postoperativen Tag, mit besonderem Fokus auf vollständige Extension.","minimum_requirements_en":"Weight-bearing as tolerated. Wear TED compression stockings at all times. Do not remove the Aquacel dressing until day 14 unless compromised or saturated. Do not drive until narcotic pain medication is discontinued. Wean from the assistive device as tolerated. Goal: range of motion 0-90° by postoperative day 14, with emphasis on full extension.","minimum_requirements_pl":"Obciążanie według tolerancji. Pończochy uciskowe TED przez cały czas. Nie usuwać opatrunku Aquacel do 14. dnia, chyba że jest uszkodzony lub przesiąknięty. Nie prowadzić pojazdów do odstawienia leków opioidowych. Stopniowo odstawiać pomoc do chodzenia według tolerancji. Cel: zakres ruchu 0–90° do 14. dnia po zabiegu, ze szczególnym naciskiem na pełny wyprost.","additional_notes_original":"Goals: Reduce swelling and edema, minimize pain, retard muscle atrophy, improve pain-free ROM, DVT prevention, independent ambulation","therapeutic_content_original":"Edema control; restore full range of motion, with full extension required by postoperative day 14; neuromuscular electrical stimulation; isometric quadriceps strengthening; heel slides, SAQ, LAQ, straight-leg raises and ankle pumps; stationary cycling for range of motion without resistance; core strengthening; manual patellar and tibiofemoral mobility; modalities as needed.","minimum_requirements_original":"Weight-bearing as tolerated. Wear TED compression stockings at all times. Do not remove the Aquacel dressing until day 14 unless compromised or saturated. Do not drive until narcotic pain medication is discontinued. Wean from the assistive device as tolerated. Goal: range of motion 0-90° by postoperative day 14, with emphasis on full extension.","structured_content_v2":"$undefined"},{"id":"0084b459-a561-5b59-8c59-fe808e07fec2","name_de":"Phase 2: Wochen 3–6","name_en":"Phase 2: Weeks 3-6","name_pl":"Faza 2: tygodnie 3–6","source_page":1,"module_number":2,"name_original":"Phase 2: Weeks 3-6","service_codes":[],"structured_content":{"de":{"goals":["Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, den Bewegungsumfang wiederherstellen und Selbstständigkeit bei Alltagsaktivitäten erreichen."],"exercises":["Vollständigen Bewegungsumfang wiederherstellen und das Übungsprogramm steigern","Einbeinstand, Vorwärts- und Seitwärts-Step-ups, Kniebeugung in Bauchlage und Fersenheben","Wassertherapie nach Abheilung der Inzision, etwa in der 4. postoperativen Woche","Schwerpunkt auf Bewegungsumfang des Knies, Gangnormalisierung sowie Hüftkraft und -stabilität","Rückkehr zu lockerem Bahnenschwimmen ohne Rollwende und Brustschwimmen möglich","Fahrradergometer oder Liege-Stepper mit minimalem Widerstand","Rumpfkräftigung."],"applies_when":["Wochen 3–6"],"restrictions":["Kein Autofahren bis zum Absetzen der Opioidanalgetika."],"progression_criteria":["Ziel: Bewegungsumfang 0–120° bis zur 6. postoperativen Woche und Erhalt der vollständigen Extension.","normalisiertes Gangbild","normalisierte Knieextension und Knieflexion bis mindestens 120°","Anheben des gestreckten Beins 2×10 ohne Extensionsdefizit","minimale oder keine reaktive Schmerz- und Schwellungszunahme bei Alltagsaktivitäten und Übungen","normalisierte Muskelaktivierung und -isolation."],"dosage_and_progression":["Belastung nach Verträglichkeit."]},"en":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, restore range of motion and achieve independence with activities of daily living."],"exercises":["Restore full range of motion and progress the exercise program","single-leg balance, forward and side step-ups, prone hamstring curls and heel raises","aquatic therapy after the incision has healed, at about 4 weeks postoperatively","focus on knee range of motion, gait normalization, and hip strength and stability","may return to easy lap swimming without flip turns or breaststroke","stationary bike or recumbent stepper with minimal resistance","core strengthening."],"applies_when":["Weeks 3-6"],"restrictions":["Do not drive until narcotic pain medication is discontinued."],"progression_criteria":["Goal: range of motion 0-120° by 6 weeks postoperatively and maintenance of full extension.","normalized gait pattern","normalized knee extension and knee flexion to at least 120°","straight-leg raise 2×10 without quadriceps lag","minimal to no reactive pain and swelling with activities of daily living and therapy exercises","normalized muscle activation and isolation."],"dosage_and_progression":["Weight-bearing as tolerated."]},"pl":{"goals":["zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, odtworzenie zakresu ruchu oraz samodzielność w czynnościach dnia codziennego."],"exercises":["Odtworzyć pełny zakres ruchu i progresywnie rozwijać program ćwiczeń","równowaga jednonóż, wejścia na stopień w przód i bokiem, zginanie kolana w leżeniu przodem oraz wspięcia na palce","terapia w wodzie po wygojeniu cięcia, około 4. tygodnia po zabiegu","nacisk na zakres ruchu kolana, normalizację chodu, siłę i stabilność biodra","możliwy powrót do spokojnego pływania bez nawrotów koziołkowych i stylu klasycznego","rower stacjonarny lub stepper poziomy z minimalnym oporem","wzmacnianie centralne."],"applies_when":["tygodnie 3–6"],"restrictions":["Nie prowadzić pojazdów do odstawienia leków opioidowych."],"progression_criteria":["Cel: zakres ruchu 0–120° do 6. tygodnia po zabiegu i utrzymanie pełnego wyprostu.","znormalizowany wzorzec chodu","znormalizowany wyprost i zgięcie kolana do co najmniej 120°","unoszenie wyprostowanej kończyny 2×10 bez deficytu wyprostu","minimalny lub nieobecny reaktywny ból i obrzęk podczas czynności dnia codziennego i ćwiczeń","znormalizowana aktywacja i izolacja mięśni."],"dosage_and_progression":["Obciążanie według tolerancji."]},"original":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, restore range of motion and achieve independence with activities of daily living."],"exercises":["Restore full range of motion and progress the exercise program","single-leg balance, forward and side step-ups, prone hamstring curls and heel raises","aquatic therapy after the incision has healed, at about 4 weeks postoperatively","focus on knee range of motion, gait normalization, and hip strength and stability","may return to easy lap swimming without flip turns or breaststroke","stationary bike or recumbent stepper with minimal resistance","core strengthening."],"applies_when":["Weeks 3-6"],"restrictions":["Do not drive until narcotic pain medication is discontinued."],"progression_criteria":["Goal: range of motion 0-120° by 6 weeks postoperatively and maintenance of full extension.","normalized gait pattern","normalized knee extension and knee flexion to at least 120°","straight-leg raise 2×10 without quadriceps lag","minimal to no reactive pain and swelling with activities of daily living and therapy exercises","normalized muscle activation and isolation."],"dosage_and_progression":["Weight-bearing as tolerated."]}},"additional_notes_de":"Ziele: Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, den Bewegungsumfang wiederherstellen und Selbstständigkeit bei Alltagsaktivitäten erreichen.","additional_notes_en":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, restore range of motion and achieve independence with activities of daily living.","additional_notes_pl":"Cele: zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, odtworzenie zakresu ruchu oraz samodzielność w czynnościach dnia codziennego.","minimum_patient_share":null,"therapeutic_content_de":"Vollständigen Bewegungsumfang wiederherstellen und das Übungsprogramm steigern; Einbeinstand, Vorwärts- und Seitwärts-Step-ups, Kniebeugung in Bauchlage und Fersenheben; Wassertherapie nach Abheilung der Inzision, etwa in der 4. postoperativen Woche; Schwerpunkt auf Bewegungsumfang des Knies, Gangnormalisierung sowie Hüftkraft und -stabilität; Rückkehr zu lockerem Bahnenschwimmen ohne Rollwende und Brustschwimmen möglich; Fahrradergometer oder Liege-Stepper mit minimalem Widerstand; Rumpfkräftigung.","therapeutic_content_en":"Restore full range of motion and progress the exercise program; single-leg balance, forward and side step-ups, prone hamstring curls and heel raises; aquatic therapy after the incision has healed, at about 4 weeks postoperatively; focus on knee range of motion, gait normalization, and hip strength and stability; may return to easy lap swimming without flip turns or breaststroke; stationary bike or recumbent stepper with minimal resistance; core strengthening.","therapeutic_content_pl":"Odtworzyć pełny zakres ruchu i progresywnie rozwijać program ćwiczeń; równowaga jednonóż, wejścia na stopień w przód i bokiem, zginanie kolana w leżeniu przodem oraz wspięcia na palce; terapia w wodzie po wygojeniu cięcia, około 4. tygodnia po zabiegu; nacisk na zakres ruchu kolana, normalizację chodu, siłę i stabilność biodra; możliwy powrót do spokojnego pływania bez nawrotów koziołkowych i stylu klasycznego; rower stacjonarny lub stepper poziomy z minimalnym oporem; wzmacnianie centralne.","minimum_requirements_de":"Belastung nach Verträglichkeit. Kein Autofahren bis zum Absetzen der Opioidanalgetika. Ziel: Bewegungsumfang 0–120° bis zur 6. postoperativen Woche und Erhalt der vollständigen Extension. Progressionskriterien: normalisiertes Gangbild; normalisierte Knieextension und Knieflexion bis mindestens 120°; Anheben des gestreckten Beins 2×10 ohne Extensionsdefizit; minimale oder keine reaktive Schmerz- und Schwellungszunahme bei Alltagsaktivitäten und Übungen; normalisierte Muskelaktivierung und -isolation.","minimum_requirements_en":"Weight-bearing as tolerated. Do not drive until narcotic pain medication is discontinued. Goal: range of motion 0-120° by 6 weeks postoperatively and maintenance of full extension. Progression criteria: normalized gait pattern; normalized knee extension and knee flexion to at least 120°; straight-leg raise 2×10 without quadriceps lag; minimal to no reactive pain and swelling with activities of daily living and therapy exercises; normalized muscle activation and isolation.","minimum_requirements_pl":"Obciążanie według tolerancji. Nie prowadzić pojazdów do odstawienia leków opioidowych. Cel: zakres ruchu 0–120° do 6. tygodnia po zabiegu i utrzymanie pełnego wyprostu. Kryteria progresji: znormalizowany wzorzec chodu; znormalizowany wyprost i zgięcie kolana do co najmniej 120°; unoszenie wyprostowanej kończyny 2×10 bez deficytu wyprostu; minimalny lub nieobecny reaktywny ból i obrzęk podczas czynności dnia codziennego i ćwiczeń; znormalizowana aktywacja i izolacja mięśni.","additional_notes_original":"Goals: Reduce swelling and edema, minimize pain, retard muscle atrophy, range of motion restoration, independent with ADLs","therapeutic_content_original":"Restore full range of motion and progress the exercise program; single-leg balance, forward and side step-ups, prone hamstring curls and heel raises; aquatic therapy after the incision has healed, at about 4 weeks postoperatively; focus on knee range of motion, gait normalization, and hip strength and stability; may return to easy lap swimming without flip turns or breaststroke; stationary bike or recumbent stepper with minimal resistance; core strengthening.","minimum_requirements_original":"Weight-bearing as tolerated. Do not drive until narcotic pain medication is discontinued. Goal: range of motion 0-120° by 6 weeks postoperatively and maintenance of full extension. Progression criteria: normalized gait pattern; normalized knee extension and knee flexion to at least 120°; straight-leg raise 2×10 without quadriceps lag; minimal to no reactive pain and swelling with activities of daily living and therapy exercises; normalized muscle activation and isolation.","structured_content_v2":"$undefined"},{"id":"74c7c932-1d0e-5436-be6f-d4027ea7cd8b","name_de":"Phase 3: Wochen 7–12","name_en":"Phase 3: Weeks 7-12","name_pl":"Faza 3: tygodnie 7–12","source_page":2,"module_number":3,"name_original":"Phase 3: Weeks 7-12","service_codes":[],"structured_content":{"de":{"goals":["vollständiger Bewegungsumfang, minimale Schmerzen, Steigerung des Übungswiderstands und Normalisierung der posturalen, Becken- und Bein-Kontrolle bei beid- und einbeinigen Aufgaben."],"exercises":["Wandkniebeugen, kleine Ausfallschritte, Progression der Step-ups bis einbeinig, Step-downs, Hüftübungen in 4 Richtungen, Beinpresse mit geringem Widerstand und hohen Wiederholungszahlen sowie Übungen für das Knie in offener Kette.","Ab Woche 8: vollständige Kniebeuge bis 70°, Seitwärtsschritte mit Band, Heel Taps, Gehen gegen Widerstand, fortgeschrittene Brücken sowie Progression von Einbeinstand und Gleichgewicht.","Rumpfkräftigung","Progression der Kräftigung der unteren Extremität zu multiplanaren Bewegungen mit Rumpf-, Hüft- und Kniekontrolle","Propriozeptionsprogression mit wechselnden Untergründen, Perturbationen und Bewegungen der oberen Extremität oder des Rumpfs","Progression zu sportartspezifischen Aufgaben","Richtungswechsel, Crossover und Carioca","zielgerechte plyometrische Übungen mit Medizinball und Schlitten","Seitwärtsschritte, Koordinationsleiter, Hütchen, Z- und W-Cuts sowie multiplanare sportartspezifische Übungen."],"applies_when":["Wochen 7–12"],"progression_criteria":["Freigabe durch den Operateur","Hamstring-Kraftindex >90 % gegenüber der Gegenseite","Quadrizeps-Kraftindex >90 %","Differenz der anterioren Reichweite im Y-Balance-Test <4 cm","keine Schmerzen oder Instabilität."],"dosage_and_progression":["Kräftigungsübungen und funktionelle Aufgaben dürfen gesteigert werden, sofern keine reaktiven Schmerzen oder kein Erguss auftreten.","Aerobe Kondition und Ausdauer steigern und dabei reaktive Ödeme überwachen."]},"en":{"goals":["full range of motion, minimal pain, increased exercise resistance, and normalized postural, pelvic and lower-extremity control during double- and single-leg tasks."],"exercises":["Wall squats, mini lunges, step-ups progressing to single-leg, step-downs, 4-way hip exercises, leg press with low resistance and high repetitions, and open-chain knee exercises.","At week 8: full squat to 70°, side steps with a band, heel taps, resisted walking, advanced bridges, and single-leg stance and balance progressions.","Core strengthening","progress lower-extremity strengthening to multiplanar movements emphasizing core stability and hip and knee control","progress proprioception with varied surfaces, perturbations, and upper-extremity or trunk movements","progress toward sport-specific tasks","cutting, crossover and carioca","goal-appropriate plyometric exercises with medicine-ball work and sled drills","shuffles, ladder footwork, cone drills, Z-cuts, W-cuts and multiplanar sport-specific drills."],"applies_when":["Weeks 7-12"],"progression_criteria":["surgeon clearance","hamstring strength index >90% versus the contralateral limb","quadriceps strength index >90%","Y-Balance anterior-reach difference <4 cm","no pain or instability.","Strengthening exercises and functional tasks may be progressed when there is no reactive pain or effusion."],"dosage_and_progression":["Increase aerobic conditioning and endurance while monitoring reactive edema."]},"pl":{"goals":["pełny zakres ruchu, minimalny ból, zwiększanie oporu ćwiczeń oraz normalizacja kontroli posturalnej, miednicy i kończyny dolnej w zadaniach obunóż i jednonóż."],"exercises":["Przysiady przy ścianie, małe wykroki, progresja wejść na stopień do wariantu jednonóż, zejścia ze stopnia, ćwiczenia biodra w 4 kierunkach, suwnica z małym oporem i dużą liczbą powtórzeń oraz ćwiczenia kolana w łańcuchu otwartym.","Od 8. tygodnia: pełny przysiad do 70°, kroki bokiem z taśmą, dotknięcia piętą, chód z oporem, zaawansowane mosty oraz progresja stania jednonóż i równowagi.","Wzmacnianie centralne","progresja wzmacniania kończyn dolnych do ruchów wielopłaszczyznowych z kontrolą tułowia, biodra i kolana","progresja propriocepcji przez zmienne podłoża, perturbacje i ruchy kończyn górnych lub tułowia","progresja do zadań specyficznych dla sportu","zmiany kierunku, crossover i carioca","odpowiednie do celów ćwiczenia plyometryczne z piłką lekarską i sankami","kroki odstawno-dostawne, drabinka koordynacyjna, pachołki, cięcia po torze Z i W oraz wielopłaszczyznowe ćwiczenia sportowe."],"applies_when":["tygodnie 7–12"],"progression_criteria":["zgoda chirurga","wskaźnik siły mięśni kulszowo-goleniowych >90% względem kończyny przeciwnej","wskaźnik siły mięśnia czworogłowego >90%","różnica przedniego zasięgu Y-Balance <4 cm","brak bólu lub niestabilności.","Można zwiększać trudność ćwiczeń wzmacniających i zadań funkcjonalnych, jeśli nie występuje reaktywny ból ani wysięk."],"dosage_and_progression":["Zwiększać kondycję tlenową i wytrzymałość, monitorując reaktywny obrzęk."]},"original":{"goals":["full range of motion, minimal pain, increased exercise resistance, and normalized postural, pelvic and lower-extremity control during double- and single-leg tasks."],"exercises":["Wall squats, mini lunges, step-ups progressing to single-leg, step-downs, 4-way hip exercises, leg press with low resistance and high repetitions, and open-chain knee exercises.","At week 8: full squat to 70°, side steps with a band, heel taps, resisted walking, advanced bridges, and single-leg stance and balance progressions.","Core strengthening","progress lower-extremity strengthening to multiplanar movements emphasizing core stability and hip and knee control","progress proprioception with varied surfaces, perturbations, and upper-extremity or trunk movements","progress toward sport-specific tasks","cutting, crossover and carioca","goal-appropriate plyometric exercises with medicine-ball work and sled drills","shuffles, ladder footwork, cone drills, Z-cuts, W-cuts and multiplanar sport-specific drills."],"applies_when":["Weeks 7-12"],"progression_criteria":["surgeon clearance","hamstring strength index >90% versus the contralateral limb","quadriceps strength index >90%","Y-Balance anterior-reach difference <4 cm","no pain or instability.","Strengthening exercises and functional tasks may be progressed when there is no reactive pain or effusion."],"dosage_and_progression":["Increase aerobic conditioning and endurance while monitoring reactive edema."]}},"additional_notes_de":"Ziele: vollständiger Bewegungsumfang, minimale Schmerzen, Steigerung des Übungswiderstands und Normalisierung der posturalen, Becken- und Bein-Kontrolle bei beid- und einbeinigen Aufgaben. Entlassungskriterien: Freigabe durch den Operateur; Hamstring-Kraftindex >90 % gegenüber der Gegenseite; Quadrizeps-Kraftindex >90 %; Differenz der anterioren Reichweite im Y-Balance-Test <4 cm; keine Schmerzen oder Instabilität.","additional_notes_en":"Goals: full range of motion, minimal pain, increased exercise resistance, and normalized postural, pelvic and lower-extremity control during double- and single-leg tasks. Discharge criteria: surgeon clearance; hamstring strength index >90% versus the contralateral limb; quadriceps strength index >90%; Y-Balance anterior-reach difference <4 cm; no pain or instability.","additional_notes_pl":"Cele: pełny zakres ruchu, minimalny ból, zwiększanie oporu ćwiczeń oraz normalizacja kontroli posturalnej, miednicy i kończyny dolnej w zadaniach obunóż i jednonóż. Kryteria wypisu: zgoda chirurga; wskaźnik siły mięśni kulszowo-goleniowych >90% względem kończyny przeciwnej; wskaźnik siły mięśnia czworogłowego >90%; różnica przedniego zasięgu Y-Balance <4 cm; brak bólu lub niestabilności.","minimum_patient_share":null,"therapeutic_content_de":"Wandkniebeugen, kleine Ausfallschritte, Progression der Step-ups bis einbeinig, Step-downs, Hüftübungen in 4 Richtungen, Beinpresse mit geringem Widerstand und hohen Wiederholungszahlen sowie Übungen für das Knie in offener Kette. Ab Woche 8: vollständige Kniebeuge bis 70°, Seitwärtsschritte mit Band, Heel Taps, Gehen gegen Widerstand, fortgeschrittene Brücken sowie Progression von Einbeinstand und Gleichgewicht. Rumpfkräftigung; Progression der Kräftigung der unteren Extremität zu multiplanaren Bewegungen mit Rumpf-, Hüft- und Kniekontrolle; Propriozeptionsprogression mit wechselnden Untergründen, Perturbationen und Bewegungen der oberen Extremität oder des Rumpfs; Progression zu sportartspezifischen Aufgaben; Richtungswechsel, Crossover und Carioca; zielgerechte plyometrische Übungen mit Medizinball und Schlitten; Seitwärtsschritte, Koordinationsleiter, Hütchen, Z- und W-Cuts sowie multiplanare sportartspezifische Übungen.","therapeutic_content_en":"Wall squats, mini lunges, step-ups progressing to single-leg, step-downs, 4-way hip exercises, leg press with low resistance and high repetitions, and open-chain knee exercises. At week 8: full squat to 70°, side steps with a band, heel taps, resisted walking, advanced bridges, and single-leg stance and balance progressions. Core strengthening; progress lower-extremity strengthening to multiplanar movements emphasizing core stability and hip and knee control; progress proprioception with varied surfaces, perturbations, and upper-extremity or trunk movements; progress toward sport-specific tasks; cutting, crossover and carioca; goal-appropriate plyometric exercises with medicine-ball work and sled drills; shuffles, ladder footwork, cone drills, Z-cuts, W-cuts and multiplanar sport-specific drills.","therapeutic_content_pl":"Przysiady przy ścianie, małe wykroki, progresja wejść na stopień do wariantu jednonóż, zejścia ze stopnia, ćwiczenia biodra w 4 kierunkach, suwnica z małym oporem i dużą liczbą powtórzeń oraz ćwiczenia kolana w łańcuchu otwartym. Od 8. tygodnia: pełny przysiad do 70°, kroki bokiem z taśmą, dotknięcia piętą, chód z oporem, zaawansowane mosty oraz progresja stania jednonóż i równowagi. Wzmacnianie centralne; progresja wzmacniania kończyn dolnych do ruchów wielopłaszczyznowych z kontrolą tułowia, biodra i kolana; progresja propriocepcji przez zmienne podłoża, perturbacje i ruchy kończyn górnych lub tułowia; progresja do zadań specyficznych dla sportu; zmiany kierunku, crossover i carioca; odpowiednie do celów ćwiczenia plyometryczne z piłką lekarską i sankami; kroki odstawno-dostawne, drabinka koordynacyjna, pachołki, cięcia po torze Z i W oraz wielopłaszczyznowe ćwiczenia sportowe.","minimum_requirements_de":"Kräftigungsübungen und funktionelle Aufgaben dürfen gesteigert werden, sofern keine reaktiven Schmerzen oder kein Erguss auftreten. Aerobe Kondition und Ausdauer steigern und dabei reaktive Ödeme überwachen.","minimum_requirements_en":"Strengthening exercises and functional tasks may be progressed when there is no reactive pain or effusion. Increase aerobic conditioning and endurance while monitoring reactive edema.","minimum_requirements_pl":"Można zwiększać trudność ćwiczeń wzmacniających i zadań funkcjonalnych, jeśli nie występuje reaktywny ból ani wysięk. Zwiększać kondycję tlenową i wytrzymałość, monitorując reaktywny obrzęk.","additional_notes_original":"Goals: Full range of motion, minimal pain, increase resistance exercises, normalize postural/pelvic and LE control with DL and SL activities\n\nCriteria for discharge:\n-Surgeon clearance\n-Hamstring strength index >90% as compared to contralateral limb\n-Quadriceps strength index >90% compared to contralateral limb\n-Y-Balance anterior reach < 4cm\n-No complaints of pain or instability","therapeutic_content_original":"Wall squats, mini lunges, step-ups progressing to single-leg, step-downs, 4-way hip exercises, leg press with low resistance and high repetitions, and open-chain knee exercises. At week 8: full squat to 70°, side steps with a band, heel taps, resisted walking, advanced bridges, and single-leg stance and balance progressions. Core strengthening; progress lower-extremity strengthening to multiplanar movements emphasizing core stability and hip and knee control; progress proprioception with varied surfaces, perturbations, and upper-extremity or trunk movements; progress toward sport-specific tasks; cutting, crossover and carioca; goal-appropriate plyometric exercises with medicine-ball work and sled drills; shuffles, ladder footwork, cone drills, Z-cuts, W-cuts and multiplanar sport-specific drills.","minimum_requirements_original":"Strengthening exercises and functional tasks may be progressed when there is no reactive pain or effusion. Increase aerobic conditioning and endurance while monitoring reactive edema.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["knee","lower_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"10240d6d-4e06-58e7-a701-d037e33a3181","slug":"us-south-shore-30-total-knee-arthroplasty","title_pl":"Protokół rehabilitacji po TKA (South Shore)","title_de":"TKA-Rehabilitationsprotokoll (South Shore)","title_en":"TKA Rehabilitation Protocol (South Shore)","title_original":"Total Knee Replacement","summary_pl":"Pooperacyjny protokół rehabilitacji dla pacjentów po artroplastyce stawu kolanowego, obejmujący cztery fazy od wczesnego okresu szpitalnego do powrotu do aktywności sportowej.","summary_de":"Postoperatives Rehabilitationsprotokoll für Patienten nach Knieendoprothetik, unterteilt in vier Phasen von der stationären Frührehabilitation bis zur Rückkehr zu Freizeitaktivitäten.","summary_en":"Post-operative rehabilitation protocol for total knee arthroplasty patients, spanning four phases from inpatient recovery to return to recreational activity.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"c8a9eec5-8931-5e40-a677-405f3bb741ce","condition_slug":"total-knee-arthroplasty","condition_name_pl":"Artroplastyka całkowita stawu kolanowego (TKA)","condition_name_de":"Totale Knieendoprothetik (TKA)","condition_name_en":"Total Knee Arthroplasty (TKA)","condition_name_original":"Total Knee Arthroplasty (TKA)","icd_codes":[],"category_key":"knee","category_pl":"Ortopedia","category_de":"Orthopädie","category_en":"Orthopedics","body_regions_pl":["kolano"],"body_regions_de":["Knie"],"body_regions_en":["knee"],"search_terms_pl":["TKA","wymiana stawu kolanowego","endoproteza kolana","rehabilitacja po TEP","TEP kolana"],"search_terms_de":["Knie-TEP","Kniegelenkersatz","TKA","Knieendoprothese","Knierehabilitation"],"search_terms_en":["TKA","total knee replacement","knee arthroplasty","post-op knee rehab"],"source_document_id":"f759cfb5-7817-5d58-b235-c86d310a8804","source_title":"Total Knee Arthroplasty (TKA) Rehabilitation Protocol","issuer":"South Shore Orthopedics","source_country_code":"US","jurisdiction_code":"US-MA","authority_level":"hospital","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"requires_clinical_update_check","official_url":"https://octanecdn.com/southshoreorthopedicscom/southshoreorthopedicscom_851896426.pdf","source_sha256":"66ad58299d60b66f2239be8c4b13ee81c325739ed628bfa6d74a8d16264e5716","authorization_required":false,"license_note":"Public source file retained locally for source verification.","modules":[{"id":"34084b0d-eb9d-56ca-9335-62ef45ff7548","name_de":"Grundsätze des Behandlungspfads und postoperative Versorgung","name_en":"Whole-pathway principles and postoperative care","name_pl":"Zasady całej ścieżki i opieka pooperacyjna","source_page":2,"module_number":1,"name_original":"Home Visits; Surgical Incision/Dressing; Showering; Medication; Driving; Elevation; Ice; Post-Operative Office Visits; Weight Bearing; Recovery/Time off Work; Typical Rehabilitation Continuum Time Frames Following TKA; Outpatient Discharge Criteria","service_codes":[],"structured_content":{"de":{"goals":["Die meisten Patient:innen können nach der Entlassung direkt nach Hause zurückkehren."],"warnings":["Verband, Wunde und Infektionszeichen überwachen; bei Bedenken den Chirurgen kontaktieren."],"exercises":[],"restrictions":["Nicht unter Opioiden fahren."],"progression_criteria":["Ambulante Physiotherapie etwa ab Woche 3; normales Gangbild vor dem Absetzen; PT-Entlassung bei 70–80% Funktion, normalem Gehen ohne Hilfsmittel, sicheren reziproken Treppen, Auto-Transfer und Schuhen; HEP fortsetzen."],"dosage_and_progression":["Operiertes Bein 3–4-mal täglich 30 Minuten hochlagern. Zu Hause Eis 3–5-mal täglich 10–20 Minuten anwenden."],"physiotherapist_actions":["Tägliche Physiotherapie im Krankenhaus durchführen; die häusliche Physiotherapie stimmt die Bereitschaft für die ambulante Therapie mit dem Operationsteam ab, typischerweise um die 3. Woche.","Belastung nach Verträglichkeit und Progression anleiten: Rollator/Krücken → Stock → kein Hilfsmittel bei normalem Gangbild.","Eis- und Hochlagerungsanleitung geben."]},"en":{"goals":["Most patients can go directly home after discharge."],"warnings":["Monitor the dressing, wound and infection signs; contact the surgeon with concerns."],"exercises":[],"restrictions":["Do not drive while taking narcotics."],"progression_criteria":["Outpatient PT around 3 weeks; normal gait before weaning the device; discharge at 70–80% function with normal walking without a device, safe reciprocal stairs, car transfer and shoes/socks; continue HEP."],"dosage_and_progression":["Elevate the operative leg 3–4 times/day for 30 minutes. At home apply ice 3–5 times/day for 10–20 minutes."],"physiotherapist_actions":["Provide daily inpatient PT; home-care PT works with the surgeon and staff to determine readiness for outpatient PT, typically around 3 weeks.","Train WBAT and device progression: walker/crutches → cane → no device when gait is normal.","Teach ice and elevation."]},"pl":{"goals":["Większość pacjentów może wrócić bezpośrednio do domu po wypisie."],"warnings":["Monitoruj opatrunek, ranę i objawy infekcji; w razie obaw skontaktuj się z chirurgiem."],"exercises":[],"restrictions":["Nie prowadź podczas przyjmowania opioidowych leków przeciwbólowych."],"progression_criteria":["Fizjoterapia ambulatoryjna około 3. tygodnia; prawidłowy chód przed odstawieniem urządzenia; wypis z PT przy 70–80% funkcji, prawidłowym chodzie bez urządzenia, bezpiecznych schodach naprzemiennych, transferze samochodowym i obuwiu; kontynuuj HEP."],"dosage_and_progression":["Unieś operowaną kończynę 3–4 razy dziennie po 30 minut. W domu stosuj lód 3–5 razy dziennie przez 10–20 minut."],"physiotherapist_actions":["Prowadź codzienną fizjoterapię w szpitalu; fizjoterapeuta opieki domowej ustala z chirurgiem gotowość do fizjoterapii ambulatoryjnej, zwykle około 3. tygodnia.","Ucz obciążania według tolerancji i progresji: balkonik/kule → laska → brak urządzenia po uzyskaniu prawidłowego chodu.","Instruktaż lodu i uniesienia kończyny."]},"original":{"goals":["Most patients are able to go directly home after discharge."],"warnings":["Should you have any cause for concern prior to your first office visit you should call your surgeon’s office for advice."],"exercises":[],"restrictions":["You cannot drive while taking narcotics."],"progression_criteria":["This will typically be around 3 weeks from your operation.","Remember, proper gait pattern must be achieved in order to discontinue use of assistive devices.","You are ready for discharge from outpatient PT typically when you reach 70-80% functional level compared to before surgery.","Walking normally without any assistive device.","Negotiate stairs reciprocally and safely.","Getting in/out of a car without difficulty.","Donning/doffing shoes and socks without difficulty.","Being discharged from PT does NOT mean that you are exempt from you home exercise program."],"dosage_and_progression":["It is recommended that you elevate your operative leg 3 to 4 times a day for 30 minutes.","Once home, you may taper down to applying ice 3-5 times a day for 10 to no more than 20 minutes at a time."],"physiotherapist_actions":["You will likely receive home care visits from a registered nurse and a physical therapist after being discharged home.","Your home care physical therapist will work with your surgeon and their staff to determine when you are ready to attend outpatient physical therapy. This will typically be around 3 weeks from your operation.","As your tolerance for weight bearing improves your physical therapist will transition you to walking with a cane.","Eventually, when your gait is normal you will be able to walk without an assistive device."]}},"additional_notes_de":"Die häusliche Versorgung dauert meist 3 Tage–3 Wochen, ambulante Physiotherapie beginnt etwa ab der 3. Woche. Kontrollen etwa nach 10–14 Tagen und 6 Wochen. Rückkehr zur Aktivität meist nach 4–6, manchmal 9–12 Monaten. Entlassung aus der PT typischerweise bei 70–80% Funktion, normalem Gehen ohne Hilfsmittel, sicherem reziprokem Treppengehen, problemlosen Autoein-/ausstieg und An-/Ausziehen von Schuhen; HEP fortsetzen. Nicht unter Opioiden fahren.","additional_notes_en":"Home care is usually 3 days–3 weeks and outpatient PT begins around 3 weeks. Follow-ups are around 10–14 days and 6 weeks. Recovery is usually 4–6 months, sometimes 9–12 months. Outpatient PT discharge is typically at 70–80% functional level with normal walking without a device, safe reciprocal stairs, car transfers and shoes/socks; continue the HEP. Do not drive while taking opioid medication.","additional_notes_pl":"Opieka domowa trwa zwykle 3 dni–3 tygodnie, a ambulatoryjna fizjoterapia zaczyna się około 3. tygodnia. Kontrole około 10–14 dni i 6 tygodni. Powrót do aktywności zwykle 4–6 miesięcy, czasem 9–12 miesięcy. Wypis z PT zwykle przy 70–80% funkcji oraz prawidłowym chodzie bez urządzenia, bezpiecznych schodach naprzemiennych, łatwym wsiadaniu do samochodu i zakładaniu/zdejmowaniu obuwia; po wypisie kontynuuj HEP. Nie prowadź podczas przyjmowania opioidowych leków przeciwbólowych.","minimum_patient_share":null,"therapeutic_content_de":"Der Behandlungspfad umfasst meist 1–2 Krankenhaustage, häusliche Versorgung über 3 Tage–3 Wochen und ambulante Physiotherapie ab etwa der 3. Woche bis Woche 12. Patient:innen stehen am Operationstag auf und arbeiten täglich mit Physio- und Ergotherapie. Belastung nach Verträglichkeit geht vom Rollator oder von Krücken zum Stock und anschließend ohne Hilfsmittel bei normalem Gangbild.","therapeutic_content_en":"The pathway is typically 1-2 days in hospital, home care 3 days-3 weeks, outpatient PT 3 weeks-12 weeks, then an independent program 12 weeks and beyond. Patients are out of bed the same day and work with PT and OT daily. WBAT progresses from walker or crutches to cane and then no device when gait is normal.","therapeutic_content_pl":"Ścieżka obejmuje zwykle 1–2 dni w szpitalu, opiekę domową przez 3 dni–3 tygodnie oraz fizjoterapię ambulatoryjną od około 3. tygodnia do 12. tygodnia. Pacjent wstaje w dniu operacji i codziennie pracuje z fizjoterapią oraz terapią zajęciową. Obciążanie według tolerancji przechodzi od balkonika lub kul do laski, a następnie bez urządzenia po uzyskaniu prawidłowego chodu.","minimum_requirements_de":"Belastung nach Verträglichkeit; Hilfsmittel vom Rollator/von Krücken zum Stock und ohne Hilfsmittel bei normalem Gangbild.","minimum_requirements_en":"WBAT; progress from walker/crutches to cane and no device when gait is normal.","minimum_requirements_pl":"Obciążanie według tolerancji; urządzenia od balkonika/kul do laski i bez urządzenia po uzyskaniu prawidłowego chodu.","additional_notes_original":"This will typically be around 3 weeks from your operation. Your first post-operative visit will be as early as 10 -14 days after the operation. Your next visit will be around 6 weeks after the operation. It is usually estimated that it will take at least 4-6 months for the patient to feel as though he or she has completely returned to a pre-injury level of activity. Some cases may take as long as 9-12 months to make a full recovery. You are ready for discharge from outpatient PT typically when you reach 70-80% functional level compared to before surgery. Walking normally without any assistive device. Negotiate stairs reciprocally and safely. Getting in/out of a car without difficulty. Donning/doffing shoes and socks without difficulty. Being discharged from PT does NOT mean that you are exempt from you home exercise program. You cannot drive while taking narcotics.","therapeutic_content_original":"Total Knee Arthroplasty is not currently an outpatient day surgery procedure. You will typically spend 1-2 days in the hospital to recover. You will be out of bed the same day as your surgery. You will be working with physical and occupational therapy on a daily basis in the hospital. This will typically be around 3 weeks from your operation. After surgery you are allowed to put as much weight on your operated leg as you can tolerate (unless otherwise indicated by your surgeon). As your tolerance for weight bearing improves your physical therapist will transition you to walking with a cane. Eventually, when your gait is normal you will be able to walk without an assistive device.","minimum_requirements_original":"After surgery you are allowed to put as much weight on your operated leg as you can tolerate. Eventually, when your gait is normal you will be able to walk without an assistive device.","structured_content_v2":"$undefined"},{"id":"be834ee3-92fb-536d-bc91-9384b13058f2","name_de":"Phase I: Tag 0 bis Entlassung","name_en":"Phase I: Day 0–hospital discharge","name_pl":"Faza I: dzień 0–wypis","source_page":6,"module_number":2,"name_original":"Phase 1: Phase (Day 0- Hospital Discharge)","service_codes":[],"structured_content":{"de":{"goals":["Schmerz und Schwellung kontrollieren","Heilendes Gewebe schützen","ROM beginnen: Knieflexion mindestens 90°, Extension ≤0°","Muskulatur der unteren Extremität aktivieren","Unabhängige funktionelle Mobilität wiederherstellen"],"warnings":[],"exercises":["Passive Kniebeugung und -streckung","Fersengleiten","Aktiv-assistierte Kniebeugung/-streckung im Sitzen","Fußpumpen","Quadrizeps-Anspannungen","Gesäßmuskel-Anspannungen","Hamstring-Anspannungen","Gestrecktes Beinheben ohne Lag","Hüftabduktion/-adduktion","Kniestreckung im Sitzen","Hüftbeugung im Sitzen"],"restrictions":["WBAT mit Krücken oder Rollator, sofern nicht anders angeordnet."],"dosage_and_progression":["Alle Übungen 3–5-mal täglich 10 Wiederholungen durchführen. Nach dem Training 10–20 Minuten Eis anwenden."],"physiotherapist_actions":["Auf sensomotorische Defizite, TVT, symptomatische orthostatische Hypotonie und symptomatisch niedrigen Hämatokrit screenen.","Bettmobilität, Transfers, Gang auf ebener Fläche, Treppen und ADL mit Hilfsmitteln trainieren.","Lagern: Rolle unter dem Knöchel, Trochanterrolle; niemals etwas unter das operierte Knie."]},"en":{"goals":["Control pain and swelling","Protect healing tissue","Begin ROM: knee flexion at least 90 degrees; knee extension less than or equal to 0 degrees","Establish lower extremity muscle activation","Restore independent functional mobility"],"warnings":[],"exercises":["Passive knee flexion and extension","Heel slides","Active assisted knee flexion/extension in sitting","Ankle pumps","Quad sets","Glut sets","Hamstring sets","Straight leg raises (SLR): emphasizing no lag","Hip abduction/adduction","Long arc quads (LAQ)","Seated hip flexion"],"restrictions":["WBAT with crutches or walker unless otherwise ordered."],"dosage_and_progression":["Perform 10 repetitions of all exercises 3–5 times/day. Use ice after exercising for 10–20 minutes."],"physiotherapist_actions":["Screen for sensory/motor deficits, DVT, symptomatic orthostatic hypotension and symptomatic low hematocrit.","Train bed mobility, transfers, level-surface gait, stairs and ADLs with adaptive equipment as needed.","Position with a towel roll under the ankle and a trochanter roll; never place anything under the operated knee."]},"pl":{"goals":["Kontroluj ból i obrzęk","Chroń gojące się tkanki","Rozpocznij ROM: zgięcie kolana co najmniej 90°, wyprost ≤0°","Aktywuj mięśnie kończyny dolnej","Przywracaj samodzielną mobilność funkcjonalną"],"warnings":[],"exercises":["Bierne zgięcie i wyprost kolana","Ślizgi piętą","Czynne wspomagane zgięcie/wyprost kolana w siadzie","Pompowanie stawami skokowymi","Napięcia czworogłowego","Napięcia pośladków","Napięcia mięśni kulszowo-goleniowych","Unoszenie wyprostowanej nogi bez opóźnienia wyprostu","Odwodzenie/przywodzenie biodra","Wyprost kolana w siadzie","Zgięcie biodra w siadzie"],"restrictions":["WBAT z kulami lub balkonikiem, chyba że zalecono inaczej."],"dosage_and_progression":["Wykonuj 10 powtórzeń wszystkich ćwiczeń 3–5 razy dziennie. Stosuj lód po ćwiczeniach przez 10–20 minut."],"physiotherapist_actions":["Wykonaj screening deficytów czuciowych/ruchowych, DVT, objawowej hipotensji ortostatycznej i objawowo niskiego hematokrytu.","Prowadź mobilność w łóżku, transfery, chód po równym podłożu, schody i ADL z wyposażeniem adaptacyjnym.","Pozycjonuj: wałek pod kostką, wałek krętarzowy; nigdy niczego pod operowanym kolanem."]},"original":{"goals":["Control pain and swelling","Protect healing tissue","Begin to restore range of motion (ROM)","Knee flexion at least 90 degrees","Knee extension less than or equal to 0 degrees","Establish lower extremity muscle activation","Restore independent functional mobility"],"warnings":[],"exercises":["Passive knee flexion and extension","Heel slides","Active assisted knee flexion/extension in sitting","Ankle pumps","Quad sets","Glut sets","Hamstring sets","Straight leg raises (SLR): emphasizing no lag","Hip abduction/adduction","Long arc quads (LAQ)","Seated hip flexion"],"restrictions":["WBAT with crutches or walker unless otherwise ordered."],"dosage_and_progression":["Perform 10 repetitions of all exercises 3-5 times a day. Use ice after exercising for 10-20 minutes."],"physiotherapist_actions":["Screen for sensory/motor deficits.","Screen for DVT, symptomatic orthostatic hypotension, symptomatic low hematocrit.","Bed mobility.","Transfer training.","Gait training on level surfaces.","Stair training.","Activities of daily living with adaptive equipment (as needed).","Use a towel roll under ankle to promote knee extension.","Use a trochanter roll to maintain hip in neutral rotation and promote knee extension.","Never place anything under the operated knee."]}},"additional_notes_de":"Niemals etwas unter das operierte Knie legen.","additional_notes_en":"Never place anything under the operated knee.","additional_notes_pl":"Unikać podkładania czegokolwiek pod kolano.","minimum_patient_share":null,"therapeutic_content_de":"Schmerz und Schwellung kontrollieren, heilendes Gewebe schützen und ROM beginnen: Knieflexion mindestens 90°, Extension ≤0°. Muskulatur der unteren Extremität aktivieren. Unabhängige funktionelle Mobilität wiederherstellen.","therapeutic_content_en":"Control pain and swelling, protect healing tissue and begin ROM: knee flexion at least 90 degrees and extension less than or equal to 0 degrees. Establish lower-extremity muscle activation. Restore independent functional mobility.","therapeutic_content_pl":"Kontroluj ból i obrzęk, chroń gojące się tkanki i rozpocznij ROM: zgięcie kolana co najmniej 90°, wyprost ≤0°. Aktywuj mięśnie kończyny dolnej. Przywracaj samodzielną mobilność funkcjonalną.","minimum_requirements_de":"Vollbelastung nach Toleranz, Gang mit Gehwagen oder Krücken.","minimum_requirements_en":"WBAT with crutches or walker.","minimum_requirements_pl":"WBAT (obciążanie do granicy bólu), chód z balkonikiem lub kulami.","additional_notes_original":"Never place anything under the operated knee.","therapeutic_content_original":"Phase 1: Phase (Day 0- Hospital Discharge). Goals: Control pain and swelling; Protect healing tissue; Begin to restore range of motion (ROM) — Knee flexion at least 90 degrees; Knee extension less than or equal to 0 degrees; Establish lower extremity muscle activation; Restore independent functional mobility. Precautions: WBAT with crutches or walker unless otherwise ordered. Screen for sensory/motor deficits. Screen for DVT, symptomatic orthostatic hypotension, symptomatic low hematocrit.","minimum_requirements_original":"WBAT with crutches or walker unless otherwise ordered. Screen for sensory/motor deficits. Screen for DVT, symptomatic orthostatic hypotension, symptomatic low hematocrit.","structured_content_v2":"$undefined"},{"id":"6a7c30d3-84e2-5152-99b6-0c7e72719c16","name_de":"Stationärer PT/OT-Plan","name_en":"Hospital PT/OT plan","name_pl":"Plan PT/OT w szpitalu","source_page":7,"module_number":3,"name_original":"Inpatient Plan of Care","service_codes":[],"structured_content":{"de":{"goals":["Am OP-Tag vom Bett in den Stuhl.","PT- und OT-Untersuchungen am ersten postoperativen Tag.","Übungen, funktionelle Mobilität und ADL bis zur Entlassung steigern."],"warnings":[],"exercises":[],"restrictions":[],"dosage_and_progression":[],"physiotherapist_actions":["Operationstag: vom Bett in den Stuhl und PT-Untersuchung.","Postoperativer Tag 1: PT- und OT-Untersuchungen; therapeutische Übungen mit ROM, Kräftigung und funktioneller Mobilität; ADL-Training.","Postoperativer Tag 2 bis Entlassung: Progression therapeutischer Übungen und funktioneller Mobilität; ADL-Training fortsetzen."]},"en":{"goals":["Out of bed to a chair on the day of surgery.","PT and OT evaluations on post-op day 1.","Progress exercise, functional mobility and ADL through discharge."],"warnings":[],"exercises":[],"restrictions":[],"dosage_and_progression":[],"physiotherapist_actions":["Day of surgery: out of bed to a chair and PT evaluation.","Post-op day 1: PT and OT evaluations; therapeutic exercise including ROM, strengthening and functional mobility; ADL training.","Post-op day 2–discharge: progression of therapeutic exercise and functional mobility; continued ADL training."]},"pl":{"goals":["Transfer z łóżka na krzesło w dniu operacji.","Ocena PT i OT w 1. dniu po operacji.","Progresja ćwiczeń, mobilności funkcjonalnej i ADL do wypisu."],"warnings":[],"exercises":[],"restrictions":[],"dosage_and_progression":[],"physiotherapist_actions":["Dzień operacji: transfer z łóżka na krzesło i ocena PT.","1. dzień po operacji: oceny PT i OT; ćwiczenia ROM, wzmacnianie i mobilność funkcjonalna; trening ADL.","2. dzień–wypis: progresja ćwiczeń terapeutycznych i mobilności funkcjonalnej; dalszy trening ADL."]},"original":{"goals":["Out of bed to a chair.","PT and OT Evaluations.","Progression of Therapeutic Exercise and Functional Mobility."],"warnings":[],"exercises":[],"restrictions":[],"dosage_and_progression":[],"physiotherapist_actions":["Day of Surgery: Out of bed to a chair.","PT Evaluation.","Post Op Day 1: PT and OT Evaluations.","Therapeutic Exercise including ROM, Strengthening, and Functional Mobility as appropriate.","ADL Training as appropriate.","Post Op Day 2-Discharge: Progression of Therapeutic Exercise and Functional Mobility.","Continued ADL Training."]}},"additional_notes_de":"","additional_notes_en":"","additional_notes_pl":"","minimum_patient_share":null,"therapeutic_content_de":"Am Operationstag vom Bett in den Stuhl transferieren und PT untersuchen. Am ersten postoperativen Tag PT/OT-Untersuchungen sowie ROM, Kräftigung und funktionelle Mobilität durchführen. Ab dem zweiten Tag bis zur Entlassung Übungen, Mobilität und ADL steigern.","therapeutic_content_en":"On the day of surgery: out of bed to a chair and PT evaluation. Post-op day 1: PT and OT evaluations, therapeutic exercise including ROM, strengthening and functional mobility, and ADL training. Post-op day 2 to discharge: progression of therapeutic exercise and functional mobility and continued ADL training.","therapeutic_content_pl":"W dniu operacji wykonaj transfer z łóżka na krzesło i ocenę PT. W 1. dniu po operacji wykonaj oceny PT/OT oraz ćwiczenia ROM, wzmacnianie i mobilność funkcjonalną. Od 2. dnia do wypisu progresuj ćwiczenia, mobilność i trening ADL.","minimum_requirements_de":"","minimum_requirements_en":"","minimum_requirements_pl":"","additional_notes_original":"","therapeutic_content_original":"Day of Surgery: Out of bed to a chair; PT Evaluation. Post Op Day 1: PT and OT Evaluations; Therapeutic Exercise including ROM, Strengthening, and Functional Mobility as appropriate; ADL Training as appropriate. Post Op Day 2-Discharge: Progression of Therapeutic Exercise and Functional Mobility; Continued ADL Training.","minimum_requirements_original":"","structured_content_v2":"$undefined"},{"id":"35b62b70-f7e5-54d7-b154-0c4209c41d54","name_de":"Phase II: Entlassung–6 Wochen","name_en":"Phase II: discharge–6 weeks","name_pl":"Faza II: wypis–6 tygodni","source_page":7,"module_number":4,"name_original":"Phase 2: (Hospital Discharge-6 Weeks)","service_codes":[],"structured_content":{"de":{"goals":["ROM bis 0–110° verbessern; Zusammenfassung nennt 0–100°","Kraft, besonders Quadrizeps, wiederherstellen","Propriozeption beginnen","Ausdauertraining beginnen","Funktionelle Mobilität normalisieren","Gehhilfen abbauen"],"exercises":["ROM-Übungen aus Phase 1 fortsetzen","Fersengleiten mit Handtuch","Knieflexion in Bauchlage","Fersenauflage oder Kniehang zur vollständigen Extension","Ergometer mit Vor-zurück-Bewegung beginnen und zu vollständigen Umdrehungen steigern","Patellofemorale und tibiofemorale Mobilisation beginnen","Hamstring-, Waden- und Quadrizepsdehnung beginnen","Quadrizeps-, Gesäß- und Hamstring-Anspannungen","SLR ohne Lag; gegen Ende Widerstand hinzufügen","Hüftabduktion/-adduktion/-extension gegen Schwerkraft; Widerstand hinzufügen","Zu geschlossenen Kettenübungen mit terminaler Kniestreckung, Mini-Kniebeugen, Step-ups und Mini-Ausfallschritten fortschreiten","Einbeinstand"],"restrictions":["WBAT: Rollator/Krücken → Stock → Hilfsmittel nach normalem Gangbild abbauen. Wundheilung, Infektionszeichen und zunehmende Schwellung überwachen."],"progression_criteria":["ROM-Ziel 0–110°; tabellarische Zusammenfassung 0–100°."],"dosage_and_progression":["ROM und Kräftigung: 10–20 Wiederholungen 3-mal täglich. Dehnen: 30 Sekunden, 2–3 Wiederholungen. Fahrrad täglich 5–10 Minuten."],"physiotherapist_actions":["Patellofemorale und tibiofemorale Mobilisationen sowie Dehnung von Hamstrings, Wade und Quadrizeps nach Indikation durchführen.","NMES am Quadrizeps bei schlechter Rekrutierung anwenden.","Gang- und Treppentraining mit geeignetem Hilfsmittel durchführen."]},"en":{"goals":["Continue to improve ROM with a goal of 0- 110 degrees.","ROM: 0 to at least 100°.","Begin to restore muscle strength throughout the operated leg, with special focus on the quadriceps.","Initiate proprioceptive training","Initiate endurance training","Normalize functional mobility","Wean assistive devices"],"exercises":["Continue with all phase 1 ROM exercises","Heel slide with towel","Prone knee flexion","Heel prop and/or prone knee hang to promote full extension","Initiate stationary biking, starting with back and forth motion progressing to full revolutions as able","Initiate hamstring, gastroc/soleus, and quadriceps stretching","Quad sets, glut sets, hamstring sets","SLR without lag, add resistance towards the end of this phase","Hip abduction/adduction/extension against gravity, add resistance towards the end of this phase","Progress to closed chain exercises including terminal knee extensions, mini-squats, step ups, and mini-lunges by the end of this phase","Single leg stance"],"restrictions":["WBAT with crutches or walker, progressing to cane and weaning as appropriate. Monitor wound healing, infection and increased swelling."],"progression_criteria":["ROM goal 0-110 degrees; summary table lists 0 to at least 100 degrees."],"dosage_and_progression":["ROM and strengthening: 10–20 repetitions 3x/day. Stretching: 30 seconds for 2–3 repetitions. Bike daily for 5–10 minutes."],"physiotherapist_actions":["Provide patellofemoral and tibio-femoral mobilizations and hamstring, gastroc/soleus and quadriceps stretching as indicated.","Use NMES to the quads if poor quadriceps recruitment is present.","Provide gait and stair training with the appropriate device."]},"pl":{"goals":["Poprawiaj ROM do celu 0–110°; podsumowanie podaje 0–100°","Odbuduj siłę, szczególnie czworogłowego","Rozpocznij propriocepcję","Rozpocznij trening wytrzymałości","Normalizuj mobilność funkcjonalną","Odstawiaj pomoce"],"exercises":["Kontynuuj ćwiczenia ROM z fazy I","Ślizg piętą z ręcznikiem","Zgięcie kolana w leżeniu przodem","Podparcie pięty lub zwis kolana dla pełnego wyprostu","Rozpocznij rower stacjonarny ruchem tam i z powrotem, następnie pełne obroty","Rozpocznij rozciąganie hamstringów, łydki i czworogłowego","Napięcia czworogłowego, pośladków i hamstringów","SLR bez opóźnienia; pod koniec fazy dodaj opór","Odwodzenie/przywodzenie/wyprost biodra przeciw grawitacji; dodaj opór","Ćwiczenia łańcucha zamkniętego: końcowy wyprost, mini-przysiady, step-up i mini-wykroki","Stanie na jednej nodze"],"restrictions":["WBAT: balkonik/kule → laska → odstawianie pomocy odpowiednio do prawidłowego chodu. Monitoruj ranę, infekcję i narastający obrzęk."],"progression_criteria":["Cel ROM 0–110°; podsumowanie tabelaryczne 0–100°."],"dosage_and_progression":["ROM i wzmacnianie: 10–20 powtórzeń 3 razy dziennie. Rozciąganie: 30 sekund, 2–3 powtórzenia. Rower codziennie 5–10 minut."],"physiotherapist_actions":["Wykonuj mobilizacje rzepkowo-udowe i piszczelowo-udowe według wskazań oraz rozciąganie hamstringów, łydki i czworogłowego.","Stosuj NMES na czworogłowy przy słabej rekrutacji.","Prowadź trening chodu i schodów z odpowiednim urządzeniem."]},"original":{"goals":["Continue to improve ROM with a goal of 0- 110 degrees.","ROM: 0 to at least 100°.","Begin to restore muscle strength throughout the operated leg, with special focus on the quadriceps.","Initiate proprioceptive training","Initiate endurance training","Normalize functional mobility","Wean assistive devices"],"exercises":["Continue with all phase 1 ROM exercises","Heel slide with towel","Prone knee flexion","Heel prop and/or prone knee hang to promote full extension","Initiate stationary biking, starting with back and forth motion progressing to full revolutions as able","Initiate hamstring, gastroc/soleus, and quadriceps stretching","Quad sets, glut sets, hamstring sets","SLR without lag, add resistance towards the end of this phase","Hip abduction/adduction/extension against gravity, add resistance towards the end of this phase","Progress to closed chain exercises including terminal knee extensions, mini-squats, step ups, and mini-lunges by the end of this phase","Single leg stance"],"restrictions":["WBAT with crutches or walker, progressing to cane, then weaning devices as appropriate.","Monitor for proper wound healing.","Monitor for signs of infection.","Monitor for increased swelling."],"progression_criteria":["Continue to improve ROM with a goal of 0- 110 degrees.","ROM: 0 to at least 100°."],"dosage_and_progression":["Perform 10-20 repetitions of all ROM, strengthening, and strengthening exercises 3x/day.","Hold stretches for 30 seconds and perform 2-3 repetitions of each.","Bike daily for 5-10 minutes if able."],"physiotherapist_actions":["Initiate patellofemoral and tibio-femoral joint mobilizations as indicated.","Initiate hamstring, gastroc/soleus, and quadriceps stretching.","Use NMES to quads if poor quadriceps recruitment is present.","Gait training with appropriate device emphasizing normal gait pattern.","Stair training with appropriate device."]}},"additional_notes_de":"ROM-Diskrepanz: Die Phasenbeschreibung nennt 0–110°, die Zusammenfassung 0–100°.","additional_notes_en":"ROM discrepancy: the phase narrative states 0–110°, while the summary table states 0–100°.","additional_notes_pl":"Rozbieżność ROM: opis fazy podaje cel 0–110°, a tabela podsumowująca 0–100°.","minimum_patient_share":null,"therapeutic_content_de":"ROM bis zum Ziel 0–110° verbessern; die Übersichtstabelle nennt 0–100°. Kraft des operierten Beins, besonders des Quadrizeps, wiederherstellen, Propriozeption und Ausdauer beginnen, Mobilität normalisieren und Hilfsmittel mit Fokus auf normales Gangbild reduzieren.","therapeutic_content_en":"Improve ROM toward 0–110°; the summary table states 0–100°. Restore operated-leg strength, especially quadriceps, initiate proprioception and endurance, normalize mobility, and wean assistive devices with emphasis on normal gait.","therapeutic_content_pl":"Poprawiaj ROM do celu 0–110°; tabela podsumowująca podaje 0–100°. Odbudowuj siłę kończyny operowanej, szczególnie czworogłowego, rozpocznij propriocepcję i wytrzymałość, normalizuj mobilność oraz odstawiaj pomoce z naciskiem na prawidłowy chód.","minimum_requirements_de":"WBAT mit Rollator oder Krücken, dann Übergang zum Stock und Absetzen der Hilfsmittel entsprechend dem Gangbild; Wundheilung, Infektion und zunehmende Schwellung überwachen.","minimum_requirements_en":"WBAT with walker or crutches, then progress to cane and wean devices as appropriate; monitor wound healing, infection signs, and increased swelling.","minimum_requirements_pl":"WBAT z balkonikiem lub kulami, następnie przejście do laski i odstawianie pomocy odpowiednio do chodu; monitoruj gojenie rany, infekcję i narastający obrzęk.","additional_notes_original":"Continue to improve ROM with a goal of 0- 110 degrees. ROM: 0 to at least 100°.","therapeutic_content_original":"Phase 2: (Hospital Discharge-6 Weeks). Goals: Continue to improve ROM with a goal of 0- 110 degrees. Begin to restore muscle strength throughout the operated leg, with special focus on the quadriceps. Initiate proprioceptive training. Initiate endurance training. Normalize all functional mobility. Wean all assistive devices, emphasizing normal gait pattern.","minimum_requirements_original":"WBAT with crutches or walker, progressing to cane, then weaning devices as appropriate. Monitor for proper wound healing. Monitor for signs of infection. Monitor for increased swelling.","structured_content_v2":"$undefined"},{"id":"2fc6937a-25d3-50eb-9f53-b48dc75248d3","name_de":"Phase III: 6–12 Wochen","name_en":"Phase III: 6–12 weeks","name_pl":"Faza III: 6–12 tygodni","source_page":8,"module_number":5,"name_original":"Phase 3: (6-12 Weeks)","service_codes":[],"structured_content":{"de":{"goals":["Knie-ROM maximieren","Normale Beinkraft, besonders Quadrizepsfunktion, wiederherstellen","Zu Aktivitäten auf Ausgangsniveau zurückkehren"],"warnings":[],"exercises":["ROM aus Phase 1 und 2 fortsetzen","Fahrrad mit leichtem bis moderatem Widerstand nach Verträglichkeit fortsetzen","Aktivitäten aus Phase 2 nach Indikation fortsetzen","Übungen aus Phase 2 mit zunehmendem Widerstand fortsetzen","Kraftmaschinen hinzufügen: Beinpresse, Hamstring-Curl, 4-Wege-Hüftmaschine","Exzentrische Quadrizepskontrolle in geschlossener Kette betonen","Einbeinstand","Statisches Gleichgewicht auf Bosu/Wackelbrett/Schaumstoff","Sanfte Agilität: Tandemgang, Seitwärtsschritte, Karaoke, Rückwärtsgehen","Fahrradprogramm","Gehprogramm beginnen"],"restrictions":["High-Impact-Aktivitäten und wiederholtes Pivotieren/Verdrehen vermeiden."],"dosage_and_progression":["ROM und Dehnen täglich; 30 Sekunden, 2–3 Wiederholungen. Kräftigung 3–5-mal pro Woche, 2–3 Sätze à 15–20. Fahrrad täglich mindestens 10 Minuten; Gehen/Fahrrad 20–30 Minuten 3-mal pro Woche."],"physiotherapist_actions":["Geh-, Fahrrad-, Agilitäts-, Gleichgewichts- und Ausdauertraining nach Verträglichkeit steigern.","Technik und exzentrische Quadrizepskontrolle bei zunehmendem Widerstand überwachen."]},"en":{"goals":["Maximize knee ROM","Restore normal LE strength, especially quadriceps function","Return to baseline functional activities"],"warnings":[],"exercises":["Continue ROM exercises from phase 1 and 2","Continue biking, adding mild to moderate resistance as tolerated","Continue with phase 2 activities as indicated","Continue with phase 2 exercises adding and increasing resistance as tolerated","Add resistance machines as appropriate including leg press, hamstring curl, and 4-way hip machine","Emphasize eccentric control of quadriceps with closed chain exercises","Single leg stance","Static balance on Bosu/wobble board/foam/etc","Add gentle agility exercises (i.e. tandem walk, side stepping, karaoke, backwards walking)","Biking program","Begin walking program"],"restrictions":["Avoid high-impact activities and activities requiring repeated pivoting or twisting."],"dosage_and_progression":["ROM and stretching daily; hold 30 seconds for 2–3 repetitions. Strengthening 3–5 times/week, 2–3 sets of 15–20 reps. Bike at least 10 minutes daily; progress biking/walking to 20–30 minutes 3x/week."],"physiotherapist_actions":["Progress walking, biking, agility, balance and endurance as tolerated.","Monitor technique and eccentric quadriceps control as resistance increases."]},"pl":{"goals":["Maksymalizuj ROM kolana","Przywróć siłę kończyny, szczególnie funkcję czworogłowego","Wróć do aktywności wyjściowych"],"warnings":[],"exercises":["Kontynuuj ROM z faz I i II","Kontynuuj rower, dodając opór według tolerancji","Kontynuuj aktywności fazy II według wskazań","Kontynuuj ćwiczenia fazy II, zwiększając opór według tolerancji","Dodaj maszyny z oporem: leg press, uginanie kolana i 4-kierunkową maszynę biodrową","Podkreślaj ekscentryczną kontrolę czworogłowego w łańcuchu zamkniętym","Stanie na jednej nodze","Równowaga na Bosu/desce/piance","Dodaj łagodne ćwiczenia zwinności: tandem, kroki bokiem, karaoke, chód tyłem","Program jazdy na rowerze","Rozpocznij program marszu"],"restrictions":["Unikaj aktywności o dużym obciążeniu udarowym i powtarzalnego pivotowania/skręcania."],"dosage_and_progression":["ROM i rozciąganie codziennie; rozciąganie 30 sekund, 2–3 powtórzenia. Wzmacnianie 3–5 razy w tygodniu, 2–3 serie po 15–20 powtórzeń. Rower codziennie co najmniej 10 minut; marsz/rower 20–30 minut 3 razy w tygodniu."],"physiotherapist_actions":["Prowadź progresję marszu i roweru oraz trening zwinności, równowagi i wytrzymałości według tolerancji.","Monitoruj technikę i ekscentryczną kontrolę czworogłowego przy zwiększaniu oporu."]},"original":{"goals":["Maximize knee ROM","Restore normal LE strength, especially quadriceps function","Return to baseline functional activities"],"warnings":[],"exercises":["Continue ROM exercises from phase 1 and 2","Continue biking, adding mild to moderate resistance as tolerated","Continue with phase 2 activities as indicated","Continue with phase 2 exercises adding and increasing resistance as tolerated","Add resistance machines as appropriate including leg press, hamstring curl, and 4-way hip machine","Emphasize eccentric control of quadriceps with closed chain exercises","Single leg stance","Static balance on Bosu/wobble board/foam/etc","Add gentle agility exercises (i.e. tandem walk, side stepping, karaoke, backwards walking)","Biking program","Begin walking program"],"restrictions":["Avoid high impact activities.","Avoid activities that require repeated pivoting/twisting."],"dosage_and_progression":["Perform ROM and stretching exercises once a day until normal ROM is achieved.","Hold stretches for 30 seconds and perform 2-3 repetitions of each.","Perform strengthening exercises 3-5 times a week.","Do 2-3 sets of 15-20 Reps.","Bike daily for ROM at least 10 minutes if able.","Progress to biking/walking for at 20-30 minutes 3x/week for endurance."],"physiotherapist_actions":["Continue with phase 2 exercises adding and increasing resistance as tolerated.","Emphasize eccentric control of quadriceps with closed chain exercises.","Begin walking program."]}},"additional_notes_de":"","additional_notes_en":"","additional_notes_pl":"","minimum_patient_share":null,"therapeutic_content_de":"Maximierung der ROM, Wiederherstellung der normalen Kraft, Rückkehr zu Alltagsaktivitäten, Agility-Training.","therapeutic_content_en":"Maximize ROM, restore normal strength, return to baseline functional activities, agility training.","therapeutic_content_pl":"Maksymalizacja zakresu ruchu, przywrócenie pełnej siły mięśniowej, powrót do podstawowych aktywności dnia codziennego, trening zwinności.","minimum_requirements_de":"Vermeidung von High-Impact-Aktivitäten und Rotationsbewegungen.","minimum_requirements_en":"Avoid high impact and twisting activities.","minimum_requirements_pl":"Unikać aktywności o dużym wpływie (high-impact) i rotacji.","additional_notes_original":"","therapeutic_content_original":"Phase 3: (6-12 Weeks). Goals: Maximize knee ROM. Restore normal LE strength, especially normal quadriceps function. Return to baseline functional activities. Precautions: Avoid high impact activities. Avoid activities that require repeated pivoting/twisting.","minimum_requirements_original":"Avoid high impact activities. Avoid activities that require repeated pivoting/twisting.","structured_content_v2":"$undefined"},{"id":"056a63d8-1930-5764-83f5-8d77dbedd247","name_de":"Phase IV: ab 12 Wochen","name_en":"Phase IV: 12 weeks and beyond","name_pl":"Faza IV: 12 tygodni i dalej","source_page":9,"module_number":6,"name_original":"Phase 4: (12 Weeks and Beyond)","service_codes":[],"structured_content":{"de":{"goals":["Kraft zur Maximierung der Funktion weiter verbessern","Zu geeigneten Freizeitaktivitäten zurückkehren"],"warnings":[],"exercises":["Tägliche ROM- und Dehnübungen fortsetzen","Kräftigung mit mehr Widerstand und weniger Wiederholungen fortsetzen","Phase-3-Übungen fortsetzen und Schwierigkeit nach Verträglichkeit erhöhen","Geh-, Fahrrad- und Ellipsentrainerprogramme fortsetzen","Aktivitäts-/sportspezifische Trainingsübungen"],"restrictions":["High-Impact- und Kontaktsport sowie wiederholtes schweres Heben vermeiden."],"dosage_and_progression":["ROM und Flexibilität täglich. Kräftigung und Propriozeption 3–5-mal pro Woche, 2–3 Sätze à 10–15 Wiederholungen. Ausdauer 30–45 Minuten 3-mal pro Woche."],"physiotherapist_actions":["Mit PT und Arzt eine individuelle Rückkehrroutine für Sport/Freizeit entwickeln.","Aktivitäts- und sportspezifisches Training durchführen."]},"en":{"goals":["Continue to improve strength to maximize functional outcomes","Return to appropriate recreational activities"],"warnings":[],"exercises":["Continue daily ROM and stretching exercises","Continue with all strengthening exercises increasing resistance and decreasing repetitions","Continue with all phase 3 exercises, increasing difficulty as tolerated","Continue with walking, biking, elliptical machine programs","Activity/sport-specific training exercises"],"restrictions":["Avoid high-impact and contact sports and repetitive heavy lifting."],"dosage_and_progression":["ROM and flexibility daily. Strengthening and proprioception 3–5x/week, 2–3 sets of 10–15 repetitions. Endurance 30–45 minutes 3x/week."],"physiotherapist_actions":["Work with PT and MD to create a customized routine for return to sports/recreational activities.","Provide activity/sport-specific training exercises."]},"pl":{"goals":["Kontynuuj poprawę siły dla maksymalnej funkcji","Wróć do odpowiednich aktywności rekreacyjnych"],"warnings":[],"exercises":["Kontynuuj codzienny ROM i rozciąganie","Kontynuuj wzmacnianie, zwiększając opór i zmniejszając powtórzenia","Kontynuuj ćwiczenia fazy III, zwiększając trudność według tolerancji","Kontynuuj marsz, rower i orbitrek","Ćwiczenia treningu specyficznego dla aktywności/sportu"],"restrictions":["Unikaj sportów o dużym obciążeniu udarowym i kontaktowych oraz powtarzalnego ciężkiego dźwigania."],"dosage_and_progression":["ROM i elastyczność codziennie. Wzmacnianie i propriocepcja 3–5 razy w tygodniu, 2–3 serie po 10–15 powtórzeń. Wytrzymałość 30–45 minut 3 razy w tygodniu."],"physiotherapist_actions":["Współpracuj z PT i lekarzem nad indywidualnym planem powrotu do sportu/rekreacji.","Prowadź trening specyficzny dla aktywności/sportu."]},"original":{"goals":["Continue to improve strength to maximize functional outcomes","Return to appropriate recreational activities"],"warnings":[],"exercises":["Continue daily ROM and stretching exercises","Continue with all strengthening exercises increasing resistance and decreasing repetitions","Continue with all phase 3 exercises, increasing difficulty as tolerated","Continue with walking, biking, elliptical machine programs","Activity/sport-specific training exercises"],"restrictions":["Avoid high impact, and contact sports.","Avoid repetitive heavy lifting."],"dosage_and_progression":["Perform ROM and flexibility exercises daily.","Perform strengthening and proprioception exercises 3-5x/week, performing 2-3 sets of 10-15 repetitions.","Continue endurance program 30-45 minutes 3x/week."],"physiotherapist_actions":["Work with PT and MD to create customized routine to allow return to appropriate sports/recreational activities.","Activity/sport-specific training exercises."]}},"additional_notes_de":"","additional_notes_en":"","additional_notes_pl":"","minimum_patient_share":null,"therapeutic_content_de":"Fortführung Kraft- und Ausdauersteigerung, Rückkehr zu Freizeitaktivitäten (Golf, Radfahren, Doppeltennis).","therapeutic_content_en":"Continue strength and endurance progression, return to recreational activities (golf, cycling, doubles tennis).","therapeutic_content_pl":"Kontynuacja zwiększania siły i wytrzymałości, powrót do aktywności rekreacyjnych (golf, rower, tenis deblowy).","minimum_requirements_de":"Vermeidung von Kontaktsportarten und schwerem Heben.","minimum_requirements_en":"Avoid contact sports and repetitive heavy lifting.","minimum_requirements_pl":"Unikać sportów kontaktowych i powtarzalnego dźwigania dużych ciężarów.","additional_notes_original":"","therapeutic_content_original":"Phase 4: (12 Weeks and Beyond). Goals: Continue to improve strength to maximize functional outcomes. Return to appropriate recreational activities (i.e. golf, doubles tennis, cycling). Precautions: Avoid high impact, and contact sports. Avoid repetitive heavy lifting.","minimum_requirements_original":"Avoid high impact, and contact sports. Avoid repetitive heavy lifting.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["knee","lower_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"0c99a0bc-fec4-5df7-a1c7-dcab488d5e46","slug":"us-south-shore-09-arthroscopic-anterior-stabilization","title_pl":"Protokół rehabilitacji po artroskopowej stabilizacji przedniej","title_de":"Rehabilitationsprotokoll nach arthroskopischer vorderer Stabilisierung","title_en":"Rehabilitation Protocol for Arthroscopic Anterior Stabilization","title_original":"Arthroscopic Anterior Stabilization","summary_pl":"Wytyczne pooperacyjne dla pacjentów po naprawie obrąbka/stabilizacji barku. Koncentracja na stopniowej progresji zakresu ruchu (PROM/AROM) z ochroną torebki przedniej.","summary_de":"Postoperative Richtlinien nach Bankart-Reparatur/Stabilisierung. Fokus auf schrittweise Steigerung des Bewegungsumfangs (PROM/AROM) bei Schutz der vorderen Kapsel.","summary_en":"Postoperative guidelines for patients following labral repair/stabilization. Focus on progressive ROM (PROM/AROM) while protecting the anterior capsule.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":["return_to_sport"],"physician_clearance_required":false,"condition_id":"4843e7b2-55dd-57d6-b5b0-5fe8651b89b2","condition_slug":"arthroscopic-anterior-stabilization","condition_name_pl":"Artroskopowa stabilizacja przednia barku","condition_name_de":"Arthroskopische vordere Schulterstabilisierung","condition_name_en":"Arthroscopic Anterior Stabilization","condition_name_original":"Arthroscopic Anterior Stabilization","icd_codes":[],"category_key":"shoulder","category_pl":"Bark","category_de":"Schulter","category_en":"Shoulder","body_regions_pl":["bark"],"body_regions_de":["Schulter"],"body_regions_en":["shoulder"],"search_terms_pl":["niestabilność barku","po operacji barku","artroskopia","rehabilitacja barku"],"search_terms_de":["Schulterinstabilität","postoperativ","Arthroskopie","Schulter-Reha"],"search_terms_en":["shoulder instability","post-op","arthroscopy","shoulder rehab"],"source_document_id":"f02b4382-1afc-5272-a14a-c1ccd4760880","source_title":"Arthroscopic Anterior Stabilization","issuer":"South Shore Orthopedics","source_country_code":"US","jurisdiction_code":"US-MA","authority_level":"hospital","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_unknown_requires_review","official_url":"https://octanecdn.com/southshoreorthopedicscom/southshoreorthopedicscom_822580407.pdf","source_sha256":"e99b379a704724f05cfa45cbebadcd34703468768508495901e229ab85170cff","authorization_required":false,"license_note":"Public source file retained locally for source verification.","modules":[{"id":"d8e94aaf-3f65-54b6-b04f-9e532d957c40","name_de":"Phase I: Erste 4 Therapie-Wochen","name_en":"Phase I: First 4 weeks of therapy","name_pl":"Faza I: Pierwsze 4 tygodnie terapii","source_page":1,"module_number":1,"name_original":"Phase I: First 4 weeks of therapy","service_codes":[],"structured_content":{"de":{"applies_when":["Erste 4 Therapie-Wochen"],"restrictions":["Kein AROM.","Kein Oberkörper-Ergometer.","Kein AROM oder aggressives Dehnen."],"progression_criteria":["Nach Erreichen von 90 Grad PROM in Abduktion: sanftes Dehnen der Außenrotation."],"dosage_and_progression":["Beginn PROM (volle Flexion/Innenrotation, Außenrotation bis 30 Grad).","Beginn meist 6 Wochen post-op.","Entwöhnung von der Schlinge (6-8 Wochen post-op)."],"physiotherapist_actions":["Patientenedukation, Gelenkschutz, Positionierung."]},"en":{"applies_when":["First 4 weeks of therapy"],"restrictions":["No AROM.","No UBE.","No AROM/aggressive stretching."],"progression_criteria":["Once 90 deg PROM abduction is achieved, gentle ER stretching is permitted."],"dosage_and_progression":["Begin PROM (full flexion/IR, ER to 30 deg).","Typically begins 6 weeks post-op.","Sling weaning (6-8 weeks post-op)."],"physiotherapist_actions":["Patient education, joint protection, positioning."]},"pl":{"applies_when":["Pierwsze 4 tygodnie terapii"],"restrictions":["Brak AROM.","Brak ergometru.","Brak AROM i agresywnego rozciągania."],"progression_criteria":["Osiągnięcie 90 stopni PROM w odwiedzeniu umożliwia rozciąganie rotacji zewnętrznej."],"dosage_and_progression":["Rozpoczęcie PROM (pełne zgięcie/rotacja wewnętrzna, rotacja zewnętrzna do 30 stopni).","Rozpoczęcie zazwyczaj 6 tygodni po operacji.","Odstawienie temblaka (6-8 tygodni po op)."],"physiotherapist_actions":["Edukacja pacjenta, ochrona stawu, pozycjonowanie."]},"original":{"applies_when":["First 4 weeks of therapy"],"restrictions":["No AROM.","No UBE.","No AROM/aggressive stretching."],"progression_criteria":["Once 90 deg PROM abduction is achieved, gentle ER stretching is permitted."],"dosage_and_progression":["Begin PROM (full flexion/IR, ER to 30 deg).","Typically begins 6 weeks post-op.","Sling weaning (6-8 weeks post-op)."],"physiotherapist_actions":["Patient education, joint protection, positioning."]}},"additional_notes_de":"Kein AROM oder aggressives Dehnen. Nach Erreichen von 90 Grad PROM in Abduktion: sanftes Dehnen der Außenrotation.","additional_notes_en":"No AROM/aggressive stretching. Once 90 deg PROM abduction is achieved, gentle ER stretching is permitted.","additional_notes_pl":"Brak AROM i agresywnego rozciągania. Osiągnięcie 90 stopni PROM w odwiedzeniu umożliwia rozciąganie rotacji zewnętrznej.","minimum_patient_share":null,"therapeutic_content_de":"Patientenedukation, Gelenkschutz, Positionierung. Kein AROM. Beginn PROM (volle Flexion/Innenrotation, Außenrotation bis 30 Grad). Kein Oberkörper-Ergometer.","therapeutic_content_en":"Patient education, joint protection, positioning. No AROM. Begin PROM (full flexion/IR, ER to 30 deg). No UBE.","therapeutic_content_pl":"Edukacja pacjenta, ochrona stawu, pozycjonowanie. Brak AROM. Rozpoczęcie PROM (pełne zgięcie/rotacja wewnętrzna, rotacja zewnętrzna do 30 stopni). Brak ergometru.","minimum_requirements_de":"Beginn meist 6 Wochen post-op. Entwöhnung von der Schlinge (6-8 Wochen post-op).","minimum_requirements_en":"Typically begins 6 weeks post-op. Sling weaning (6-8 weeks post-op).","minimum_requirements_pl":"Rozpoczęcie zazwyczaj 6 tygodni po operacji. Odstawienie temblaka (6-8 tygodni po op).","additional_notes_original":"No AROM/aggressive stretching. Once 90 deg PROM abduction is achieved, gentle ER stretching is permitted.","therapeutic_content_original":"Patient education, joint protection, positioning. No AROM. Begin PROM (full flexion/IR, ER to 30 deg). No UBE.","minimum_requirements_original":"Typically begins 6 weeks post-op. Sling weaning (6-8 weeks post-op).","structured_content_v2":"$undefined"},{"id":"df891812-1d46-51d5-8729-06e270a9ab88","name_de":"Phase II: Therapie-Wochen 4-6","name_en":"Phase II: Weeks 4-6 of therapy","name_pl":"Faza II: Tygodnie 4-6 terapii","source_page":1,"module_number":2,"name_original":"Phase II: Weeks 4-6 of therapy","service_codes":[],"structured_content":{"de":{"exercises":["Hinteres Dehnen (Kapsel, Cross-arm, Innenrotation in Seitenlage)."],"applies_when":["Therapie-Wochen 4-6"],"restrictions":["Vermeidung von Stress für die vordere Kapsel."],"progression_criteria":["Schmerzfreie vollständige passive Beweglichkeit (PROM) erforderlich."],"dosage_and_progression":["Progression PROM (Außenrotation 30-50 Grad).","Beginn AROM (Flexion) bei schmerzfreier PROM."],"physiotherapist_actions":["Hintere-untere Mobilisation, Schulterblatt-Kräftigung."]},"en":{"exercises":["Posterior capsular stretching (cross-arm, side-lying IR)."],"applies_when":["Weeks 4-6 of therapy"],"restrictions":["Avoid stressing anterior capsule."],"progression_criteria":["Requires pain-free full PROM."],"dosage_and_progression":["Progress PROM (ER 30-50 deg).","Begin AROM (flexion) if PROM pain-free."],"physiotherapist_actions":["Posterior-inferior mobilization, scapular strengthening."]},"pl":{"exercises":["Rozciąganie tylne (torebka, cross-arm, rotacja wewn. na boku)."],"applies_when":["Tygodnie 4-6 terapii"],"restrictions":["Unikać stresu dla torebki przedniej."],"progression_criteria":["Wymagana bezbolesna pełna bierna ruchomość (PROM)."],"dosage_and_progression":["Progresja PROM (rotacja zewn. 30-50 stopni).","Rozpoczęcie AROM (zgięcie), jeśli PROM bezbolesny."],"physiotherapist_actions":["Mobilizacja tylno-dolna, wzmacnianie łopatki."]},"original":{"exercises":["Posterior capsular stretching (cross-arm, side-lying IR)."],"applies_when":["Weeks 4-6 of therapy"],"restrictions":["Avoid stressing anterior capsule."],"progression_criteria":["Requires pain-free full PROM."],"dosage_and_progression":["Progress PROM (ER 30-50 deg).","Begin AROM (flexion) if PROM pain-free."],"physiotherapist_actions":["Posterior-inferior mobilization, scapular strengthening."]}},"additional_notes_de":"Vermeidung von Stress für die vordere Kapsel. Hinteres Dehnen (Kapsel, Cross-arm, Innenrotation in Seitenlage).","additional_notes_en":"Avoid stressing anterior capsule. Posterior capsular stretching (cross-arm, side-lying IR).","additional_notes_pl":"Unikać stresu dla torebki przedniej. Rozciąganie tylne (torebka, cross-arm, rotacja wewn. na boku).","minimum_patient_share":null,"therapeutic_content_de":"Progression PROM (Außenrotation 30-50 Grad). Beginn AROM (Flexion) bei schmerzfreier PROM. Hintere-untere Mobilisation, Schulterblatt-Kräftigung.","therapeutic_content_en":"Progress PROM (ER 30-50 deg). Begin AROM (flexion) if PROM pain-free. Posterior-inferior mobilization, scapular strengthening.","therapeutic_content_pl":"Progresja PROM (rotacja zewn. 30-50 stopni). Rozpoczęcie AROM (zgięcie), jeśli PROM bezbolesny. Mobilizacja tylno-dolna, wzmacnianie łopatki.","minimum_requirements_de":"Schmerzfreie vollständige passive Beweglichkeit (PROM) erforderlich.","minimum_requirements_en":"Requires pain-free full PROM.","minimum_requirements_pl":"Wymagana bezbolesna pełna bierna ruchomość (PROM).","additional_notes_original":"Avoid stressing anterior capsule. Posterior capsular stretching (cross-arm, side-lying IR).","therapeutic_content_original":"Progress PROM (ER 30-50 deg). Begin AROM (flexion) if PROM pain-free. Posterior-inferior mobilization, scapular strengthening.","minimum_requirements_original":"Requires pain-free full PROM.","structured_content_v2":"$undefined"},{"id":"f081282d-4b1f-555b-a118-8a0c5554b4d2","name_de":"Phase III: Therapie-Wochen 6-12","name_en":"Phase III: Weeks 6-12 of therapy","name_pl":"Faza III: Tygodnie 6-12 terapii","source_page":1,"module_number":3,"name_original":"Phase III: Weeks 6-12 of therapy","service_codes":[],"structured_content":{"de":{"exercises":["Schulterblatt-Stabilisierung."],"applies_when":["Therapie-Wochen 6-12"],"dosage_and_progression":["Fortsetzung Steigerung PROM Außenrotation (voll am Körper).","Progression AROM in allen Ebenen bei Schmerzfreiheit.","Außenrotation bis 75 Grad in der Scapula-Ebene vor der 8. Woche."]},"en":{"exercises":["Scapular stabilizer strengthening."],"applies_when":["Weeks 6-12 of therapy"],"dosage_and_progression":["Continue increasing ER PROM (full at side).","Progress AROM in all planes if pain-free.","ER to 75 deg in scapular plane before 8 weeks."]},"pl":{"exercises":["Stabilizacja łopatki."],"applies_when":["Tygodnie 6-12 terapii"],"dosage_and_progression":["Kontynuacja zwiększania PROM rotacji zewnętrznej (pełna przy boku).","Progresja AROM we wszystkich płaszczyznach przy braku bólu.","ER do 75 stopni w płaszczyźnie łopatki przed 8. tygodniem."]},"original":{"exercises":["Scapular stabilizer strengthening."],"applies_when":["Weeks 6-12 of therapy"],"dosage_and_progression":["Continue increasing ER PROM (full at side).","Progress AROM in all planes if pain-free.","ER to 75 deg in scapular plane before 8 weeks."]}},"additional_notes_de":"Außenrotation bis 75 Grad in der Scapula-Ebene vor der 8. Woche.","additional_notes_en":"ER to 75 deg in scapular plane before 8 weeks.","additional_notes_pl":"ER do 75 stopni w płaszczyźnie łopatki przed 8. tygodniem.","minimum_patient_share":null,"therapeutic_content_de":"Fortsetzung Steigerung PROM Außenrotation (voll am Körper). Progression AROM in allen Ebenen bei Schmerzfreiheit. Schulterblatt-Stabilisierung.","therapeutic_content_en":"Continue increasing ER PROM (full at side). Progress AROM in all planes if pain-free. Scapular stabilizer strengthening.","therapeutic_content_pl":"Kontynuacja zwiększania PROM rotacji zewnętrznej (pełna przy boku). Progresja AROM we wszystkich płaszczyznach przy braku bólu. Stabilizacja łopatki.","minimum_requirements_de":"","minimum_requirements_en":"","minimum_requirements_pl":"","additional_notes_original":"ER to 75 deg in scapular plane before 8 weeks.","therapeutic_content_original":"Continue increasing ER PROM (full at side). Progress AROM in all planes if pain-free. Scapular stabilizer strengthening.","minimum_requirements_original":"","structured_content_v2":"$undefined"},{"id":"6b2881ae-6482-5fe3-99a0-5d1f57052aed","name_de":"Phase IV: Über 12 Wochen","name_en":"Phase IV: Beyond 12 weeks","name_pl":"Faza IV: Powyżej 12 tygodnia","source_page":2,"module_number":4,"name_original":"Phase IV: Beyond 12 weeks","service_codes":[],"structured_content":{"de":{"warnings":["Gesamte Genesungszeit ca. 9-12 Monate."],"exercises":["Wochen 12-16: Progression ROM und Stabilität (kein Krafttraining).","Wochen 16-20: Sanfte Kräftigung (kein Military Press), Wurftraining (nach Freigabe)."],"applies_when":["Über 12 Wochen"],"restrictions":["Kein Krafttraining vor dem 4. Monat.","Kontaktsport nicht vor 6 Monaten."]},"en":{"warnings":["Total recovery time 9-12 months."],"exercises":["Weeks 12-16: Progress ROM and stabilization (no weight training).","Weeks 16-20: Gentle strengthening (no military press), interval throwing (if cleared)."],"applies_when":["Beyond 12 weeks"],"restrictions":["No strengthening before 4 months.","No contact sports before 6 months."]},"pl":{"warnings":["Całkowity czas powrotu do sprawności: 9-12 miesięcy."],"exercises":["Tygodnie 12-16: Progresja ROM i stabilizacji (bez obciążeń).","Tygodnie 16-20: Delikatne wzmacnianie (unikać wyciskania nad głowę), trening rzutowy (za zgodą chirurga)."],"applies_when":["Powyżej 12 tygodnia"],"restrictions":["Brak wzmacniania do 4. miesiąca.","Sporty kontaktowe nie wcześniej niż po 6 miesiącach."]},"original":{"warnings":["Total recovery time 9-12 months."],"exercises":["Weeks 12-16: Progress ROM and stabilization (no weight training).","Weeks 16-20: Gentle strengthening (no military press), interval throwing (if cleared)."],"applies_when":["Beyond 12 weeks"],"restrictions":["No strengthening before 4 months.","No contact sports before 6 months."]}},"additional_notes_de":"Gesamte Genesungszeit ca. 9-12 Monate.","additional_notes_en":"Total recovery time 9-12 months.","additional_notes_pl":"Całkowity czas powrotu do sprawności: 9-12 miesięcy.","minimum_patient_share":null,"therapeutic_content_de":"Wochen 12-16: Progression ROM und Stabilität (kein Krafttraining). Wochen 16-20: Sanfte Kräftigung (kein Military Press), Wurftraining (nach Freigabe).","therapeutic_content_en":"Weeks 12-16: Progress ROM and stabilization (no weight training). Weeks 16-20: Gentle strengthening (no military press), interval throwing (if cleared).","therapeutic_content_pl":"Tygodnie 12-16: Progresja ROM i stabilizacji (bez obciążeń). Tygodnie 16-20: Delikatne wzmacnianie (unikać wyciskania nad głowę), trening rzutowy (za zgodą chirurga).","minimum_requirements_de":"Kein Krafttraining vor dem 4. Monat. Kontaktsport nicht vor 6 Monaten.","minimum_requirements_en":"No strengthening before 4 months. No contact sports before 6 months.","minimum_requirements_pl":"Brak wzmacniania do 4. miesiąca. Sporty kontaktowe nie wcześniej niż po 6 miesiącach.","additional_notes_original":"Total recovery time 9-12 months.","therapeutic_content_original":"Weeks 12-16: Progress ROM and stabilization (no weight training). Weeks 16-20: Gentle strengthening (no military press), interval throwing (if cleared).","minimum_requirements_original":"No strengthening before 4 months. No contact sports before 6 months.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["shoulder","upper_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"f1a1fcc1-edc9-5298-b924-84d08c856e59","slug":"uk-nhs-lothian-thr-2020","title_pl":"NHS Lothian: fizjoterapia po całkowitej endoprotezoplastyce biodra","title_de":"NHS Lothian: Physiotherapie nach totaler Hüftendoprothese","title_en":"NHS Lothian: Physiotherapy Orthopaedic Guidelines — Total Hip Replacement","title_original":"Lothian Physiotherapy Orthopaedic Guidelines — Total Hip Replacement","summary_pl":"Szpitalne wytyczne fizjoterapii po całkowitej endoprotezoplastyce biodra, od dnia operacji do powrotu do funkcji; czasy są orientacyjne i wymagają indywidualnego rozumowania klinicznego.","summary_de":"Stationäre physiotherapeutische Leitlinie nach totaler Hüftendoprothese vom Operationstag bis zur Funktionsrückkehr; Zeitangaben sind Näherungen und erfordern klinisches Denken.","summary_en":"Hospital physiotherapy guideline after total hip replacement from the day of surgery through return to function; timescales are approximate and require clinical reasoning.","country_code":"UK","source_language":"en","publication_year":2020,"version_label":"2020 · November 2020","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":["adults after total hip replacement","older adults after hip arthroplasty"],"clinical_contexts":["acute postoperative","early rehabilitation","late rehabilitation"],"care_pathways":["orthopaedic inpatient care","outpatient physiotherapy"],"physician_clearance_required":true,"condition_id":"a922f6b7-2dff-516e-a84d-44e8f5131ff7","condition_slug":"total-hip-replacement","condition_name_pl":"Całkowita endoprotezoplastyka stawu biodrowego","condition_name_de":"Totale Hüftendoprothese","condition_name_en":"Total Hip Replacement","condition_name_original":"Total Hip Replacement","icd_codes":[],"category_key":"lower-extremity","category_pl":"Fizjoterapia ortopedyczna","category_de":"Orthopädische Physiotherapie","category_en":"Orthopaedic physical therapy","body_regions_pl":["Biodro","Kończyna dolna","Chód"],"body_regions_de":["Hüfte","Untere Extremität","Gehen"],"body_regions_en":["Hip","Lower extremity","Walking"],"search_terms_pl":["endoproteza biodra","THR","TEP biodra","po operacji biodra","chód"],"search_terms_de":["Hüftendoprothese","THR","Hüft-TEP","Gang"],"search_terms_en":["total hip replacement","THR","hip arthroplasty","gait"],"source_document_id":"529ccd76-5f39-5814-8dd4-6cd2b5ad2673","source_title":"Lothian Physiotherapy Orthopaedic Guidelines — Total Hip Replacement","issuer":"Lothian Physiotherapy Orthopaedic Guidelines / NHS Lothian","source_country_code":"UK","jurisdiction_code":"UK-SCT","authority_level":"hospital","document_type":"physiotherapy_protocol","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"requires_update_review","official_url":"https://www.nhslothian.scot.nhs.uk/","source_sha256":"b1a19364d723a5989c827f8a581fe6620f47e00ab13439b5ee98ce91c55e72dd","authorization_required":false,"license_note":"Public source file retained locally for source verification.","modules":[{"id":"5726c7d8-1e1e-5c39-86a3-8fea7c6aceb6","name_de":"Grundsätze des gesamten Behandlungspfads","name_en":"Whole-pathway principles","name_pl":"Zasady całej ścieżki","source_page":2,"module_number":1,"name_original":"Key Points","service_codes":[],"structured_content":{"de":{"goals":["Frühe Mobilisation am Tag 0 oder 1 verkürzt den Aufenthalt, verringert postoperative Komplikationen und erhöht die Patientenzufriedenheit."],"restrictions":["Bei posteriorer oder lateraler Zugangstechnik die Kombination aus Flexion, Innenrotation und Adduktion vermeiden."],"progression_criteria":["Geringe Schwellung, rückläufiger Schmerz, gute Muskelrekrutierung und ein gutes Gangbild.","Zeitangaben sind Näherungen; die Erholung kann besonders in der frühen postoperativen Phase unterschiedlich schnell verlaufen."],"dosage_and_progression":["In der unmittelbaren postoperativen Phase werden funktionelle Meilensteine mit zwei Physiotherapiesitzungen täglich statt einer üblicherweise früher erreicht; dies ist die Sitzungsfrequenz, nicht die Dosierung einer einzelnen Übung."],"physiotherapist_actions":["Ein physiotherapeutisch geleitetes funktionelles Übungsprogramm durchführen."]},"en":{"goals":["Early mobilisation on day 0 or day 1 reduces length of stay and postoperative complications and increases patient satisfaction."],"restrictions":["With a posterior/lateral approach, avoid the combination of flexion, internal rotation, and adduction."],"progression_criteria":["Minimal swelling, resolution of pain, good muscle recruitment, and a good gait pattern.","Timescales are approximate and recovery may vary, particularly in the early post-operative period."],"dosage_and_progression":["In the immediate post-operative period, twice-daily physiotherapy rather than once daily usually achieves functional milestones earlier; this is session frequency, not the dosage of an individual exercise."],"physiotherapist_actions":["Provide a physiotherapy-led functional exercise programme."]},"pl":{"goals":["Wczesna mobilizacja w dniu 0 lub 1 skraca pobyt, zmniejsza liczbę powikłań pooperacyjnych i zwiększa satysfakcję pacjenta."],"restrictions":["Przy dostępie tylnym lub bocznym unikaj połączenia zgięcia, rotacji wewnętrznej i przywiedzenia."],"progression_criteria":["Minimalny obrzęk, ustępowanie bólu, dobra rekrutacja mięśni i dobry wzorzec chodu.","Czasy są orientacyjne, a tempo powrotu może się różnić, szczególnie we wczesnym okresie pooperacyjnym."],"dosage_and_progression":["W bezpośrednim okresie pooperacyjnym dwie sesje fizjoterapii dziennie zamiast jednej zwykle pozwalają wcześniej osiągać funkcjonalne kamienie milowe; jest to częstotliwość sesji, nie dawka pojedynczego ćwiczenia."],"physiotherapist_actions":["Prowadź funkcjonalny program ćwiczeń fizjoterapeutycznych."]},"original":{"goals":["Early mobilisation (day 0 or day 1), reduces overall length of stay and reduces post-op complications. It also increases patient satisfaction."],"restrictions":["Reduction of hip precautions- avoid combination of flexion, internal rotation and adduction with the posterior/ lateral approach."],"progression_criteria":["Please note that timescales are approximate and rehabilitation should be guided, at each stage, by minimal swelling, resolution of pain, good muscle recruitment and a good gait pattern.","Rates of recovery may vary for THR patients, particularly in the early post-operative period."],"dosage_and_progression":["In the immediate post-operative period patients that receive twice daily physiotherapy as opposed to once per day usually attain earlier achievement of functional milestones."],"physiotherapist_actions":["A physiotherapy led functional exercise programme can lead to patients having significant functional improvement following THR and therefore achieving optimal function."]}},"additional_notes_de":"Die verfügbare Evidenz zur Rehabilitation nach totaler Hüftendoprothese ist von begrenzter Qualität. Bei posteriorer oder lateraler Zugangstechnik sollte die Kombination aus Flexion, Innenrotation und Adduktion vermieden werden.","additional_notes_en":"There is a lack of good-quality studies on rehabilitation following total hip replacement. Avoid the combination of flexion, internal rotation, and adduction with a posterior/lateral approach.","additional_notes_pl":"Dostępne badania dotyczące rehabilitacji po całkowitej endoprotezoplastyce biodra są ograniczone jakościowo. Przy dostępie tylnym lub bocznym należy unikać połączenia zgięcia, rotacji wewnętrznej i przywiedzenia.","minimum_patient_share":null,"therapeutic_content_de":"Eine frühe Mobilisation am Tag 0 oder 1 verkürzt die Aufenthaltsdauer, reduziert postoperative Komplikationen und erhöht die Patientenzufriedenheit. Ein physiotherapeutisch angeleitetes funktionelles Übungsprogramm kann die Funktion nach einer totalen Hüftendoprothese deutlich verbessern. In der unmittelbaren postoperativen Phase erreichen Patient:innen mit zweimal täglicher Physiotherapie gegenüber einmal täglich meist früher funktionelle Meilensteine.","therapeutic_content_en":"Early mobilisation (day 0 or day 1) reduces overall length of stay and post-operative complications and increases patient satisfaction. A physiotherapy-led functional exercise programme can lead to significant functional improvement following THR and therefore optimal function. In the immediate post-operative period, patients who receive twice-daily physiotherapy as opposed to once per day usually attain functional milestones earlier.","therapeutic_content_pl":"Wczesna mobilizacja w dniu 0 lub 1 skraca pobyt i zmniejsza ryzyko powikłań pooperacyjnych oraz zwiększa satysfakcję pacjenta. Program funkcjonalnych ćwiczeń prowadzony przez fizjoterapeutę może poprawić funkcję po całkowitej endoprotezoplastyce biodra. We wczesnym okresie pooperacyjnym dwie sesje fizjoterapii dziennie, w porównaniu z jedną sesją dziennie, zwykle pozwalają wcześniej osiągnąć kamienie milowe funkcji.","minimum_requirements_de":"Die Progression sollte in jeder Phase an geringer Schwellung, rückläufigem Schmerz, guter Muskelrekrutierung und einem guten Gangbild ausgerichtet werden. Zeitangaben sind Näherungen und die Erholung kann besonders früh postoperativ unterschiedlich schnell verlaufen.","minimum_requirements_en":"At each stage, guide rehabilitation by minimal swelling, resolution of pain, good muscle recruitment, and a good gait pattern. Timescales are approximate and rates of recovery may vary, particularly in the early post-operative period.","minimum_requirements_pl":"Postęp na każdym etapie powinien być prowadzony przy małym obrzęku, ustępowaniu bólu, dobrej rekrutacji mięśni i dobrym wzorcu chodu. Czasy są orientacyjne, a tempo powrotu może się różnić, szczególnie we wczesnym okresie pooperacyjnym.","additional_notes_original":"Lack of good quality studies on rehabilitation following total hip replacement. Reduction of hip precautions- avoid combination of flexion, internal rotation and adduction with the posterior/ lateral approach.","therapeutic_content_original":"Early mobilisation (day 0 or day 1), reduces overall length of stay and reduces post-op complications. It also increases patient satisfaction. A physiotherapy led functional exercise programme can lead to patients having significant functional improvement following THR and therefore achieving optimal function. In the immediate post-operative period patients that receive twice daily physiotherapy as opposed to once per day usually attain earlier achievement of functional milestones.","minimum_requirements_original":"Please note that timescales are approximate and rehabilitation should be guided, at each stage, by minimal swelling, resolution of pain, good muscle recruitment and a good gait pattern. Rates of recovery may vary for THR patients, particularly in the early post-operative period.","structured_content_v2":"$undefined"},{"id":"9a335ccc-20a3-51ea-a56f-e849700a8ada","name_de":"Phase 1 — unmittelbar postoperativ (0–7 Tage)","name_en":"Phase 1 — Immediate post-op: 0–7 days","name_pl":"Etap 1 — bezpośrednio po operacji (0–7 dni)","source_page":3,"module_number":2,"name_original":"Phase 1 Immediate post-op: 0-7 days","service_codes":[],"structured_content":{"de":{"goals":["Selbstständige Mobilität mit geeigneter Gehhilfe.","Unabhängige Transfers.","Treppenbeurteilung.","Häusliches Übungsprogramm im Bett, Sitzen und Stehen."],"progression_criteria":["Geringe Schwellung, rückläufiger Schmerz, gute Muskelrekrutierung und ein gutes Gangbild."],"physiotherapist_actions":["Bei Bedarf Kälte zur Schwellungskontrolle einsetzen.","Täglich eine Zeit lang in Rückenlage liegen lassen, um Schwellungskontrolle und Bewegungsumfang zu unterstützen."]},"en":{"goals":["Independent mobility with appropriate walking aids.","Independent transfers.","Stairs assessment.","Home exercise programme consisting of bed, chair, and standing."],"progression_criteria":["Minimal swelling, resolution of pain, good muscle recruitment, and a good gait pattern."],"physiotherapist_actions":["Use ice therapy for swelling management as required.","Have the patient lie supine for a period daily to aid swelling management and ROM."]},"pl":{"goals":["Samodzielne poruszanie się z odpowiednią pomocą do chodzenia.","Niezależne transfery.","Ocena schodów.","Domowy program ćwiczeń w łóżku, na krześle i w staniu."],"progression_criteria":["Minimalny obrzęk, ustępowanie bólu, dobra rekrutacja mięśni i dobry wzorzec chodu."],"physiotherapist_actions":["Zastosuj chłodzenie w celu kontroli obrzęku, jeśli jest potrzebne.","Zaplanuj codzienny czas w leżeniu tyłem dla kontroli obrzęku i zakresu ruchu."]},"original":{"goals":["Achieve independent mobility with appropriate walking aids.","Independent all transfers.","Stairs assessment.","Home exercise programme consisting of bed, chair and standing."],"progression_criteria":["Rehabilitation should be guided, at each stage, by minimal swelling, resolution of pain, good muscle recruitment and a good gait pattern."],"physiotherapist_actions":["Ice therapy for swelling management as required.","Lie supine for time period daily to aid swelling management and ROM."]}},"additional_notes_de":"Die Quelle nennt keine konkreten Übungen, Serien, Wiederholungen oder ein Belastungsprotokoll.","additional_notes_en":"The source does not name specific exercises, sets, repetitions, or a loading protocol.","additional_notes_pl":"Źródło nie podaje nazw konkretnych ćwiczeń, serii, powtórzeń ani protokołu obciążania.","minimum_patient_share":null,"therapeutic_content_de":"Ziele: selbstständige Mobilität mit geeigneter Gehhilfe, unabhängige Transfers, Treppenbeurteilung sowie ein häusliches Übungsprogramm im Bett, Sitzen und Stehen. Maßnahmen: Kälte zur Schwellungskontrolle und tägliche Rückenlage zur Unterstützung von Schwellungskontrolle und Bewegungsumfang.","therapeutic_content_en":"Goals: achieve independent mobility with appropriate walking aids, independent transfers, stairs assessment, and a home exercise programme consisting of bed, chair, and standing. Recommendations: ice therapy for swelling management and lie supine for a period daily to aid swelling management and ROM.","therapeutic_content_pl":"Cele: samodzielne poruszanie się z odpowiednią pomocą do chodzenia, niezależne transfery, ocena schodów oraz domowy program ćwiczeń w łóżku, na krześle i w staniu. Działania: chłodzenie w celu kontroli obrzęku oraz codzienny czas w leżeniu tyłem dla kontroli obrzęku i zakresu ruchu.","minimum_requirements_de":"Progression an geringer Schwellung, rückläufigem Schmerz, guter Muskelrekrutierung und einem guten Gangbild ausrichten.","minimum_requirements_en":"Guide progression by minimal swelling, resolution of pain, good muscle recruitment, and a good gait pattern.","minimum_requirements_pl":"Postęp kieruj według małego obrzęku, ustępowania bólu, dobrej rekrutacji mięśni i dobrego wzorca chodu.","additional_notes_original":"","therapeutic_content_original":"Phase 1 Immediate post-op: 0-7 days. Goals: Achieve independent mobility with appropriate walking aids; Independent all transfers; Stairs assessment; Home exercise programme consisting of bed, chair and standing. Recommendations: Ice therapy for swelling management as required; Lie supine for time period daily to aid swelling management and ROM.","minimum_requirements_original":"Rehabilitation should be guided, at each stage, by minimal swelling, resolution of pain, good muscle recruitment and a good gait pattern.","structured_content_v2":"$undefined"},{"id":"67e1c1db-315a-585b-89cf-80b0ad0ae871","name_de":"Phase 2 — frühe Rehabilitation (1–6 Wochen)","name_en":"Phase 2 — Early rehab: 1–6 weeks","name_pl":"Etap 2 — wczesna rehabilitacja (1–6 tygodni)","source_page":3,"module_number":3,"name_original":"Phase 2 Early rehab:1-6 weeks","service_codes":[],"structured_content":{"de":{"goals":["Mehr Mobilität.","Mehr Selbstständigkeit.","Größerer Bewegungsumfang des Gelenks.","Mehr Muskelkraft."],"progression_criteria":["Geringe Schwellung, rückläufiger Schmerz, gute Muskelrekrutierung und ein gutes Gangbild."],"physiotherapist_actions":["Gang-Reedukation durchführen.","Funktionelle Rehabilitation und ein Übungsprogramm durchführen.","Gehhilfen reduzieren."]},"en":{"goals":["Increase mobility.","Increase independence.","Increase joint ROM.","Increase muscle strength."],"progression_criteria":["Minimal swelling, resolution of pain, good muscle recruitment, and a good gait pattern."],"physiotherapist_actions":["Provide gait re-education.","Provide functional rehabilitation and an exercise programme.","Decrease use of walking aids."]},"pl":{"goals":["Zwiększenie mobilności.","Zwiększenie samodzielności.","Zwiększenie zakresu ruchu stawu.","Zwiększenie siły mięśniowej."],"progression_criteria":["Minimalny obrzęk, ustępowanie bólu, dobra rekrutacja mięśni i dobry wzorzec chodu."],"physiotherapist_actions":["Prowadź reedukację chodu.","Prowadź rehabilitację funkcjonalną i program ćwiczeń.","Zmniejszaj użycie pomocy do chodzenia."]},"original":{"goals":["Increase mobility.","Increase independence.","Increase joint ROM.","Increase muscle strength."],"progression_criteria":["Rehabilitation should be guided, at each stage, by minimal swelling, resolution of pain, good muscle recruitment and a good gait pattern."],"physiotherapist_actions":["Gait re-education.","Functional rehabilitation.","Exercise Programme.","Decrease use of walking aids."]}},"additional_notes_de":"Die Quelle nennt keine konkreten Übungen, Serien oder Wiederholungen.","additional_notes_en":"The source does not name specific exercises, sets, or repetitions.","additional_notes_pl":"Źródło nie podaje nazw konkretnych ćwiczeń, serii ani powtórzeń.","minimum_patient_share":null,"therapeutic_content_de":"Ziele: mehr Mobilität und Selbstständigkeit, größerer Bewegungsumfang und Muskelkraft. Maßnahmen: Gang-Reedukation, funktionelle Rehabilitation, Übungsprogramm und Verringerung der Gehhilfen.","therapeutic_content_en":"Goals: increase mobility, independence, joint ROM, and muscle strength. Recommendations: gait re-education, functional rehabilitation, exercise programme, and decrease use of walking aids.","therapeutic_content_pl":"Cele: zwiększenie mobilności, samodzielności, zakresu ruchu stawu i siły mięśniowej. Działania: reedukacja chodu, rehabilitacja funkcjonalna, program ćwiczeń i zmniejszanie użycia pomocy do chodzenia.","minimum_requirements_de":"Progression an geringer Schwellung, rückläufigem Schmerz, guter Muskelrekrutierung und gutem Gangbild ausrichten.","minimum_requirements_en":"Base progression on minimal swelling, resolution of pain, good muscle recruitment, and a good gait pattern.","minimum_requirements_pl":"Progresję opieraj na minimalnym obrzęku, ustępowaniu bólu, dobrej rekrutacji mięśni i dobrym wzorcu chodu.","additional_notes_original":"","therapeutic_content_original":"Phase 2 Early rehab:1-6 weeks. Goals: Increase mobility; Increase independence; Increase joint ROM; Increase muscle strength. Recommendations: Gait re-education; Functional rehabilitation; Exercise Programme; Decrease use of walking aids.","minimum_requirements_original":"Rehabilitation should be guided, at each stage, by minimal swelling, resolution of pain, good muscle recruitment and a good gait pattern.","structured_content_v2":"$undefined"},{"id":"d0d80537-370e-5c82-85f6-929d79ebf4d8","name_de":"Phase 3 — späte Rehabilitation (6–12 Wochen)","name_en":"Phase 3 — Late rehab: 6–12 weeks","name_pl":"Etap 3 — późna rehabilitacja (6–12 tygodni)","source_page":4,"module_number":4,"name_original":"Phase 3 Late rehab: 6-12weeks","service_codes":[],"structured_content":{"de":{"goals":["Selbstständige Mobilität ohne Gehhilfe, wenn angemessen.","Verbesserung von Gang und Bewegungsumfang.","Angeleitete Rückkehr zu Bewegung."],"progression_criteria":["Geringe Schwellung, rückläufiger Schmerz, gute Muskelrekrutierung und ein gutes Gangbild."],"physiotherapist_actions":["Gang-Reedukation nach Bedarf fortsetzen.","Sport- oder aktivitätsspezifische Rehabilitation einsetzen."]},"en":{"goals":["Independent mobility without walking aids if appropriate.","Gait and ROM achieved.","Return to exercise as appropriate with guidance."],"progression_criteria":["Minimal swelling, resolution of pain, good muscle recruitment, and a good gait pattern."],"physiotherapist_actions":["Continue gait re-education as required.","Provide sports/activity-specific rehabilitation."]},"pl":{"goals":["Samodzielne poruszanie się bez pomocy, jeśli jest to właściwe.","Poprawa chodu i osiągnięcie zakresu ruchu.","Powrót do ćwiczeń zgodnie z zaleceniami."],"progression_criteria":["Minimalny obrzęk, ustępowanie bólu, dobra rekrutacja mięśni i dobry wzorzec chodu."],"physiotherapist_actions":["Kontynuuj reedukację chodu w razie potrzeby.","Włącz rehabilitację specyficzną dla sportu lub aktywności."]},"original":{"goals":["Independent mobility without walking aids if appropriate.","Gait.","Rom achieved.","Return to exercise as appropriate with guidance."],"progression_criteria":["Please note that timescales are approximate and rehabilitation should be guided, at each stage, by minimal swelling, resolution of pain, good muscle recruitment and a good gait pattern."],"physiotherapist_actions":["Continue gait- re-ed as required.","Sports/ activity specific rehab."]}},"additional_notes_de":"Die Quelle nennt keine konkreten Übungen, Serien, Wiederholungen oder ein Belastungsprotokoll.","additional_notes_en":"The source does not name specific exercises, sets, repetitions, or a loading protocol.","additional_notes_pl":"Źródło nie podaje nazw konkretnych ćwiczeń, serii, powtórzeń ani protokołu obciążania.","minimum_patient_share":null,"therapeutic_content_de":"Ziele: selbstständige Mobilität ohne Gehhilfe, wenn angemessen, Fortführung der Gang-Reedukation nach Bedarf, Verbesserung von Gang und Bewegungsumfang sowie angeleitete Rückkehr zu Bewegung. Maßnahmen: Fortsetzung der Gang-Reedukation und sport- oder aktivitätsspezifische Rehabilitation.","therapeutic_content_en":"Goals: independent mobility without walking aids if appropriate, continued gait re-education as required, gait and ROM achieved, and return to exercise as appropriate with guidance. Recommendations: continue gait re-education as required and sports/activity-specific rehabilitation.","therapeutic_content_pl":"Cele: samodzielne poruszanie się bez pomocy, jeśli jest to właściwe, utrzymanie reedukacji chodu w razie potrzeby, osiągnięcie poprawy chodu i zakresu ruchu oraz powrót do ćwiczeń zgodnie z zaleceniami. Działania: kontynuacja reedukacji chodu i rehabilitacja specyficzna dla sportu lub aktywności.","minimum_requirements_de":"Progression an geringer Schwellung, rückläufigem Schmerz, guter Muskelrekrutierung und gutem Gangbild ausrichten.","minimum_requirements_en":"Guide progression by minimal swelling, resolution of pain, good muscle recruitment, and a good gait pattern.","minimum_requirements_pl":"Postęp kieruj według małego obrzęku, ustępowania bólu, dobrej rekrutacji mięśni i dobrego wzorca chodu.","additional_notes_original":"","therapeutic_content_original":"Phase 3 Late rehab: 6-12weeks. Goals: Independent mobility without walking aids if appropriate. Gait. Rom achieved. Return to exercise as appropriate with guidance. Recommendations: Continue gait- re-ed as required. Sports/ activity specific rehab.","minimum_requirements_original":"Rehabilitation should be guided, at each stage, by minimal swelling, resolution of pain, good muscle recruitment and a good gait pattern.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["hip_pelvis","lower_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"86f2cedc-94ae-5a05-bcf8-15315dde764a","slug":"us-jared-lee-23-total-hip-arthroplasty","title_pl":"Protokół rehabilitacji po całkowitej endoprotezoplastyce stawu biodrowego","title_de":"Rehabilitationsprotokoll nach Hüft-Totalendoprothese","title_en":"Total Hip Arthroplasty Rehabilitation Protocol","title_original":"THA Rehabilitation","summary_pl":"Trzyfazowy protokół po całkowitej endoprotezoplastyce stawu biodrowego, obejmujący wczesne uruchamianie, progresję siły i powrót funkcjonalny.","summary_de":"Dreiphasiges Protokoll nach Hüft-Totalendoprothese mit Frühmobilisation, Kraftaufbau und funktioneller Rückkehr.","summary_en":"Three-phase protocol after total hip arthroplasty covering early mobilization, strength progression and functional return.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"394caacf-c99c-59b2-9bd6-86b801456e84","condition_slug":"total-hip-arthroplasty","condition_name_pl":"Całkowita endoprotezoplastyka stawu biodrowego (TEP)","condition_name_de":"Totalendoprothese (TEP) des Hüftgelenks","condition_name_en":"Total Hip Arthroplasty (THA)","condition_name_original":"Total Hip Arthroplasty (THA)","icd_codes":[],"category_key":"hip","category_pl":"Ortopedia","category_de":"Orthopädie","category_en":"Orthopedics","body_regions_pl":["biodro"],"body_regions_de":["Hüfte"],"body_regions_en":["hip"],"search_terms_pl":["TEP","endoproteza biodra","rehabilitacja pooperacyjna","staw biodrowy"],"search_terms_de":["TEP","Hüft-TEP","Hüftprothese","Rehabilitation nach Hüft-OP"],"search_terms_en":["THA","total hip replacement","hip arthroplasty","post-op hip rehab"],"source_document_id":"0940af9e-f74f-58de-98b3-12a474db7e4a","source_title":"THA Rehabilitation","issuer":"Jared Lee, MD","source_country_code":"US","jurisdiction_code":"US-CO","authority_level":"clinic","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_requires_review","official_url":"https://jaredleemd.com/wp-content/uploads/2025/06/THA-Rehabilitation-Protocol.pdf","source_sha256":"be0074f19e605bca58fe3fbf524a507d7b58713d8cf3f584079091aebcd0fa32","authorization_required":true,"license_note":"All Rights Reserved. Authorization is required before final public release. Current development and staging remain allowed by the owner's decision.","modules":[{"id":"87ed88b8-08e9-584d-8a70-18b4366cea8c","name_de":"Phase 1: Wochen 0–2","name_en":"Phase 1: Weeks 0-2","name_pl":"Faza 1: tygodnie 0–2","source_page":1,"module_number":1,"name_original":"Phase 1: Weeks 0-2","service_codes":[],"structured_content":{"de":{"goals":["Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, den schmerzfreien Bewegungsumfang verbessern, tiefe Venenthrombosen verhindern und selbstständiges Gehen erreichen."],"exercises":["Wiederherstellung des Bewegungsumfangs durch aktive, aktiv-assistierte und passive Übungen","isometrische Quadrizepskräftigung","Übungen in Rückenlage und im Sitzen einschließlich Fußpumpen, Fersengleiten, Innen- und Außenrotation der Hüfte, Kniestreckung im vollen Bewegungsbogen im Sitzen, Hüftflexion im Sitzen sowie Hüftadduktion und -abduktion","Fahrradergometer ohne Widerstand","Rumpfkräftigung","Heimübungsprogramm."],"applies_when":["Wochen 0–2"],"restrictions":["Kein Autofahren bis zum Absetzen der Opioidanalgetika.","Keine für den anterioren Hüftzugang typischen Einschränkungen"],"dosage_and_progression":["Belastung nach Verträglichkeit.","Unterarmgehstützen oder Gehwagen nach Vorgabe schrittweise absetzen."],"physiotherapist_actions":["TED-Kompressionsstrümpfe 14 Tage lang durchgehend tragen, ausgenommen bei Hygiene und Ankleiden.","Den Aquacel-Verband 14 Tage postoperativ entfernen.","Treppen- und Gangtraining","physikalische Maßnahmen nach Bedarf"]},"en":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, improve pain-free range of motion, prevent deep-vein thrombosis and achieve independent ambulation."],"exercises":["restore range of motion with active, active-assisted and passive exercises","isometric quadriceps strengthening","supine and seated exercises including ankle pumps, heel slides, hip internal and external rotation, long-arc quadriceps, seated hip flexion, and hip adduction and abduction","stationary cycling without resistance","core strengthening","home exercise program."],"applies_when":["Weeks 0-2"],"restrictions":["Do not drive until narcotic pain medication is discontinued.","No anterior hip restrictions"],"dosage_and_progression":["Weight-bearing as tolerated.","Wean from crutches or walker as indicated."],"physiotherapist_actions":["Wear TED compression stockings at all times except for hygiene and dressing for 14 days.","Remove the Aquacel dressing at 14 days postoperatively.","stair and gait training","modalities as needed"]},"pl":{"goals":["zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, poprawa bezbolesnego zakresu ruchu, zapobieganie zakrzepicy żył głębokich i samodzielne chodzenie."],"exercises":["odtwarzanie zakresu ruchu przez ćwiczenia czynne, czynne wspomagane i bierne","izometryczne wzmacnianie mięśnia czworogłowego","ćwiczenia w leżeniu i siadzie, w tym pompki stopy, ślizgi pięty, rotacja wewnętrzna i zewnętrzna biodra, wyprost kolana w pełnym zakresie w siadzie, zgięcie biodra w siadzie oraz przywodzenie i odwodzenie biodra","rower stacjonarny bez oporu","wzmacnianie centralne","trening schodów i chodu","program ćwiczeń domowych."],"applies_when":["tygodnie 0–2"],"restrictions":["Nie prowadzić pojazdów do odstawienia leków opioidowych.","Bez ograniczeń typowych dla przedniego dostępu do stawu biodrowego"],"dosage_and_progression":["Obciążanie według tolerancji.","Stopniowo odstawiać kule lub balkonik zgodnie ze wskazaniami."],"physiotherapist_actions":["Pończochy uciskowe TED przez cały czas z wyjątkiem higieny i zmiany ubrania przez 14 dni.","Usunąć opatrunek Aquacel po 14 dniach od zabiegu.","fizykoterapia według potrzeb"]},"original":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, improve pain-free range of motion, prevent deep-vein thrombosis and achieve independent ambulation."],"exercises":["restore range of motion with active, active-assisted and passive exercises","isometric quadriceps strengthening","supine and seated exercises including ankle pumps, heel slides, hip internal and external rotation, long-arc quadriceps, seated hip flexion, and hip adduction and abduction","stationary cycling without resistance","core strengthening","home exercise program."],"applies_when":["Weeks 0-2"],"restrictions":["Do not drive until narcotic pain medication is discontinued.","No anterior hip restrictions"],"dosage_and_progression":["Weight-bearing as tolerated.","Wean from crutches or walker as indicated."],"physiotherapist_actions":["Wear TED compression stockings at all times except for hygiene and dressing for 14 days.","Remove the Aquacel dressing at 14 days postoperatively.","stair and gait training","modalities as needed"]}},"additional_notes_de":"Ziele: Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, den schmerzfreien Bewegungsumfang verbessern, tiefe Venenthrombosen verhindern und selbstständiges Gehen erreichen.","additional_notes_en":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, improve pain-free range of motion, prevent deep-vein thrombosis and achieve independent ambulation.","additional_notes_pl":"Cele: zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, poprawa bezbolesnego zakresu ruchu, zapobieganie zakrzepicy żył głębokich i samodzielne chodzenie.","minimum_patient_share":null,"therapeutic_content_de":"Keine für den anterioren Hüftzugang typischen Einschränkungen; Wiederherstellung des Bewegungsumfangs durch aktive, aktiv-assistierte und passive Übungen; isometrische Quadrizepskräftigung; Übungen in Rückenlage und im Sitzen einschließlich Fußpumpen, Fersengleiten, Innen- und Außenrotation der Hüfte, Kniestreckung im vollen Bewegungsbogen im Sitzen, Hüftflexion im Sitzen sowie Hüftadduktion und -abduktion; Fahrradergometer ohne Widerstand; Rumpfkräftigung; Treppen- und Gangtraining; physikalische Maßnahmen nach Bedarf; Heimübungsprogramm.","therapeutic_content_en":"No anterior hip restrictions; restore range of motion with active, active-assisted and passive exercises; isometric quadriceps strengthening; supine and seated exercises including ankle pumps, heel slides, hip internal and external rotation, long-arc quadriceps, seated hip flexion, and hip adduction and abduction; stationary cycling without resistance; core strengthening; stair and gait training; modalities as needed; home exercise program.","therapeutic_content_pl":"Bez ograniczeń typowych dla przedniego dostępu do stawu biodrowego; odtwarzanie zakresu ruchu przez ćwiczenia czynne, czynne wspomagane i bierne; izometryczne wzmacnianie mięśnia czworogłowego; ćwiczenia w leżeniu i siadzie, w tym pompki stopy, ślizgi pięty, rotacja wewnętrzna i zewnętrzna biodra, wyprost kolana w pełnym zakresie w siadzie, zgięcie biodra w siadzie oraz przywodzenie i odwodzenie biodra; rower stacjonarny bez oporu; wzmacnianie centralne; trening schodów i chodu; fizykoterapia według potrzeb; program ćwiczeń domowych.","minimum_requirements_de":"Belastung nach Verträglichkeit. TED-Kompressionsstrümpfe 14 Tage lang durchgehend tragen, ausgenommen bei Hygiene und Ankleiden. Den Aquacel-Verband 14 Tage postoperativ entfernen. Kein Autofahren bis zum Absetzen der Opioidanalgetika. Unterarmgehstützen oder Gehwagen nach Vorgabe schrittweise absetzen.","minimum_requirements_en":"Weight-bearing as tolerated. Wear TED compression stockings at all times except for hygiene and dressing for 14 days. Remove the Aquacel dressing at 14 days postoperatively. Do not drive until narcotic pain medication is discontinued. Wean from crutches or walker as indicated.","minimum_requirements_pl":"Obciążanie według tolerancji. Pończochy uciskowe TED przez cały czas z wyjątkiem higieny i zmiany ubrania przez 14 dni. Usunąć opatrunek Aquacel po 14 dniach od zabiegu. Nie prowadzić pojazdów do odstawienia leków opioidowych. Stopniowo odstawiać kule lub balkonik zgodnie ze wskazaniami.","additional_notes_original":"Goals: Reduce swelling and edema, minimize pain, retard muscle atrophy, improve pain-free ROM, DVT prevention, independent ambulation","therapeutic_content_original":"No anterior hip restrictions; restore range of motion with active, active-assisted and passive exercises; isometric quadriceps strengthening; supine and seated exercises including ankle pumps, heel slides, hip internal and external rotation, long-arc quadriceps, seated hip flexion, and hip adduction and abduction; stationary cycling without resistance; core strengthening; stair and gait training; modalities as needed; home exercise program.","minimum_requirements_original":"Weight-bearing as tolerated. Wear TED compression stockings at all times except for hygiene and dressing for 14 days. Remove the Aquacel dressing at 14 days postoperatively. Do not drive until narcotic pain medication is discontinued. Wean from crutches or walker as indicated.","structured_content_v2":"$undefined"},{"id":"17007b17-ad7a-5a30-bcce-c23fa91c1a29","name_de":"Phase 2: Wochen 3–6","name_en":"Phase 2: Weeks 3-6","name_pl":"Faza 2: tygodnie 3–6","source_page":1,"module_number":2,"name_original":"Phase 2: Weeks 3-6","service_codes":[],"structured_content":{"de":{"goals":["Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, den Bewegungsumfang wiederherstellen und Selbstständigkeit bei Alltagsaktivitäten erreichen."],"exercises":["Progression des Übungsprogramms","Einbeinstand, Vorwärts- und Seitwärts-Step-ups, Kniebeugung in Bauchlage und Fersenheben","Wassertherapie nach Abheilung der Inzision, etwa in Woche 4","Rückkehr zu lockerem Bahnenschwimmen ohne Rollwende und Brustschwimmen möglich","Fahrradergometer oder Liege-Stepper mit minimalem Widerstand","Rumpfkräftigung","progressive Hüftkräftigung in allen Ebenen","progressive Kräftigung von Quadrizeps, ischiokruraler und Glutealmuskulatur","Beckenbodenprogramm","Korrektur von Beckenkippung und Haltung","Heimübungsprogramm."],"applies_when":["Wochen 3–6"],"restrictions":["Kein Autofahren bis zum Absetzen der Opioidanalgetika."],"progression_criteria":["normalisiertes Gangbild","Anheben des gestreckten Beins 2×10 ohne Extensionsdefizit","minimale oder keine reaktive Schmerz- und Schwellungszunahme bei Alltagsaktivitäten und physiotherapeutischen Übungen","normalisierte Muskelaktivierung und -isolation."],"dosage_and_progression":["Belastung nach Verträglichkeit."]},"en":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, restore range of motion and achieve independence with activities of daily living."],"exercises":["Progress the exercise program","single-leg balance, forward and side step-ups, prone hamstring curls and heel raises","aquatic therapy after the incision has healed, at about week 4","may return to easy lap swimming without flip turns or breaststroke","stationary bike or recumbent stepper with minimal resistance","core strengthening","progressive hip strengthening in all planes","progressive quadriceps, hamstring and gluteal strengthening","pelvic-floor program","address pelvic tilt and posture","home exercise program."],"applies_when":["Weeks 3-6"],"restrictions":["Do not drive until narcotic pain medication is discontinued."],"progression_criteria":["normalized gait pattern","straight-leg raise 2×10 without quadriceps lag","minimal to no reactive pain and swelling with activities of daily living and physical-therapy exercises","normalized muscle activation and isolation."],"dosage_and_progression":["Weight-bearing as tolerated."]},"pl":{"goals":["zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, odtworzenie zakresu ruchu oraz samodzielność w czynnościach dnia codziennego."],"exercises":["Progresja programu ćwiczeń","równowaga jednonóż, wejścia na stopień w przód i bokiem, zginanie kolana w leżeniu przodem oraz wspięcia na palce","terapia w wodzie po wygojeniu cięcia, około 4. tygodnia","możliwy powrót do spokojnego pływania bez nawrotów koziołkowych i stylu klasycznego","rower stacjonarny lub stepper poziomy z minimalnym oporem","wzmacnianie centralne","progresywne wzmacnianie biodra we wszystkich płaszczyznach","progresywne wzmacnianie mięśnia czworogłowego, mięśni kulszowo-goleniowych i pośladkowych","program mięśni dna miednicy","korekcja ustawienia miednicy i postawy","program ćwiczeń domowych."],"applies_when":["tygodnie 3–6"],"restrictions":["Nie prowadzić pojazdów do odstawienia leków opioidowych."],"progression_criteria":["znormalizowany wzorzec chodu","unoszenie wyprostowanej kończyny 2×10 bez deficytu wyprostu","minimalny lub nieobecny reaktywny ból i obrzęk podczas czynności dnia codziennego i ćwiczeń fizjoterapeutycznych","znormalizowana aktywacja i izolacja mięśni."],"dosage_and_progression":["Obciążanie według tolerancji."]},"original":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, restore range of motion and achieve independence with activities of daily living."],"exercises":["Progress the exercise program","single-leg balance, forward and side step-ups, prone hamstring curls and heel raises","aquatic therapy after the incision has healed, at about week 4","may return to easy lap swimming without flip turns or breaststroke","stationary bike or recumbent stepper with minimal resistance","core strengthening","progressive hip strengthening in all planes","progressive quadriceps, hamstring and gluteal strengthening","pelvic-floor program","address pelvic tilt and posture","home exercise program."],"applies_when":["Weeks 3-6"],"restrictions":["Do not drive until narcotic pain medication is discontinued."],"progression_criteria":["normalized gait pattern","straight-leg raise 2×10 without quadriceps lag","minimal to no reactive pain and swelling with activities of daily living and physical-therapy exercises","normalized muscle activation and isolation."],"dosage_and_progression":["Weight-bearing as tolerated."]}},"additional_notes_de":"Ziele: Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, den Bewegungsumfang wiederherstellen und Selbstständigkeit bei Alltagsaktivitäten erreichen.","additional_notes_en":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, restore range of motion and achieve independence with activities of daily living.","additional_notes_pl":"Cele: zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, odtworzenie zakresu ruchu oraz samodzielność w czynnościach dnia codziennego.","minimum_patient_share":null,"therapeutic_content_de":"Progression des Übungsprogramms; Einbeinstand, Vorwärts- und Seitwärts-Step-ups, Kniebeugung in Bauchlage und Fersenheben; Wassertherapie nach Abheilung der Inzision, etwa in Woche 4; Rückkehr zu lockerem Bahnenschwimmen ohne Rollwende und Brustschwimmen möglich; Fahrradergometer oder Liege-Stepper mit minimalem Widerstand; Rumpfkräftigung; progressive Hüftkräftigung in allen Ebenen; progressive Kräftigung von Quadrizeps, ischiokruraler und Glutealmuskulatur; Beckenbodenprogramm; Korrektur von Beckenkippung und Haltung; Heimübungsprogramm.","therapeutic_content_en":"Progress the exercise program; single-leg balance, forward and side step-ups, prone hamstring curls and heel raises; aquatic therapy after the incision has healed, at about week 4; may return to easy lap swimming without flip turns or breaststroke; stationary bike or recumbent stepper with minimal resistance; core strengthening; progressive hip strengthening in all planes; progressive quadriceps, hamstring and gluteal strengthening; pelvic-floor program; address pelvic tilt and posture; home exercise program.","therapeutic_content_pl":"Progresja programu ćwiczeń; równowaga jednonóż, wejścia na stopień w przód i bokiem, zginanie kolana w leżeniu przodem oraz wspięcia na palce; terapia w wodzie po wygojeniu cięcia, około 4. tygodnia; możliwy powrót do spokojnego pływania bez nawrotów koziołkowych i stylu klasycznego; rower stacjonarny lub stepper poziomy z minimalnym oporem; wzmacnianie centralne; progresywne wzmacnianie biodra we wszystkich płaszczyznach; progresywne wzmacnianie mięśnia czworogłowego, mięśni kulszowo-goleniowych i pośladkowych; program mięśni dna miednicy; korekcja ustawienia miednicy i postawy; program ćwiczeń domowych.","minimum_requirements_de":"Belastung nach Verträglichkeit. Kein Autofahren bis zum Absetzen der Opioidanalgetika. Progressionskriterien: normalisiertes Gangbild; Anheben des gestreckten Beins 2×10 ohne Extensionsdefizit; minimale oder keine reaktive Schmerz- und Schwellungszunahme bei Alltagsaktivitäten und physiotherapeutischen Übungen; normalisierte Muskelaktivierung und -isolation.","minimum_requirements_en":"Weight-bearing as tolerated. Do not drive until narcotic pain medication is discontinued. Progression criteria: normalized gait pattern; straight-leg raise 2×10 without quadriceps lag; minimal to no reactive pain and swelling with activities of daily living and physical-therapy exercises; normalized muscle activation and isolation.","minimum_requirements_pl":"Obciążanie według tolerancji. Nie prowadzić pojazdów do odstawienia leków opioidowych. Kryteria progresji: znormalizowany wzorzec chodu; unoszenie wyprostowanej kończyny 2×10 bez deficytu wyprostu; minimalny lub nieobecny reaktywny ból i obrzęk podczas czynności dnia codziennego i ćwiczeń fizjoterapeutycznych; znormalizowana aktywacja i izolacja mięśni.","additional_notes_original":"Goals: Reduce swelling and edema, minimize pain, retard muscle atrophy, range of motion restoration, independent with ADLs","therapeutic_content_original":"Progress the exercise program; single-leg balance, forward and side step-ups, prone hamstring curls and heel raises; aquatic therapy after the incision has healed, at about week 4; may return to easy lap swimming without flip turns or breaststroke; stationary bike or recumbent stepper with minimal resistance; core strengthening; progressive hip strengthening in all planes; progressive quadriceps, hamstring and gluteal strengthening; pelvic-floor program; address pelvic tilt and posture; home exercise program.","minimum_requirements_original":"Weight-bearing as tolerated. Do not drive until narcotic pain medication is discontinued. Progression criteria: normalized gait pattern; straight-leg raise 2×10 without quadriceps lag; minimal to no reactive pain and swelling with activities of daily living and physical-therapy exercises; normalized muscle activation and isolation.","structured_content_v2":"$undefined"},{"id":"34346abc-fda9-5b96-b2a8-6352f699f229","name_de":"Phase 3: Wochen 7–12","name_en":"Phase 3: Weeks 7-12","name_pl":"Faza 3: tygodnie 7–12","source_page":2,"module_number":3,"name_original":"Phase 3: Weeks 7-12","service_codes":[],"structured_content":{"de":{"goals":["vollständiger Bewegungsumfang, minimale Schmerzen, Steigerung des Übungswiderstands und Normalisierung der posturalen, Becken- und Bein-Kontrolle bei beid- und einbeinigen Aufgaben."],"exercises":["Wandkniebeugen, kleine Ausfallschritte, Progression der Step-ups bis einbeinig, Step-downs, Hüftübungen in 4 Richtungen, Beinpresse mit geringem Widerstand und hohen Wiederholungszahlen sowie Übungen für das Knie in offener Kette.","Ab Woche 8: vollständige Kniebeuge bis mindestens 70°, Seitwärtsschritte mit Band, Heel Taps, Gehen gegen Widerstand, fortgeschrittene Brücken, einbeinige Übungen und Gleichgewichtsprogressionen.","Rumpfkräftigung","Progression der Kräftigung der unteren Extremität zu multiplanaren Bewegungen mit Rumpf-, Hüft- und Kniekontrolle","Propriozeptionsprogression mit wechselnden Untergründen, Perturbationen und Bewegungen der oberen Extremität oder des Rumpfs","Progression zu sportartspezifischen Aufgaben","Erhaltungs-Heimübungsprogramm","Richtungswechsel, Crossover und Carioca","zielgerechte plyometrische Übungen mit Medizinball und Schlitten","Seitwärtsschritte, Koordinationsleiter, Hütchen, Z- und W-Cuts sowie multiplanare sportartspezifische Übungen."],"applies_when":["Wochen 7–12"],"progression_criteria":["Freigabe durch den Operateur","Hamstring-Kraftindex >90 % gegenüber der Gegenseite","Quadrizeps-Kraftindex >90 %","Differenz der anterioren Reichweite im Y-Balance-Test <4 cm","keine Schmerzen oder Instabilität."],"dosage_and_progression":["Kräftigungsübungen und funktionelle Aufgaben dürfen gesteigert werden, sofern keine reaktiven Schmerzen oder kein Erguss auftreten.","Aerobe Kondition und Ausdauer steigern und dabei reaktive Ödeme überwachen."]},"en":{"goals":["full range of motion, minimal pain, increased exercise resistance, and normalized postural, pelvic and lower-extremity control during double- and single-leg tasks."],"exercises":["Wall squats, mini lunges, step-ups progressing to single-leg, step-downs, 4-way hip exercises, leg press with low resistance and high repetitions, and open-chain knee exercises.","At week 8: full squat to at least 70°, side steps with a band, heel taps, resisted walking, advanced bridges, single-leg exercises and balance progressions.","Core strengthening","progress lower-extremity strengthening to multiplanar movements emphasizing core stability and hip and knee control","progress proprioception with varied surfaces, perturbations, and upper-extremity or trunk movements","progress toward sport-specific tasks","maintenance home exercise program","cutting, crossover and carioca","goal-appropriate plyometric exercises with medicine-ball work and sled drills","shuffles, ladder footwork, cone drills, Z-cuts, W-cuts and multiplanar sport-specific drills."],"applies_when":["Weeks 7-12"],"progression_criteria":["surgeon clearance","hamstring strength index >90% versus the contralateral limb","quadriceps strength index >90%","Y-Balance anterior-reach difference <4 cm","no pain or instability.","Strengthening exercises and functional tasks may be progressed when there is no reactive pain or effusion."],"dosage_and_progression":["Increase aerobic conditioning and endurance while monitoring reactive edema."]},"pl":{"goals":["pełny zakres ruchu, minimalny ból, zwiększanie oporu ćwiczeń oraz normalizacja kontroli posturalnej, miednicy i kończyny dolnej w zadaniach obunóż i jednonóż."],"exercises":["Przysiady przy ścianie, małe wykroki, progresja wejść na stopień do wariantu jednonóż, zejścia ze stopnia, ćwiczenia biodra w 4 kierunkach, suwnica z małym oporem i dużą liczbą powtórzeń oraz ćwiczenia kolana w łańcuchu otwartym.","Od 8. tygodnia: pełny przysiad do co najmniej 70°, kroki bokiem z taśmą, dotknięcia piętą, chód z oporem, zaawansowane mosty, ćwiczenia jednonóż i progresja równowagi.","Wzmacnianie centralne","progresja wzmacniania kończyn dolnych do ruchów wielopłaszczyznowych z kontrolą tułowia, biodra i kolana","progresja propriocepcji przez zmienne podłoża, perturbacje i ruchy kończyn górnych lub tułowia","progresja do zadań specyficznych dla sportu","podtrzymujący program domowy","zmiany kierunku, crossover i carioca","odpowiednie do celów ćwiczenia plyometryczne z piłką lekarską i sankami","kroki odstawno-dostawne, drabinka koordynacyjna, pachołki, cięcia po torze Z i W oraz wielopłaszczyznowe ćwiczenia sportowe."],"applies_when":["tygodnie 7–12"],"progression_criteria":["zgoda chirurga","wskaźnik siły mięśni kulszowo-goleniowych >90% względem kończyny przeciwnej","wskaźnik siły mięśnia czworogłowego >90%","różnica przedniego zasięgu Y-Balance <4 cm","brak bólu lub niestabilności.","Można zwiększać trudność ćwiczeń wzmacniających i zadań funkcjonalnych, jeśli nie występuje reaktywny ból ani wysięk."],"dosage_and_progression":["Zwiększać kondycję tlenową i wytrzymałość, monitorując reaktywny obrzęk."]},"original":{"goals":["full range of motion, minimal pain, increased exercise resistance, and normalized postural, pelvic and lower-extremity control during double- and single-leg tasks."],"exercises":["Wall squats, mini lunges, step-ups progressing to single-leg, step-downs, 4-way hip exercises, leg press with low resistance and high repetitions, and open-chain knee exercises.","At week 8: full squat to at least 70°, side steps with a band, heel taps, resisted walking, advanced bridges, single-leg exercises and balance progressions.","Core strengthening","progress lower-extremity strengthening to multiplanar movements emphasizing core stability and hip and knee control","progress proprioception with varied surfaces, perturbations, and upper-extremity or trunk movements","progress toward sport-specific tasks","maintenance home exercise program","cutting, crossover and carioca","goal-appropriate plyometric exercises with medicine-ball work and sled drills","shuffles, ladder footwork, cone drills, Z-cuts, W-cuts and multiplanar sport-specific drills."],"applies_when":["Weeks 7-12"],"progression_criteria":["surgeon clearance","hamstring strength index >90% versus the contralateral limb","quadriceps strength index >90%","Y-Balance anterior-reach difference <4 cm","no pain or instability.","Strengthening exercises and functional tasks may be progressed when there is no reactive pain or effusion."],"dosage_and_progression":["Increase aerobic conditioning and endurance while monitoring reactive edema."]}},"additional_notes_de":"Ziele: vollständiger Bewegungsumfang, minimale Schmerzen, Steigerung des Übungswiderstands und Normalisierung der posturalen, Becken- und Bein-Kontrolle bei beid- und einbeinigen Aufgaben. Entlassungskriterien: Freigabe durch den Operateur; Hamstring-Kraftindex >90 % gegenüber der Gegenseite; Quadrizeps-Kraftindex >90 %; Differenz der anterioren Reichweite im Y-Balance-Test <4 cm; keine Schmerzen oder Instabilität.","additional_notes_en":"Goals: full range of motion, minimal pain, increased exercise resistance, and normalized postural, pelvic and lower-extremity control during double- and single-leg tasks. Discharge criteria: surgeon clearance; hamstring strength index >90% versus the contralateral limb; quadriceps strength index >90%; Y-Balance anterior-reach difference <4 cm; no pain or instability.","additional_notes_pl":"Cele: pełny zakres ruchu, minimalny ból, zwiększanie oporu ćwiczeń oraz normalizacja kontroli posturalnej, miednicy i kończyny dolnej w zadaniach obunóż i jednonóż. Kryteria wypisu: zgoda chirurga; wskaźnik siły mięśni kulszowo-goleniowych >90% względem kończyny przeciwnej; wskaźnik siły mięśnia czworogłowego >90%; różnica przedniego zasięgu Y-Balance <4 cm; brak bólu lub niestabilności.","minimum_patient_share":null,"therapeutic_content_de":"Wandkniebeugen, kleine Ausfallschritte, Progression der Step-ups bis einbeinig, Step-downs, Hüftübungen in 4 Richtungen, Beinpresse mit geringem Widerstand und hohen Wiederholungszahlen sowie Übungen für das Knie in offener Kette. Ab Woche 8: vollständige Kniebeuge bis mindestens 70°, Seitwärtsschritte mit Band, Heel Taps, Gehen gegen Widerstand, fortgeschrittene Brücken, einbeinige Übungen und Gleichgewichtsprogressionen. Rumpfkräftigung; Progression der Kräftigung der unteren Extremität zu multiplanaren Bewegungen mit Rumpf-, Hüft- und Kniekontrolle; Propriozeptionsprogression mit wechselnden Untergründen, Perturbationen und Bewegungen der oberen Extremität oder des Rumpfs; Progression zu sportartspezifischen Aufgaben; Erhaltungs-Heimübungsprogramm; Richtungswechsel, Crossover und Carioca; zielgerechte plyometrische Übungen mit Medizinball und Schlitten; Seitwärtsschritte, Koordinationsleiter, Hütchen, Z- und W-Cuts sowie multiplanare sportartspezifische Übungen.","therapeutic_content_en":"Wall squats, mini lunges, step-ups progressing to single-leg, step-downs, 4-way hip exercises, leg press with low resistance and high repetitions, and open-chain knee exercises. At week 8: full squat to at least 70°, side steps with a band, heel taps, resisted walking, advanced bridges, single-leg exercises and balance progressions. Core strengthening; progress lower-extremity strengthening to multiplanar movements emphasizing core stability and hip and knee control; progress proprioception with varied surfaces, perturbations, and upper-extremity or trunk movements; progress toward sport-specific tasks; maintenance home exercise program; cutting, crossover and carioca; goal-appropriate plyometric exercises with medicine-ball work and sled drills; shuffles, ladder footwork, cone drills, Z-cuts, W-cuts and multiplanar sport-specific drills.","therapeutic_content_pl":"Przysiady przy ścianie, małe wykroki, progresja wejść na stopień do wariantu jednonóż, zejścia ze stopnia, ćwiczenia biodra w 4 kierunkach, suwnica z małym oporem i dużą liczbą powtórzeń oraz ćwiczenia kolana w łańcuchu otwartym. Od 8. tygodnia: pełny przysiad do co najmniej 70°, kroki bokiem z taśmą, dotknięcia piętą, chód z oporem, zaawansowane mosty, ćwiczenia jednonóż i progresja równowagi. Wzmacnianie centralne; progresja wzmacniania kończyn dolnych do ruchów wielopłaszczyznowych z kontrolą tułowia, biodra i kolana; progresja propriocepcji przez zmienne podłoża, perturbacje i ruchy kończyn górnych lub tułowia; progresja do zadań specyficznych dla sportu; podtrzymujący program domowy; zmiany kierunku, crossover i carioca; odpowiednie do celów ćwiczenia plyometryczne z piłką lekarską i sankami; kroki odstawno-dostawne, drabinka koordynacyjna, pachołki, cięcia po torze Z i W oraz wielopłaszczyznowe ćwiczenia sportowe.","minimum_requirements_de":"Kräftigungsübungen und funktionelle Aufgaben dürfen gesteigert werden, sofern keine reaktiven Schmerzen oder kein Erguss auftreten. Aerobe Kondition und Ausdauer steigern und dabei reaktive Ödeme überwachen.","minimum_requirements_en":"Strengthening exercises and functional tasks may be progressed when there is no reactive pain or effusion. Increase aerobic conditioning and endurance while monitoring reactive edema.","minimum_requirements_pl":"Można zwiększać trudność ćwiczeń wzmacniających i zadań funkcjonalnych, jeśli nie występuje reaktywny ból ani wysięk. Zwiększać kondycję tlenową i wytrzymałość, monitorując reaktywny obrzęk.","additional_notes_original":"Goals: Full range of motion, minimal pain, increase resistance exercises, normalize postural/pelvic and LE control with DL and SL activities\n\nCriteria for discharge:\n-Surgeon clearance\n-Hamstring strength index >90% as compared to contralateral limb\n-Quadriceps strength index >90% compared to contralateral limb\n-Y-Balance anterior reach < 4cm\n-No complaints of pain or instability","therapeutic_content_original":"Wall squats, mini lunges, step-ups progressing to single-leg, step-downs, 4-way hip exercises, leg press with low resistance and high repetitions, and open-chain knee exercises. At week 8: full squat to at least 70°, side steps with a band, heel taps, resisted walking, advanced bridges, single-leg exercises and balance progressions. Core strengthening; progress lower-extremity strengthening to multiplanar movements emphasizing core stability and hip and knee control; progress proprioception with varied surfaces, perturbations, and upper-extremity or trunk movements; progress toward sport-specific tasks; maintenance home exercise program; cutting, crossover and carioca; goal-appropriate plyometric exercises with medicine-ball work and sled drills; shuffles, ladder footwork, cone drills, Z-cuts, W-cuts and multiplanar sport-specific drills.","minimum_requirements_original":"Strengthening exercises and functional tasks may be progressed when there is no reactive pain or effusion. Increase aerobic conditioning and endurance while monitoring reactive edema.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["hip_pelvis","lower_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"0073e4df-1b1d-5091-81b8-0d68a1cba920","slug":"us-south-shore-34-total-hip-arthroplasty","title_pl":"Protokół rehabilitacji po endoprotezoplastyce stawu biodrowego (South Shore)","title_de":"Rehabilitationsprotokoll nach Hüfttotalendoprothese (South Shore)","title_en":"Rehabilitation Protocol after Total Hip Arthroplasty (South Shore)","title_original":"Total Hip Replacement","summary_pl":"Protokół pooperacyjny obejmujący zasady zależne od dojścia operacyjnego, cztery fazy rehabilitacji, dokładne ćwiczenia, dawkowanie i kryteria wypisu z fizjoterapii.","summary_de":"Postoperatives Protokoll mit zugangsspezifischen Vorsichtsmaßnahmen, vier Rehabilitationsphasen, konkreten Übungen, Dosierung und Entlassungskriterien aus der Physiotherapie.","summary_en":"Post-operative protocol covering approach-specific precautions, four rehabilitation phases, exact exercises, dosage and outpatient PT discharge criteria.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"394caacf-c99c-59b2-9bd6-86b801456e84","condition_slug":"total-hip-arthroplasty","condition_name_pl":"Całkowita endoprotezoplastyka stawu biodrowego (TEP)","condition_name_de":"Totalendoprothese (TEP) des Hüftgelenks","condition_name_en":"Total Hip Arthroplasty (THA)","condition_name_original":"Total Hip Arthroplasty (THA)","icd_codes":[],"category_key":"hip","category_pl":"Ortopedia","category_de":"Orthopädie","category_en":"Orthopedics","body_regions_pl":["biodro"],"body_regions_de":["Hüfte"],"body_regions_en":["hip"],"search_terms_pl":["TEP","endoproteza biodra","rehabilitacja pooperacyjna","staw biodrowy"],"search_terms_de":["TEP","Hüft-TEP","Hüftprothese","Rehabilitation nach Hüft-OP"],"search_terms_en":["THA","total hip replacement","hip arthroplasty","post-op hip rehab"],"source_document_id":"a9aabccf-d04f-5ca3-b3a1-e24295795c92","source_title":"Total Hip Arthroplasty (THA) Rehabilitation Protocol","issuer":"South Shore Orthopedics","source_country_code":"US","jurisdiction_code":"US-MA","authority_level":"hospital","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"requires_clinical_update_check","official_url":"https://octanecdn.com/southshoreorthopedicscom/southshoreorthopedicscom_611969844.pdf","source_sha256":"7f775c51459f55fa2bfec046297f89d53c14722c89800155174d28846ec077dd","authorization_required":false,"license_note":"Public source file retained locally for source verification.","modules":[{"id":"fd342685-37c5-54ac-9839-5dd46f71d6fd","name_de":"Postoperative Mobilisation und zugangsspezifische Vorsichtsmaßnahmen","name_en":"Postoperative mobility and approach-specific precautions","name_pl":"Mobilizacja po operacji i ograniczenia zależne od dojścia","source_page":2,"module_number":1,"name_original":"Dislocation Precautions; Home Visits","service_codes":[],"structured_content":{"de":{"warnings":["Der Operateur legt das anzuwendende Vorsichtsmaßnahmen-Set und dessen Dauer fest."],"exercises":[],"restrictions":["Posteriorer Zugang: Hüfte nicht über 90° beugen, nicht innenrotieren, das Bein nicht über die Neutralstellung adduzieren und die Beine nicht kreuzen; diese Bewegungen nicht kombinieren.","Anterolateraler Zugang: das Bein nicht abduzieren, nicht über Neutral adduzieren, nicht hinter den Körper führen und die Hüfte nicht außenrotieren; diese Bewegungen nicht kombinieren.","Globale Vorsichtsmaßnahmen: Hüfte nicht über 90° beugen, weder innen- noch außenrotieren, nicht flach oder in Bauchlage liegen und keine Brücke durchführen."],"dosage_and_progression":[],"physiotherapist_actions":["Patient:innen am Operationstag mobilisieren und während des Krankenhausaufenthalts täglich Physio- und Ergotherapie durchführen.","Nach der Entlassung Mobilität, Kraft und Aktivitätstoleranz in der häuslichen Physiotherapie wiederherstellen.","Die Bereitschaft für ambulante Physiotherapie mit dem Operationsteam abstimmen."]},"en":{"warnings":["The surgeon specifies which precaution set to follow and how long it remains in place."],"exercises":[],"restrictions":["Posterior approach: do not flex the hip beyond 90°, internally rotate the hip, adduct the leg beyond neutral or cross the legs; do not combine these motions.","Anterolateral approach: do not abduct the leg, adduct beyond neutral, extend the leg behind the body or externally rotate the hip; do not combine these motions.","Global precautions: do not flex the hip beyond 90°, internally or externally rotate the hip, lie flat or prone, or perform bridging."],"dosage_and_progression":[],"physiotherapist_actions":["Mobilize the patient out of bed on the day of surgery and provide daily inpatient PT and OT.","After discharge, restore mobility, strength and activity tolerance through home-care PT.","Coordinate readiness for outpatient PT with the surgeon and staff."]},"pl":{"warnings":["Chirurg wskazuje właściwy zestaw ograniczeń oraz czas jego obowiązywania."],"exercises":[],"restrictions":["Dojście tylne: nie zginaj biodra powyżej 90°, nie rotuj biodra do wewnątrz, nie przywódź kończyny poza pozycję neutralną i nie krzyżuj nóg; nie łącz tych ruchów.","Dojście przednio-boczne: nie odwódź kończyny, nie przywódź jej poza pozycję neutralną, nie przesuwaj nogi za tułów i nie rotuj biodra na zewnątrz; nie łącz tych ruchów.","Ograniczenia globalne: nie zginaj biodra powyżej 90°, nie rotuj biodra do wewnątrz ani na zewnątrz, nie leż płasko ani na brzuchu i nie wykonuj mostków."],"dosage_and_progression":[],"physiotherapist_actions":["Pionizuj pacjenta w dniu operacji i prowadź codzienną fizjoterapię wraz z terapią zajęciową podczas pobytu w szpitalu.","Po wypisie przywracaj mobilność, siłę i tolerancję aktywności w opiece domowej.","Ustal z chirurgiem i jego personelem gotowość pacjenta do fizjoterapii ambulatoryjnej."]},"original":{"warnings":["Your surgeon will instruct you which precautions to follow. Your surgeon will determine the timeframe for how long these precautions will be in place."],"exercises":[],"restrictions":["Posterior Approach: do NOT bend your hip more than 90 degrees, do NOT rotate your hip inward, do NOT bring your leg in across your body beyond neutral (i.e. do not cross your legs), NO combinations of these motions.","Anterolateral Approach: do NOT swing your leg out to the side, do NOT bring your leg in across your body beyond neutral (i.e. do not cross your legs), do NOT move your leg backwards behind your body, do NOT rotate your hip outward, NO combinations of these motions.","Global Precautions: do NOT bend your hip more than 90 degrees, do NOT rotate your hip inward or outward (keep your knee and toe facing forward), NO lying flat, NO lying on your stomach, and NO bridging."],"dosage_and_progression":[],"physiotherapist_actions":["You will be out of bed the same day as your surgery. You will be working with physical and occupational therapy on a daily basis in the hospital.","The physical therapist will help you work to restore mobility, strength and tolerance for activity.","Your home care physical therapist will work with your surgeon and their staff to determine when you are ready to attend outpatient physical therapy."]}},"additional_notes_de":"Nach der Entlassung arbeitet die häusliche Physiotherapie an Mobilität, Kraft und Aktivitätstoleranz und stimmt die Bereitschaft für ambulante Physiotherapie mit dem Operationsteam ab.","additional_notes_en":"After discharge, home-care PT works on mobility, strength and activity tolerance and coordinates readiness for outpatient PT with the surgeon.","additional_notes_pl":"Po wypisie fizjoterapeuta opieki domowej pracuje nad mobilnością, siłą i tolerancją aktywności oraz uzgadnia z chirurgiem gotowość do fizjoterapii ambulatoryjnej.","minimum_patient_share":null,"therapeutic_content_de":"Patient:innen stehen am Operationstag auf und arbeiten im Krankenhaus täglich mit Physio- und Ergotherapie. Die Vorsichtsmaßnahmen nach Hüft-TEP richten sich nach posteriorem, anterolateralem oder globalem Schema.","therapeutic_content_en":"Patients are out of bed on the day of surgery and work with physical and occupational therapy daily in hospital. Precautions after THA depend on the posterior, anterolateral or global approach set.","therapeutic_content_pl":"Pacjent wstaje w dniu operacji i codziennie pracuje w szpitalu z fizjoterapią oraz terapią zajęciową. Ograniczenia po endoprotezoplastyce zależą od dojścia tylnego, przednio-bocznego albo zestawu globalnego.","minimum_requirements_de":"Nur die vom Operationsteam festgelegten Vorsichtsmaßnahmen und deren angeordnete Dauer anwenden.","minimum_requirements_en":"Use the precaution set and duration specified by the surgeon.","minimum_requirements_pl":"Stosuj wyłącznie ograniczenia wskazane przez chirurga i przez czas określony przez chirurga.","additional_notes_original":"Your home care physical therapist will work with your surgeon and their staff to determine when you are ready to attend outpatient physical therapy.","therapeutic_content_original":"After surgery you will spend 1-2 days in the hospital. You will be out of bed the same day as your surgery. You will be working with physical and occupational therapy on a daily basis in the hospital.","minimum_requirements_original":"Your surgeon will instruct you which precautions to follow. Your surgeon will determine the timeframe for how long these precautions will be in place.","structured_content_v2":"$undefined"},{"id":"b8fe1ca0-b5a7-5067-bea5-c6fc14e38478","name_de":"Häusliche Versorgung, Wunde, Hochlagerung und Eis","name_en":"Home care, wound, elevation and ice","name_pl":"Opieka domowa, rana, uniesienie i lód","source_page":3,"module_number":2,"name_original":"Home Visits; Surgical Incision/Dressing; Showering; Elevation; Ice; Post Operative Visits","service_codes":[],"structured_content":{"de":{"warnings":["Wundsekretion und Infektionszeichen überwachen; bei Bedenken vor der ersten Kontrolle das Operationsteam kontaktieren.","Zur Sicherheit beim Duschen möglichst eine Duschbank verwenden."],"exercises":[],"restrictions":["Gewebekleber oder Steri-Strips nicht selbst entfernen.","Bei nässender Wunde während des Duschens einen wasserdichten Verband verwenden.","Während der Einnahme opioidartiger Schmerzmittel nicht fahren.","Die Rückkehr zum Fahren entscheidet der Operateur; die Quelle nennt üblicherweise 6 Wochen nach rechter und 4 Wochen nach linker Hüftoperation."],"progression_criteria":["Die Bereitschaft für ambulante Physiotherapie wird gemeinsam von häuslicher Physiotherapie und Operationsteam bestimmt."],"dosage_and_progression":["Das operierte Bein 3–4-mal täglich 30 Minuten in Rückenlage, vollständig gestreckt und mit dem Fuß oberhalb des Herzens hochlagern.","Zu Hause Eis 3–5-mal täglich 10–20 Minuten, typischerweise nach Übungen, immer mit einer Lage zwischen Eis und Haut anwenden."],"physiotherapist_actions":["Die häusliche Physiotherapie stimmt die Bereitschaft für ambulante Physiotherapie mit dem Operationsteam ab, typischerweise um Woche 5–6.","Mit der Patientin oder dem Patienten einen individuellen Plan für Eis und Hochlagerung festlegen."]},"en":{"warnings":["Monitor incision drainage and infection signs; contact the surgeon with concerns before the first visit.","Use a shower bench if possible for safety."],"exercises":[],"restrictions":["Do not remove surgical glue or Steri-Strips yourself.","If the incision is draining, protect it with a watertight dressing during showering.","Do not drive while taking narcotic pain medication.","The surgeon determines return to driving; the source states commonly 6 weeks after right and 4 weeks after left hip replacement."],"progression_criteria":["Home-care PT and the surgeon’s team jointly determine readiness for outpatient PT."],"dosage_and_progression":["Elevate the operative leg 3-4 times/day for 30 minutes while supine, with the leg fully straight and the foot above heart level.","At home apply ice 3-5 times/day for 10-20 minutes, typically after exercise, with one layer between ice and skin."],"physiotherapist_actions":["Home-care PT coordinates readiness for outpatient PT with the surgeon and staff, typically around weeks 5-6.","Customize an elevation and icing plan with the patient."]},"pl":{"warnings":["Monitoruj drenaż rany i objawy infekcji; w razie obaw przed pierwszą kontrolą skontaktuj się z chirurgiem.","Dla bezpieczeństwa podczas prysznica najlepiej użyć ławki prysznicowej."],"exercises":[],"restrictions":["Nie usuwaj samodzielnie kleju chirurgicznego ani pasków Steri-Strip.","Jeżeli rana drenuje, zabezpiecz ją szczelnym opatrunkiem podczas prysznica.","Nie prowadź samochodu podczas przyjmowania opioidowych leków przeciwbólowych.","Decyzję o powrocie do prowadzenia podejmuje chirurg; źródło podaje zwykle 6 tygodni po operacji prawego biodra i 4 tygodnie po operacji lewego."],"progression_criteria":["Gotowość do fizjoterapii ambulatoryjnej ustalają wspólnie fizjoterapeuta domowy i zespół chirurga."],"dosage_and_progression":["Unieś operowaną kończynę 3–4 razy dziennie po 30 minut, w leżeniu tyłem, z wyprostowaną kończyną i stopą powyżej serca.","W domu stosuj lód 3–5 razy dziennie przez 10–20 minut, zwykle po ćwiczeniach, zawsze przez jedną warstwę materiału."],"physiotherapist_actions":["Fizjoterapeuta opieki domowej uzgadnia z chirurgiem gotowość do fizjoterapii ambulatoryjnej, zwykle około 5.–6. tygodnia.","Dostosuj z pacjentem plan stosowania lodu i uniesienia kończyny."]},"original":{"warnings":["Should you have any cause for concern prior to your first office visit you should call your surgeon’s office for advice.","It is best to use a shower bench if possible for safety."],"exercises":[],"restrictions":["Allow the steri-strips to fall off on their own or to be removed at your next doctor’s office visit. If your surgeon used glue to close the wound do not remove it.","If the incision is draining try to keep it from getting wet during showering by using a water-tight dressing.","You cannot drive while taking narcotics.","Commonly, you are not permitted to drive for 6 weeks if you had your right hip replaced, and 4 weeks if you had your left hip replaced."],"progression_criteria":["Your home care physical therapist will work with your surgeon and their staff to determine when you are ready to attend outpatient physical therapy."],"dosage_and_progression":["It is recommended that you elevate your operative leg 3 to 4 times a day for 30 minutes. To elevate properly make sure to lie flat on your back and have your operative leg in a fully straightened position with your foot above the level of your heart.","Once home, taper down to applying ice to 3-5 times a day for 10 to no more than 20 minutes at a time, typically after exercise. Always maintain one layer between ice and the skin."],"physiotherapist_actions":["Your home care physical therapist will work with your surgeon and their staff to determine when you are ready to attend outpatient physical therapy. If necessary, this would typically be around 5-6 weeks from your operation.","The home care physical therapist can help you customize a plan on how and when to best apply ice."]}},"additional_notes_de":"Die erste Kontrolle erfolgt meist nach 10–14 Tagen, die nächste um Woche 6.","additional_notes_en":"The first follow-up is typically at 10-14 days and the next around 6 weeks.","additional_notes_pl":"Pierwsza kontrola odbywa się zwykle po 10–14 dniach, a kolejna około 6. tygodnia.","minimum_patient_share":null,"therapeutic_content_de":"Die häusliche Physiotherapie führt zur Bereitschaft für die ambulante Therapie, typischerweise um Woche 5–6. Die Versorgung umfasst sicheres Duschen, Wundkontrolle, Hochlagerung und Eis.","therapeutic_content_en":"Home-care PT guides readiness for outpatient treatment, typically around weeks 5-6. Care includes safe showering, wound monitoring, elevation and ice.","therapeutic_content_pl":"Fizjoterapia domowa prowadzi pacjenta do gotowości do leczenia ambulatoryjnego, zwykle około 5.–6. tygodnia. Opieka obejmuje bezpieczny prysznic, kontrolę rany, uniesienie kończyny i lód.","minimum_requirements_de":"Eine nässende Wunde nicht ohne wasserdichten Verband durchnässen und immer eine Lage zwischen Eis und Haut belassen.","minimum_requirements_en":"Keep a draining incision dry with a watertight dressing and always maintain one layer between ice and skin.","minimum_requirements_pl":"Nie zamaczaj drenującej rany bez szczelnego opatrunku i zawsze utrzymuj jedną warstwę między lodem a skórą.","additional_notes_original":"Your first post-operative visit will be as early as 10-14 days after the operation. Your next visit will be around 6 weeks after the operation.","therapeutic_content_original":"Your home care physical therapist will work with your surgeon and their staff to determine when you are ready to attend outpatient physical therapy. If necessary, this would typically be around 5-6 weeks from your operation.","minimum_requirements_original":"If the incision is draining try to keep it from getting wet during showering by using a water-tight dressing. Always maintain one layer between ice and the skin.","structured_content_v2":"$undefined"},{"id":"7a472fab-b13f-5eee-b64e-fc32f4553580","name_de":"Belastung, Gehhilfe und aktive Mitarbeit","name_en":"Weight bearing, assistive device and active participation","name_pl":"Obciążanie, urządzenie pomocnicze i aktywny udział","source_page":4,"module_number":3,"name_original":"Weight Bearing; Recovery/Time off Work","service_codes":[],"structured_content":{"de":{"exercises":[],"restrictions":["Belastung nach Verträglichkeit, sofern nicht anders angeordnet.","Mindestens in den ersten 6 Wochen eine Gehhilfe verwenden."],"progression_criteria":["Bei steigender Belastungstoleranz vom Rollator oder von Krücken zum Stock übergehen.","Nach 6 Wochen die Gehhilfe nur nach ärztlicher Freigabe und bei normalem Gangbild absetzen."],"dosage_and_progression":["Täglich Übungen zur angemessenen Wiederherstellung von ROM und Kraft durchführen."],"physiotherapist_actions":["Gang mit Rollator oder Krücken schulen und bei steigender Belastungstoleranz zum Stock übergehen.","Das Gangbild vor dem Absetzen der Gehhilfe korrigieren."]},"en":{"exercises":[],"restrictions":["Weight bear as tolerated unless otherwise indicated by the surgeon.","Use an assistive device for at least the first 6 weeks."],"progression_criteria":["Transition from walker or crutches to a cane as weight-bearing tolerance improves.","After 6 weeks, discontinue the device only with surgeon clearance and a proper gait pattern."],"dosage_and_progression":["Perform daily exercises to ensure proper return of ROM and strength."],"physiotherapist_actions":["Train gait with a walker or crutches, then transition to a cane as weight-bearing tolerance improves.","Correct gait mechanics before discontinuing the assistive device."]},"pl":{"exercises":[],"restrictions":["Obciążaj według tolerancji, chyba że chirurg zaleci inaczej.","Używaj urządzenia pomocniczego przez co najmniej pierwsze 6 tygodni."],"progression_criteria":["Przejdź z balkonika lub kul do laski wraz ze wzrostem tolerancji obciążania.","Po 6 tygodniach odstaw urządzenie tylko po zgodzie chirurga i uzyskaniu prawidłowego wzorca chodu."],"dosage_and_progression":["Wykonuj codzienne ćwiczenia ukierunkowane na prawidłowy powrót ROM i siły."],"physiotherapist_actions":["Ucz chodu z balkonikiem lub kulami, następnie przejdź do laski wraz ze wzrostem tolerancji obciążania.","Koryguj wzorzec chodu przed odstawieniem urządzenia pomocniczego."]},"original":{"exercises":[],"restrictions":["After surgery you are allowed to put as much weight on your operated leg as you can tolerate (unless otherwise indicated by your surgeon).","You must use some form of an assistive device for at least the first six weeks after your surgery."],"progression_criteria":["As your tolerance for weight bearing improves your physical therapist will transition you to walking with a cane.","After six weeks you may receive clearance from your surgeon to transition off of your assistive device. Remember, proper gait pattern must be achieved in order to discontinue use of assistive devices."],"dosage_and_progression":["You must be an active participant during this process, performing daily exercises to ensure there is proper return of range of motion and strength."],"physiotherapist_actions":["Initially you will need to use a walker or crutches to help you walk. As your tolerance for weight bearing improves your physical therapist will transition you to walking with a cane.","Remember, proper gait pattern must be achieved in order to discontinue use of assistive devices."]}},"additional_notes_de":"Die Rückkehr zum früheren Aktivitätsniveau dauert meist 4–6 Monate, manchmal 9–12 Monate.","additional_notes_en":"Return to the previous activity level usually takes 4-6 months and may take 9-12 months.","additional_notes_pl":"Powrót do wcześniejszego poziomu aktywności trwa zwykle 4–6 miesięcy, a czasem 9–12 miesięcy.","minimum_patient_share":null,"therapeutic_content_de":"Nach der Operation gilt Belastung nach Verträglichkeit, sofern nicht anders angeordnet. Patient:innen führen täglich Übungen zur Wiederherstellung von ROM und Kraft durch.","therapeutic_content_en":"After surgery, weight bearing is allowed as tolerated unless otherwise ordered. Patients perform daily exercises to restore ROM and strength.","therapeutic_content_pl":"Po operacji obowiązuje obciążanie według tolerancji, chyba że chirurg zaleci inaczej. Pacjent wykonuje codzienne ćwiczenia dla odzyskania ROM i siły.","minimum_requirements_de":"Mindestens in den ersten 6 Wochen eine Gehhilfe verwenden und erst nach ärztlicher Freigabe sowie normalem Gangbild absetzen.","minimum_requirements_en":"Use an assistive device for at least the first 6 weeks and discontinue it only after surgeon clearance and a proper gait pattern.","minimum_requirements_pl":"Używaj urządzenia pomocniczego przez co najmniej pierwsze 6 tygodni i odstaw je dopiero po zgodzie chirurga oraz uzyskaniu prawidłowego chodu.","additional_notes_original":"It is usually estimated that it will take at least 4-6 months for the patient to feel as though he or she has completely returned to a pre-injury level of activity. Some cases may take as long as 9-12 months to make a full recovery.","therapeutic_content_original":"After surgery you are allowed to put as much weight on your operated leg as you can tolerate (unless otherwise indicated by your surgeon). You must be an active participant during this process, performing daily exercises to ensure there is proper return of range of motion and strength.","minimum_requirements_original":"You must use some form of an assistive device for at least the first six weeks after your surgery. Remember, proper gait pattern must be achieved in order to discontinue use of assistive devices.","structured_content_v2":"$undefined"},{"id":"ad9222d5-2283-5d90-802b-5e43d0b2eb39","name_de":"Rehabilitationsverlauf und ambulante Entlassungskriterien","name_en":"Rehabilitation continuum and outpatient discharge criteria","name_pl":"Ciąg rehabilitacji i kryteria wypisu ambulatoryjnego","source_page":5,"module_number":4,"name_original":"Typical Rehabilitation Continuum Time Frames Following THA; Outpatient Discharge Criteria","service_codes":[],"structured_content":{"de":{"exercises":[],"restrictions":["Die Entlassung aus der Physiotherapie bedeutet nicht, dass das Heimübungsprogramm entfällt."],"progression_criteria":["Typischerweise 70–80% des präoperativen Funktionsniveaus erreichen und das Ausgangsniveau berücksichtigen.","Ohne Gehhilfe normal gehen.","Treppen reziprok und sicher bewältigen.","Ohne Schwierigkeiten ins Auto ein- und aussteigen.","Schuhe und Socken ohne Schwierigkeiten an- und ausziehen."],"dosage_and_progression":["Typischer Verlauf: Krankenhaus Tag 0–2, häusliche Versorgung oder Rehabilitation ab Tag 3 bis Woche 5–6, ambulante Physiotherapie von Woche 5–6 bis 12 und selbstständiges Programm ab Woche 12."],"physiotherapist_actions":["Ein individuelles Heimübungsprogramm erstellen, das nach der Entlassung aus der Physiotherapie fortgesetzt wird."]},"en":{"exercises":[],"restrictions":["Discharge from PT does not exempt the patient from the home exercise program."],"progression_criteria":["Typically reach 70-80% of the preoperative functional level while considering prior function.","Walk normally without an assistive device.","Negotiate stairs reciprocally and safely.","Get in and out of a car without difficulty.","Don and doff shoes and socks without difficulty."],"dosage_and_progression":["Typical continuum: inpatient stay days 0-2, home care or rehabilitation from day 3 to weeks 5-6, outpatient PT from weeks 5-6 to 12 and an independent program from week 12."],"physiotherapist_actions":["Design an individualized home exercise program that continues after discharge from PT."]},"pl":{"exercises":[],"restrictions":["Wypis z fizjoterapii nie oznacza zwolnienia z programu ćwiczeń domowych."],"progression_criteria":["Osiągnij zwykle 70–80% poziomu funkcji względem stanu przed operacją, z uwzględnieniem wcześniejszej sprawności.","Chodź prawidłowo bez urządzenia pomocniczego.","Pokonuj schody naprzemiennie i bezpiecznie.","Wsiadaj do samochodu i wysiadaj bez trudności.","Zakładaj i zdejmuj buty oraz skarpety bez trudności."],"dosage_and_progression":["Typowa ścieżka: szpital dzień 0–2, opieka domowa lub rehabilitacja od 3. dnia do 5.–6. tygodnia, fizjoterapia ambulatoryjna od 5.–6. do 12. tygodnia, program samodzielny od 12. tygodnia."],"physiotherapist_actions":["Zaprojektuj indywidualny program domowy, który pacjent kontynuuje po wypisie z fizjoterapii."]},"original":{"exercises":[],"restrictions":["Being discharged from PT does NOT mean that you are exempt from you home exercise program."],"progression_criteria":["You are ready for discharge from outpatient PT typically when you reach 70-80% functional level compared to before surgery. This can vary greatly based on your prior level of function.","Walking normally without any assistive device.","Negotiate stairs reciprocally and safely.","Getting in/out of a car without difficulty.","Donning/doffing shoes and socks without difficulty."],"dosage_and_progression":["Inpatient Stay Day 0-2; Home Care Rehab 3 Days-5/6 Weeks; Outpatient PT 5/6 Weeks-12 Weeks; Independent Program 12 Weeks and Beyond."],"physiotherapist_actions":["For optimal outcome after surgery, it is important to continue with your specific program designed by your PT."]}},"additional_notes_de":"Die ambulante Entlassung erfolgt typischerweise bei 70–80% des präoperativen Funktionsniveaus und hängt vom Ausgangsniveau ab.","additional_notes_en":"Outpatient discharge is typically at 70-80% of the preoperative functional level and varies with prior function.","additional_notes_pl":"Wypis ambulatoryjny następuje zwykle przy 70–80% poziomu funkcji względem stanu przed operacją, zależnie od wcześniejszej sprawności.","minimum_patient_share":null,"therapeutic_content_de":"Der typische Verlauf führt vom Krankenhaus über häusliche Versorgung und ambulante Physiotherapie zum selbstständigen Programm ab Woche 12.","therapeutic_content_en":"The typical continuum progresses from inpatient care through home care and outpatient PT to an independent program from week 12.","therapeutic_content_pl":"Typowa ścieżka prowadzi od pobytu szpitalnego przez opiekę domową i fizjoterapię ambulatoryjną do programu samodzielnego od 12. tygodnia.","minimum_requirements_de":"Die Entlassung aus der Physiotherapie beendet das individuelle Heimübungsprogramm nicht.","minimum_requirements_en":"Discharge from PT does not end the individualized home exercise program.","minimum_requirements_pl":"Wypis z fizjoterapii nie zwalnia z indywidualnego programu ćwiczeń domowych.","additional_notes_original":"You are ready for discharge from outpatient PT typically when you reach 70-80% functional level compared to before surgery. This can vary greatly based on your prior level of function.","therapeutic_content_original":"Typical Rehabilitation Continuum Time Frames Following THA: Inpatient Stay Day 0-2; Home Care Rehab 3 Days-5/6 Weeks; Outpatient PT 5/6 Weeks-12 Weeks; Independent Program 12 Weeks and Beyond.","minimum_requirements_original":"Being discharged from PT does NOT mean that you are exempt from you home exercise program.","structured_content_v2":"$undefined"},{"id":"9516288b-f044-570d-b897-4d29f4e4ea8f","name_de":"Phase 1: Operationstag bis Entlassung","name_en":"Phase 1: day of surgery to hospital discharge","name_pl":"Faza 1: od dnia operacji do wypisu","source_page":6,"module_number":5,"name_original":"Phase 1: Post-op Phase (Day 0- Hospital Discharge)","service_codes":[],"structured_content":{"de":{"goals":["Schmerz und Schwellung kontrollieren.","Heilendes Gewebe schützen.","Wiederherstellung des ROM beginnen.","Muskulatur der unteren Extremität aktivieren.","Unabhängige funktionelle Mobilität wiederherstellen.","Patient:innen zu ihren Luxationsvorsichtsmaßnahmen schulen."],"warnings":["Auf TVT screenen.","Symptomatische orthostatische Hypotonie überwachen.","Symptomatisch niedrigen Hämatokrit überwachen."],"exercises":["Fersengleiten","Fußpumpen","Hüftinnen- und -außenrotation in Rückenlage","Quadrizeps-Anspannungen","Gesäßmuskel-Anspannungen","Hamstring-Anspannungen","Hüftabduktion und -adduktion in Rückenlage","Kniestreckung im Sitzen — LAQ","Hüftbeugung im Sitzen","Kurze Kniestreckung — SAQ"],"restrictions":["Alle Übungen innerhalb der individuellen Luxationsvorsichtsmaßnahmen durchführen.","Belastung nach Verträglichkeit mit Krücken oder Rollator, sofern nicht anders angeordnet.","Bei posterioren Vorsichtsmaßnahmen das Fußende des Bettes flach arretieren und niemals etwas unter das operierte Knie legen.","Im Bett stets einen Abduktionskeil verwenden, sofern nicht anders angeordnet."],"dosage_and_progression":[],"physiotherapist_actions":["Auf sensomotorische Defizite, TVT, symptomatische orthostatische Hypotonie und symptomatisch niedrigen Hämatokrit screenen.","Bettmobilität, Transfers, Gang auf ebener Fläche, Treppen und ADL mit adaptiven Hilfsmitteln nach Bedarf trainieren.","Die Hüfte mit einer Trochanterrolle neutral lagern und die Kniestreckung fördern."]},"en":{"goals":["Control pain and swelling.","Protect healing tissue.","Begin to restore ROM.","Establish lower-extremity muscle activation.","Restore independent functional mobility.","Educate the patient about dislocation precautions."],"warnings":["Screen for DVT.","Monitor symptomatic orthostatic hypotension.","Monitor symptomatic low hematocrit."],"exercises":["Heel slides","Ankle pumps","Supine hip internal and external rotation","Quad sets","Glut sets","Hamstring sets","Supine hip abduction and adduction","Long arc quads — LAQ","Seated hip flexion","Short arc quads — SAQ"],"restrictions":["Perform all exercises within the patient’s dislocation precautions.","WBAT with crutches or walker unless otherwise ordered.","For posterior precautions, lock the foot of the bed flat and never place anything under the operated knee.","Use an abduction wedge in bed at all times unless otherwise ordered."],"dosage_and_progression":[],"physiotherapist_actions":["Screen for sensory or motor deficits, DVT, symptomatic orthostatic hypotension and symptomatic low hematocrit.","Train bed mobility, transfers, gait on level surfaces, stairs and ADLs with adaptive equipment as needed.","Use a trochanter roll to maintain neutral hip rotation and promote knee extension."]},"pl":{"goals":["Kontroluj ból i obrzęk.","Chroń gojące się tkanki.","Rozpocznij odzyskiwanie ROM.","Uruchom aktywację mięśni kończyny dolnej.","Przywracaj samodzielną mobilność funkcjonalną.","Naucz pacjenta jego ograniczeń dyslokacyjnych."],"warnings":["Monitoruj DVT.","Monitoruj objawową hipotensję ortostatyczną.","Monitoruj objawowo niski hematokryt."],"exercises":["Ślizgi piętą","Pompowanie stawem skokowym","Rotacja wewnętrzna i zewnętrzna biodra w leżeniu tyłem","Napięcia mięśnia czworogłowego","Napięcia mięśni pośladkowych","Napięcia mięśni kulszowo-goleniowych","Odwodzenie i przywodzenie biodra w leżeniu tyłem","Wyprost kolana w siadzie — LAQ","Zgięcie biodra w siadzie","Krótki wyprost kolana — SAQ"],"restrictions":["Wszystkie ćwiczenia wykonuj w granicach indywidualnych ograniczeń dyslokacyjnych.","WBAT z kulami lub balkonikiem, chyba że zalecono inaczej.","Przy ograniczeniach dla dojścia tylnego zablokuj stopę łóżka w pozycji płaskiej i nigdy nie podkładaj niczego pod operowane kolano.","W łóżku używaj klina odwodzącego przez cały czas, chyba że zalecono inaczej."],"dosage_and_progression":[],"physiotherapist_actions":["Wykonaj screening deficytów czuciowo-ruchowych, DVT, objawowej hipotensji ortostatycznej i objawowo niskiego hematokrytu.","Prowadź mobilność w łóżku, transfery, chód po równym podłożu, schody i ADL z wyposażeniem adaptacyjnym według potrzeb.","Pozycjonuj biodro neutralnie za pomocą wałka krętarzowego i wspieraj wyprost kolana."]},"original":{"goals":["Control pain and swelling.","Protect healing tissue.","Begin to restore range of motion (ROM).","Establish lower extremity muscle activation.","Restore independent functional mobility.","Educate the patient regarding their dislocation precautions."],"warnings":["Screen for DVT.","Screen for symptomatic orthostatic hypotension.","Screen for symptomatic low hematocrit."],"exercises":["Heel slides","Ankle pumps","Supine hip internal/external rotation","Quad sets","Glut sets","Hamstring sets","Supine hip abduction/adduction","Long arc quads (LAQ)","Seated hip flexion","Short arc quads (SAQ)"],"restrictions":["All exercises performed within the patient’s dislocation precautions.","WBAT with crutches or walker unless otherwise ordered.","Posterior Precautions: ensure the foot of the bed is locked in a flat position. Never place anything under the operated knee for posterior precautions.","Use of abduction wedge when in bed at all times unless otherwise ordered."],"dosage_and_progression":[],"physiotherapist_actions":["Screen for sensory/motor deficits; screen for DVT, symptomatic orthostatic hypotension, symptomatic low hematocrit.","Bed mobility; transfer training; gait training on level surfaces; stair training; ADL’s with adaptive equipment as needed.","Use a trochanter roll to maintain hip in neutral rotation and promote knee extension."]}},"additional_notes_de":"Auf sensomotorische Defizite, TVT, symptomatische orthostatische Hypotonie und symptomatisch niedrigen Hämatokrit screenen.","additional_notes_en":"Screen for sensory or motor deficits, DVT, symptomatic orthostatic hypotension and symptomatic low hematocrit.","additional_notes_pl":"Wykonaj screening deficytów czuciowo-ruchowych, DVT, objawowej hipotensji ortostatycznej i objawowo niskiego hematokrytu.","minimum_patient_share":null,"therapeutic_content_de":"Schmerz und Schwellung kontrollieren, Gewebe schützen, ROM und Muskelaktivierung der unteren Extremität beginnen und unabhängige funktionelle Mobilität wiederherstellen.","therapeutic_content_en":"Control pain and swelling, protect healing tissue, begin ROM and lower-extremity muscle activation and restore independent functional mobility.","therapeutic_content_pl":"Kontroluj ból i obrzęk, chroń tkanki, rozpocznij odzyskiwanie ROM i aktywację mięśni kończyny dolnej oraz przywracaj samodzielną mobilność funkcjonalną.","minimum_requirements_de":"Alle Übungen innerhalb der individuellen Luxationsvorsichtsmaßnahmen und mit Belastung nach Verträglichkeit an Krücken oder Rollator durchführen, sofern nicht anders angeordnet.","minimum_requirements_en":"Perform all exercises within the patient’s dislocation precautions and use WBAT with crutches or walker unless otherwise ordered.","minimum_requirements_pl":"Wszystkie ćwiczenia wykonuj w granicach indywidualnych ograniczeń dyslokacyjnych i przy WBAT z kulami lub balkonikiem, chyba że zalecono inaczej.","additional_notes_original":"Screen for sensory/motor deficits. Screen for DVT, symptomatic orthostatic hypotension, symptomatic low hematocrit.","therapeutic_content_original":"Control pain and swelling. Protect healing tissue. Begin to restore range of motion (ROM). Establish lower extremity muscle activation. Restore independent functional mobility. Educate the patient regarding their dislocation precautions.","minimum_requirements_original":"All exercises performed within the patient’s dislocation precautions. WBAT with crutches or walker unless otherwise ordered.","structured_content_v2":"$undefined"},{"id":"6fa559a7-d21b-5c46-9db5-e084272d9927","name_de":"Phase 1: Dosierung und stationärer Physio-/Ergotherapieplan","name_en":"Phase 1: dosage and inpatient PT/OT plan","name_pl":"Faza 1: dawkowanie i szpitalny plan PT/OT","source_page":7,"module_number":6,"name_original":"Guidelines; Inpatient Plan of Care","service_codes":[],"structured_content":{"de":{"exercises":[],"restrictions":["Beim posterioren Zugang bei Bedarf einen geeigneten erhöhten Hüftstuhl verwenden."],"dosage_and_progression":["Alle Übungen 3–5-mal täglich mit 10 Wiederholungen durchführen und danach 10–20 Minuten Eis anwenden."],"physiotherapist_actions":["Am Operationstag aus dem Bett auf einen Stuhl mobilisieren.","Am ersten postoperativen Tag Physio- und Ergotherapie-Befund sowie geeignete ROM-, Kräftigungs-, funktionelle Mobilitäts- und ADL-Maßnahmen durchführen.","Ab dem zweiten postoperativen Tag bis zur Entlassung therapeutische Übungen und funktionelle Mobilität steigern.","ADL-Training bis zur Entlassung fortsetzen."]},"en":{"exercises":[],"restrictions":["For a posterior approach, use a hip chair when appropriate."],"dosage_and_progression":["Perform 10 repetitions of all exercises 3-5 times/day and use ice for 10-20 minutes after exercise."],"physiotherapist_actions":["On the day of surgery, mobilize the patient out of bed to a chair.","On postoperative day 1, complete PT and OT evaluations and provide appropriate ROM, strengthening, functional mobility and ADL training.","From postoperative day 2 through discharge, progress therapeutic exercise and functional mobility.","Continue ADL training through discharge."]},"pl":{"exercises":[],"restrictions":["Przy dojściu tylnym używaj wysokiego krzesła biodrowego, gdy jest to odpowiednie."],"dosage_and_progression":["Wykonuj 10 powtórzeń wszystkich ćwiczeń 3–5 razy dziennie i stosuj lód po ćwiczeniach przez 10–20 minut."],"physiotherapist_actions":["W dniu operacji posadź pacjenta na krześle poza łóżkiem.","W pierwszym dniu po operacji wykonaj ocenę PT i OT oraz prowadź odpowiednie ćwiczenia ROM, wzmacnianie, mobilność funkcjonalną i trening ADL.","Od drugiego dnia po operacji do wypisu progresuj ćwiczenia terapeutyczne i mobilność funkcjonalną.","Kontynuuj trening ADL do wypisu."]},"original":{"exercises":[],"restrictions":["Use of hip chair (posterior approach) when appropriate."],"dosage_and_progression":["Perform 10 repetitions of all exercises 3-5 times a day. Use ice after exercising for 10-20 minutes."],"physiotherapist_actions":["Day of Surgery: Out of bed to a chair.","Post Op Day 1: PT and OT Evaluations; Therapeutic Exercise including ROM, Strengthening, and Functional Mobility as appropriate; ADL Training as appropriate.","Post Op Day 2-Discharge: Progression of Therapeutic Exercise and Functional Mobility.","Continued ADL Training."]}},"additional_notes_de":"Beim posterioren Zugang kann bei Bedarf ein geeigneter erhöhter Hüftstuhl verwendet werden.","additional_notes_en":"For the posterior approach, use a hip chair when appropriate.","additional_notes_pl":"Przy dojściu tylnym można użyć odpowiedniego wysokiego krzesła biodrowego.","minimum_patient_share":null,"therapeutic_content_de":"Die stationäre Phase umfasst Mobilisation am Operationstag, Physio-/Ergotherapie-Befund am ersten postoperativen Tag und Progression von Übungen, funktioneller Mobilität und ADL bis zur Entlassung.","therapeutic_content_en":"The inpatient phase includes out-of-bed mobility on surgery day, PT/OT evaluation on postoperative day 1 and progression of exercise, functional mobility and ADLs through discharge.","therapeutic_content_pl":"Faza szpitalna obejmuje pionizację w dniu operacji, ocenę PT/OT w pierwszym dniu po operacji oraz progresję ćwiczeń, mobilności funkcjonalnej i ADL do wypisu.","minimum_requirements_de":"Alle Übungen 3–5-mal täglich mit 10 Wiederholungen durchführen und danach 10–20 Minuten Eis anwenden.","minimum_requirements_en":"Perform 10 repetitions of all exercises 3-5 times/day and use ice for 10-20 minutes after exercise.","minimum_requirements_pl":"Wszystkie ćwiczenia wykonuj po 10 powtórzeń 3–5 razy dziennie i stosuj lód po ćwiczeniach przez 10–20 minut.","additional_notes_original":"Use of hip chair (posterior approach) when appropriate.","therapeutic_content_original":"Day of Surgery: Out of bed to a chair. Post Op Day 1: PT and OT Evaluations; Therapeutic Exercise including ROM, Strengthening, and Functional Mobility as appropriate; ADL Training as appropriate. Post Op Day 2-Discharge: Progression of Therapeutic Exercise and Functional Mobility; Continued ADL Training.","minimum_requirements_original":"Perform 10 repetitions of all exercises 3-5 times a day. Use ice after exercising for 10-20 minutes.","structured_content_v2":"$undefined"},{"id":"79aa6697-cf35-51da-854f-0824a1bb05ae","name_de":"Phase 2: Mobilität — Teil 1","name_en":"Phase 2: mobility — part 1","name_pl":"Faza 2: mobilność — część 1","source_page":7,"module_number":7,"name_original":"Phase 2: Mobility Phase (Hospital Discharge-6 Weeks)","service_codes":[],"structured_content":{"de":{"goals":["Wiederherstellung der Muskelkraft im gesamten operierten Bein beginnen.","Propriozeptionstraining beginnen.","Ausdauertraining beginnen.","Gesamte funktionelle Mobilität normalisieren.","Ein normales Gangbild mit dem Ziel erreichen, Hilfsmittel am Phasenende bei ärztlicher Freigabe abzusetzen."],"warnings":["Infektionszeichen und zunehmende Schwellung überwachen."],"exercises":["Alle ROM-Übungen aus Phase 1 fortsetzen","Sanfte Dehnung von Hamstrings, Gastrocnemius/Soleus und Quadrizeps","Quadrizeps-, Gesäß- und Hamstring-Anspannungen fortsetzen","LAQ und Hüftbeugung im Sitzen fortsetzen","Brücke — nur innerhalb des zugeordneten Vorsichtsmaßnahmen-Sets","Hüftflexion, -abduktion, -adduktion und -extension im Stand"],"restrictions":["Alle Übungen innerhalb der individuellen Luxationsvorsichtsmaßnahmen durchführen.","Belastung nach Verträglichkeit mit Rollator oder Krücken und Progression zum Stock, sofern nicht anders angeordnet.","Keine Brücke durchführen, wenn globale Vorsichtsmaßnahmen gelten.","Gehhilfen nicht ohne ärztliche Freigabe absetzen."],"dosage_and_progression":[],"physiotherapist_actions":["Wundheilung, Infektionszeichen und zunehmende Schwellung überwachen.","Übungen ausschließlich innerhalb der individuellen Luxationsvorsichtsmaßnahmen auswählen."]},"en":{"goals":["Begin to restore muscle strength throughout the operated leg.","Initiate proprioceptive training.","Initiate endurance training.","Normalize all functional mobility.","Demonstrate a normal gait pattern with the goal of weaning assistive devices at the end of the phase if permitted by the surgeon."],"warnings":["Monitor for infection signs and increased swelling."],"exercises":["Continue all phase 1 ROM exercises","Gentle hamstring, gastroc/soleus and quadriceps stretching","Continue quad, glut and hamstring sets","Continue LAQ and seated hip flexion","Bridging — only within the assigned precaution set","Standing hip flexion, abduction, adduction and extension"],"restrictions":["Perform all exercises within the patient’s dislocation precautions.","WBAT with walker or crutches, progressing to a cane unless otherwise ordered.","Do not perform bridging when global precautions apply.","Do not discontinue assistive devices without surgeon permission."],"dosage_and_progression":[],"physiotherapist_actions":["Monitor proper wound healing, infection signs and increased swelling.","Select exercises only within the patient’s dislocation precautions."]},"pl":{"goals":["Rozpocznij przywracanie siły mięśni całej operowanej kończyny.","Rozpocznij trening propriocepcji.","Rozpocznij trening wytrzymałości.","Normalizuj całą mobilność funkcjonalną.","Uzyskaj prawidłowy wzorzec chodu z celem odstawienia urządzeń pomocniczych pod koniec fazy, jeżeli chirurg zezwoli."],"warnings":["Monitoruj objawy infekcji i zwiększony obrzęk."],"exercises":["Kontynuacja wszystkich ćwiczeń ROM z fazy 1","Delikatne rozciąganie mięśni kulszowo-goleniowych, brzuchatego i płaszczkowatego łydki oraz mięśnia czworogłowego","Kontynuacja napięć mięśnia czworogłowego, pośladkowych i kulszowo-goleniowych","Kontynuacja LAQ i zgięcia biodra w siadzie","Mostek — tylko w granicach przypisanego zestawu ograniczeń dyslokacyjnych","Zgięcie, odwodzenie, przywodzenie i wyprost biodra w staniu"],"restrictions":["Wszystkie ćwiczenia wykonuj w granicach ograniczeń dyslokacyjnych pacjenta.","WBAT z balkonikiem lub kulami, z progresją do laski, chyba że zalecono inaczej.","Nie wykonuj mostków, jeżeli pacjent ma przypisane globalne ograniczenia.","Nie odstawiaj urządzeń pomocniczych bez zgody chirurga."],"dosage_and_progression":[],"physiotherapist_actions":["Monitoruj prawidłowe gojenie rany, objawy infekcji i zwiększony obrzęk.","Dobieraj ćwiczenia wyłącznie w granicach ograniczeń dyslokacyjnych pacjenta."]},"original":{"goals":["Begin to restore muscle strength throughout the operated leg.","Initiate proprioceptive training.","Initiate endurance training.","Normalize all functional mobility.","Demonstrate normal gait pattern with goal to wean all assistive devices at the end of this phase (if permitted by surgeon)."],"warnings":["Monitor for signs of infection and increased swelling."],"exercises":["Continue with all phase 1 ROM exercises","Initiate gentle hamstring, gastroc/soleus, and quadriceps stretching","Continue quad sets, glut sets, hamstring sets","Continue LAQ and seated hip flexion","Bridging","Standing hip flexion/abduction/adduction/extension"],"restrictions":["All exercises performed within the patient’s dislocation precautions.","WBAT with crutches or walker, progressing to cane unless otherwise ordered.","Global Precautions: NO bridging.","Demonstrate normal gait pattern with goal to wean all assistive devices at the end of this phase (if permitted by surgeon)."],"dosage_and_progression":[],"physiotherapist_actions":["Monitor for proper wound healing; monitor for signs of infection; monitor for increased swelling.","All exercises performed within the patient’s dislocation precautions."]}},"additional_notes_de":"Wundheilung, Infektionszeichen und zunehmende Schwellung überwachen.","additional_notes_en":"Monitor wound healing, infection signs and increased swelling.","additional_notes_pl":"Monitoruj prawidłowe gojenie rany, objawy infekcji i wzrost obrzęku.","minimum_patient_share":null,"therapeutic_content_de":"Von der Entlassung bis Woche 6 Kraft wiederherstellen, Propriozeption und Ausdauer beginnen, Mobilität und Gangbild normalisieren.","therapeutic_content_en":"From discharge to week 6, restore strength, initiate proprioception and endurance and normalize mobility and gait.","therapeutic_content_pl":"Od wypisu do 6. tygodnia przywracaj siłę, rozpoczynaj propriocepcję i wytrzymałość, normalizuj mobilność oraz wzorzec chodu.","minimum_requirements_de":"Individuelle Luxationsvorsichtsmaßnahmen einhalten und Belastung nach Verträglichkeit vom Rollator oder von Krücken zum Stock steigern, sofern nicht anders angeordnet.","minimum_requirements_en":"Observe individual dislocation precautions and progress WBAT from walker or crutches to a cane unless otherwise ordered.","minimum_requirements_pl":"Przestrzegaj indywidualnych ograniczeń dyslokacyjnych i progresuj WBAT z balkonika lub kul do laski, chyba że zalecono inaczej.","additional_notes_original":"Monitor for proper wound healing. Monitor for signs of infection. Monitor for increased swelling.","therapeutic_content_original":"Begin to restore muscle strength throughout the operated leg. Initiate proprioceptive training. Initiate endurance training. Normalize all functional mobility. Demonstrate normal gait pattern with goal to wean all assistive devices at the end of this phase (if permitted by surgeon).","minimum_requirements_original":"Dislocation precautions. WBAT with crutches or walker, progressing to cane unless otherwise ordered.","structured_content_v2":"$undefined"},{"id":"0e9f7dc6-b1d7-5be0-9175-03cbf69f8762","name_de":"Phase 2: Mobilität — Übungen und Dosierung","name_en":"Phase 2: mobility — exercises and dosage","name_pl":"Faza 2: mobilność — ćwiczenia i dawkowanie","source_page":8,"module_number":8,"name_original":"Phase 2: Recommended Exercises and Guidelines","service_codes":[],"structured_content":{"de":{"exercises":["Bis zum Phasenende: terminale Kniestreckung, Mini-Kniebeugen, Step-ups und Mini-Ausfallschritte in geschlossener Kette","Gewichtsverlagerung","Einbeinstand","Ergometer ohne bis minimalen Widerstand ab Woche 3–4 postoperativ"],"restrictions":["Alle Übungen innerhalb der individuellen Luxationsvorsichtsmaßnahmen durchführen."],"dosage_and_progression":["ROM- und Kräftigungsübungen 3-mal täglich mit 10–20 Wiederholungen durchführen.","Dehnungen 30 Sekunden halten und jeweils 2–3 Wiederholungen durchführen.","Wenn möglich täglich 5–10 Minuten Ergometer fahren."],"physiotherapist_actions":["Gangtraining mit geeigneter Gehhilfe und Schwerpunkt auf normalem Gangbild durchführen.","Treppentraining mit geeigneter Gehhilfe durchführen."]},"en":{"exercises":["By the end of the phase: closed-chain terminal knee extensions, mini-squats, step-ups and mini-lunges","Weight shifting activities","Single-leg stance","Stationary cycling with minimal to no resistance from weeks 3-4 post-op"],"restrictions":["Perform all exercises within the patient’s dislocation precautions."],"dosage_and_progression":["Perform ROM and strengthening exercises for 10-20 repetitions 3 times/day.","Hold stretches for 30 seconds and perform 2-3 repetitions of each.","Bike daily for 5-10 minutes if able."],"physiotherapist_actions":["Provide gait training with the appropriate device while emphasizing a normal gait pattern.","Provide stair training with the appropriate device."]},"pl":{"exercises":["Pod koniec fazy: wyprost końcowy kolana, mini-przysiady, step-up i mini-wykroki w zamkniętym łańcuchu","Przenoszenie ciężaru ciała","Stanie na jednej nodze","Rower stacjonarny z minimalnym lub zerowym oporem od 3.–4. tygodnia po operacji"],"restrictions":["Wszystkie ćwiczenia wykonuj w granicach ograniczeń dyslokacyjnych pacjenta."],"dosage_and_progression":["Ćwiczenia ROM i wzmacniające wykonuj po 10–20 powtórzeń 3 razy dziennie.","Rozciąganie utrzymuj 30 sekund i wykonuj po 2–3 powtórzenia.","Jeżeli możliwe, jeździj na rowerze codziennie przez 5–10 minut."],"physiotherapist_actions":["Prowadź trening chodu z odpowiednim urządzeniem, kładąc nacisk na prawidłowy wzorzec.","Prowadź trening schodów z odpowiednim urządzeniem."]},"original":{"exercises":["Progress to closed chain exercises including terminal knee extensions, mini-squats, step ups, and mini-lunges by the end of this phase","Weight shifting activities","Single leg stance","Initiate stationary biking with minimal to no resistance 3-4 weeks post-op"],"restrictions":["All exercises performed within the patient’s dislocation precautions."],"dosage_and_progression":["Perform 10-20 repetitions of all ROM, strengthening, and strengthening exercises 3x/day.","Hold stretches for 30 seconds and perform 2-3 repetitions of each.","Bike daily for 5-10 minutes if able."],"physiotherapist_actions":["Gait training with appropriate device emphasizing normal gait pattern.","Stair training with appropriate device."]}},"additional_notes_de":"Ergometertraining ohne bis minimalen Widerstand beginnt 3–4 Wochen postoperativ.","additional_notes_en":"Stationary cycling with minimal to no resistance begins 3-4 weeks post-op.","additional_notes_pl":"Rower stacjonarny z minimalnym lub zerowym oporem rozpoczyna się 3–4 tygodnie po operacji.","minimum_patient_share":null,"therapeutic_content_de":"Bis zum Phasenende zu Übungen in geschlossener Kette, Propriozeption, Gang- und Treppentraining sowie Ergometertraining fortschreiten.","therapeutic_content_en":"By the end of the phase, progress to closed-chain exercise, proprioception, gait and stair training and stationary cycling.","therapeutic_content_pl":"Pod koniec fazy progresuj do ćwiczeń zamkniętych łańcuchów, propriocepcji, treningu chodu i schodów oraz roweru stacjonarnego.","minimum_requirements_de":"Alle Übungen bleiben innerhalb der individuellen Luxationsvorsichtsmaßnahmen.","minimum_requirements_en":"All exercises remain within the patient’s dislocation precautions.","minimum_requirements_pl":"Wszystkie ćwiczenia pozostają w granicach indywidualnych ograniczeń dyslokacyjnych.","additional_notes_original":"Initiate stationary biking with minimal to no resistance 3-4 weeks post-op. Perform 10-20 repetitions of all ROM, strengthening, and strengthening exercises 3x/day. Hold stretches for 30 seconds and perform 2-3 repetitions of each. Bike daily for 5-10 minutes if able.","therapeutic_content_original":"Progress to closed chain exercises including terminal knee extensions, mini-squats, step ups, and mini-lunges by the end of this phase. Weight shifting activities. Single leg stance. Gait training with appropriate device emphasizing normal gait pattern. Stair training with appropriate device.","minimum_requirements_original":"All exercises performed within the patient’s dislocation precautions.","structured_content_v2":"$undefined"},{"id":"b09468ff-b9aa-50f5-8c3a-c318ebc2272a","name_de":"Phase 3: Kräftigung — Woche 6–12","name_en":"Phase 3: strengthening — weeks 6-12","name_pl":"Faza 3: wzmacnianie — 6–12 tygodni","source_page":8,"module_number":9,"name_original":"Phase 3: Strengthening Phase (6-12 Weeks)","service_codes":[],"structured_content":{"de":{"goals":["Normale Kraft der unteren Extremität wiederherstellen.","Zu den funktionellen Ausgangsaktivitäten zurückkehren."],"exercises":["ROM-Übungen aus Phase 1 und 2 bis zur Normalisierung fortsetzen","Übungen aus Phase 2 mit steigendem Widerstand fortsetzen","Widerstandsgeräte: Beinpresse, Hamstring-Curl und 4-Wege-Hüftmaschine","Übungen in geschlossener Kette mit Schwerpunkt auf exzentrischer Kontrolle von Quadrizeps und Hüftabduktoren","Einbeinstand","Statisches Gleichgewicht auf BOSU, Wackelbrett oder Schaumstoff","Sanfte Agilitätsübungen: Tandemgang, Seitwärtsschritte und Rückwärtsgehen","Ergometer mit leichtem bis moderatem Widerstand nach Verträglichkeit","Gehprogramm"],"restrictions":["Alle Übungen innerhalb der individuellen Luxationsvorsichtsmaßnahmen durchführen.","High-Impact-Aktivitäten vermeiden.","Aktivitäten mit wiederholtem Pivotieren oder Drehen vermeiden."],"dosage_and_progression":["ROM- und Dehnübungen einmal täglich durchführen, Dehnungen 30 Sekunden halten und 2–3-mal wiederholen.","Kräftigungsübungen 3–5-mal pro Woche mit 2–3 Sätzen zu 15–20 Wiederholungen durchführen."],"physiotherapist_actions":["Übungen aus Phase 2 fortsetzen und den Widerstand nach Verträglichkeit steigern.","Bei Übungen in geschlossener Kette die exzentrische Kontrolle von Quadrizeps und Hüftabduktoren betonen."]},"en":{"goals":["Restore normal lower-extremity strength.","Return to baseline functional activities."],"exercises":["Continue phase 1 and 2 ROM exercises until ROM is normalized","Continue phase 2 exercises with increasing resistance","Resistance machines: leg press, hamstring curl and 4-way hip machine","Closed-chain exercise emphasizing eccentric control of quadriceps and hip abductors","Single-leg stance","Static balance on BOSU, wobble board or foam","Gentle agility: tandem walking, side stepping and backwards walking","Stationary cycling with mild to moderate resistance as tolerated","Walking program"],"restrictions":["Perform all exercises within the patient’s dislocation precautions.","Avoid high-impact activities.","Avoid activities requiring repeated pivoting or twisting."],"dosage_and_progression":["Perform ROM and stretching once/day, holding stretches for 30 seconds for 2-3 repetitions.","Perform strengthening 3-5 times/week for 2-3 sets of 15-20 repetitions."],"physiotherapist_actions":["Continue phase 2 exercises and add or increase resistance as tolerated.","Emphasize eccentric control of the quadriceps and hip abductors during closed-chain exercise."]},"pl":{"goals":["Przywróć prawidłową siłę kończyny dolnej.","Wróć do wyjściowych aktywności funkcjonalnych."],"exercises":["Kontynuacja ćwiczeń ROM z faz 1 i 2 do normalizacji ROM","Kontynuacja ćwiczeń fazy 2 ze zwiększanym oporem","Maszyny oporowe: prasa nożna, uginanie podudzi i maszyna czterokierunkowa dla biodra","Ćwiczenia zamkniętego łańcucha z naciskiem na kontrolę ekscentryczną mięśnia czworogłowego i odwodzicieli biodra","Stanie na jednej nodze","Równowaga statyczna na BOSU, desce chybotliwej lub piance","Łagodne ćwiczenia zwinności: chód tandemowy, kroki bokiem i chód tyłem","Rower z lekkim do umiarkowanego oporem według tolerancji","Program chodzenia"],"restrictions":["Wszystkie ćwiczenia wykonuj w granicach ograniczeń dyslokacyjnych pacjenta.","Unikaj aktywności high-impact.","Unikaj aktywności wymagających powtarzanego pivotingu lub skręcania."],"dosage_and_progression":["Ćwiczenia ROM i rozciąganie wykonuj raz dziennie, utrzymując rozciąganie 30 sekund po 2–3 powtórzenia.","Ćwiczenia wzmacniające wykonuj 3–5 razy w tygodniu po 2–3 serie po 15–20 powtórzeń."],"physiotherapist_actions":["Progresuj ćwiczenia fazy 2, dodając i zwiększając opór według tolerancji.","Podkreślaj ekscentryczną kontrolę mięśnia czworogłowego i odwodzicieli biodra w ćwiczeniach zamkniętego łańcucha."]},"original":{"goals":["Restore normal LE strength.","Return to baseline functional activities."],"exercises":["Continue ROM exercises from phase 1 and 2 until ROM normalized","Continue with phase 2 exercises adding and increasing resistance as tolerated","Add resistance machines as appropriate including leg press, hamstring curl, and 4-way hip machine","Emphasize eccentric control of quadriceps and hip abductors with closed chain exercises","Single leg stance","Static balance on Bosu/wobble board/foam/etc","Add gentle agility exercises (i.e. tandem walk, side stepping, backwards walking)","Continue biking, adding mild to moderate resistance as tolerated","Begin walking program"],"restrictions":["All exercises performed within the patient’s dislocation precautions.","Avoid high impact activities.","Avoid activities that require repeated pivoting/twisting."],"dosage_and_progression":["Perform ROM and stretching exercises once a day. Hold stretches for 30 seconds and perform 2-3 repetitions of each.","Perform strengthening exercises 3-5 times a week. Do 2-3 sets of 15-20 Reps."],"physiotherapist_actions":["Continue with phase 2 exercises adding and increasing resistance as tolerated.","Emphasize eccentric control of quadriceps and hip abductors with closed chain exercises."]}},"additional_notes_de":"Widerstand nach Verträglichkeit steigern und exzentrische Kontrolle von Quadrizeps und Hüftabduktoren betonen.","additional_notes_en":"Increase resistance as tolerated and emphasize eccentric control of the quadriceps and hip abductors.","additional_notes_pl":"Zwiększaj opór według tolerancji i podkreślaj kontrolę ekscentryczną mięśnia czworogłowego oraz odwodzicieli biodra.","minimum_patient_share":null,"therapeutic_content_de":"Normale Kraft der unteren Extremität und frühere funktionelle Aktivitäten durch Progression von Widerstand, Propriozeption, sanfter Agilität und Ausdauer wiederherstellen.","therapeutic_content_en":"Restore normal lower-extremity strength and baseline function through progressive resistance, proprioception, gentle agility and endurance.","therapeutic_content_pl":"Przywracaj prawidłową siłę kończyny dolnej i wcześniejszą aktywność funkcjonalną poprzez progresję oporu, propriocepcji, łagodnej zwinności i wytrzymałości.","minimum_requirements_de":"Luxationsvorsichtsmaßnahmen einhalten und High-Impact-Aktivitäten sowie wiederholtes Pivotieren und Drehen vermeiden.","minimum_requirements_en":"Observe dislocation precautions and avoid high-impact activity and repeated pivoting or twisting.","minimum_requirements_pl":"Przestrzegaj ograniczeń dyslokacyjnych, unikaj aktywności high-impact oraz powtarzanego pivotingu i skręcania.","additional_notes_original":"Perform ROM and stretching exercises once a day. Hold stretches for 30 seconds and perform 2-3 repetitions of each. Perform strengthening exercises 3-5 times a week. Do 2-3 sets of 15-20 Reps.","therapeutic_content_original":"Restore normal LE strength. Return to baseline functional activities. Continue with phase 2 exercises adding and increasing resistance as tolerated. Emphasize eccentric control of quadriceps and hip abductors with closed chain exercises.","minimum_requirements_original":"Dislocation precautions. Avoid high impact activities. Avoid activities that require repeated pivoting/twisting.","structured_content_v2":"$undefined"},{"id":"c1b55367-8ccd-53c6-ba6d-9af993fbfc4b","name_de":"Phase 3: Ausdauerprogression","name_en":"Phase 3: endurance progression","name_pl":"Faza 3: progresja wytrzymałości","source_page":9,"module_number":10,"name_original":"Phase 3 Guidelines — endurance continuation","service_codes":[],"structured_content":{"de":{"exercises":[],"progression_criteria":["Dauer nur nach Verträglichkeit und innerhalb der individuellen Vorsichtsmaßnahmen steigern."],"dosage_and_progression":["Ergometer oder Gehprogramm auf 20–30 Minuten 3-mal pro Woche steigern."],"physiotherapist_actions":["Das Ausdauerprogramm nach Verträglichkeit steigern."]},"en":{"exercises":[],"progression_criteria":["Increase duration only as tolerated and within individual precautions."],"dosage_and_progression":["Progress cycling or walking to 20-30 minutes 3 times/week for endurance."],"physiotherapist_actions":["Progress the endurance program according to tolerance."]},"pl":{"exercises":[],"progression_criteria":["Zwiększaj czas tylko według tolerancji i w granicach indywidualnych ograniczeń."],"dosage_and_progression":["Progresuj jazdę na rowerze lub chód do 20–30 minut 3 razy w tygodniu."],"physiotherapist_actions":["Progresuj program wytrzymałościowy według tolerancji pacjenta."]},"original":{"exercises":[],"progression_criteria":["Progress to biking/walking for at 20-30 minutes 3x/week for endurance."],"dosage_and_progression":["Progress to biking/walking for at 20-30 minutes 3x/week for endurance."],"physiotherapist_actions":["Progress to biking/walking for endurance."]}},"additional_notes_de":"Dies ist die Fortsetzung der Dosierung von Phase 3 auf Seite 9 und keine neue Phase.","additional_notes_en":"This is the continuation of phase 3 dosage on page 9, not a new phase.","additional_notes_pl":"To dokończenie dawkowania fazy 3 ze strony 9, bez tworzenia nowej fazy.","minimum_patient_share":null,"therapeutic_content_de":"Ergometer- oder Gehprogramm auf 20–30 Minuten dreimal pro Woche steigern.","therapeutic_content_en":"Progress cycling or walking to 20-30 minutes three times/week.","therapeutic_content_pl":"Progresuj program rowerowy lub chód do 20–30 minut trzy razy w tygodniu.","minimum_requirements_de":"Ausdauer nach Verträglichkeit innerhalb der Luxationsvorsichtsmaßnahmen steigern.","minimum_requirements_en":"Progress endurance as tolerated within dislocation precautions.","minimum_requirements_pl":"Zwiększaj wytrzymałość według tolerancji w ramach ograniczeń dyslokacyjnych.","additional_notes_original":"Phase 3: Strengthening Phase (6-12 Weeks).","therapeutic_content_original":"Progress to biking/walking for at 20-30 minutes 3x/week for endurance.","minimum_requirements_original":"Progress to biking/walking for endurance.","structured_content_v2":"$undefined"},{"id":"eea3f354-f998-5247-bb25-b488d1f576a0","name_de":"Phase 4: Fortgeschritten — ab Woche 12","name_en":"Phase 4: advanced — week 12 and beyond","name_pl":"Faza 4: zaawansowana — od 12. tygodnia","source_page":9,"module_number":11,"name_original":"Phase 4: Advanced Phase (12 Weeks and Beyond)","service_codes":[],"structured_content":{"de":{"goals":["Kraft weiter verbessern, um funktionelle Ergebnisse zu maximieren.","Gemeinsam mit Physiotherapie und Arzt einen individuellen Plan zur Rückkehr zu geeigneten Sport- und Freizeitaktivitäten erstellen."],"exercises":["Tägliche ROM- und Dehnübungen","Kräftigung mit steigendem Widerstand und sinkender Wiederholungszahl fortsetzen","Propriozeptionsübungen aus Phase 3 mit steigender Schwierigkeit fortsetzen","Gehen, Ergometer und Crosstrainer","Aktivitäts- oder sportartspezifische Übungen"],"restrictions":["Luxationsvorsichtsmaßnahmen nach ärztlicher Anordnung einhalten.","High-Impact-Aktivitäten und Kontaktsport vermeiden.","Wiederholtes schweres Heben vermeiden."],"dosage_and_progression":["ROM und Flexibilität täglich durchführen.","Kräftigung und Propriozeption 3–5-mal pro Woche mit 2–3 Sätzen zu 10–15 Wiederholungen durchführen.","Ausdauerprogramm 3-mal pro Woche 30–45 Minuten fortsetzen."],"physiotherapist_actions":["Mit Patient:in und Arzt ein individuelles Programm zur Rückkehr zu geeigneten Aktivitäten erstellen.","Widerstand, Propriozeptionsschwierigkeit und funktionelles Training nach Verträglichkeit steigern."]},"en":{"goals":["Continue improving strength to maximize functional outcomes.","Work with PT and the physician to create an individualized return to appropriate sport and recreational activity."],"exercises":["Daily ROM and stretching exercises","Continue strengthening with increasing resistance and decreasing repetitions","Continue phase 3 proprioception with increasing difficulty","Walking, cycling and elliptical programs","Activity- or sport-specific training exercises"],"restrictions":["Follow dislocation precautions according to surgeon’s orders.","Avoid high-impact activities and contact sports.","Avoid repetitive heavy lifting."],"dosage_and_progression":["Perform ROM and flexibility daily.","Perform strengthening and proprioception 3-5 times/week for 2-3 sets of 10-15 repetitions.","Continue endurance training for 30-45 minutes 3 times/week."],"physiotherapist_actions":["Create an individualized return-to-activity program with the patient and physician.","Progress resistance, proprioceptive difficulty and functional training as tolerated."]},"pl":{"goals":["Kontynuuj poprawę siły, aby maksymalizować wyniki funkcjonalne.","Wspólnie z fizjoterapeutą i lekarzem opracuj indywidualny plan powrotu do odpowiednich aktywności sportowych i rekreacyjnych."],"exercises":["Codzienne ćwiczenia ROM i rozciąganie","Kontynuacja wzmacniania ze zwiększaniem oporu i zmniejszaniem liczby powtórzeń","Kontynuacja ćwiczeń propriocepcji z fazy 3 ze zwiększaniem trudności","Chód, rower i orbitrek","Ćwiczenia specyficzne dla aktywności lub sportu"],"restrictions":["Stosuj ograniczenia dyslokacyjne zgodnie z zaleceniem chirurga.","Unikaj aktywności high-impact i sportów kontaktowych.","Unikaj powtarzanego ciężkiego dźwigania."],"dosage_and_progression":["ROM i elastyczność wykonuj codziennie.","Wzmacnianie i propriocepcję wykonuj 3–5 razy w tygodniu po 2–3 serie po 10–15 powtórzeń.","Kontynuuj program wytrzymałościowy przez 30–45 minut 3 razy w tygodniu."],"physiotherapist_actions":["Opracuj z pacjentem i lekarzem indywidualny program powrotu do odpowiednich aktywności.","Progresuj opór, trudność propriocepcji i trening funkcjonalny według tolerancji."]},"original":{"goals":["Continue to improve strength to maximize functional outcomes.","Work with PT and MD to create customized routine to allow return to appropriate sports/recreational activities (i.e. golf, doubles tennis, cycling, hiking)."],"exercises":["Continue daily ROM and stretching exercises","Continue with all strengthening exercises increasing resistance and decreasing repetitions","Continue with all phase 3 exercises, increasing difficulty as tolerated","Continue with walking, biking, elliptical machine programs","Activity/sport-specific training exercises"],"restrictions":["Dislocation precautions according to surgeon’s orders.","Avoid high impact and contact sports.","Avoid repetitive heavy lifting."],"dosage_and_progression":["Perform ROM and flexibility exercises daily.","Perform strengthening and proprioception exercises 3-5x/week, performing 2-3 sets of 10-15 repetitions.","Continue endurance program 30-45 minutes 3x/week."],"physiotherapist_actions":["Work with PT and MD to create customized routine to allow return to appropriate sports/recreational activities.","Activity/sport-specific training exercises."]}},"additional_notes_de":"Die Quelle nennt Golf, Doppeltennis, Radfahren und Wandern als Beispiele geeigneter Aktivitäten.","additional_notes_en":"The source lists golf, doubles tennis, cycling and hiking as examples of appropriate activities.","additional_notes_pl":"Źródło wymienia golf, tenis deblowy, jazdę na rowerze i piesze wędrówki jako przykłady odpowiednich aktywności.","minimum_patient_share":null,"therapeutic_content_de":"Kraft weiter verbessern und gemeinsam mit Physiotherapie und Arzt eine individuelle Rückkehr zu geeigneten Freizeitaktivitäten planen.","therapeutic_content_en":"Continue improving strength and work with PT and the physician on an individualized return to appropriate recreational activity.","therapeutic_content_pl":"Kontynuuj poprawę siły i wspólnie z fizjoterapeutą oraz lekarzem opracuj indywidualny powrót do odpowiednich aktywności rekreacyjnych.","minimum_requirements_de":"Luxationsvorsichtsmaßnahmen nach ärztlicher Anordnung einhalten und High-Impact-Aktivitäten, Kontaktsport sowie wiederholtes schweres Heben vermeiden.","minimum_requirements_en":"Follow surgeon-ordered dislocation precautions and avoid high-impact activity, contact sports and repetitive heavy lifting.","minimum_requirements_pl":"Stosuj ograniczenia dyslokacyjne zgodnie z zaleceniem chirurga i unikaj aktywności high-impact, sportów kontaktowych oraz powtarzanego ciężkiego dźwigania.","additional_notes_original":"Perform ROM and flexibility exercises daily. Perform strengthening and proprioception exercises 3-5x/week, performing 2-3 sets of 10-15 repetitions. Continue endurance program 30-45 minutes 3x/week.","therapeutic_content_original":"Continue to improve strength to maximize functional outcomes. Work with PT and MD to create customized routine to allow return to appropriate sports/recreational activities (i.e. golf, doubles tennis, cycling, hiking).","minimum_requirements_original":"Dislocation precautions according to surgeon’s orders. Avoid high impact and contact sports. Avoid repetitive heavy lifting.","structured_content_v2":"$undefined"},{"id":"10ea9d1c-3db6-5da9-a545-4f673752a091","name_de":"Zugangsspezifische Bettpositionierung","name_en":"Approach-specific bed positioning","name_pl":"Pozycjonowanie łóżka zależne od dojścia","source_page":10,"module_number":12,"name_original":"POSITIONING (when in bed) — table clarification","service_codes":[],"structured_content":{"de":{"warnings":["Die Quelle druckt „food of the bed“; der Tippfehler ist dokumentiert und die Anweisung wird als Einstellung des Fußendes verstanden."],"exercises":[],"restrictions":["Bei posterioren Vorsichtsmaßnahmen bleibt das Fußende flach arretiert.","Bei anterioren Vorsichtsmaßnahmen bleibt das Fußende entriegelt und leicht angehoben."],"dosage_and_progression":[],"physiotherapist_actions":["Das Fußende entsprechend dem zugeordneten Zugang einstellen und die neutrale Hüftrotation prüfen."]},"en":{"warnings":["The source prints “food of the bed”; the typo is documented and the instruction is interpreted as the foot-of-bed position."],"exercises":[],"restrictions":["For posterior precautions, keep the foot of the bed locked flat.","For anterior precautions, keep the foot of the bed unlocked and slightly flexed."],"dosage_and_progression":[],"physiotherapist_actions":["Set the foot of the bed according to the assigned approach and check neutral hip rotation."]},"pl":{"warnings":["Źródło drukuje „food of the bed”; zachowano informację o literówce, a instrukcję zinterpretowano jako ustawienie stopy łóżka."],"exercises":[],"restrictions":["Przy ograniczeniach dla dojścia tylnego stopa łóżka pozostaje zablokowana w pozycji płaskiej.","Przy ograniczeniach dla dojścia przedniego stopa łóżka pozostaje odblokowana i lekko zgięta."],"dosage_and_progression":[],"physiotherapist_actions":["Ustaw stopę łóżka zgodnie z przypisanym dojściem i sprawdź neutralną rotację biodra."]},"original":{"warnings":["The source table prints “food of the bed” in both positioning instructions."],"exercises":[],"restrictions":["Posterior Precautions: ensure the food of the bed is locked in a flat position.","Anterior Precautions: food of the bed is unlocked and slightly flexed."],"dosage_and_progression":[],"physiotherapist_actions":["Trochanter roll to maintain hip neutral rotation and promote knee extension."]}},"additional_notes_de":"Die Quelltabelle enthält zweimal den Tippfehler „food of the bed“; aus dem Kontext ist „foot of the bed“ gemeint.","additional_notes_en":"The source table prints “food of the bed” twice; context indicates “foot of the bed.”","additional_notes_pl":"Tabela źródłowa dwukrotnie zawiera literówkę „food of the bed”; znaczenie wynika z kontekstu jako „foot of the bed”.","minimum_patient_share":null,"therapeutic_content_de":"Die Übersichtstabelle ergänzt eine eigene Fußendeinstellung für den anterioren Zugang und bestätigt die flache Position beim posterioren Zugang.","therapeutic_content_en":"The summary table adds a distinct foot-of-bed position for anterior precautions and confirms a flat position for posterior precautions.","therapeutic_content_pl":"Tabela podsumowująca dodaje osobną pozycję stopy łóżka dla dojścia przedniego oraz potwierdza ustawienie płaskie dla dojścia tylnego.","minimum_requirements_de":"Die zum operativen Zugang passende Einstellung verwenden und diese Regel nicht auf andere Vorsichtsmaßnahmen-Sets übertragen.","minimum_requirements_en":"Use the position appropriate to the surgical approach and do not transfer it between precaution sets.","minimum_requirements_pl":"Stosuj ustawienie odpowiednie dla dojścia operacyjnego i nie przenoś tej zasady między zestawami ograniczeń.","additional_notes_original":"The source table prints “food of the bed” in both positioning instructions.","therapeutic_content_original":"POSITIONING (when in bed): Posterior Precautions: ensure the food of the bed is locked in a flat position. Anterior Precautions: food of the bed is unlocked and slightly flexed.","minimum_requirements_original":"Trochanter roll to maintain hip neutral rotation and promote knee extension. Never place anything under the operated knee for posterior precautions.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["hip_pelvis","lower_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"4ec88e91-6095-5202-a65c-20353b0da546","slug":"us-apta-hip-oa-2025","title_pl":"APTA Orthopedics: choroba zwyrodnieniowa stawu biodrowego — rewizja 2025","title_de":"APTA Orthopedics: Hüftarthrose — Revision 2025","title_en":"APTA Orthopedics: Hip Pain and Mobility Deficits—Hip Osteoarthritis: Revision 2025","title_original":"Hip Pain and Mobility Deficits—Hip Osteoarthritis: Revision 2025","summary_pl":"CPG dla fizjoterapeutów dorosłych z chorobą zwyrodnieniową stawu biodrowego; obejmuje terapię manualną, ćwiczenia, edukację, wsparcie redukcji masy ciała oraz trening funkcjonalny, chodu i równowagi.","summary_de":"CPG für Physiotherapeuten bei Erwachsenen mit Hüftarthrose; behandelt manuelle Therapie, Übungen, Aufklärung, Unterstützung bei Gewichtsreduktion sowie funktionelles Training, Gang- und Gleichgewichtstraining.","summary_en":"CPG for physical therapists treating adults with hip osteoarthritis; covers manual therapy, exercise, education, support for weight reduction, and functional, gait, and balance training.","country_code":"US","source_language":"en","publication_year":2025,"version_label":"2025 · JOSPT 55(11), CPG1–CPG31 · epub 12 September 2025","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"guideline","patient_populations":["adults with hip osteoarthritis"],"clinical_contexts":["conservative management"],"care_pathways":["non-surgical physiotherapy"],"physician_clearance_required":false,"condition_id":"a64715bd-e7b6-5845-8d62-3d9591689268","condition_slug":"hip-osteoarthritis","condition_name_pl":"Choroba zwyrodnieniowa stawu biodrowego","condition_name_de":"Hüftarthrose","condition_name_en":"Hip Osteoarthritis","condition_name_original":"Hip Osteoarthritis","icd_codes":[],"category_key":"hip","category_pl":"Fizjoterapia ortopedyczna","category_de":"Orthopädische Physiotherapie","category_en":"Orthopaedic physical therapy","body_regions_pl":["Biodro","Kończyna dolna","Chód","Równowaga"],"body_regions_de":["Hüfte","Untere Extremität","Gehen","Gleichgewicht"],"body_regions_en":["Hip","Lower extremity","Walking","Balance"],"search_terms_pl":["artroza biodra","choroba zwyrodnieniowa biodra","koksartroza","ból biodra","chód","równowaga"],"search_terms_de":["Hüftarthrose","Coxarthrose","Hüftschmerz","Gehen","Gleichgewicht"],"search_terms_en":["hip osteoarthritis","hip OA","hip pain","gait","balance"],"source_document_id":"1c7ff3aa-43db-52b0-8c9b-5d312499a63c","source_title":"Hip Pain and Mobility Deficits—Hip Osteoarthritis: Revision 2025","issuer":"Academy of Orthopaedic Physical Therapy and American Academy of Sports Physical Therapy, APTA","source_country_code":"US","jurisdiction_code":"US","authority_level":"national_professional_society","document_type":"physiotherapy_cpg","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"current","official_url":"https://www.orthopt.org/uploads/content_files/files/Hip_pain_and_mobility_deficits_hip_osteoarthritis_2025.pdf","source_sha256":"7910e402535bc614d820f67e6c60b1658401f9a76beb28da46543e37946ee300","authorization_required":true,"license_note":"Copyright © 2025 APTA Orthopedics/JOSPT. APTA Orthopedics consents to reproduction and distribution of this guideline for educational purposes; other uses require permission. Authorization review is required before final public release.","modules":[{"id":"ba7f5052-5f23-52b2-9eb4-3c7268b058f6","name_de":"Manuelle Therapie der Hüfte","name_en":"Hip Manual Therapy","name_pl":"Terapia manualna biodra","source_page":3,"module_number":1,"name_original":"Hip Manual Therapy","service_codes":[],"structured_content":{"de":{"warnings":["Empfehlung A."],"physiotherapist_actions":["Für leichte bis mittelschwere Hüftarthrose mit dokumentierter Einschränkung der Gelenkbeweglichkeit, Flexibilität und/oder Schmerzen.","Manuelle Weichteil- und/oder Gelenktherapie einschließlich Long-Axis-Traktion der Hüfte mit hoher oder niedriger Kraft sowie Mobilisation mit Bewegung anwenden, um Bewegungsumfang, Schmerz und Funktion bei leichter bis mittelschwerer Hüftarthrose und eingeschränkter Gelenkbeweglichkeit, Flexibilität und/oder Schmerzen zu verbessern."]},"en":{"warnings":["Recommendation A."],"physiotherapist_actions":["For mild-to-moderate hip OA with documented joint mobility, flexibility, and/or pain impairments.","Use manual therapy with soft tissue and/or joint mobilization, including high- and low-force long-axis hip distraction and hip mobilization with movement, to improve ROM, pain, and function in mild-to-moderate hip OA with mobility, flexibility, and/or pain impairments."]},"pl":{"warnings":["Rekomendacja A."],"physiotherapist_actions":["Dotyczy łagodnej lub umiarkowanej choroby zwyrodnieniowej biodra z udokumentowanym ograniczeniem ruchomości, elastyczności i/lub bólem.","Stosuj terapię manualną tkanek miękkich i/lub stawową, w tym trakcję osiową biodra o dużej lub małej sile oraz mobilizację z ruchem, aby poprawiać zakres ruchu, zmniejszać ból i poprawiać funkcję u osób z łagodną lub umiarkowaną chorobą zwyrodnieniową biodra oraz zaburzeniem ruchomości stawu, elastyczności i/lub bólem."]},"original":{"warnings":["Recommendation A."],"physiotherapist_actions":["For mild-to-moderate hip OA with documented joint mobility, flexibility, and/or pain impairments.","Use manual therapy with soft tissue and/or joint mobilization, including high- and low-force long-axis hip distraction and hip mobilization with movement, to improve ROM, pain, and function in mild-to-moderate hip OA with mobility, flexibility, and/or pain impairments."]}},"additional_notes_de":"Empfehlung A.","additional_notes_en":"Recommendation A.","additional_notes_pl":"Rekomendacja A.","minimum_patient_share":null,"therapeutic_content_de":"Manuelle Weichteil- und/oder Gelenktherapie einschließlich Long-Axis-Traktion der Hüfte mit hoher oder niedriger Kraft sowie Mobilisation mit Bewegung anwenden, um Bewegungsumfang, Schmerz und Funktion bei leichter bis mittelschwerer Hüftarthrose und eingeschränkter Gelenkbeweglichkeit, Flexibilität und/oder Schmerzen zu verbessern.","therapeutic_content_en":"Use manual therapy with soft tissue and/or joint mobilization, including high- and low-force long-axis hip distraction and hip mobilization with movement, to improve ROM, pain, and function in mild-to-moderate hip OA with mobility, flexibility, and/or pain impairments.","therapeutic_content_pl":"Stosuj terapię manualną tkanek miękkich i/lub stawową, w tym trakcję osiową biodra o dużej lub małej sile oraz mobilizację z ruchem, aby poprawiać zakres ruchu, zmniejszać ból i poprawiać funkcję u osób z łagodną lub umiarkowaną chorobą zwyrodnieniową biodra oraz zaburzeniem ruchomości stawu, elastyczności i/lub bólem.","minimum_requirements_de":"Für leichte bis mittelschwere Hüftarthrose mit dokumentierter Einschränkung der Gelenkbeweglichkeit, Flexibilität und/oder Schmerzen.","minimum_requirements_en":"For mild-to-moderate hip OA with documented joint mobility, flexibility, and/or pain impairments.","minimum_requirements_pl":"Dotyczy łagodnej lub umiarkowanej choroby zwyrodnieniowej biodra z udokumentowanym ograniczeniem ruchomości, elastyczności i/lub bólem.","additional_notes_original":"2025 Recommendation: A.","therapeutic_content_original":"Clinicians should use manual therapy with soft tissue and/or joint mobilization, including high- and low-force long-axis hip distraction and hip mobilization with movement, to increase ROM, decrease pain, and improve function for patients with mild-to-moderate hip OA and impairments of joint mobility, flexibility, and/or pain.","minimum_requirements_original":"For patients with mild-to-moderate hip OA and impairments of joint mobility, flexibility, and/or pain.","structured_content_v2":"$undefined"},{"id":"ee75f50a-3a41-5145-986f-358a3acfacfa","name_de":"Anpassung der manuellen Therapie","name_en":"Manual Therapy Adaptation","name_pl":"Dostosowanie terapii manualnej","source_page":4,"module_number":2,"name_original":"Manual Therapy Adaptation","service_codes":[],"structured_content":{"de":{"warnings":["Empfehlung F."],"physiotherapist_actions":["Individuelle knöcherne Hüftmorphologie sowie Gewebetoleranz und Reizbarkeit berücksichtigen.","Manuelle Therapie und Kraftamplitude können an die knöcherne Hüftmorphologie sowie die Gewebetoleranz und Reizbarkeit des Patienten angepasst werden."]},"en":{"warnings":["Recommendation F."],"physiotherapist_actions":["Consider the individual bony hip morphology and tissue tolerance or irritability.","Manual therapy procedures and force amplitude may be modified according to the patient’s bony hip morphology and tissue tolerance or irritability."]},"pl":{"warnings":["Rekomendacja F."],"exercises":["Można modyfikować techniki terapii manualnej i amplitudę siły zgodnie z kostną morfologią biodra oraz tolerancją tkanek i ich drażliwością u danego pacjenta."],"physiotherapist_actions":["Uwzględnij indywidualną morfologię kostną biodra oraz tolerancję i drażliwość tkanek."]},"original":{"warnings":["Recommendation F."],"physiotherapist_actions":["Consider the individual bony hip morphology and tissue tolerance or irritability.","Manual therapy procedures and force amplitude may be modified according to the patient’s bony hip morphology and tissue tolerance or irritability."]}},"additional_notes_de":"Empfehlung F.","additional_notes_en":"Recommendation F.","additional_notes_pl":"Rekomendacja F.","minimum_patient_share":null,"therapeutic_content_de":"Manuelle Therapie und Kraftamplitude können an die knöcherne Hüftmorphologie sowie die Gewebetoleranz und Reizbarkeit des Patienten angepasst werden.","therapeutic_content_en":"Manual therapy procedures and force amplitude may be modified according to the patient’s bony hip morphology and tissue tolerance or irritability.","therapeutic_content_pl":"Można modyfikować techniki terapii manualnej i amplitudę siły zgodnie z kostną morfologią biodra oraz tolerancją tkanek i ich drażliwością u danego pacjenta.","minimum_requirements_de":"Individuelle knöcherne Hüftmorphologie sowie Gewebetoleranz und Reizbarkeit berücksichtigen.","minimum_requirements_en":"Consider the individual bony hip morphology and tissue tolerance or irritability.","minimum_requirements_pl":"Uwzględnij indywidualną morfologię kostną biodra oraz tolerancję i drażliwość tkanek.","additional_notes_original":"2025 Recommendation: F.","therapeutic_content_original":"Clinician may modify their manual therapy procedures and force amplitude according to the patient’s bony hip morphology and tissue tolerance/irritability.","minimum_requirements_original":"According to the patient’s bony hip morphology and tissue tolerance/irritability.","structured_content_v2":"$undefined"},{"id":"2c558771-ac7a-53c7-b1a5-9f5a88f25b9d","name_de":"Individualisiertes Übungsprogramm","name_en":"Individualized Exercise Program","name_pl":"Indywidualny program ćwiczeń","source_page":6,"module_number":3,"name_original":"Individualized Exercise Program","service_codes":[],"structured_content":{"de":{"warnings":["Empfehlung A."],"exercises":["Ein individualisiertes Übungsprogramm, gegebenenfalls einschließlich Bewegungstherapie im Wasser, verordnen, um Beweglichkeit, Kraft, Funktion und Schmerz zu verbessern."],"physiotherapist_actions":["Dosierung gemäß CPG: 1–5-mal pro Woche, 30–120 Minuten je Sitzung, über 5–16 Wochen."]},"en":{"warnings":["Recommendation A."],"exercises":["Prescribe an individualized exercise program, potentially including aquatic therapy, to improve motion, strength, function, and pain."],"physiotherapist_actions":["CPG dosage: 1 to 5 times per week, 30 to 120 minutes per session, for 5 to 16 weeks."]},"pl":{"warnings":["Rekomendacja A."],"exercises":["Zalecaj indywidualny program ćwiczeń, który może obejmować terapię w wodzie, aby poprawiać ruch, siłę, funkcję i ból."],"physiotherapist_actions":["Dawka według CPG: 1–5 razy na tydzień, 30–120 minut na sesję, przez 5–16 tygodni."]},"original":{"warnings":["Recommendation A."],"exercises":["Prescribe an individualized exercise program, potentially including aquatic therapy, to improve motion, strength, function, and pain."],"physiotherapist_actions":["CPG dosage: 1 to 5 times per week, 30 to 120 minutes per session, for 5 to 16 weeks."]}},"additional_notes_de":"Empfehlung A.","additional_notes_en":"Recommendation A.","additional_notes_pl":"Rekomendacja A.","minimum_patient_share":null,"therapeutic_content_de":"Ein individualisiertes Übungsprogramm, gegebenenfalls einschließlich Bewegungstherapie im Wasser, verordnen, um Beweglichkeit, Kraft, Funktion und Schmerz zu verbessern.","therapeutic_content_en":"Prescribe an individualized exercise program, potentially including aquatic therapy, to improve motion, strength, function, and pain.","therapeutic_content_pl":"Zalecaj indywidualny program ćwiczeń, który może obejmować terapię w wodzie, aby poprawiać ruch, siłę, funkcję i ból.","minimum_requirements_de":"Dosierung gemäß CPG: 1–5-mal pro Woche, 30–120 Minuten je Sitzung, über 5–16 Wochen.","minimum_requirements_en":"CPG dosage: 1 to 5 times per week, 30 to 120 minutes per session, for 5 to 16 weeks.","minimum_requirements_pl":"Dawka według CPG: 1–5 razy na tydzień, 30–120 minut na sesję, przez 5–16 tygodni.","additional_notes_original":"2025 Recommendation: A.","therapeutic_content_original":"Clinicians should prescribe an individualized exercise program, potentially including aquatic therapy, to improve motion, strength, function, and pain, with dosages ranging from 1 to 5 times per week, each lasting 30–120 min, over a duration of 5–16 weeks.","minimum_requirements_original":"1 to 5 times per week; 30–120 min each; 5–16 weeks.","structured_content_v2":"$undefined"},{"id":"95b438cb-8eca-5162-a0d4-fb80fcc35233","name_de":"Dry Needling von myofaszialen Triggerpunkten","name_en":"Dry Needling for Myofascial Trigger Points","name_pl":"Suche igłowanie punktów spustowych","source_page":8,"module_number":4,"name_original":"Dry Needling for Myofascial Trigger Points","service_codes":[],"structured_content":{"de":{"warnings":["Empfehlung A."],"physiotherapist_actions":["Gilt für einen kurzen Zeitraum von 3 Wochen und für Hüftarthrose Grad II–III.","Dry Needling von myofaszialen Triggerpunkten des Iliopsoas, Rectus femoris, Tensor fasciae latae sowie Gluteus medius und minimus anwenden, um bei Hüftarthrose Grad II–III kurzfristig Muskelelastizität, Schmerz, Bewegungsumfang, Funktion und Kraftentwicklung zu verbessern."]},"en":{"warnings":["Recommendation A."],"physiotherapist_actions":["Applies to a short-term period of 3 weeks and Grades II and III hip OA.","Use dry needling for myofascial trigger points in the iliopsoas, rectus femoris, tensor fasciae latae, gluteus medius, and gluteus minimus for short-term improvements in muscle extensibility, pain, ROM, function, and muscle force production in Grades II and III hip OA."]},"pl":{"warnings":["Rekomendacja A."],"physiotherapist_actions":["Dotyczy krótkiego okresu 3 tygodni oraz choroby zwyrodnieniowej biodra stopnia II–III.","Stosuj suche igłowanie punktów spustowych mięśnia biodrowo-lędźwiowego, prostego uda, napinacza powięzi szerokiej oraz mięśni pośladkowych średniego i małego, aby krótkoterminowo poprawiać elastyczność mięśni, ból, zakres ruchu, funkcję i wytwarzanie siły u osób z chorobą zwyrodnieniową biodra II–III stopnia."]},"original":{"warnings":["Recommendation A."],"physiotherapist_actions":["Applies to a short-term period of 3 weeks and Grades II and III hip OA.","Use dry needling for myofascial trigger points in the iliopsoas, rectus femoris, tensor fasciae latae, gluteus medius, and gluteus minimus for short-term improvements in muscle extensibility, pain, ROM, function, and muscle force production in Grades II and III hip OA."]}},"additional_notes_de":"Empfehlung A.","additional_notes_en":"Recommendation A.","additional_notes_pl":"Rekomendacja A.","minimum_patient_share":null,"therapeutic_content_de":"Dry Needling von myofaszialen Triggerpunkten des Iliopsoas, Rectus femoris, Tensor fasciae latae sowie Gluteus medius und minimus anwenden, um bei Hüftarthrose Grad II–III kurzfristig Muskelelastizität, Schmerz, Bewegungsumfang, Funktion und Kraftentwicklung zu verbessern.","therapeutic_content_en":"Use dry needling for myofascial trigger points in the iliopsoas, rectus femoris, tensor fasciae latae, gluteus medius, and gluteus minimus for short-term improvements in muscle extensibility, pain, ROM, function, and muscle force production in Grades II and III hip OA.","therapeutic_content_pl":"Stosuj suche igłowanie punktów spustowych mięśnia biodrowo-lędźwiowego, prostego uda, napinacza powięzi szerokiej oraz mięśni pośladkowych średniego i małego, aby krótkoterminowo poprawiać elastyczność mięśni, ból, zakres ruchu, funkcję i wytwarzanie siły u osób z chorobą zwyrodnieniową biodra II–III stopnia.","minimum_requirements_de":"Gilt für einen kurzen Zeitraum von 3 Wochen und für Hüftarthrose Grad II–III.","minimum_requirements_en":"Applies to a short-term period of 3 weeks and Grades II and III hip OA.","minimum_requirements_pl":"Dotyczy krótkiego okresu 3 tygodni oraz choroby zwyrodnieniowej biodra stopnia II–III.","additional_notes_original":"2025 Recommendation: A.","therapeutic_content_original":"Clinicians should use DN to treat MTrP in the iliopsoas, rectus femoris, tensor fasciae latae, gluteus medius, and gluteus minimus muscles for short-term (3 weeks) improvements in muscle extensibility, pain, ROM, function, and muscle force production, in those with Grades II and III hip OA.","minimum_requirements_original":"Short-term (3 weeks); Grades II and III hip OA.","structured_content_v2":"$undefined"},{"id":"4d205d16-4e45-5c14-85ee-9a08282684b0","name_de":"Patientenedukation und Schmerzbewältigung","name_en":"Patient Education and Pain Coping","name_pl":"Edukacja pacjenta i radzenie sobie z bólem","source_page":8,"module_number":5,"name_original":"Patient Education and Pain Coping","service_codes":[],"structured_content":{"de":{"warnings":["Empfehlung B."],"exercises":["Patientenedukation zu Aktivitätsanpassung, Übungen, Unterstützung der Gewichtsreduktion bei Übergewicht und Entlastung arthrotischer Gelenke anbieten"],"physiotherapist_actions":["Die Aufklärung umfasst Aktivitätsanpassung, Übungen, Unterstützung der Gewichtsreduktion bei Übergewicht und Gelenkentlastung.","internetbasiertes Schmerzbewältigungstraining mit Übungen und/oder manueller Therapie kombinieren."]},"en":{"warnings":["Recommendation B."],"progression_criteria":["Education includes activity modification, exercise, support for weight reduction when overweight, and joint unloading."],"physiotherapist_actions":["Provide education on activity modification, exercise, support for weight reduction when overweight, and methods of unloading arthritic joints","combine internet-based pain coping skills training with exercise and/or manual therapy."]},"pl":{"warnings":["Rekomendacja B."],"exercises":["łącz internetowy trening radzenia sobie z bólem z ćwiczeniami i/lub terapią manualną."],"physiotherapist_actions":["Edukacja obejmuje modyfikację aktywności, ćwiczenia, wsparcie redukcji masy ciała przy nadwadze i odciążanie stawów.","Prowadź edukację dotyczącą modyfikacji aktywności, ćwiczeń, wspierania redukcji masy ciała przy nadwadze oraz sposobów odciążania stawów dotkniętych chorobą zwyrodnieniową"]},"original":{"warnings":["Recommendation B."],"progression_criteria":["Education includes activity modification, exercise, support for weight reduction when overweight, and joint unloading."],"physiotherapist_actions":["Provide education on activity modification, exercise, support for weight reduction when overweight, and methods of unloading arthritic joints","combine internet-based pain coping skills training with exercise and/or manual therapy."]}},"additional_notes_de":"Empfehlung B.","additional_notes_en":"Recommendation B.","additional_notes_pl":"Rekomendacja B.","minimum_patient_share":null,"therapeutic_content_de":"Patientenedukation zu Aktivitätsanpassung, Übungen, Unterstützung der Gewichtsreduktion bei Übergewicht und Entlastung arthrotischer Gelenke anbieten; internetbasiertes Schmerzbewältigungstraining mit Übungen und/oder manueller Therapie kombinieren.","therapeutic_content_en":"Provide education on activity modification, exercise, support for weight reduction when overweight, and methods of unloading arthritic joints; combine internet-based pain coping skills training with exercise and/or manual therapy.","therapeutic_content_pl":"Prowadź edukację dotyczącą modyfikacji aktywności, ćwiczeń, wspierania redukcji masy ciała przy nadwadze oraz sposobów odciążania stawów dotkniętych chorobą zwyrodnieniową; łącz internetowy trening radzenia sobie z bólem z ćwiczeniami i/lub terapią manualną.","minimum_requirements_de":"Die Aufklärung umfasst Aktivitätsanpassung, Übungen, Unterstützung der Gewichtsreduktion bei Übergewicht und Gelenkentlastung.","minimum_requirements_en":"Education includes activity modification, exercise, support for weight reduction when overweight, and joint unloading.","minimum_requirements_pl":"Edukacja obejmuje modyfikację aktywności, ćwiczenia, wsparcie redukcji masy ciała przy nadwadze i odciążanie stawów.","additional_notes_original":"2025 Recommendation: B.","therapeutic_content_original":"Clinicians should provide patient education on activity modification, exercise, supporting weight reduction when overweight, and methods of unloading the arthritic joints, as well as internet-based pain coping skills training combined with exercise and/or manual therapy.","minimum_requirements_original":"Education on activity modification, exercise, supporting weight reduction when overweight, and unloading arthritic joints.","structured_content_v2":"$undefined"},{"id":"34b18c8f-15d6-57d1-b9ea-606ba48f9737","name_de":"Unterstützung der Gewichtsreduktion","name_en":"Support for Weight Reduction","name_pl":"Wsparcie redukcji masy ciała","source_page":9,"module_number":6,"name_original":"Support for Weight Reduction","service_codes":[],"structured_content":{"de":{"warnings":["Empfehlung B."],"exercises":["Zusätzlich zur Bewegungstherapie mit Ärzten, Ernährungswissenschaftlern oder Diätassistenten zusammenarbeiten, um die Gewichtsreduktion bei Personen mit Hüftarthrose und Übergewicht oder Adipositas zu unterstützen."],"physiotherapist_actions":["Die Zusammenarbeit ergänzt die Bewegungstherapie."]},"en":{"warnings":["Recommendation B."],"exercises":["In addition to exercise intervention, collaborate with physicians, nutritionists, or dietitians to support weight reduction in individuals with hip OA who are overweight or obese."],"physiotherapist_actions":["Collaboration is in addition to exercise intervention."]},"pl":{"warnings":["Rekomendacja B."],"exercises":["Oprócz interwencji ćwiczeniowej współpracuj z lekarzami, żywieniowcami lub dietetykami, aby wspierać redukcję masy ciała u osób z chorobą zwyrodnieniową biodra i nadwagą lub otyłością."],"physiotherapist_actions":["Współpraca jest dodatkiem do interwencji ćwiczeniowej."]},"original":{"warnings":["Recommendation B."],"exercises":["In addition to exercise intervention, collaborate with physicians, nutritionists, or dietitians to support weight reduction in individuals with hip OA who are overweight or obese."],"physiotherapist_actions":["Collaboration is in addition to exercise intervention."]}},"additional_notes_de":"Empfehlung B.","additional_notes_en":"Recommendation B.","additional_notes_pl":"Rekomendacja B.","minimum_patient_share":null,"therapeutic_content_de":"Zusätzlich zur Bewegungstherapie mit Ärzten, Ernährungswissenschaftlern oder Diätassistenten zusammenarbeiten, um die Gewichtsreduktion bei Personen mit Hüftarthrose und Übergewicht oder Adipositas zu unterstützen.","therapeutic_content_en":"In addition to exercise intervention, collaborate with physicians, nutritionists, or dietitians to support weight reduction in individuals with hip OA who are overweight or obese.","therapeutic_content_pl":"Oprócz interwencji ćwiczeniowej współpracuj z lekarzami, żywieniowcami lub dietetykami, aby wspierać redukcję masy ciała u osób z chorobą zwyrodnieniową biodra i nadwagą lub otyłością.","minimum_requirements_de":"Die Zusammenarbeit ergänzt die Bewegungstherapie.","minimum_requirements_en":"Collaboration is in addition to exercise intervention.","minimum_requirements_pl":"Współpraca jest dodatkiem do interwencji ćwiczeniowej.","additional_notes_original":"2025 Recommendation: B.","therapeutic_content_original":"In addition to providing exercise intervention, clinicians should collaborate with physicians, nutritionists, or dietitians to support weight reduction in individuals with hip OA who are overweight or obese.","minimum_requirements_original":"In addition to providing exercise intervention.","structured_content_v2":"$undefined"},{"id":"e7e83ce0-2a28-54fa-b488-0bd4e67263f0","name_de":"Funktionelles Training sowie Gang- und Gleichgewichtstraining","name_en":"Functional, Gait, and Balance Training","name_pl":"Trening funkcjonalny, chodu i równowagi","source_page":9,"module_number":7,"name_original":"Functional, Gait, and Balance Training","service_codes":[],"structured_content":{"de":{"warnings":["Empfehlung C."],"exercises":["Beeinträchtigungsbasiertes funktionelles Training sowie Gang- und Gleichgewichtstraining einschließlich der korrekten Verwendung von Hilfsmitteln (Stock, Unterarmgehstützen, Rollator) anbieten, wenn Anamnese oder Untersuchung Aktivitäts-, Gleichgewichts- und/oder Gangprobleme zeigt."],"physiotherapist_actions":["Erfordert in Anamnese oder Untersuchung dokumentierte Aktivitäts-, Gleichgewichts- und/oder Gangeinschränkungen."]},"en":{"warnings":["Recommendation C."],"exercises":["Provide impairment-based functional, gait, and balance training, including proper use of assistive devices such as canes, crutches, and walkers, when history or examination documents activity limitations, balance impairment, and/or gait limitations."],"physiotherapist_actions":["Requires activity, balance, and/or gait limitations documented in the history or physical examination."]},"pl":{"warnings":["Rekomendacja C."],"exercises":["Prowadź trening funkcjonalny, chodu i równowagi oparty na stwierdzonych zaburzeniach, z nauką prawidłowego używania pomocy (laski, kul, balkoników), gdy wywiad lub badanie wykazuje ograniczenia aktywności, zaburzenia równowagi i/lub chodu."],"physiotherapist_actions":["Wymaga udokumentowanych w wywiadzie lub badaniu ograniczeń aktywności, równowagi i/lub chodu."]},"original":{"warnings":["Recommendation C."],"exercises":["Provide impairment-based functional, gait, and balance training, including proper use of assistive devices such as canes, crutches, and walkers, when history or examination documents activity limitations, balance impairment, and/or gait limitations."],"physiotherapist_actions":["Requires activity, balance, and/or gait limitations documented in the history or physical examination."]}},"additional_notes_de":"Empfehlung C.","additional_notes_en":"Recommendation C.","additional_notes_pl":"Rekomendacja C.","minimum_patient_share":null,"therapeutic_content_de":"Beeinträchtigungsbasiertes funktionelles Training sowie Gang- und Gleichgewichtstraining einschließlich der korrekten Verwendung von Hilfsmitteln (Stock, Unterarmgehstützen, Rollator) anbieten, wenn Anamnese oder Untersuchung Aktivitäts-, Gleichgewichts- und/oder Gangprobleme zeigt.","therapeutic_content_en":"Provide impairment-based functional, gait, and balance training, including proper use of assistive devices such as canes, crutches, and walkers, when history or examination documents activity limitations, balance impairment, and/or gait limitations.","therapeutic_content_pl":"Prowadź trening funkcjonalny, chodu i równowagi oparty na stwierdzonych zaburzeniach, z nauką prawidłowego używania pomocy (laski, kul, balkoników), gdy wywiad lub badanie wykazuje ograniczenia aktywności, zaburzenia równowagi i/lub chodu.","minimum_requirements_de":"Erfordert in Anamnese oder Untersuchung dokumentierte Aktivitäts-, Gleichgewichts- und/oder Gangeinschränkungen.","minimum_requirements_en":"Requires activity, balance, and/or gait limitations documented in the history or physical examination.","minimum_requirements_pl":"Wymaga udokumentowanych w wywiadzie lub badaniu ograniczeń aktywności, równowagi i/lub chodu.","additional_notes_original":"2025 Recommendation: C.","therapeutic_content_original":"Clinicians should provide impairment-based functional, gait, and balance training, including the proper use of assistive devices (canes, crutches, walkers), to patients with hip OA and activity limitations, balance impairment, and/or gait limitations when associated problems are observed and documented during the history or physical assessment of the patient.","minimum_requirements_original":"Associated problems are observed and documented during the history or physical assessment.","structured_content_v2":"$undefined"},{"id":"23fe13e1-3aa3-550b-a567-e5b13fa3edfd","name_de":"Individualisierung therapeutischer Aktivitäten","name_en":"Individualizing Therapeutic Activities","name_pl":"Indywidualizacja aktywności terapeutycznych","source_page":9,"module_number":8,"name_original":"Individualizing Therapeutic Activities","service_codes":[],"structured_content":{"de":{"warnings":["Empfehlung C."],"exercises":["Die Auswahl therapeutischer Aktivitäten anhand der Werte des Patienten, seiner Teilhabe am täglichen Leben und seines Bedarfs an funktionellen Aktivitäten individualisieren."],"physiotherapist_actions":["Werte des Patienten, Teilhabe am täglichen Leben und funktionelle Bedürfnisse berücksichtigen."]},"en":{"warnings":["Recommendation C."],"exercises":["Individualize therapeutic activities based on the patient’s values, daily-life participation, and functional activity needs."],"physiotherapist_actions":["Consider the patient’s values, daily-life participation, and functional activity needs."]},"pl":{"warnings":["Rekomendacja C."],"exercises":["Indywidualizuj dobór aktywności terapeutycznych na podstawie wartości pacjenta, jego uczestnictwa w życiu codziennym i potrzeb w zakresie aktywności funkcjonalnej."],"physiotherapist_actions":["Uwzględnij wartości pacjenta, uczestnictwo w życiu codziennym i potrzeby funkcjonalne."]},"original":{"warnings":["Recommendation C."],"exercises":["Individualize therapeutic activities based on the patient’s values, daily-life participation, and functional activity needs."],"physiotherapist_actions":["Consider the patient’s values, daily-life participation, and functional activity needs."]}},"additional_notes_de":"Empfehlung C.","additional_notes_en":"Recommendation C.","additional_notes_pl":"Rekomendacja C.","minimum_patient_share":null,"therapeutic_content_de":"Die Auswahl therapeutischer Aktivitäten anhand der Werte des Patienten, seiner Teilhabe am täglichen Leben und seines Bedarfs an funktionellen Aktivitäten individualisieren.","therapeutic_content_en":"Individualize therapeutic activities based on the patient’s values, daily-life participation, and functional activity needs.","therapeutic_content_pl":"Indywidualizuj dobór aktywności terapeutycznych na podstawie wartości pacjenta, jego uczestnictwa w życiu codziennym i potrzeb w zakresie aktywności funkcjonalnej.","minimum_requirements_de":"Werte des Patienten, Teilhabe am täglichen Leben und funktionelle Bedürfnisse berücksichtigen.","minimum_requirements_en":"Consider the patient’s values, daily-life participation, and functional activity needs.","minimum_requirements_pl":"Uwzględnij wartości pacjenta, uczestnictwo w życiu codziennym i potrzeby funkcjonalne.","additional_notes_original":"2025 Recommendation: C.","therapeutic_content_original":"Clinicians should individualize prescription of therapeutic activities based on the patient’s values, daily life participation, and functional activity needs.","minimum_requirements_original":"Based on the patient’s values, daily life participation, and functional activity needs.","structured_content_v2":"$undefined"},{"id":"9c40a76b-1a8a-55a5-9990-e8881a9fa26c","name_de":"Therapeutischer Ultraschall — gemeinsame Entscheidungsfindung","name_en":"Therapeutic Ultrasound—Shared Decision Making","name_pl":"Ultradźwięki terapeutyczne — wspólna decyzja","source_page":9,"module_number":9,"name_original":"Therapeutic Ultrasound—Shared Decision Making","service_codes":[],"structured_content":{"de":{"warnings":["Empfehlung D."],"exercises":["Therapeutischer Ultraschall kann im Rahmen gemeinsamer Entscheidungsfindung zur konventionellen Physiotherapie ergänzt werden","Patienten über widersprüchliche Wirksamkeitsnachweise bei Hüftarthrose und mögliche Kosten informieren."],"physiotherapist_actions":["Vor der Anwendung widersprüchliche Wirksamkeitsnachweise und mögliche Kosten besprechen."]},"en":{"warnings":["Recommendation D."],"exercises":["Therapeutic ultrasound may be added to conventional physical therapy in shared decision making","inform patients about conflicting evidence on efficacy in hip OA and potential costs."],"physiotherapist_actions":["Before use, discuss conflicting evidence on efficacy and potential costs."]},"pl":{"warnings":["Rekomendacja D."],"exercises":["Ultradźwięki terapeutyczne mogą być dodane do konwencjonalnej fizjoterapii po wspólnym podjęciu decyzji","pacjenta należy poinformować o sprzecznych danych dotyczących skuteczności w chorobie zwyrodnieniowej biodra i o możliwych kosztach."],"physiotherapist_actions":["Przed zastosowaniem omów sprzeczne dane o skuteczności i potencjalne koszty."]},"original":{"warnings":["Recommendation D."],"exercises":["Therapeutic ultrasound may be added to conventional physical therapy in shared decision making","inform patients about conflicting evidence on efficacy in hip OA and potential costs."],"physiotherapist_actions":["Before use, discuss conflicting evidence on efficacy and potential costs."]}},"additional_notes_de":"Empfehlung D.","additional_notes_en":"Recommendation D.","additional_notes_pl":"Rekomendacja D.","minimum_patient_share":null,"therapeutic_content_de":"Therapeutischer Ultraschall kann im Rahmen gemeinsamer Entscheidungsfindung zur konventionellen Physiotherapie ergänzt werden; Patienten über widersprüchliche Wirksamkeitsnachweise bei Hüftarthrose und mögliche Kosten informieren.","therapeutic_content_en":"Therapeutic ultrasound may be added to conventional physical therapy in shared decision making; inform patients about conflicting evidence on efficacy in hip OA and potential costs.","therapeutic_content_pl":"Ultradźwięki terapeutyczne mogą być dodane do konwencjonalnej fizjoterapii po wspólnym podjęciu decyzji; pacjenta należy poinformować o sprzecznych danych dotyczących skuteczności w chorobie zwyrodnieniowej biodra i o możliwych kosztach.","minimum_requirements_de":"Vor der Anwendung widersprüchliche Wirksamkeitsnachweise und mögliche Kosten besprechen.","minimum_requirements_en":"Before use, discuss conflicting evidence on efficacy and potential costs.","minimum_requirements_pl":"Przed zastosowaniem omów sprzeczne dane o skuteczności i potencjalne koszty.","additional_notes_original":"2025 Recommendation: D.","therapeutic_content_original":"Therapeutic US may be added to conventional physical therapy in the context of shared decision making; however, patients should be informed of the conflicting evidence on its efficacy for hip OA and any potential costs.","minimum_requirements_original":"In the context of shared decision making; inform patients of conflicting evidence and potential costs.","structured_content_v2":"$undefined"},{"id":"36160c1e-9133-5520-88cc-1e4fd4347e92","name_de":"Orthese nicht als Erstlinientherapie","name_en":"Bracing Is Not First-Line Treatment","name_pl":"Orteza nie jako leczenie pierwszego wyboru","source_page":10,"module_number":10,"name_original":"Bracing Is Not First-Line Treatment","service_codes":[],"structured_content":{"de":{"warnings":["Empfehlung F."],"exercises":["Eine Orthese nicht als Erstlinientherapie anwenden."],"progression_criteria":["Erst erwägen, wenn Übungen oder manuelle Therapie die Teilhabe an Aktivitäten mit Dreh- oder Pivotbewegungen nicht verbessern."],"physiotherapist_actions":["Sie kann erwogen werden, wenn Übungen oder manuelle Therapie die Teilhabe an Aktivitäten mit Dreh- oder Pivotbewegungen bei leichter bis mittelschwerer Hüftarthrose, besonders bei beidseitiger Hüftarthrose, nicht verbessern."]},"en":{"warnings":["Recommendation F."],"restrictions":["Consider only after exercise or manual therapy does not improve participation in turning or pivoting activities.","Do not use bracing as first-line treatment."],"physiotherapist_actions":["A brace may be used after exercise or manual therapy does not improve participation in activities requiring turning or pivoting in mild-to-moderate hip OA, especially bilateral hip OA."]},"pl":{"warnings":["Rekomendacja F."],"exercises":["Można ją rozważyć po nieskuteczności ćwiczeń lub terapii manualnej w poprawie uczestnictwa w aktywnościach wymagających skrętu lub obrotu u osób z łagodną lub umiarkowaną chorobą zwyrodnieniową biodra, szczególnie obustronną."],"restrictions":["Nie stosuj ortezy jako leczenia pierwszego wyboru."],"physiotherapist_actions":["Rozważenie dopiero po nieskuteczności ćwiczeń lub terapii manualnej dla aktywności wymagających skrętu lub obrotu."]},"original":{"warnings":["Recommendation F."],"restrictions":["Consider only after exercise or manual therapy does not improve participation in turning or pivoting activities.","Do not use bracing as first-line treatment."],"physiotherapist_actions":["A brace may be used after exercise or manual therapy does not improve participation in activities requiring turning or pivoting in mild-to-moderate hip OA, especially bilateral hip OA."]}},"additional_notes_de":"Empfehlung F.","additional_notes_en":"Recommendation F.","additional_notes_pl":"Rekomendacja F.","minimum_patient_share":null,"therapeutic_content_de":"Eine Orthese nicht als Erstlinientherapie anwenden. Sie kann erwogen werden, wenn Übungen oder manuelle Therapie die Teilhabe an Aktivitäten mit Dreh- oder Pivotbewegungen bei leichter bis mittelschwerer Hüftarthrose, besonders bei beidseitiger Hüftarthrose, nicht verbessern.","therapeutic_content_en":"Do not use bracing as first-line treatment. A brace may be used after exercise or manual therapy does not improve participation in activities requiring turning or pivoting in mild-to-moderate hip OA, especially bilateral hip OA.","therapeutic_content_pl":"Nie stosuj ortezy jako leczenia pierwszego wyboru. Można ją rozważyć po nieskuteczności ćwiczeń lub terapii manualnej w poprawie uczestnictwa w aktywnościach wymagających skrętu lub obrotu u osób z łagodną lub umiarkowaną chorobą zwyrodnieniową biodra, szczególnie obustronną.","minimum_requirements_de":"Erst erwägen, wenn Übungen oder manuelle Therapie die Teilhabe an Aktivitäten mit Dreh- oder Pivotbewegungen nicht verbessern.","minimum_requirements_en":"Consider only after exercise or manual therapy does not improve participation in turning or pivoting activities.","minimum_requirements_pl":"Rozważenie dopiero po nieskuteczności ćwiczeń lub terapii manualnej dla aktywności wymagających skrętu lub obrotu.","additional_notes_original":"2025 Recommendation: F.","therapeutic_content_original":"Clinicians should not use bracing as a first line of treatment. A brace may be used after exercise or manual therapies are unsuccessful in improving participation in activities that require turning/pivoting for patients with mild-to-moderate hip OA, especially in those with bilateral hip OA.","minimum_requirements_original":"Not as first-line treatment; consider after exercise or manual therapies are unsuccessful for turning/pivoting activities.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"clinical_practice_guideline","content_role":"supporting_guideline","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"condition","body_region_codes":["hip_pelvis","lower_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["recommendation_set"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"54fd8a8f-93f8-5113-b026-2118f8b584ef","slug":"us-south-shore-31-hip-osteoarthritis","title_pl":"Protokół rehabilitacji w chorobie zwyrodnieniowej stawu biodrowego","title_de":"Rehabilitationsprotokoll bei Hüftarthrose","title_en":"Hip Osteoarthritis Rehabilitation Protocol","title_original":"Hip Arthritis","summary_pl":"Konserwatywny program rehabilitacji obejmujący poprawę ruchomości, kontrolę bólu i progresywne wzmacnianie stawu biodrowego.","summary_de":"Konservatives Rehabilitationsprogramm zur Verbesserung der Beweglichkeit, Schmerzkontrolle und progressiven Kräftigung der Hüfte.","summary_en":"Conservative rehabilitation program focusing on range of motion, pain management, and progressive hip strengthening.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"a64715bd-e7b6-5845-8d62-3d9591689268","condition_slug":"hip-osteoarthritis","condition_name_pl":"Choroba zwyrodnieniowa stawu biodrowego","condition_name_de":"Hüftarthrose","condition_name_en":"Hip Osteoarthritis","condition_name_original":"Hip Osteoarthritis","icd_codes":[],"category_key":"hip","category_pl":"Fizjoterapia ortopedyczna","category_de":"Orthopädische 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Orthopedics","source_country_code":"US","jurisdiction_code":"US-MA","authority_level":"hospital","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"stale_requires_clinical_update_check","official_url":"https://octanecdn.com/southshoreorthopedicscom/southshoreorthopedicscom_253326150.pdf","source_sha256":"b5b35dafdfc324908fa10768fc0ab54c75df06664e1ccb91c1a609becdc2cb41","authorization_required":false,"license_note":"Public source file retained locally for source verification.","modules":[{"id":"786324f3-f1cd-5b5d-b7ea-3f3ebdf6878e","name_de":"Phase 1: Entzündungsphase","name_en":"Phase 1: Inflammatory Phase","name_pl":"Faza 1: Faza zapalna","source_page":3,"module_number":1,"name_original":"Phase 1: Inflammatory Phase","service_codes":[],"structured_content":{"de":{"goals":["Schmerz- und Entzündungsreduktion, Wiederherstellung des schmerzfreien Bewegungsumfangs (ROM) und Flexibilität."],"exercises":["ROM-Übungen: 2-3 Sätze à 15-20 Wdh.","Dehnen: täglich, 2-3 Wdh. à 30 Sek."],"applies_when":["Entzündungsphase"],"physiotherapist_actions":["Manuelle Therapie anwenden, leichtes Fahrradergometertraining bei Toleranz."]},"en":{"goals":["Pain and inflammation control, restoration of pain-free range of motion (ROM) and flexibility."],"exercises":["ROM exercises: 2-3 sets of 15-20 reps.","Stretching: daily, 2-3 reps of 30 seconds."],"applies_when":["Inflammatory Phase"],"physiotherapist_actions":["Include manual therapy and gentle cycling if tolerated."]},"pl":{"goals":["Redukcja bólu i stanu zapalnego, przywrócenie bezbolesnego zakresu ruchu (ROM) i elastyczności."],"exercises":["Ćwiczenia ROM: 2-3 serie po 15-20 powtórzeń.","Rozciąganie: codziennie, 2-3 powtórzenia po 30 sekund."],"applies_when":["Faza zapalna"],"physiotherapist_actions":["Stosować terapię manualną i delikatny rower stacjonarny jeśli jest tolerowany."]},"original":{"goals":["Pain and inflammation control, restoration of pain-free range of motion (ROM) and flexibility."],"exercises":["ROM exercises: 2-3 sets of 15-20 reps.","Stretching: daily, 2-3 reps of 30 seconds."],"applies_when":["Inflammatory Phase"],"physiotherapist_actions":["Include manual therapy and gentle cycling if tolerated."]}},"additional_notes_de":"Manuelle Therapie anwenden, leichtes Fahrradergometertraining bei Toleranz.","additional_notes_en":"Include manual therapy and gentle cycling if tolerated.","additional_notes_pl":"Stosować terapię manualną i delikatny rower stacjonarny jeśli jest tolerowany.","minimum_patient_share":null,"therapeutic_content_de":"Schmerz- und Entzündungsreduktion, Wiederherstellung des schmerzfreien Bewegungsumfangs (ROM) und Flexibilität.","therapeutic_content_en":"Pain and inflammation control, restoration of pain-free range of motion (ROM) and flexibility.","therapeutic_content_pl":"Redukcja bólu i stanu zapalnego, przywrócenie bezbolesnego zakresu ruchu (ROM) i elastyczności.","minimum_requirements_de":"ROM-Übungen: 2-3 Sätze à 15-20 Wdh. Dehnen: täglich, 2-3 Wdh. à 30 Sek.","minimum_requirements_en":"ROM exercises: 2-3 sets of 15-20 reps. Stretching: daily, 2-3 reps of 30 seconds.","minimum_requirements_pl":"Ćwiczenia ROM: 2-3 serie po 15-20 powtórzeń. Rozciąganie: codziennie, 2-3 powtórzenia po 30 sekund.","additional_notes_original":"Include manual therapy and gentle cycling if tolerated.","therapeutic_content_original":"Pain and inflammation control, restoration of pain-free range of motion (ROM) and flexibility.","minimum_requirements_original":"ROM exercises: 2-3 sets of 15-20 reps. Stretching: daily, 2-3 reps of 30 seconds.","structured_content_v2":"$undefined"},{"id":"964456d4-9438-5f13-be6b-b2cdafc959aa","name_de":"Phase 2: Subakute Phase A","name_en":"Phase 2: Sub-acute Phase A","name_pl":"Faza 2: Faza podostra A","source_page":4,"module_number":2,"name_original":"Phase 2: Sub-acute Phase A","service_codes":[],"structured_content":{"de":{"goals":["Gelenkschutz, fortgesetzte Verbesserung der Flexibilität, Beginn der Kräftigung (offene Kette)."],"exercises":["Kräftigung: täglich, 2-3 Sätze à 15-20 Wdh."],"applies_when":["Subakute Phase A"],"physiotherapist_actions":["Cardio: 3-5 Mal pro Woche, 20-35 Min.","Fokus auf Beckenbrücke, Abduktion, Hüftextension und Stabilität."]},"en":{"goals":["Joint protection, continued flexibility improvement, introduction of strengthening (open chain)."],"exercises":["Strengthening: daily, 2-3 sets of 15-20 reps."],"applies_when":["Sub-acute Phase A"],"physiotherapist_actions":["Cardio: 3-5 times per week, 20-35 minutes.","Focus on bridging, abduction, hip extension, and stability."]},"pl":{"goals":["Ochrona stawu, dalsza poprawa elastyczności, wprowadzenie wzmacniania (łańcuch otwarty)."],"exercises":["Wzmacnianie: codziennie, 2-3 serie po 15-20 powtórzeń."],"applies_when":["Faza podostra A"],"physiotherapist_actions":["Kardio: 3-5 razy w tygodniu, 20-35 minut.","Skupienie na moście biodrowym, odwodzeniu, wyproście biodra i stabilizacji."]},"original":{"goals":["Joint protection, continued flexibility improvement, introduction of strengthening (open chain)."],"exercises":["Strengthening: daily, 2-3 sets of 15-20 reps."],"applies_when":["Sub-acute Phase A"],"physiotherapist_actions":["Cardio: 3-5 times per week, 20-35 minutes.","Focus on bridging, abduction, hip extension, and stability."]}},"additional_notes_de":"Fokus auf Beckenbrücke, Abduktion, Hüftextension und Stabilität.","additional_notes_en":"Focus on bridging, abduction, hip extension, and stability.","additional_notes_pl":"Skupienie na moście biodrowym, odwodzeniu, wyproście biodra i stabilizacji.","minimum_patient_share":null,"therapeutic_content_de":"Gelenkschutz, fortgesetzte Verbesserung der Flexibilität, Beginn der Kräftigung (offene Kette).","therapeutic_content_en":"Joint protection, continued flexibility improvement, introduction of strengthening (open chain).","therapeutic_content_pl":"Ochrona stawu, dalsza poprawa elastyczności, wprowadzenie wzmacniania (łańcuch otwarty).","minimum_requirements_de":"Kräftigung: täglich, 2-3 Sätze à 15-20 Wdh. Cardio: 3-5 Mal pro Woche, 20-35 Min.","minimum_requirements_en":"Strengthening: daily, 2-3 sets of 15-20 reps. Cardio: 3-5 times per week, 20-35 minutes.","minimum_requirements_pl":"Wzmacnianie: codziennie, 2-3 serie po 15-20 powtórzeń. Kardio: 3-5 razy w tygodniu, 20-35 minut.","additional_notes_original":"Focus on bridging, abduction, hip extension, and stability.","therapeutic_content_original":"Joint protection, continued flexibility improvement, introduction of strengthening (open chain).","minimum_requirements_original":"Strengthening: daily, 2-3 sets of 15-20 reps. Cardio: 3-5 times per week, 20-35 minutes.","structured_content_v2":"$undefined"},{"id":"a7d1cc99-b31f-5c14-9c5d-1f4d01d26688","name_de":"Phase 3: Subakute Phase B","name_en":"Phase 3: Sub-acute Phase B","name_pl":"Faza 3: Faza podostra B","source_page":5,"module_number":3,"name_original":"Phase 3: Sub-acute Phase B","service_codes":[],"structured_content":{"de":{"goals":["Maximierung der Kraft, Einführung von Kräftigung in der geschlossenen Kette und Stabilität."],"exercises":["Kräftigung: 3 Mal pro Woche, 2-3 Sätze à 15-20 Wdh.","Step-up-Übungen."],"applies_when":["Subakute Phase B"],"dosage_and_progression":["Einsatz von Hilfsmitteln (Bälle, Rollen) und Fitnessgeräten."],"physiotherapist_actions":["Cardio: 20-45 Min."]},"en":{"goals":["Maximizing strength, introduction of closed-chain strengthening, and stability."],"exercises":["Strengthening: 3 times per week, 2-3 sets of 15-20 reps.","Progress with step-ups."],"applies_when":["Sub-acute Phase B"],"dosage_and_progression":["Use of gym equipment and proprioceptive tools."],"physiotherapist_actions":["Cardio: 20-45 minutes."]},"pl":{"goals":["Maksymalizacja siły, wprowadzenie wzmacniania w łańcuchu zamkniętym i stabilizacja."],"exercises":["Wzmacnianie: 3 razy w tygodniu, 2-3 serie po 15-20 powtórzeń.","Ćwiczenia typu step-up."],"applies_when":["Faza podostra B"],"dosage_and_progression":["Wprowadzenie przyborów (piłki, rolki) oraz sprzętu siłowego."],"physiotherapist_actions":["Kardio: 20-45 minut."]},"original":{"goals":["Maximizing strength, introduction of closed-chain strengthening, and stability."],"exercises":["Strengthening: 3 times per week, 2-3 sets of 15-20 reps.","Progress with step-ups."],"applies_when":["Sub-acute Phase B"],"dosage_and_progression":["Use of gym equipment and proprioceptive tools."],"physiotherapist_actions":["Cardio: 20-45 minutes."]}},"additional_notes_de":"Einsatz von Hilfsmitteln (Bälle, Rollen) und Fitnessgeräten. Step-up-Übungen.","additional_notes_en":"Use of gym equipment and proprioceptive tools. Progress with step-ups.","additional_notes_pl":"Wprowadzenie przyborów (piłki, rolki) oraz sprzętu siłowego. Ćwiczenia typu step-up.","minimum_patient_share":null,"therapeutic_content_de":"Maximierung der Kraft, Einführung von Kräftigung in der geschlossenen Kette und Stabilität.","therapeutic_content_en":"Maximizing strength, introduction of closed-chain strengthening, and stability.","therapeutic_content_pl":"Maksymalizacja siły, wprowadzenie wzmacniania w łańcuchu zamkniętym i stabilizacja.","minimum_requirements_de":"Kräftigung: 3 Mal pro Woche, 2-3 Sätze à 15-20 Wdh. Cardio: 20-45 Min.","minimum_requirements_en":"Strengthening: 3 times per week, 2-3 sets of 15-20 reps. Cardio: 20-45 minutes.","minimum_requirements_pl":"Wzmacnianie: 3 razy w tygodniu, 2-3 serie po 15-20 powtórzeń. Kardio: 20-45 minut.","additional_notes_original":"Use of gym equipment and proprioceptive tools. Progress with step-ups.","therapeutic_content_original":"Maximizing strength, introduction of closed-chain strengthening, and stability.","minimum_requirements_original":"Strengthening: 3 times per week, 2-3 sets of 15-20 reps. Cardio: 20-45 minutes.","structured_content_v2":"$undefined"},{"id":"390121ea-bb67-57ce-906e-9e59d239f15a","name_de":"Phase 4: Rückkehr zum Sport","name_en":"Phase 4: Return to sport/Activity","name_pl":"Faza 4: Powrót do aktywności","source_page":6,"module_number":4,"name_original":"Phase 4: Return to sport/Activity","service_codes":[],"structured_content":{"de":{"exercises":["Fortgeschrittene Kräftigung einbeinig, Dynamik, Vorbereitung auf das Laufen.","Kräftigung: 3 Mal pro Woche, 2-3 Sätze à 15-20 Wdh.","Dehnen täglich.","Statische und dynamische Ausfallschritte, einbeiniges Kreuzheben, Laufprogression nach Vorgabe."],"applies_when":["Rückkehr zum Sport"]},"en":{"exercises":["Advanced single-leg strengthening, dynamic exercises, return to running progression.","Strengthening: 3 times per week, 2-3 sets of 15-20 reps.","Stretching daily.","Static and dynamic lunges, single-leg deadlift, running progression as outlined by PT/MD."],"applies_when":["Return to sport/Activity"]},"pl":{"exercises":["Zaawansowane wzmacnianie jednonóż, dynamika, przygotowanie do biegania.","Wzmacnianie: 3 razy w tygodniu, 2-3 serie po 15-20 powtórzeń.","Rozciąganie codziennie.","Wykroki statyczne i dynamiczne, martwy ciąg jednonóż, progresja biegowa zgodnie z wytycznymi."],"applies_when":["Powrót do aktywności"]},"original":{"exercises":["Advanced single-leg strengthening, dynamic exercises, return to running progression.","Strengthening: 3 times per week, 2-3 sets of 15-20 reps.","Stretching daily.","Static and dynamic lunges, single-leg deadlift, running progression as outlined by PT/MD."],"applies_when":["Return to sport/Activity"]}},"additional_notes_de":"Statische und dynamische Ausfallschritte, einbeiniges Kreuzheben, Laufprogression nach Vorgabe.","additional_notes_en":"Static and dynamic lunges, single-leg deadlift, running progression as outlined by PT/MD.","additional_notes_pl":"Wykroki statyczne i dynamiczne, martwy ciąg jednonóż, progresja biegowa zgodnie z wytycznymi.","minimum_patient_share":null,"therapeutic_content_de":"Fortgeschrittene Kräftigung einbeinig, Dynamik, Vorbereitung auf das Laufen.","therapeutic_content_en":"Advanced single-leg strengthening, dynamic exercises, return to running progression.","therapeutic_content_pl":"Zaawansowane wzmacnianie jednonóż, dynamika, przygotowanie do biegania.","minimum_requirements_de":"Kräftigung: 3 Mal pro Woche, 2-3 Sätze à 15-20 Wdh. Dehnen täglich.","minimum_requirements_en":"Strengthening: 3 times per week, 2-3 sets of 15-20 reps. Stretching daily.","minimum_requirements_pl":"Wzmacnianie: 3 razy w tygodniu, 2-3 serie po 15-20 powtórzeń. Rozciąganie codziennie.","additional_notes_original":"Static and dynamic lunges, single-leg deadlift, running progression as outlined by PT/MD.","therapeutic_content_original":"Advanced single-leg strengthening, dynamic exercises, return to running progression.","minimum_requirements_original":"Strengthening: 3 times per week, 2-3 sets of 15-20 reps. Stretching daily.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"condition","body_region_codes":["hip_pelvis","lower_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"47b18891-957c-59fc-82b9-ebf983b2f361","slug":"de-drv-rts-diabetes-typ2-2025","title_pl":"DRV RTS 2025: rehabilitacja w cukrzycy typu 2 — moduł fizjoterapii","title_de":"DRV RTS 2025: Rehabilitation bei Diabetes mellitus Typ 2 — Physiotherapiemodul","title_en":"DRV RTS 2025: Rehabilitation for Type 2 Diabetes — Physical Therapy Module","title_original":"Reha-Therapiestandards Diabetes mellitus Typ 2","summary_pl":"Niemiecki krajowy standard rehabilitacji DRV dla cukrzycy typu 2. Zaimportowano wyłącznie ETM 01 Bewegungstherapie, który zawiera rzeczywiste świadczenia treningowe i fizjoterapeutyczne; pozostałe moduły wielospecjalistyczne pominięto.","summary_de":"Nationaler DRV-Reha-Therapiestandard für Diabetes Typ 2. Importiert wurde ausschließlich ETM 01 Bewegungstherapie mit Bewegungs- und physiotherapeutischen Leistungen; die übrigen interdisziplinären Module wurden ausgelassen.","summary_en":"National DRV rehabilitation standard for type 2 diabetes. Only ETM 01 Bewegungstherapie was imported because it contains exercise and physical therapy services; other multidisciplinary modules were omitted.","country_code":"DE","source_language":"de","publication_year":2025,"version_label":"2025 · Stand Oktober 2025","target_professions":["physiotherapist","multidisciplinary_team"],"clinical_scope":"multidisciplinary","structure_type":"modules","patient_populations":["adults with type 2 diabetes mellitus","adults with obesity and metabolic comorbidity"],"clinical_contexts":["inpatient rehabilitation","day rehabilitation"],"care_pathways":["medical rehabilitation"],"physician_clearance_required":true,"condition_id":"219dd1f7-9f73-57e7-8019-bc11860749be","condition_slug":"type-2-diabetes-mellitus","condition_name_pl":"Cukrzyca typu 2","condition_name_de":"Diabetes mellitus Typ 2","condition_name_en":"Type 2 Diabetes Mellitus","condition_name_original":"Type 2 Diabetes Mellitus","icd_codes":[],"category_key":"lower-extremity","category_pl":"Rehabilitacja metaboliczna i fizjoterapia","category_de":"Stoffwechselrehabilitation und Physiotherapie","category_en":"Metabolic rehabilitation and physical therapy","body_regions_pl":["Kończyna dolna","Całe ciało"],"body_regions_de":["Untere Extremität","Ganzkörper"],"body_regions_en":["Lower extremity","Whole body"],"search_terms_pl":["cukrzyca typu 2","ćwiczenia","trening wytrzymałościowy","trening siłowy","otyłość"],"search_terms_de":["Diabetes Typ 2","Bewegungstherapie","Ausdauertraining","Krafttraining","Adipositas"],"search_terms_en":["type 2 diabetes","exercise therapy","endurance training","strength training","obesity"],"source_document_id":"2410155f-48f4-562c-9837-e7135736127d","source_title":"Reha-Therapiestandards Diabetes mellitus Typ 2","issuer":"Deutsche Rentenversicherung Bund","source_country_code":"DE","jurisdiction_code":"DE","authority_level":"national_agency","document_type":"rehabilitation_standard","source_clinical_scope":"multidisciplinary","source_target_professions":["physiotherapist","multidisciplinary_team"],"freshness_status":"current_review_required","official_url":"https://www.reha-therapiestandards-drv.de","source_sha256":"f88273f9c509da1a899efe44acf559b2b28ef5ae596c80e37227bdb75cbcac53","authorization_required":false,"license_note":"Public source file retained locally for source verification.","modules":[{"id":"040a035c-f3fb-56cd-8c1d-0a54f04b3e68","name_de":"ETM 01 — Bewegungstherapie","name_en":"ETM 01 — Exercise Therapy","name_pl":"ETM 01 — terapia ruchem","source_page":13,"module_number":1,"name_original":"ETM 01 — Bewegungstherapie","service_codes":[],"structured_content":{"de":{"warnings":["Die KTL umfasst Ausdauer-, Kraft- und Koordinationstraining, krankheitsorientierte Bewegungstherapie und physiotherapeutische Behandlung, einschließlich muskuloskelettaler Erkrankungen."],"exercises":["Individuell geeignete Maßnahmen zur Wiederherstellung körperlicher Funktionen, Belastbarkeit und Trainierbarkeit einsetzen.","Physische Ressourcen, insbesondere die aerobe Ausdauer, stärken und funktionelle Aktivitäten (z. 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ADL).","Standard wymaga co najmniej 300 minut tygodniowo w co najmniej 5 sesjach i objęcia co najmniej 80% rehabilitantów","należy uwzględnić wszystkie trzy obszary: wytrzymałość, siłę/funkcję oraz orientację ruchową."],"physiotherapist_actions":["Monitoruj tolerancję wysiłku, glikemię i choroby współistniejące zgodnie z planem medycznym","dobierz obciążenie indywidualnie."]},"original":{"warnings":["KTL services include endurance, strength, and coordination training, disease-oriented exercise therapy, and physical therapy, including treatment for musculoskeletal diseases."],"exercises":["Select individualized interventions to restore physical functions, exercise capacity, and trainability.","Strengthen physical resources, especially aerobic endurance, and teach functional activities such as ADLs.","The standard requires at least 300 minutes per week in at least 5 sessions and a minimum 80% patient share","all three areas—endurance, strength/function, and movement orientation—must be covered."],"physiotherapist_actions":["Monitor exercise tolerance, glucose, and comorbidities according to the medical plan","dose loading individually."]}},"additional_notes_de":"Die KTL umfasst Ausdauer-, Kraft- und Koordinationstraining, krankheitsorientierte Bewegungstherapie und physiotherapeutische Behandlung, einschließlich muskuloskelettaler Erkrankungen.","additional_notes_en":"KTL services include endurance, strength, and coordination training, disease-oriented exercise therapy, and physical therapy, including treatment for musculoskeletal diseases.","additional_notes_pl":"Kody KTL obejmują trening wytrzymałościowy, siłowy, koordynacyjny, sportowo-ruchowy i leczenie fizjoterapeutyczne, w tym chorób mięśniowo-szkieletowych.","minimum_patient_share":null,"therapeutic_content_de":"Individuell geeignete Maßnahmen zur Wiederherstellung körperlicher Funktionen, Belastbarkeit und Trainierbarkeit einsetzen. Physische Ressourcen, insbesondere die aerobe Ausdauer, stärken und funktionelle Aktivitäten (z. B. ADL) vermitteln. Der Standard fordert mindestens 300 Minuten pro Woche in mindestens 5 Einheiten und einen Mindestanteil von 80 %; alle drei Bereiche Ausdauer, Kraft/Funktion und Bewegungsorientierung müssen berücksichtigt werden.","therapeutic_content_en":"Select individualized interventions to restore physical functions, exercise capacity, and trainability. Strengthen physical resources, especially aerobic endurance, and teach functional activities such as ADLs. The standard requires at least 300 minutes per week in at least 5 sessions and a minimum 80% patient share; all three areas—endurance, strength/function, and movement orientation—must be covered.","therapeutic_content_pl":"Dobieraj indywidualnie działania służące przywracaniu funkcji fizycznych, wydolności i możliwości treningu. Wzmacniaj zasoby fizyczne, zwłaszcza wydolność tlenową, oraz ucz aktywności funkcjonalnych (np. ADL). Standard wymaga co najmniej 300 minut tygodniowo w co najmniej 5 sesjach i objęcia co najmniej 80% rehabilitantów; należy uwzględnić wszystkie trzy obszary: wytrzymałość, siłę/funkcję oraz orientację ruchową.","minimum_requirements_de":"Belastungsverträglichkeit, Blutzucker und Komorbiditäten nach dem medizinischen Plan überwachen; Belastung individuell dosieren.","minimum_requirements_en":"Monitor exercise tolerance, glucose, and comorbidities according to the medical plan; dose loading individually.","minimum_requirements_pl":"Monitoruj tolerancję wysiłku, glikemię i choroby współistniejące zgodnie z planem medycznym; dobierz obciążenie indywidualnie.","additional_notes_original":"Die KTL umfasst Ausdauer-, Kraft- und Koordinationstraining, krankheitsorientierte Bewegungstherapie und physiotherapeutische Behandlung, einschließlich muskuloskelettaler Erkrankungen.","therapeutic_content_original":"Ziele gewichtet in Abhängigkeit von den individuellen Voraussetzungen: Anbahnung, Übung und Training zur (Wieder-)Herstellung von physischen Funktionen, Belastbarkeit und Trainierbarkeit; Stärkung physischer Ressourcen/Funktionen (insbesondere aerobe Ausdauer) und Vermittlung von Aktivitäten (z. B. ADL). Mindestdauer pro Woche: mind. 300 Minuten; Mindesthäufigkeit: mind. 5 mal; Mindestanteil: mind. 80 %. Alle drei Bereiche (Ausdauerorientierte Aktivitäten, Muskelkräftigung und Funktionstraining, Förderung der Bewegungsorientierung) sind zu bedienen.","minimum_requirements_original":"Monitor exercise tolerance, glucose, and comorbidities according to the medical plan; dose loading individually.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_service_standard","content_role":"supporting_guideline","classification_status":"verified","clinical_domain":"metabolic_endocrine","clinical_entity_type":"condition","body_region_codes":["whole_body"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["module_matrix"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"104212e3-b3a9-516a-b294-e5e3bc874b44","slug":"us-south-shore-27-partial-meniscectomy","title_pl":"Protokół rehabilitacji po częściowym usunięciu łąkotki","title_de":"Rehabilitationsprotokoll nach partieller Meniskektomie","title_en":"Rehabilitation Protocol for Partial Meniscectomy","title_original":"Partial Meniscectomy","summary_pl":"Trzyfazowy program rehabilitacji po artroskopowej meniskektomii, ukierunkowany na kontrolę bólu, odzyskanie zakresu ruchu i bezpieczny powrót do aktywności.","summary_de":"Dreiphasiges Rehabilitationsprogramm nach arthroskopischer Meniskektomie mit Fokus auf Schmerzkontrolle, Wiederherstellung der Beweglichkeit und sichere Rückkehr zur Aktivität.","summary_en":"Three-phase rehabilitation program following arthroscopic meniscectomy, focusing on pain control, range of motion restoration, and safe return to activity.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"eae23334-4555-58cf-b870-e0f283152a18","condition_slug":"partial-meniscectomy","condition_name_pl":"Częściowe usunięcie łąkotki","condition_name_de":"Partielle Meniskektomie","condition_name_en":"Partial Meniscectomy","condition_name_original":"Partial Meniscectomy","icd_codes":[],"category_key":"knee","category_pl":"Kolano","category_de":"Knie","category_en":"Knee","body_regions_pl":["kolano"],"body_regions_de":["Knie"],"body_regions_en":["knee"],"search_terms_pl":["meniskektomia","uszkodzenie łąkotki","artroskopia kolana","rehabilitacja kolana"],"search_terms_de":["Meniskektomie","Meniskusriss","Kniearthroskopie","Knierehabilitation"],"search_terms_en":["meniscectomy","meniscus tear","knee arthroscopy","post-op rehab"],"source_document_id":"6788d20a-d43e-51c0-a6c1-d95b070634ea","source_title":"Partial Meniscectomy","issuer":"South Shore Orthopedics","source_country_code":"US","jurisdiction_code":"US-MA","authority_level":"hospital","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"stale_requires_clinical_update_check","official_url":"https://octanecdn.com/southshoreorthopedicscom/southshoreorthopedicscom_400845758.pdf","source_sha256":"ad774be9dba564566e6f69cc0982b5a4b293e3c89e3560310a96b138a1eea286","authorization_required":false,"license_note":"Public source file retained locally for source verification.","modules":[{"id":"d831242a-e545-5baf-b44b-6f8c83574ebb","name_de":"Grundlagen und postoperative 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tolerancji obciążenia"],"exercises":["Anatomia łąkotki, zasady stosowania lodu, używanie kul (WBAT), higiena ran pooperacyjnych."],"applies_when":["Podstawy i zalecenia pooperacyjne"],"physiotherapist_actions":["Lód 3-5 razy dziennie przez 10-20 min, unikanie moczenia ran przed usunięciem szwów.","dążyć do chodu bez utykania."]},"original":{"warnings":["Crutch use depends on weight-bearing tolerance"],"exercises":["Meniscus anatomy, ice application guidelines, crutch use (WBAT), wound care."],"applies_when":["Foundations and Post-operative Care"],"physiotherapist_actions":["Ice 3-5 times daily for 10-20 mins, keep incisions dry until suture removal.","aim for non-limping gait."]}},"additional_notes_de":"Krückennutzung je nach Belastungstoleranz; Ziel: Gangbild ohne Hinken.","additional_notes_en":"Crutch use depends on weight-bearing tolerance; aim for non-limping gait.","additional_notes_pl":"Użycie kul zależy od tolerancji obciążenia; dążyć do chodu bez utykania.","minimum_patient_share":null,"therapeutic_content_de":"Anatomie des Meniskus, Anwendung von Eis, Nutzung von Krücken (WBAT), Wundversorgung.","therapeutic_content_en":"Meniscus anatomy, ice application guidelines, crutch use (WBAT), wound care.","therapeutic_content_pl":"Anatomia łąkotki, zasady stosowania lodu, używanie kul (WBAT), higiena ran pooperacyjnych.","minimum_requirements_de":"Eis 3-5 Mal täglich für 10-20 Min, Wunden bis zur Nahtentfernung trocken halten.","minimum_requirements_en":"Ice 3-5 times daily for 10-20 mins, keep incisions dry until suture removal.","minimum_requirements_pl":"Lód 3-5 razy dziennie przez 10-20 min, unikanie moczenia ran przed usunięciem szwów.","additional_notes_original":"Crutch use depends on weight-bearing tolerance; aim for non-limping gait.","therapeutic_content_original":"Meniscus anatomy, ice application guidelines, crutch use (WBAT), wound care.","minimum_requirements_original":"Ice 3-5 times daily for 10-20 mins, keep incisions dry until suture removal.","structured_content_v2":"$undefined"},{"id":"8be114f9-bd6e-5012-bed2-e02036f4109d","name_de":"Phase 1: 0-2 Wochen","name_en":"Phase 1: 0-2 Weeks","name_pl":"Faza 1: 0-2 tygodnie","source_page":4,"module_number":2,"name_original":"Phase 1: 0-2 Weeks","service_codes":[],"structured_content":{"de":{"exercises":["Heel slides, Sitz-Extension, SLR (ohne Lag), Heimtrainer (geringer Widerstand)."],"applies_when":["0-2 Wochen"],"restrictions":["Steh- und Gehzeiten zu Beginn einschränken."],"physiotherapist_actions":["Schmerz-/Schwellungskontrolle, Quadrizeps-Aktivierung, Wiederherstellung der vollen Extension, ROM-Übungen."]},"en":{"exercises":["Heel slides, seated extension, SLR (no lag), stationary bike (low resistance)."],"applies_when":["0-2 Weeks"],"restrictions":["Limit standing/walking time initially."],"physiotherapist_actions":["Pain/swelling control, quadriceps activation, restore full extension, ROM exercises."]},"pl":{"exercises":["Heel slides, wyprost w siadzie, SLR (bez uciekania), ćwiczenia na rowerze stacjonarnym (mały opór)."],"applies_when":["0-2 tygodnie"],"restrictions":["Ograniczyć czas stania/chodzenia w fazie początkowej."],"physiotherapist_actions":["Kontrola bólu/obrzęku, aktywacja czworogłowego, przywrócenie pełnego wyprostu, ćwiczenia ROM."]},"original":{"exercises":["Heel slides, seated extension, SLR (no lag), stationary bike (low resistance)."],"applies_when":["0-2 Weeks"],"restrictions":["Limit standing/walking time initially."],"physiotherapist_actions":["Pain/swelling control, quadriceps activation, restore full extension, ROM exercises."]}},"additional_notes_de":"Steh- und Gehzeiten zu Beginn einschränken.","additional_notes_en":"Limit standing/walking time initially.","additional_notes_pl":"Ograniczyć czas stania/chodzenia w fazie początkowej.","minimum_patient_share":null,"therapeutic_content_de":"Schmerz-/Schwellungskontrolle, Quadrizeps-Aktivierung, Wiederherstellung der vollen Extension, ROM-Übungen.","therapeutic_content_en":"Pain/swelling control, quadriceps activation, restore full extension, ROM exercises.","therapeutic_content_pl":"Kontrola bólu/obrzęku, aktywacja czworogłowego, przywrócenie pełnego wyprostu, ćwiczenia ROM.","minimum_requirements_de":"Heel slides, Sitz-Extension, SLR (ohne Lag), Heimtrainer (geringer Widerstand).","minimum_requirements_en":"Heel slides, seated extension, SLR (no lag), stationary bike (low resistance).","minimum_requirements_pl":"Heel slides, wyprost w siadzie, SLR (bez uciekania), ćwiczenia na rowerze stacjonarnym (mały opór).","additional_notes_original":"Limit standing/walking time initially.","therapeutic_content_original":"Pain/swelling control, quadriceps activation, restore full extension, ROM exercises.","minimum_requirements_original":"Heel slides, seated extension, SLR (no lag), stationary bike (low resistance).","structured_content_v2":"$undefined"},{"id":"f3a79012-337f-5dd7-8763-6dad48d42072","name_de":"Phase 2: 2-6 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Wo. Crosstrainer/Schwimmen, Mini-Kniebeugen, Wadenheben."],"applies_when":["2-6 Wochen"],"restrictions":["Step-Downs vermeiden aufgrund patellofemoraler Belastung."]},"en":{"goals":["Normalize gait, closed-chain strengthening, flexibility, cardio."],"exercises":["Bike with resistance, elliptical/swimming at 4 weeks, mini-squats, heel raises."],"applies_when":["2-6 Weeks"],"restrictions":["Avoid forward step downs due to patellofemoral load."]},"pl":{"goals":["Normalizacja wzorca chodu, wzmacnianie w łańcuchu zamkniętym, poprawa elastyczności, cardio."],"exercises":["Rower z większym oporem, od 4. tyg. eliptyk i pływanie, mini-przysiady, wspięcia na palce."],"applies_when":["2-6 tygodni"],"restrictions":["Unikać przysiadów z wykrokiem w dół (step downs) ze względu na obciążenie rzepkowo-udowe."]},"original":{"goals":["Normalize gait, closed-chain strengthening, flexibility, cardio."],"exercises":["Bike with resistance, elliptical/swimming at 4 weeks, mini-squats, heel raises."],"applies_when":["2-6 Weeks"],"restrictions":["Avoid forward step downs due to patellofemoral load."]}},"additional_notes_de":"Step-Downs vermeiden aufgrund patellofemoraler Belastung.","additional_notes_en":"Avoid forward step downs due to patellofemoral load.","additional_notes_pl":"Unikać przysiadów z wykrokiem w dół (step downs) ze względu na obciążenie rzepkowo-udowe.","minimum_patient_share":null,"therapeutic_content_de":"Normalisierung des Gangbildes, Kräftigung in geschlossener Kette, Verbesserung der Flexibilität, Cardio.","therapeutic_content_en":"Normalize gait, closed-chain strengthening, flexibility, cardio.","therapeutic_content_pl":"Normalizacja wzorca chodu, wzmacnianie w łańcuchu zamkniętym, poprawa elastyczności, cardio.","minimum_requirements_de":"Heimtrainer mit höherem Widerstand, ab 4. Wo. Crosstrainer/Schwimmen, Mini-Kniebeugen, Wadenheben.","minimum_requirements_en":"Bike with resistance, elliptical/swimming at 4 weeks, mini-squats, heel raises.","minimum_requirements_pl":"Rower z większym oporem, od 4. tyg. eliptyk i pływanie, mini-przysiady, wspięcia na palce.","additional_notes_original":"Avoid forward step downs due to patellofemoral load.","therapeutic_content_original":"Normalize gait, closed-chain strengthening, flexibility, cardio.","minimum_requirements_original":"Bike with resistance, elliptical/swimming at 4 weeks, mini-squats, heel raises.","structured_content_v2":"$undefined"},{"id":"51593619-2064-5034-970a-c199da4888e2","name_de":"Phase 3: 6-12 Wochen","name_en":"Phase 3: 6-12 Weeks","name_pl":"Faza 3: 6-12 tygodni","source_page":6,"module_number":4,"name_original":"Phase 3: 6-12 Weeks","service_codes":[],"structured_content":{"de":{"exercises":["Kniebeugen bis 90°, statische/dynamische Ausfallschritte, Bosu-Training, ab 6. Wo. Laufen/Plyometrie (nach ärztl. 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Wo. Laufen/Plyometrie (nach ärztl. Freigabe).","minimum_requirements_en":"Squats to 90°, static/dynamic lunges, Bosu exercises, running/plyometrics at 6 weeks (MD clearance).","minimum_requirements_pl":"Przysiady do 90°, wykroki statyczne/dynamiczne, ćwiczenia na Bosu, od 6. tyg. bieganie i plyometria (za zgodą lekarza).","additional_notes_original":"Agility drills require PT supervision.","therapeutic_content_original":"Progressive strengthening, plyometrics, agility, return to running.","minimum_requirements_original":"Squats to 90°, static/dynamic lunges, Bosu exercises, running/plyometrics at 6 weeks (MD clearance).","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["knee","lower_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"303486c5-6732-5ef3-b774-bf9ee50cbc41","slug":"us-jared-lee-11-large-rotator-cuff-repair","title_pl":"Protokół rehabilitacji po dużej naprawie stożka rotatorów","title_de":"Rehabilitationsprotokoll nach Rekonstruktion einer großen Rotatorenmanschettenruptur","title_en":"Large Rotator Cuff Repair Rehabilitation Protocol","title_original":"Large Rotator Cuff Repair Rehabilitation","summary_pl":"Pięciofazowy protokół po dużej naprawie stożka rotatorów, z bardziej zachowawczymi progami wczesnego zakresu ruchu.","summary_de":"Fünfphasiges Protokoll nach Rekonstruktion einer großen Rotatorenmanschettenruptur mit konservativeren frühen Bewegungsgrenzen.","summary_en":"Five-phase rehabilitation protocol after large rotator cuff repair with more conservative early range-of-motion limits.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"6fe50f65-d161-5ade-95da-90ac32fea18a","condition_slug":"large-rotator-cuff-repair","condition_name_pl":"Duża naprawa stożka rotatorów","condition_name_de":"Rekonstruktion einer großen Rotatorenmanschettenruptur","condition_name_en":"Large Rotator Cuff Repair","condition_name_original":"Large Rotator Cuff Repair","icd_codes":[],"category_key":"shoulder","category_pl":"Bark","category_de":"Schulter","category_en":"Shoulder","body_regions_pl":["Bark"],"body_regions_de":["Schulter"],"body_regions_en":["Shoulder"],"search_terms_pl":["duża naprawa stożka rotatorów","duże uszkodzenie stożka rotatorów","rehabilitacja barku po operacji"],"search_terms_de":["große Rotatorenmanschettenrekonstruktion","große Rotatorenmanschettenruptur","postoperative Schulterrehabilitation"],"search_terms_en":["large rotator cuff repair","large rotator cuff tear rehabilitation"],"source_document_id":"956b08f2-52c5-5229-aa40-d61f192bdcdc","source_title":"Large Rotator Cuff Repair Rehabilitation","issuer":"Jared Lee, MD","source_country_code":"US","jurisdiction_code":"US-CO","authority_level":"clinic","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_requires_review","official_url":"https://jaredleemd.com/wp-content/uploads/2025/06/Large-Rotator-Cuff-Repair-Rehabilitation-Protocol.pdf","source_sha256":"550d3b57e15338be0f6ccdbe017b097ee03ec668bad83bf7047f5823ed8d7a3f","authorization_required":false,"license_note":"Public source file retained locally for source verification.","modules":[{"id":"9127b986-616b-527d-b4a1-714cd445f10f","name_de":"Phase I: Wochen 0–4","name_en":"Phase I: Weeks 0-4","name_pl":"Faza I: tygodnie 0–4","source_page":1,"module_number":1,"name_original":"Phase I: Weeks 0-4","service_codes":[],"structured_content":{"de":{"goals":["Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, die chirurgische Rekonstruktion schützen und Schultersteife vermeiden."],"exercises":["Passiver Bewegungsumfang: Flexion und Abduktion 0–60° sowie Außenrotation bis neutral für 4 Wochen","in Rückenlage den Ellenbogen mit Handtuchrolle oder Kissen neutral unterstützen","6 Wochen keine Abstützung des Körpergewichts über die operierte Extremität","voller Ellenbogenbewegungsumfang ohne Widerstand bei angelegtem Arm","Kräftigung der Skapulastabilisatoren","Dehnung und Bewegungsübungen der Halswirbelsäule","Ballpressen","Pendelübungen","Skapulaisometrie","Kryotherapie"],"applies_when":["Wochen 0–4"],"restrictions":["keine Kräftigungsübungen."],"progression_criteria":["passiver Bewegungsumfang wird toleriert und mindestens 4 Wochen postoperativ."],"physiotherapist_actions":["Armschlinge 4 Wochen durchgehend außer bei Körperpflege und Physiotherapie","den Arm 4 Wochen nicht über 90° anheben","mit der operierten Extremität 6 Wochen nicht mehr als 3 lb heben","Duschen ab dem 2. postoperativen Tag nach Entfernung des großen Verbands erlaubt","physikalische Maßnahmen nach Bedarf","Schmerz- und Ödemkontrolle","Weichteilmobilisation","Gelenkmobilisationen Grad I–II und Oszillationen zur Schmerzlinderung."]},"en":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness."],"exercises":["Passive range of motion 0-60° flexion and abduction and external rotation to neutral for 4 weeks","in supine, support the elbow with a towel roll or pillow in neutral","full elbow range of motion without resistance with the arm at the side","periscapular strengthening","neck stretching and range of motion","ball squeezes","pendulums","scapular isometrics","cryotherapy"],"applies_when":["Weeks 0-4"],"restrictions":["no arm elevation above 90° for 4 weeks","no lifting more than 3 lb with the surgical limb for 6 weeks","no strengthening.","no support of body weight through the surgical extremity for 6 weeks"],"progression_criteria":["tolerates PROM and is at least 4 weeks postoperative."],"dosage_and_progression":["showering allowed from postoperative day 2 after removing the bulky dressing"],"physiotherapist_actions":["Sling at all times except hygiene and physical therapy for 4 weeks","modalities as needed","pain and edema control","soft-tissue mobilization","Grade I-II joint mobilizations and oscillations for pain relief."]},"pl":{"goals":["zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona naprawy chirurgicznej oraz zapobieganie sztywności barku."],"exercises":["Bierny zakres ruchu: zgięcie i odwodzenie 0–60° oraz rotacja zewnętrzna do pozycji neutralnej przez 4 tygodnie","w leżeniu tyłem podparcie łokcia wałkiem z ręcznika lub poduszką w pozycji neutralnej","pełny zakres ruchu łokcia bez oporu przy ramieniu ułożonym wzdłuż tułowia","wzmacnianie stabilizatorów łopatki","rozciąganie i zakres ruchu odcinka szyjnego","ściskanie piłki","ćwiczenia wahadłowe","izometria łopatki","krioterapia"],"applies_when":["tygodnie 0–4"],"restrictions":["przez 4 tygodnie nie unosić ramienia powyżej 90°","przez 6 tygodni nie podnosić operowaną kończyną ciężaru większego niż 3 lb","bez ćwiczeń wzmacniających.","przez 6 tygodni bez podpierania ciężaru ciała operowaną kończyną"],"progression_criteria":["tolerowany bierny zakres ruchu i co najmniej 4 tygodnie od zabiegu."],"dosage_and_progression":["prysznic dozwolony od 2. doby po zabiegu po zdjęciu dużego opatrunku"],"physiotherapist_actions":["Temblak przez cały czas z wyjątkiem higieny i fizjoterapii przez 4 tygodnie","fizykoterapia według potrzeb","kontrola bólu i obrzęku","mobilizacja tkanek miękkich","mobilizacje stawowe stopnia I–II i oscylacje przeciwbólowe."]},"original":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness."],"exercises":["Passive range of motion 0-60° flexion and abduction and external rotation to neutral for 4 weeks","in supine, support the elbow with a towel roll or pillow in neutral","full elbow range of motion without resistance with the arm at the side","periscapular strengthening","neck stretching and range of motion","ball squeezes","pendulums","scapular isometrics","cryotherapy"],"applies_when":["Weeks 0-4"],"restrictions":["no arm elevation above 90° for 4 weeks","no lifting more than 3 lb with the surgical limb for 6 weeks","no strengthening.","no support of body weight through the surgical extremity for 6 weeks"],"progression_criteria":["tolerates PROM and is at least 4 weeks postoperative."],"dosage_and_progression":["showering allowed from postoperative day 2 after removing the bulky dressing"],"physiotherapist_actions":["Sling at all times except hygiene and physical therapy for 4 weeks","modalities as needed","pain and edema control","soft-tissue mobilization","Grade I-II joint mobilizations and oscillations for pain relief."]}},"additional_notes_de":"Ziele: Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, die chirurgische Rekonstruktion schützen und Schultersteife vermeiden. Progressionskriterien: passiver Bewegungsumfang wird toleriert und mindestens 4 Wochen postoperativ.","additional_notes_en":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness. Progression criteria: tolerates PROM and is at least 4 weeks postoperative.","additional_notes_pl":"Cele: zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona naprawy chirurgicznej oraz zapobieganie sztywności barku. Kryteria progresji: tolerowany bierny zakres ruchu i co najmniej 4 tygodnie od zabiegu.","minimum_patient_share":null,"therapeutic_content_de":"Passiver Bewegungsumfang: Flexion und Abduktion 0–60° sowie Außenrotation bis neutral für 4 Wochen; in Rückenlage den Ellenbogen mit Handtuchrolle oder Kissen neutral unterstützen; 6 Wochen keine Abstützung des Körpergewichts über die operierte Extremität; voller Ellenbogenbewegungsumfang ohne Widerstand bei angelegtem Arm; physikalische Maßnahmen nach Bedarf; Schmerz- und Ödemkontrolle; Kräftigung der Skapulastabilisatoren; Dehnung und Bewegungsübungen der Halswirbelsäule; Weichteilmobilisation; Ballpressen; Pendelübungen; Skapulaisometrie; Kryotherapie; Gelenkmobilisationen Grad I–II und Oszillationen zur Schmerzlinderung.","therapeutic_content_en":"Passive range of motion 0-60° flexion and abduction and external rotation to neutral for 4 weeks; in supine, support the elbow with a towel roll or pillow in neutral; no support of body weight through the surgical extremity for 6 weeks; full elbow range of motion without resistance with the arm at the side; modalities as needed; pain and edema control; periscapular strengthening; neck stretching and range of motion; soft-tissue mobilization; ball squeezes; pendulums; scapular isometrics; cryotherapy; Grade I-II joint mobilizations and oscillations for pain relief.","therapeutic_content_pl":"Bierny zakres ruchu: zgięcie i odwodzenie 0–60° oraz rotacja zewnętrzna do pozycji neutralnej przez 4 tygodnie; w leżeniu tyłem podparcie łokcia wałkiem z ręcznika lub poduszką w pozycji neutralnej; przez 6 tygodni bez podpierania ciężaru ciała operowaną kończyną; pełny zakres ruchu łokcia bez oporu przy ramieniu ułożonym wzdłuż tułowia; fizykoterapia według potrzeb; kontrola bólu i obrzęku; wzmacnianie stabilizatorów łopatki; rozciąganie i zakres ruchu odcinka szyjnego; mobilizacja tkanek miękkich; ściskanie piłki; ćwiczenia wahadłowe; izometria łopatki; krioterapia; mobilizacje stawowe stopnia I–II i oscylacje przeciwbólowe.","minimum_requirements_de":"Armschlinge 4 Wochen durchgehend außer bei Körperpflege und Physiotherapie; den Arm 4 Wochen nicht über 90° anheben; mit der operierten Extremität 6 Wochen nicht mehr als 3 lb heben; Duschen ab dem 2. postoperativen Tag nach Entfernung des großen Verbands erlaubt; keine Kräftigungsübungen.","minimum_requirements_en":"Sling at all times except hygiene and physical therapy for 4 weeks; no arm elevation above 90° for 4 weeks; no lifting more than 3 lb with the surgical limb for 6 weeks; showering allowed from postoperative day 2 after removing the bulky dressing; no strengthening.","minimum_requirements_pl":"Temblak przez cały czas z wyjątkiem higieny i fizjoterapii przez 4 tygodnie; przez 4 tygodnie nie unosić ramienia powyżej 90°; przez 6 tygodni nie podnosić operowaną kończyną ciężaru większego niż 3 lb; prysznic dozwolony od 2. doby po zabiegu po zdjęciu dużego opatrunku; bez ćwiczeń wzmacniających.","additional_notes_original":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness. Progression criteria: tolerates PROM and is at least 4 weeks postoperative.","therapeutic_content_original":"Passive range of motion 0-60° flexion and abduction and external rotation to neutral for 4 weeks; in supine, support the elbow with a towel roll or pillow in neutral; no support of body weight through the surgical extremity for 6 weeks; full elbow range of motion without resistance with the arm at the side; modalities as needed; pain and edema control; periscapular strengthening; neck stretching and range of motion; soft-tissue mobilization; ball squeezes; pendulums; scapular isometrics; cryotherapy; Grade I-II joint mobilizations and oscillations for pain relief.","minimum_requirements_original":"Sling at all times except hygiene and physical therapy for 4 weeks; no arm elevation above 90° for 4 weeks; no lifting more than 3 lb with the surgical limb for 6 weeks; showering allowed from postoperative day 2 after removing the bulky dressing; no strengthening.","structured_content_v2":"$undefined"},{"id":"b7714c24-2daa-5fdc-bdae-ff6a582ebf5f","name_de":"Phase II: Wochen 5–6","name_en":"Phase II: Weeks 5-6","name_pl":"Faza II: tygodnie 5–6","source_page":1,"module_number":2,"name_original":"Phase II: Weeks 5-6","service_codes":[],"structured_content":{"de":{"goals":["Bewegungsumfang steigern, Schmerzen und Muskelatrophie begrenzen, die Rekonstruktion schützen und mit der neuromuskulären Kontrolle beginnen."],"exercises":["Passiver Bewegungsumfang: Flexion und Abduktion 0–120° sowie Außenrotation bis 30°","Schmerz und Entzündung kontrollieren","aktiv-assistierte Bewegungen in Rückenlage beginnen","Haltungs- und Rumpfübungen","nach 4 Wochen submaximale Isometrie für Schulterflexion, Abduktion, Extension und Außenrotation möglich","Rudern in Bauchlage bis neutral","Ausdauertraining: Gehen und Fahrradergometer, kein Laufband, Crosstrainer, Stepper oder Rennrad."],"applies_when":["Wochen 5–6"],"restrictions":["heilendes Gewebe nicht überlasten","kein Laufband, Crosstrainer, Stepper oder Rennrad."],"progression_criteria":["passive und aktiv-assistierte Bewegungen sowie Isometrie werden toleriert, passive Vorwärtsflexion bis 120° und mindestens 6 Wochen postoperativ."],"dosage_and_progression":["Übungen aus Phase I fortsetzen"],"physiotherapist_actions":["Armschlinge 6 Wochen durchgehend außer bei Körperpflege und Physiotherapie","mit der operierten Extremität 6 Wochen nicht mehr als 3 lb heben.","Haltungsstörungen korrigieren und heilendes Gewebe nicht überlasten"]},"en":{"goals":["progress range of motion, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control."],"exercises":["Passive range of motion 0-120° flexion and abduction and external rotation to 30°","initiate supine active-assisted range of motion","postural exercises","core strengthening","after 4 weeks may begin submaximal isometrics for shoulder flexion, abduction, extension and external rotation","prone row to neutral","cardiovascular exercise: walking and stationary bike only, no treadmill, elliptical, stair climber or road bike."],"applies_when":["Weeks 5-6"],"restrictions":["no lifting more than 3 lb with the surgical limb for 6 weeks.","avoid overstressing healing tissues","no treadmill, elliptical, stair climber or road bike."],"progression_criteria":["passive and active-assisted range of motion and isometrics are tolerated, passive forward flexion reaches 120° and the patient is at least 6 weeks postoperative."],"dosage_and_progression":["continue Phase I exercises"],"physiotherapist_actions":["Sling at all times except hygiene and physical therapy for 6 weeks","correct postural dysfunction","control pain and inflammation"]},"pl":{"goals":["zwiększanie zakresu ruchu, ograniczenie bólu i zaniku mięśni, ochrona naprawy i rozpoczęcie kontroli nerwowo-mięśniowej."],"exercises":["Bierny zakres ruchu: zgięcie i odwodzenie 0–120° oraz rotacja zewnętrzna do 30°","rozpocząć czynny wspomagany zakres ruchu w leżeniu tyłem","ćwiczenia posturalne i mięśni tułowia","po 4 tygodniach można rozpocząć submaksymalną izometrię zgięcia, odwodzenia, wyprostu i rotacji zewnętrznej barku","wiosłowanie w leżeniu przodem do pozycji neutralnej","trening wydolnościowy: marsz i rower stacjonarny, bez bieżni, orbitreka, steppera i roweru szosowego."],"applies_when":["tygodnie 5–6"],"restrictions":["przez 6 tygodni nie podnosić operowaną kończyną ciężaru większego niż 3 lb.","nie przeciążać gojących się tkanek","bez bieżni, orbitreka, steppera i roweru szosowego."],"progression_criteria":["tolerowany bierny i czynny wspomagany zakres ruchu oraz izometria, bierne zgięcie do przodu 120° i co najmniej 6 tygodni od zabiegu."],"dosage_and_progression":["kontynuować ćwiczenia fazy I"],"physiotherapist_actions":["Temblak przez cały czas z wyjątkiem higieny i fizjoterapii przez 6 tygodni","korygować zaburzenia postawy i nie przeciążać gojących się tkanek","kontrolować ból i stan zapalny"]},"original":{"goals":["progress range of motion, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control."],"exercises":["Passive range of motion 0-120° flexion and abduction and external rotation to 30°","initiate supine active-assisted range of motion","postural exercises","core strengthening","after 4 weeks may begin submaximal isometrics for shoulder flexion, abduction, extension and external rotation","prone row to neutral","cardiovascular exercise: walking and stationary bike only, no treadmill, elliptical, stair climber or road bike."],"applies_when":["Weeks 5-6"],"restrictions":["no lifting more than 3 lb with the surgical limb for 6 weeks.","avoid overstressing healing tissues","no treadmill, elliptical, stair climber or road bike."],"progression_criteria":["passive and active-assisted range of motion and isometrics are tolerated, passive forward flexion reaches 120° and the patient is at least 6 weeks postoperative."],"dosage_and_progression":["continue Phase I exercises"],"physiotherapist_actions":["Sling at all times except hygiene and physical therapy for 6 weeks","correct postural dysfunction","control pain and inflammation"]}},"additional_notes_de":"Ziele: Bewegungsumfang steigern, Schmerzen und Muskelatrophie begrenzen, die Rekonstruktion schützen und mit der neuromuskulären Kontrolle beginnen. Progressionskriterien: passive und aktiv-assistierte Bewegungen sowie Isometrie werden toleriert, passive Vorwärtsflexion bis 120° und mindestens 6 Wochen postoperativ.","additional_notes_en":"Goals: progress range of motion, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control. Progression criteria: passive and active-assisted range of motion and isometrics are tolerated, passive forward flexion reaches 120° and the patient is at least 6 weeks postoperative.","additional_notes_pl":"Cele: zwiększanie zakresu ruchu, ograniczenie bólu i zaniku mięśni, ochrona naprawy i rozpoczęcie kontroli nerwowo-mięśniowej. Kryteria progresji: tolerowany bierny i czynny wspomagany zakres ruchu oraz izometria, bierne zgięcie do przodu 120° i co najmniej 6 tygodni od zabiegu.","minimum_patient_share":null,"therapeutic_content_de":"Passiver Bewegungsumfang: Flexion und Abduktion 0–120° sowie Außenrotation bis 30°; Haltungsstörungen korrigieren und heilendes Gewebe nicht überlasten; Schmerz und Entzündung kontrollieren; aktiv-assistierte Bewegungen in Rückenlage beginnen; Haltungs- und Rumpfübungen; nach 4 Wochen submaximale Isometrie für Schulterflexion, Abduktion, Extension und Außenrotation möglich; Rudern in Bauchlage bis neutral; Ausdauertraining: Gehen und Fahrradergometer, kein Laufband, Crosstrainer, Stepper oder Rennrad.","therapeutic_content_en":"Passive range of motion 0-120° flexion and abduction and external rotation to 30°; correct postural dysfunction; avoid overstressing healing tissues; control pain and inflammation; initiate supine active-assisted range of motion; postural exercises; core strengthening; after 4 weeks may begin submaximal isometrics for shoulder flexion, abduction, extension and external rotation; prone row to neutral; cardiovascular exercise: walking and stationary bike only, no treadmill, elliptical, stair climber or road bike.","therapeutic_content_pl":"Bierny zakres ruchu: zgięcie i odwodzenie 0–120° oraz rotacja zewnętrzna do 30°; korygować zaburzenia postawy i nie przeciążać gojących się tkanek; kontrolować ból i stan zapalny; rozpocząć czynny wspomagany zakres ruchu w leżeniu tyłem; ćwiczenia posturalne i mięśni tułowia; po 4 tygodniach można rozpocząć submaksymalną izometrię zgięcia, odwodzenia, wyprostu i rotacji zewnętrznej barku; wiosłowanie w leżeniu przodem do pozycji neutralnej; trening wydolnościowy: marsz i rower stacjonarny, bez bieżni, orbitreka, steppera i roweru szosowego.","minimum_requirements_de":"Armschlinge 6 Wochen durchgehend außer bei Körperpflege und Physiotherapie; Übungen aus Phase I fortsetzen; mit der operierten Extremität 6 Wochen nicht mehr als 3 lb heben.","minimum_requirements_en":"Sling at all times except hygiene and physical therapy for 6 weeks; continue Phase I exercises; no lifting more than 3 lb with the surgical limb for 6 weeks.","minimum_requirements_pl":"Temblak przez cały czas z wyjątkiem higieny i fizjoterapii przez 6 tygodni; kontynuować ćwiczenia fazy I; przez 6 tygodni nie podnosić operowaną kończyną ciężaru większego niż 3 lb.","additional_notes_original":"Goals: progress range of motion, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control. Progression criteria: passive and active-assisted range of motion and isometrics are tolerated, passive forward flexion reaches 120° and the patient is at least 6 weeks postoperative.","therapeutic_content_original":"Passive range of motion 0-120° flexion and abduction and external rotation to 30°; correct postural dysfunction; avoid overstressing healing tissues; control pain and inflammation; initiate supine active-assisted range of motion; postural exercises; core strengthening; after 4 weeks may begin submaximal isometrics for shoulder flexion, abduction, extension and external rotation; prone row to neutral; cardiovascular exercise: walking and stationary bike only, no treadmill, elliptical, stair climber or road bike.","minimum_requirements_original":"Sling at all times except hygiene and physical therapy for 6 weeks; continue Phase I exercises; no lifting more than 3 lb with the surgical limb for 6 weeks.","structured_content_v2":"$undefined"},{"id":"06b7d5d2-11df-533f-9a6b-13fa85250e11","name_de":"Phase III: Wochen 7–9","name_en":"Phase III: Weeks 7-9","name_pl":"Faza III: tygodnie 7–9","source_page":2,"module_number":3,"name_original":"Phase III: Weeks 7-9","service_codes":[],"structured_content":{"de":{"goals":["voller Bewegungsumfang, minimale Schmerzen sowie bessere neuromuskuläre Kontrolle und Mechanik."],"exercises":["Nach Erreichen des vollständigen passiven Bewegungsumfangs zu aktiven und aktiv-assistierten Bewegungen übergehen","Fokus auf neuromuskuläre Kontrolle und korrekte Mechanik","Skapulastabilisation und -kräftigung","aktive Bewegungen kontrolliert steigern","Skaption und aktive Schulterbewegungen beginnen","Ausdauertraining: Gehen und Fahrradergometer, kein Laufband, Crosstrainer, Stepper oder Rennrad."],"applies_when":["Wochen 7–9"],"restrictions":["keine Kräftigung","kein Laufband, Crosstrainer, Stepper oder Rennrad."],"progression_criteria":["aktiver Bewegungsumfang wird toleriert, aktive Flexion bis 120° mit guter Mechanik und mindestens 8 Wochen postoperativ."],"dosage_and_progression":["Armschlinge ablegen","Übungen aus Phase I und II fortsetzen"],"physiotherapist_actions":["mit der operierten Extremität nicht mehr als 5 lb heben."]},"en":{"goals":["full ROM, minimal pain, improve neuromuscular control and mechanics."],"exercises":["After full passive ROM is achieved, progress to active and active-assisted ROM","focus on neuromuscular control and correct mechanics","scapular stabilization and strengthening","controlled progression of AROM","initiate scaption and shoulder AROM","cardiovascular exercise: walking and stationary bike only, no treadmill, elliptical, stair climber or road bike."],"applies_when":["Weeks 7-9"],"restrictions":["no strengthening","no lifting more than 5 lb with the surgical limb.","no treadmill, elliptical, stair climber or road bike."],"progression_criteria":["tolerates AROM, active flexion reaches 120° with good mechanics and the patient is at least 8 weeks postoperative."],"dosage_and_progression":["Discontinue sling","continue Phase I and II exercises"]},"pl":{"goals":["pełny zakres ruchu, minimalny ból oraz poprawa kontroli nerwowo-mięśniowej i mechaniki."],"exercises":["Po uzyskaniu pełnego biernego zakresu ruchu przejść do zakresu czynnego i czynnego wspomaganego","skupić się na kontroli nerwowo-mięśniowej i prawidłowej mechanice","stabilizacja i wzmacnianie łopatki","kontrolowana progresja czynnego zakresu ruchu","rozpocząć unoszenie w płaszczyźnie łopatki i czynne ruchy barku","trening wydolnościowy: marsz i rower stacjonarny, bez bieżni, orbitreka, steppera i roweru szosowego."],"applies_when":["tygodnie 7–9"],"restrictions":["bez wzmacniania","nie podnosić operowaną kończyną ciężaru większego niż 5 lb.","bez bieżni, orbitreka, steppera i roweru szosowego."],"progression_criteria":["tolerowany czynny zakres ruchu, czynne zgięcie do 120° z prawidłową mechaniką i co najmniej 8 tygodni od zabiegu."],"dosage_and_progression":["Odstawić temblak","kontynuować ćwiczenia faz I i II"]},"original":{"goals":["full ROM, minimal pain, improve neuromuscular control and mechanics."],"exercises":["After full passive ROM is achieved, progress to active and active-assisted ROM","focus on neuromuscular control and correct mechanics","scapular stabilization and strengthening","controlled progression of AROM","initiate scaption and shoulder AROM","cardiovascular exercise: walking and stationary bike only, no treadmill, elliptical, stair climber or road bike."],"applies_when":["Weeks 7-9"],"restrictions":["no strengthening","no lifting more than 5 lb with the surgical limb.","no treadmill, elliptical, stair climber or road bike."],"progression_criteria":["tolerates AROM, active flexion reaches 120° with good mechanics and the patient is at least 8 weeks postoperative."],"dosage_and_progression":["Discontinue sling","continue Phase I and II exercises"]}},"additional_notes_de":"Ziele: voller Bewegungsumfang, minimale Schmerzen sowie bessere neuromuskuläre Kontrolle und Mechanik. Progressionskriterien: aktiver Bewegungsumfang wird toleriert, aktive Flexion bis 120° mit guter Mechanik und mindestens 8 Wochen postoperativ.","additional_notes_en":"Goals: full ROM, minimal pain, improve neuromuscular control and mechanics. Progression criteria: tolerates AROM, active flexion reaches 120° with good mechanics and the patient is at least 8 weeks postoperative.","additional_notes_pl":"Cele: pełny zakres ruchu, minimalny ból oraz poprawa kontroli nerwowo-mięśniowej i mechaniki. Kryteria progresji: tolerowany czynny zakres ruchu, czynne zgięcie do 120° z prawidłową mechaniką i co najmniej 8 tygodni od zabiegu.","minimum_patient_share":null,"therapeutic_content_de":"Nach Erreichen des vollständigen passiven Bewegungsumfangs zu aktiven und aktiv-assistierten Bewegungen übergehen; Fokus auf neuromuskuläre Kontrolle und korrekte Mechanik; Skapulastabilisation und -kräftigung; aktive Bewegungen kontrolliert steigern; Skaption und aktive Schulterbewegungen beginnen; Ausdauertraining: Gehen und Fahrradergometer, kein Laufband, Crosstrainer, Stepper oder Rennrad.","therapeutic_content_en":"After full passive ROM is achieved, progress to active and active-assisted ROM; focus on neuromuscular control and correct mechanics; scapular stabilization and strengthening; controlled progression of AROM; initiate scaption and shoulder AROM; cardiovascular exercise: walking and stationary bike only, no treadmill, elliptical, stair climber or road bike.","therapeutic_content_pl":"Po uzyskaniu pełnego biernego zakresu ruchu przejść do zakresu czynnego i czynnego wspomaganego; skupić się na kontroli nerwowo-mięśniowej i prawidłowej mechanice; stabilizacja i wzmacnianie łopatki; kontrolowana progresja czynnego zakresu ruchu; rozpocząć unoszenie w płaszczyźnie łopatki i czynne ruchy barku; trening wydolnościowy: marsz i rower stacjonarny, bez bieżni, orbitreka, steppera i roweru szosowego.","minimum_requirements_de":"Armschlinge ablegen; Übungen aus Phase I und II fortsetzen; keine Kräftigung; mit der operierten Extremität nicht mehr als 5 lb heben.","minimum_requirements_en":"Discontinue sling; continue Phase I and II exercises; no strengthening; no lifting more than 5 lb with the surgical limb.","minimum_requirements_pl":"Odstawić temblak; kontynuować ćwiczenia faz I i II; bez wzmacniania; nie podnosić operowaną kończyną ciężaru większego niż 5 lb.","additional_notes_original":"Goals: full ROM, minimal pain, improve neuromuscular control and mechanics. Progression criteria: tolerates AROM, active flexion reaches 120° with good mechanics and the patient is at least 8 weeks postoperative.","therapeutic_content_original":"After full passive ROM is achieved, progress to active and active-assisted ROM; focus on neuromuscular control and correct mechanics; scapular stabilization and strengthening; controlled progression of AROM; initiate scaption and shoulder AROM; cardiovascular exercise: walking and stationary bike only, no treadmill, elliptical, stair climber or road bike.","minimum_requirements_original":"Discontinue sling; continue Phase I and II exercises; no strengthening; no lifting more than 5 lb with the surgical limb.","structured_content_v2":"$undefined"},{"id":"e1506e98-51b6-5442-ae1b-5dc0728c61e4","name_de":"Phase IV: Wochen 10–12","name_en":"Phase IV: Weeks 10-12","name_pl":"Faza IV: tygodnie 10–12","source_page":2,"module_number":4,"name_original":"Phase IV: Weeks 10-12","service_codes":[],"structured_content":{"de":{"goals":["voller Bewegungsumfang, Schmerzfreiheit, korrekte Mechanik und Beginn der Kräftigung."],"exercises":["Übungen aus Phase II und III fortsetzen","multiplanare Bewegungen steigern","leichte Kräftigung beginnen","schmerzfreien aktiven Bewegungsumfang, fortgeschrittene Schulterbewegungen und neuromuskuläre Kontrolle steigern","PNF-Muster mit leichtem Widerstand","skapulothorakale Kontrolle","Übungen in geschlossener Kette mit Ball an der Wand","Außenrotation in verschiedenen Abduktionswinkeln steigern","Übungen in Bauchlage um Kräftigung erweitern und Rumpfkräftigung ausbauen."],"applies_when":["Wochen 10–12"],"progression_criteria":["alle funktionellen Aktivitäten ohne Einschränkung oder Schmerz und aktive Schulterflexion bis 140° im Stand mit guter Mechanik."],"dosage_and_progression":["Übungen aus Phase II und III fortsetzen, jedoch keine schwere Kräftigung."]},"en":{"goals":["full ROM, no pain, good mechanics, begin strengthening."],"exercises":["Continue phase II and III exercises","progress multi‑planar movements","initiate light strengthening exercises","progress non‑painful AROM","advanced shoulder motions and neuromuscular control","PNF patterns with light resistance","good scapulothoracic awareness","closed chain exercises: ball on the wall","progress external rotation ROM in varying angles of abduction","progress prone exercises to include strengthening","core strengthening progression."],"applies_when":["Weeks 10-12"],"restrictions":["no heavy strengthening.","no heavy strengthening"],"progression_criteria":["able to perform all functional activities without limitations or pain","able to actively flex shoulder to 140° in standing position with good mechanics."],"dosage_and_progression":["Continue phase II and III exercises","progress multi‑planar movements"]},"pl":{"goals":["pełny zakres ruchu, brak bólu, prawidłowa mechanika i rozpoczęcie wzmacniania."],"exercises":["Kontynuować ćwiczenia faz II i III","rozwijać ruchy wielopłaszczyznowe","rozpocząć lekkie wzmacnianie","zwiększać bezbolesny czynny zakres ruchu, zaawansowane ruchy barku i kontrolę nerwowo-mięśniową","wzorce PNF z lekkim oporem","kontrola łopatkowo-żebrowa","ćwiczenia w łańcuchu zamkniętym z piłką na ścianie","zwiększać rotację zewnętrzną w różnych kątach odwodzenia","rozwijać ćwiczenia w leżeniu przodem z elementami wzmacniania oraz wzmacnianie mięśni tułowia."],"applies_when":["tygodnie 10–12"],"progression_criteria":["wszystkie czynności funkcjonalne bez ograniczeń i bólu oraz czynne zgięcie barku do 140° w staniu z prawidłową mechaniką."],"dosage_and_progression":["Kontynuować ćwiczenia faz II i III, ale bez ciężkiego wzmacniania."]},"original":{"goals":["full ROM, no pain, good mechanics, begin strengthening."],"exercises":["Continue phase II and III exercises","progress multi‑planar movements","initiate light strengthening exercises","progress non‑painful AROM","advanced shoulder motions and neuromuscular control","PNF patterns with light resistance","good scapulothoracic awareness","closed chain exercises: ball on the wall","progress external rotation ROM in varying angles of abduction","progress prone exercises to include strengthening","core strengthening progression."],"applies_when":["Weeks 10-12"],"restrictions":["no heavy strengthening.","no heavy strengthening"],"progression_criteria":["able to perform all functional activities without limitations or pain","able to actively flex shoulder to 140° in standing position with good mechanics."],"dosage_and_progression":["Continue phase II and III exercises","progress multi‑planar movements"]}},"additional_notes_de":"Ziele: voller Bewegungsumfang, Schmerzfreiheit, korrekte Mechanik und Beginn der Kräftigung. Progressionskriterien: alle funktionellen Aktivitäten ohne Einschränkung oder Schmerz und aktive Schulterflexion bis 140° im Stand mit guter Mechanik.","additional_notes_en":"Goals: full ROM, no pain, good mechanics, begin strengthening. Criteria for progression: able to perform all functional activities without limitations or pain; able to actively flex shoulder to 140° in standing position with good mechanics.","additional_notes_pl":"Cele: pełny zakres ruchu, brak bólu, prawidłowa mechanika i rozpoczęcie wzmacniania. Kryteria progresji: wszystkie czynności funkcjonalne bez ograniczeń i bólu oraz czynne zgięcie barku do 140° w staniu z prawidłową mechaniką.","minimum_patient_share":null,"therapeutic_content_de":"Übungen aus Phase II und III fortsetzen; multiplanare Bewegungen steigern; leichte Kräftigung beginnen; schmerzfreien aktiven Bewegungsumfang, fortgeschrittene Schulterbewegungen und neuromuskuläre Kontrolle steigern; PNF-Muster mit leichtem Widerstand; skapulothorakale Kontrolle; Übungen in geschlossener Kette mit Ball an der Wand; Außenrotation in verschiedenen Abduktionswinkeln steigern; Übungen in Bauchlage um Kräftigung erweitern und Rumpfkräftigung ausbauen.","therapeutic_content_en":"Continue phase II and III exercises; progress multi‑planar movements; no heavy strengthening; initiate light strengthening exercises; progress non‑painful AROM; advanced shoulder motions and neuromuscular control; PNF patterns with light resistance; good scapulothoracic awareness; closed chain exercises: ball on the wall; progress external rotation ROM in varying angles of abduction; progress prone exercises to include strengthening; core strengthening progression.","therapeutic_content_pl":"Kontynuować ćwiczenia faz II i III; rozwijać ruchy wielopłaszczyznowe; rozpocząć lekkie wzmacnianie; zwiększać bezbolesny czynny zakres ruchu, zaawansowane ruchy barku i kontrolę nerwowo-mięśniową; wzorce PNF z lekkim oporem; kontrola łopatkowo-żebrowa; ćwiczenia w łańcuchu zamkniętym z piłką na ścianie; zwiększać rotację zewnętrzną w różnych kątach odwodzenia; rozwijać ćwiczenia w leżeniu przodem z elementami wzmacniania oraz wzmacnianie mięśni tułowia.","minimum_requirements_de":"Übungen aus Phase II und III fortsetzen, jedoch keine schwere Kräftigung.","minimum_requirements_en":"Continue phase II and III exercises; progress multi‑planar movements; no heavy strengthening.","minimum_requirements_pl":"Kontynuować ćwiczenia faz II i III, ale bez ciężkiego wzmacniania.","additional_notes_original":"Goals: full ROM, no pain, good mechanics, begin strengthening. Criteria for progression: able to perform all functional activities without limitations or pain; able to actively flex shoulder to 140° in standing position with good mechanics.","therapeutic_content_original":"Continue phase II and III exercises; progress multi‑planar movements; no heavy strengthening; initiate light strengthening exercises; progress non‑painful AROM; advanced shoulder motions and neuromuscular control; PNF patterns with light resistance; good scapulothoracic awareness; closed chain exercises: ball on the wall; progress external rotation ROM in varying angles of abduction; progress prone exercises to include strengthening; core strengthening progression.","minimum_requirements_original":"Continue phase II and III exercises; progress multi‑planar movements; no heavy strengthening.","structured_content_v2":"$undefined"},{"id":"f6e1102d-9cef-5c10-a82b-ffb03ab48e5b","name_de":"Phase V: ab Woche 12","name_en":"Phase V: Week 12 and onward","name_pl":"Faza V: od 12. tygodnia","source_page":2,"module_number":5,"name_original":"Phase V: Week 12 and onward","service_codes":[],"structured_content":{"de":{"exercises":["Sport- oder berufsspezifisches Training und Rückkehr zu Freizeitaktivitäten","Kraft und Ausdauer normalisieren","Schulterbewegungen mit unterschiedlichen Geschwindigkeiten und Winkeln ohne Kompensation","Rotatorenmanschette in verschiedenen Winkeln und Geschwindigkeiten progressiv kräftigen","Krafttraining von vielen Wiederholungen mit geringer Last zu weniger Wiederholungen mit höherer Last steigern","Wurfprogression oder Überkopfprogramm, falls indiziert."],"applies_when":["ab Woche 12"],"progression_criteria":["Kraftdefizit <10 %","Limb-Symmetry-Index ≥90 %","45/50 Punkte in biomechanischen Funktionstests, sofern durchgeführt","keine Schmerzen und keine berichtete Instabilität.","Rückkehr zum Sport nach Freigabe durch Physiotherapeut und Operateur"],"dosage_and_progression":["vollständige Rückkehr zur Aktivität üblicherweise etwa 5 Monate postoperativ."]},"en":{"exercises":["Sport or work specific training","return to recreational activities","normalize strength and endurance","continue to work on shoulder motion in varying speeds and angles without compensation","progress rotator cuff strengthening in different angles and velocities","progress weight strengthening with high reps low weight to low reps higher weight","throwing progression or overhead program if indicated."],"applies_when":["Week 12 and onward"],"progression_criteria":["may return to sports after clearance from therapist and surgeon","full return to activity typically at 5 months s/p.","Criteria for discharge: <10% strength deficit","limb similarly index ≥90%","45/50 on biomechanical functional tests (if performed)","no pain or complaints of instability."],"dosage_and_progression":["return to recreational activities"],"physiotherapist_actions":["Sport or work specific training","normalize strength and endurance."]},"pl":{"exercises":["Trening specyficzny dla sportu lub pracy i powrót do aktywności rekreacyjnych","normalizacja siły i wytrzymałości","ruchy barku z różną prędkością i pod różnymi kątami bez kompensacji","progresywne wzmacnianie stożka rotatorów w różnych kątach i prędkościach","trening siłowy od dużej liczby powtórzeń z małym obciążeniem do mniejszej liczby powtórzeń z większym obciążeniem","progresja rzutów lub program pracy nad głową, jeżeli wskazany."],"applies_when":["od 12. tygodnia"],"progression_criteria":["deficyt siły <10%","wskaźnik podobieństwa kończyn ≥90%","wynik 45/50 w biomechanicznych testach funkcjonalnych, jeżeli wykonano","brak bólu i zgłaszanej niestabilności."],"dosage_and_progression":["Powrót do sportu po zgodzie fizjoterapeuty i chirurga","pełny powrót do aktywności zwykle około 5. miesiąca po zabiegu."]},"original":{"exercises":["Sport or work specific training","return to recreational activities","normalize strength and endurance","continue to work on shoulder motion in varying speeds and angles without compensation","progress rotator cuff strengthening in different angles and velocities","progress weight strengthening with high reps low weight to low reps higher weight","throwing progression or overhead program if indicated."],"applies_when":["Week 12 and onward"],"progression_criteria":["may return to sports after clearance from therapist and surgeon","full return to activity typically at 5 months s/p.","Criteria for discharge: <10% strength deficit","limb similarly index ≥90%","45/50 on biomechanical functional tests (if performed)","no pain or complaints of instability."],"dosage_and_progression":["return to recreational activities"],"physiotherapist_actions":["Sport or work specific training","normalize strength and endurance."]}},"additional_notes_de":"Entlassungskriterien: Kraftdefizit <10 %; Limb-Symmetry-Index ≥90 %; 45/50 Punkte in biomechanischen Funktionstests, sofern durchgeführt; keine Schmerzen und keine berichtete Instabilität.","additional_notes_en":"Criteria for progression: may return to sports after clearance from therapist and surgeon; full return to activity typically at 5 months s/p. Criteria for discharge: <10% strength deficit; limb similarly index ≥90%; 45/50 on biomechanical functional tests (if performed); no pain or complaints of instability.","additional_notes_pl":"Kryteria wypisu: deficyt siły <10%; wskaźnik podobieństwa kończyn ≥90%; wynik 45/50 w biomechanicznych testach funkcjonalnych, jeżeli wykonano; brak bólu i zgłaszanej niestabilności.","minimum_patient_share":null,"therapeutic_content_de":"Sport- oder berufsspezifisches Training und Rückkehr zu Freizeitaktivitäten; Kraft und Ausdauer normalisieren; Schulterbewegungen mit unterschiedlichen Geschwindigkeiten und Winkeln ohne Kompensation; Rotatorenmanschette in verschiedenen Winkeln und Geschwindigkeiten progressiv kräftigen; Krafttraining von vielen Wiederholungen mit geringer Last zu weniger Wiederholungen mit höherer Last steigern; Wurfprogression oder Überkopfprogramm, falls indiziert.","therapeutic_content_en":"Sport or work specific training; return to recreational activities; normalize strength and endurance; continue to work on shoulder motion in varying speeds and angles without compensation; progress rotator cuff strengthening in different angles and velocities; progress weight strengthening with high reps low weight to low reps higher weight; throwing progression or overhead program if indicated.","therapeutic_content_pl":"Trening specyficzny dla sportu lub pracy i powrót do aktywności rekreacyjnych; normalizacja siły i wytrzymałości; ruchy barku z różną prędkością i pod różnymi kątami bez kompensacji; progresywne wzmacnianie stożka rotatorów w różnych kątach i prędkościach; trening siłowy od dużej liczby powtórzeń z małym obciążeniem do mniejszej liczby powtórzeń z większym obciążeniem; progresja rzutów lub program pracy nad głową, jeżeli wskazany.","minimum_requirements_de":"Rückkehr zum Sport nach Freigabe durch Physiotherapeut und Operateur; vollständige Rückkehr zur Aktivität üblicherweise etwa 5 Monate postoperativ.","minimum_requirements_en":"Sport or work specific training; return to recreational activities; normalize strength and endurance.","minimum_requirements_pl":"Powrót do sportu po zgodzie fizjoterapeuty i chirurga; pełny powrót do aktywności zwykle około 5. miesiąca po zabiegu.","additional_notes_original":"Criteria for progression: may return to sports after clearance from therapist and surgeon; full return to activity typically at 5 months s/p. Criteria for discharge: <10% strength deficit; limb similarly index ≥90%; 45/50 on biomechanical functional tests (if performed); no pain or complaints of instability.","therapeutic_content_original":"Sport or work specific training; return to recreational activities; normalize strength and endurance; continue to work on shoulder motion in varying speeds and angles without compensation; progress rotator cuff strengthening in different angles and velocities; progress weight strengthening with high reps low weight to low reps higher weight; throwing progression or overhead program if indicated.","minimum_requirements_original":"Sport or work specific training; return to recreational activities; normalize strength and endurance.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["shoulder","upper_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"59501690-dae7-580d-b714-5ebc78596b80","slug":"de-drv-rts-tep-2025","title_pl":"Niemiecki standard rehabilitacji po endoprotezie biodra lub kolana — RTS 2025","title_de":"Reha-Therapiestandards Hüft- und Knie-TEP 2025","title_en":"Rehabilitation Therapy Standards for Hip and Knee TEP 2025","title_original":"Reha-Therapiestandards Hüft- und Knie-TEP 2025","summary_pl":"Oficjalny standard Deutsche Rentenversicherung dla całodziennej ambulatoryjnej i stacjonarnej rehabilitacji medycznej dorosłych po endoprotezoplastyce biodra lub kolana. Dokument opisuje 12 modułów terapii ETM oraz ich wymagania minimalne.","summary_de":"Offizieller Standard der Deutschen Rentenversicherung für die ganztägig ambulante und stationäre medizinische Rehabilitation von Erwachsenen nach Hüft- oder Knie-Totalendoprothese. Das Dokument beschreibt zwölf Therapiemodule (ETM) und deren Mindestanforderungen.","summary_en":"Official German Pension Insurance (DRV) standard for all-day outpatient and inpatient medical rehabilitation of adults following total hip or knee replacement. The document describes 12 therapy modules (ETM) and their minimum requirements.","country_code":"DE","source_language":"de","publication_year":2025,"version_label":"2025","target_professions":["physiotherapist","physician","psychologist","dietitian"],"clinical_scope":"multidisciplinary","structure_type":"modules","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"37405f61-eb8a-5022-be7f-63aad1fc6217","condition_slug":"endoproteza-biodra-kolana","condition_name_pl":"Endoproteza biodra lub kolana","condition_name_de":"Hüft- und Knie-TEP","condition_name_en":"Total Hip and Knee Arthroplasty","condition_name_original":"Hüft- oder Knie-TEP","icd_codes":["M16","M17","S72.01-S72.05","Z96.64","Z96.65"],"category_key":"orthopedics","category_pl":"Ortopedia","category_de":"Orthopädie","category_en":"Orthopedics","body_regions_pl":["biodro","kolano","kończyna dolna"],"body_regions_de":["Hüfte","Knie","untere Extremität"],"body_regions_en":["hip","knee","lower limb"],"search_terms_pl":["endoproteza","endoprotezoplastyka","proteza biodra","proteza kolana","TEP","rehabilitacja pooperacyjna"],"search_terms_de":["Endoprothese","Hüftprothese","Knieprothese","Hüft-TEP","Knie-TEP","TEP","postoperative Rehabilitation"],"search_terms_en":["total hip replacement","total knee replacement","joint replacement","THR","TKR","postoperative rehabilitation"],"source_document_id":"18fabe59-cb81-58f8-b83f-ceab7f91020d","source_title":"Reha-Therapiestandards Hüft- und Knie-TEP 2025","issuer":"Deutsche Rentenversicherung Bund","source_country_code":"DE","jurisdiction_code":"DE","authority_level":"national_agency","document_type":"national_rehabilitation_standard","source_clinical_scope":"multidisciplinary","source_target_professions":["physiotherapist","physician","psychologist","dietitian"],"freshness_status":"current_2025","official_url":"https://www.deutsche-rentenversicherung.de/SharedDocs/Downloads/DE/Experten/reha_forschung/forschungs-praxis/RTS_BR_TEP_2025_downloadseite","source_sha256":"1a358af1b5f2e523c7a5cd954221d8db0deb2bfc1abe6a6cf39c0cf92c38c14c","authorization_required":false,"license_note":"Verify licence before app ingestion or redistribution","modules":[{"id":"e1f49cb5-ede0-5a46-a795-580ea29ba9dc","name_de":"Bewegungstherapie","name_en":"Exercise Therapy","name_pl":"Terapia ruchowa","source_page":13,"module_number":1,"name_original":"Bewegungstherapie","service_codes":["A011","A012","A021","A029","A031","A041","A051","A061","A062","A069","A071","A081","A091","B011","B012","B013","B014","B015","B016","B019","B021","B031","L011","L012","L019"],"structured_content":{"de":{"goals":["Ziele gewichtet nach Voraussetzungen: (Wieder-)Herstellung von physischen Funktionen, Belastbarkeit und Trainierbarkeit (z. B. Gleichgewicht, Gangsicherheit).","Stärkung physischer Ressourcen (v. a. aerobe Ausdauer) und Vermittlung von Aktivitäten (ADL, Sport, Beruf).","Stärkung psychischer/sozialer Ressourcen, Aufbau von Bewegungskompetenz zur Bindung an einen aktiven Lebensstil."],"warnings":["Unterteilt in 3 Bereiche (Ausdauer, Kraft/Funktion, Bewegungsorientierung); Bedienung aller drei Bereiche gefordert."],"dosage_and_progression":["mind. 360 Minuten pro Woche, mind. 5 mal."]},"en":{"goals":["Goals weighted by individual conditions: (re)establishment of physical functions, resilience, and trainability (e.g., balance, gait safety).","Strengthening physical resources (esp. aerobic endurance) and imparting activities (ADL, sports, work).","Strengthening psychological and social resources, building movement competence to encourage an active lifestyle."],"warnings":["Divided into 3 areas (endurance, strength/function, movement orientation); addressing all three areas is required."],"dosage_and_progression":["at least 360 minutes per week, at least 5 times."]},"pl":{"goals":["Cele dobiera się do indywidualnych możliwości pacjenta.","Moduł obejmuje ćwiczenie i trening służący przywracaniu funkcji fizycznych, wydolności i zdolności treningowej, w tym równowagi oraz bezpieczeństwa i symetrii chodu.","Wzmacnia zasoby fizyczne, szczególnie wydolność tlenową, kompetencje ruchowe potrzebne w codzienności, sporcie i pracy, a także poczucie własnej skuteczności i umiejętność utrzymania aktywnego stylu życia."],"warnings":["Moduł obejmuje trzy obszary: aktywności wytrzymałościowe, wzmacnianie mięśni i trening funkcjonalny oraz rozwijanie orientacji na ruch.","Wymagane jest uwzględnienie wszystkich trzech obszarów."],"dosage_and_progression":["Minimum 360 minut tygodniowo, co najmniej 5 razy w tygodniu."]},"original":{"goals":["Ziele gewichtet in Abhängigkeit von den individuellen Voraussetzungen:","Anbahnung, Übung und Training zur (Wieder-)Herstellung von physischen Funktionen, Belastbarkeit und Trainierbarkeit (z. B. Therapie zur Verbesserung von Gleichgewicht, Gangsicherheit und –symmetrie).","Stärkung physischer Ressourcen/Funktionen (insbesondere aerobe Ausdauer) und Vermittlung von Aktivitäten (z. B. ADL, sport- und berufsbezogene Bewegungskompetenzen).","Stärkung psychischer und sozialer Ressourcen durch positive und nachhaltig umsetzbare Bewegungserfahrungen, bewegungsbezogene Selbstwirksamkeitserfahrungen, Aufbau von Bewegungs- und Steuerungskompetenz zur Bindung an einen körperlich aktiven Lebensstil."],"warnings":["Das ETM „Bewegungstherapie“ wird in drei Bereiche (1: Ausdauerorientierte Aktivitäten; 2: Muskelkräftigung und Funktionstraining; 3: Förderung der Bewegungsorientierung) unterteilt und eine Bedienung aller drei Bereiche gefordert."],"dosage_and_progression":["Mindestdauer pro Woche: Mindesthäufigkeit pro Woche: mind. 360 Minuten mind. 5 mal."]}},"additional_notes_de":"Unterteilt in 3 Bereiche (Ausdauer, Kraft/Funktion, Bewegungsorientierung); Bedienung aller drei Bereiche gefordert.","additional_notes_en":"Divided into 3 areas (endurance, strength/function, movement orientation); addressing all three areas is required.","additional_notes_pl":"Moduł obejmuje trzy obszary: aktywności wytrzymałościowe, wzmacnianie mięśni i trening funkcjonalny oraz rozwijanie orientacji na ruch. Wymagane jest uwzględnienie wszystkich trzech obszarów.","minimum_patient_share":90,"therapeutic_content_de":"Ziele gewichtet nach Voraussetzungen: (Wieder-)Herstellung von physischen Funktionen, Belastbarkeit und Trainierbarkeit (z. B. Gleichgewicht, Gangsicherheit). Stärkung physischer Ressourcen (v. a. aerobe Ausdauer) und Vermittlung von Aktivitäten (ADL, Sport, Beruf). Stärkung psychischer/sozialer Ressourcen, Aufbau von Bewegungskompetenz zur Bindung an einen aktiven Lebensstil.","therapeutic_content_en":"Goals weighted by individual conditions: (re)establishment of physical functions, resilience, and trainability (e.g., balance, gait safety). Strengthening physical resources (esp. aerobic endurance) and imparting activities (ADL, sports, work). Strengthening psychological and social resources, building movement competence to encourage an active lifestyle.","therapeutic_content_pl":"Cele dobiera się do indywidualnych możliwości pacjenta. Moduł obejmuje ćwiczenie i trening służący przywracaniu funkcji fizycznych, wydolności i zdolności treningowej, w tym równowagi oraz bezpieczeństwa i symetrii chodu. Wzmacnia zasoby fizyczne, szczególnie wydolność tlenową, kompetencje ruchowe potrzebne w codzienności, sporcie i pracy, a także poczucie własnej skuteczności i umiejętność utrzymania aktywnego stylu życia.","minimum_requirements_de":"mind. 360 Minuten pro Woche, mind. 5 mal.","minimum_requirements_en":"at least 360 minutes per week, at least 5 times.","minimum_requirements_pl":"Minimum 360 minut tygodniowo, co najmniej 5 razy w tygodniu.","additional_notes_original":"Das ETM „Bewegungstherapie“ wird in drei Bereiche (1: Ausdauerorientierte Aktivitäten; 2: Muskelkräftigung und Funktionstraining; 3: Förderung der Bewegungsorientierung) unterteilt und eine Bedienung aller drei Bereiche gefordert.","therapeutic_content_original":"Ziele gewichtet in Abhängigkeit von den individuellen Voraussetzungen: • Anbahnung, Übung und Training zur (Wieder-)Herstellung von physischen Funktionen, Belastbarkeit und Trainierbarkeit (z. B. Therapie zur Verbesserung von Gleichgewicht, Gangsicherheit und –symmetrie) • Stärkung physischer Ressourcen/Funktionen (insbesondere aerobe Ausdauer) und Vermittlung von Aktivitäten (z. B. ADL, sport- und berufsbezogene Bewegungskompetenzen) • Stärkung psychischer und sozialer Ressourcen durch positive und nachhaltig umsetzbare Bewegungserfahrungen, bewegungsbezogene Selbstwirksamkeitserfahrungen, Aufbau von Bewegungs- und Steuerungskompetenz zur Bindung an einen körperlich aktiven Lebensstil.","minimum_requirements_original":"Mindestdauer pro Woche: Mindesthäufigkeit pro Woche: mind. 360 Minuten mind. 5 mal","module_kind":"service_module","structured_content_v2":{"evidence":{"items":[],"status":"not_reported"},"exercises":{"items":[],"status":"not_reported"},"assessment":{"items":[],"status":"not_reported"},"provenance":[{"id":"etm-01-content","pdf_page_to":13,"original_text":"Ziele gewichtet in Abhängigkeit von den individuellen Voraussetzungen: • Anbahnung, Übung und Training zur (Wieder-)Herstellung von physischen Funktionen, Belastbarkeit und Trainierbarkeit (z. B. 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Bereiche gefordert.","en":"ETM Exercise Therapy is divided into three areas: endurance-oriented activities; muscle strengthening and functional training; and promotion of movement orientation. All three areas must be addressed.","pl":"Moduł obejmuje trzy obszary: aktywności wytrzymałościowe, wzmacnianie mięśni i trening funkcjonalny oraz rozwijanie orientacji na ruch. Wymagane jest uwzględnienie wszystkich trzech obszarów.","original":"Das ETM „Bewegungstherapie“ wird in drei Bereiche (1: Ausdauerorientierte Aktivitäten; 2: Muskelkräftigung und Funktionstraining; 3: Förderung der Bewegungsorientierung) unterteilt und eine Bedienung aller drei Bereiche gefordert."},"provenance_id":"etm-01-delivery"}],"minimum_duration":{"basis":"per_week","status":"reported","minutes":360},"minimum_frequency":{"basis":"per_week","count":5,"status":"reported"},"therapeutic_content":[{"id":"etm-01-therapeutic-content","text":{"de":"Ziele gewichtet in Abhängigkeit von den individuellen Voraussetzungen: • Anbahnung, Übung und Training zur (Wieder-)Herstellung von physischen Funktionen, Belastbarkeit und Trainierbarkeit (z. B. Therapie zur Verbesserung von Gleichgewicht, Gangsicherheit und –symmetrie) • Stärkung physischer Ressourcen/Funktionen (insbesondere aerobe Ausdauer) und Vermittlung von Aktivitäten (z. B. ADL, sport- und berufsbezogene Bewegungskompetenzen) • Stärkung psychischer und sozialer Ressourcen durch positive und nachhaltig umsetzbare Bewegungserfahrungen, bewegungsbezogene Selbstwirksamkeitserfahrungen, Aufbau von Bewegungs- und Steuerungskompetenz zur Bindung an einen körperlich aktiven Lebensstil.","en":"Goals are weighted according to individual prerequisites: initiation, practice, and training to restore physical functions, load capacity, and trainability, for example by improving balance, gait safety, and gait symmetry; strengthening physical resources and functions, particularly aerobic endurance, and teaching activities such as ADLs and movement skills for sport and work; strengthening psychological and social resources through positive, sustainable movement experiences and movement-related self-efficacy, and building movement and self-management competence to support a physically active lifestyle.","pl":"Cele dobiera się do indywidualnych możliwości pacjenta. Moduł obejmuje ćwiczenie i trening służący przywracaniu funkcji fizycznych, wydolności i zdolności treningowej, w tym równowagi oraz bezpieczeństwa i symetrii chodu. Wzmacnia zasoby fizyczne, szczególnie wydolność tlenową, kompetencje ruchowe potrzebne w codzienności, sporcie i pracy, a także poczucie własnej skuteczności i umiejętność utrzymania aktywnego stylu życia.","original":"Ziele gewichtet in Abhängigkeit von den individuellen Voraussetzungen: • Anbahnung, Übung und Training zur (Wieder-)Herstellung von physischen Funktionen, Belastbarkeit und Trainierbarkeit (z. B. Therapie zur Verbesserung von Gleichgewicht, Gangsicherheit und –symmetrie) • Stärkung physischer Ressourcen/Funktionen (insbesondere aerobe Ausdauer) und Vermittlung von Aktivitäten (z. B. ADL, sport- und berufsbezogene Bewegungskompetenzen) • Stärkung psychischer und sozialer Ressourcen durch positive und nachhaltig umsetzbare Bewegungserfahrungen, bewegungsbezogene Selbstwirksamkeitserfahrungen, Aufbau von Bewegungs- und Steuerungskompetenz zur Bindung an einen körperlich aktiven Lebensstil."},"provenance_id":"etm-01-content"}],"minimum_patient_share_percent":{"value":90,"status":"reported"}},"therapist_actions":{"items":[],"status":"not_reported"},"monitoring_and_safety":{"items":[],"status":"not_reported"},"protection_and_loading":{"items":[],"status":"not_reported"},"unmapped_source_content":{"items":[],"status":"not_applicable"},"progression_and_completion":{"items":[],"status":"not_reported"}}},{"id":"057c8a78-b6a9-531c-b307-f2fb2c0cd1f2","name_de":"Psychologische Interventionen","name_en":"Psychological Interventions","name_pl":"Interwencje psychologiczne","source_page":14,"module_number":2,"name_original":"Psychologische Interventionen","service_codes":["F011","F012","F013","F014","F015","F021","F031","F032","F034","F035","F039","F041","G011","G012","G013","G014","G015","G016","G017","G019","G021","G022","G023","G024","G025","G026","G027","G028","G029","G051","G061","G071"],"structured_content":{"de":{"goals":["Bearbeitung psychischer Belastungen im Berufs- und Alltagsleben, Aktivierung psychischer Ressourcen, Entwicklung einer positiven Lebensperspektive, Akzeptanz von Krankheitsfolgen, Intervention bei begleitenden psychischen Störungen, Bahnung von Weiterbehandlung."],"dosage_and_progression":["mind. 60 Minuten pro Rehabilitation."]},"en":{"goals":["Addressing psychological stress in professional and daily life, activating psychological resources, developing a positive life perspective, accepting consequences of the disease, intervention for comorbid mental disorders, and facilitating follow-up treatment."],"dosage_and_progression":["at least 60 minutes per rehabilitation."]},"pl":{"goals":["Rozpoznawanie i przepracowanie obciążeń psychicznych oraz problemów wpływających na życie zawodowe i codzienne.","Moduł obejmuje aktywizowanie zasobów psychicznych, rozwijanie realistycznej i pozytywnej perspektywy, akceptację długotrwałych następstw choroby, pomoc przy współistniejących zaburzeniach psychicznych oraz przygotowanie odpowiednich możliwości dalszego leczenia po rehabilitacji."],"dosage_and_progression":["Minimum 60 minut w trakcie rehabilitacji."]},"original":{"goals":["Klärung und Bearbeitung psychischer Belastungen und Problemkonstellationen sowie daraus resultierender Beanspruchungen im Berufs- und Alltagsleben, Aktivierung psychischer Ressourcen, Entwicklung einer realitätsangepassten, positiven Lebensperspektive, Akzeptanz und Umgang mit unabänderlichen bzw. langfristigen Krankheitsfolgen, Intervention bei begleitenden psychischen Störungen und Bahnung angemessener Weiterbehandlungsoptionen für die Zeit nach der Rehabilitation."],"dosage_and_progression":["Mindestdauer pro Rehabilitation: mind. 60 Minuten."]}},"additional_notes_de":"","additional_notes_en":"","additional_notes_pl":"","minimum_patient_share":30,"therapeutic_content_de":"Bearbeitung psychischer Belastungen im Berufs- und Alltagsleben, Aktivierung psychischer Ressourcen, Entwicklung einer positiven Lebensperspektive, Akzeptanz von Krankheitsfolgen, Intervention bei begleitenden psychischen Störungen, Bahnung von Weiterbehandlung.","therapeutic_content_en":"Addressing psychological stress in professional and daily life, activating psychological resources, developing a positive life perspective, accepting consequences of the disease, intervention for comorbid mental disorders, and facilitating follow-up treatment.","therapeutic_content_pl":"Rozpoznawanie i przepracowanie obciążeń psychicznych oraz problemów wpływających na życie zawodowe i codzienne. Moduł obejmuje aktywizowanie zasobów psychicznych, rozwijanie realistycznej i pozytywnej perspektywy, akceptację długotrwałych następstw choroby, pomoc przy współistniejących zaburzeniach psychicznych oraz przygotowanie odpowiednich możliwości dalszego leczenia po rehabilitacji.","minimum_requirements_de":"mind. 60 Minuten pro Rehabilitation.","minimum_requirements_en":"at least 60 minutes per rehabilitation.","minimum_requirements_pl":"Minimum 60 minut w trakcie rehabilitacji.","additional_notes_original":"","therapeutic_content_original":"Klärung und Bearbeitung psychischer Belastungen und Problemkonstellationen sowie daraus resultierender Beanspruchungen im Berufs- und Alltagsleben, Aktivierung psychischer Ressourcen, Entwicklung einer realitätsangepassten, positiven Lebensperspektive, Akzeptanz und Umgang mit unabänderlichen bzw. langfristigen Krankheitsfolgen, Intervention bei begleitenden psychischen Störungen und Bahnung angemessener Weiterbehandlungsoptionen für die Zeit nach 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Die Schulungsangebote sollten zudem die Motivation zur Mitwirkung und Eigenverantwortlichkeit fördern und möglichst aktivierende Methoden beinhalten, beispielsweise Strategien zur Zielsetzung, Planung und Selbstbeobachtung sowie die Anwendung von Feedbackverfahren und motivierender Gesprächsführung."},"provenance_id":"etm-03-content"}],"minimum_patient_share_percent":{"value":70,"status":"reported"}},"therapist_actions":{"items":[],"status":"not_reported"},"monitoring_and_safety":{"items":[],"status":"not_reported"},"protection_and_loading":{"items":[],"status":"not_reported"},"unmapped_source_content":{"items":[],"status":"not_applicable"},"progression_and_completion":{"items":[],"status":"not_reported"}}},{"id":"e022525b-e8d0-5d55-b9a9-6398dbf641b2","name_de":"Gesundheitsbildung","name_en":"Health Education","name_pl":"Edukacja zdrowotna","source_page":16,"module_number":4,"name_original":"Gesundheitsbildung","service_codes":["C012","C021","C041","C042","C043","C044","C051","C062","C063","C065","C071","C081","C083","C084","C089"],"structured_content":{"de":{"goals":["Verdeutlichung der Bedeutung von Lebensstilfaktoren, Informationen zu modifizierbaren Risikofaktoren, Motivationsstärkung und Eigeninitiative.","Förderung vorteilhaften Gesundheitsverhaltens durch Beratung, Anleitung und Vortrag."],"warnings":["Maximal ein Vortrag (30 Minuten) geht in die Erfüllung ein."],"dosage_and_progression":["mind. 75 Minuten pro Rehabilitation."]},"en":{"goals":["Highlighting the importance of lifestyle factors, providing information on modifiable risk factors, and strengthening motivation and initiative.","Promoting beneficial health behavior through counseling, instruction, and lectures."],"warnings":["A maximum of one lecture (30 minutes) counts toward fulfillment."],"dosage_and_progression":["at least 75 minutes per rehabilitation."]},"pl":{"goals":["Seminaria i inne formy edukacji pokazujące znaczenie czynników stylu życia.","Celem jest przekazanie informacji o modyfikowalnych czynnikach ryzyka, wzmacnianie inicjatywy pacjenta i motywacji oraz wspieranie korzystnych zachowań zdrowotnych poprzez poradnictwo, instruktaż i wykłady."],"warnings":["Do realizacji modułu można zaliczyć maksymalnie jeden wykład trwający 30 minut."],"dosage_and_progression":["Minimum 75 minut w trakcie rehabilitacji."]},"original":{"goals":["Bedeutung der Lebensstilfaktoren soll in Seminaren zu gesundheitsbezogenen Themen verdeutlicht werden.","Das Ziel ist Informationen zu modifizierbaren Risikofaktoren zu geben und Motivation z. 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Förderung vorteilhaften Gesundheitsverhaltens durch Beratung, Anleitung und Vortrag.","therapeutic_content_en":"Highlighting the importance of lifestyle factors, providing information on modifiable risk factors, and strengthening motivation and initiative. Promoting beneficial health behavior through counseling, instruction, and lectures.","therapeutic_content_pl":"Seminaria i inne formy edukacji pokazujące znaczenie czynników stylu życia. Celem jest przekazanie informacji o modyfikowalnych czynnikach ryzyka, wzmacnianie inicjatywy pacjenta i motywacji oraz wspieranie korzystnych zachowań zdrowotnych poprzez poradnictwo, instruktaż i wykłady.","minimum_requirements_de":"mind. 75 Minuten pro Rehabilitation.","minimum_requirements_en":"at least 75 minutes per rehabilitation.","minimum_requirements_pl":"Minimum 75 minut w trakcie rehabilitacji.","additional_notes_original":"Maximal ein Vortrag (30 Minuten) geht in die Erfüllung des ETM „Gesundheitsbildung“ ein.","therapeutic_content_original":"Bedeutung der Lebensstilfaktoren soll in Seminaren zu gesundheitsbezogenen Themen verdeutlicht werden. Das Ziel ist Informationen zu modifizierbaren Risikofaktoren zu geben und Motivation z. B. durch Förderung der Eigeninitiative zu stärken. Ergänzend können Beratung, Anleitung und Vortrag genutzt werden, um vorteilhaftes Gesundheitsverhalten zu fördern.","minimum_requirements_original":"Mindestdauer pro Rehabilitation: mind. 75 Minuten","module_kind":"service_module","structured_content_v2":{"evidence":{"items":[],"status":"not_reported"},"exercises":{"items":[],"status":"not_reported"},"assessment":{"items":[],"status":"not_reported"},"provenance":[{"id":"etm-04-content","pdf_page_to":16,"original_text":"Bedeutung der Lebensstilfaktoren soll in Seminaren zu gesundheitsbezogenen Themen verdeutlicht werden. Das Ziel ist Informationen zu modifizierbaren Risikofaktoren zu geben und Motivation z. B. durch Förderung der Eigeninitiative zu stärken. 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Das Ziel ist Informationen zu modifizierbaren Risikofaktoren zu geben und Motivation z. B. durch Förderung der Eigeninitiative zu stärken. Ergänzend können Beratung, Anleitung und Vortrag genutzt werden, um vorteilhaftes Gesundheitsverhalten zu fördern.","en":"Use seminars on health-related topics to explain the importance of lifestyle factors. Provide information about modifiable risk factors and strengthen motivation, for example by promoting the patient’s own initiative. Counseling, instruction, and lectures may supplement this work to promote beneficial health behavior.","pl":"Seminaria i inne formy edukacji pokazujące znaczenie czynników stylu życia. Celem jest przekazanie informacji o modyfikowalnych czynnikach ryzyka, wzmacnianie inicjatywy pacjenta i motywacji oraz wspieranie korzystnych zachowań zdrowotnych poprzez poradnictwo, instruktaż i wykłady.","original":"Bedeutung der Lebensstilfaktoren soll in Seminaren zu gesundheitsbezogenen Themen verdeutlicht werden. Das Ziel ist Informationen zu modifizierbaren Risikofaktoren zu geben und Motivation z. B. durch Förderung der Eigeninitiative zu stärken. Ergänzend können Beratung, Anleitung und Vortrag genutzt werden, um vorteilhaftes Gesundheitsverhalten zu fördern."},"provenance_id":"etm-04-content"}],"minimum_patient_share_percent":{"value":70,"status":"reported"}},"therapist_actions":{"items":[],"status":"not_reported"},"monitoring_and_safety":{"items":[],"status":"not_reported"},"protection_and_loading":{"items":[],"status":"not_reported"},"unmapped_source_content":{"items":[],"status":"not_applicable"},"progression_and_completion":{"items":[],"status":"not_reported"}}},{"id":"2b060514-f711-5653-a33b-74f8023f9ee6","name_de":"Abhängigkeitssensibilisierung","name_en":"Addiction Awareness","name_pl":"Profilaktyka i rozpoznawanie uzależnień","source_page":16,"module_number":5,"name_original":"Abhängigkeitssensibilisierung","service_codes":["C085","F036","F037","F038"],"structured_content":{"de":{"goals":["Aufklärung über Risiken von Genuss- und Suchtmitteln/Medien, Reflexion über eigenes Konsumverhalten und dessen Auswirkung auf die Gesundheit."],"dosage_and_progression":["mind. 45 Minuten pro Rehabilitation."]},"en":{"goals":["Education on the risks of stimulants, addictive substances, and media; reflection on personal consumption behavior and its impact on health."],"dosage_and_progression":["at least 45 minutes per rehabilitation."]},"pl":{"goals":["Edukacja zwiększająca świadomość ryzyka związanego z używkami, substancjami uzależniającymi i mediami.","Moduł ma skłonić pacjenta do refleksji nad własnym zachowaniem konsumpcyjnym i jego wpływem na zdrowie."],"dosage_and_progression":["Minimum 45 minut w trakcie rehabilitacji."]},"original":{"goals":["Durch Aufklärung und Informationsvermittlung Bewusstsein für die Risiken und Gefahren von Genuss- und Suchtmitteln/Medien zu schaffen und eine Reflexion über das eigene Konsumverhalten und dessen Auswirkung auf die Gesundheit anzustoßen."],"dosage_and_progression":["Mindestdauer pro Rehabilitation: mind. 45 Minuten."]}},"additional_notes_de":"","additional_notes_en":"","additional_notes_pl":"","minimum_patient_share":20,"therapeutic_content_de":"Aufklärung über Risiken von Genuss- und Suchtmitteln/Medien, Reflexion über eigenes Konsumverhalten und dessen Auswirkung auf die Gesundheit.","therapeutic_content_en":"Education on the risks of stimulants, addictive substances, and media; reflection on personal consumption behavior and its impact on health.","therapeutic_content_pl":"Edukacja zwiększająca świadomość ryzyka związanego z używkami, substancjami uzależniającymi i mediami. Moduł ma skłonić pacjenta do refleksji nad własnym zachowaniem konsumpcyjnym i jego wpływem na zdrowie.","minimum_requirements_de":"mind. 45 Minuten pro Rehabilitation.","minimum_requirements_en":"at least 45 minutes per rehabilitation.","minimum_requirements_pl":"Minimum 45 minut w trakcie rehabilitacji.","additional_notes_original":"","therapeutic_content_original":"Durch Aufklärung und Informationsvermittlung Bewusstsein für die Risiken und Gefahren von Genuss- und Suchtmitteln/Medien zu schaffen und eine Reflexion über das eigene Konsumverhalten und dessen Auswirkung auf die Gesundheit anzustoßen.","minimum_requirements_original":"Mindestdauer pro Rehabilitation: mind. 45 Minuten","module_kind":"service_module","structured_content_v2":{"evidence":{"items":[],"status":"not_reported"},"exercises":{"items":[],"status":"not_reported"},"assessment":{"items":[],"status":"not_reported"},"provenance":[{"id":"etm-05-content","pdf_page_to":16,"original_text":"Durch Aufklärung und Informationsvermittlung Bewusstsein für die Risiken und Gefahren von Genuss- und Suchtmitteln/Medien zu schaffen und eine Reflexion über das eigene Konsumverhalten und dessen Auswirkung auf die Gesundheit anzustoßen.","pdf_page_from":16,"section_label":"ETM 05 – Therapeutische Inhalte","source_sha256":"1a358af1b5f2e523c7a5cd954221d8db0deb2bfc1abe6a6cf39c0cf92c38c14c","table_or_figure":null,"source_document_id":"18fabe59-cb81-58f8-b83f-ceab7f91020d","source_content_kind":"text","source_page_label_to":"16","source_page_label_from":"16","translation_verification":{"de":"source_aligned","en":"verified_against_source","pl":"verified_against_source","original":"source_text"}},{"id":"etm-05-delivery","pdf_page_to":16,"original_text":"ETM 05 Abhängigkeitssensibilisierung Therapeutische Inhalte Durch Aufklärung und Informationsvermittlung Bewusstsein für die Risiken und Gefahren von Genuss- und Suchtmitteln/Medien zu schaffen und eine Reflexion über das eigene Konsumverhalten und dessen Auswirkung auf die Gesundheit anzustoßen. Formale Ausgestaltung Mindestdauer pro Rehabilitation: mind. 45 Minuten KTL- Leistungs- einheiten C085 Seminar: Alltagsdrogen F036 Psychologische Gruppenarbeit problemorientiert: Umgang mit Alkohol F037 Psychologische Gruppenarbeit problemorientiert: Umgang mit Medien F038 Psychologische Gruppenarbeit problemorientiert: Rauchentwöhnung Mindestanteil entsprechend zu behandelnder Rehabilitand*innen mind. 20 % Weitere Hinweise","pdf_page_from":16,"section_label":"ETM 05 – Formale Ausgestaltung und KTL-Leistungseinheiten","source_sha256":"1a358af1b5f2e523c7a5cd954221d8db0deb2bfc1abe6a6cf39c0cf92c38c14c","table_or_figure":null,"source_document_id":"18fabe59-cb81-58f8-b83f-ceab7f91020d","source_content_kind":"table","source_page_label_to":"16","source_page_label_from":"16","translation_verification":{"de":"source_aligned","en":"verified_against_source","pl":"verified_against_source","original":"source_text"}}],"content_kind":"service_module","contract_version":"1.2","service_delivery":{"status":"reported","performers":{"items":[],"status":"not_reported"},"service_units":[{"code":"C085","code_system":"KTL","source_group":null,"label_original":"Seminar: Alltagsdrogen","code_system_version":"2025"},{"code":"F036","code_system":"KTL","source_group":null,"label_original":"Psychologische Gruppenarbeit problemorientiert: Umgang mit Alkohol","code_system_version":"2025"},{"code":"F037","code_system":"KTL","source_group":null,"label_original":"Psychologische Gruppenarbeit problemorientiert: Umgang mit Medien","code_system_version":"2025"},{"code":"F038","code_system":"KTL","source_group":null,"label_original":"Psychologische Gruppenarbeit problemorientiert: Rauchentwöhnung","code_system_version":"2025"}],"additional_rules":[],"minimum_duration":{"basis":"per_rehabilitation","status":"reported","minutes":45},"minimum_frequency":{"basis":null,"count":null,"status":"not_reported"},"therapeutic_content":[{"id":"etm-05-therapeutic-content","text":{"de":"Durch Aufklärung und Informationsvermittlung Bewusstsein für die Risiken und Gefahren von Genuss- und Suchtmitteln/Medien zu schaffen und eine Reflexion über das eigene Konsumverhalten und dessen Auswirkung auf die Gesundheit anzustoßen.","en":"Use education and information to build awareness of the risks and dangers associated with recreational substances, addictive substances, and media, and prompt reflection on the patient’s own consumption behavior and its effects on health.","pl":"Edukacja zwiększająca świadomość ryzyka związanego z używkami, substancjami uzależniającymi i mediami. Moduł ma skłonić pacjenta do refleksji nad własnym zachowaniem konsumpcyjnym i jego wpływem na zdrowie.","original":"Durch Aufklärung und Informationsvermittlung Bewusstsein für die Risiken und Gefahren von Genuss- und Suchtmitteln/Medien zu schaffen und eine Reflexion über das eigene Konsumverhalten und dessen Auswirkung auf die Gesundheit anzustoßen."},"provenance_id":"etm-05-content"}],"minimum_patient_share_percent":{"value":20,"status":"reported"}},"therapist_actions":{"items":[],"status":"not_reported"},"monitoring_and_safety":{"items":[],"status":"not_reported"},"protection_and_loading":{"items":[],"status":"not_reported"},"unmapped_source_content":{"items":[],"status":"not_applicable"},"progression_and_completion":{"items":[],"status":"not_reported"}}},{"id":"94631016-b929-51cf-ac50-7855a007081b","name_de":"Funktionelle und arbeitsweltbezogene Therapien","name_en":"Functional and Vocational Therapies","name_pl":"Terapie funkcjonalne i związane z pracą","source_page":17,"module_number":6,"name_original":"Funktionelle und arbeitsweltbezogene Therapien","service_codes":["E011","E012","E021","E031","E041","E042","E051","E061","E062","E063","E069","E071","E082","E111","H271","H272"],"structured_content":{"de":{"goals":["Training von Fertigkeiten, Selbstwirksamkeit und Durchhaltevermögen mit Bezug zu Beruf (körperliche Anforderungen) und Alltag (ADL, Gehfähigkeit).","Stufenweise Heranführung an Grundanforderungen, Konsolidierung basaler Arbeitsfähigkeiten, Stärkung beruflicher Handlungskompetenz."],"dosage_and_progression":["mind. 60 Minuten pro Woche."]},"en":{"goals":["Training of skills, self-efficacy, and endurance related to work (physical requirements) and daily life (ADL, walking ability).","Gradual introduction to basic requirements, consolidation of fundamental work abilities, and strengthening vocational competence."],"dosage_and_progression":["at least 60 minutes per week."]},"pl":{"goals":["Interwencje dostosowane do indywidualnych potrzeb, zasobów, czynników kontekstowych, motywacji i ograniczeń wydolności.","Obejmują trening umiejętności, poczucia własnej skuteczności i wytrzymałości w czynnościach ważnych zawodowo lub w życiu codziennym, takich jak konkretne wymagania fizyczne, czynności dnia codziennego i chodzenie.","Pacjent jest stopniowo przygotowywany do podstawowych wymagań życia i pracy oraz wzmacnia kompetencje zawodowe."],"dosage_and_progression":["Minimum 60 minut tygodniowo."]},"original":{"goals":["Auf individuellen Bedarf, Ressourcen, Kontextfaktoren, Motivationslage und Leistungsgrenzen abgestimmte Interventionen v.a. zum Training von Fertigkeiten, Selbstwirksamkeit und Durchhaltevermögen mit Bezug zu individuell relevanten Tätigkeiten im Bereich Beruf (z. B. konkrete körperliche Anforderungen) und/oder Alltag (z. B. ADL, Gehfähigkeit).","Stufenweise Heranführung an die Grundanforderungen des Alltags- und Arbeitslebens, Konsolidierung basaler Arbeitsfähigkeiten und je nach Berufsfeld, Arbeitsplatz und Arbeitssituation Stärkung der beruflichen Handlungskompetenz."],"dosage_and_progression":["Mindestdauer pro Woche: mind. 60 Minuten."]}},"additional_notes_de":"","additional_notes_en":"","additional_notes_pl":"","minimum_patient_share":50,"therapeutic_content_de":"Training von Fertigkeiten, Selbstwirksamkeit und Durchhaltevermögen mit Bezug zu Beruf (körperliche Anforderungen) und Alltag (ADL, Gehfähigkeit). Stufenweise Heranführung an Grundanforderungen, Konsolidierung basaler Arbeitsfähigkeiten, Stärkung beruflicher Handlungskompetenz.","therapeutic_content_en":"Training of skills, self-efficacy, and endurance related to work (physical requirements) and daily life (ADL, walking ability). Gradual introduction to basic requirements, consolidation of fundamental work abilities, and strengthening vocational competence.","therapeutic_content_pl":"Interwencje dostosowane do indywidualnych potrzeb, zasobów, czynników kontekstowych, motywacji i ograniczeń wydolności. Obejmują trening umiejętności, poczucia własnej skuteczności i wytrzymałości w czynnościach ważnych zawodowo lub w życiu codziennym, takich jak konkretne wymagania fizyczne, czynności dnia codziennego i chodzenie. Pacjent jest stopniowo przygotowywany do podstawowych wymagań życia i pracy oraz wzmacnia kompetencje zawodowe.","minimum_requirements_de":"mind. 60 Minuten pro Woche.","minimum_requirements_en":"at least 60 minutes per week.","minimum_requirements_pl":"Minimum 60 minut tygodniowo.","additional_notes_original":"","therapeutic_content_original":"Auf individuellen Bedarf, Ressourcen, Kontextfaktoren, Motivationslage und Leistungsgrenzen abgestimmte Interventionen v.a. zum Training von Fertigkeiten, Selbstwirksamkeit und Durchhaltevermögen mit Bezug zu individuell relevanten Tätigkeiten im Bereich Beruf (z. B. konkrete körperliche Anforderungen) und/oder Alltag (z. B. ADL, Gehfähigkeit). Stufenweise Heranführung an die Grundanforderungen des Alltags- und Arbeitslebens, Konsolidierung basaler Arbeitsfähigkeiten und je nach Berufsfeld, Arbeitsplatz und Arbeitssituation Stärkung der beruflichen Handlungskompetenz.","minimum_requirements_original":"Mindestdauer pro Woche: mind. 60 Minuten","module_kind":"service_module","structured_content_v2":{"evidence":{"items":[],"status":"not_reported"},"exercises":{"items":[],"status":"not_reported"},"assessment":{"items":[],"status":"not_reported"},"provenance":[{"id":"etm-06-content","pdf_page_to":17,"original_text":"Auf individuellen Bedarf, Ressourcen, Kontextfaktoren, Motivationslage und Leistungsgrenzen abgestimmte Interventionen v.a. zum Training von Fertigkeiten, Selbstwirksamkeit und Durchhaltevermögen mit Bezug zu individuell relevanten Tätigkeiten im Bereich Beruf (z. B. konkrete körperliche Anforderungen) und/oder Alltag (z. B. ADL, Gehfähigkeit). 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B. konkrete körperliche Anforderungen) und/oder Alltag (z. B. ADL, Gehfähigkeit). Stufenweise Heranführung an die Grundanforderungen des Alltags- und Arbeitslebens, Konsolidierung basaler Arbeitsfähigkeiten und je nach Berufsfeld, Arbeitsplatz und Arbeitssituation Stärkung der beruflichen Handlungskompetenz.","en":"Tailor interventions to individual needs, resources, contextual factors, motivation, and performance limits, particularly to train skills, self-efficacy, and perseverance in personally relevant work activities, such as specific physical demands, and/or daily activities, such as ADLs and walking. Gradually prepare the patient for the basic demands of daily and working life, consolidate fundamental work abilities, and strengthen occupational competence according to the profession, workplace, and work situation.","pl":"Interwencje dostosowane do indywidualnych potrzeb, zasobów, czynników kontekstowych, motywacji i ograniczeń wydolności. 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Neben dem aktiven Einüben sollte das Angebot auch die Erarbeitung von Strategien für die Anwendung im Alltag enthalten.","en":"Teach and train relaxation techniques and methods, such as autogenic training and Jacobson progressive muscle relaxation, as practical interventions, together with mindfulness-oriented methods for stress regulation. In addition to active practice, develop strategies for applying the methods in daily life.","pl":"Nauka i trening technik relaksacyjnych, takich jak trening autogenny i progresywna relaksacja mięśni Jacobsona, oraz metod opartych na uważności służących regulacji stresu. Oprócz ćwiczeń praktycznych moduł powinien obejmować strategie stosowania tych metod w codziennym życiu.","original":"Vermittlung und Training von Entspannungstechniken und -verfahren (z. B. autogenes Training, Muskelrelaxation nach Jacobson) als praktische Intervention und achtsamkeitsorientierte Verfahren zur Stressregulierung. Neben dem aktiven Einüben sollte das Angebot auch die Erarbeitung von Strategien für die Anwendung im Alltag enthalten."},"provenance_id":"etm-08-content"}],"minimum_patient_share_percent":{"value":20,"status":"reported"}},"therapist_actions":{"items":[],"status":"not_reported"},"monitoring_and_safety":{"items":[],"status":"not_reported"},"protection_and_loading":{"items":[],"status":"not_reported"},"unmapped_source_content":{"items":[],"status":"not_applicable"},"progression_and_completion":{"items":[],"status":"not_reported"}}},{"id":"3311d948-15d7-5cf5-9503-ecd4aeb80e27","name_de":"Leistungen zur sozialen und beruflichen Integration","name_en":"Social and Vocational Integration","name_pl":"Integracja społeczna i zawodowa","source_page":19,"module_number":9,"name_original":"Leistungen zur sozialen und beruflichen Integration","service_codes":["C011","C031","D011","D012","D013","D021","D022","D023","D029","D041","D043","D045","D046","D049","D051"],"structured_content":{"de":{"goals":["Beratung zu sozialen, beruflichen und sozialrechtlichen Themen.","Unterstützung bei Problemlagen, Abgleich von Anforderungen mit Fähigkeitsprofil, Förderung der Eingliederung ins Erwerbsleben."],"warnings":["z. 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Fragen zu wirtschaftlicher Sicherung, Rentenfragen, Klärung sozialrechtlicher Fragen, Wohnungsfragen."],"dosage_and_progression":["mind. 45 Minuten pro Rehabilitation."]},"en":{"goals":["Counseling on social, vocational, and social law topics.","Support in problem situations, matching requirements with ability profile, and promoting integration into the workforce."],"warnings":["e.g., questions on financial security, pension issues, social law, or housing."],"dosage_and_progression":["at least 45 minutes per rehabilitation."]},"pl":{"goals":["Poradnictwo dotyczące spraw społecznych, zawodowych i socjalnoprawnych oraz wsparcie przy problemach społecznych lub zawodowych.","Obejmuje porównanie wymagań zawodowych z aktualnym profilem możliwości pacjenta i wspieranie jego powrotu do aktywności zawodowej."],"warnings":["Może obejmować zabezpieczenie ekonomiczne, sprawy emerytalne i rentowe, wyjaśnienie zagadnień socjalnoprawnych oraz mieszkaniowych."],"dosage_and_progression":["Minimum 45 minut w trakcie rehabilitacji."]},"original":{"goals":["Beratung zu sozialen, beruflichen und sozialrechtlichen Themen sowie Angebote zur Unterstützung bei sozialen oder beruflichen Problemlagen inkl. Abgleich von beruflichen und arbeitsbezogenen Anforderungen und aktuellem Fähigkeitsprofil, Förderung der Eingliederung ins Erwerbsleben."],"warnings":["z. B. Fragen zu wirtschaftlicher Sicherung, Rentenfragen, Klärung sozialrechtlicher Fragen, Wohnungsfragen."],"dosage_and_progression":["Mindestdauer pro Rehabilitation: mind. 45 Minuten."]}},"additional_notes_de":"z. B. Fragen zu wirtschaftlicher Sicherung, Rentenfragen, Klärung sozialrechtlicher Fragen, Wohnungsfragen.","additional_notes_en":"e.g., questions on financial security, pension issues, social law, or housing.","additional_notes_pl":"Może obejmować zabezpieczenie ekonomiczne, sprawy emerytalne i rentowe, wyjaśnienie zagadnień socjalnoprawnych oraz mieszkaniowych.","minimum_patient_share":70,"therapeutic_content_de":"Beratung zu sozialen, beruflichen und sozialrechtlichen Themen. Unterstützung bei Problemlagen, Abgleich von Anforderungen mit Fähigkeitsprofil, Förderung der Eingliederung ins Erwerbsleben.","therapeutic_content_en":"Counseling on social, vocational, and social law topics. Support in problem situations, matching requirements with ability profile, and promoting integration into the workforce.","therapeutic_content_pl":"Poradnictwo dotyczące spraw społecznych, zawodowych i socjalnoprawnych oraz wsparcie przy problemach społecznych lub zawodowych. Obejmuje porównanie wymagań zawodowych z aktualnym profilem możliwości pacjenta i wspieranie jego powrotu do aktywności zawodowej.","minimum_requirements_de":"mind. 45 Minuten pro Rehabilitation.","minimum_requirements_en":"at least 45 minutes per rehabilitation.","minimum_requirements_pl":"Minimum 45 minut w trakcie rehabilitacji.","additional_notes_original":"z. B. Fragen zu wirtschaftlicher Sicherung, Rentenfragen, Klärung sozialrechtlicher Fragen, Wohnungsfragen","therapeutic_content_original":"Beratung zu sozialen, beruflichen und sozialrechtlichen Themen sowie Angebote zur Unterstützung bei sozialen oder beruflichen Problemlagen inkl. Abgleich von beruflichen und arbeitsbezogenen Anforderungen und aktuellem Fähigkeitsprofil, Förderung der Eingliederung ins Erwerbsleben","minimum_requirements_original":"Mindestdauer pro Rehabilitation: mind. 45 Minuten","module_kind":"service_module","structured_content_v2":{"evidence":{"items":[],"status":"not_reported"},"exercises":{"items":[],"status":"not_reported"},"assessment":{"items":[],"status":"not_reported"},"provenance":[{"id":"etm-09-content","pdf_page_to":19,"original_text":"Beratung zu sozialen, beruflichen und sozialrechtlichen Themen sowie Angebote zur Unterstützung bei sozialen oder beruflichen Problemlagen inkl. Abgleich von beruflichen und arbeitsbezogenen Anforderungen und aktuellem Fähigkeitsprofil, Förderung der Eingliederung ins Erwerbsleben","pdf_page_from":19,"section_label":"ETM 09 – Therapeutische Inhalte","source_sha256":"1a358af1b5f2e523c7a5cd954221d8db0deb2bfc1abe6a6cf39c0cf92c38c14c","table_or_figure":null,"source_document_id":"18fabe59-cb81-58f8-b83f-ceab7f91020d","source_content_kind":"text","source_page_label_to":"19","source_page_label_from":"19","translation_verification":{"de":"source_aligned","en":"verified_against_source","pl":"verified_against_source","original":"source_text"}},{"id":"etm-09-delivery","pdf_page_to":19,"original_text":"$1c","pdf_page_from":19,"section_label":"ETM 09 – Formale Ausgestaltung und KTL-Leistungseinheiten","source_sha256":"1a358af1b5f2e523c7a5cd954221d8db0deb2bfc1abe6a6cf39c0cf92c38c14c","table_or_figure":null,"source_document_id":"18fabe59-cb81-58f8-b83f-ceab7f91020d","source_content_kind":"table","source_page_label_to":"19","source_page_label_from":"19","translation_verification":{"de":"source_aligned","en":"verified_against_source","pl":"verified_against_source","original":"source_text"}}],"content_kind":"service_module","contract_version":"1.2","service_delivery":{"status":"reported","performers":{"items":[],"status":"not_reported"},"service_units":[{"code":"C011","code_system":"KTL","source_group":null,"label_original":"Ärztliche sozialmedizinische Beratung","code_system_version":"2025"},{"code":"C031","code_system":"KTL","source_group":null,"label_original":"Gespräche mit Rehabilitand und Betriebsangehörigen","code_system_version":"2025"},{"code":"D011","code_system":"KTL","source_group":null,"label_original":"Psychosoziale Beratung","code_system_version":"2025"},{"code":"D012","code_system":"KTL","source_group":null,"label_original":"Sozialrechtliche Beratung","code_system_version":"2025"},{"code":"D013","code_system":"KTL","source_group":null,"label_original":"Orientierende Sozialberatung","code_system_version":"2025"},{"code":"D021","code_system":"KTL","source_group":null,"label_original":"Beratung zu Leistungen zur Teilhabe am Arbeitsleben","code_system_version":"2025"},{"code":"D022","code_system":"KTL","source_group":null,"label_original":"Beratung zur stufenweisen Wiedereingliederung","code_system_version":"2025"},{"code":"D023","code_system":"KTL","source_group":null,"label_original":"Beratung zu beruflichen Perspektiven und Berufsklärung","code_system_version":"2025"},{"code":"D029","code_system":"KTL","source_group":null,"label_original":"Sonstige Beratung zur beruflichen Integration","code_system_version":"2025"},{"code":"D041","code_system":"KTL","source_group":null,"label_original":"Soziale Arbeit: Umgang mit beruflichen Belastungen und Konflikten am Arbeitsplatz","code_system_version":"2025"},{"code":"D043","code_system":"KTL","source_group":null,"label_original":"Soziale Arbeit: Berufliche Orientierung und berufliche Integration","code_system_version":"2025"},{"code":"D045","code_system":"KTL","source_group":null,"label_original":"Soziale Arbeit: Sozialrechtliche Fragen","code_system_version":"2025"},{"code":"D046","code_system":"KTL","source_group":null,"label_original":"Soziale Arbeit: Training der sozialen Kompetenz","code_system_version":"2025"},{"code":"D049","code_system":"KTL","source_group":null,"label_original":"Sonstige soziale Arbeit","code_system_version":"2025"},{"code":"D051","code_system":"KTL","source_group":null,"label_original":"Angehörigengespräch psychosozial","code_system_version":"2025"}],"additional_rules":[{"id":"etm-09-additional-rule","text":{"de":"z. B. Fragen zu wirtschaftlicher Sicherung, Rentenfragen, Klärung sozialrechtlicher Fragen, Wohnungsfragen","en":"Examples include financial security, pension matters, clarification of social-law issues, and housing matters.","pl":"Może obejmować zabezpieczenie ekonomiczne, sprawy emerytalne i rentowe, wyjaśnienie zagadnień socjalnoprawnych oraz mieszkaniowych.","original":"z. B. Fragen zu wirtschaftlicher Sicherung, Rentenfragen, Klärung sozialrechtlicher Fragen, Wohnungsfragen"},"provenance_id":"etm-09-delivery"}],"minimum_duration":{"basis":"per_rehabilitation","status":"reported","minutes":45},"minimum_frequency":{"basis":null,"count":null,"status":"not_reported"},"therapeutic_content":[{"id":"etm-09-therapeutic-content","text":{"de":"Beratung zu sozialen, beruflichen und sozialrechtlichen Themen sowie Angebote zur Unterstützung bei sozialen oder beruflichen Problemlagen inkl. Abgleich von beruflichen und arbeitsbezogenen Anforderungen und aktuellem Fähigkeitsprofil, Förderung der Eingliederung ins Erwerbsleben","en":"Provide counseling on social, occupational, and social-law matters and support for social or occupational problems, including comparison of occupational and work-related demands with the patient’s current ability profile, and promote reintegration into working life.","pl":"Poradnictwo dotyczące spraw społecznych, zawodowych i socjalnoprawnych oraz wsparcie przy problemach społecznych lub zawodowych. Obejmuje porównanie wymagań zawodowych z aktualnym profilem możliwości pacjenta i wspieranie jego powrotu do aktywności zawodowej.","original":"Beratung zu sozialen, beruflichen und sozialrechtlichen Themen sowie Angebote zur Unterstützung bei sozialen oder beruflichen Problemlagen inkl. Abgleich von beruflichen und arbeitsbezogenen Anforderungen und aktuellem Fähigkeitsprofil, Förderung der Eingliederung ins Erwerbsleben"},"provenance_id":"etm-09-content"}],"minimum_patient_share_percent":{"value":70,"status":"reported"}},"therapist_actions":{"items":[],"status":"not_reported"},"monitoring_and_safety":{"items":[],"status":"not_reported"},"protection_and_loading":{"items":[],"status":"not_reported"},"unmapped_source_content":{"items":[],"status":"not_applicable"},"progression_and_completion":{"items":[],"status":"not_reported"}}},{"id":"11117e89-171b-5c68-a9f7-5aaec82c52eb","name_de":"Beratung nachgehender Leistungen","name_en":"Aftercare Counseling","name_pl":"Planowanie dalszej opieki i rehabilitacji","source_page":20,"module_number":10,"name_original":"Beratung nachgehender Leistungen","service_codes":["D031","D032","D033","D039","D044"],"structured_content":{"de":{"goals":["Beratung zu Maßnahmen zur Stabilisierung des Behandlungserfolgs.","Information zu Reha-Nachsorge, Fallmanagement, Selbsthilfe; Anbahnung von Kontaktgesprächen zu Vor- und Nachbehandlern."],"warnings":["Jede Abstimmung oder Anleitung geht maximal einmal in die Erfüllung der RTS ein."],"dosage_and_progression":["mind. 30 Minuten pro Rehabilitation."]},"en":{"goals":["Counseling on measures to stabilize treatment success.","Information on rehab aftercare, case management, and self-help; initiating contact with pre- and post-treatment providers."],"warnings":["Each coordination or instruction counts a maximum of once towards fulfillment."],"dosage_and_progression":["at least 30 minutes per rehabilitation."]},"pl":{"goals":["Poradnictwo dotyczące odpowiednich działań następczych i dalszego leczenia, które stabilizują wynik rehabilitacji.","Obejmuje informacje o rehabilitacji następczej, zarządzaniu przypadkiem, aktywnościach indywidualnych i zorganizowanych, możliwościach samopomocy oraz nawiązywanie kontaktu z osobami prowadzącymi leczenie przed i po rehabilitacji."],"warnings":["Każde uzgodnienie lub instruktaż można zaliczyć do realizacji RTS maksymalnie jeden raz."],"dosage_and_progression":["Minimum 30 minut w trakcie rehabilitacji."]},"original":{"goals":["Beratung zu geeigneten nach- und weitergehenden Maßnahmen zur Stabilisierung des Behandlungserfolgs; Informationsvermittlung zu Angeboten der Reha-Nachsorge und des Fallmanagements, sowie mögliche individuelle oder organisierte Aktivitäten und Selbsthilfemöglichkeiten, die Lebensstiländerungen und Krankheitsbewältigung unterstützen sowie Anbahnung von Kontaktgesprächen zu Vor- und Nachbehandler*innen."],"warnings":["Jede Abstimmung oder Anleitung geht maximal einmal in die Erfüllung der RTS ein."],"dosage_and_progression":["Mindestdauer pro Rehabilitation: mind. 30 Minuten."]}},"additional_notes_de":"Jede Abstimmung oder Anleitung geht maximal einmal in die Erfüllung der RTS ein.","additional_notes_en":"Each coordination or instruction counts a maximum of once towards fulfillment.","additional_notes_pl":"Każde uzgodnienie lub instruktaż można zaliczyć do realizacji RTS maksymalnie jeden raz.","minimum_patient_share":80,"therapeutic_content_de":"Beratung zu Maßnahmen zur Stabilisierung des Behandlungserfolgs. Information zu Reha-Nachsorge, Fallmanagement, Selbsthilfe; Anbahnung von Kontaktgesprächen zu Vor- und Nachbehandlern.","therapeutic_content_en":"Counseling on measures to stabilize treatment success. Information on rehab aftercare, case management, and self-help; initiating contact with pre- and post-treatment providers.","therapeutic_content_pl":"Poradnictwo dotyczące odpowiednich działań następczych i dalszego leczenia, które stabilizują wynik rehabilitacji. Obejmuje informacje o rehabilitacji następczej, zarządzaniu przypadkiem, aktywnościach indywidualnych i zorganizowanych, możliwościach samopomocy oraz nawiązywanie kontaktu z osobami prowadzącymi leczenie przed i po rehabilitacji.","minimum_requirements_de":"mind. 30 Minuten pro Rehabilitation.","minimum_requirements_en":"at least 30 minutes per rehabilitation.","minimum_requirements_pl":"Minimum 30 minut w trakcie rehabilitacji.","additional_notes_original":"Jede Abstimmung oder Anleitung geht maximal einmal in die Erfüllung der RTS ein.","therapeutic_content_original":"Beratung zu geeigneten nach- und weitergehenden Maßnahmen zur Stabilisierung des Behandlungserfolgs; Informationsvermittlung zu Angeboten der Reha-Nachsorge und des Fallmanagements, sowie mögliche individuelle oder organisierte Aktivitäten und Selbsthilfemöglichkeiten, die Lebensstiländerungen und Krankheitsbewältigung unterstützen sowie Anbahnung von Kontaktgesprächen zu Vor- und Nachbehandler*innen.","minimum_requirements_original":"Mindestdauer pro Rehabilitation: mind. 30 Minuten","module_kind":"service_module","structured_content_v2":{"evidence":{"items":[],"status":"not_reported"},"exercises":{"items":[],"status":"not_reported"},"assessment":{"items":[],"status":"not_reported"},"provenance":[{"id":"etm-10-content","pdf_page_to":20,"original_text":"Beratung zu geeigneten nach- und weitergehenden Maßnahmen zur Stabilisierung des Behandlungserfolgs; Informationsvermittlung zu Angeboten der Reha-Nachsorge und des Fallmanagements, sowie mögliche individuelle oder organisierte Aktivitäten und Selbsthilfemöglichkeiten, die Lebensstiländerungen und Krankheitsbewältigung unterstützen sowie Anbahnung von Kontaktgesprächen zu Vor- und Nachbehandler*innen.","pdf_page_from":20,"section_label":"ETM 10 – Therapeutische Inhalte","source_sha256":"1a358af1b5f2e523c7a5cd954221d8db0deb2bfc1abe6a6cf39c0cf92c38c14c","table_or_figure":null,"source_document_id":"18fabe59-cb81-58f8-b83f-ceab7f91020d","source_content_kind":"text","source_page_label_to":"20","source_page_label_from":"20","translation_verification":{"de":"source_aligned","en":"verified_against_source","pl":"verified_against_source","original":"source_text"}},{"id":"etm-10-delivery","pdf_page_to":20,"original_text":"$1d","pdf_page_from":20,"section_label":"ETM 10 – Formale Ausgestaltung und KTL-Leistungseinheiten","source_sha256":"1a358af1b5f2e523c7a5cd954221d8db0deb2bfc1abe6a6cf39c0cf92c38c14c","table_or_figure":null,"source_document_id":"18fabe59-cb81-58f8-b83f-ceab7f91020d","source_content_kind":"table","source_page_label_to":"20","source_page_label_from":"20","translation_verification":{"de":"source_aligned","en":"verified_against_source","pl":"verified_against_source","original":"source_text"}}],"content_kind":"service_module","contract_version":"1.2","service_delivery":{"status":"reported","performers":{"items":[],"status":"not_reported"},"service_units":[{"code":"D031","code_system":"KTL","source_group":null,"label_original":"Beratung zu ambulanten bzw. stationären Hilfen und Pflege","code_system_version":"2025"},{"code":"D032","code_system":"KTL","source_group":null,"label_original":"Abstimmung zu Kontakt- und Informationsgesprächen mit Vor- und Nachbehandlern","code_system_version":"2025"},{"code":"D033","code_system":"KTL","source_group":null,"label_original":"Beratung zu Nachsorgeangeboten, Selbsthilfegruppen und externen Beratungsstellen","code_system_version":"2025"},{"code":"D039","code_system":"KTL","source_group":null,"label_original":"Sonstige Beratung zu Nachsorge und weitergehenden Maßnahmen","code_system_version":"2025"},{"code":"D044","code_system":"KTL","source_group":null,"label_original":"Soziale Arbeit: Nachsorge und weitergehende Maßnahmen","code_system_version":"2025"}],"additional_rules":[{"id":"etm-10-additional-rule","text":{"de":"Jede Abstimmung oder Anleitung geht maximal einmal in die Erfüllung der RTS ein.","en":"Each coordination activity or instruction counts no more than once toward RTS fulfillment.","pl":"Każde uzgodnienie lub instruktaż można zaliczyć do realizacji RTS maksymalnie jeden raz.","original":"Jede Abstimmung oder Anleitung geht maximal einmal in die Erfüllung der RTS ein."},"provenance_id":"etm-10-delivery"}],"minimum_duration":{"basis":"per_rehabilitation","status":"reported","minutes":30},"minimum_frequency":{"basis":null,"count":null,"status":"not_reported"},"therapeutic_content":[{"id":"etm-10-therapeutic-content","text":{"de":"Beratung zu geeigneten nach- und weitergehenden Maßnahmen zur Stabilisierung des Behandlungserfolgs; Informationsvermittlung zu Angeboten der Reha-Nachsorge und des Fallmanagements, sowie mögliche individuelle oder organisierte Aktivitäten und Selbsthilfemöglichkeiten, die Lebensstiländerungen und Krankheitsbewältigung unterstützen sowie Anbahnung von Kontaktgesprächen zu Vor- und Nachbehandler*innen.","en":"Advise on suitable follow-up and continuing measures to stabilize the treatment outcome. Provide information about rehabilitation aftercare and case management, individual or organized activities, and self-help options that support lifestyle change and coping with illness, and initiate contact discussions with providers involved before and after rehabilitation.","pl":"Poradnictwo dotyczące odpowiednich działań następczych i dalszego leczenia, które stabilizują wynik rehabilitacji. Obejmuje informacje o rehabilitacji następczej, zarządzaniu przypadkiem, aktywnościach indywidualnych i zorganizowanych, możliwościach samopomocy oraz nawiązywanie kontaktu z osobami prowadzącymi leczenie przed i po rehabilitacji.","original":"Beratung zu geeigneten nach- und weitergehenden Maßnahmen zur Stabilisierung des Behandlungserfolgs; Informationsvermittlung zu Angeboten der Reha-Nachsorge und des Fallmanagements, sowie mögliche individuelle oder organisierte Aktivitäten und Selbsthilfemöglichkeiten, die Lebensstiländerungen und Krankheitsbewältigung unterstützen sowie Anbahnung von Kontaktgesprächen zu Vor- und Nachbehandler*innen."},"provenance_id":"etm-10-content"}],"minimum_patient_share_percent":{"value":80,"status":"reported"}},"therapist_actions":{"items":[],"status":"not_reported"},"monitoring_and_safety":{"items":[],"status":"not_reported"},"protection_and_loading":{"items":[],"status":"not_reported"},"unmapped_source_content":{"items":[],"status":"not_applicable"},"progression_and_completion":{"items":[],"status":"not_reported"}}},{"id":"c2bc6cf8-51dd-59c5-ac14-77dd22f4b829","name_de":"Alltagstraining","name_en":"Activities of Daily Living (ADL) Training","name_pl":"Trening czynności dnia codziennego","source_page":20,"module_number":11,"name_original":"Alltagstraining","service_codes":["E081","E091","E101","E102","E103","E109","H021","H049","H081","H201","L031","L041"],"structured_content":{"de":{"goals":["Training zur Verbesserung von Alltagsaktivitäten, Wiederherstellung/Erhalt der körperlichen Selbstversorgung oder eigenständigen Lebensführung.","Umgang mit Hilfsmitteln und Integration der Einschränkung ins Leben."],"warnings":["Jede Abstimmung oder Anleitung geht maximal einmal in die Erfüllung der RTS ein."],"dosage_and_progression":["mind. 30 Minuten pro Woche."]},"en":{"goals":["Training to improve daily activities, restoring/maintaining physical self-care or independent living.","Managing assistive devices and integrating limitations into daily life."],"warnings":["Each coordination or instruction counts a maximum of once towards fulfillment."],"dosage_and_progression":["at least 30 minutes per week."]},"pl":{"goals":["Ukierunkowany trening poprawiający aktywności dnia codziennego oraz przywracający, poprawiający lub podtrzymujący samodzielną samoobsługę i niezależne funkcjonowanie.","Pacjent uczy się korzystania z pomocy technicznych, radzenia sobie z ograniczeniami i włączania choroby lub niepełnosprawności w codzienne życie."],"warnings":["Każde uzgodnienie lub instruktaż można zaliczyć do realizacji RTS maksymalnie jeden raz."],"dosage_and_progression":["Minimum 30 minut tygodniowo."]},"original":{"goals":["Gezieltes Training zur Verbesserung der Alltagsaktivitäten, Wiederherstellung/ Verbesserung oder Erhalt der körperlichen Selbstversorgung oder der eigenständigen Lebensführung.","Lernen, mit Hilfsmitteln und Einschränkungen umzugehen und die Krankheit/Behinderung in das Leben zu integrieren."],"warnings":["Jede Abstimmung oder Anleitung geht maximal einmal in die Erfüllung der RTS ein."],"dosage_and_progression":["Mindestdauer pro Woche: mind. 30 Minuten."]}},"additional_notes_de":"Jede Abstimmung oder Anleitung geht maximal einmal in die Erfüllung der RTS ein.","additional_notes_en":"Each coordination or instruction counts a maximum of once towards fulfillment.","additional_notes_pl":"Każde uzgodnienie lub instruktaż można zaliczyć do realizacji RTS maksymalnie jeden raz.","minimum_patient_share":50,"therapeutic_content_de":"Training zur Verbesserung von Alltagsaktivitäten, Wiederherstellung/Erhalt der körperlichen Selbstversorgung oder eigenständigen Lebensführung. 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In die Auswertung zur Reha-Qualitätssicherung gehen alle Rehabili- tand*innen (nur Anschlussrehabilitation, AHB) ab 18 Jahre ein, deren Behandlungsdauer zwischen 18 und 42 Tagen lag.","pdf_page_from":11,"section_label":"14. Geltungsbereich","source_sha256":"1a358af1b5f2e523c7a5cd954221d8db0deb2bfc1abe6a6cf39c0cf92c38c14c","table_or_figure":null,"source_document_id":"18fabe59-cb81-58f8-b83f-ceab7f91020d","source_content_kind":"text","source_page_label_to":"11","source_page_label_from":"11","translation_verification":{"de":"source_aligned","en":"verified_against_source","pl":"verified_against_source","original":"source_text"}},{"id":"protocol-weekly-values-are-averages","pdf_page_to":6,"original_text":"Der zeitliche Bezugsrahmen „pro Woche“ ist dabei als rechnerische Größe zu verstehen, d.h. die angegebene Mindestdauer/Mindesthäufigkeit stellt einen Durchschnittswert bezogen auf die Gesamtdauer des Reha- Aufenthalts dar. Mit anderen Worten, die Leistung muss in dem genannten Umfang nicht in jeder Woche des Reha-Aufenthalts erbracht werden.","pdf_page_from":6,"section_label":"3.2. Formale Ausgestaltung","source_sha256":"1a358af1b5f2e523c7a5cd954221d8db0deb2bfc1abe6a6cf39c0cf92c38c14c","table_or_figure":null,"source_document_id":"18fabe59-cb81-58f8-b83f-ceab7f91020d","source_content_kind":"text","source_page_label_to":"6","source_page_label_from":"6","translation_verification":{"de":"source_aligned","en":"verified_against_source","pl":"verified_against_source","original":"source_text"}},{"id":"protocol-ktl-units-are-options","pdf_page_to":6,"original_text":"Im Abschnitt „KTL-Leistungs einheiten“ sind alle für das ETM in Frage kommenden bzw. möglichen Interventionen in Form von KTL-Codes der KTL 2025 aufgelistet. Aus einer Vielzahl an Leistungen können für die Rehabilitand*innen die am besten geeigneten und die dem Therapie- konzept der Einrichtung entsprechenden Behandlungselemente ausge- wählt werden. Nicht alle angegebenen KTL-Codes eines ETM müssen verwendet werden.","pdf_page_from":6,"section_label":"3.3. KTL-Leistungseinheiten","source_sha256":"1a358af1b5f2e523c7a5cd954221d8db0deb2bfc1abe6a6cf39c0cf92c38c14c","table_or_figure":null,"source_document_id":"18fabe59-cb81-58f8-b83f-ceab7f91020d","source_content_kind":"text","source_page_label_to":"6","source_page_label_from":"6","translation_verification":{"de":"source_aligned","en":"verified_against_source","pl":"verified_against_source","original":"source_text"}},{"id":"protocol-minimums-and-individual-need","pdf_page_to":7,"original_text":"Mindestanteil, Mindestdauer und ggf. Mindesthäufigkeit definieren die untere Grenze des Leistungsspektrums für eine adäquate Rehabilitation und sollten deshalb nicht unterschritten werden. Ein Überschreiten der Mindestanforderungen ist nicht nur wünschenswert, sondern in vielen Fällen auch aus therapeutischer Sicht erforderlich. Letztlich müssen sich die zu erbringenden Leistungen an den individuellen Bedarfen der Betroffenen ausrichten.","pdf_page_from":7,"section_label":"4. Bedeutung der Mindestangaben in den ETM","source_sha256":"1a358af1b5f2e523c7a5cd954221d8db0deb2bfc1abe6a6cf39c0cf92c38c14c","table_or_figure":null,"source_document_id":"18fabe59-cb81-58f8-b83f-ceab7f91020d","source_content_kind":"text","source_page_label_to":"7","source_page_label_from":"7","translation_verification":{"de":"source_aligned","en":"verified_against_source","pl":"verified_against_source","original":"source_text"}},{"id":"protocol-shared-individual-selection","pdf_page_to":8,"original_text":"Reha-Therapiestandards geben dem therapeutischen Team Entscheidungs- hilfen für die Ausgestaltung von Therapien für definierte Indikationsgruppen. Die evidenzbasierten Therapiemodule in ihrer Gesamtheit bilden den Rahmen, innerhalb dessen sich eine evidenzbasierte Rehabilitation abspielen sollte. Die Auswahl der jeweiligen Leistung(en) aus dem ETM orientiert sich dann am individuellen Bedarf der Rehabilitand*innen und den gemeinsam ver- einbarten Reha-Zielen.","pdf_page_from":8,"section_label":"7. Anwendung der ETM in der Praxis","source_sha256":"1a358af1b5f2e523c7a5cd954221d8db0deb2bfc1abe6a6cf39c0cf92c38c14c","table_or_figure":null,"source_document_id":"18fabe59-cb81-58f8-b83f-ceab7f91020d","source_content_kind":"text","source_page_label_to":"8","source_page_label_from":"8","translation_verification":{"de":"source_aligned","en":"verified_against_source","pl":"verified_against_source","original":"source_text"}},{"id":"protocol-digital-and-self-training-limits","pdf_page_to":8,"original_text":"Soweit die KTL 2025 eine digitale Leistungserbringung erlaubt, können entsprechende Leistungen auch in digitaler Form zur Erfüllung der RTS beitragen (≤ 15 %). Leistungen an Begleitpersonen werden nur bei den RTS für Kinder und Jugendliche angerechnet. Die Leistungsart „Eigentraining mit Monitoring“ kann nicht zur Erfüllung der Mindestanforderungen der RTS genutzt werden.","pdf_page_from":8,"section_label":"6. Die KTL als Basis für die Beschreibung der ETM-Leistungen","source_sha256":"1a358af1b5f2e523c7a5cd954221d8db0deb2bfc1abe6a6cf39c0cf92c38c14c","table_or_figure":null,"source_document_id":"18fabe59-cb81-58f8-b83f-ceab7f91020d","source_content_kind":"text","source_page_label_to":"8","source_page_label_from":"8","translation_verification":{"de":"source_aligned","en":"verified_against_source","pl":"verified_against_source","original":"source_text"}}],"content_kind":"protocol_context","applicability":{"items":[{"id":"diagnostic-scope","text":{"de":"Die vorliegenden Reha-Therapiestandards gelten für alle Rehabilitationen mit folgenden Erstdiagnosen (ICD-10-GM) im Entlassungsbericht: Die S-Codes (S72.01 – S72.05) müssen gemeinsam mit der Zweitdia- gnose Z96.64 oder Z96.65 verschlüsselt sein. Die Z-Codes Z96.64 und Z96.65 müssen gemeinsam mit der Zweitdiagnose M16, M17 oder einem S-Code (S72.01 – S72.05) verschlüsselt sein. Die M-Codes (M16, M17) müssen mit der Zweitdiagnose Z96.64 oder Z96.65 präzisiert werden.","en":"The standard applies to rehabilitation episodes whose discharge report records M16–M17, S72.01–S72.05, or Z96.64/Z96.65 as the primary diagnosis, with the source-specified pairing of primary and secondary diagnoses.","pl":"Standard dotyczy rehabilitacji, w których w karcie wypisowej jako rozpoznanie główne podano M16–M17, S72.01–S72.05 albo Z96.64/Z96.65, z wymaganymi przez źródło powiązaniami rozpoznania głównego i dodatkowego.","original":"Die vorliegenden Reha-Therapiestandards gelten für alle Rehabilitationen mit folgenden Erstdiagnosen (ICD-10-GM) im Entlassungsbericht: Die S-Codes (S72.01 – S72.05) müssen gemeinsam mit der Zweitdia- gnose Z96.64 oder Z96.65 verschlüsselt sein. Die Z-Codes Z96.64 und Z96.65 müssen gemeinsam mit der Zweitdiagnose M16, M17 oder einem S-Code (S72.01 – S72.05) verschlüsselt sein. Die M-Codes (M16, M17) müssen mit der Zweitdiagnose Z96.64 oder Z96.65 präzisiert werden."},"provenance_id":"protocol-diagnostic-scope"},{"id":"setting-and-population","text":{"de":"Der Geltungsbereich der Reha-Therapiestandards bezieht sich auf die ganztägig ambulante und stationäre medizinische Rehabilitation. In die Auswertung zur Reha-Qualitätssicherung gehen alle Rehabili- tand*innen (nur Anschlussrehabilitation, AHB) ab 18 Jahre ein, deren Behandlungsdauer zwischen 18 und 42 Tagen lag.","en":"The scope covers all-day outpatient and inpatient medical rehabilitation. Quality-assurance evaluation includes adults aged 18 years or older, only in post-acute follow-up rehabilitation (AHB), with a treatment duration of 18–42 days.","pl":"Zakres obejmuje całodzienną ambulatoryjną i stacjonarną rehabilitację medyczną. Do oceny jakości włącza się osoby od 18. roku życia, wyłącznie w ramach rehabilitacji bezpośrednio po leczeniu szpitalnym (AHB), z czasem leczenia 18–42 dni.","original":"Der Geltungsbereich der Reha-Therapiestandards bezieht sich auf die ganztägig ambulante und stationäre medizinische Rehabilitation. In die Auswertung zur Reha-Qualitätssicherung gehen alle Rehabili- tand*innen (nur Anschlussrehabilitation, AHB) ab 18 Jahre ein, deren Behandlungsdauer zwischen 18 und 42 Tagen lag."},"provenance_id":"protocol-setting-and-population"}],"status":"reported"},"contract_version":"1.2","global_delivery_rules":{"items":[{"id":"weekly-values-are-averages","text":{"de":"Der zeitliche Bezugsrahmen „pro Woche“ ist dabei als rechnerische Größe zu verstehen, d.h. die angegebene Mindestdauer/Mindesthäufigkeit stellt einen Durchschnittswert bezogen auf die Gesamtdauer des Reha- Aufenthalts dar. Mit anderen Worten, die Leistung muss in dem genannten Umfang nicht in jeder Woche des Reha-Aufenthalts erbracht werden.","en":"Values stated as “per week” are averages calculated across the entire rehabilitation stay; the service does not have to be delivered at that volume in every individual week.","pl":"Wartości oznaczone „na tydzień” są średnią obliczaną dla całego pobytu rehabilitacyjnego; świadczenie nie musi być realizowane w tym wymiarze w każdym pojedynczym tygodniu.","original":"Der zeitliche Bezugsrahmen „pro Woche“ ist dabei als rechnerische Größe zu verstehen, d.h. die angegebene Mindestdauer/Mindesthäufigkeit stellt einen Durchschnittswert bezogen auf die Gesamtdauer des Reha- Aufenthalts dar. Mit anderen Worten, die Leistung muss in dem genannten Umfang nicht in jeder Woche des Reha-Aufenthalts erbracht werden."},"provenance_id":"protocol-weekly-values-are-averages"},{"id":"ktl-units-are-options","text":{"de":"Im Abschnitt „KTL-Leistungs einheiten“ sind alle für das ETM in Frage kommenden bzw. möglichen Interventionen in Form von KTL-Codes der KTL 2025 aufgelistet. Aus einer Vielzahl an Leistungen können für die Rehabilitand*innen die am besten geeigneten und die dem Therapie- konzept der Einrichtung entsprechenden Behandlungselemente ausge- wählt werden. Nicht alle angegebenen KTL-Codes eines ETM müssen verwendet werden.","en":"The KTL codes listed for an ETM are eligible interventions. Select the services best suited to the patient and the facility’s therapy concept; not every code in an ETM has to be used.","pl":"Kody KTL wymienione w ETM są możliwymi interwencjami. Należy wybrać świadczenia najlepiej dopasowane do pacjenta i koncepcji terapii placówki; nie trzeba stosować wszystkich kodów danego ETM.","original":"Im Abschnitt „KTL-Leistungs einheiten“ sind alle für das ETM in Frage kommenden bzw. möglichen Interventionen in Form von KTL-Codes der KTL 2025 aufgelistet. Aus einer Vielzahl an Leistungen können für die Rehabilitand*innen die am besten geeigneten und die dem Therapie- konzept der Einrichtung entsprechenden Behandlungselemente ausge- wählt werden. Nicht alle angegebenen KTL-Codes eines ETM müssen verwendet werden."},"provenance_id":"protocol-ktl-units-are-options"},{"id":"minimums-and-individual-need","text":{"de":"Mindestanteil, Mindestdauer und ggf. Mindesthäufigkeit definieren die untere Grenze des Leistungsspektrums für eine adäquate Rehabilitation und sollten deshalb nicht unterschritten werden. Ein Überschreiten der Mindestanforderungen ist nicht nur wünschenswert, sondern in vielen Fällen auch aus therapeutischer Sicht erforderlich. Letztlich müssen sich die zu erbringenden Leistungen an den individuellen Bedarfen der Betroffenen ausrichten.","en":"The minimum patient share, duration, and—where stated—frequency define the lower boundary of adequate rehabilitation and should not be undercut. Exceeding these minima may be therapeutically necessary; services must follow individual needs.","pl":"Minimalny odsetek, czas i — jeśli podano — częstotliwość stanowią dolną granicę odpowiedniej rehabilitacji i nie powinny być zmniejszane. Przekroczenie minimów bywa terapeutycznie konieczne; świadczenia należy dostosować do indywidualnych potrzeb.","original":"Mindestanteil, Mindestdauer und ggf. Mindesthäufigkeit definieren die untere Grenze des Leistungsspektrums für eine adäquate Rehabilitation und sollten deshalb nicht unterschritten werden. Ein Überschreiten der Mindestanforderungen ist nicht nur wünschenswert, sondern in vielen Fällen auch aus therapeutischer Sicht erforderlich. Letztlich müssen sich die zu erbringenden Leistungen an den individuellen Bedarfen der Betroffenen ausrichten."},"provenance_id":"protocol-minimums-and-individual-need"},{"id":"shared-individual-selection","text":{"de":"Reha-Therapiestandards geben dem therapeutischen Team Entscheidungs- hilfen für die Ausgestaltung von Therapien für definierte Indikationsgruppen. Die evidenzbasierten Therapiemodule in ihrer Gesamtheit bilden den Rahmen, innerhalb dessen sich eine evidenzbasierte Rehabilitation abspielen sollte. Die Auswahl der jeweiligen Leistung(en) aus dem ETM orientiert sich dann am individuellen Bedarf der Rehabilitand*innen und den gemeinsam ver- einbarten Reha-Zielen.","en":"The RTS provides a decision framework for the therapeutic team. Specific services within an ETM are selected according to the individual patient’s needs and jointly agreed rehabilitation goals.","pl":"RTS stanowi ramy decyzyjne dla zespołu terapeutycznego. Konkretne świadczenia z ETM wybiera się na podstawie indywidualnych potrzeb pacjenta i wspólnie uzgodnionych celów rehabilitacji.","original":"Reha-Therapiestandards geben dem therapeutischen Team Entscheidungs- hilfen für die Ausgestaltung von Therapien für definierte Indikationsgruppen. Die evidenzbasierten Therapiemodule in ihrer Gesamtheit bilden den Rahmen, innerhalb dessen sich eine evidenzbasierte Rehabilitation abspielen sollte. Die Auswahl der jeweiligen Leistung(en) aus dem ETM orientiert sich dann am individuellen Bedarf der Rehabilitand*innen und den gemeinsam ver- einbarten Reha-Zielen."},"provenance_id":"protocol-shared-individual-selection"},{"id":"digital-and-self-training-limits","text":{"de":"Soweit die KTL 2025 eine digitale Leistungserbringung erlaubt, können entsprechende Leistungen auch in digitaler Form zur Erfüllung der RTS beitragen (≤ 15 %). Leistungen an Begleitpersonen werden nur bei den RTS für Kinder und Jugendliche angerechnet. Die Leistungsart „Eigentraining mit Monitoring“ kann nicht zur Erfüllung der Mindestanforderungen der RTS genutzt werden.","en":"Where KTL 2025 permits digital delivery, it may account for no more than 15% of RTS fulfillment. The service type “self-training with monitoring” cannot count toward the RTS minimum requirements.","pl":"Jeżeli KTL 2025 dopuszcza realizację cyfrową, może ona stanowić najwyżej 15% realizacji RTS. Kategoria „trening własny z monitorowaniem” nie może być zaliczona do spełnienia minimalnych wymagań RTS.","original":"Soweit die KTL 2025 eine digitale Leistungserbringung erlaubt, können entsprechende Leistungen auch in digitaler Form zur Erfüllung der RTS beitragen (≤ 15 %). Leistungen an Begleitpersonen werden nur bei den RTS für Kinder und Jugendliche angerechnet. Die Leistungsart „Eigentraining mit Monitoring“ kann nicht zur Erfüllung der Mindestanforderungen der RTS genutzt werden."},"provenance_id":"protocol-digital-and-self-training-limits"}],"status":"reported"},"unmapped_source_content":{"items":[],"status":"not_applicable"}}},{"id":"796334a3-858b-5ce6-9ac1-455a234d9f59","slug":"us-south-shore-19-reverse-total-shoulder-arthroplasty","title_pl":"Protokół rehabilitacji po endoprotezoplastyce odwróconej barku","title_de":"Rehabilitationsprotokoll nach Reverse-Schulter-TEP","title_en":"Reverse Total Shoulder Arthroplasty Rehab Protocol","title_original":"Reverse Total Shoulder Arthroplasty","summary_pl":"Protokół pooperacyjny dla pacjentów po rTSA, obejmujący fazy od 0 do ponad 12 tygodni.","summary_de":"Postoperatives Protokoll für rTSA-Patienten, umfasst Phasen von 0 bis über 12 Wochen.","summary_en":"Postoperative rehabilitation protocol for patients following rTSA, covering phases from 0 to 12+ weeks.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"b1d53116-6659-5119-942f-ca355b471c36","condition_slug":"reverse-total-shoulder-arthroplasty","condition_name_pl":"Endoprotezoplastyka odwrócona stawu barkowego","condition_name_de":"Reverse-Schultertotalendoprothese","condition_name_en":"Reverse Total Shoulder Arthroplasty","condition_name_original":"Reverse Total Shoulder Arthroplasty","icd_codes":[],"category_key":"shoulder","category_pl":"Ortopedia - 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Einführung von Umlenkrollen (sofern PROM > 90°) und horizontaler Adduktion. Beginn aktiver Bewegungsumfänge (AROM).","therapeutic_content_en":"Advance PROM and AAROM in scapular plane. Pulleys permitted if PROM > 90°, horizontal adduction. Start AROM.","therapeutic_content_pl":"Progresja PROM i AAROM w płaszczyźnie łopatki. Możliwe wprowadzenie szyn (jeśli PROM > 90°) oraz rotacji poziomej. Rozpoczęcie aktywnego zakresu ruchu (AROM).","minimum_requirements_de":"","minimum_requirements_en":"","minimum_requirements_pl":"","additional_notes_original":"","therapeutic_content_original":"Advance PROM and AAROM in scapular plane. Pulleys permitted if PROM > 90°, horizontal adduction. Start AROM.","minimum_requirements_original":"","structured_content_v2":"$undefined"},{"id":"be413279-5f83-52ed-9f84-7d0c9ff51f5c","name_de":"Phase III: 6.-12. Woche","name_en":"Phase III: Weeks 6-12","name_pl":"Faza III: 6-12 tygodnie","source_page":2,"module_number":3,"name_original":"Phase III: Weeks 6-12","service_codes":[],"structured_content":{"de":{"applies_when":["6.-12. Woche"],"dosage_and_progression":["Einführung schmerzfreier isometrischer Kräftigungsübungen für Skapula und Deltoideus.","Weiterführung distaler Übungen.","Beginn leichter funktioneller Aktivitäten."],"physiotherapist_actions":["Überwachung der Deltoideus-Aktivität zur Vermeidung von Akromion-Stressfrakturen."]},"en":{"applies_when":["Weeks 6-12"],"dosage_and_progression":["Introduce scapular and deltoid sub-maximal pain-free isometrics.","Progress distal extremity exercises.","Begin light functional activities."],"physiotherapist_actions":["Monitor deltoid activity to prevent acromion stress fracture."]},"pl":{"applies_when":["6-12 tygodnie"],"dosage_and_progression":["Wprowadzenie izometrycznych ćwiczeń wzmacniających łopatkę i mięsień naramienny (bezbólowo).","Kontynuacja progresji ćwiczeń dystalnych.","Początek lekkich czynności funkcjonalnych."],"physiotherapist_actions":["Monitorowanie aktywności mięśnia naramiennego w celu uniknięcia przeciążenia wyrostka barkowego (ryzyko złamania zmęczeniowego)."]},"original":{"applies_when":["Weeks 6-12"],"dosage_and_progression":["Introduce scapular and deltoid sub-maximal pain-free isometrics.","Progress distal extremity exercises.","Begin light functional activities."],"physiotherapist_actions":["Monitor deltoid activity to prevent acromion stress fracture."]}},"additional_notes_de":"Beginn leichter funktioneller Aktivitäten.","additional_notes_en":"Begin light functional activities.","additional_notes_pl":"Początek lekkich czynności funkcjonalnych.","minimum_patient_share":null,"therapeutic_content_de":"Einführung schmerzfreier isometrischer Kräftigungsübungen für Skapula und Deltoideus. Weiterführung distaler Übungen.","therapeutic_content_en":"Introduce scapular and deltoid sub-maximal pain-free isometrics. Progress distal extremity exercises.","therapeutic_content_pl":"Wprowadzenie izometrycznych ćwiczeń wzmacniających łopatkę i mięsień naramienny (bezbólowo). Kontynuacja progresji ćwiczeń dystalnych.","minimum_requirements_de":"Überwachung der Deltoideus-Aktivität zur Vermeidung von Akromion-Stressfrakturen.","minimum_requirements_en":"Monitor deltoid activity to prevent acromion stress fracture.","minimum_requirements_pl":"Monitorowanie aktywności mięśnia naramiennego w celu uniknięcia przeciążenia wyrostka barkowego (ryzyko złamania zmęczeniowego).","additional_notes_original":"Begin light functional activities.","therapeutic_content_original":"Introduce scapular and deltoid sub-maximal pain-free isometrics. Progress distal extremity exercises.","minimum_requirements_original":"Monitor deltoid activity to prevent acromion stress fracture.","structured_content_v2":"$undefined"},{"id":"a1aea270-a8eb-5561-8801-1761eadfd30a","name_de":"Phase IV: Ab der 12. Woche","name_en":"Phase IV: Beyond 12 weeks","name_pl":"Faza IV: Powyżej 12 tygodni","source_page":2,"module_number":4,"name_original":"Phase IV: Beyond 12 weeks","service_codes":[],"structured_content":{"de":{"warnings":["Erwartete Erholungszeit: ca. 6-9 Monate."],"exercises":["Allmähliche Steigerung der Kräftigung."],"applies_when":["Ab der 12. Woche"],"progression_criteria":["Entlassungskriterien: Schmerzfreier AROM-Erhalt, maximierte Funktion gemäß Patientenzielen, Rückkehr zu ADLs."],"dosage_and_progression":["Rückkehr zu moderaten funktionalen Aktivitäten, Hobbys und Sport (Golf, Doppeltennis)."]},"en":{"warnings":["Expected recovery time is approx 6-9 months."],"exercises":["Gradual strengthening progression."],"applies_when":["Beyond 12 weeks"],"progression_criteria":["Discharge criteria: maintain non-painful AROM, maximized functional use, return to ADLs."],"dosage_and_progression":["Return to moderately challenging functional activities, hobbies, sports."]},"pl":{"warnings":["Całkowity czas powrotu do sprawności: ok. 6-9 miesięcy."],"exercises":["Stopniowa progresja wzmacniania."],"applies_when":["Powyżej 12 tygodni"],"progression_criteria":["Kryteria wypisu: utrzymanie bezbolesnego AROM, zmaksymalizowana funkcja w zakresie celów pacjenta, powrót do ADL."],"dosage_and_progression":["Powrót do umiarkowanych aktywności funkcjonalnych, hobby i sportów (golf, gra w tenisa deblowego)."]},"original":{"warnings":["Expected recovery time is approx 6-9 months."],"exercises":["Gradual strengthening progression."],"applies_when":["Beyond 12 weeks"],"progression_criteria":["Discharge criteria: maintain non-painful AROM, maximized functional use, return to ADLs."],"dosage_and_progression":["Return to moderately challenging functional activities, hobbies, sports."]}},"additional_notes_de":"Erwartete Erholungszeit: ca. 6-9 Monate.","additional_notes_en":"Expected recovery time is approx 6-9 months.","additional_notes_pl":"Całkowity czas powrotu do sprawności: ok. 6-9 miesięcy.","minimum_patient_share":null,"therapeutic_content_de":"Allmähliche Steigerung der Kräftigung. Rückkehr zu moderaten funktionalen Aktivitäten, Hobbys und Sport (Golf, Doppeltennis).","therapeutic_content_en":"Gradual strengthening progression. Return to moderately challenging functional activities, hobbies, sports.","therapeutic_content_pl":"Stopniowa progresja wzmacniania. Powrót do umiarkowanych aktywności funkcjonalnych, hobby i sportów (golf, gra w tenisa deblowego).","minimum_requirements_de":"Entlassungskriterien: Schmerzfreier AROM-Erhalt, maximierte Funktion gemäß Patientenzielen, Rückkehr zu ADLs.","minimum_requirements_en":"Discharge criteria: maintain non-painful AROM, maximized functional use, return to ADLs.","minimum_requirements_pl":"Kryteria wypisu: utrzymanie bezbolesnego AROM, zmaksymalizowana funkcja w zakresie celów pacjenta, powrót do ADL.","additional_notes_original":"Expected recovery time is approx 6-9 months.","therapeutic_content_original":"Gradual strengthening progression. Return to moderately challenging functional activities, hobbies, sports.","minimum_requirements_original":"Discharge criteria: maintain non-painful AROM, maximized functional use, return to ADLs.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["shoulder","upper_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"628a58e8-2f73-58b4-b8d3-d87921465721","slug":"us-jared-lee-07-reverse-total-shoulder-arthroplasty","title_pl":"Protokół rehabilitacji po odwróconej endoprotezoplastyce stawu barkowego","title_de":"Rehabilitationsprotokoll nach inverser Schultertotalendoprothese","title_en":"Reverse Total Shoulder Arthroplasty Rehabilitation Protocol","title_original":"Reverse Total Shoulder Arthroplasty PT","summary_pl":"Czterofazowy protokół po odwróconej endoprotezoplastyce stawu barkowego, od wczesnej ochrony operowanych struktur do aktywności funkcjonalnej.","summary_de":"Vierphasiges Protokoll nach inverser Schultertotalendoprothese – vom frühen Schutz der operierten Strukturen bis zur funktionellen Aktivität.","summary_en":"Four-phase postoperative rehabilitation protocol for reverse total shoulder arthroplasty, from early protection to functional 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barku","fizjoterapia pooperacyjna"],"search_terms_de":["rTSA","Schulter-TEP","Schulteroperation","postoperative Rehabilitation"],"search_terms_en":["rTSA","reverse shoulder arthroplasty","shoulder replacement","post-op rehab"],"source_document_id":"016221db-56df-5c6d-b4c9-eceafbfb5a12","source_title":"Reverse Total Shoulder Arthroplasty PT","issuer":"Jared Lee, MD","source_country_code":"US","jurisdiction_code":"US-CO","authority_level":"clinic","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_requires_review","official_url":"https://jaredleemd.com/wp-content/uploads/2025/06/Reverse-Total-Shoulder-Arthroplasty-PT-Protocol.pdf","source_sha256":"41bcb97776c63f91db597aefe6bf7729f3ac362cb5104f19f62cb7527b768682","authorization_required":false,"license_note":"Public source file retained locally for source verification.","modules":[{"id":"ad8b009b-8b59-5987-8005-d54e423a7c6a","name_de":"Phase I: Wochen 0–2","name_en":"Phase I: Weeks 0-2","name_pl":"Faza I: tygodnie 0–2","source_page":1,"module_number":1,"name_original":"Phase I: Weeks 0-2","service_codes":[],"structured_content":{"de":{"goals":["Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, die operierten Strukturen schützen und Schultersteife vermeiden."],"exercises":["Bewegungsumfang: Flexion und Abduktion 0–90° sowie Außenrotation 0–30°","uneingeschränkter Bewegungsumfang und Kräftigung von Ellenbogen, Handgelenk und Hand bei angelegtem Arm","Wall Slides","Pendelübungen","Skapularetraktion","Dehnung und Bewegungsübungen der Halswirbelsäule"],"applies_when":["Wochen 0–2"],"restrictions":["keine Lasten über 5 lb heben","keine Kräftigungsübungen."],"physiotherapist_actions":["Nach Abklingen der Nervenblockade tagsüber zu Hause eine einfache Armschlinge nach Komfort tragen","bis zur ersten postoperativen Kontrolle in der Schlinge schlafen und sie außer Haus bis zu diesem Termin tragen","physikalische Maßnahmen nach Bedarf."]},"en":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness."],"exercises":["Range of motion 0-90° flexion and abduction and external rotation 0-30°","unrestricted elbow, wrist and hand range of motion and strengthening with the arm at the side","wall slides","pendulums","scapular retraction","cervical stretching and range of motion"],"applies_when":["Weeks 0-2"],"restrictions":["no lifting greater than 5 lb","no strengthening."],"progression_criteria":["sleep in the sling until the first postoperative visit and wear it when out until that visit"],"physiotherapist_actions":["Use a simple sling for comfort at home during the day once the nerve block has worn off","modalities as needed."]},"pl":{"goals":["zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona operowanych struktur oraz zapobieganie sztywności barku."],"exercises":["Zakres ruchu: zgięcie i odwodzenie 0–90° oraz rotacja zewnętrzna 0–30°","nieograniczony zakres ruchu i wzmacnianie łokcia, nadgarstka oraz ręki przy ramieniu ułożonym wzdłuż tułowia","ślizgi po ścianie","ćwiczenia wahadłowe","retrakcja łopatki","rozciąganie i ćwiczenia zakresu ruchu odcinka szyjnego"],"applies_when":["tygodnie 0–2"],"restrictions":["nie podnosić ciężaru większego niż 5 lb","bez ćwiczeń wzmacniających."],"physiotherapist_actions":["Po ustąpieniu blokady nerwowej prosty temblak w domu w ciągu dnia dla komfortu","spać w temblaku do pierwszej kontroli pooperacyjnej i nosić go poza domem do tej kontroli","fizykoterapia według potrzeb."]},"original":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness."],"exercises":["Range of motion 0-90° flexion and abduction and external rotation 0-30°","unrestricted elbow, wrist and hand range of motion and strengthening with the arm at the side","wall slides","pendulums","scapular retraction","cervical stretching and range of motion"],"applies_when":["Weeks 0-2"],"restrictions":["no lifting greater than 5 lb","no strengthening."],"progression_criteria":["sleep in the sling until the first postoperative visit and wear it when out until that visit"],"physiotherapist_actions":["Use a simple sling for comfort at home during the day once the nerve block has worn off","modalities as needed."]}},"additional_notes_de":"Ziele: Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, die operierten Strukturen schützen und Schultersteife vermeiden.","additional_notes_en":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness.","additional_notes_pl":"Cele: zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona operowanych struktur oraz zapobieganie sztywności barku.","minimum_patient_share":null,"therapeutic_content_de":"Bewegungsumfang: Flexion und Abduktion 0–90° sowie Außenrotation 0–30°; uneingeschränkter Bewegungsumfang und Kräftigung von Ellenbogen, Handgelenk und Hand bei angelegtem Arm; Wall Slides; Pendelübungen; Skapularetraktion; Dehnung und Bewegungsübungen der Halswirbelsäule; physikalische Maßnahmen nach Bedarf.","therapeutic_content_en":"Range of motion 0-90° flexion and abduction and external rotation 0-30°; unrestricted elbow, wrist and hand range of motion and strengthening with the arm at the side; wall slides; pendulums; scapular retraction; cervical stretching and range of motion; modalities as needed.","therapeutic_content_pl":"Zakres ruchu: zgięcie i odwodzenie 0–90° oraz rotacja zewnętrzna 0–30°; nieograniczony zakres ruchu i wzmacnianie łokcia, nadgarstka oraz ręki przy ramieniu ułożonym wzdłuż tułowia; ślizgi po ścianie; ćwiczenia wahadłowe; retrakcja łopatki; rozciąganie i ćwiczenia zakresu ruchu odcinka szyjnego; fizykoterapia według potrzeb.","minimum_requirements_de":"Nach Abklingen der Nervenblockade tagsüber zu Hause eine einfache Armschlinge nach Komfort tragen; bis zur ersten postoperativen Kontrolle in der Schlinge schlafen und sie außer Haus bis zu diesem Termin tragen; keine Lasten über 5 lb heben; keine Kräftigungsübungen.","minimum_requirements_en":"Use a simple sling for comfort at home during the day once the nerve block has worn off; sleep in the sling until the first postoperative visit and wear it when out until that visit; no lifting greater than 5 lb; no strengthening.","minimum_requirements_pl":"Po ustąpieniu blokady nerwowej prosty temblak w domu w ciągu dnia dla komfortu; spać w temblaku do pierwszej kontroli pooperacyjnej i nosić go poza domem do tej kontroli; nie podnosić ciężaru większego niż 5 lb; bez ćwiczeń wzmacniających.","additional_notes_original":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness.","therapeutic_content_original":"Range of motion 0-90° flexion and abduction and external rotation 0-30°; unrestricted elbow, wrist and hand range of motion and strengthening with the arm at the side; wall slides; pendulums; scapular retraction; cervical stretching and range of motion; modalities as needed.","minimum_requirements_original":"Use a simple sling for comfort at home during the day once the nerve block has worn off; sleep in the sling until the first postoperative visit and wear it when out until that visit; no lifting greater than 5 lb; no strengthening.","structured_content_v2":"$undefined"},{"id":"4c75c8f8-1651-5b3b-ace1-5e28e02c3c2a","name_de":"Phase II: Wochen 3–6","name_en":"Phase II: Weeks 3-6","name_pl":"Faza II: tygodnie 3–6","source_page":1,"module_number":2,"name_original":"Phase II: Weeks 3-6","service_codes":[],"structured_content":{"de":{"goals":["Bewegungsumfang steigern, Schmerzen und Muskelatrophie begrenzen, die operierten Strukturen schützen und mit der neuromuskulären Kontrolle beginnen."],"exercises":["Schrittweise zum vollen Bewegungsumfang in allen Ebenen","isometrische Kräftigung der Rotatorenmanschette","tiefe Ruderzüge für die periskapuläre Muskulatur und Serratus Punches","leichte Bizepscurls und Übungen zur motorischen Kontrolle des Trizeps","rhythmische Stabilisation","horizontale Adduktion in Seitenlage","Oberkörperergometer ohne Widerstand"],"applies_when":["Wochen 3–6"],"restrictions":["keine Kräftigung in Außenrotation","keine Lasten über 5 lb heben."],"dosage_and_progression":["Die einfache Armschlinge kann schrittweise abgelegt werden"],"physiotherapist_actions":["physikalische Maßnahmen nach Bedarf."]},"en":{"goals":["progress range of motion, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control."],"exercises":["Progress to full range of motion in all planes","rotator cuff isometric strengthening","periscapular low rows and serratus punches","light biceps curls and triceps motor-control exercises","rhythmic stabilization","side-lying horizontal adduction","upper-body ergometer without resistance"],"applies_when":["Weeks 3-6"],"restrictions":["no strengthening in external rotation","no lifting greater than 5 lb."],"dosage_and_progression":["May wean from the simple sling"],"physiotherapist_actions":["modalities as needed."]},"pl":{"goals":["zwiększanie zakresu ruchu, ograniczenie bólu i zaniku mięśni, ochrona operowanych struktur oraz rozpoczęcie kontroli nerwowo-mięśniowej."],"exercises":["Stopniowo uzyskać pełny zakres ruchu we wszystkich płaszczyznach","izometryczne wzmacnianie stożka rotatorów","niskie wiosłowanie dla mięśni okoł łopatkowych i protrakcja zębatego przedniego","lekkie uginanie przedramion i ćwiczenia kontroli ruchowej tricepsa","stabilizacja rytmiczna","przywodzenie poziome w leżeniu bokiem","ergometr kończyn górnych bez oporu"],"applies_when":["tygodnie 3–6"],"restrictions":["bez wzmacniania w rotacji zewnętrznej","nie podnosić ciężaru większego niż 5 lb."],"dosage_and_progression":["Można stopniowo odstawiać prosty temblak"],"physiotherapist_actions":["fizykoterapia według potrzeb."]},"original":{"goals":["progress range of motion, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control."],"exercises":["Progress to full range of motion in all planes","rotator cuff isometric strengthening","periscapular low rows and serratus punches","light biceps curls and triceps motor-control exercises","rhythmic stabilization","side-lying horizontal adduction","upper-body ergometer without resistance"],"applies_when":["Weeks 3-6"],"restrictions":["no strengthening in external rotation","no lifting greater than 5 lb."],"dosage_and_progression":["May wean from the simple sling"],"physiotherapist_actions":["modalities as needed."]}},"additional_notes_de":"Ziele: Bewegungsumfang steigern, Schmerzen und Muskelatrophie begrenzen, die operierten Strukturen schützen und mit der neuromuskulären Kontrolle beginnen.","additional_notes_en":"Goals: progress range of motion, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control.","additional_notes_pl":"Cele: zwiększanie zakresu ruchu, ograniczenie bólu i zaniku mięśni, ochrona operowanych struktur oraz rozpoczęcie kontroli nerwowo-mięśniowej.","minimum_patient_share":null,"therapeutic_content_de":"Schrittweise zum vollen Bewegungsumfang in allen Ebenen; isometrische Kräftigung der Rotatorenmanschette; tiefe Ruderzüge für die periskapuläre Muskulatur und Serratus Punches; leichte Bizepscurls und Übungen zur motorischen Kontrolle des Trizeps; rhythmische Stabilisation; horizontale Adduktion in Seitenlage; Oberkörperergometer ohne Widerstand; physikalische Maßnahmen nach Bedarf.","therapeutic_content_en":"Progress to full range of motion in all planes; rotator cuff isometric strengthening; periscapular low rows and serratus punches; light biceps curls and triceps motor-control exercises; rhythmic stabilization; side-lying horizontal adduction; upper-body ergometer without resistance; modalities as needed.","therapeutic_content_pl":"Stopniowo uzyskać pełny zakres ruchu we wszystkich płaszczyznach; izometryczne wzmacnianie stożka rotatorów; niskie wiosłowanie dla mięśni okoł łopatkowych i protrakcja zębatego przedniego; lekkie uginanie przedramion i ćwiczenia kontroli ruchowej tricepsa; stabilizacja rytmiczna; przywodzenie poziome w leżeniu bokiem; ergometr kończyn górnych bez oporu; fizykoterapia według potrzeb.","minimum_requirements_de":"Die einfache Armschlinge kann schrittweise abgelegt werden; keine Kräftigung in Außenrotation; keine Lasten über 5 lb heben.","minimum_requirements_en":"May wean from the simple sling; no strengthening in external rotation; no lifting greater than 5 lb.","minimum_requirements_pl":"Można stopniowo odstawiać prosty temblak; bez wzmacniania w rotacji zewnętrznej; nie podnosić ciężaru większego niż 5 lb.","additional_notes_original":"Goals: progress range of motion, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control.","therapeutic_content_original":"Progress to full range of motion in all planes; rotator cuff isometric strengthening; periscapular low rows and serratus punches; light biceps curls and triceps motor-control exercises; rhythmic stabilization; side-lying horizontal adduction; upper-body ergometer without resistance; modalities as needed.","minimum_requirements_original":"May wean from the simple sling; no strengthening in external rotation; no lifting greater than 5 lb.","structured_content_v2":"$undefined"},{"id":"03df2cc7-01bc-5378-b949-5c36febb3438","name_de":"Phase III: Wochen 7–12","name_en":"Phase III: Weeks 7-12","name_pl":"Faza III: tygodnie 7–12","source_page":1,"module_number":3,"name_original":"Phase III: Weeks 7-12","service_codes":[],"structured_content":{"de":{"goals":["voller Bewegungsumfang, minimale Schmerzen, Beginn der Muskelaktivierung und Kräftigung sowie Schutz der operierten Strukturen."],"exercises":["Kräftigung der Rotatorenmanschette nach Verträglichkeit steigern","Push-up Plus, Widerstandsbänder, Schulterextension in Bauchlage und Vorwärtsstöße","Oberkörperergometer mit Widerstand","PNF-Muster mit Widerstandsbändern","Wall Slides mit Widerstand."],"applies_when":["Wochen 7–12"],"restrictions":["Keine Lasten über 10 lb heben"],"physiotherapist_actions":["voller Bewegungsumfang in allen Ebenen","Kräftigung in allen Ebenen."]},"en":{"goals":["full range of motion, minimal pain, begin muscular activation and strengthening and protect the repair."],"exercises":["Progress rotator cuff strengthening as tolerated","push-up plus, resistance bands, prone shoulder extensions and forward punches","upper-body ergometer with resistance","PNF patterns with resistance bands","wall slides with resistance."],"applies_when":["Weeks 7-12"],"restrictions":["No lifting greater than 10 lb"],"physiotherapist_actions":["full range of motion in all planes","strengthening in all planes."]},"pl":{"goals":["pełny zakres ruchu, minimalny ból, rozpoczęcie aktywacji mięśniowej i wzmacniania oraz ochrona operowanych struktur."],"exercises":["Stopniowo zwiększać wzmacnianie stożka rotatorów w granicach tolerancji","pompka z protrakcją łopatek, taśmy oporowe, wyprost barku w leżeniu przodem i wypchnięcia ramion w przód","ergometr kończyn górnych z oporem","wzorce PNF z taśmami oporowymi","ślizgi po ścianie z oporem."],"applies_when":["tygodnie 7–12"],"restrictions":["Nie podnosić ciężaru większego niż 10 lb"],"physiotherapist_actions":["pełny zakres ruchu we wszystkich płaszczyznach","wzmacnianie we wszystkich płaszczyznach."]},"original":{"goals":["full range of motion, minimal pain, begin muscular activation and strengthening and protect the repair."],"exercises":["Progress rotator cuff strengthening as tolerated","push-up plus, resistance bands, prone shoulder extensions and forward punches","upper-body ergometer with resistance","PNF patterns with resistance bands","wall slides with resistance."],"applies_when":["Weeks 7-12"],"restrictions":["No lifting greater than 10 lb"],"physiotherapist_actions":["full range of motion in all planes","strengthening in all planes."]}},"additional_notes_de":"Ziele: voller Bewegungsumfang, minimale Schmerzen, Beginn der Muskelaktivierung und Kräftigung sowie Schutz der operierten Strukturen.","additional_notes_en":"Goals: full range of motion, minimal pain, begin muscular activation and strengthening and protect the repair.","additional_notes_pl":"Cele: pełny zakres ruchu, minimalny ból, rozpoczęcie aktywacji mięśniowej i wzmacniania oraz ochrona operowanych struktur.","minimum_patient_share":null,"therapeutic_content_de":"Kräftigung der Rotatorenmanschette nach Verträglichkeit steigern; Push-up Plus, Widerstandsbänder, Schulterextension in Bauchlage und Vorwärtsstöße; Oberkörperergometer mit Widerstand; PNF-Muster mit Widerstandsbändern; Wall Slides mit Widerstand.","therapeutic_content_en":"Progress rotator cuff strengthening as tolerated; push-up plus, resistance bands, prone shoulder extensions and forward punches; upper-body ergometer with resistance; PNF patterns with resistance bands; wall slides with resistance.","therapeutic_content_pl":"Stopniowo zwiększać wzmacnianie stożka rotatorów w granicach tolerancji; pompka z protrakcją łopatek, taśmy oporowe, wyprost barku w leżeniu przodem i wypchnięcia ramion w przód; ergometr kończyn górnych z oporem; wzorce PNF z taśmami oporowymi; ślizgi po ścianie z oporem.","minimum_requirements_de":"Keine Lasten über 10 lb heben; voller Bewegungsumfang in allen Ebenen; Kräftigung in allen Ebenen.","minimum_requirements_en":"No lifting greater than 10 lb; full range of motion in all planes; strengthening in all planes.","minimum_requirements_pl":"Nie podnosić ciężaru większego niż 10 lb; pełny zakres ruchu we wszystkich płaszczyznach; wzmacnianie we wszystkich płaszczyznach.","additional_notes_original":"Goals: full range of motion, minimal pain, begin muscular activation and strengthening and protect the repair.","therapeutic_content_original":"Progress rotator cuff strengthening as tolerated; push-up plus, resistance bands, prone shoulder extensions and forward punches; upper-body ergometer with resistance; PNF patterns with resistance bands; wall slides with resistance.","minimum_requirements_original":"No lifting greater than 10 lb; full range of motion in all planes; strengthening in all planes.","structured_content_v2":"$undefined"},{"id":"0b3c3483-86d0-559b-a738-41a5cd9f5966","name_de":"Phase IV: Wochen 13–18","name_en":"Phase IV: Weeks 13-18","name_pl":"Faza IV: tygodnie 13–18","source_page":1,"module_number":4,"name_original":"Phase IV: Weeks 13-18","service_codes":[],"structured_content":{"de":{"goals":["funktionelle Aktivitäten sowie fortgeschrittene sportliche und Freizeitaktivitäten nach Vorgabe des Operateurs steigern."],"exercises":["Alle Kräftigungsübungen fortsetzen","vollen Bewegungsumfang erhalten","Kräftigung der Außenrotation","periskapuläre T- und Y-Übungen","progressive Ballstabilisation an der Wand und Ballprellen an der Wand","sportartspezifische Progression nach Indikation."],"applies_when":["Wochen 13–18"],"restrictions":["kein schweres Krafttraining bis Woche 16."],"progression_criteria":["Kraftdefizit <10 %","Limb-Symmetry-Index ≥90 %","45/50 Punkte in biomechanischen Funktionstests, sofern durchgeführt","keine Schmerzen und keine berichtete Instabilität.","Ärztliche Freigabe und Erreichen aller Meilensteine bis Woche 18"]},"en":{"goals":["progress functional activities and advanced sport and recreational activity per surgeon."],"exercises":["Continue all strengthening exercises","maintain full range of motion","external rotation strengthening","periscapular T's and Y's","progressive ball stabilization on the wall and wall-ball dribbles","sport-specific activity progression as indicated."],"applies_when":["Weeks 13-18"],"restrictions":["no heavy weightlifting until week 16."],"progression_criteria":["<10% strength deficit","limb similarity index ≥90%","45/50 on biomechanical functional tests, if performed","no pain or complaints of instability.","Medical clearance and all milestones achieved by week 18"]},"pl":{"goals":["rozwijanie aktywności funkcjonalnych oraz zaawansowanej aktywności sportowej i rekreacyjnej zgodnie z decyzją chirurga."],"exercises":["Kontynuować wszystkie ćwiczenia wzmacniające","utrzymywać pełny zakres ruchu","wzmacnianie rotacji zewnętrznej","ćwiczenia T i Y mięśni okoł łopatkowych","stopniowana stabilizacja piłki na ścianie i kozłowanie piłki o ścianę","progresja aktywności specyficznych dla sportu zgodnie ze wskazaniami."],"applies_when":["tygodnie 13–18"],"restrictions":["bez ciężkiego treningu siłowego do 16. tygodnia."],"progression_criteria":["deficyt siły <10%","wskaźnik podobieństwa kończyn ≥90%","wynik 45/50 w biomechanicznych testach funkcjonalnych, jeżeli wykonano","brak bólu i zgłaszanej niestabilności.","Zgoda lekarza i osiągnięcie wszystkich kamieni milowych do 18. tygodnia"]},"original":{"goals":["progress functional activities and advanced sport and recreational activity per surgeon."],"exercises":["Continue all strengthening exercises","maintain full range of motion","external rotation strengthening","periscapular T's and Y's","progressive ball stabilization on the wall and wall-ball dribbles","sport-specific activity progression as indicated."],"applies_when":["Weeks 13-18"],"restrictions":["no heavy weightlifting until week 16."],"progression_criteria":["<10% strength deficit","limb similarity index ≥90%","45/50 on biomechanical functional tests, if performed","no pain or complaints of instability.","Medical clearance and all milestones achieved by week 18"]}},"additional_notes_de":"Ziele: funktionelle Aktivitäten sowie fortgeschrittene sportliche und Freizeitaktivitäten nach Vorgabe des Operateurs steigern. Entlassungskriterien: Kraftdefizit <10 %; Limb-Symmetry-Index ≥90 %; 45/50 Punkte in biomechanischen Funktionstests, sofern durchgeführt; keine Schmerzen und keine berichtete Instabilität.","additional_notes_en":"Goals: progress functional activities and advanced sport and recreational activity per surgeon. Discharge criteria: <10% strength deficit; limb similarity index ≥90%; 45/50 on biomechanical functional tests, if performed; no pain or complaints of instability.","additional_notes_pl":"Cele: rozwijanie aktywności funkcjonalnych oraz zaawansowanej aktywności sportowej i rekreacyjnej zgodnie z decyzją chirurga. Kryteria wypisu: deficyt siły <10%; wskaźnik podobieństwa kończyn ≥90%; wynik 45/50 w biomechanicznych testach funkcjonalnych, jeżeli wykonano; brak bólu i zgłaszanej niestabilności.","minimum_patient_share":null,"therapeutic_content_de":"Alle Kräftigungsübungen fortsetzen; vollen Bewegungsumfang erhalten; Kräftigung der Außenrotation; periskapuläre T- und Y-Übungen; progressive Ballstabilisation an der Wand und Ballprellen an der Wand; sportartspezifische Progression nach Indikation.","therapeutic_content_en":"Continue all strengthening exercises; maintain full range of motion; external rotation strengthening; periscapular T's and Y's; progressive ball stabilization on the wall and wall-ball dribbles; sport-specific activity progression as indicated.","therapeutic_content_pl":"Kontynuować wszystkie ćwiczenia wzmacniające; utrzymywać pełny zakres ruchu; wzmacnianie rotacji zewnętrznej; ćwiczenia T i Y mięśni okoł łopatkowych; stopniowana stabilizacja piłki na ścianie i kozłowanie piłki o ścianę; progresja aktywności specyficznych dla sportu zgodnie ze wskazaniami.","minimum_requirements_de":"Ärztliche Freigabe und Erreichen aller Meilensteine bis Woche 18; kein schweres Krafttraining bis Woche 16.","minimum_requirements_en":"Medical clearance and all milestones achieved by week 18; no heavy weightlifting until week 16.","minimum_requirements_pl":"Zgoda lekarza i osiągnięcie wszystkich kamieni milowych do 18. tygodnia; bez ciężkiego treningu siłowego do 16. tygodnia.","additional_notes_original":"Goals: progress functional activities and advanced sport and recreational activity per surgeon. Discharge criteria: <10% strength deficit; limb similarity index ≥90%; 45/50 on biomechanical functional tests, if performed; no pain or complaints of instability.","therapeutic_content_original":"Continue all strengthening exercises; maintain full range of motion; external rotation strengthening; periscapular T's and Y's; progressive ball stabilization on the wall and wall-ball dribbles; sport-specific activity progression as indicated.","minimum_requirements_original":"Medical clearance and all milestones achieved by week 18; no heavy weightlifting until week 16.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["shoulder","upper_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"ee6a5ff5-4d45-519c-9d6e-d20520ed29e5","slug":"us-jared-lee-02-tibial-im-nailing","title_pl":"Protokół rehabilitacji po gwoźdźowaniu śródszpikowym kości piszczelowej","title_de":"Rehabilitationsprotokoll nach Marknagelung der Tibia","title_en":"Tibial IM Nailing Rehabilitation Protocol","title_original":"Tibial IM Nailing Rehabilitation","summary_pl":"Pooperacyjny protokół rehabilitacji po gwoździowaniu śródszpikowym kości piszczelowej, obejmujący cztery fazy od ochrony miejsca operowanego do powrotu do aktywności sportowej.","summary_de":"Postoperatives Rehabilitationsprotokoll nach intramedullärer Nagelung der Tibia in vier Phasen – vom Schutz des Operationsgebiets bis zur Rückkehr zu sportlichen Aktivitäten.","summary_en":"Post‑operative rehabilitation protocol for tibial intramedullary nailing divided into four phases.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"c10e06d9-0071-5b36-9096-d7020a3087cf","condition_slug":"tibial-im-nailing","condition_name_pl":"Gwoźdźowanie śródszpikowe kości piszczelowej","condition_name_de":"Marknagelung der Tibia","condition_name_en":"Tibial IM Nailing","condition_name_original":"Tibial IM Nailing","icd_codes":[],"category_key":"lower-leg","category_pl":"Mala noga","category_de":"Unterschenkel","category_en":"Lower Leg","body_regions_pl":["Mala noga"],"body_regions_de":["Unterschenkel"],"body_regions_en":["Lower Leg"],"search_terms_pl":["gwoźdźowanie śródszpikowe piszczelowej","intramedullary nailing tibia"],"search_terms_de":["Marknagelung Tibia","intramedullary nailing tibia"],"search_terms_en":["tibial IM nailing","intramedullary nailing tibia"],"source_document_id":"8f37d913-678c-5e43-bcb1-f7155885e849","source_title":"Tibial IM Nailing Rehabilitation","issuer":"Jared Lee, MD","source_country_code":"US","jurisdiction_code":"US-CO","authority_level":"clinic","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_requires_review","official_url":"https://jaredleemd.com/wp-content/uploads/2025/06/Tibial-IM-Nailing-Rehabilitation-Protocol.pdf","source_sha256":"ed150310fc4aad686195e6d798f46a62295b9f8bae42af388b98461afea61811","authorization_required":true,"license_note":"All Rights Reserved. Authorization is required before final public release. Current development and staging remain allowed by the owner's decision.","modules":[{"id":"b1928575-1d34-5841-9180-385120575646","name_de":"Phase 1: Wochen 0–2","name_en":"Phase 1: Weeks 0-2","name_pl":"Faza 1: tygodnie 0–2","source_page":1,"module_number":1,"name_original":"Phase 1: Weeks 0-2","service_codes":[],"structured_content":{"de":{"goals":["Schwellung und Ödem reduzieren.","Schmerzen begrenzen.","Muskelatrophie verlangsamen.","Operierte Strukturen schützen."],"exercises":["Übungen zum vollständigen Kniebewegungsumfang innerhalb der Verträglichkeit durchführen.","Fersengleiten an der Wand durchführen.","Knieflexion und -extension im Sitzen durchführen.","Patellamobilisation durchführen.","Mobilisation der Knieextension durchführen.","Isometrische Quadrizepsanspannungen durchführen.","Gestrecktes Beinheben durchführen.","Clamshells und Ballpressen durchführen.","Isometrische Anspannungen der ischiokruralen Muskulatur durchführen.","Sitz- und Reichübung mit einem Handtuch durchführen.","Fahrradergometer mit dem gesunden Bein einsetzen."],"applies_when":["Vom Operationstag bis zum Ende der 2. postoperativen Woche anwenden."],"restrictions":["Die operierte Extremität nicht belasten.","Die Schiene bis zum Ende der 2. postoperativen Woche belassen.","Die Schiene darf ohne Belastung der operierten Extremität auf dem Boden abgestellt werden."]},"en":{"goals":["Reduce swelling and edema.","Minimize pain.","Retard muscle atrophy.","Protect the surgical repair."],"exercises":["Perform full knee range-of-motion exercises as tolerated.","Perform wall slides.","Perform seated knee flexion and extension.","Perform patellar mobilizations.","Perform extension mobilization.","Perform isometric quadriceps contractions.","Perform straight-leg raises.","Perform clams and ball squeezes.","Perform hamstring sets.","Perform sit and reach with a towel.","Use a stationary bike with the well leg."],"applies_when":["Use from surgery through the end of postoperative week 2."],"restrictions":["Do not weight bear through the operative extremity.","Keep the splint in place through postoperative week 2.","The splint may rest on the ground without weight bearing through the operative extremity."]},"pl":{"goals":["Zmniejszaj obrzęk i opuchliznę.","Ograniczaj ból.","Spowalniaj zanik mięśni.","Chroń operowane struktury."],"exercises":["Prowadź ćwiczenia pełnego zakresu ruchu kolana w granicach tolerancji pacjenta.","Wykonuj ślizgi piętą po ścianie.","Wykonuj zgięcie i wyprost kolana w siadzie.","Prowadź mobilizację rzepki.","Prowadź mobilizację wyprostu kolana.","Wykonuj izometryczne napięcia mięśnia czworogłowego.","Wykonuj unoszenie wyprostowanej kończyny.","Wykonuj ćwiczenia typu clamshell i ściskanie piłki.","Wykonuj izometryczne napięcia mięśni kulszowo-goleniowych.","Wykonuj ćwiczenie w siadzie z sięganiem przy użyciu ręcznika.","Stosuj rower stacjonarny napędzany zdrową kończyną."],"applies_when":["Stosuj od zabiegu do końca 2. tygodnia po operacji."],"restrictions":["Nie obciążaj operowanej kończyny.","Pozostaw szynę do końca 2. tygodnia po zabiegu.","Szynę można oprzeć o podłoże bez obciążania operowanej kończyny."]},"original":{"goals":["Reduce swelling and edema.","Minimize pain.","Retard muscle atrophy.","Protect surgical repair."],"exercises":["Full knee ROM as tolerated.","Wall slides.","Seated knee flexion/extension.","Patellar mobilizations.","Extension mobilization.","Isometric quadriceps contractions.","Straight leg raises.","Clams.","Ball squeezes.","Hamstring sets.","Sit and reach with towel.","Stationary bike with well leg."],"applies_when":["Phase 1: Weeks 0–2."],"restrictions":["Non weight bearing.","May rest splint on ground.","Remain in splint until 2 weeks s/p."]}},"additional_notes_de":"Ziele: Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen und die operierten Strukturen schützen.","additional_notes_en":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect surgical repair.","additional_notes_pl":"Cele: zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni oraz ochrona operowanych struktur.","minimum_patient_share":null,"therapeutic_content_de":"Voller Kniebewegungsumfang nach Verträglichkeit; Fersengleiten an der Wand; Knieflexion und -extension im Sitzen; Patellamobilisation und Mobilisation der Extension; isometrische Quadrizepsanspannung, gestrecktes Beinheben, Clamshells und Ballpressen; isometrische Anspannung der ischiokruralen Muskulatur; Sitz- und Reichübung mit einem Handtuch; Fahrradergometer mit dem gesunden Bein.","therapeutic_content_en":"Full knee ROM as tolerated; wall slides; seated knee flexion/extension; patellar mobilizations; extension mobilization; isometric quadriceps contractions, straight leg raises, clams, ball squeezes; hamstring sets; sit and reach with towel; stationary bike with well leg.","therapeutic_content_pl":"Pełny zakres ruchu kolana według tolerancji; ślizgi piętą po ścianie; zgięcie i wyprost kolana w siadzie; mobilizacja rzepki i mobilizacja wyprostu; izometryczne napięcia mięśnia czworogłowego, unoszenie wyprostowanej kończyny, ćwiczenia typu clamshell i ściskanie piłki; izometryczne napięcia mięśni kulszowo-goleniowych; ćwiczenie w siadzie z sięganiem przy użyciu ręcznika; rower stacjonarny napędzany zdrową kończyną.","minimum_requirements_de":"Keine Belastung der operierten Extremität; die Schiene darf auf dem Boden abgestellt werden; die Schiene bis 2 Wochen postoperativ belassen.","minimum_requirements_en":"Non weight bearing, may rest splint on ground; remain in splint until 2 weeks s/p.","minimum_requirements_pl":"Bez obciążania operowanej kończyny; szynę można oprzeć o podłoże; pozostawić szynę do 2. tygodnia po zabiegu.","additional_notes_original":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect surgical repair.","therapeutic_content_original":"Full knee ROM as tolerated; wall slides; seated knee flexion/extension; patellar mobilizations; extension mobilization; isometric quadriceps contractions, straight leg raises, clams, ball squeezes; hamstring sets; sit and reach with towel; stationary bike with well leg.","minimum_requirements_original":"Non weight bearing, may rest splint on ground; remain in splint until 2 weeks s/p.","structured_content_v2":"$undefined"},{"id":"dfdaa38d-25bf-5df9-9baa-90dd139167dc","name_de":"Phase 2: Wochen 2–6","name_en":"Phase 2: Weeks 2-6","name_pl":"Faza 2: tygodnie 2–6","source_page":1,"module_number":2,"name_original":"Phase 2: Weeks 2-6","service_codes":[],"structured_content":{"de":{"goals":["Schwellung und Ödem weiter reduzieren.","Schmerzen weiter begrenzen.","Muskelatrophie begrenzen.","Operierte Strukturen schützen.","Bewegungsumfang wiederherstellen."],"exercises":["Vorherige Übungen fortsetzen.","Sprunggelenkpumpen durchführen.","Passiven und aktiven Bewegungsumfang des Sprunggelenks nach Verträglichkeit durchführen.","Ruderergometer mit Einsatz des gesunden Beins verwenden.","Oberkörperergometer zur Erhaltung der Ausdauer einsetzen."],"applies_when":["In der 2. bis 6. postoperativen Woche anwenden."],"restrictions":["Eine Teilbelastung von 50 % mit Unterarmgehstützen nicht überschreiten.","Die Belastung an die Verträglichkeit des Patienten anpassen."],"physiotherapist_actions":["Den Übergang in einen Walker-Stiefel begleiten.","Narbenmassage, Dry Needling und instrumentengestützte Weichteilmobilisation (IASTM) nach Verträglichkeit durchführen."]},"en":{"goals":["Further reduce swelling and edema.","Further minimize pain.","Limit muscle atrophy.","Protect the surgical repair.","Restore range of motion."],"exercises":["Continue the previous exercises.","Perform ankle pumps.","Perform passive and active ankle range of motion as tolerated.","Use a rowing machine with the well leg.","Use an upper-body ergometer for cardiovascular fitness."],"applies_when":["Use during postoperative weeks 2 through 6."],"restrictions":["Do not exceed 50% partial weight bearing with crutches.","Adjust loading to patient tolerance."],"physiotherapist_actions":["Guide the transition into a walker boot.","Provide scar massage, dry needling and IASTM as tolerated."]},"pl":{"goals":["Dalej zmniejszaj obrzęk i opuchliznę.","Dalej ograniczaj ból.","Ograniczaj zanik mięśni.","Chroń operowane struktury.","Odzyskuj zakres ruchu."],"exercises":["Kontynuuj wcześniejsze ćwiczenia.","Wykonuj pompki stawu skokowego.","Prowadź bierny i czynny zakres ruchu stawu skokowego w granicach tolerancji pacjenta.","Stosuj ergometr wioślarski z pracą zdrowej kończyny.","Stosuj ergometr kończyn górnych dla podtrzymania wydolności."],"applies_when":["Stosuj od 2. do 6. tygodnia po operacji."],"restrictions":["Nie przekraczaj częściowego obciążania do 50% z użyciem kul.","Dostosuj obciążanie do tolerancji pacjenta."],"physiotherapist_actions":["Przeprowadź przejście pacjenta do buta ortopedycznego typu walker.","Stosuj masaż blizny, suche igłowanie i mobilizację tkanek miękkich narzędziami (IASTM) w granicach tolerancji pacjenta."]},"original":{"goals":["Reduce swelling and edema.","Minimize pain.","Retard muscle atrophy.","Protect surgical repair.","ROM restoration."],"exercises":["Continue previous exercises.","Ankle pumps.","Passive and active ankle ROM as tolerated.","Rowing with well leg.","UBE for cardiovascular fitness.","Scar massage, dry needling, IASTM as tolerated."],"applies_when":["Phase 2: Weeks 2–6."],"restrictions":["Transition into walker boot.","Partial weight bearing 50% with crutches as tolerated."]}},"additional_notes_de":"Ziele: Schwellung und Schmerzen weiter reduzieren, Muskelatrophie begrenzen, die operierten Strukturen schützen und den Bewegungsumfang wiederherstellen.","additional_notes_en":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect surgical repair, ROM restoration.","additional_notes_pl":"Cele: dalsze zmniejszanie obrzęku i bólu, ograniczenie zaniku mięśni, ochrona operowanych struktur oraz odzyskiwanie zakresu ruchu.","minimum_patient_share":null,"therapeutic_content_de":"Vorherige Übungen fortsetzen; Sprunggelenkpumpen; passiver und aktiver Bewegungsumfang des Sprunggelenks nach Verträglichkeit; Ruderergometer mit Einsatz des gesunden Beins; Oberkörperergometer zur Erhaltung der Ausdauer; Narbenmassage, Dry Needling und instrumentengestützte Weichteilmobilisation (IASTM) nach Verträglichkeit.","therapeutic_content_en":"Continue previous exercises; ankle pumps; passive and active ankle ROM as tolerated; rowing with well leg; UBE for cardiovascular fitness; scar massage, dry needling, IASTM as tolerated.","therapeutic_content_pl":"Kontynuować wcześniejsze ćwiczenia; pompki stawu skokowego; bierny i czynny zakres ruchu stawu skokowego według tolerancji; ergometr wioślarski z pracą zdrowej kończyny; ergometr kończyn górnych dla podtrzymania wydolności; masaż blizny, suche igłowanie i mobilizacja tkanek miękkich narzędziami (IASTM) według tolerancji.","minimum_requirements_de":"Übergang in einen Walker-Stiefel; Teilbelastung bis 50 % mit Unterarmgehstützen nach Verträglichkeit.","minimum_requirements_en":"Transition into walker boot; partial weight bearing 50% with crutches as tolerated.","minimum_requirements_pl":"Przejść do buta ortopedycznego typu walker; częściowe obciążanie do 50% z użyciem kul, według tolerancji.","additional_notes_original":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect surgical repair, ROM restoration.","therapeutic_content_original":"Continue previous exercises; ankle pumps; passive and active ankle ROM as tolerated; rowing with well leg; UBE for cardiovascular fitness; scar massage, dry needling, IASTM as tolerated.","minimum_requirements_original":"Transition into walker boot; partial weight bearing 50% with crutches as tolerated.","structured_content_v2":"$undefined"},{"id":"2fd4cd6f-4545-5fc0-93a6-355d14756f9f","name_de":"Phase 3: Wochen 6–12","name_en":"Phase 3: Weeks 6-12","name_pl":"Faza 3: tygodnie 6–12","source_page":1,"module_number":3,"name_original":"Phase 3: Weeks 6-12","service_codes":[],"structured_content":{"de":{"goals":["Vollen Bewegungsumfang erreichen.","Minimale Schmerzen anstreben.","Den Übungswiderstand steigern.","Ein normales Gangbild wiederherstellen.","Die Transplantatfixierung schützen — dies ist die wörtliche Formulierung der Quelle."],"warnings":["Die Quelle verwendet trotz intramedullärer Nagelung den Begriff „graft fixation“ („Transplantatfixierung“); die Formulierung wurde ohne Sinnänderung beibehalten."],"exercises":["Vorherige Übungen fortsetzen.","Ab Woche 8 Zehen- und Fersenheben sowie Gleichgewichtsübungen durchführen.","Ab Woche 8 Fahrradergometer mit beiden Beinen einsetzen.","Ab Woche 8 Aquajogging einsetzen.","Ab Woche 8 Laufbandgehen bei 7 % Steigung durchführen.","Ab Woche 8 Crosstrainer einsetzen.","Ab Woche 8 Ruderergometer mit beiden Beinen einsetzen.","Ab Woche 8 Stepper einsetzen."],"applies_when":["In der 6. bis 12. postoperativen Woche anwenden.","Die als „ab Woche 8“ bezeichneten Übungen nicht vor der 8. Woche beginnen."],"restrictions":["Keine Aktivitäten mit hoher Stoßbelastung einführen."],"progression_criteria":["Vor Beginn des Ablegens des Stiefels muss eine schmerzfreie Vollbelastung im Stiefel erreicht sein."],"dosage_and_progression":["Am Fahrradergometer ohne Widerstand beginnen und den Widerstand anschließend schrittweise steigern.","Nach vollständigem Ablegen des Stiefels die Extremität nach Verträglichkeit belasten."],"physiotherapist_actions":["Den Patienten nach Verträglichkeit schrittweise zur Vollbelastung im Walker-Stiefel ohne Gehstützen führen.","Das schrittweise Ablegen des Walker-Stiefels erst nach schmerzfreier Vollbelastung im Stiefel beginnen.","Das Ablegen des Walker-Stiefels über 1–2 Wochen nach Verträglichkeit begleiten."]},"en":{"goals":["Achieve full range of motion.","Maintain minimal pain.","Increase exercise resistance.","Restore a normal gait pattern.","Protect graft fixation — this is the source wording."],"warnings":["Although this document concerns intramedullary nailing, the source uses the term “graft fixation”; it has been retained without changing its meaning."],"exercises":["Continue the previous exercises.","From week 8, perform toe and heel raises and balance exercises.","From week 8, use a bike with both legs.","From week 8, use aqua jogging.","From week 8, perform treadmill walking at a 7% incline.","From week 8, use an elliptical trainer.","From week 8, use a rowing machine with both legs.","From week 8, use a stair stepper."],"applies_when":["Use during postoperative weeks 6 through 12.","Do not begin exercises designated “week 8” before week 8."],"restrictions":["Do not introduce heavy-impact activity."],"progression_criteria":["Before boot weaning, the patient must achieve full, pain-free weight bearing in the boot."],"dosage_and_progression":["Begin cycling without resistance and then progressively add resistance.","After boot weaning, weight bear as tolerated."],"physiotherapist_actions":["Progress the patient to full weight bearing in the boot without crutches as tolerated.","Begin boot weaning only after full, pain-free weight bearing in the boot is achieved.","Guide boot weaning over 1–2 weeks according to patient tolerance."]},"pl":{"goals":["Osiągaj pełny zakres ruchu.","Utrzymuj minimalny ból.","Zwiększaj opór ćwiczeń.","Przywracaj prawidłowy wzorzec chodu.","Chroń stabilizację przeszczepu — jest to dosłowne sformułowanie źródła."],"warnings":["Źródło używa określenia „graft fixation” („stabilizacja przeszczepu”) mimo że dokument dotyczy gwoździowania śródszpikowego; zachowano je bez zmiany sensu."],"exercises":["Kontynuuj wcześniejsze ćwiczenia.","Od 8. tygodnia wykonuj wspięcia na palce i pięty oraz ćwiczenia równowagi.","Od 8. tygodnia stosuj rower stacjonarny z pracą obu kończyn.","Od 8. tygodnia stosuj aqua jogging.","Od 8. tygodnia prowadź marsz na bieżni z nachyleniem 7%.","Od 8. tygodnia stosuj orbitrek.","Od 8. tygodnia stosuj ergometr wioślarski z pracą obu kończyn.","Od 8. tygodnia stosuj stepper."],"applies_when":["Stosuj od 6. do 12. tygodnia po operacji.","Ćwiczenia wskazane jako „od 8. tygodnia” rozpoczynaj nie wcześniej niż w 8. tygodniu."],"restrictions":["Nie wprowadzaj aktywności o dużym obciążeniu udarowym."],"progression_criteria":["Przed rozpoczęciem odstawiania buta pacjent musi osiągnąć pełne, bezbolesne obciążanie w bucie."],"dosage_and_progression":["Na rowerze stacjonarnym rozpocznij bez oporu, następnie stopniowo zwiększaj opór.","Po całkowitym odstawieniu buta obciążaj kończynę według tolerancji pacjenta."],"physiotherapist_actions":["Stopniowo przeprowadzaj pacjenta do pełnego obciążania w bucie typu walker bez kul, w granicach tolerancji.","Rozpocznij stopniowe odstawianie buta dopiero po uzyskaniu pełnego, bezbolesnego obciążania w bucie.","Prowadź odstawianie buta przez 1–2 tygodnie zgodnie z tolerancją pacjenta."]},"original":{"goals":["Full ROM.","Minimal pain.","Increase resistance exercises.","Restore normal gait pattern.","Protect graft fixation."],"exercises":["Continue previous exercises.","Toe and heel raises.","Balance series.","Bike with both legs, no resistance then progress to resistance.","Aqua jogging.","Treadmill walking at 7% incline.","Elliptical trainer.","Rowing with both legs.","Stair stepper."],"applies_when":["Phase 3: Weeks 6–12.","Week 8."],"restrictions":["Progress to full weight bearing in boot without crutches as tolerated.","Once full weight bearing in boot achieved and pain free, begin 1–2-week boot wean based on tolerance.","Once boot wean achieved: patient may weight bear as tolerated.","No heavy impact activity."]}},"additional_notes_de":"Ziele: voller Bewegungsumfang, minimale Schmerzen, Steigerung der Widerstandsübungen, Wiederherstellung eines normalen Gangbildes und Schutz der Transplantatfixierung.","additional_notes_en":"Goals: full ROM, minimal pain, increase resistance exercises, restore normal gait pattern, protect graft fixation.","additional_notes_pl":"Cele: pełny zakres ruchu, minimalny ból, zwiększanie oporu ćwiczeń, przywrócenie prawidłowego wzorca chodu oraz ochrona stabilizacji przeszczepu.","minimum_patient_share":null,"therapeutic_content_de":"Vorherige Übungen fortsetzen; ab Woche 8: Zehen- und Fersenheben sowie Gleichgewichtsübungen; Fahrradergometer mit beiden Beinen, zunächst ohne Widerstand und anschließend mit progressivem Widerstand; Aquajogging; Laufbandgehen bei 7 % Steigung; Crosstrainer; Ruderergometer mit beiden Beinen; Stepper.","therapeutic_content_en":"Continue previous exercises; week 8: toe and heel raises, balance series; bike with both legs, no resistance then progress to resistance; aqua jogging; treadmill walking at 7% incline; elliptical trainer; rowing with both legs; stair stepper.","therapeutic_content_pl":"Kontynuować wcześniejsze ćwiczenia; od 8. tygodnia: wspięcia na palce i pięty oraz ćwiczenia równowagi; rower stacjonarny z pracą obu kończyn, początkowo bez oporu, następnie z progresją oporu; aqua jogging; marsz na bieżni z nachyleniem 7%; orbitrek; ergometr wioślarski z pracą obu kończyn; stepper.","minimum_requirements_de":"Nach Verträglichkeit zur Vollbelastung im Walker-Stiefel ohne Gehstützen übergehen; nach schmerzfreier Vollbelastung den Walker über 1–2 Wochen schrittweise ablegen; danach Belastung nach Verträglichkeit; keine Aktivitäten mit hoher Stoßbelastung.","minimum_requirements_en":"Progress to full weight bearing in boot without crutches as tolerated; once full weight bearing in boot achieved and pain free, begin 1–2‑week boot wean based on tolerance; once boot wean achieved: patient may weight bear as tolerated; no heavy impact activity.","minimum_requirements_pl":"Stopniowo przejść do pełnego obciążania w bucie typu walker bez kul, według tolerancji; po uzyskaniu bezbolesnego pełnego obciążania rozpocząć trwające 1–2 tygodnie stopniowe odstawianie buta; po odstawieniu obciążać kończynę według tolerancji; bez aktywności z dużymi obciążeniami udarowymi.","additional_notes_original":"Goals: full ROM, minimal pain, increase resistance exercises, restore normal gait pattern, protect graft fixation.","therapeutic_content_original":"Continue previous exercises; week 8: toe and heel raises, balance series; bike with both legs, no resistance then progress to resistance; aqua jogging; treadmill walking at 7% incline; elliptical trainer; rowing with both legs; stair stepper.","minimum_requirements_original":"Progress to full weight bearing in boot without crutches as tolerated; once full weight bearing in boot achieved and pain free, begin 1–2‑week boot wean based on tolerance; once boot wean achieved: patient may weight bear as tolerated; no heavy impact activity.","structured_content_v2":"$undefined"},{"id":"d4c870d1-6c10-533e-97ce-47c0571e30d4","name_de":"Phase 4: Wochen 12–16","name_en":"Phase 4: Weeks 12-16","name_pl":"Faza 4: tygodnie 12–16","source_page":2,"module_number":4,"name_original":"Phase 4: Weeks 12-16","service_codes":[],"structured_content":{"de":{"goals":["Eine korrekte Gangmechanik wiederherstellen.","Die Kraft der unteren Extremität verbessern.","Den vollständigen Bewegungsumfang erhalten.","Die neuromuskuläre Kontrolle entwickeln.","Die Propriozeption wiederherstellen.","Die Leistung steigern.","Den Patienten schulen."],"exercises":["Beidbeinige Kniebeugen durchführen.","Beidbeinige Brücken durchführen.","Rückwärtige Ausfallschritte mit Haltephase durchführen.","Balance Squats durchführen.","Einbeiniges Kreuzheben durchführen.","Beinpresse durchführen.","Dynamisches Gleichgewicht trainieren.","Richtungswechsel, Crossover und Carioca trainieren.","Plyometrische Übungen einschließlich Medizinball- und Schlittenübungen einsetzen.","Agilitätsübungen mit Seitwärtsschritten, Koordinationsleiter, Hütchen, Z- und W-Cuts sowie multiplanaren sportartspezifischen Drills einsetzen."],"applies_when":["In der 12. bis 16. postoperativen Woche anwenden."],"progression_criteria":["Die Freigabe durch den Operateur einholen.","Einen Kraftindex der ischiokruralen Muskulatur >90 % gegenüber der Gegenseite erreichen.","Einen Quadrizeps-Kraftindex >90 % gegenüber der Gegenseite erreichen.","Im Y-Balance-Test eine Differenz der anterioren Reichweite <4 cm gegenüber der Gegenseite erreichen.","Keine Schmerzen, Instabilität oder Valguskollaps feststellen.","Bei einbeinigen Ausdaueraufgaben keine Femuradduktion oder -innenrotation, kein Absinken des Beckens und keine übermäßige Rumpfneigung feststellen.","Ab Woche 16 nach Freigabe eine Rückkehr zu Skifahren, Basketball, Tennis, American Football und Fußball erwägen."],"dosage_and_progression":["Den Lauf vorwärts und rückwärts schrittweise mit ½, ¾ und voller Geschwindigkeit steigern.","Nach Freigabe sind Golf, Wandern, Radfahren und Schneeschuhlaufen möglich."],"physiotherapist_actions":["Das Kräftigungsprogramm weiterentwickeln.","Die Laufprogression vorwärts und rückwärts anleiten.","Plyometrische Übungen an den Zielen des Patienten ausrichten.","Die Entlasskriterien vor Abschluss des Protokolls beurteilen."]},"en":{"goals":["Restore proper gait mechanics.","Improve lower-extremity strength.","Maintain full range of motion.","Develop neuromuscular control.","Restore proprioception.","Progress power.","Educate the patient."],"exercises":["Perform double-leg knee bends.","Perform double-leg bridges.","Perform reverse lunges with a static hold.","Perform balance squats.","Perform single-leg deadlifts.","Perform leg press.","Train dynamic balance.","Train cutting, crossover and carioca.","Use plyometric exercises, including medicine-ball work and sled drills.","Use agility drills: shuffles, ladder footwork, cone drills, Z-cuts, W-cuts and multi-planar sport-specific drills."],"applies_when":["Use during postoperative weeks 12 through 16."],"progression_criteria":["Obtain surgeon clearance.","Achieve a hamstring strength index >90% of the contralateral limb.","Achieve a quadriceps strength index >90% of the contralateral limb.","Achieve a Y-Balance anterior-reach difference <4 cm compared with the contralateral limb.","Confirm no pain, instability or valgus collapse.","During single-leg endurance tasks, confirm no femoral adduction or internal rotation, pelvic drop or excessive trunk lean.","From week 16, with clearance, consider return to skiing, basketball, tennis, American football and soccer."],"dosage_and_progression":["Progress forward and backward running at ½, ¾ and full speed.","With clearance, the patient may golf, hike, bike and snowshoe."],"physiotherapist_actions":["Progress the strengthening program.","Guide forward and backward running progression.","Select plyometric exercise according to patient goals.","Assess the discharge criteria before completing the protocol."]},"pl":{"goals":["Przywracaj prawidłową mechanikę chodu.","Poprawiaj siłę kończyny dolnej.","Utrzymuj pełny zakres ruchu.","Rozwijaj kontrolę nerwowo-mięśniową.","Przywracaj propriocepcję.","Zwiększaj moc.","Prowadź edukację pacjenta."],"exercises":["Wykonuj przysiady obunóż.","Wykonuj mosty obunóż.","Wykonuj wykroki w tył z zatrzymaniem.","Wykonuj przysiady równoważne.","Wykonuj martwy ciąg jednonóż.","Wykonuj ćwiczenie na suwnicy.","Prowadź trening równowagi dynamicznej.","Prowadź zmiany kierunku, crossover i carioca.","Stosuj ćwiczenia pliometryczne, w tym pracę z piłką lekarską i saniami.","Stosuj ćwiczenia zwinności: kroki odstawno-dostawne, drabinkę koordynacyjną, pachołki, cięcia Z i W oraz wielopłaszczyznowe ćwiczenia specyficzne dla sportu."],"applies_when":["Stosuj od 12. do 16. tygodnia po operacji."],"progression_criteria":["Uzyskaj zgodę chirurga.","Osiągnij wskaźnik siły mięśni kulszowo-goleniowych >90% względem kończyny przeciwległej.","Osiągnij wskaźnik siły mięśnia czworogłowego >90% względem kończyny przeciwległej.","W teście Y-Balance utrzymaj różnicę zasięgu anterior reach <4 cm względem kończyny przeciwległej.","Potwierdź brak bólu, niestabilności i zapadania kolana do koślawości.","Podczas jednonóż wykonywanych zadań wytrzymałościowych potwierdź brak przywiedzenia i rotacji wewnętrznej uda, opadania miednicy oraz nadmiernego pochylenia tułowia.","Od 16. tygodnia, po uzyskaniu zgody, rozważ powrót do narciarstwa, koszykówki, tenisa, futbolu amerykańskiego i piłki nożnej."],"dosage_and_progression":["Stopniowo zwiększaj bieg do przodu i do tyłu z prędkością ½, ¾ i pełną.","Po uzyskaniu zgody pacjent może uprawiać golf, piesze wędrówki, jazdę na rowerze i chodzić na rakietach śnieżnych."],"physiotherapist_actions":["Rozwijaj program wzmacniania.","Prowadź progresję biegu do przodu i do tyłu.","Dobieraj ćwiczenia pliometryczne do celów pacjenta.","Oceń kryteria wypisu przed zakończeniem protokołu."]},"original":{"goals":["Proper gait mechanics.","Improve lower extremity strength.","Full ROM.","Neuromuscular control.","Restore proprioception.","Progress power.","Patient education."],"exercises":["Progress strengthening program.","Double leg knee bends.","Double leg bridges.","Reverse lunges with static hold.","Balance squats.","Single leg deadlift.","Leg press.","Forward and backward running progression (½, ¾, full speed).","Progress dynamic balance.","Cutting, crossover, carioca, etc.","Plyometric exercises as appropriate to patient goals: med ball work, sled drills.","Agility drills: shuffles, ladder footwork, cone drills, z-cuts, w-cuts, multi-planar sports specific drills.","Patient may golf, hike, bike, snowshoe."],"applies_when":["Phase 4: Weeks 12–16."],"restrictions":["Full weight bearing.","Full ROM."],"progression_criteria":["Surgeon clearance.","Hamstring strength index >90% contralateral.","Quadriceps strength index >90% contralateral.","Y-Balance anterior reach <4 cm.","No pain or instability.","No valgus collapse.","No femoral adduction/IR pelvic drop of excessive trunk lean when performing single leg endurance tasks.","Week 16: Patient my return to skiing, basketball, tennis, football, soccer, etc. with clearance."]}},"additional_notes_de":"Entlassungskriterien: Freigabe durch den Operateur; Kraftindex der ischiokruralen Muskulatur >90 % und Quadrizeps-Kraftindex >90 % im Vergleich zur Gegenseite; beim Y-Balance-Test Differenz der anterioren Reichweite <4 cm; keine Schmerzen, Instabilität oder Valguskollaps; bei einbeinigen Ausdaueraufgaben keine Femuradduktion oder -innenrotation, kein Absinken des Beckens und keine übermäßige Rumpfneigung. Ab Woche 16 Rückkehr zu Skifahren, Basketball, Tennis, American Football und Fußball nach Freigabe möglich.","additional_notes_en":"Criteria for discharge: surgeon clearance; hamstring strength index >90% contralateral; quadriceps strength index >90% contralateral; Y‑Balance anterior reach <4 cm; no pain or instability; no valgus collapse; no femoral adduction/IR pelvic drop of excessive trunk lean when performing single leg endurance tasks. Week 16: patient may return to skiing, basketball, tennis, football, soccer, etc. with clearance.","additional_notes_pl":"Kryteria wypisu: zgoda chirurga; wskaźnik siły mięśni kulszowo-goleniowych >90% i mięśnia czworogłowego >90% względem kończyny przeciwległej; w teście Y-Balance różnica sięgania do przodu <4 cm; brak bólu, niestabilności i zapadania kolana do koślawości; podczas jednonóż wykonywanych zadań wytrzymałościowych brak przywiedzenia i rotacji wewnętrznej uda, opadania miednicy oraz nadmiernego pochylenia tułowia. Od 16. tygodnia możliwy powrót do narciarstwa, koszykówki, tenisa, futbolu amerykańskiego i piłki nożnej po uzyskaniu zgody.","minimum_patient_share":null,"therapeutic_content_de":"Kräftigungsprogramm steigern: beidbeinige Kniebeugen und Brücken, rückwärtige Ausfallschritte mit Haltephase, Balance Squats, einbeiniges Kreuzheben und Beinpresse; Laufprogression vorwärts und rückwärts mit ½, ¾ und voller Geschwindigkeit; dynamisches Gleichgewicht; Richtungswechsel, Crossover und Carioca; zielgerechte Plyometrie einschließlich Medizinball- und Schlittenübungen; Agilitätsübungen mit Seitwärtsschritten, Koordinationsleiter, Hütchen, Z- und W-Cuts sowie multiplanaren sportartspezifischen Drills. Golf, Wandern, Radfahren und Schneeschuhlaufen sind erlaubt.","therapeutic_content_en":"Progress strengthening program; double leg knee bends; double leg bridges; reverse lunges with static hold; balance squats; single leg deadlift; leg press; forward and backward running progression (½, ¾, full speed); progress dynamic balance; cutting, crossover, carioca, etc.; plyometric exercises as appropriate to patient goals: med ball work, sled drills; agility drills: shuffles, ladder footwork, cone drills, z-cuts, w-cuts, multi-planar sports specific drills; patient may golf, hike, bike, snowshoe.","therapeutic_content_pl":"Rozwijać program wzmacniania: przysiady obunóż, mosty obunóż, wykroki w tył z zatrzymaniem, przysiady równoważne, martwy ciąg jednonóż i suwnica; progresja biegu do przodu i do tyłu z prędkością ½, ¾ i pełną; dynamiczna równowaga; zmiany kierunku, crossover i carioca; ćwiczenia pliometryczne zgodne z celami pacjenta, w tym piłka lekarska i pchanie lub ciągnięcie sań; ćwiczenia zwinności: kroki odstawno-dostawne, drabinka koordynacyjna, pachołki, cięcia Z i W oraz wielopłaszczyznowe ćwiczenia specyficzne dla sportu. Dozwolone są golf, piesze wędrówki, jazda na rowerze i chodzenie na rakietach śnieżnych.","minimum_requirements_de":"Vollbelastung und voller Bewegungsumfang.","minimum_requirements_en":"Full weight bearing; full ROM.","minimum_requirements_pl":"Pełne obciążanie i pełny zakres ruchu.","additional_notes_original":"Criteria for discharge: surgeon clearance; hamstring strength index >90% contralateral; quadriceps strength index >90% contralateral; Y‑Balance anterior reach <4 cm; no pain or instability; no valgus collapse; no femoral adduction/IR pelvic drop of excessive trunk lean when performing single leg endurance tasks. Week 16: Patient my return to skiing, basketball, tennis, football, soccer, etc. with clearance.","therapeutic_content_original":"Progress strengthening program; double leg knee bends; double leg bridges; reverse lunges with static hold; balance squats; single leg deadlift; leg press; forward and backward running progression (½, ¾, full speed); progress dynamic balance; cutting, crossover, carioca, etc.; plyometric exercises as appropriate to patient goals: med ball work, sled drills; agility drills: shuffles, ladder footwork, cone drills, z-cuts, w-cuts, multi-planar sports specific drills; patient may golf, hike, bike, snowshoe.","minimum_requirements_original":"Full weight bearing; full 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Schulterblatt, HWS, Ellenbogen, Unterarm, Handgelenk und Hand.","Vorwärtsflexion und Abduktion auf 60° begrenzt."],"applies_when":["Schutz"],"physiotherapist_actions":["Armschlinge Tag und Nacht.","Armschlinge für 4 Wochen.","Empfohlen beim Schlafen und bei körperlichen Aktivitäten."]},"en":{"warnings":["Sling may be removed for therapy."],"exercises":["Passive and active assisted scapula, cervical spine, elbow, forearm, wrist, and hand exercises.","Forward flexion and abduction limited to 60°."],"applies_when":["Protection"],"physiotherapist_actions":["Sling usage day and night.","Sling usage for 4 weeks.","Recommended for sleeping and physical activities."]},"pl":{"warnings":["Temblak może być zdejmowany do ćwiczeń."],"exercises":["Ćwiczenia bierne i czynne wspomagane łopatki, kręgosłupa szyjnego, łokcia, przedramienia, nadgarstka i dłoni.","Zgięcie do przodu i odwiedzenie ograniczone do 60°."],"applies_when":["Ochrona"],"physiotherapist_actions":["Stosowanie temblaka w dzień i w nocy.","Użycie temblaka przez 4 tygodnie.","Zalecane noszenie podczas snu i aktywności fizycznej."]},"original":{"warnings":["Sling may be removed for therapy."],"exercises":["Passive and active assisted scapula, cervical spine, elbow, forearm, wrist, and hand exercises.","Forward flexion and abduction limited to 60°."],"applies_when":["Protection"],"physiotherapist_actions":["Sling usage day and night.","Sling usage for 4 weeks.","Recommended for sleeping and physical activities."]}},"additional_notes_de":"Schlinge darf zur Therapie abgenommen werden. Empfohlen beim Schlafen und bei körperlichen Aktivitäten.","additional_notes_en":"Sling may be removed for therapy. Recommended for sleeping and physical activities.","additional_notes_pl":"Temblak może być zdejmowany do ćwiczeń. Zalecane noszenie podczas snu i aktywności fizycznej.","minimum_patient_share":null,"therapeutic_content_de":"Armschlinge Tag und Nacht. Passive und aktiv-assistierte Übungen für Schulterblatt, HWS, Ellenbogen, Unterarm, Handgelenk und Hand. Vorwärtsflexion und Abduktion auf 60° begrenzt.","therapeutic_content_en":"Sling usage day and night. Passive and active assisted scapula, cervical spine, elbow, forearm, wrist, and hand exercises. Forward flexion and abduction limited to 60°.","therapeutic_content_pl":"Stosowanie temblaka w dzień i w nocy. Ćwiczenia bierne i czynne wspomagane łopatki, kręgosłupa szyjnego, łokcia, przedramienia, nadgarstka i dłoni. Zgięcie do przodu i odwiedzenie ograniczone do 60°.","minimum_requirements_de":"Armschlinge für 4 Wochen.","minimum_requirements_en":"Sling usage for 4 weeks.","minimum_requirements_pl":"Użycie temblaka przez 4 tygodnie.","additional_notes_original":"Sling may be removed for therapy. Recommended for sleeping and physical activities.","therapeutic_content_original":"Sling usage day and night. Passive and active assisted scapula, cervical spine, elbow, forearm, wrist, and hand exercises. Forward flexion and abduction limited to 60°.","minimum_requirements_original":"Sling usage for 4 weeks.","structured_content_v2":"$undefined"},{"id":"7be23fa0-6794-5d29-940b-2b9cb6165cf9","name_de":"Phase 4-6 Wochen: Bewegungserweiterung","name_en":"Phase 4-6 weeks: ROM progression","name_pl":"Faza 4-6 tygodni: Zwiększanie zakresu","source_page":2,"module_number":2,"name_original":"Phase 4-6 weeks: ROM progression","service_codes":[],"structured_content":{"de":{"exercises":["Passive und aktive Übungen zur Erreichung des funktionellen Bewegungsumfangs durch langsames, schmerzfreies Dehnen."],"applies_when":["Bewegungserweiterung"],"physiotherapist_actions":["Selbstständig oder mit Physiotherapeuten möglich."]},"en":{"exercises":["Passive and active exercises to achieve functional range of motion (ROM) with slow, pain-free stretching."],"applies_when":["ROM progression"],"physiotherapist_actions":["Performed independently or with physical therapist."]},"pl":{"exercises":["Ćwiczenia bierne i czynne w celu osiągnięcia funkcjonalnego zakresu ruchu (ROM) poprzez powolny, bezbolesny stretching."],"applies_when":["Zwiększanie zakresu"],"physiotherapist_actions":["Możliwe samodzielnie lub z fizjoterapeutą."]},"original":{"exercises":["Passive and active exercises to achieve functional range of motion (ROM) with slow, pain-free stretching."],"applies_when":["ROM progression"],"physiotherapist_actions":["Performed independently or with physical therapist."]}},"additional_notes_de":"Selbstständig oder mit Physiotherapeuten möglich.","additional_notes_en":"Performed independently or with physical therapist.","additional_notes_pl":"Możliwe samodzielnie lub z fizjoterapeutą.","minimum_patient_share":null,"therapeutic_content_de":"Passive und aktive Übungen zur Erreichung des funktionellen Bewegungsumfangs durch langsames, schmerzfreies Dehnen.","therapeutic_content_en":"Passive and active exercises to achieve functional range of motion (ROM) with slow, pain-free stretching.","therapeutic_content_pl":"Ćwiczenia bierne i czynne w celu osiągnięcia funkcjonalnego zakresu ruchu (ROM) poprzez powolny, bezbolesny stretching.","minimum_requirements_de":"","minimum_requirements_en":"","minimum_requirements_pl":"","additional_notes_original":"Performed independently or with physical therapist.","therapeutic_content_original":"Passive and active exercises to achieve functional range of motion (ROM) with slow, pain-free stretching.","minimum_requirements_original":"","structured_content_v2":"$undefined"},{"id":"c45f1cc4-ee1a-544e-9a08-ce90ed0bf7d8","name_de":"Phase 6-12+ Wochen: Rückkehr zur Aktivität","name_en":"Phase 6-12+ weeks: Return to activity","name_pl":"Faza 6-12+ tygodni: Powrót do aktywności","source_page":2,"module_number":3,"name_original":"Phase 6-12+ weeks: Return to activity","service_codes":[],"structured_content":{"de":{"exercises":["Wiederherstellung des präoperativen Bewegungsumfangs und progressive Kräftigungsübungen."],"applies_when":["Rückkehr zur Aktivität"],"restrictions":["Vermeidung von ruckartigen Bewegungen und Heben in den ersten 3 Monaten."],"dosage_and_progression":["Vorübergehende Beschwerden möglich."]},"en":{"exercises":["Regaining pre-op ROM and continuing progressive strengthening exercises."],"applies_when":["Return to activity"],"restrictions":["Avoid sudden movements and lifting during the first 3 months."],"dosage_and_progression":["Temporary discomfort expected."]},"pl":{"exercises":["Odzyskiwanie przedoperacyjnego zakresu ruchu (ROM) i progresywne ćwiczenia wzmacniające."],"applies_when":["Powrót do aktywności"],"restrictions":["Unikać gwałtownych ruchów i dźwigania przez pierwsze 3 miesiące."],"dosage_and_progression":["Możliwy przejściowy dyskomfort lub ból."]},"original":{"exercises":["Regaining pre-op ROM and continuing progressive strengthening exercises."],"applies_when":["Return to activity"],"restrictions":["Avoid sudden movements and lifting during the first 3 months."],"dosage_and_progression":["Temporary discomfort expected."]}},"additional_notes_de":"Vorübergehende Beschwerden möglich. Vermeidung von ruckartigen Bewegungen und Heben in den ersten 3 Monaten.","additional_notes_en":"Temporary discomfort expected. Avoid sudden movements and lifting during the first 3 months.","additional_notes_pl":"Możliwy przejściowy dyskomfort lub ból. Unikać gwałtownych ruchów i dźwigania przez pierwsze 3 miesiące.","minimum_patient_share":null,"therapeutic_content_de":"Wiederherstellung des präoperativen Bewegungsumfangs und progressive Kräftigungsübungen.","therapeutic_content_en":"Regaining pre-op ROM and continuing progressive strengthening exercises.","therapeutic_content_pl":"Odzyskiwanie przedoperacyjnego zakresu ruchu (ROM) i progresywne ćwiczenia wzmacniające.","minimum_requirements_de":"","minimum_requirements_en":"","minimum_requirements_pl":"","additional_notes_original":"Temporary discomfort expected. 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Risikofaktoren","service_codes":[],"structured_content":{"de":{"warnings":["Dies ist ein diagnostischer Schritt, keine eigenständige medizinische Diagnose."],"exercises":["Das Physiotherapiekapitel empfiehlt die Erfassung von Frailty, Fitness, Aktivität, Sturzrisiko, Sturzangst sowie Mangelernährungs- und Sarkopenierisiko.","Genannt werden EFIP, 6MWT, SPPB, TUG, 30CST und SARC-F."],"physiotherapist_actions":["Instrumente an Fähigkeiten und Durchführbarkeit anpassen."]},"en":{"warnings":["This is a diagnostic step, not a standalone medical diagnosis."],"exercises":["The physical therapy chapter recommends assessing frailty, fitness, activity, fall risk, fear of falling, and malnutrition and sarcopenia risk.","Measures include EFIP, 6MWT, SPPB, TUG, 30CST, and SARC-F."],"physiotherapist_actions":["Adapt measures to patient abilities and feasibility."]},"pl":{"warnings":["To etap diagnostyczny, nie samodzielne rozpoznanie medyczne."],"exercises":["W module fizjoterapii zaleca się ocenę 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Genannt werden EFIP, 6MWT, SPPB, TUG, 30CST und SARC-F.","therapeutic_content_en":"The physical therapy chapter recommends assessing frailty, fitness, activity, fall risk, fear of falling, and malnutrition and sarcopenia risk. Measures include EFIP, 6MWT, SPPB, TUG, 30CST, and SARC-F.","therapeutic_content_pl":"W module fizjoterapii zaleca się ocenę kruchości, sprawności, aktywności, ryzyka upadku, lęku przed upadkiem oraz ryzyka niedożywienia i sarkopenii. Wskazane narzędzia obejmują EFIP, 6MWT, SPPB, TUG, 30CST i SARC-F.","minimum_requirements_de":"Instrumente an Fähigkeiten und Durchführbarkeit anpassen.","minimum_requirements_en":"Adapt measures to patient abilities and feasibility.","minimum_requirements_pl":"Dobierz narzędzia do możliwości pacjenta i wykonalności badania.","additional_notes_original":"Dies ist ein diagnostischer Schritt, keine eigenständige medizinische Diagnose.","therapeutic_content_original":"EFIP; 6MWT; SPPB; TUG; 30CST; SARC-F.","minimum_requirements_original":"Adapt measures to patient abilities and feasibility.","structured_content_v2":"$undefined"},{"id":"c4f4edd6-2210-58ef-b1c2-a1927f6a15e4","name_de":"Personalisierte Intervention und FITT","name_en":"Personalized Intervention and FITT","name_pl":"Interwencja spersonalizowana i FITT","source_page":40,"module_number":2,"name_original":"Personalisierte Intervention und FITT","service_codes":[],"structured_content":{"de":{"warnings":["Die Leitlinie nennt Bereiche für Frequenz und Dauer, aber kein einheitliches Protokoll."],"exercises":["Eine personalisierte Intervention soll insbesondere bei sehr gebrechlichen älteren Menschen erwogen werden.","Ziele werden gemeinsam festgelegt","das Programm wird nach FITT und unter Berücksichtigung von Fähigkeiten, Umgebung und subjektiver Belastung gestaltet."],"physiotherapist_actions":["ADL-Ziele, Asymmetrie, Medikamente, Angehörige und Sicherheit des Heimtrainings berücksichtigen."]},"en":{"warnings":["The guideline gives ranges for frequency and duration, not one universal protocol."],"exercises":["Consider a personalized intervention, especially for very frail older adults.","Set goals jointly and tailor the program using FITT while considering abilities, environment, and perceived exertion."],"physiotherapist_actions":["Consider ADL goals, asymmetry, medication, carers, and home-exercise safety."]},"pl":{"warnings":["Wytyczna podaje zakresy częstotliwości i czasu, ale nie jeden uniwersalny protokół."],"exercises":["Zaleca się rozważenie interwencji spersonalizowanej, szczególnie u osób bardzo kruchych.","Cele ustala się z pacjentem, a program dobiera według częstotliwości, intensywności, czasu i typu (FITT), z uwzględnieniem możliwości, środowiska i samooceny wysiłku."],"physiotherapist_actions":["Uwzględnij cele ADL, asymetrię, leki, rodzinę/opiekunów i bezpieczeństwo ćwiczeń domowych."]},"original":{"warnings":["The guideline gives ranges for frequency and duration, not one universal protocol."],"exercises":["Consider a personalized intervention, especially for very frail older adults.","Set goals jointly and tailor the program using FITT while considering abilities, environment, and perceived exertion."],"physiotherapist_actions":["Consider ADL goals, asymmetry, medication, carers, and home-exercise safety."]}},"additional_notes_de":"Die Leitlinie nennt Bereiche für Frequenz und Dauer, aber kein einheitliches Protokoll.","additional_notes_en":"The guideline gives ranges for frequency and duration, not one universal protocol.","additional_notes_pl":"Wytyczna podaje zakresy częstotliwości i czasu, ale nie jeden uniwersalny protokół.","minimum_patient_share":null,"therapeutic_content_de":"Eine personalisierte Intervention soll insbesondere bei sehr gebrechlichen älteren Menschen erwogen werden. Ziele werden gemeinsam festgelegt; das Programm wird nach FITT und unter Berücksichtigung von Fähigkeiten, Umgebung und subjektiver Belastung gestaltet.","therapeutic_content_en":"Consider a personalized intervention, especially for very frail older adults. Set goals jointly and tailor the program using FITT while considering abilities, environment, and perceived exertion.","therapeutic_content_pl":"Zaleca się rozważenie interwencji spersonalizowanej, szczególnie u osób bardzo kruchych. Cele ustala się z pacjentem, a program dobiera według częstotliwości, intensywności, czasu i typu (FITT), z uwzględnieniem możliwości, środowiska i samooceny wysiłku.","minimum_requirements_de":"ADL-Ziele, Asymmetrie, Medikamente, Angehörige und Sicherheit des Heimtrainings berücksichtigen.","minimum_requirements_en":"Consider ADL goals, asymmetry, medication, carers, and home-exercise safety.","minimum_requirements_pl":"Uwzględnij cele ADL, asymetrię, leki, rodzinę/opiekunów i bezpieczeństwo ćwiczeń domowych.","additional_notes_original":"Die Leitlinie nennt Bereiche für Frequenz und Dauer, aber kein einheitliches Protokoll.","therapeutic_content_original":"Persoonsgerichte interventie; FITT; frequentie 1–3x per week in first line; 2–5x per week in hospital setting.","minimum_requirements_original":"Consider ADL goals, asymmetry, medication, carers, and home-exercise safety.","structured_content_v2":"$undefined"},{"id":"65b4bddb-a0af-50a8-842d-cf43b2ded8b5","name_de":"Balanstraining","name_en":"Balance Training","name_pl":"Trening równowagi","source_page":44,"module_number":3,"name_original":"Balanstraining","service_codes":[],"structured_content":{"de":{"warnings":["Das Training kann individuell oder in der Gruppe erfolgen."],"exercises":["Bei gebrechlichen älteren Menschen oder erhöhtem Sturzrisiko soll konventionelles Balance-, Geh- und Funktionstraining eingesetzt werden","Tai-Chi sowie proaktives und reaktives Parcourstraining können erwogen werden."],"physiotherapist_actions":["Heim-, Vor-Ort- oder kombiniertes Training entsprechend Mobilität und Kontext wählen."]},"en":{"warnings":["Training may be individual or group-based."],"exercises":["For frail older adults or those at increased fall risk, use conventional balance, gait, and functional training","Tai Chi and proactive/reactive obstacle-course training may be considered."],"physiotherapist_actions":["Choose home, on-site, or combined training based on mobility and context."]},"pl":{"warnings":["Trening może być indywidualny lub grupowy."],"exercises":["U osób kruchych lub z podwyższonym ryzykiem upadku stosuj konwencjonalny trening równowagi obejmujący chód, równowagę i zadania funkcjonalne","można rozważyć Tai Chi oraz proaktywny i reaktywny tor przeszkód."],"physiotherapist_actions":["Wybierz trening domowy, na miejscu lub łączony zgodnie z mobilnością i kontekstem."]},"original":{"warnings":["Training may be individual or group-based."],"exercises":["For frail older adults or those at increased fall risk, use conventional balance, gait, and functional training","Tai Chi and proactive/reactive obstacle-course training may be considered."],"physiotherapist_actions":["Choose home, on-site, or combined training based on mobility and context."]}},"additional_notes_de":"Das Training kann individuell oder in der Gruppe erfolgen.","additional_notes_en":"Training may be individual or group-based.","additional_notes_pl":"Trening może być indywidualny lub grupowy.","minimum_patient_share":null,"therapeutic_content_de":"Bei gebrechlichen älteren Menschen oder erhöhtem Sturzrisiko soll konventionelles Balance-, Geh- und Funktionstraining eingesetzt werden; Tai-Chi sowie proaktives und reaktives Parcourstraining können erwogen werden.","therapeutic_content_en":"For frail older adults or those at increased fall risk, use conventional balance, gait, and functional training; Tai Chi and proactive/reactive obstacle-course training may be considered.","therapeutic_content_pl":"U osób kruchych lub z podwyższonym ryzykiem upadku stosuj konwencjonalny trening równowagi obejmujący chód, równowagę i zadania funkcjonalne; można rozważyć Tai Chi oraz proaktywny i reaktywny tor przeszkód.","minimum_requirements_de":"Heim-, Vor-Ort- oder kombiniertes Training entsprechend Mobilität und Kontext wählen.","minimum_requirements_en":"Choose home, on-site, or combined training based on mobility and context.","minimum_requirements_pl":"Wybierz trening domowy, na miejscu lub łączony zgodnie z mobilnością i kontekstem.","additional_notes_original":"Das Training kann individuell oder in der Gruppe erfolgen.","therapeutic_content_original":"Konventionelles Balance-, Geh- und Funktionstraining; Tai Chi; proaktives und reaktives Parcourstraining.","minimum_requirements_original":"Choose home, on-site, or combined training based on mobility and context.","structured_content_v2":"$undefined"},{"id":"e4d14cd7-4a27-5a09-8900-08c4ff0fcbbb","name_de":"Funktionelles Training","name_en":"Functional Training","name_pl":"Trening funkcjonalny","source_page":47,"module_number":4,"name_original":"Funktionelles Training","service_codes":[],"structured_content":{"de":{"warnings":["Die Evidenz ist unterschiedlich","die Empfehlung stützt sich auch auf klinische Einschätzung."],"exercises":["Jede Trainingsintervention bei gebrechlichen älteren Menschen soll eine funktionelle Komponente enthalten, die zu Hause durchführbar ist.","Beispiele sind Gewichtsverlagerung, Hindernisse, Aufstehen, Treppen, Gehen und ADL-Aufgaben."],"physiotherapist_actions":["Aufgaben an schwierige Aktivitäten anpassen und Transfer nach Hause sichern."]},"en":{"warnings":["Evidence varies","the recommendation also reflects clinical judgment."],"exercises":["Every training intervention for frail older adults should include a functional component that can be performed at home.","Examples include weight shifting, obstacles, sit-to-stand, stairs, walking, and ADL tasks."],"physiotherapist_actions":["Tailor tasks to difficult patient activities and ensure transfer to home."]},"pl":{"warnings":["Dowody dotyczące efektów są zróżnicowane","zalecenie wynika także z oceny klinicznej zespołu."],"exercises":["Każda interwencja treningowa u osoby kruchej powinna zawierać komponent funkcjonalny, możliwy do wykonania w domu.","Przykłady obejmują przenoszenie ciężaru, przeszkody, wstawanie, schody, chodzenie i zadania ADL."],"physiotherapist_actions":["Dopasuj zadania do trudnych aktywności pacjenta i zapewnij transfer do domu."]},"original":{"warnings":["Evidence varies","the recommendation also reflects clinical judgment."],"exercises":["Every training intervention for frail older adults should include a functional component that can be performed at home.","Examples include weight shifting, obstacles, sit-to-stand, stairs, walking, and ADL tasks."],"physiotherapist_actions":["Tailor tasks to difficult patient activities and ensure transfer to home."]}},"additional_notes_de":"Die Evidenz ist unterschiedlich; die Empfehlung stützt sich auch auf klinische Einschätzung.","additional_notes_en":"Evidence varies; the recommendation also reflects clinical judgment.","additional_notes_pl":"Dowody dotyczące efektów są zróżnicowane; zalecenie wynika także z oceny klinicznej zespołu.","minimum_patient_share":null,"therapeutic_content_de":"Jede Trainingsintervention bei gebrechlichen älteren Menschen soll eine funktionelle Komponente enthalten, die zu Hause durchführbar ist. Beispiele sind Gewichtsverlagerung, Hindernisse, Aufstehen, Treppen, Gehen und ADL-Aufgaben.","therapeutic_content_en":"Every training intervention for frail older adults should include a functional component that can be performed at home. Examples include weight shifting, obstacles, sit-to-stand, stairs, walking, and ADL tasks.","therapeutic_content_pl":"Każda interwencja treningowa u osoby kruchej powinna zawierać komponent funkcjonalny, możliwy do wykonania w domu. Przykłady obejmują przenoszenie ciężaru, przeszkody, wstawanie, schody, chodzenie i zadania ADL.","minimum_requirements_de":"Aufgaben an schwierige Aktivitäten anpassen und Transfer nach Hause sichern.","minimum_requirements_en":"Tailor tasks to difficult patient activities and ensure transfer to home.","minimum_requirements_pl":"Dopasuj zadania do trudnych aktywności pacjenta i zapewnij transfer do domu.","additional_notes_original":"Die Evidenz ist unterschiedlich; die Empfehlung stützt sich auch auf klinische Einschätzung.","therapeutic_content_original":"Bei jeder Trainingsintervention eine Komponente des funktionellen Trainings anwenden.","minimum_requirements_original":"Tailor tasks to difficult patient activities and ensure transfer to home.","structured_content_v2":"$undefined"},{"id":"b6de9b1a-0080-5e80-9f8d-ff2647cefe59","name_de":"Selbstmanagement eines aktiven Lebensstils","name_en":"Self-Management of Active Behavior","name_pl":"Samodzielne utrzymanie aktywności","source_page":50,"module_number":5,"name_original":"Selbstmanagement eines aktiven Lebensstils","service_codes":[],"structured_content":{"de":{"warnings":["Hausbesuche und digitale Unterstützung können erwogen werden."],"exercises":["Individuelle Aktivitäts- und Verhaltensziele mit ADL-Bezug festlegen, Feedback geben, lokale Angebote besprechen und ein sicheres Heimprogramm unterstützen.","Aktivitätstagebuch, Schrittzähler und telefonische Nachsorge können eingesetzt werden."],"physiotherapist_actions":["Physische, psychologische und soziale Kontextfaktoren berücksichtigen."]},"en":{"warnings":["Home visits and digital support may be considered."],"exercises":["Set individual activity and behavior goals applicable to ADLs, provide feedback, discuss local activities, and support a safe home program.","Activity diaries, step counters, and telephone follow-up may be used."],"physiotherapist_actions":["Consider the patient’s physical, psychological, and social context."]},"pl":{"warnings":["Można rozważyć wizyty domowe i wsparcie cyfrowe."],"exercises":["Ustalaj indywidualne cele aktywności i zachowania możliwe do zastosowania w ADL, dawaj informację zwrotną, omawiaj lokalne aktywności i wspieraj bezpieczny program domowy.","Można używać dziennika aktywności, krokomierza i kontaktu telefonicznego po interwencji."],"physiotherapist_actions":["Uwzględnij kontekst fizyczny, psychologiczny i społeczny pacjenta."]},"original":{"warnings":["Home visits and digital support may be considered."],"exercises":["Set individual activity and behavior goals applicable to ADLs, provide feedback, discuss local activities, and support a safe home program.","Activity diaries, step counters, and telephone follow-up may be used."],"physiotherapist_actions":["Consider the patient’s physical, psychological, and social context."]}},"additional_notes_de":"Hausbesuche und digitale Unterstützung können erwogen werden.","additional_notes_en":"Home visits and digital support may be considered.","additional_notes_pl":"Można rozważyć wizyty domowe i wsparcie cyfrowe.","minimum_patient_share":null,"therapeutic_content_de":"Individuelle Aktivitäts- und Verhaltensziele mit ADL-Bezug festlegen, Feedback geben, lokale Angebote besprechen und ein sicheres Heimprogramm unterstützen. Aktivitätstagebuch, Schrittzähler und telefonische Nachsorge können eingesetzt werden.","therapeutic_content_en":"Set individual activity and behavior goals applicable to ADLs, provide feedback, discuss local activities, and support a safe home program. Activity diaries, step counters, and telephone follow-up may be used.","therapeutic_content_pl":"Ustalaj indywidualne cele aktywności i zachowania możliwe do zastosowania w ADL, dawaj informację zwrotną, omawiaj lokalne aktywności i wspieraj bezpieczny program domowy. Można używać dziennika aktywności, krokomierza i kontaktu telefonicznego po interwencji.","minimum_requirements_de":"Physische, psychologische und soziale Kontextfaktoren berücksichtigen.","minimum_requirements_en":"Consider the patient’s physical, psychological, and social context.","minimum_requirements_pl":"Uwzględnij kontekst fizyczny, psychologiczny i społeczny pacjenta.","additional_notes_original":"Hausbesuche und digitale Unterstützung können erwogen werden.","therapeutic_content_original":"Individuell relevante uitkomst- en gedragsdoelen; feedback; activity tracker; activiteitendagboek; telefonische follow-up.","minimum_requirements_original":"Consider the patient’s physical, psychological, and social context.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"clinical_practice_guideline","content_role":"supporting_guideline","classification_status":"verified","clinical_domain":"geriatric_multisystem","clinical_entity_type":"population","body_region_codes":["whole_body"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["care_process","recommendation_set"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"e470dfd5-e9d4-5dfb-bbf3-4ad054ebfba9","slug":"us-south-shore-01-bankart-repair","title_pl":"Protokół rehabilitacji po naprawie Bankarta","title_de":"Rehabilitationsprotokoll nach Bankart-Refixierung","title_en":"South Shore Bankart Repair Protocol","title_original":"Bankart Repair","summary_pl":"24-tygodniowy progresywny protokół pooperacyjny skupiający się na ochronie tkanek, odzyskaniu zakresu ruchu i wzmacnianiu obręczy barkowej.","summary_de":"24-wöchiges progressives postoperatives Protokoll zur Gewebeschonung, Wiederherstellung des Bewegungsumfangs und Kräftigung des Schultergürtels.","summary_en":"24-week progressive post-operative protocol focused on tissue protection, range of motion recovery, and shoulder girdle strengthening.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"c8f9a434-50d8-5e26-b2c3-0b778563e741","condition_slug":"bankart-repair","condition_name_pl":"Naprawa Bankarta","condition_name_de":"Bankart-Refixierung","condition_name_en":"Bankart Repair","condition_name_original":"Bankart Repair","icd_codes":[],"category_key":"shoulder","category_pl":"Bark","category_de":"Schulter","category_en":"Shoulder","body_regions_pl":["Bark"],"body_regions_de":["Schulter"],"body_regions_en":["Shoulder"],"search_terms_pl":["naprawa obrąbka","niestabilność barku","po operacji","fizjoterapia barku"],"search_terms_de":["Labrumriss","Schulterinstabilität","postoperativ","Schulter-Physiotherapie"],"search_terms_en":["labrum tear","shoulder instability","post-op","arthroscopic"],"source_document_id":"9448f76f-d0b6-5731-9994-c9bcd7f8ee9a","source_title":"Bankart Repair","issuer":"South Shore Orthopedics","source_country_code":"US","jurisdiction_code":"US-MA","authority_level":"hospital","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"stale_requires_clinical_update_check","official_url":"https://octanecdn.com/southshoreorthopedicscom/southshoreorthopedicscom_876460257.pdf","source_sha256":"a3ea5c93c2e58118f73109f253abf54d2ea04191ae6107de77f5cfd5a3edc1ea","authorization_required":false,"license_note":"Public source file retained locally for source verification.","modules":[{"id":"e49cc876-640a-5eb8-9829-f8082aa6a69c","name_de":"Phase 1: Passive Bewegungsabläufe (0-4 Wochen)","name_en":"Phase 1: Passive ROM (0-4 weeks)","name_pl":"Faza 1: Bierny zakres ruchu (0-4 tydzień)","source_page":4,"module_number":1,"name_original":"Phase 1: Passive ROM (0-4 weeks)","service_codes":[],"structured_content":{"de":{"exercises":["Übungen: Pendelübungen, Scapulamobilität, passive Flexion."],"applies_when":["Passive Bewegungsabläufe (0-4 Wochen)"],"restrictions":["Kein aktives Überkopf- oder Hinterkopf-Reichen, kein Heben."],"physiotherapist_actions":["Schmerz- und Ödemkontrolle, Schutz des heilenden Gewebes, Einleitung des passiven Bewegungsumfangs (ROM).","Orthese für 0-4 Wochen."]},"en":{"exercises":["Exercises: pendulums, scapular mobility, passive flexion."],"applies_when":["Passive ROM (0-4 weeks)"],"restrictions":["No active overhead/behind-head reach, no lifting."],"physiotherapist_actions":["Control pain and swelling, protect healing tissue, initiate passive ROM.","Sling 0-4 weeks."]},"pl":{"exercises":["Ćwiczenia: wahadłowe, mobilność łopatki, bierne wyprosty."],"applies_when":["Bierny zakres ruchu (0-4 tydzień)"],"restrictions":["Zakaz aktywnego ruchu nad głową, za głowę i dźwigania."],"physiotherapist_actions":["Kontrola bólu i obrzęku, ochrona gojących się tkanek, rozpoczęcie biernego zakresu ruchu (ROM).","Orteza przez 0-4 tygodnie."]},"original":{"exercises":["Exercises: pendulums, scapular mobility, passive flexion."],"applies_when":["Passive ROM (0-4 weeks)"],"restrictions":["No active overhead/behind-head reach, no lifting."],"physiotherapist_actions":["Control pain and swelling, protect healing tissue, initiate passive ROM.","Sling 0-4 weeks."]}},"additional_notes_de":"Übungen: Pendelübungen, Scapulamobilität, passive Flexion.","additional_notes_en":"Exercises: pendulums, scapular mobility, passive flexion.","additional_notes_pl":"Ćwiczenia: wahadłowe, mobilność łopatki, bierne wyprosty.","minimum_patient_share":null,"therapeutic_content_de":"Schmerz- und Ödemkontrolle, Schutz des heilenden Gewebes, Einleitung des passiven Bewegungsumfangs (ROM).","therapeutic_content_en":"Control pain and swelling, protect healing tissue, initiate passive ROM.","therapeutic_content_pl":"Kontrola bólu i obrzęku, ochrona gojących się tkanek, rozpoczęcie biernego zakresu ruchu (ROM).","minimum_requirements_de":"Kein aktives Überkopf- oder Hinterkopf-Reichen, kein Heben. Orthese für 0-4 Wochen.","minimum_requirements_en":"No active overhead/behind-head reach, no lifting. Sling 0-4 weeks.","minimum_requirements_pl":"Zakaz aktywnego ruchu nad głową, za głowę i dźwigania. Orteza przez 0-4 tygodnie.","additional_notes_original":"Exercises: pendulums, scapular mobility, passive flexion.","therapeutic_content_original":"Control pain and swelling, protect healing tissue, initiate passive ROM.","minimum_requirements_original":"No active overhead/behind-head reach, no lifting. Sling 0-4 weeks.","structured_content_v2":"$undefined"},{"id":"f50f56c7-c0db-5e10-b5a7-895d0d31fa10","name_de":"Phase 2: Aktiver Bewegungsumfang (4-8 Wochen)","name_en":"Phase 2: Active ROM (4-8 weeks)","name_pl":"Faza 2: Aktywny zakres ruchu (4-8 tydzień)","source_page":4,"module_number":2,"name_original":"Phase 2: Active ROM (4-8 weeks)","service_codes":[],"structured_content":{"de":{"exercises":["Weiterer Gewebeschutz, Verbesserung des ROM, Beginn der Kräftigung der periskapulären Muskulatur und Rotatorenmanschette."],"applies_when":["Aktiver Bewegungsumfang (4-8 Wochen)"],"restrictions":["Vermeidung von Heben.","Arm nur vor dem Körper einsetzen."],"dosage_and_progression":["Einführung aktiver Übungen ab Woche 6."]},"en":{"exercises":["Continued tissue protection, improve ROM, initiate peri-scapular and rotator cuff strengthening."],"applies_when":["Active ROM (4-8 weeks)"],"restrictions":["Avoid lifting.","Use arm in front of body only."],"dosage_and_progression":["Introduction of active exercises from week 6."]},"pl":{"exercises":["Dalsza ochrona tkanek, poprawa ROM, inicjacja wzmacniania mięśni okołopatkowych i stożka rotatorów."],"applies_when":["Aktywny zakres ruchu (4-8 tydzień)"],"restrictions":["Unikanie dźwigania.","Używanie ręki tylko w przedniej płaszczyźnie ciała."],"dosage_and_progression":["Wprowadzenie ćwiczeń czynnych po 6. tygodniu."]},"original":{"exercises":["Continued tissue protection, improve ROM, initiate peri-scapular and rotator cuff strengthening."],"applies_when":["Active ROM (4-8 weeks)"],"restrictions":["Avoid lifting.","Use arm in front of body only."],"dosage_and_progression":["Introduction of active exercises from week 6."]}},"additional_notes_de":"Einführung aktiver Übungen ab Woche 6.","additional_notes_en":"Introduction of active exercises from week 6.","additional_notes_pl":"Wprowadzenie ćwiczeń czynnych po 6. tygodniu.","minimum_patient_share":null,"therapeutic_content_de":"Weiterer Gewebeschutz, Verbesserung des ROM, Beginn der Kräftigung der periskapulären Muskulatur und Rotatorenmanschette.","therapeutic_content_en":"Continued tissue protection, improve ROM, initiate peri-scapular and rotator cuff strengthening.","therapeutic_content_pl":"Dalsza ochrona tkanek, poprawa ROM, inicjacja wzmacniania mięśni okołopatkowych i stożka rotatorów.","minimum_requirements_de":"Vermeidung von Heben. Arm nur vor dem Körper einsetzen.","minimum_requirements_en":"Avoid lifting. Use arm in front of body only.","minimum_requirements_pl":"Unikanie dźwigania. Używanie ręki tylko w przedniej płaszczyźnie ciała.","additional_notes_original":"Introduction of active exercises from week 6.","therapeutic_content_original":"Continued tissue protection, improve ROM, initiate peri-scapular and rotator cuff strengthening.","minimum_requirements_original":"Avoid lifting. Use arm in front of body only.","structured_content_v2":"$undefined"},{"id":"cd0850a4-3811-51d2-90e6-ca0b51b86ced","name_de":"Phase 3: Kräftigung (8-12 Wochen)","name_en":"Phase 3: Strengthening (8-12 weeks)","name_pl":"Faza 3: Wzmacnianie (8-12 tydzień)","source_page":5,"module_number":3,"name_original":"Phase 3: Strengthening (8-12 weeks)","service_codes":[],"structured_content":{"de":{"exercises":["Erreichen des vollen ROM, progressive Kräftigung der Rotatorenmanschette und Scapulastabilisatoren."],"applies_when":["Kräftigung (8-12 Wochen)"],"restrictions":["Kein Heben über 1-2 Pfund.","Vorsicht bei Überkopfbewegungen."],"physiotherapist_actions":["Fokus auf skapulohumeralen Rhythmus."]},"en":{"exercises":["Attain full ROM, progress rotator cuff and scapular strengthening."],"applies_when":["Strengthening (8-12 weeks)"],"restrictions":["No lifting over 1-2 lbs.","Caution with overhead."],"physiotherapist_actions":["Focus on scapulohumeral rhythm."]},"pl":{"exercises":["Osiągnięcie pełnego ROM, progresywne wzmacnianie stożka rotatorów i stabilizatorów łopatki."],"applies_when":["Wzmacnianie (8-12 tydzień)"],"restrictions":["Zakaz dźwigania powyżej 1-2 funtów.","Uwaga na ruchy nad głową."],"physiotherapist_actions":["Skupienie na rytmie łopatkowo-ramiennym."]},"original":{"exercises":["Attain full ROM, progress rotator cuff and scapular strengthening."],"applies_when":["Strengthening (8-12 weeks)"],"restrictions":["No lifting over 1-2 lbs.","Caution with overhead."],"physiotherapist_actions":["Focus on scapulohumeral rhythm."]}},"additional_notes_de":"Fokus auf skapulohumeralen Rhythmus.","additional_notes_en":"Focus on scapulohumeral rhythm.","additional_notes_pl":"Skupienie na rytmie łopatkowo-ramiennym.","minimum_patient_share":null,"therapeutic_content_de":"Erreichen des vollen ROM, progressive Kräftigung der Rotatorenmanschette und Scapulastabilisatoren.","therapeutic_content_en":"Attain full ROM, progress rotator cuff and scapular strengthening.","therapeutic_content_pl":"Osiągnięcie pełnego ROM, progresywne wzmacnianie stożka rotatorów i stabilizatorów łopatki.","minimum_requirements_de":"Kein Heben über 1-2 Pfund. Vorsicht bei Überkopfbewegungen.","minimum_requirements_en":"No lifting over 1-2 lbs. Caution with overhead.","minimum_requirements_pl":"Zakaz dźwigania powyżej 1-2 funtów. Uwaga na ruchy nad głową.","additional_notes_original":"Focus on scapulohumeral rhythm.","therapeutic_content_original":"Attain full ROM, progress rotator cuff and scapular strengthening.","minimum_requirements_original":"No lifting over 1-2 lbs. Caution with overhead.","structured_content_v2":"$undefined"},{"id":"1dbdef86-fc6b-56f4-827e-24ae572cbfed","name_de":"Phase 4: Rückkehr zum Sport (12-24 Wochen)","name_en":"Phase 4: Return to Sport (12-24 weeks)","name_pl":"Faza 4: Powrót do sportu (12-24 tydzień)","source_page":6,"module_number":4,"name_original":"Phase 4: Return to Sport (12-24 weeks)","service_codes":[],"structured_content":{"de":{"exercises":["Volle Kraft, funktioneller Armgebrauch, Vorbereitung auf sportartspezifische Belastungen."],"applies_when":["Rückkehr zum Sport (12-24 Wochen)"],"dosage_and_progression":["Einführung von Krafttraining und Plyometrie."],"physiotherapist_actions":["Rückkehr zum Sport nach ärztlicher Rücksprache."]},"en":{"exercises":["Full strength, functional use, preparation for sport-specific demands."],"applies_when":["Return to Sport (12-24 weeks)"],"dosage_and_progression":["Introduce weight training and plyometrics."],"physiotherapist_actions":["Return to sport plan discussed with physician."]},"pl":{"exercises":["Pełna siła, funkcjonalne użytkowanie ręki, przygotowanie do specyficznych obciążeń sportowych."],"applies_when":["Powrót do sportu (12-24 tydzień)"],"dosage_and_progression":["Wprowadzenie treningu siłowego i pliometrii."],"physiotherapist_actions":["Decyzja o powrocie do sportu konsultowana z lekarzem."]},"original":{"exercises":["Full strength, functional use, preparation for sport-specific demands."],"applies_when":["Return to Sport (12-24 weeks)"],"dosage_and_progression":["Introduce weight training and plyometrics."],"physiotherapist_actions":["Return to sport plan discussed with physician."]}},"additional_notes_de":"Einführung von Krafttraining und Plyometrie.","additional_notes_en":"Introduce weight training and plyometrics.","additional_notes_pl":"Wprowadzenie treningu siłowego i pliometrii.","minimum_patient_share":null,"therapeutic_content_de":"Volle Kraft, funktioneller Armgebrauch, Vorbereitung auf sportartspezifische Belastungen.","therapeutic_content_en":"Full strength, functional use, preparation for sport-specific demands.","therapeutic_content_pl":"Pełna siła, funkcjonalne użytkowanie ręki, przygotowanie do specyficznych obciążeń sportowych.","minimum_requirements_de":"Rückkehr zum Sport nach ärztlicher Rücksprache.","minimum_requirements_en":"Return to sport plan discussed with physician.","minimum_requirements_pl":"Decyzja o powrocie do sportu konsultowana z lekarzem.","additional_notes_original":"Introduce weight training and plyometrics.","therapeutic_content_original":"Full strength, functional use, preparation for sport-specific demands.","minimum_requirements_original":"Return to sport plan discussed with physician.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["shoulder","upper_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"7a6ed621-b626-5be2-999f-b2a20ec271a0","slug":"us-jared-lee-12-extensor-tendon-repair","title_pl":"Protokół rehabilitacji po naprawie ścięgna prostownika ręki","title_de":"Rehabilitationsprotokoll nach Rekonstruktion einer Strecksehne der Hand","title_en":"Extensor Tendon Repair Rehabilitation Protocol","title_original":"Extensor Tendon Repair","summary_pl":"Czterofazowy protokół po naprawie ścięgna prostownika ręki z dynamicznym i statycznym ortezowaniem.","summary_de":"Vierphasiges Protokoll nach Strecksehnenrekonstruktion der Hand mit dynamischer und statischer Orthesenversorgung.","summary_en":"Four-phase rehabilitation protocol after hand extensor tendon repair with dynamic and static orthosis management.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"d05261d0-3d19-5822-8a79-464551ac84c2","condition_slug":"extensor-tendon-repair","condition_name_pl":"Naprawa ścięgna prostownika ręki","condition_name_de":"Rekonstruktion einer Strecksehne der Hand","condition_name_en":"Hand Extensor Tendon Repair","condition_name_original":"Hand Extensor Tendon Repair","icd_codes":[],"category_key":"hand-wrist","category_pl":"Ręka i nadgarstek","category_de":"Hand und Handgelenk","category_en":"Hand and Wrist","body_regions_pl":["Ręka","Nadgarstek"],"body_regions_de":["Hand","Handgelenk"],"body_regions_en":["Hand","Wrist"],"search_terms_pl":["naprawa ścięgna prostownika","ścięgno prostownika ręki","rehabilitacja ręki po operacji"],"search_terms_de":["Strecksehnenrekonstruktion","Strecksehne Hand","Handrehabilitation"],"search_terms_en":["extensor tendon repair","hand extensor tendon rehabilitation"],"source_document_id":"7a5d32dd-10cf-5d27-98f1-61493e77c1cd","source_title":"Extensor Tendon Repair","issuer":"Jared Lee, MD","source_country_code":"US","jurisdiction_code":"US-CO","authority_level":"clinic","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_requires_review","official_url":"https://jaredleemd.com/wp-content/uploads/2025/06/Extensor-Tendon-Repair-Protocol.pdf","source_sha256":"fecee7937dbe441e8d1b300639547a3c8c1e182d9a7c71cd086471a0435b1817","authorization_required":true,"license_note":"All Rights Reserved. Authorization is required before final public release. Current development and staging remain allowed by the owner's decision.","modules":[{"id":"01201734-660d-597d-b468-7c18d60b0245","name_de":"Phase I: Wochen 0–4","name_en":"Phase I: Weeks 0-4","name_pl":"Faza I: tygodnie 0–4","source_page":1,"module_number":1,"name_original":"Phase 1: Weeks 0-4","service_codes":[],"structured_content":{"de":{"goals":["Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, die chirurgische Rekonstruktion schützen und Steifigkeit vermeiden."],"exercises":["In der dynamischen Orthese: aktive Flexion der MCP-Gelenke bei durch den Rückzug der Gummibänder extendierten PIP- und DIP-Gelenken","aktive MCP-Extension bei PIP und DIP in Hakenstellung","in Woche 3 aktive MCP-Flexion bis 60°, in Woche 4 bis 75° für alle Finger zulassen.","anschließend bewegt er das Handgelenk aus voller passiver Extension bis 0°, während der Patient die PIP-Gelenke aktiv bis 60° flektiert."],"applies_when":["Wochen 0–4"],"physiotherapist_actions":["Für die Nacht eine statische Unterarm-Handgelenkorthese mit 30° Handgelenkextension, MCP 0–20° und PIP 0° anfertigen.","Für den Tag eine dynamische Unterarm-Handgelenkorthese anfertigen: Handgelenk 0°, MCP von Zeige-, Mittel-, Ring- und Kleinfinger durch Gummibandzug in den Schlaufen bei 0°","aktive MCP-Flexion von Zeige- und Mittelfinger bis 30–35° sowie von Ring- und Kleinfinger bis 40–45° zulassen, durch Stoppperlen begrenzt.","Volare Fingerrinnen können unter den Lederschlaufen platziert werden, um das Gleiten des M. extensor digitorum communis (EDC) zu verbessern.","Mit dem Physiotherapeuten: nach Abnahme der Orthese hält der Therapeut Handgelenk und IP-Gelenke bei 0° und flektiert die MCP-Gelenke passiv bis 45°"]},"en":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid stiffness."],"exercises":["Within the dynamic orthosis: active MCP flexion with PIP and DIP joints extended by rubber-band recoil","active MCP extension with PIP and DIP joints in the hook position","at week 3 allow 60° active MCP flexion and at week 4 allow 75° active MCP flexion to all fingers.","the therapist then moves the wrist from full passive extension to 0° while the patient actively flexes the PIP joints to 60°."],"applies_when":["Weeks 0-4"],"dosage_and_progression":["Volar finger gutters may be placed under leather slings for greater extensor digitorum communis (EDC) glide."],"physiotherapist_actions":["For sleep, fabricate a forearm-based static wrist orthosis with the wrist extended 30°, MCP joints at 0-20° and PIP joints at 0°.","For daytime, fabricate a forearm-based dynamic wrist orthosis: wrist at 0°, index, middle, ring and small-finger MCP joints held at 0° by rubber-band tension in slings","allow 30-35° active MCP flexion of the index and middle fingers and 40-45° of the ring and small fingers, blocked by stop beads.","With the therapist: after orthosis removal, the therapist holds the wrist and IP joints at 0° and passively flexes the MCP joints to 45°"]},"pl":{"goals":["zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona naprawy chirurgicznej oraz zapobieganie sztywności."],"exercises":["W ortezie dynamicznej: czynne zgięcie stawów MCP przy wyprostowanych PIP i DIP wspomaganych powrotem gumowych taśm","czynny wyprost MCP przy stawach PIP i DIP w pozycji haczykowej","w 3. tygodniu dopuścić czynne zgięcie MCP do 60°, a w 4. tygodniu do 75° dla wszystkich palców.","następnie przesuwa nadgarstek z pełnego biernego wyprostu do 0°, a pacjent czynnie zgina PIP do 60°."],"applies_when":["tygodnie 0–4"],"dosage_and_progression":["Pod skórzanymi podwieszkami można umieścić dłoniowe rynienki palców dla lepszego ślizgu ścięgna prostownika wspólnego palców (EDC)."],"physiotherapist_actions":["Na noc wykonać statyczną ortezę przedramienno-nadgarstkową z nadgarstkiem w 30° wyprostu, MCP w 0–20° i PIP w 0°.","Na dzień wykonać dynamiczną ortezę przedramienno-nadgarstkową: nadgarstek 0°, MCP palca wskazującego, środkowego, serdecznego i małego w 0° pod napięciem gumowych taśm w podwieszkach","dopuścić czynne zgięcie MCP palca wskazującego i środkowego do 30–35° oraz serdecznego i małego do 40–45°, ograniczone koralikami blokującymi.","Z fizjoterapeutą: po zdjęciu ortezy fizjoterapeuta utrzymuje nadgarstek i stawy IP w 0° oraz biernie zgina MCP do 45°"]},"original":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid stiffness."],"exercises":["Within the dynamic orthosis: active MCP flexion with PIP and DIP joints extended by rubber-band recoil","active MCP extension with PIP and DIP joints in the hook position","at week 3 allow 60° active MCP flexion and at week 4 allow 75° active MCP flexion to all fingers.","the therapist then moves the wrist from full passive extension to 0° while the patient actively flexes the PIP joints to 60°."],"applies_when":["Weeks 0-4"],"dosage_and_progression":["Volar finger gutters may be placed under leather slings for greater extensor digitorum communis (EDC) glide."],"physiotherapist_actions":["For sleep, fabricate a forearm-based static wrist orthosis with the wrist extended 30°, MCP joints at 0-20° and PIP joints at 0°.","For daytime, fabricate a forearm-based dynamic wrist orthosis: wrist at 0°, index, middle, ring and small-finger MCP joints held at 0° by rubber-band tension in slings","allow 30-35° active MCP flexion of the index and middle fingers and 40-45° of the ring and small fingers, blocked by stop beads.","With the therapist: after orthosis removal, the therapist holds the wrist and IP joints at 0° and passively flexes the MCP joints to 45°"]}},"additional_notes_de":"Ziele: Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, die chirurgische Rekonstruktion schützen und Steifigkeit vermeiden.","additional_notes_en":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid stiffness.","additional_notes_pl":"Cele: zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona naprawy chirurgicznej oraz zapobieganie sztywności.","minimum_patient_share":null,"therapeutic_content_de":"In der dynamischen Orthese: aktive Flexion der MCP-Gelenke bei durch den Rückzug der Gummibänder extendierten PIP- und DIP-Gelenken; aktive MCP-Extension bei PIP und DIP in Hakenstellung; in Woche 3 aktive MCP-Flexion bis 60°, in Woche 4 bis 75° für alle Finger zulassen. Mit dem Physiotherapeuten: nach Abnahme der Orthese hält der Therapeut Handgelenk und IP-Gelenke bei 0° und flektiert die MCP-Gelenke passiv bis 45°; anschließend bewegt er das Handgelenk aus voller passiver Extension bis 0°, während der Patient die PIP-Gelenke aktiv bis 60° flektiert.","therapeutic_content_en":"Within the dynamic orthosis: active MCP flexion with PIP and DIP joints extended by rubber-band recoil; active MCP extension with PIP and DIP joints in the hook position; at week 3 allow 60° active MCP flexion and at week 4 allow 75° active MCP flexion to all fingers. With the therapist: after orthosis removal, the therapist holds the wrist and IP joints at 0° and passively flexes the MCP joints to 45°; the therapist then moves the wrist from full passive extension to 0° while the patient actively flexes the PIP joints to 60°.","therapeutic_content_pl":"W ortezie dynamicznej: czynne zgięcie stawów MCP przy wyprostowanych PIP i DIP wspomaganych powrotem gumowych taśm; czynny wyprost MCP przy stawach PIP i DIP w pozycji haczykowej; w 3. tygodniu dopuścić czynne zgięcie MCP do 60°, a w 4. tygodniu do 75° dla wszystkich palców. Z fizjoterapeutą: po zdjęciu ortezy fizjoterapeuta utrzymuje nadgarstek i stawy IP w 0° oraz biernie zgina MCP do 45°; następnie przesuwa nadgarstek z pełnego biernego wyprostu do 0°, a pacjent czynnie zgina PIP do 60°.","minimum_requirements_de":"Für die Nacht eine statische Unterarm-Handgelenkorthese mit 30° Handgelenkextension, MCP 0–20° und PIP 0° anfertigen. Für den Tag eine dynamische Unterarm-Handgelenkorthese anfertigen: Handgelenk 0°, MCP von Zeige-, Mittel-, Ring- und Kleinfinger durch Gummibandzug in den Schlaufen bei 0°; aktive MCP-Flexion von Zeige- und Mittelfinger bis 30–35° sowie von Ring- und Kleinfinger bis 40–45° zulassen, durch Stoppperlen begrenzt. Volare Fingerrinnen können unter den Lederschlaufen platziert werden, um das Gleiten des M. extensor digitorum communis (EDC) zu verbessern.","minimum_requirements_en":"For sleep, fabricate a forearm-based static wrist orthosis with the wrist extended 30°, MCP joints at 0-20° and PIP joints at 0°. For daytime, fabricate a forearm-based dynamic wrist orthosis: wrist at 0°, index, middle, ring and small-finger MCP joints held at 0° by rubber-band tension in slings; allow 30-35° active MCP flexion of the index and middle fingers and 40-45° of the ring and small fingers, blocked by stop beads. Volar finger gutters may be placed under leather slings for greater extensor digitorum communis (EDC) glide.","minimum_requirements_pl":"Na noc wykonać statyczną ortezę przedramienno-nadgarstkową z nadgarstkiem w 30° wyprostu, MCP w 0–20° i PIP w 0°. Na dzień wykonać dynamiczną ortezę przedramienno-nadgarstkową: nadgarstek 0°, MCP palca wskazującego, środkowego, serdecznego i małego w 0° pod napięciem gumowych taśm w podwieszkach; dopuścić czynne zgięcie MCP palca wskazującego i środkowego do 30–35° oraz serdecznego i małego do 40–45°, ograniczone koralikami blokującymi. Pod skórzanymi podwieszkami można umieścić dłoniowe rynienki palców dla lepszego ślizgu ścięgna prostownika wspólnego palców (EDC).","additional_notes_original":"Goals: Reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair, and avoid stiffness.","therapeutic_content_original":"Within the dynamic orthosis: active MCP flexion with PIP and DIP joints extended by rubber-band recoil; active MCP extension with PIP and DIP joints in the hook position; at week 3 allow 60° active MCP flexion and at week 4 allow 75° active MCP flexion to all fingers. With the therapist: after orthosis removal, the therapist holds the wrist and IP joints at 0° and passively flexes the MCP joints to 45°; the therapist then moves the wrist from full passive extension to 0° while the patient actively flexes the PIP joints to 60°.","minimum_requirements_original":"For sleep, fabricate a forearm-based static wrist orthosis with the wrist extended 30°, MCP joints at 0-20° and PIP joints at 0°. For daytime, fabricate a forearm-based dynamic wrist orthosis: wrist at 0°, index, middle, ring and small-finger MCP joints held at 0° by rubber-band tension in slings; allow 30-35° active MCP flexion of the index and middle fingers and 40-45° of the ring and small fingers, blocked by stop beads. Volar finger gutters may be placed under leather slings for greater extensor digitorum communis (EDC) glide.","structured_content_v2":"$undefined"},{"id":"2d212424-09a7-5bb1-97ec-7347eae0a92e","name_de":"Phase II: Wochen 4–5","name_en":"Phase II: Weeks 4-5","name_pl":"Faza II: tygodnie 4–5","source_page":1,"module_number":2,"name_original":"Phase 2: Weeks 4-5","service_codes":[],"structured_content":{"de":{"goals":["Bewegungsumfang steigern, Schmerzen und Muskelatrophie begrenzen, die Rekonstruktion schützen und mit der neuromuskulären Kontrolle beginnen."],"exercises":["Aktiven vollständigen Faustschluss und kombinierte Handgelenkflexion mit geschlossener Faust beginnen"],"applies_when":["Wochen 4–5"],"restrictions":["keine Kräftigung"],"physiotherapist_actions":["Die statische Unterarmorthese auf 20° Handgelenkextension anpassen","die dynamische Orthese am Ende der 4. Woche absetzen.","Narbenmassage."]},"en":{"goals":["progress range of motion, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control."],"exercises":["Initiate an active full fist and composite wrist flexion with the fist"],"applies_when":["Weeks 4-5"],"restrictions":["no strengthening"],"dosage_and_progression":["discontinue the dynamic orthosis at the end of week 4."],"physiotherapist_actions":["Adjust the forearm-based static orthosis to 20° wrist extension","scar massage."]},"pl":{"goals":["zwiększanie zakresu ruchu, ograniczenie bólu i zaniku mięśni, ochrona naprawy oraz rozpoczęcie kontroli nerwowo-mięśniowej."],"exercises":["Rozpocząć czynne zaciskanie pełnej pięści oraz złożone zgięcie nadgarstka z zaciśniętą pięścią"],"applies_when":["tygodnie 4–5"],"restrictions":["bez wzmacniania"],"physiotherapist_actions":["Dostosować statyczną ortezę przedramienną, ustawiając nadgarstek w 20° wyprostu","zakończyć stosowanie ortezy dynamicznej pod koniec 4. tygodnia.","masaż blizny."]},"original":{"goals":["progress range of motion, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control."],"exercises":["Initiate an active full fist and composite wrist flexion with the fist"],"applies_when":["Weeks 4-5"],"restrictions":["no strengthening"],"dosage_and_progression":["discontinue the dynamic orthosis at the end of week 4."],"physiotherapist_actions":["Adjust the forearm-based static orthosis to 20° wrist extension","scar massage."]}},"additional_notes_de":"Ziele: Bewegungsumfang steigern, Schmerzen und Muskelatrophie begrenzen, die Rekonstruktion schützen und mit der neuromuskulären Kontrolle beginnen.","additional_notes_en":"Goals: progress range of motion, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control.","additional_notes_pl":"Cele: zwiększanie zakresu ruchu, ograniczenie bólu i zaniku mięśni, ochrona naprawy oraz rozpoczęcie kontroli nerwowo-mięśniowej.","minimum_patient_share":null,"therapeutic_content_de":"Aktiven vollständigen Faustschluss und kombinierte Handgelenkflexion mit geschlossener Faust beginnen; keine Kräftigung; Narbenmassage.","therapeutic_content_en":"Initiate an active full fist and composite wrist flexion with the fist; no strengthening; scar massage.","therapeutic_content_pl":"Rozpocząć czynne zaciskanie pełnej pięści oraz złożone zgięcie nadgarstka z zaciśniętą pięścią; bez wzmacniania; masaż blizny.","minimum_requirements_de":"Die statische Unterarmorthese auf 20° Handgelenkextension anpassen; die dynamische Orthese am Ende der 4. Woche absetzen.","minimum_requirements_en":"Adjust the forearm-based static orthosis to 20° wrist extension; discontinue the dynamic orthosis at the end of week 4.","minimum_requirements_pl":"Dostosować statyczną ortezę przedramienną, ustawiając nadgarstek w 20° wyprostu; zakończyć stosowanie ortezy dynamicznej pod koniec 4. tygodnia.","additional_notes_original":"Goals: Progress range of motion, minimize pain, retard muscle atrophy, protect the repair, and begin neuromuscular control.","therapeutic_content_original":"Initiate an active full fist and composite wrist flexion with the fist; no strengthening; scar massage.","minimum_requirements_original":"Adjust the forearm-based static orthosis to 20° wrist extension; discontinue the dynamic orthosis at the end of week 4.","structured_content_v2":"$undefined"},{"id":"112348a0-9b79-504e-aa88-dce5beed8885","name_de":"Phase III: Wochen 6–8","name_en":"Phase III: Weeks 6-8","name_pl":"Faza III: tygodnie 6–8","source_page":2,"module_number":3,"name_original":"Phase 3: Weeks 6-8","service_codes":[],"structured_content":{"de":{"goals":["voller Bewegungsumfang, minimale Schmerzen, bessere Kraft und Ausdauer sowie mehr neuromuskuläre Kontrolle, dynamische Stabilität und Kraft der Skapulamuskulatur."],"exercises":["Dehnung von Hand und Handgelenk","Kräftigung der intrinsischen Handmuskulatur","vollständiger passiver Bewegungsumfang mit Progression zu vollständigen aktiven und aktiv-assistierten Bewegungen nach Verträglichkeit","leichte feinmotorische Aktivität beginnen","in Woche 7 progressive Widerstandsübungen beginnen","in Woche 8 Kräftigung beginnen und nach Verträglichkeit steigern."],"applies_when":["Wochen 6–8"],"physiotherapist_actions":["Die statische Unterarmorthese bei fehlendem Extensionsdefizit absetzen.","Bei einem MCP-Extensionsdefizit von 15° die Unterarmorthese nachts weitere 2–4 Wochen tragen."]},"en":{"goals":["full range of motion, minimal pain, improve power and endurance, increase neuromuscular control, dynamic stability and scapular muscle strength."],"exercises":["Hand and wrist stretching","intrinsic hand strengthening","full passive range of motion progressing to full active and active-assisted range as tolerated","begin light fine-motor activity","at week 7 begin progressive resistance exercises","at week 8 begin strengthening and progress as tolerated."],"applies_when":["Weeks 6-8"],"progression_criteria":["Discontinue the static forearm-based orthosis if there is no extension lag.","If there is a 15° MCP extension lag, wear the forearm-based orthosis at night for an additional 2-4 weeks."]},"pl":{"goals":["pełny zakres ruchu, minimalny ból, poprawa siły i wytrzymałości, zwiększenie kontroli nerwowo-mięśniowej, stabilności dynamicznej i siły mięśni łopatki."],"exercises":["Rozciąganie ręki i nadgarstka","wzmacnianie mięśni wewnętrznych ręki","pełny bierny zakres ruchu z progresją do pełnego czynnego i czynnego wspomaganego w granicach tolerancji","rozpocząć lekkie czynności motoryki precyzyjnej","w 7. tygodniu rozpocząć progresywne ćwiczenia oporowe","w 8. tygodniu rozpocząć wzmacnianie i zwiększać je w granicach tolerancji."],"applies_when":["tygodnie 6–8"],"dosage_and_progression":["Odstawić statyczną ortezę przedramienną, jeżeli nie ma deficytu wyprostu."],"physiotherapist_actions":["Przy deficycie wyprostu MCP 15° nosić nocną ortezę przedramienną przez dodatkowe 2–4 tygodnie."]},"original":{"goals":["full range of motion, minimal pain, improve power and endurance, increase neuromuscular control, dynamic stability and scapular muscle strength."],"exercises":["Hand and wrist stretching","intrinsic hand strengthening","full passive range of motion progressing to full active and active-assisted range as tolerated","begin light fine-motor activity","at week 7 begin progressive resistance exercises","at week 8 begin strengthening and progress as tolerated."],"applies_when":["Weeks 6-8"],"progression_criteria":["Discontinue the static forearm-based orthosis if there is no extension lag.","If there is a 15° MCP extension lag, wear the forearm-based orthosis at night for an additional 2-4 weeks."]}},"additional_notes_de":"Ziele: voller Bewegungsumfang, minimale Schmerzen, bessere Kraft und Ausdauer sowie mehr neuromuskuläre Kontrolle, dynamische Stabilität und Kraft der Skapulamuskulatur.","additional_notes_en":"Goals: full range of motion, minimal pain, improve power and endurance, increase neuromuscular control, dynamic stability and scapular muscle strength.","additional_notes_pl":"Cele: pełny zakres ruchu, minimalny ból, poprawa siły i wytrzymałości, zwiększenie kontroli nerwowo-mięśniowej, stabilności dynamicznej i siły mięśni łopatki.","minimum_patient_share":null,"therapeutic_content_de":"Dehnung von Hand und Handgelenk; Kräftigung der intrinsischen Handmuskulatur; vollständiger passiver Bewegungsumfang mit Progression zu vollständigen aktiven und aktiv-assistierten Bewegungen nach Verträglichkeit; leichte feinmotorische Aktivität beginnen; in Woche 7 progressive Widerstandsübungen beginnen; in Woche 8 Kräftigung beginnen und nach Verträglichkeit steigern.","therapeutic_content_en":"Hand and wrist stretching; intrinsic hand strengthening; full passive range of motion progressing to full active and active-assisted range as tolerated; begin light fine-motor activity; at week 7 begin progressive resistance exercises; at week 8 begin strengthening and progress as tolerated.","therapeutic_content_pl":"Rozciąganie ręki i nadgarstka; wzmacnianie mięśni wewnętrznych ręki; pełny bierny zakres ruchu z progresją do pełnego czynnego i czynnego wspomaganego w granicach tolerancji; rozpocząć lekkie czynności motoryki precyzyjnej; w 7. tygodniu rozpocząć progresywne ćwiczenia oporowe; w 8. tygodniu rozpocząć wzmacnianie i zwiększać je w granicach tolerancji.","minimum_requirements_de":"Die statische Unterarmorthese bei fehlendem Extensionsdefizit absetzen. Bei einem MCP-Extensionsdefizit von 15° die Unterarmorthese nachts weitere 2–4 Wochen tragen.","minimum_requirements_en":"Discontinue the static forearm-based orthosis if there is no extension lag. If there is a 15° MCP extension lag, wear the forearm-based orthosis at night for an additional 2-4 weeks.","minimum_requirements_pl":"Odstawić statyczną ortezę przedramienną, jeżeli nie ma deficytu wyprostu. Przy deficycie wyprostu MCP 15° nosić nocną ortezę przedramienną przez dodatkowe 2–4 tygodnie.","additional_notes_original":"Goals: Full range of motion, minimal pain, improve power and endurance, increase neuromuscular control, dynamic stability, and scapular muscle strength.","therapeutic_content_original":"Hand and wrist stretching; intrinsic hand strengthening; full passive range of motion progressing to full active and active-assisted range as tolerated; begin light fine-motor activity; at week 7 begin progressive resistance exercises; at week 8 begin strengthening and progress as tolerated.","minimum_requirements_original":"Discontinue the static forearm-based orthosis if there is no extension lag. If there is a 15° MCP extension lag, wear the forearm-based orthosis at night for an additional 2-4 weeks.","structured_content_v2":"$undefined"},{"id":"fafa8707-69f6-560a-b303-283f862e4ead","name_de":"Phase IV: ab Wochen 8–10","name_en":"Phase IV: Weeks 8-10 and onward","name_pl":"Faza IV: od tygodni 8–10","source_page":2,"module_number":4,"name_original":"Phase 4: Weeks 8-10 and onward","service_codes":[],"structured_content":{"de":{"goals":["funktionelle Aktivitäten sowie fortgeschrittene sportliche und Freizeitaktivitäten nach Vorgabe des Operateurs steigern."],"exercises":["Statische und dynamische Kräftigungsübungen","Bewegungsumfang erhalten."],"applies_when":["ab Wochen 8–10"],"progression_criteria":["Kraftdefizit <10 %","Limb-Symmetry-Index ≥90 %","45/50 Punkte in biomechanischen Funktionstests, sofern durchgeführt","keine Schmerzen und keine berichtete Instabilität."],"dosage_and_progression":["Kräftigung steigern."],"physiotherapist_actions":["Alle Orthesen absetzen"]},"en":{"goals":["progress functional activities and advanced sport and recreational activity per surgeon."],"exercises":["Static and dynamic strengthening exercises","maintain range of motion."],"applies_when":["Weeks 8-10 and onward"],"progression_criteria":["<10% strength deficit","limb similarity index ≥90%","45/50 on biomechanical functional tests, if performed","no pain or complaints of instability."],"dosage_and_progression":["Discontinue all orthoses","progress strengthening."]},"pl":{"goals":["rozwijanie aktywności funkcjonalnych oraz zaawansowanej aktywności sportowej i rekreacyjnej zgodnie z decyzją chirurga."],"exercises":["Statyczne i dynamiczne ćwiczenia wzmacniające","utrzymywać zakres ruchu."],"applies_when":["od tygodni 8–10"],"progression_criteria":["deficyt siły <10%","wskaźnik podobieństwa kończyn ≥90%","wynik 45/50 w biomechanicznych testach funkcjonalnych, jeżeli wykonano","brak bólu i zgłaszanej niestabilności."],"dosage_and_progression":["Odstawić wszystkie ortezy","zwiększać wzmacnianie."]},"original":{"goals":["progress functional activities and advanced sport and recreational activity per surgeon."],"exercises":["Static and dynamic strengthening exercises","maintain range of motion."],"applies_when":["Weeks 8-10 and onward"],"progression_criteria":["<10% strength deficit","limb similarity index ≥90%","45/50 on biomechanical functional tests, if performed","no pain or complaints of instability."],"dosage_and_progression":["Discontinue all orthoses","progress strengthening."]}},"additional_notes_de":"Ziele: funktionelle Aktivitäten sowie fortgeschrittene sportliche und Freizeitaktivitäten nach Vorgabe des Operateurs steigern. Entlassungskriterien: Kraftdefizit <10 %; Limb-Symmetry-Index ≥90 %; 45/50 Punkte in biomechanischen Funktionstests, sofern durchgeführt; keine Schmerzen und keine berichtete Instabilität.","additional_notes_en":"Goals: progress functional activities and advanced sport and recreational activity per surgeon. Discharge criteria: <10% strength deficit; limb similarity index ≥90%; 45/50 on biomechanical functional tests, if performed; no pain or complaints of instability.","additional_notes_pl":"Cele: rozwijanie aktywności funkcjonalnych oraz zaawansowanej aktywności sportowej i rekreacyjnej zgodnie z decyzją chirurga. Kryteria wypisu: deficyt siły <10%; wskaźnik podobieństwa kończyn ≥90%; wynik 45/50 w biomechanicznych testach funkcjonalnych, jeżeli wykonano; brak bólu i zgłaszanej niestabilności.","minimum_patient_share":null,"therapeutic_content_de":"Statische und dynamische Kräftigungsübungen; Bewegungsumfang erhalten.","therapeutic_content_en":"Static and dynamic strengthening exercises; maintain range of motion.","therapeutic_content_pl":"Statyczne i dynamiczne ćwiczenia wzmacniające; utrzymywać zakres ruchu.","minimum_requirements_de":"Alle Orthesen absetzen; Kräftigung steigern.","minimum_requirements_en":"Discontinue all orthoses; progress strengthening.","minimum_requirements_pl":"Odstawić wszystkie ortezy; zwiększać wzmacnianie.","additional_notes_original":"Goals: Progression of functional activities, advanced sport and recreational activity per surgeon. Criteria for Discharge: <10% strength deficit; Limb similarity index of 90% or greater; 45/50 on biomechanical functional tests (if performed); NO pain or complaints of instability.","therapeutic_content_original":"Static and dynamic strengthening exercises; maintain range of motion.","minimum_requirements_original":"Discontinue all orthoses; progress strengthening.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["hand_wrist","upper_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"48efe318-44bc-59eb-a267-039c721f11fd","slug":"us-south-shore-29-patellar-quadriceps-tendon-repair","title_pl":"Protokół rehabilitacji po naprawie ścięgna czworogłowego/rzepki (South Shore)","title_de":"Rehabilitationsprotokoll nach Quadrizeps-/Patellarsehnenrekonstruktion (South Shore)","title_en":"Quad/Patella Tendon Repair Rehabilitation Protocol (South Shore)","title_original":"Quad/Patella Tendon Repair","summary_pl":"Pooperacyjny protokół rehabilitacji skupiony na ochronie naprawy, kontroli obrzęku i stopniowej mobilizacji.","summary_de":"Postoperatives Rehabilitationsprotokoll mit Fokus auf Schutz der Rekonstruktion, Ödemkontrolle und schrittweiser Mobilisierung.","summary_en":"Postoperative rehabilitation protocol focusing on protection of the tendon repair, swelling control, and progressive mobilization.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":true,"condition_id":"28fc2471-f843-50ce-b09b-8b71f1b529b9","condition_slug":"patellar-quadriceps-tendon-repair","condition_name_pl":"Naprawa ścięgna rzepki lub czworogłowego","condition_name_de":"Reparatur der Patellar- oder Quadrizepssehne","condition_name_en":"Patellar/Quadriceps Tendon Repair","condition_name_original":"Patellar/Quadriceps Tendon Repair","icd_codes":[],"category_key":"knee","category_pl":"Ortopedia pooperacyjna","category_de":"Postoperative Orthopädie","category_en":"Postoperative Orthopedics","body_regions_pl":["kolano"],"body_regions_de":["Knie"],"body_regions_en":["knee"],"search_terms_pl":["ścięgno rzepki","ścięgno czworogłowe","rehabilitacja pooperacyjna kolano","zerwanie ścięgna","naprawa ścięgna","po operacji","rehabilitacja kolana","Stan po naprawie ścięgna czworogłowego/rzepki"],"search_terms_de":["Patellasehne","Quadrizepssehne","Knie-Rehabilitation","Sehnenreparatur","Sehnenrekonstruktion","postoperativ","Knie-Reha","Sehnenriss","Zustand nach Quadrizeps-/Patellarsehnenrekonstruktion"],"search_terms_en":["patellar tendon","quadriceps tendon","postoperative rehab","tendon repair","post-op","knee rehab","tendon rupture","Status after quadriceps/patellar tendon repair"],"source_document_id":"afabde16-bd95-5835-bd52-6f2bb07fc2ea","source_title":"Quad/Patella Tendon Repair","issuer":"South Shore Orthopedics","source_country_code":"US","jurisdiction_code":"US-MA","authority_level":"hospital","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"stale_requires_clinical_update_check","official_url":"https://octanecdn.com/southshoreorthopedicscom/southshoreorthopedicscom_594296819.pdf","source_sha256":"67f72747a51a8bfb0f28c0b5a197d5a8946724d52561173800488a98d28acb7c","authorization_required":false,"license_note":"Public source file retained locally for source verification.","modules":[{"id":"879c83f5-64b1-5e1b-8ab4-cb8145f0a969","name_de":"Aktive Mitarbeit und Beginn der Physiotherapie","name_en":"Active participation and PT timing","name_pl":"Aktywny udział i rozpoczęcie PT","source_page":2,"module_number":1,"name_original":"Recovery/Time off Work; Hospital Stay/Post Operative Visits","service_codes":[],"structured_content":{"de":{"exercises":[],"restrictions":[],"progression_criteria":["Der individuelle Zeitplan für Aktivität und Arbeit wird bei den postoperativen Besuchen mit dem Chirurgen besprochen."],"dosage_and_progression":["Tägliche Übungen; Physiotherapie meist nach dem Besuch etwa zwei Wochen postoperativ."],"physiotherapist_actions":["Nach chirurgischer Freigabe individuell beurteilen und behandeln."]},"en":{"exercises":[],"restrictions":[],"progression_criteria":["The surgeon discusses the individual timetable for return to activity and work during postoperative visits."],"dosage_and_progression":["Daily exercises; PT usually after the approximately two-week postoperative visit."],"physiotherapist_actions":["Assess and establish an individual PT plan after surgeon clearance."]},"pl":{"exercises":[],"restrictions":[],"progression_criteria":["Indywidualny harmonogram powrotu do aktywności i pracy omawia chirurg podczas wizyt pooperacyjnych."],"dosage_and_progression":["Codzienne ćwiczenia; PT zwykle po wizycie około 2 tygodnie po operacji."],"physiotherapist_actions":["Ocenić pacjenta i ustalić indywidualny plan PT po zgodzie chirurga."]},"original":{"exercises":[],"restrictions":[],"progression_criteria":["Your individual time table for return to activities and work will be discussed by your surgeon during post operative office visits."],"dosage_and_progression":["performing daily exercises","approximately two weeks after the operation"],"physiotherapist_actions":["cleared to make an appointment to begin Physical Therapy"]}},"additional_notes_de":"Häufige Komplikationen sind Schwäche und Bewegungsverlust.","additional_notes_en":"Common complications include weakness and loss of motion.","additional_notes_pl":"Najczęstsze powikłania naprawy to osłabienie i utrata ruchu.","minimum_patient_share":null,"therapeutic_content_de":"Der Patient soll aktiv mitarbeiten, täglich üben und die Physiotherapie nach der postoperativen Kontrolle, meist etwa zwei Wochen nach der Operation, beginnen.","therapeutic_content_en":"The patient must be an active participant, performing daily exercises, and PT is usually started after the approximately two-week postoperative visit.","therapeutic_content_pl":"Pacjent ma aktywnie uczestniczyć w procesie, codziennie wykonywać ćwiczenia i rozpocząć PT po kontroli pooperacyjnej, zwykle około 2 tygodni po operacji.","minimum_requirements_de":"Die Rückkehr zum Niveau vor der Verletzung dauert meist mindestens sechs Monate, manchmal ein Jahr; der Zeitplan wird vom Chirurgen festgelegt.","minimum_requirements_en":"Return to pre-injury activity is usually at least 6 months and sometimes a year; the surgeon determines the timetable.","minimum_requirements_pl":"Powrót do poziomu sprzed urazu zwykle wymaga co najmniej 6 miesięcy, czasem roku; terminy ustala chirurg.","additional_notes_original":"The most common complications of patellar tendon repair include weakness and loss of motion.","therapeutic_content_original":"He or she must be an active participant during this process, performing daily exercises to ensure there is proper return of range of motion and strength. At this time you will most likely be cleared to make an appointment to begin Physical Therapy.","minimum_requirements_original":"It is usually estimated that it will take at least 6 months; Some cases may take as long as a year; Your individual time table; will be discussed by your surgeon.","structured_content_v2":"$undefined"},{"id":"057b8e33-7bb8-56b6-9fc0-408173a9c3d5","name_de":"Häusliche Versorgung, Eis, Gehen und Orthese","name_en":"Home care, ice, walking and brace","name_pl":"Opieka domowa, lód, chód i orteza","source_page":3,"module_number":2,"name_original":"At Home; Ice; Walking; Brace; Driving","service_codes":[],"structured_content":{"de":{"exercises":[],"restrictions":["Belastung nach Anordnung; Orthese beim Gehen in Extension verriegelt; meist ≤90° Beugung sechs Wochen.","Verband täglich wechseln und die Wunde auf Infektionszeichen kontrollieren; immer eine Schutzschicht zwischen Eis und Haut lassen.","Nicht unter narkotischen Schmerzmitteln oder bei weiterhin erforderlicher Orthese fahren."],"progression_criteria":["Ausschleichen erst nach ärztlicher Freigabe und sicherem Gang."],"dosage_and_progression":["Eis 3–5×/Tag für 10–20 Minuten."],"physiotherapist_actions":["Gangschulung mit Krücken/Gehhilfe und Ausschleichen nur nach Freigabe.","Orthese anpassen und Verriegelung schulen."]},"en":{"exercises":[],"restrictions":["Do not exceed prescribed weight bearing; brace locked in extension for walking; generally ≤90° flexion for six weeks.","Replace the dressing daily and inspect the incision for infection; always keep one protective layer between ice and skin.","Do not drive while taking narcotic pain medicine or while leg weakness still requires the brace."],"progression_criteria":["Wean aids only with MD permission and safe gait."],"dosage_and_progression":["Ice 3–5 times/day for 10–20 minutes."],"physiotherapist_actions":["Train crutch/walker gait and weaning only with permission.","Teach brace positioning and locking."]},"pl":{"exercises":[],"restrictions":["Nie obciążać ponad zalecenia; orteza zablokowana w wyproście przy chodzeniu; zwykle zgięcie ≤90° przez 6 tygodni.","Codziennie zmieniaj opatrunek i kontroluj ranę pod kątem infekcji; zawsze utrzymuj warstwę ochronną między lodem a skórą.","Nie prowadź podczas przyjmowania narkotycznych leków przeciwbólowych ani gdy osłabienie nogi nadal wymaga ortezy."],"progression_criteria":["Odstawianie pomocy tylko po zgodzie MD i poprawie bezpieczeństwa chodu."],"dosage_and_progression":["Lód 3–5×/dzień po 10–20 min."],"physiotherapist_actions":["Instruktaż chodu o kulach/chodziku i bezpiecznego odstawiania pomocy po zgodzie lekarza.","Instruktaż ustawienia i blokowania ortezy."]},"original":{"exercises":[],"restrictions":["keep the brace locked in extension while walking","not allowed to bend the knee past 90 degrees for the first six weeks","replace your post-op dressing daily and inspect your incision for signs of infection","Always maintain one layer of protection between ice and the skin","not allowed to drive as long as you are taking narcotic pain medicine"],"progression_criteria":[],"dosage_and_progression":["3-5 times a day for 10-20 minutes at a time"],"physiotherapist_actions":["instruct you on how to safely wean from using your crutches"]}},"additional_notes_de":"Krücken erst nach zwei Wochen und ärztlicher Zustimmung ausschleichen; kein Fahren unter Narkotika oder bei erforderlicher Orthese.","additional_notes_en":"Wean from crutches after two weeks only with permission; no driving while taking narcotics or while the brace is still required.","additional_notes_pl":"Odstawianie kul po 2 tygodniach tylko za zgodą lekarza; prowadzenie zakazane przy narkotycznych lekach lub słabej nodze wymagającej ortezy.","minimum_patient_share":null,"therapeutic_content_de":"Tägliche Wundkontrolle und Verbandwechsel, Kühlen, sicheres Gehen mit Krücken/Gehhilfe und Umgang mit der hinged knee brace.","therapeutic_content_en":"Daily incision care, icing, safe walking with crutches/walker, and hinged knee-brace use.","therapeutic_content_pl":"Codzienna kontrola rany i zmiany opatrunku, chłodzenie, nauka bezpiecznego chodu o kulach/chodziku oraz obsługi ortezy zawiasowej.","minimum_requirements_de":"Eis 3–5-mal täglich 10–20 Minuten durch eine Schutzschicht; Belastung nach Anordnung; in den ersten sechs Wochen meist nicht über 90° beugen; Orthese mindestens sechs Wochen.","minimum_requirements_en":"Ice 3–5 times daily for 10–20 minutes through a protective layer; weight bearing as instructed; generally no flexion beyond 90 degrees for six weeks; brace at least six weeks.","minimum_requirements_pl":"Lód 3–5 razy dziennie po 10–20 min przez warstwę ochronną; WB według zaleceń; nie zginać >90° przez pierwsze 6 tygodni; orteza zwykle ≥6 tygodni.","additional_notes_original":"With your doctor’s permission your therapist will instruct you on how to safely wean; after 2 weeks post op. Driving is generally not permitted when your leg is weak enough that you still need to use the post operative brace.","therapeutic_content_original":"You must use ice on your knee; It is very important for you to use crutches (or a walker); Generally, it is recommended that you keep the brace locked in extension while walking at all times.","minimum_requirements_original":"Ice should be applied 3-5 times a day for 10-20 minutes at a time.; Generally, patients are not allowed to bend the knee past 90 degrees for the first six weeks; You will need to use this knee brace for at least six weeks.","structured_content_v2":"$undefined"},{"id":"afcedabf-a2e7-50ad-9d3d-fa084bca703a","name_de":"Phase 1: stationäre Phase","name_en":"Phase 1: Inpatient phase","name_pl":"Faza 1: pobyt w szpitalu","source_page":4,"module_number":3,"name_original":"Phase 1: Inpatient Phase (Surgery- Hospital Discharge)","service_codes":[],"structured_content":{"de":{"exercises":["Ankle pumps","Heel Prop/passive Extension","Übungen der Gegenseite"],"restrictions":["WBAT nach Anordnung; Orthese in Extension verriegelt; nichts unter dem Knie."],"progression_criteria":["Sichere unabhängige Mobilität und Entlassungsplan."],"dosage_and_progression":["OP-Tag Stuhltransfer; POD1 PT/OT; POD2–Entlassung Progression."],"physiotherapist_actions":["PT-Evaluation, Schulung von Gehen auf ebener Fläche, Treppen, Transfers und ADL mit Hilfsmitteln sowie Zusammenarbeit mit OT und Case Management."]},"en":{"exercises":["Ankle pumps","Heel prop/passive extension","Contralateral leg exercise"],"restrictions":["WBAT as ordered; brace locked in extension; nothing under knee."],"progression_criteria":["Safe independent mobility and discharge plan."],"dosage_and_progression":["Day of surgery chair transfer; POD1 PT/OT; POD2–discharge progression."],"physiotherapist_actions":["PT evaluation; gait training on level surfaces; stair, transfer and ADL training with adaptive equipment as needed; collaboration with OT and case management."]},"pl":{"exercises":["Pompki stóp","Heel prop/pasywny wyprost","Ćwiczenia nogi przeciwnej"],"restrictions":["WBAT według zlecenia; orteza zablokowana w wyproście; nic pod kolanem."],"progression_criteria":["Bezpieczna niezależna mobilność i plan wypisu."],"dosage_and_progression":["Dzień operacji: wstanie do krzesła; POD1: PT/OT i ćwiczenia; POD2–wypis: progresja."],"physiotherapist_actions":["Ocena PT, nauka chodu po płaskim, schodów, transferów i ADL z wyposażeniem adaptacyjnym oraz współpraca z OT i case management."]},"original":{"exercises":["Ankle pumps","Heel Prop (passive extension)","Contralateral leg exercise"],"restrictions":["WBAT with Crutches/Walker","Brace locked in extension","Never place anything under the operative knee"],"progression_criteria":[],"dosage_and_progression":["Day of Surgery","Post Op Day 1","Post Op Day 2-Discharge"],"physiotherapist_actions":["Gait training on level surfaces","Stair training","Transfer training","ADL’s with adaptive equip as needed","PT Evaluation","PT service and OT Evaluation"]}},"additional_notes_de":"Operationstag: Stuhltransfer und PT-Evaluation; POD1 PT/OT; POD2 bis Entlassung Progression.","additional_notes_en":"Day of surgery: out of bed to chair and PT evaluation; POD1 PT/OT; POD2–discharge progression.","additional_notes_pl":"Dzień operacji: transfer do krzesła i ocena PT; POD1: PT/OT; POD2–wypis: progresja ćwiczeń i mobilności.","minimum_patient_share":null,"therapeutic_content_de":"Ankle pumps, Heel Prop/passive Extension, Übungen der Gegenseite; Geh-, Treppen-, Transfer- und ADL-Schulung; Handtuchrolle unter dem Knöchel.","therapeutic_content_en":"Ankle pumps, heel prop/passive extension, contralateral-leg exercise; gait, stair, transfer and ADL training; towel roll under ankle.","therapeutic_content_pl":"Pompki stóp, heel prop/pasywny wyprost, ćwiczenia nogi przeciwnej; nauka chodu, schodów, transferów i ADL; wałek pod kostkę.","minimum_requirements_de":"WBAT mit Krücken/Gehhilfe, Orthese in Extension verriegelt; nichts unter das operierte Knie legen.","minimum_requirements_en":"WBAT with crutches/walker, brace locked in extension; never place anything under operative knee.","minimum_requirements_pl":"WBAT z kulami/chodzikiem, orteza zablokowana w wyproście; nie podkładać niczego pod operowane kolano.","additional_notes_original":"Day of Surgery: Out of bed to chair; PT Evaluation. Post Op Day 1: PT service and OT Evaluation. Post Op Day 2-Discharge: Progression of Therapeutic Exercise and Functional Mobility.","therapeutic_content_original":"Ankle pumps; Heel Prop (passive extension); Contralateral leg exercise; Gait training; Stair training; Transfer training; ADL’s with adaptive equip as needed.","minimum_requirements_original":"WBAT with Crutches/Walker; Brace locked in extension at all times; Never place anything under the operative knee.","structured_content_v2":"$undefined"},{"id":"c9bcd600-7a79-5ea5-8ea8-26c65e5c079f","name_de":"Phase 2: 0–2 Wochen — vollständige Dosierung","name_en":"Phase 2: 0–2 weeks — full dosage","name_pl":"Faza 2: 0–2 tygodnie — pełne dawki","source_page":5,"module_number":4,"name_original":"Phase 2 (Immediate Post Operative Phase Hospital Discharge - 2 Weeks)","service_codes":[],"structured_content":{"de":{"exercises":["Heel Slides","Assistierte Kniebeugung/-streckung im Sitzen","Heel Prop","Banddehnung","Ankle Pumps","Quad Sets"],"restrictions":["WBAT nach Anordnung; Orthese beim Gehen/Schlafen verriegelt; Beugung nach MD."],"progression_criteria":["Schmerz-/Ödemkontrolle, volle Extension und gute Quadrizepsaktivierung."],"dosage_and_progression":["Heel Slides 2×20; assistiert 2×20; Heel Prop 5 min; Dehnung 30 s ×3–5; Pumps ≥2×20; Quad Sets 2–3×20; 3–5×/Tag."],"physiotherapist_actions":["ROM innerhalb der Beugebegrenzung und Quadrizepsaktivierung anleiten."]},"en":{"exercises":["Heel slides","Assisted sitting knee flexion/extension","Heel prop","Belt calf/hamstring stretch","Unresisted ankle pumps","Quad sets"],"restrictions":["WBAT as ordered; brace locked for ambulation/sleep; flexion per MD."],"progression_criteria":["Pain/swelling control, full extension and good quadriceps activation."],"dosage_and_progression":["Heel slides 2×20; assisted flex/ext 2×20; heel prop 5 min; stretch 30 s ×3–5; ankle pumps ≥2×20; quad sets 2–3×20; 3–5×/day."],"physiotherapist_actions":["Guide ROM within flexion limits and quadriceps activation."]},"pl":{"exercises":["Heel slides","Wspomagane zgięcie/wyprost w siadzie","Heel prop","Rozciąganie łydki/hamstringów pasem","Pompki stóp bez oporu","Quad sets"],"restrictions":["WBAT wg zlecenia; orteza zablokowana przy chodzeniu i śnie; zgięcie wg MD."],"progression_criteria":["Kontrola bólu/obrzęku, pełny wyprost i dobra aktywacja czworogłowego."],"dosage_and_progression":["Heel slides 2×20; assisted flex/ext 2×20; heel prop 5 min; stretch 30 s ×3–5; ankle pumps ≥2×20; quad sets 2–3×20; program 3–5×/dzień."],"physiotherapist_actions":["Prowadzić ROM w ograniczeniu zgięcia i aktywację czworogłowego."]},"original":{"exercises":["Heel Slides","Assisted Knee Flexion/Extension in Sitting","Heel Prop","Belt Stretch (Calf/Hamstring)","Ankle Pumps without resistance","Quad Sets"],"restrictions":["within flexion limitations","Brace locked in extension with ambulation and while sleeping"],"progression_criteria":[],"dosage_and_progression":["2 Sets of 20 Repetitions","5 Minutes","Hold 30 Seconds 3-5 Repetitions","3-5 times a day as tolerated"],"physiotherapist_actions":[]}},"additional_notes_de":"WBAT mit Krücken/Gehhilfe; Orthese beim Gehen und Schlafen verriegelt, im Sitzen nach MD-Winkel entriegelt.","additional_notes_en":"WBAT with crutches/walker; brace locked for ambulation and sleeping, unlocked sitting at MD-prescribed flexion angle.","additional_notes_pl":"WBAT z kulami/chodzikiem; orteza zablokowana przy chodzeniu i śnie, odblokowana w siadzie według kąta MD.","minimum_patient_share":null,"therapeutic_content_de":"Heel Slides, assistierte Kniebeugung/-streckung im Sitzen, Heel Prop, Banddehnung, Ankle Pumps, Quad Sets.","therapeutic_content_en":"Heel slides, assisted knee flexion/extension in sitting, heel prop, belt stretch, ankle pumps, quad sets.","therapeutic_content_pl":"Heel slides, wspomagane zgięcie/wyprost w siadzie, heel prop, rozciąganie pasem, pompki stóp, quad sets.","minimum_requirements_de":"ROM und Kräftigung 3–5-mal täglich nach Verträglichkeit; volle Extension als Priorität.","minimum_requirements_en":"ROM and strengthening 3–5 times daily as tolerated; full extension is emphasized.","minimum_requirements_pl":"ROM i siła 3–5 razy dziennie, według tolerancji; pełny wyprost jako priorytet.","additional_notes_original":"Brace locked in extension with ambulation and while sleeping. Brace unlocked when sitting (flexion angle per MD order).","therapeutic_content_original":"Heel Slides; 2 Sets of 20 Repetitions; Assisted Knee Flexion/Extension in Sitting; 2 Sets of 20 Repetitions; Heel Prop; 5 Minutes; Belt Stretch; Hold 30 Seconds 3-5 Repetitions; Ankle Pumps; at least 2 Sets of 20 Repetitions; Quad Sets 2-3 Sets of 20 Repetitions.","minimum_requirements_original":"Perform Range of Motion and Strengthening exercises 3-5 times a day as tolerated.","structured_content_v2":"$undefined"},{"id":"61f41ddc-bf41-589c-9272-837706aac262","name_de":"Phase 3: 2–6 Wochen — ROM und Schutz (Teil 1)","name_en":"Phase 3: 2–6 weeks — ROM and protection (part 1)","name_pl":"Faza 3: 2–6 tygodni — ROM i ochrona (część 1)","source_page":5,"module_number":5,"name_original":"Phase 3 (Protected ROM Phase 2-6 Weeks)","service_codes":[],"structured_content":{"de":{"exercises":["ROM aus Phase 1","Quad Sets","Offene Hüftabduktion/-extension/-adduktion","Aktive Kniebeugung 0–90°"],"restrictions":["Flexion 0–90°; Orthese beim Gehen verriegelt; Reparaturschutz."],"progression_criteria":["90° ohne Verschlechterung von Schwellung/Schmerz schrittweise erreichen."],"dosage_and_progression":["Beugung über sechs Wochen langsam bis 90° steigern."],"physiotherapist_actions":["ROM, Erguss und VMO-Aktivierung überwachen; Widerstand individuell wählen."]},"en":{"exercises":["Phase 1 ROM","Quad sets","Open-chain hip abduction/extension/adduction","Active knee flexion 0–90°"],"restrictions":["0–90° flexion; brace locked for ambulation; continue protecting repair."],"progression_criteria":["Progress toward 90° without worsening swelling/pain."],"dosage_and_progression":["Slowly progress flexion to 90 degrees over six weeks."],"physiotherapist_actions":["Monitor ROM, effusion and VMO activation; select resistance appropriately."]},"pl":{"exercises":["ROM z fazy 1","Quad sets","Odwodzenie/wyprost/przywodzenie biodra w OKC","Aktywne zgięcie kolana 0–90°"],"restrictions":["Zgięcie 0–90°; orteza zablokowana przy chodzeniu; nadal ochrona naprawy."],"progression_criteria":["Stopniowe osiąganie 90° bez pogorszenia obrzęku/bólu."],"dosage_and_progression":["Powoli progresować zgięcie do 90° przez 6 tygodni."],"physiotherapist_actions":["Monitorować ROM, wysięk i aktywację VMO; dobierać opór adekwatnie do przypadku."]},"original":{"exercises":["Continue ROM exercises from Phase 1","Quad Sets","Open chain hip abduction, extension, adduction","Active Knee Flexion (0-90 degrees only)"],"restrictions":["Continue limited knee flexion (0-90 degrees)","Brace locked with ambulation"],"progression_criteria":[],"dosage_and_progression":["slowly progress flexion to 90 degrees"],"physiotherapist_actions":[]}},"additional_notes_de":"Bei Bedarf Knöchelgewicht oder Widerstandsband hinzufügen.","additional_notes_en":"Add ankle weight or resistance band as appropriate.","additional_notes_pl":"Dodaj obciążnik na kostkę lub taśmę, jeśli właściwe.","minimum_patient_share":null,"therapeutic_content_de":"ROM aus Phase 1 fortsetzen, Beugung langsam bis 90°, Quad Sets für VMO, offene Hüftübungen und aktive Kniebeugung.","therapeutic_content_en":"Continue Phase 1 ROM, slowly progress flexion to 90 degrees, quad sets for VMO, open-chain hip work and active knee flexion.","therapeutic_content_pl":"Kontynuacja ROM z fazy 1, wolna progresja zgięcia do 90°, quad sets dla VMO, ćwiczenia biodra w otwartym łańcuchu i aktywne zgięcie kolana.","minimum_requirements_de":"WBAT mit schrittweisem Ausschleichen; Orthese beim Gehen verriegelt; Flexion 0–90°.","minimum_requirements_en":"WBAT with progressive weaning of aids; brace locked for ambulation; 0–90 degrees flexion.","minimum_requirements_pl":"WBAT z progresywnym odstawianiem kul/chodzika; orteza zablokowana przy chodzeniu; zgięcie 0–90°.","additional_notes_original":"add ankle weight or resistance band as appropriate","therapeutic_content_original":"Continue ROM exercises from Phase 1 (slowly progress flexion to 90 degrees); Continue Quad Sets (as needed for VMO activation); Open chain hip abduction, extension, adduction; Active Knee Flexion (0-90 degrees only).","minimum_requirements_original":"WBAT with progressive weaning of crutches or walker as able; Continue limited knee flexion (0-90 degrees); Brace locked with ambulation.","structured_content_v2":"$undefined"},{"id":"494fd12a-765c-592d-860e-bc55f75b68c6","name_de":"Phase 3: 2–6 Wochen — Abschlussübungen und Dosierung","name_en":"Phase 3: 2–6 weeks — final exercises and dosage","name_pl":"Faza 3: 2–6 tygodni — ćwiczenia końcowe i dawka","source_page":6,"module_number":6,"name_original":"Heel Raises; No SLR or Open Chain Active Knee Extension Until 6 Wks","service_codes":[],"structured_content":{"de":{"exercises":["Fersenheben"],"restrictions":["Kein SLR und keine aktive offene Kniestreckung bis sechs Wochen."],"progression_criteria":[],"dosage_and_progression":["1×/Tag; 2–3×15–20."],"physiotherapist_actions":["Schützende ROM- und Kraftprogression fortsetzen."]},"en":{"exercises":["Heel raises"],"restrictions":["No SLR or active open-chain knee extension until six weeks."],"progression_criteria":[],"dosage_and_progression":["Once daily; 2–3×15–20."],"physiotherapist_actions":["Continue protected ROM and strengthening progression."]},"pl":{"exercises":["Wspięcia na palce"],"restrictions":["Bez SLR i aktywnego wyprostu OKC do 6 tygodni."],"progression_criteria":[],"dosage_and_progression":["1×/dzień; 2–3×15–20."],"physiotherapist_actions":["Kontynuować ochronną progresję ROM i siły."]},"original":{"exercises":["Heel Raises"],"restrictions":["No SLR or Open Chain Active Knee Extension Until 6 Wks"],"progression_criteria":[],"dosage_and_progression":["once a day","2-3 sets of 15-20 repetitions"],"physiotherapist_actions":[]}},"additional_notes_de":"SLR und aktive offene Kniestreckung erst nach sechs Wochen.","additional_notes_en":"SLR and active open-chain knee extension only after six weeks.","additional_notes_pl":"SLR i aktywny wyprost OKC dopiero po 6 tygodniach.","minimum_patient_share":null,"therapeutic_content_de":"Fersenheben und Fortsetzung der Phase-3-Übungen.","therapeutic_content_en":"Heel raises and continuation of phase-3 exercises.","therapeutic_content_pl":"Wspięcia na palce i kontynuacja ćwiczeń fazy 3.","minimum_requirements_de":"Alle ROM- und Kräftigungsübungen einmal täglich, 2–3 Sätze mit 15–20 Wiederholungen.","minimum_requirements_en":"All ROM and strengthening exercises once daily, 2–3 sets of 15–20 repetitions.","minimum_requirements_pl":"Wszystkie ćwiczenia ROM i siłowe raz dziennie, 2–3 serie po 15–20 powtórzeń.","additional_notes_original":"No SLR or Open Chain Active Knee Extension Until 6 Wks","therapeutic_content_original":"Heel Raises. *No SLR or Open Chain Active Knee Extension Until 6 Wks*","minimum_requirements_original":"Perform all ROM and strengthening exercises once a day. Do 2-3 sets of 15-20 repetitions.","structured_content_v2":"$undefined"},{"id":"0bdf467f-b02a-506c-a70e-b9eedb26129f","name_de":"Phase 4: frühe Kräftigung 6–12 Wochen","name_en":"Phase 4: early strengthening 6–12 weeks","name_pl":"Faza 4: wczesne wzmacnianie 6–12 tygodni","source_page":6,"module_number":7,"name_original":"Phase 4 (Early Strengthening Phase 6-12 Weeks)","service_codes":[],"structured_content":{"de":{"exercises":["ROM bis volle Beugung","Dehnung von Hamstrings, Wade, Glutealmuskulatur, Adduktoren und ITB","Rad","Offene Hüftabduktion/-extension/-adduktion und Hamstring Curls","Kniebeugen bis 30°","Beinpresse","CKC-Terminalextension","Einbeinstand/Balance"],"restrictions":["Keine Quadrizepsdehnung bis 12 Wochen; kein Laufen/Ballistik."],"progression_criteria":["Besserer Gang und Kraft erlauben schrittweises Ausschleichen."],"dosage_and_progression":["Dehnung 30 s ×2–3 täglich; Cardio 3–5×/Woche 20–30 min; Kraft 3–5×/Woche 2–3×15–20."],"physiotherapist_actions":["Gang normalisieren, Orthese ausschleichen, Form und patellofemoralen Schmerz kontrollieren."]},"en":{"exercises":["ROM to full flexion","Lower-extremity stretching: hamstrings, calf, glutes, adductors and ITB","Cycling","Open-chain hip work and hamstring curls","Squats to 30°","Leg press","CKC terminal knee extension","Single-leg stance/balance"],"restrictions":["No quadriceps stretching until 12 weeks; no running/ballistic movement."],"progression_criteria":["Improved gait and strength permit gradual brace weaning."],"dosage_and_progression":["Stretch 30 s ×2–3 daily; cardio 3–5×/week 20–30 min; strength 3–5×/week 2–3×15–20."],"physiotherapist_actions":["Normalize gait, wean brace, monitor form and PF pain."]},"pl":{"exercises":["ROM do pełnego zgięcia","Rozciąganie hamstringów/łydki/pośladków/przywodzicieli/ITB","Rower","Biodro i hamstring curl","Przysiady do 30°","Leg press","Terminalny wyprost CKC","Stanie jednonóż i balans"],"restrictions":["Bez rozciągania czworogłowego do 12 tyg.; bez biegania i balistyki."],"progression_criteria":["Lepszy chód i siła umożliwiające stopniowe odstawienie ortezy."],"dosage_and_progression":["Rozciąganie 30 s ×2–3 codziennie; cardio 3–5×/tydz. 20–30 min; siła 3–5×/tydz. 2–3×15–20."],"physiotherapist_actions":["Normalizować chód, progresować ortezę, kontrolować formę i ból PF."]},"original":{"exercises":["Continue ROM exercises from phase 1 and 2 (slowly progress to full knee flexion)","Add Lower Extremity stretching (Hamstring, Calf, Glutes, Adductors, ITB, etc)","Cycle with minimal resistance","Continue Progression of Open chain hip abduction, extension, adduction and Hamstring Curls","Squats to 30°","Low Load, Low Flexion Angle Leg Press","Closed Chain Terminal Knee Extension","Single Leg Stance","Static Balance on Bosu/Wobble Board/Foam/Etc"],"restrictions":["No Quadriceps Stretching until 12 wks","No running or ballistic movements"],"progression_criteria":[],"dosage_and_progression":["Hold stretches for 30 seconds","3-5 times a week for 20-30 minutes","2-3 sets of 15-20 Reps"],"physiotherapist_actions":[]}},"additional_notes_de":"Orthese bei besserem Gang ausschleichen; schmerzhafte patellofemorale Belastung vermeiden; kein Laufen/keine ballistischen Bewegungen.","additional_notes_en":"Wean brace as gait improves; avoid painful patellofemoral stress and excessive loading; no running or ballistic movement.","additional_notes_pl":"Odstawiać ortezę wraz z poprawą chodu; unikać bolesnego stresu rzepkowo-udowego i przeciążenia; bez biegania/ruchów balistycznych.","minimum_patient_share":null,"therapeutic_content_de":"Volle Beugung, Dehnung der unteren Extremität außer Quadrizeps, Rad mit minimalem Widerstand, Hüftübungen und Hamstring Curl, Kniebeugen bis 30°, Beinpresse, CKC-Terminalextension, Einbeinstand und Balance.","therapeutic_content_en":"Progress to full flexion, lower-extremity stretching except quadriceps, minimal-resistance cycling, open-chain hip work and hamstring curls, squats to 30°, leg press, CKC terminal knee extension, single-leg stance and balance.","therapeutic_content_pl":"Pełne zgięcie, rozciąganie kończyny dolnej poza czworogłowym, rower z minimalnym oporem, ćwiczenia biodra i hamstring curl, przysiady do 30°, leg press, terminalny wyprost CKC, stanie jednonóż i balans.","minimum_requirements_de":"Dehnung 30 s ×2–3 täglich; Cardio 3–5×/Woche 20–30 min; Kraft 3–5×/Woche 2–3×15–20.","minimum_requirements_en":"Stretch 30 seconds ×2–3 daily; cardio 3–5 times/week for 20–30 minutes; strengthening 3–5 times/week, 2–3×15–20.","minimum_requirements_pl":"Rozciąganie 30 s ×2–3 codziennie; cardio 3–5×/tydz. 20–30 min; siła 3–5×/tydz. 2–3×15–20.","additional_notes_original":"Stress proper gait as wean from brace. Must avoid painful patella femoral stress and excessive loading. No running or ballistic movements.","therapeutic_content_original":"Continue ROM exercises from phase 1 and 2 (slowly progress to full knee flexion); Add Lower Extremity stretching (Hamstring, Calf, Glutes, Adductors, ITB, etc); No Quadriceps Stretching until 12 wks; Cycle with minimal resistance; Continue Progression of Open chain hip abduction, extension, adduction and Hamstring Curls; Squats to 30°; Low Load, Low Flexion Angle Leg Press; Closed Chain Terminal Knee Extension; Single Leg Stance; Static Balance on Bosu/Wobble Board/Foam/Etc.","minimum_requirements_original":"Hold stretches for 30 seconds and perform 2-3 repetitions; Cardio; 3-5 times a week for 20-30 minutes; strengthening; 3-5 times a week. Do 2-3 sets of 15-20 Reps.","structured_content_v2":"$undefined"},{"id":"7acae152-94af-5a76-8ce5-6c321785daf4","name_de":"Phase 5: fortgeschrittene Kräftigung 12–24 Wochen","name_en":"Phase 5: advanced strengthening 12–24 weeks","name_pl":"Faza 5: zaawansowane wzmacnianie 12–24 tygodnie","source_page":7,"module_number":8,"name_original":"Phase 5 (Advanced Strengthening Phase 12-24 Weeks)","service_codes":[],"structured_content":{"de":{"exercises":["Dehnung","Rad","Ellipsentrainer/Schwimmen","SLR","Geräte: Beinpresse, Hamstring Curl und Multi-Hip","Seitliche und Crossover-Step-ups","Statische bis dynamische Ausfallschritte und seitlicher Ausfallschritt","Späte Phase: einbeinige Kniebeuge, Split Squat und einbeiniges Kreuzheben","Dynamisches Gleichgewicht"],"restrictions":["Forward Step-down nicht empfohlen; Laufen/Springen/Plyometrie nach Zeitplan und MD."],"progression_criteria":["Kein PF-Schmerz und Toleranz der Belastungssteigerung."],"dosage_and_progression":["Dehnung täglich; Cardio 3–5×/Woche 20–40 min; Kraft/Propriozeption 3×/Woche 2–3×15–20; Dynamik 2×/Woche."],"physiotherapist_actions":["Individuellen Jogging-/Agility-Plan erstellen und von zwei- zu einbeinig steigern."]},"en":{"exercises":["Stretching","Cycling","Elliptical/swimming","SLR","Gym equipment: leg press, hamstring curl and multi-hip","Lateral and crossover step-ups","Static-to-dynamic lunge progression and lateral lunge","Late-phase single-leg squat, split squat and single-leg dead lift","Dynamic balance"],"restrictions":["Forward step-down not recommended; running/jumping/plyometrics per timing and MD."],"progression_criteria":["No PF pain and tolerance of progressive loading."],"dosage_and_progression":["Stretch daily; cardio 3–5×/week 20–40 min; strength/proprioception 3×/week 2–3×15–20; dynamics twice weekly."],"physiotherapist_actions":["Create an individual jogging/agility plan and progress double-leg to single-leg."]},"pl":{"exercises":["Rozciąganie","Rower","Orbitrek/pływanie","SLR","Sprzęt: leg press, hamstring curl i multi-hip","Step-upy boczne i crossover","Wykroki statyczne do dynamicznych oraz wykrok boczny","Późna faza: przysiad jednonóż, split squat i martwy ciąg jednonóż","Balans dynamiczny"],"restrictions":["Forward step-down niewskazany; bieganie/skoki/plyometria według terminów i MD."],"progression_criteria":["Brak bólu PF i tolerancja progresywnego obciążenia."],"dosage_and_progression":["Rozciąganie codziennie 30 s ×2–3; cardio 3–5×/tydz. 20–40 min; siła/propriocepcja 3×/tydz. 2–3×15–20; dynamika 2×/tydz."],"physiotherapist_actions":["Ułożyć indywidualny plan joggingu/agility i progresować z obunóż do jednonóż."]},"original":{"exercises":["Continue daily stretching","Add gentle Quadriceps stretching","Continue cycle with increased resistance","Add elliptical, swimming","Continue SLR Program","Slow Progression to gym Equipment (Leg Press, Ham Curl, Multi-Hip)","Begin Step-Up Progressions (lateral step-ups, cross over step-ups)","Lunge progression (static to dynamic)","Lateral Lunge","Progressive Single Leg Strengthening late in phase (single leg squat, split squat, single leg dead lift)","Dynamic Balance"],"restrictions":["No Running, Jumping, Plyometric Progressions until 20-24 Wks","No sports (gradual return to sports after 6 months)","Forward Step Downs are not recommended"],"progression_criteria":[],"dosage_and_progression":["daily","3-5 times a week for 20-40 minutes","3 times a week","2 times a week"],"physiotherapist_actions":["Work with PT or MD to create patient specific plan"]}},"additional_notes_de":"Kein Laufen, Springen oder Plyometrie bis 20–24 Wochen nach MD; kein Sport bis zur schrittweisen Rückkehr nach sechs Monaten; Forward Step-down nicht empfohlen; Joggen/Agilität ab 20 Wochen, Springen nach 24 Wochen mit MD-Freigabe.","additional_notes_en":"No running, jumping or plyometrics until 20–24 weeks per MD; no sports until gradual return after 6 months; forward step-down not recommended; jogging/agility at 20 weeks and jumping after 24 weeks with MD approval.","additional_notes_pl":"Bez biegania, skoków i plyometrii do 20–24 tygodni wg MD; bez sportu do stopniowego powrotu po 6 miesiącach; forward step-down niewskazany; jogging/agility od 20 tygodni, skoki po 24 tygodniach za zgodą MD.","minimum_patient_share":null,"therapeutic_content_de":"Tägliche Dehnung, sanfte Quadrizepsdehnung, Rad mit mehr Widerstand, Ellipsentrainer/Schwimmen, SLR, Kraftgeräte, seitliche/Crossover-Step-ups, Ausfallschritte, einbeinige Kraft und dynamisches Gleichgewicht.","therapeutic_content_en":"Daily stretching, gentle quadriceps stretch, cycling with increased resistance, elliptical/swimming, SLR, gym equipment, lateral/crossover step-ups, lunges, single-leg strengthening and dynamic balance.","therapeutic_content_pl":"Codzienne rozciąganie, delikatne rozciąganie czworogłowego, rower z większym oporem, orbitrek/pływanie, SLR, sprzęt siłowy, step-upy boczne/crossover, wykroki, siła jednonóż i balans dynamiczny.","minimum_requirements_de":"Dehnung 30 s ×2–3 täglich; Cardio 3–5×/Woche 20–40 min; Kraft/Propriozeption 3×/Woche 2–3×15–20; Dynamik 2×/Woche.","minimum_requirements_en":"Stretch 30 seconds ×2–3 daily; cardio 3–5 times/week for 20–40 minutes; strength/proprioception 3 times/week, 2–3×15–20; dynamic progression twice weekly.","minimum_requirements_pl":"Rozciąganie 30 s ×2–3 codziennie; cardio 3–5×/tydz. 20–40 min; siła/propriocepcja 3×/tydz. 2–3×15–20; progresje dynamiczne 2×/tydz.","additional_notes_original":"No Running, Jumping, Plyometric Progressions until 20-24 Wks (per MD). No sports (gradual return to sports after 6 months). Forward Step Downs are not recommended due to increased patella femoral load. May begin slow progression of jogging and agility training with MD approval at 20 Wks. Jumping Progressions after 24 Wks with MD approval.","therapeutic_content_original":"Continue cycle with increased resistance; Add elliptical, swimming; Continue SLR Program; Slow Progression to gym Equipment; Begin Step-Up Progressions; Lunge progression; Progressive Single Leg Strengthening; Dynamic Balance.","minimum_requirements_original":"Perform stretching program daily; Cardio; 3-5 times a week for 20-40 minutes; strengthening/proprioception; 3 times a week; dynamic progression exercises 2 times a week.","structured_content_v2":"$undefined"},{"id":"14c30fe5-f65b-51eb-a48e-81dadde35426","name_de":"Ziele der Phase 6","name_en":"Phase 6 goals","name_pl":"Cele fazy 6","source_page":7,"module_number":9,"name_original":"Phase 6 (Return to Sport/Activity Phase 24 Weeks and Beyond) — Goals","service_codes":[],"structured_content":{"de":{"goals":["Ausreichende ROM, Beweglichkeit und Kraft erhalten.","Progressive/dynamische Kräftigung, Propriozeption, Plyometrie und Agilität fortsetzen.","Ausreichende Kraft für den Beginn der Sportprogression nach chirurgischer Freigabe erreichen."],"restrictions":["Keine Sportprogression ohne chirurgische Freigabe."],"progression_criteria":["Ausreichende ROM, Beweglichkeit und Kraft."],"dosage_and_progression":["Weitere Progression ab 24 Wochen."],"physiotherapist_actions":["Sportbereitschaft beurteilen und mit dem Chirurgen zusammenarbeiten."]},"en":{"goals":["Maintain adequate ROM, flexibility and strength.","Continue progressive/dynamic strengthening, proprioceptive, plyometric and agility training.","Achieve adequate strength to begin return-to-sport progressions pending surgeon clearance."],"restrictions":["Do not begin return-to-sport without surgeon clearance."],"progression_criteria":["Adequate ROM, flexibility and strength."],"dosage_and_progression":["Continue progression from 24 weeks."],"physiotherapist_actions":["Assess readiness and coordinate return-to-sport with surgeon."]},"pl":{"goals":["Utrzymanie odpowiedniego ROM, elastyczności i siły.","Kontynuacja progresywnego/dynamicznego wzmacniania, propriocepcji, plyometrii i agility.","Uzyskanie siły wystarczającej do rozpoczęcia progresji powrotu do sportu po zgodzie chirurga."],"restrictions":["Nie rozpoczynać powrotu do sportu bez zgody chirurga."],"progression_criteria":["Adekwatny ROM, elastyczność i siła."],"dosage_and_progression":["Dalsza progresja od 24 tygodnia."],"physiotherapist_actions":["Ocenić gotowość do progresji sportowej i współpracować z chirurgiem."]},"original":{"goals":["Maintain adequate ROM, flexibility and strength","Continue progressive/dynamic strengthening, proprioceptive, plyometric and agility training","Achieve adequate strength to begin return to sport progressions (pending surgeon’s clearance)"],"restrictions":["pending surgeon’s clearance"],"progression_criteria":[],"dosage_and_progression":["24 Weeks and Beyond"],"physiotherapist_actions":[]}},"additional_notes_de":"Dies sind Ziele, keine zusätzliche Übungsliste; Dosierung steht in Modul 10.","additional_notes_en":"These are goals, not an additional exercise list; dosage is in module 10.","additional_notes_pl":"To są cele, nie dodatkowa lista ćwiczeń; dawkowanie znajduje się w module 10.","minimum_patient_share":null,"therapeutic_content_de":"ROM, Beweglichkeit und Kraft erhalten; progressive Kraft-, Propriozeptions-, Plyometrie- und Agility-Arbeit; ausreichende Kraft für die Sportprogression.","therapeutic_content_en":"Maintain ROM, flexibility and strength; continue progressive strength, proprioceptive, plyometric and agility training; achieve strength adequate for return-to-sport progressions.","therapeutic_content_pl":"Utrzymanie ROM, elastyczności i siły; dalsza progresja siłowa, proprioceptywna, plyometryczna i agility; uzyskanie siły do powrotu do sportu.","minimum_requirements_de":"Phase ab 24 Wochen; Sportprogression nur nach Freigabe des Chirurgen.","minimum_requirements_en":"Phase begins at 24 weeks and beyond; return-to-sport progression pending surgeon clearance.","minimum_requirements_pl":"Faza od 24 tygodni wzwyż; rozpoczęcie progresji sportowej zależy od zgody chirurga.","additional_notes_original":"Goals","therapeutic_content_original":"Maintain adequate ROM, flexibility and strength. Continue progressive/dynamic strengthening, proprioceptive, plyometric and agility training. Achieve adequate strength to begin return to sport progressions (pending surgeon’s clearance).","minimum_requirements_original":"Phase 24 Weeks and Beyond; pending surgeon’s clearance.","structured_content_v2":"$undefined"},{"id":"0615b7b1-c2af-5168-8efe-f0484b9970f8","name_de":"Phase 6: Übungen und Dosierung","name_en":"Phase 6: exercises and dosage","name_pl":"Faza 6: ćwiczenia i dawkowanie","source_page":8,"module_number":10,"name_original":"Phase 6 — Recommended Exercises and Guidelines","service_codes":[],"structured_content":{"de":{"exercises":["Dehnung","Cardio","Kraft aus Phase 4","Propriozeption","Plyometrie/Sprünge/Agility","Sportplan"],"restrictions":["Kontrollierte Plyometrie; Rückkehr nach chirurgischer Freigabe."],"progression_criteria":[],"dosage_and_progression":["Dehnung 30 s ×2–3 täglich; Cardio 3–5×/Woche 20–40 min; Kraft/Propriozeption 3×/Woche 2–3×15–20; Plyometrie 2×/Woche."],"physiotherapist_actions":["Spezifischen Sport-Rückkehrplan mit PT und/oder MD erstellen."]},"en":{"exercises":["Lower-extremity stretching","Cardio","Phase-4 strengthening","Proprioception","Plyometrics/jumping/agility","Return-to-sport plan"],"restrictions":["Controlled plyometrics; return after surgeon clearance."],"progression_criteria":[],"dosage_and_progression":["Stretch 30 s ×2–3 daily; cardio 3–5×/week 20–40 min; strength/proprioception 3×/week 2–3×15–20; plyometrics twice weekly."],"physiotherapist_actions":["Develop a specific return-to-sport plan with PT and/or MD."]},"pl":{"exercises":["Rozciąganie kończyny dolnej","Cardio","Siła z fazy 4","Propriocepcja","Plyometria/skoki/agility","Plan powrotu do sportu"],"restrictions":["Plyometria kontrolowana; powrót po zgodzie chirurga."],"progression_criteria":[],"dosage_and_progression":["Rozciąganie 30 s ×2–3 codziennie; cardio 3–5×/tydz. 20–40 min; siła/propriocepcja 3×/tydz. 2–3×15–20; plyometria 2×/tydz."],"physiotherapist_actions":["Opracować specyficzny plan powrotu do sportu z PT i/lub MD."]},"original":{"exercises":["Continue daily lower extremity stretching","Continue cardio program","Continue strengthening program from phase 4","Continue and advance proprioceptive training","Progress plyometric/jumping program"],"restrictions":["Limited and controlled plyometric/ballistic movements"],"progression_criteria":[],"dosage_and_progression":["Hold stretches for 30 seconds","3-5 times a week for 20-40 minutes","3 times a week","2 times a week"],"physiotherapist_actions":["Outline specific return to sport/activity program with PT and/or MD"]}},"additional_notes_de":"Plyometrische Bewegungen begrenzt und kontrolliert; schrittweise Sport-Rückkehr, meist 6–9 Monate oder länger.","additional_notes_en":"Plyometric/ballistic movements are limited and controlled; gradual return to sport, usually 6–9 months or greater.","additional_notes_pl":"Ruchy plyometryczne ograniczone i kontrolowane; powrót do sportu stopniowo, zwykle 6–9 miesięcy lub dłużej.","minimum_patient_share":null,"therapeutic_content_de":"Tägliche Dehnung, Cardio mit Progression, Kraftprogramm aus Phase 4 mit höherer Last und geringerem Volumen, anspruchsvollere Propriozeption, Sprung-/Plyometrie-/Agility-Progression und Sportplan.","therapeutic_content_en":"Daily lower-extremity stretching, progressive cardio, phase-4 strengthening with increased load and decreased volume, advanced proprioception, plyometric/jumping/agility progression and sport plan.","therapeutic_content_pl":"Codzienne rozciąganie kończyny dolnej, cardio z progresją, siła z fazy 4 przy większym obciążeniu i mniejszej objętości, trudniejsza propriocepcja, progresja skoków/plyometrii/agility i plan powrotu do sportu.","minimum_requirements_de":"Dehnung 30 s ×2–3 täglich; Cardio 3–5×/Woche 20–40 min; Kraft/Propriozeption 3×/Woche 2–3×15–20; Plyometrie/Sprünge/Agility 2×/Woche.","minimum_requirements_en":"Stretch 30 seconds ×2–3 daily; cardio 3–5 times/week for 20–40 minutes; strength/proprioception 3 times/week, 2–3×15–20; plyometric/jumping/agility twice weekly.","minimum_requirements_pl":"Rozciąganie 30 s ×2–3 codziennie; cardio 3–5×/tydz. 20–40 min; siła/propriocepcja 3×/tydz. 2–3×15–20; plyometria/skoki/agility 2×/tydz.","additional_notes_original":"Limited and controlled plyometric/ballistic movements. Gradual return to sport pending surgeon’s clearance (6-9 months or greater).","therapeutic_content_original":"Continue daily lower extremity stretching; Continue cardio program and progress intensity and duration; Continue strengthening program from phase 4 (increase load and decrease volume); Progress plyometric/jumping program as outlined by PT or MD.","minimum_requirements_original":"Hold stretches for 30 seconds and perform 2-3 repetitions; Cardio program; 3-5 times a week for 20-40 minutes; Perform plyometric/jumping/agility exercises 2 times a week.","structured_content_v2":"$undefined"},{"id":"53c7e3da-02a8-5716-9b73-11939c73d168","name_de":"Einzigartige Ergänzungen der Tabelle für Phase 1–4","name_en":"Unique table additions for phases 1–4","name_pl":"Unikalne uzupełnienia tabeli faz 1–4","source_page":9,"module_number":11,"name_original":"Weight Bearing and Gait; Focus; Range of Motion; Recommended Exercises; Precautions","service_codes":[],"structured_content":{"de":{"exercises":["Hüft-Abd/Add/Extension","Hamstring Curl im Stand/Bauchlage","SLR","Aktive OKC-Kniestreckung mit geringer Last"],"restrictions":[],"progression_criteria":[],"dosage_and_progression":[],"physiotherapist_actions":[]},"en":{"exercises":["Hip abduction/adduction/extension","Standing or prone hamstring curl","SLR","Active low-load OKC knee extension"],"restrictions":[],"progression_criteria":[],"dosage_and_progression":[],"physiotherapist_actions":[]},"pl":{"exercises":["Hip Abd/Add/Extension","Standing or prone hamstring curl","SLR","Active low-load OKC knee extension"],"restrictions":[],"progression_criteria":[],"dosage_and_progression":[],"physiotherapist_actions":[]},"original":{"exercises":["Hip Abd/Add/Extension","Standing or Prone Hamstring Curl","Add SLR","Active Low Load Open Chain Knee Extension"],"restrictions":[],"progression_criteria":[],"dosage_and_progression":[],"physiotherapist_actions":[]}},"additional_notes_de":"Dies sind Tabellenergänzungen, keine neuen Phasen; der Unterschied zwischen Text und Tabelle bleibt bestehen.","additional_notes_en":"These are table additions, not new phases; the narrative/table difference is retained.","additional_notes_pl":"To uzupełnienia tabeli, nie nowe fazy; należy zachować różnicę między narracją a tabelą.","minimum_patient_share":null,"therapeutic_content_de":"Die Übersichtstabelle ergänzt in Phase 2 Hüft-Abduktion/Adduktion/Extension und Hamstring Curl im Stand oder Bauchlage; in Phase 4 SLR und aktive OKC-Kniestreckung mit geringer Last.","therapeutic_content_en":"The summary table uniquely adds phase-2 hip abduction/adduction/extension and standing or prone hamstring curl; phase 4 adds SLR and low-load active open-chain knee extension.","therapeutic_content_pl":"Tabela zbiorcza doprecyzowuje w fazie 2 ćwiczenia biodra 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Wochen"],"restrictions":["Keine aktive Schulterbewegung, keine Pendelübungen.","Verbot von Oberkörper-Ergometern."],"physiotherapist_actions":["Patientenschulung, Gelenkschutz."]},"en":{"exercises":["Elbow/wrist/hand AROM.","Passive forward elevation to 90°, ER to 30°.","Scapular strengthening."],"applies_when":["0-4 Weeks"],"restrictions":["No active shoulder movement, no pendulums.","NO UPPER BODY ERGOMETER AT ANY TIME."],"physiotherapist_actions":["Patient education, joint protection."]},"pl":{"exercises":["AROM łokcia/nadgarstka/dłoni.","Pasywne zgięcie do 90°, rotacja zewnętrzna do 30°.","Wzmocnienie łopatki."],"applies_when":["0-4 tygodnie"],"restrictions":["Brak aktywnego ruchu barku, brak wahadeł.","Zakaz stosowania cykloergometru kończyn górnych."],"physiotherapist_actions":["Edukacja pacjenta, ochrona stawu."]},"original":{"exercises":["Elbow/wrist/hand AROM.","Passive forward elevation to 90°, ER to 30°.","Scapular strengthening."],"applies_when":["0-4 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Keine aktive Schulterbewegung, keine Pendelübungen. AROM Ellbogen/Handgelenk. Passive Elevation bis 90°, Außenrotation bis 30°. Scapulastabilisation.","therapeutic_content_en":"Patient education, joint protection. No active shoulder movement, no pendulums. Elbow/wrist/hand AROM. Passive forward elevation to 90°, ER to 30°. Scapular strengthening.","therapeutic_content_pl":"Edukacja pacjenta, ochrona stawu. Brak aktywnego ruchu barku, brak wahadeł. AROM łokcia/nadgarstka/dłoni. Pasywne zgięcie do 90°, rotacja zewnętrzna do 30°. Wzmocnienie łopatki.","minimum_requirements_de":"Verbot von Oberkörper-Ergometern.","minimum_requirements_en":"NO UPPER BODY ERGOMETER AT ANY TIME.","minimum_requirements_pl":"Zakaz stosowania cykloergometru kończyn górnych.","additional_notes_original":"","therapeutic_content_original":"Patient education, joint protection. No active shoulder movement, no pendulums. Elbow/wrist/hand AROM. Passive forward elevation to 90°, ER to 30°. Scapular strengthening.","minimum_requirements_original":"NO UPPER BODY ERGOMETER AT ANY TIME.","structured_content_v2":"$undefined"},{"id":"5d496668-60b1-5263-9d4f-57c8a2cd987c","name_de":"Phase II: 4-6 Wochen","name_en":"Phase II: 4-6 Weeks","name_pl":"Faza II: 4-6 tygodni","source_page":1,"module_number":2,"name_original":"Phase II: 4-6 Weeks","service_codes":[],"structured_content":{"de":{"applies_when":["4-6 Wochen"],"dosage_and_progression":["Progression Scapulastabilisation, Steigerung passiver ROM.","Aquatherapie ab Woche 6 für AAROM möglich (kein Schwimmen)."]},"en":{"applies_when":["4-6 Weeks"],"dosage_and_progression":["Progress scapular strengthening, gradual PROM.","Aquatic therapy after 6 weeks for AAROM (no swimming)."]},"pl":{"applies_when":["4-6 tygodni"],"dosage_and_progression":["Progresja wzmacniania łopatki, stopniowa progresja biernego zakresu ruchu (PROM).","Możliwa terapia w wodzie (AAROM) po 6. tygodniu (bez pływania)."]},"original":{"applies_when":["4-6 Weeks"],"dosage_and_progression":["Progress scapular strengthening, gradual PROM.","Aquatic therapy after 6 weeks for AAROM (no swimming)."]}},"additional_notes_de":"","additional_notes_en":"","additional_notes_pl":"","minimum_patient_share":null,"therapeutic_content_de":"Progression Scapulastabilisation, Steigerung passiver ROM. Aquatherapie ab Woche 6 für AAROM möglich (kein Schwimmen).","therapeutic_content_en":"Progress scapular strengthening, gradual PROM. Aquatic therapy after 6 weeks for AAROM (no swimming).","therapeutic_content_pl":"Progresja wzmacniania łopatki, stopniowa progresja biernego zakresu ruchu (PROM). Możliwa terapia w wodzie (AAROM) po 6. tygodniu (bez pływania).","minimum_requirements_de":"","minimum_requirements_en":"","minimum_requirements_pl":"","additional_notes_original":"","therapeutic_content_original":"Progress scapular strengthening, gradual PROM. Aquatic therapy after 6 weeks for AAROM (no swimming).","minimum_requirements_original":"","structured_content_v2":"$undefined"},{"id":"04c46873-a069-52c4-9422-489e3ceacf53","name_de":"Phase III: 6-12 Wochen","name_en":"Phase III: 6-12 Weeks","name_pl":"Faza III: 6-12 tygodni","source_page":1,"module_number":3,"name_original":"Phase III: 6-12 Weeks","service_codes":[],"structured_content":{"de":{"exercises":["Übergang von PROM zu AAROM und AROM.","Kapseldehnung."],"applies_when":["6-12 Wochen"],"restrictions":["Keine Kräftigung der Rotatorenmanschette."],"dosage_and_progression":["Außenrotation in verschiedenen Winkeln.","Kräftigung von Scapula, Rücken und Bizeps mit leichtem Widerstand möglich."]},"en":{"exercises":["Progression to AAROM and AROM to normalize ROM.","Posterior capsule stretching."],"applies_when":["6-12 Weeks"],"restrictions":["No rotator cuff strengthening."],"dosage_and_progression":["External rotation at various angles.","May perform scapular, back, and biceps strengthening with light resistance."]},"pl":{"exercises":["Przejście z PROM przez AAROM do AROM.","Rozciąganie torebki stawowej."],"applies_when":["6-12 tygodni"],"restrictions":["Brak ćwiczeń oporowych na stożek rotatorów."],"dosage_and_progression":["Wprowadzenie rotacji zewnętrznej pod różnymi kątami.","Możliwe wzmacnianie łopatki, pleców i bicepsa przy lekkim oporze."]},"original":{"exercises":["Progression to AAROM and AROM to normalize ROM.","Posterior capsule stretching."],"applies_when":["6-12 Weeks"],"restrictions":["No rotator cuff strengthening."],"dosage_and_progression":["External rotation at various angles.","May perform scapular, back, and biceps strengthening with light resistance."]}},"additional_notes_de":"Kräftigung von Scapula, Rücken und Bizeps mit leichtem Widerstand möglich.","additional_notes_en":"May perform scapular, back, and biceps strengthening with light resistance.","additional_notes_pl":"Możliwe wzmacnianie łopatki, pleców i bicepsa przy lekkim oporze.","minimum_patient_share":null,"therapeutic_content_de":"Übergang von PROM zu AAROM und AROM. Außenrotation in verschiedenen Winkeln. Kapseldehnung. Keine Kräftigung der Rotatorenmanschette.","therapeutic_content_en":"Progression to AAROM and AROM to normalize ROM. External rotation at various angles. Posterior capsule stretching. No rotator cuff strengthening.","therapeutic_content_pl":"Przejście z PROM przez AAROM do AROM. Wprowadzenie rotacji zewnętrznej pod różnymi kątami. Rozciąganie torebki stawowej. Brak ćwiczeń oporowych na stożek rotatorów.","minimum_requirements_de":"","minimum_requirements_en":"","minimum_requirements_pl":"","additional_notes_original":"May perform scapular, back, and biceps strengthening with light resistance.","therapeutic_content_original":"Progression to AAROM and AROM to normalize ROM. External rotation at various angles. Posterior capsule stretching. No rotator cuff strengthening.","minimum_requirements_original":"","structured_content_v2":"$undefined"},{"id":"5596e278-9255-5f52-b4dc-23d6f21d1c12","name_de":"Phase IV: Über 12 Wochen","name_en":"Phase IV: Beyond 12 Weeks","name_pl":"Faza IV: Powyżej 12 tygodni","source_page":2,"module_number":4,"name_original":"Phase IV: Beyond 12 Weeks","service_codes":[],"structured_content":{"de":{"warnings":["Gesamte Heilungsdauer ca. 9-12 Monate."],"exercises":["Dynamische Stabilisierung, geschlossene Kette.","Schmerzfreie Übungen ohne Kompensationsmuster."],"applies_when":["Über 12 Wochen"],"dosage_and_progression":["Rückkehr zu ADLs/Arbeit.","Beginn der Rotatorenmanschetten-Kräftigung ab dem 5. Monat bei normalem ROM."]},"en":{"warnings":["Expected Recovery Time is approximately 9-12 Months."],"exercises":["Dynamic stabilization, closed chain activities.","Activities should be pain-free and performed without substitutions."],"applies_when":["Beyond 12 Weeks"],"dosage_and_progression":["Return to ADLs and work.","Initiate rotator cuff strengthening at 5 months if full ROM achieved."]},"pl":{"warnings":["Całkowity czas rekonwalescencji: 9-12 miesięcy."],"exercises":["Stabilizacja dynamiczna, łańcuch zamknięty.","Ćwiczenia bezbolesne, bez kompensacji."],"applies_when":["Powyżej 12 tygodni"],"dosage_and_progression":["Powrót do ADL i pracy.","Wprowadzenie wzmacniania stożka rotatorów od 5. miesiąca (jeśli osiągnięto pełny ROM)."]},"original":{"warnings":["Expected Recovery Time is approximately 9-12 Months."],"exercises":["Dynamic stabilization, closed chain activities.","Activities should be pain-free and performed without substitutions."],"applies_when":["Beyond 12 Weeks"],"dosage_and_progression":["Return to ADLs and work.","Initiate rotator cuff strengthening at 5 months if full ROM achieved."]}},"additional_notes_de":"Gesamte Heilungsdauer ca. 9-12 Monate.","additional_notes_en":"Expected Recovery Time is approximately 9-12 Months.","additional_notes_pl":"Całkowity czas rekonwalescencji: 9-12 miesięcy.","minimum_patient_share":null,"therapeutic_content_de":"Dynamische Stabilisierung, geschlossene Kette. Rückkehr zu ADLs/Arbeit. Beginn der Rotatorenmanschetten-Kräftigung ab dem 5. Monat bei normalem ROM.","therapeutic_content_en":"Dynamic stabilization, closed chain activities. Return to ADLs and work. Initiate rotator cuff strengthening at 5 months if full ROM achieved.","therapeutic_content_pl":"Stabilizacja dynamiczna, łańcuch zamknięty. Powrót do ADL i pracy. Wprowadzenie wzmacniania stożka rotatorów od 5. miesiąca (jeśli osiągnięto pełny ROM).","minimum_requirements_de":"Schmerzfreie Übungen ohne Kompensationsmuster.","minimum_requirements_en":"Activities should be pain-free and performed without substitutions.","minimum_requirements_pl":"Ćwiczenia bezbolesne, bez kompensacji.","additional_notes_original":"Expected Recovery Time is approximately 9-12 Months.","therapeutic_content_original":"Dynamic stabilization, closed chain activities. Return to ADLs and work. Initiate rotator cuff strengthening at 5 months if full ROM achieved.","minimum_requirements_original":"Activities should be pain-free and performed without substitutions.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["shoulder","upper_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"e21e16eb-aea5-5719-a941-a703bd886bf6","slug":"us-jared-lee-05-rotator-cuff-repair","title_pl":"Protokół rehabilitacji po naprawie stożka rotatorów","title_de":"Rehabilitationsprotokoll nach Rotatorenmanschettenrekonstruktion","title_en":"Rotator Cuff Repair 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MD","source_country_code":"US","jurisdiction_code":"US-CO","authority_level":"clinic","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_requires_review","official_url":"https://jaredleemd.com/wp-content/uploads/2025/06/Rotator-Cuff-Repair-Rehabilitation-Protocol.pdf","source_sha256":"a4e4c54cf72e910c62ddac7fec5000ec82acaa1b0c4ebc950f406b93d64fe2d8","authorization_required":false,"license_note":"Public source file retained locally for source verification.","modules":[{"id":"c24b7268-038f-5699-a87b-17eecb9ded3c","name_de":"Phase I: Wochen 0–4","name_en":"Phase I: Weeks 0-4","name_pl":"Faza I: tygodnie 0–4","source_page":1,"module_number":1,"name_original":"Phase I: Weeks 0-4","service_codes":[],"structured_content":{"de":{"goals":["Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, die chirurgische Rekonstruktion schützen und Schultersteife vermeiden."],"exercises":["Passiver Bewegungsumfang: Flexion und Abduktion 0–90° sowie Außenrotation 0–30° für 4 Wochen","in Rückenlage den Ellenbogen mit Handtuchrolle oder Kissen neutral unterstützen","6 Wochen keine Abstützung des Körpergewichts über die operierte Extremität","voller Ellenbogenbewegungsumfang ohne Widerstand bei angelegtem Arm","Kräftigung der Skapulastabilisatoren","Dehnung und Bewegungsübungen der Halswirbelsäule","Ballpressen","Pendelübungen","Skapulaisometrie","Kryotherapie"],"applies_when":["Wochen 0–4"],"restrictions":["keine Kräftigungsübungen."],"progression_criteria":["passiver Bewegungsumfang wird toleriert und mindestens 4 Wochen postoperativ."],"physiotherapist_actions":["Armschlinge 4 Wochen durchgehend außer bei Körperpflege und Physiotherapie","den Arm 4 Wochen nicht über 90° anheben","mit der operierten Extremität 6 Wochen nicht mehr als 3 lb heben","Duschen ab dem 2. postoperativen Tag nach Entfernung des großen Verbands erlaubt","physikalische Maßnahmen nach Bedarf","Schmerz- und Ödemkontrolle","Weichteilmobilisation","Gelenkmobilisationen Grad I–II und Oszillationen zur Schmerzlinderung."]},"en":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness."],"exercises":["Passive ROM 0-90° flexion and abduction and external rotation 0-30° for 4 weeks","in supine, support the elbow with a towel roll or pillow in neutral","full elbow ROM without resistance with the arm at the side","periscapular strengthening","neck stretching and ROM","ball squeezes","pendulums","scapular isometrics","cryotherapy"],"applies_when":["Weeks 0-4"],"restrictions":["no arm elevation above 90° for 4 weeks","no lifting more than 3 lb with the surgical limb for 6 weeks","no strengthening.","no support of body weight through the surgical extremity for 6 weeks"],"progression_criteria":["tolerates PROM and is at least 4 weeks postoperative."],"dosage_and_progression":["showering allowed from postoperative day 2 after removing the bulky dressing"],"physiotherapist_actions":["Sling at all times except hygiene and physical therapy for 4 weeks","modalities as needed","pain and edema control","soft-tissue mobilization","Grade I-II joint mobilizations and oscillations for pain relief."]},"pl":{"goals":["zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona naprawy chirurgicznej oraz zapobieganie sztywności barku."],"exercises":["Bierny zakres ruchu: zgięcie i odwodzenie 0–90° oraz rotacja zewnętrzna 0–30° przez 4 tygodnie","w leżeniu tyłem podparcie łokcia wałkiem z ręcznika lub poduszką w pozycji neutralnej","pełny zakres ruchu łokcia bez oporu przy ramieniu ułożonym wzdłuż tułowia","wzmacnianie stabilizatorów łopatki","rozciąganie i zakres ruchu odcinka szyjnego","ściskanie piłki","ćwiczenia wahadłowe","izometria łopatki","krioterapia"],"applies_when":["tygodnie 0–4"],"restrictions":["przez 4 tygodnie nie unosić ramienia powyżej 90°","przez 6 tygodni nie podnosić operowaną kończyną ciężaru większego niż 3 lb","bez ćwiczeń wzmacniających.","przez 6 tygodni bez podpierania ciężaru ciała operowaną kończyną"],"progression_criteria":["tolerowany bierny zakres ruchu i co najmniej 4 tygodnie od zabiegu."],"dosage_and_progression":["prysznic dozwolony od 2. doby po zabiegu po zdjęciu dużego opatrunku"],"physiotherapist_actions":["Temblak przez cały czas z wyjątkiem higieny i fizjoterapii przez 4 tygodnie","fizykoterapia według potrzeb","kontrola bólu i obrzęku","mobilizacja tkanek miękkich","mobilizacje stawowe stopnia I–II i oscylacje przeciwbólowe."]},"original":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness."],"exercises":["Passive ROM 0-90° flexion and abduction and external rotation 0-30° for 4 weeks","in supine, support the elbow with a towel roll or pillow in neutral","full elbow ROM without resistance with the arm at the side","periscapular strengthening","neck stretching and ROM","ball squeezes","pendulums","scapular isometrics","cryotherapy"],"applies_when":["Weeks 0-4"],"restrictions":["no arm elevation above 90° for 4 weeks","no lifting more than 3 lb with the surgical limb for 6 weeks","no strengthening.","no support of body weight through the surgical extremity for 6 weeks"],"progression_criteria":["tolerates PROM and is at least 4 weeks postoperative."],"dosage_and_progression":["showering allowed from postoperative day 2 after removing the bulky dressing"],"physiotherapist_actions":["Sling at all times except hygiene and physical therapy for 4 weeks","modalities as needed","pain and edema control","soft-tissue mobilization","Grade I-II joint mobilizations and oscillations for pain relief."]}},"additional_notes_de":"Ziele: Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, die chirurgische Rekonstruktion schützen und Schultersteife vermeiden. Progressionskriterien: passiver Bewegungsumfang wird toleriert und mindestens 4 Wochen postoperativ.","additional_notes_en":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness. Progression criteria: tolerates PROM and is at least 4 weeks postoperative.","additional_notes_pl":"Cele: zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona naprawy chirurgicznej oraz zapobieganie sztywności barku. Kryteria progresji: tolerowany bierny zakres ruchu i co najmniej 4 tygodnie od zabiegu.","minimum_patient_share":null,"therapeutic_content_de":"Passiver Bewegungsumfang: Flexion und Abduktion 0–90° sowie Außenrotation 0–30° für 4 Wochen; in Rückenlage den Ellenbogen mit Handtuchrolle oder Kissen neutral unterstützen; 6 Wochen keine Abstützung des Körpergewichts über die operierte Extremität; voller Ellenbogenbewegungsumfang ohne Widerstand bei angelegtem Arm; physikalische Maßnahmen nach Bedarf; Schmerz- und Ödemkontrolle; Kräftigung der Skapulastabilisatoren; Dehnung und Bewegungsübungen der Halswirbelsäule; Weichteilmobilisation; Ballpressen; Pendelübungen; Skapulaisometrie; Kryotherapie; Gelenkmobilisationen Grad I–II und Oszillationen zur Schmerzlinderung.","therapeutic_content_en":"Passive ROM 0-90° flexion and abduction and external rotation 0-30° for 4 weeks; in supine, support the elbow with a towel roll or pillow in neutral; no support of body weight through the surgical extremity for 6 weeks; full elbow ROM without resistance with the arm at the side; modalities as needed; pain and edema control; periscapular strengthening; neck stretching and ROM; soft-tissue mobilization; ball squeezes; pendulums; scapular isometrics; cryotherapy; Grade I-II joint mobilizations and oscillations for pain relief.","therapeutic_content_pl":"Bierny zakres ruchu: zgięcie i odwodzenie 0–90° oraz rotacja zewnętrzna 0–30° przez 4 tygodnie; w leżeniu tyłem podparcie łokcia wałkiem z ręcznika lub poduszką w pozycji neutralnej; przez 6 tygodni bez podpierania ciężaru ciała operowaną kończyną; pełny zakres ruchu łokcia bez oporu przy ramieniu ułożonym wzdłuż tułowia; fizykoterapia według potrzeb; kontrola bólu i obrzęku; wzmacnianie stabilizatorów łopatki; rozciąganie i zakres ruchu odcinka szyjnego; mobilizacja tkanek miękkich; ściskanie piłki; ćwiczenia wahadłowe; izometria łopatki; krioterapia; mobilizacje stawowe stopnia I–II i oscylacje przeciwbólowe.","minimum_requirements_de":"Armschlinge 4 Wochen durchgehend außer bei Körperpflege und Physiotherapie; den Arm 4 Wochen nicht über 90° anheben; mit der operierten Extremität 6 Wochen nicht mehr als 3 lb heben; Duschen ab dem 2. postoperativen Tag nach Entfernung des großen Verbands erlaubt; keine Kräftigungsübungen.","minimum_requirements_en":"Sling at all times except hygiene and physical therapy for 4 weeks; no arm elevation above 90° for 4 weeks; no lifting more than 3 lb with the surgical limb for 6 weeks; showering allowed from postoperative day 2 after removing the bulky dressing; no strengthening.","minimum_requirements_pl":"Temblak przez cały czas z wyjątkiem higieny i fizjoterapii przez 4 tygodnie; przez 4 tygodnie nie unosić ramienia powyżej 90°; przez 6 tygodni nie podnosić operowaną kończyną ciężaru większego niż 3 lb; prysznic dozwolony od 2. doby po zabiegu po zdjęciu dużego opatrunku; bez ćwiczeń wzmacniających.","additional_notes_original":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness. Progression criteria: tolerates PROM and is at least 4 weeks postoperative.","therapeutic_content_original":"Passive ROM 0-90° flexion and abduction and external rotation 0-30° for 4 weeks; in supine, support the elbow with a towel roll or pillow in neutral; no support of body weight through the surgical extremity for 6 weeks; full elbow ROM without resistance with the arm at the side; modalities as needed; pain and edema control; periscapular strengthening; neck stretching and ROM; soft-tissue mobilization; ball squeezes; pendulums; scapular isometrics; cryotherapy; Grade I-II joint mobilizations and oscillations for pain relief.","minimum_requirements_original":"Sling at all times except hygiene and physical therapy for 4 weeks; no arm elevation above 90° for 4 weeks; no lifting more than 3 lb with the surgical limb for 6 weeks; showering allowed from postoperative day 2 after removing the bulky dressing; no strengthening.","structured_content_v2":"$undefined"},{"id":"2b73c23b-2e7d-562c-b1fe-c08f083db568","name_de":"Phase II: Wochen 5–6","name_en":"Phase II: Weeks 5-6","name_pl":"Faza II: tygodnie 5–6","source_page":1,"module_number":2,"name_original":"Phase II: Weeks 5-6","service_codes":[],"structured_content":{"de":{"goals":["Bewegungsumfang steigern, Schmerzen und Muskelatrophie begrenzen, die Rekonstruktion schützen und mit der neuromuskulären Kontrolle beginnen."],"exercises":["Zum vollständigen passiven Bewegungsumfang fortschreiten","Schmerz und Entzündung kontrollieren","aktiv-assistierte Bewegungen in Rückenlage beginnen","Haltungs- und Rumpfübungen","nach 4 Wochen submaximale Isometrie für Schulterflexion, Abduktion, Extension und Außenrotation möglich","Rudern in Bauchlage bis neutral","Ausdauertraining: Gehen und Fahrradergometer, kein Laufband, Crosstrainer, Stepper oder Rennrad."],"applies_when":["Wochen 5–6"],"restrictions":["heilendes Gewebe nicht überlasten","kein Laufband, Crosstrainer, Stepper oder Rennrad."],"progression_criteria":["passive und aktiv-assistierte Bewegungen sowie Isometrie werden toleriert, passive Vorwärtsflexion bis 135° und mindestens 6 Wochen postoperativ."],"dosage_and_progression":["Übungen aus Phase I fortsetzen"],"physiotherapist_actions":["Armschlinge 6 Wochen durchgehend außer bei Körperpflege und Physiotherapie","mit der operierten Extremität 6 Wochen nicht mehr als 3 lb heben.","Haltungsstörungen korrigieren und heilendes Gewebe nicht überlasten"]},"en":{"goals":["progress ROM, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control."],"exercises":["Progress to full passive ROM","initiate supine AAROM","postural exercises","core strengthening","after 4 weeks may begin submaximal isometrics for shoulder flexion, abduction, extension and external rotation","prone row to neutral","cardiovascular exercise: walking and stationary bike only, no treadmill, elliptical, stair climber or road bike."],"applies_when":["Weeks 5-6"],"restrictions":["no lifting more than 3 lb with the surgical limb for 6 weeks.","avoid overstressing healing tissues","no treadmill, elliptical, stair climber or road bike."],"progression_criteria":["PROM, AAROM and isometrics are tolerated, passive forward flexion reaches 135° and the patient is at least 6 weeks postoperative."],"dosage_and_progression":["continue Phase I exercises"],"physiotherapist_actions":["Sling at all times except hygiene and physical therapy for 6 weeks","correct postural dysfunction","control pain and inflammation"]},"pl":{"goals":["zwiększanie zakresu ruchu, ograniczenie bólu i zaniku mięśni, ochrona naprawy i rozpoczęcie kontroli nerwowo-mięśniowej."],"exercises":["Dążyć do pełnego biernego zakresu ruchu","rozpocząć czynny wspomagany zakres ruchu w leżeniu tyłem","ćwiczenia posturalne i mięśni tułowia","po 4 tygodniach można rozpocząć submaksymalną izometrię zgięcia, odwodzenia, wyprostu i rotacji zewnętrznej barku","wiosłowanie w leżeniu przodem do pozycji neutralnej","trening wydolnościowy: marsz i rower stacjonarny, bez bieżni, orbitreka, steppera i roweru szosowego."],"applies_when":["tygodnie 5–6"],"restrictions":["przez 6 tygodni nie podnosić operowaną kończyną ciężaru większego niż 3 lb.","nie przeciążać gojących się tkanek","bez bieżni, orbitreka, steppera i roweru szosowego."],"progression_criteria":["tolerowany bierny i czynny wspomagany zakres ruchu oraz izometria, bierne zgięcie do przodu 135° i co najmniej 6 tygodni od zabiegu."],"dosage_and_progression":["kontynuować ćwiczenia fazy I"],"physiotherapist_actions":["Temblak przez cały czas z wyjątkiem higieny i fizjoterapii przez 6 tygodni","korygować zaburzenia postawy i nie przeciążać gojących się tkanek","kontrolować ból i stan zapalny"]},"original":{"goals":["progress ROM, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control."],"exercises":["Progress to full passive ROM","initiate supine AAROM","postural exercises","core strengthening","after 4 weeks may begin submaximal isometrics for shoulder flexion, abduction, extension and external rotation","prone row to neutral","cardiovascular exercise: walking and stationary bike only, no treadmill, elliptical, stair climber or road bike."],"applies_when":["Weeks 5-6"],"restrictions":["no lifting more than 3 lb with the surgical limb for 6 weeks.","avoid overstressing healing tissues","no treadmill, elliptical, stair climber or road bike."],"progression_criteria":["PROM, AAROM and isometrics are tolerated, passive forward flexion reaches 135° and the patient is at least 6 weeks postoperative."],"dosage_and_progression":["continue Phase I exercises"],"physiotherapist_actions":["Sling at all times except hygiene and physical therapy for 6 weeks","correct postural dysfunction","control pain and inflammation"]}},"additional_notes_de":"Ziele: Bewegungsumfang steigern, Schmerzen und Muskelatrophie begrenzen, die Rekonstruktion schützen und mit der neuromuskulären Kontrolle beginnen. Progressionskriterien: passive und aktiv-assistierte Bewegungen sowie Isometrie werden toleriert, passive Vorwärtsflexion bis 135° und mindestens 6 Wochen postoperativ.","additional_notes_en":"Goals: progress ROM, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control. Progression criteria: PROM, AAROM and isometrics are tolerated, passive forward flexion reaches 135° and the patient is at least 6 weeks postoperative.","additional_notes_pl":"Cele: zwiększanie zakresu ruchu, ograniczenie bólu i zaniku mięśni, ochrona naprawy i rozpoczęcie kontroli nerwowo-mięśniowej. Kryteria progresji: tolerowany bierny i czynny wspomagany zakres ruchu oraz izometria, bierne zgięcie do przodu 135° i co najmniej 6 tygodni od zabiegu.","minimum_patient_share":null,"therapeutic_content_de":"Zum vollständigen passiven Bewegungsumfang fortschreiten; Haltungsstörungen korrigieren und heilendes Gewebe nicht überlasten; Schmerz und Entzündung kontrollieren; aktiv-assistierte Bewegungen in Rückenlage beginnen; Haltungs- und Rumpfübungen; nach 4 Wochen submaximale Isometrie für Schulterflexion, Abduktion, Extension und Außenrotation möglich; Rudern in Bauchlage bis neutral; Ausdauertraining: Gehen und Fahrradergometer, kein Laufband, Crosstrainer, Stepper oder Rennrad.","therapeutic_content_en":"Progress to full passive ROM; correct postural dysfunction; avoid overstressing healing tissues; control pain and inflammation; initiate supine AAROM; postural exercises; core strengthening; after 4 weeks may begin submaximal isometrics for shoulder flexion, abduction, extension and external rotation; prone row to neutral; cardiovascular exercise: walking and stationary bike only, no treadmill, elliptical, stair climber or road bike.","therapeutic_content_pl":"Dążyć do pełnego biernego zakresu ruchu; korygować zaburzenia postawy i nie przeciążać gojących się tkanek; kontrolować ból i stan zapalny; rozpocząć czynny wspomagany zakres ruchu w leżeniu tyłem; ćwiczenia posturalne i mięśni tułowia; po 4 tygodniach można rozpocząć submaksymalną izometrię zgięcia, odwodzenia, wyprostu i rotacji zewnętrznej barku; wiosłowanie w leżeniu przodem do pozycji neutralnej; trening wydolnościowy: marsz i rower stacjonarny, bez bieżni, orbitreka, steppera i roweru szosowego.","minimum_requirements_de":"Armschlinge 6 Wochen durchgehend außer bei Körperpflege und Physiotherapie; Übungen aus Phase I fortsetzen; mit der operierten Extremität 6 Wochen nicht mehr als 3 lb heben.","minimum_requirements_en":"Sling at all times except hygiene and physical therapy for 6 weeks; continue Phase I exercises; no lifting more than 3 lb with the surgical limb for 6 weeks.","minimum_requirements_pl":"Temblak przez cały czas z wyjątkiem higieny i fizjoterapii przez 6 tygodni; kontynuować ćwiczenia fazy I; przez 6 tygodni nie podnosić operowaną kończyną ciężaru większego niż 3 lb.","additional_notes_original":"Goals: progress ROM, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control. Progression criteria: PROM, AAROM and isometrics are tolerated, passive forward flexion reaches 135° and the patient is at least 6 weeks postoperative.","therapeutic_content_original":"Progress to full passive ROM; correct postural dysfunction; avoid overstressing healing tissues; control pain and inflammation; initiate supine AAROM; postural exercises; core strengthening; after 4 weeks may begin submaximal isometrics for shoulder flexion, abduction, extension and external rotation; prone row to neutral; cardiovascular exercise: walking and stationary bike only, no treadmill, elliptical, stair climber or road bike.","minimum_requirements_original":"Sling at all times except hygiene and physical therapy for 6 weeks; continue Phase I exercises; no lifting more than 3 lb with the surgical limb for 6 weeks.","structured_content_v2":"$undefined"},{"id":"a28a2934-761a-50b0-8dba-1855bd9fbda0","name_de":"Phase III: Wochen 7–9","name_en":"Phase III: Weeks 7-9","name_pl":"Faza III: tygodnie 7–9","source_page":2,"module_number":3,"name_original":"Phase III: Weeks 7-9","service_codes":[],"structured_content":{"de":{"goals":["voller Bewegungsumfang, minimale Schmerzen sowie bessere neuromuskuläre Kontrolle und Mechanik."],"exercises":["Nach Erreichen des vollständigen passiven Bewegungsumfangs zu aktiven und aktiv-assistierten Bewegungen übergehen","Fokus auf neuromuskuläre Kontrolle und korrekte Mechanik","Skapulastabilisation und -kräftigung","aktive Bewegungen kontrolliert steigern","Skaption und aktive Schulterbewegungen beginnen","Ausdauertraining: Gehen und Fahrradergometer, kein Laufband, Crosstrainer, Stepper oder Rennrad."],"applies_when":["Wochen 7–9"],"restrictions":["keine Kräftigung","kein Laufband, Crosstrainer, Stepper oder Rennrad."],"progression_criteria":["aktiver Bewegungsumfang wird toleriert, aktive Flexion bis 120° mit guter Mechanik und mindestens 8 Wochen postoperativ."],"dosage_and_progression":["Armschlinge ablegen","Übungen aus Phase I und II fortsetzen"],"physiotherapist_actions":["mit der operierten Extremität nicht mehr als 5 lb heben."]},"en":{"goals":["full ROM, minimal pain, improve neuromuscular control and mechanics."],"exercises":["After full passive ROM is achieved, progress to active and active-assisted ROM","focus on neuromuscular control and correct mechanics","scapular stabilization and strengthening","controlled progression of AROM","initiate scaption and shoulder AROM","cardiovascular exercise: walking and stationary bike only, no treadmill, elliptical, stair climber or road bike."],"applies_when":["Weeks 7-9"],"restrictions":["no strengthening","no lifting more than 5 lb with the surgical limb.","no treadmill, elliptical, stair climber or road bike."],"progression_criteria":["tolerates AROM, active flexion reaches 120° with good mechanics and the patient is at least 8 weeks postoperative."],"dosage_and_progression":["Discontinue sling","continue Phase I and II exercises"]},"pl":{"goals":["pełny zakres ruchu, minimalny ból oraz poprawa kontroli nerwowo-mięśniowej i mechaniki."],"exercises":["Po uzyskaniu pełnego biernego zakresu ruchu przejść do zakresu czynnego i czynnego wspomaganego","skupić się na kontroli nerwowo-mięśniowej i prawidłowej mechanice","stabilizacja i wzmacnianie łopatki","kontrolowana progresja czynnego zakresu ruchu","rozpocząć unoszenie w płaszczyźnie łopatki i czynne ruchy barku","trening wydolnościowy: marsz i rower stacjonarny, bez bieżni, orbitreka, steppera i roweru szosowego."],"applies_when":["tygodnie 7–9"],"restrictions":["bez wzmacniania","nie podnosić operowaną kończyną ciężaru większego niż 5 lb.","bez bieżni, orbitreka, steppera i roweru szosowego."],"progression_criteria":["tolerowany czynny zakres ruchu, czynne zgięcie do 120° z prawidłową mechaniką i co najmniej 8 tygodni od zabiegu."],"dosage_and_progression":["Odstawić temblak","kontynuować ćwiczenia faz I i II"]},"original":{"goals":["full ROM, minimal pain, improve neuromuscular control and mechanics."],"exercises":["After full passive ROM is achieved, progress to active and active-assisted ROM","focus on neuromuscular control and correct mechanics","scapular stabilization and strengthening","controlled progression of AROM","initiate scaption and shoulder AROM","cardiovascular exercise: walking and stationary bike only, no treadmill, elliptical, stair climber or road bike."],"applies_when":["Weeks 7-9"],"restrictions":["no strengthening","no lifting more than 5 lb with the surgical limb.","no treadmill, elliptical, stair climber or road bike."],"progression_criteria":["tolerates AROM, active flexion reaches 120° with good mechanics and the patient is at least 8 weeks postoperative."],"dosage_and_progression":["Discontinue sling","continue Phase I and II exercises"]}},"additional_notes_de":"Ziele: voller Bewegungsumfang, minimale Schmerzen sowie bessere neuromuskuläre Kontrolle und Mechanik. Progressionskriterien: aktiver Bewegungsumfang wird toleriert, aktive Flexion bis 120° mit guter Mechanik und mindestens 8 Wochen postoperativ.","additional_notes_en":"Goals: full ROM, minimal pain, improve neuromuscular control and mechanics. Progression criteria: tolerates AROM, active flexion reaches 120° with good mechanics and the patient is at least 8 weeks postoperative.","additional_notes_pl":"Cele: pełny zakres ruchu, minimalny ból oraz poprawa kontroli nerwowo-mięśniowej i mechaniki. Kryteria progresji: tolerowany czynny zakres ruchu, czynne zgięcie do 120° z prawidłową mechaniką i co najmniej 8 tygodni od zabiegu.","minimum_patient_share":null,"therapeutic_content_de":"Nach Erreichen des vollständigen passiven Bewegungsumfangs zu aktiven und aktiv-assistierten Bewegungen übergehen; Fokus auf neuromuskuläre Kontrolle und korrekte Mechanik; Skapulastabilisation und -kräftigung; aktive Bewegungen kontrolliert steigern; Skaption und aktive Schulterbewegungen beginnen; Ausdauertraining: Gehen und Fahrradergometer, kein Laufband, Crosstrainer, Stepper oder Rennrad.","therapeutic_content_en":"After full passive ROM is achieved, progress to active and active-assisted ROM; focus on neuromuscular control and correct mechanics; scapular stabilization and strengthening; controlled progression of AROM; initiate scaption and shoulder AROM; cardiovascular exercise: walking and stationary bike only, no treadmill, elliptical, stair climber or road bike.","therapeutic_content_pl":"Po uzyskaniu pełnego biernego zakresu ruchu przejść do zakresu czynnego i czynnego wspomaganego; skupić się na kontroli nerwowo-mięśniowej i prawidłowej mechanice; stabilizacja i wzmacnianie łopatki; kontrolowana progresja czynnego zakresu ruchu; rozpocząć unoszenie w płaszczyźnie łopatki i czynne ruchy barku; trening wydolnościowy: marsz i rower stacjonarny, bez bieżni, orbitreka, steppera i roweru szosowego.","minimum_requirements_de":"Armschlinge ablegen; Übungen aus Phase I und II fortsetzen; keine Kräftigung; mit der operierten Extremität nicht mehr als 5 lb heben.","minimum_requirements_en":"Discontinue sling; continue Phase I and II exercises; no strengthening; no lifting more than 5 lb with the surgical limb.","minimum_requirements_pl":"Odstawić temblak; kontynuować ćwiczenia faz I i II; bez wzmacniania; nie podnosić operowaną kończyną ciężaru większego niż 5 lb.","additional_notes_original":"Goals: full ROM, minimal pain, improve neuromuscular control and mechanics. Progression criteria: tolerates AROM, active flexion reaches 120° with good mechanics and the patient is at least 8 weeks postoperative.","therapeutic_content_original":"After full passive ROM is achieved, progress to active and active-assisted ROM; focus on neuromuscular control and correct mechanics; scapular stabilization and strengthening; controlled progression of AROM; initiate scaption and shoulder AROM; cardiovascular exercise: walking and stationary bike only, no treadmill, elliptical, stair climber or road bike.","minimum_requirements_original":"Discontinue sling; continue Phase I and II exercises; no strengthening; no lifting more than 5 lb with the surgical limb.","structured_content_v2":"$undefined"},{"id":"3bf10a62-640f-5d07-89c5-8ce2f0ec67e6","name_de":"Phase IV: Wochen 10–12","name_en":"Phase IV: Weeks 10-12","name_pl":"Faza IV: tygodnie 10–12","source_page":2,"module_number":4,"name_original":"Phase IV: Weeks 10-12","service_codes":[],"structured_content":{"de":{"goals":["voller Bewegungsumfang, Schmerzfreiheit, korrekte Mechanik und Beginn der Kräftigung."],"exercises":["Übungen aus Phase II und III fortsetzen","multiplanare Bewegungen steigern","leichte Kräftigung beginnen","schmerzfreien aktiven Bewegungsumfang, fortgeschrittene Schulterbewegungen und neuromuskuläre Kontrolle steigern","PNF-Muster mit leichtem Widerstand","skapulothorakale Kontrolle","Übungen in geschlossener Kette mit Ball an der Wand","Außenrotation in verschiedenen Abduktionswinkeln steigern","Übungen in Bauchlage um Kräftigung erweitern und Rumpfkräftigung ausbauen."],"applies_when":["Wochen 10–12"],"progression_criteria":["alle funktionellen Aktivitäten ohne Einschränkung oder Schmerz und aktive Schulterflexion bis 140° im Stand mit guter Mechanik."],"dosage_and_progression":["Übungen aus Phase II und III fortsetzen, jedoch keine schwere Kräftigung."]},"en":{"goals":["full ROM, no pain, good mechanics, begin strengthening."],"exercises":["Continue phase II and III exercises","progress multi‑planar movements","initiate light strengthening exercises","progress non‑painful AROM","advanced shoulder motions and neuromuscular control","PNF patterns with light resistance","good scapulothoracic awareness","closed chain exercises: ball on the wall","progress external rotation ROM in varying angles of abduction","progress prone exercises to include strengthening","core strengthening progression."],"applies_when":["Weeks 10-12"],"restrictions":["no heavy strengthening.","no heavy strengthening"],"progression_criteria":["able to perform all functional activities without limitations or pain","able to actively flex shoulder to 140° in standing position with good mechanics."],"dosage_and_progression":["Continue phase II and III exercises","progress multi‑planar movements"]},"pl":{"goals":["pełny zakres ruchu, brak bólu, prawidłowa mechanika i rozpoczęcie wzmacniania."],"exercises":["Kontynuować ćwiczenia faz II i III","rozwijać ruchy wielopłaszczyznowe","rozpocząć lekkie wzmacnianie","zwiększać bezbolesny czynny zakres ruchu, zaawansowane ruchy barku i kontrolę nerwowo-mięśniową","wzorce PNF z lekkim oporem","kontrola łopatkowo-żebrowa","ćwiczenia w łańcuchu zamkniętym z piłką na ścianie","zwiększać rotację zewnętrzną w różnych kątach odwodzenia","rozwijać ćwiczenia w leżeniu przodem z elementami wzmacniania oraz wzmacnianie mięśni tułowia."],"applies_when":["tygodnie 10–12"],"progression_criteria":["wszystkie czynności funkcjonalne bez ograniczeń i bólu oraz czynne zgięcie barku do 140° w staniu z prawidłową mechaniką."],"dosage_and_progression":["Kontynuować ćwiczenia faz II i III, ale bez ciężkiego wzmacniania."]},"original":{"goals":["full ROM, no pain, good mechanics, begin strengthening."],"exercises":["Continue phase II and III exercises","progress multi‑planar movements","initiate light strengthening exercises","progress non‑painful AROM","advanced shoulder motions and neuromuscular control","PNF patterns with light resistance","good scapulothoracic awareness","closed chain exercises: ball on the wall","progress external rotation ROM in varying angles of abduction","progress prone exercises to include strengthening","core strengthening progression."],"applies_when":["Weeks 10-12"],"restrictions":["no heavy strengthening.","no heavy strengthening"],"progression_criteria":["able to perform all functional activities without limitations or pain","able to actively flex shoulder to 140° in standing position with good mechanics."],"dosage_and_progression":["Continue phase II and III exercises","progress multi‑planar movements"]}},"additional_notes_de":"Ziele: voller Bewegungsumfang, Schmerzfreiheit, korrekte Mechanik und Beginn der Kräftigung. Progressionskriterien: alle funktionellen Aktivitäten ohne Einschränkung oder Schmerz und aktive Schulterflexion bis 140° im Stand mit guter Mechanik.","additional_notes_en":"Goals: full ROM, no pain, good mechanics, begin strengthening. Criteria for progression: able to perform all functional activities without limitations or pain; able to actively flex shoulder to 140° in standing position with good mechanics.","additional_notes_pl":"Cele: pełny zakres ruchu, brak bólu, prawidłowa mechanika i rozpoczęcie wzmacniania. Kryteria progresji: wszystkie czynności funkcjonalne bez ograniczeń i bólu oraz czynne zgięcie barku do 140° w staniu z prawidłową mechaniką.","minimum_patient_share":null,"therapeutic_content_de":"Übungen aus Phase II und III fortsetzen; multiplanare Bewegungen steigern; leichte Kräftigung beginnen; schmerzfreien aktiven Bewegungsumfang, fortgeschrittene Schulterbewegungen und neuromuskuläre Kontrolle steigern; PNF-Muster mit leichtem Widerstand; skapulothorakale Kontrolle; Übungen in geschlossener Kette mit Ball an der Wand; Außenrotation in verschiedenen Abduktionswinkeln steigern; Übungen in Bauchlage um Kräftigung erweitern und Rumpfkräftigung ausbauen.","therapeutic_content_en":"Continue phase II and III exercises; progress multi‑planar movements; no heavy strengthening; initiate light strengthening exercises; progress non‑painful AROM; advanced shoulder motions and neuromuscular control; PNF patterns with light resistance; good scapulothoracic awareness; closed chain exercises: ball on the wall; progress external rotation ROM in varying angles of abduction; progress prone exercises to include strengthening; core strengthening progression.","therapeutic_content_pl":"Kontynuować ćwiczenia faz II i III; rozwijać ruchy wielopłaszczyznowe; rozpocząć lekkie wzmacnianie; zwiększać bezbolesny czynny zakres ruchu, zaawansowane ruchy barku i kontrolę nerwowo-mięśniową; wzorce PNF z lekkim oporem; kontrola łopatkowo-żebrowa; ćwiczenia w łańcuchu zamkniętym z piłką na ścianie; zwiększać rotację zewnętrzną w różnych kątach odwodzenia; rozwijać ćwiczenia w leżeniu przodem z elementami wzmacniania oraz wzmacnianie mięśni tułowia.","minimum_requirements_de":"Übungen aus Phase II und III fortsetzen, jedoch keine schwere Kräftigung.","minimum_requirements_en":"Continue phase II and III exercises; progress multi‑planar movements; no heavy strengthening.","minimum_requirements_pl":"Kontynuować ćwiczenia faz II i III, ale bez ciężkiego wzmacniania.","additional_notes_original":"Goals: full ROM, no pain, good mechanics, begin strengthening. Criteria for progression: able to perform all functional activities without limitations or pain; able to actively flex shoulder to 140° in standing position with good mechanics.","therapeutic_content_original":"Continue phase II and III exercises; progress multi‑planar movements; no heavy strengthening; initiate light strengthening exercises; progress non‑painful AROM; advanced shoulder motions and neuromuscular control; PNF patterns with light resistance; good scapulothoracic awareness; closed chain exercises: ball on the wall; progress external rotation ROM in varying angles of abduction; progress prone exercises to include strengthening; core strengthening progression.","minimum_requirements_original":"Continue phase II and III exercises; progress multi‑planar movements; no heavy strengthening.","structured_content_v2":"$undefined"},{"id":"7a9a542f-20ff-55dc-b37b-d74841e9b92e","name_de":"Phase V: ab Woche 12","name_en":"Phase V: Week 12 and onward","name_pl":"Faza V: od 12. tygodnia","source_page":2,"module_number":5,"name_original":"Phase V: Week 12 and onward","service_codes":[],"structured_content":{"de":{"exercises":["Sport- oder berufsspezifisches Training und Rückkehr zu Freizeitaktivitäten","Kraft und Ausdauer normalisieren","Schulterbewegungen mit unterschiedlichen Geschwindigkeiten und Winkeln ohne Kompensation","Rotatorenmanschette in verschiedenen Winkeln und Geschwindigkeiten progressiv kräftigen","Krafttraining von vielen Wiederholungen mit geringer Last zu weniger Wiederholungen mit höherer Last steigern","Wurfprogression oder Überkopfprogramm, falls indiziert."],"applies_when":["ab Woche 12"],"progression_criteria":["Kraftdefizit <10 %","Limb-Symmetry-Index ≥90 %","45/50 Punkte in biomechanischen Funktionstests, sofern durchgeführt","keine Schmerzen und keine berichtete Instabilität.","Rückkehr zum Sport nach Freigabe durch Physiotherapeut und Operateur"],"dosage_and_progression":["vollständige Rückkehr zur Aktivität üblicherweise etwa 5 Monate postoperativ."]},"en":{"exercises":["Sport or work specific training","return to recreational activities","normalize strength and endurance","continue to work on shoulder motion in varying speeds and angles without compensation","progress rotator cuff strengthening in different angles and velocities","progress weight strengthening with high reps low weight to low reps higher weight","throwing progression or overhead program if indicated."],"applies_when":["Week 12 and onward"],"progression_criteria":["may return to sports after clearance from therapist and surgeon","full return to activity typically at 5 months s/p.","Criteria for discharge: <10% strength deficit","limb similarly index ≥90%","45/50 on biomechanical functional tests (if performed)","no pain or complaints of instability."],"dosage_and_progression":["return to recreational activities"],"physiotherapist_actions":["Sport or work specific training","normalize strength and endurance."]},"pl":{"exercises":["Trening specyficzny dla sportu lub pracy i powrót do aktywności rekreacyjnych","normalizacja siły i wytrzymałości","ruchy barku z różną prędkością i pod różnymi kątami bez kompensacji","progresywne wzmacnianie stożka rotatorów w różnych kątach i prędkościach","trening siłowy od dużej liczby powtórzeń z małym obciążeniem do mniejszej liczby powtórzeń z większym obciążeniem","progresja rzutów lub program pracy nad głową, jeżeli wskazany."],"applies_when":["od 12. tygodnia"],"progression_criteria":["deficyt siły <10%","wskaźnik podobieństwa kończyn ≥90%","wynik 45/50 w biomechanicznych testach funkcjonalnych, jeżeli wykonano","brak bólu i zgłaszanej niestabilności."],"dosage_and_progression":["Powrót do sportu po zgodzie fizjoterapeuty i chirurga","pełny powrót do aktywności zwykle około 5. miesiąca po zabiegu."]},"original":{"exercises":["Sport or work specific training","return to recreational activities","normalize strength and endurance","continue to work on shoulder motion in varying speeds and angles without compensation","progress rotator cuff strengthening in different angles and velocities","progress weight strengthening with high reps low weight to low reps higher weight","throwing progression or overhead program if indicated."],"applies_when":["Week 12 and onward"],"progression_criteria":["may return to sports after clearance from therapist and surgeon","full return to activity typically at 5 months s/p.","Criteria for discharge: <10% strength deficit","limb similarly index ≥90%","45/50 on biomechanical functional tests (if performed)","no pain or complaints of instability."],"dosage_and_progression":["return to recreational activities"],"physiotherapist_actions":["Sport or work specific training","normalize strength and endurance."]}},"additional_notes_de":"Entlassungskriterien: Kraftdefizit <10 %; Limb-Symmetry-Index ≥90 %; 45/50 Punkte in biomechanischen Funktionstests, sofern durchgeführt; keine Schmerzen und keine berichtete Instabilität.","additional_notes_en":"Criteria for progression: may return to sports after clearance from therapist and surgeon; full return to activity typically at 5 months s/p. Criteria for discharge: <10% strength deficit; limb similarly index ≥90%; 45/50 on biomechanical functional tests (if performed); no pain or complaints of instability.","additional_notes_pl":"Kryteria wypisu: deficyt siły <10%; wskaźnik podobieństwa kończyn ≥90%; wynik 45/50 w biomechanicznych testach funkcjonalnych, jeżeli wykonano; brak bólu i zgłaszanej niestabilności.","minimum_patient_share":null,"therapeutic_content_de":"Sport- oder berufsspezifisches Training und Rückkehr zu Freizeitaktivitäten; Kraft und Ausdauer normalisieren; Schulterbewegungen mit unterschiedlichen Geschwindigkeiten und Winkeln ohne Kompensation; Rotatorenmanschette in verschiedenen Winkeln und Geschwindigkeiten progressiv kräftigen; Krafttraining von vielen Wiederholungen mit geringer Last zu weniger Wiederholungen mit höherer Last steigern; Wurfprogression oder Überkopfprogramm, falls indiziert.","therapeutic_content_en":"Sport or work specific training; return to recreational activities; normalize strength and endurance; continue to work on shoulder motion in varying speeds and angles without compensation; progress rotator cuff strengthening in different angles and velocities; progress weight strengthening with high reps low weight to low reps higher weight; throwing progression or overhead program if indicated.","therapeutic_content_pl":"Trening specyficzny dla sportu lub pracy i powrót do aktywności rekreacyjnych; normalizacja siły i wytrzymałości; ruchy barku z różną prędkością i pod różnymi kątami bez kompensacji; progresywne wzmacnianie stożka rotatorów w różnych kątach i prędkościach; trening siłowy od dużej liczby powtórzeń z małym obciążeniem do mniejszej liczby powtórzeń z większym obciążeniem; progresja rzutów lub program pracy nad głową, jeżeli wskazany.","minimum_requirements_de":"Rückkehr zum Sport nach Freigabe durch Physiotherapeut und Operateur; vollständige Rückkehr zur Aktivität üblicherweise etwa 5 Monate postoperativ.","minimum_requirements_en":"Sport or work specific training; return to recreational activities; normalize strength and endurance.","minimum_requirements_pl":"Powrót do sportu po zgodzie fizjoterapeuty i chirurga; pełny powrót do aktywności zwykle około 5. miesiąca po zabiegu.","additional_notes_original":"Criteria for progression: may return to sports after clearance from therapist and surgeon; full return to activity typically at 5 months s/p. Criteria for discharge: <10% strength deficit; limb similarly index ≥90%; 45/50 on biomechanical functional tests (if performed); no pain or complaints of instability.","therapeutic_content_original":"Sport or work specific training; return to recreational activities; normalize strength and endurance; continue to work on shoulder motion in varying speeds and angles without compensation; progress rotator cuff strengthening in different angles and velocities; progress weight strengthening with high reps low weight to low reps higher weight; throwing progression or overhead program if indicated.","minimum_requirements_original":"Sport or work specific training; return to recreational activities; normalize strength and endurance.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["shoulder","upper_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"c05b786a-f203-5048-939c-ebd463810b07","slug":"us-jared-lee-04-rotator-cuff-repair-with-open-bt","title_pl":"Protokół rehabilitacji po naprawie stożka rotatorów z tenodezą bicepsa","title_de":"Rehabilitationsprotokoll nach Rotatorenmanschettenrekonstruktion mit Bizeps-Tenodese","title_en":"Rotator Cuff Repair with Open BT Rehabilitation Protocol","title_original":"Rotator Cuff Repair with Open BT Rehabilitation","summary_pl":"Pięciofazowy protokół po naprawie stożka rotatorów z otwartą tenodezą bicepsa, od ochrony operowanych struktur do powrotu do sportu lub pracy.","summary_de":"Fünfphasiges Protokoll nach Rotatorenmanschettenrekonstruktion mit offener Bizeps-Tenodese – vom Schutz der operierten Strukturen bis zur Rückkehr zu Sport oder Arbeit.","summary_en":"Post‑operative rehabilitation protocol for rotator cuff repair with open biceps tenodesis divided into five phases.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"c828d8b9-e009-501c-90b7-4c281ee9b23e","condition_slug":"rotator-cuff-repair-with-open-bt","condition_name_pl":"Naprawa stożka rotatorów z tenodezą bicepsa","condition_name_de":"Rotatorenmanschettenrekonstruktion mit Bizeps-Tenodese","condition_name_en":"Rotator Cuff Repair with Open Biceps Tenodesis","condition_name_original":"Rotator Cuff Repair with Open Biceps Tenodesis","icd_codes":[],"category_key":"shoulder","category_pl":"Bark","category_de":"Schulter","category_en":"Shoulder","body_regions_pl":["Bark"],"body_regions_de":["Schulter"],"body_regions_en":["Shoulder"],"search_terms_pl":["naprawa stożka rotatorów","tenodeza bicepsa","ścięgno głowy długiej bicepsa","rehabilitacja barku po operacji"],"search_terms_de":["Rotatorenmanschettenrekonstruktion","Bizeps-Tenodese","lange Bizepssehne","postoperative Schulterrehabilitation"],"search_terms_en":["rotator cuff repair open biceps tenodesis","rotator cuff repair BT"],"source_document_id":"24bff637-c926-5dbf-867c-3a5d3452a0fb","source_title":"Rotator Cuff Repair with Open BT Rehabilitation","issuer":"Jared Lee, MD","source_country_code":"US","jurisdiction_code":"US-CO","authority_level":"clinic","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_requires_review","official_url":"https://jaredleemd.com/wp-content/uploads/2025/06/Rotator-Cuff-Repair-with-Open-BT-Rehabilitation-Protocol.pdf","source_sha256":"902ea02b74d071a660aed6e4c86eae1a2a6ddd0eeb841e79e01945328f7a0846","authorization_required":false,"license_note":"Public source file retained locally for source verification.","modules":[{"id":"1eaa580d-9a74-5aa3-a674-352783b398ef","name_de":"Phase I: Wochen 0–4","name_en":"Phase I: Weeks 0-4","name_pl":"Faza I: tygodnie 0–4","source_page":1,"module_number":1,"name_original":"Phase I: Weeks 0-4","service_codes":[],"structured_content":{"de":{"goals":["Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, die chirurgische Rekonstruktion schützen und Schultersteife vermeiden."],"exercises":["Passiver Bewegungsumfang: Flexion und Abduktion 0–90° sowie Außenrotation 0–30° für 4 Wochen","in Rückenlage den Ellenbogen mit Handtuchrolle oder Kissen neutral unterstützen","6 Wochen keine Abstützung des Körpergewichts über die operierte Extremität","voller Ellenbogenbewegungsumfang ohne Widerstand bei angelegtem Arm","Kräftigung der Skapulastabilisatoren","Dehnung und Bewegungsübungen der Halswirbelsäule","Ballpressen","Pendelübungen","Skapulaisometrie","Kryotherapie"],"applies_when":["Wochen 0–4"],"restrictions":["keine Kräftigungsübungen."],"progression_criteria":["passiver Bewegungsumfang wird toleriert und mindestens 4 Wochen postoperativ."],"physiotherapist_actions":["Armschlinge 6 Wochen durchgehend außer bei Körperpflege und Physiotherapie","den Arm 4 Wochen nicht über 90° anheben","mit der operierten Extremität 6 Wochen nicht mehr als 3 lb heben","Duschen ab dem 2. postoperativen Tag nach Entfernung des großen Verbands erlaubt","physikalische Maßnahmen nach Bedarf","Schmerz- und Ödemkontrolle","Weichteilmobilisation","Gelenkmobilisationen Grad I–II und Oszillationen zur Schmerzlinderung."]},"en":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness."],"exercises":["Passive ROM 0-90° flexion and abduction and external rotation 0-30° for 4 weeks","in supine, support the elbow with a towel roll or pillow in neutral","full elbow ROM without resistance with the arm at the side","periscapular strengthening","neck stretching and ROM","ball squeezes","pendulums","scapular isometrics","cryotherapy"],"applies_when":["Weeks 0-4"],"restrictions":["no arm elevation above 90° for 4 weeks","no lifting more than 3 lb with the surgical limb for 6 weeks","no strengthening.","no support of body weight through the surgical extremity for 6 weeks"],"progression_criteria":["tolerates PROM and is at least 4 weeks postoperative."],"dosage_and_progression":["showering allowed from postoperative day 2 after removing the bulky dressing"],"physiotherapist_actions":["Sling at all times except hygiene and physical therapy for 6 weeks","modalities as needed","pain and edema control","soft-tissue mobilization","Grade I-II joint mobilizations and oscillations for pain relief."]},"pl":{"goals":["zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona naprawy chirurgicznej oraz zapobieganie sztywności barku."],"exercises":["Bierny zakres ruchu: zgięcie i odwodzenie 0–90° oraz rotacja zewnętrzna 0–30° przez 4 tygodnie","w leżeniu tyłem podparcie łokcia wałkiem z ręcznika lub poduszką w pozycji neutralnej","pełny zakres ruchu łokcia bez oporu przy ramieniu ułożonym wzdłuż tułowia","wzmacnianie stabilizatorów łopatki","rozciąganie i zakres ruchu odcinka szyjnego","ściskanie piłki","ćwiczenia wahadłowe","izometria łopatki","krioterapia"],"applies_when":["tygodnie 0–4"],"restrictions":["przez 4 tygodnie nie unosić ramienia powyżej 90°","przez 6 tygodni nie podnosić operowaną kończyną ciężaru większego niż 3 lb","bez ćwiczeń wzmacniających.","przez 6 tygodni bez podpierania ciężaru ciała operowaną kończyną"],"progression_criteria":["tolerowany bierny zakres ruchu i co najmniej 4 tygodnie od zabiegu."],"dosage_and_progression":["prysznic dozwolony od 2. doby po zabiegu po zdjęciu dużego opatrunku"],"physiotherapist_actions":["Temblak przez cały czas z wyjątkiem higieny i fizjoterapii przez 6 tygodni","fizykoterapia według potrzeb","kontrola bólu i obrzęku","mobilizacja tkanek miękkich","mobilizacje stawowe stopnia I–II i oscylacje przeciwbólowe."]},"original":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness."],"exercises":["Passive ROM 0-90° flexion and abduction and external rotation 0-30° for 4 weeks","in supine, support the elbow with a towel roll or pillow in neutral","full elbow ROM without resistance with the arm at the side","periscapular strengthening","neck stretching and ROM","ball squeezes","pendulums","scapular isometrics","cryotherapy"],"applies_when":["Weeks 0-4"],"restrictions":["no arm elevation above 90° for 4 weeks","no lifting more than 3 lb with the surgical limb for 6 weeks","no strengthening.","no support of body weight through the surgical extremity for 6 weeks"],"progression_criteria":["tolerates PROM and is at least 4 weeks postoperative."],"dosage_and_progression":["showering allowed from postoperative day 2 after removing the bulky dressing"],"physiotherapist_actions":["Sling at all times except hygiene and physical therapy for 6 weeks","modalities as needed","pain and edema control","soft-tissue mobilization","Grade I-II joint mobilizations and oscillations for pain relief."]}},"additional_notes_de":"Ziele: Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, die chirurgische Rekonstruktion schützen und Schultersteife vermeiden. Progressionskriterien: passiver Bewegungsumfang wird toleriert und mindestens 4 Wochen postoperativ.","additional_notes_en":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness. Progression criteria: tolerates PROM and is at least 4 weeks postoperative.","additional_notes_pl":"Cele: zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona naprawy chirurgicznej oraz zapobieganie sztywności barku. Kryteria progresji: tolerowany bierny zakres ruchu i co najmniej 4 tygodnie od zabiegu.","minimum_patient_share":null,"therapeutic_content_de":"Passiver Bewegungsumfang: Flexion und Abduktion 0–90° sowie Außenrotation 0–30° für 4 Wochen; in Rückenlage den Ellenbogen mit Handtuchrolle oder Kissen neutral unterstützen; 6 Wochen keine Abstützung des Körpergewichts über die operierte Extremität; voller Ellenbogenbewegungsumfang ohne Widerstand bei angelegtem Arm; physikalische Maßnahmen nach Bedarf; Schmerz- und Ödemkontrolle; Kräftigung der Skapulastabilisatoren; Dehnung und Bewegungsübungen der Halswirbelsäule; Weichteilmobilisation; Ballpressen; Pendelübungen; Skapulaisometrie; Kryotherapie; Gelenkmobilisationen Grad I–II und Oszillationen zur Schmerzlinderung.","therapeutic_content_en":"Passive ROM 0-90° flexion and abduction and external rotation 0-30° for 4 weeks; in supine, support the elbow with a towel roll or pillow in neutral; no support of body weight through the surgical extremity for 6 weeks; full elbow ROM without resistance with the arm at the side; modalities as needed; pain and edema control; periscapular strengthening; neck stretching and ROM; soft-tissue mobilization; ball squeezes; pendulums; scapular isometrics; cryotherapy; Grade I-II joint mobilizations and oscillations for pain relief.","therapeutic_content_pl":"Bierny zakres ruchu: zgięcie i odwodzenie 0–90° oraz rotacja zewnętrzna 0–30° przez 4 tygodnie; w leżeniu tyłem podparcie łokcia wałkiem z ręcznika lub poduszką w pozycji neutralnej; przez 6 tygodni bez podpierania ciężaru ciała operowaną kończyną; pełny zakres ruchu łokcia bez oporu przy ramieniu ułożonym wzdłuż tułowia; fizykoterapia według potrzeb; kontrola bólu i obrzęku; wzmacnianie stabilizatorów łopatki; rozciąganie i zakres ruchu odcinka szyjnego; mobilizacja tkanek miękkich; ściskanie piłki; ćwiczenia wahadłowe; izometria łopatki; krioterapia; mobilizacje stawowe stopnia I–II i oscylacje przeciwbólowe.","minimum_requirements_de":"Armschlinge 6 Wochen durchgehend außer bei Körperpflege und Physiotherapie; den Arm 4 Wochen nicht über 90° anheben; mit der operierten Extremität 6 Wochen nicht mehr als 3 lb heben; Duschen ab dem 2. postoperativen Tag nach Entfernung des großen Verbands erlaubt; keine Kräftigungsübungen.","minimum_requirements_en":"Sling at all times except hygiene and physical therapy for 6 weeks; no arm elevation above 90° for 4 weeks; no lifting more than 3 lb with the surgical limb for 6 weeks; showering allowed from postoperative day 2 after removing the bulky dressing; no strengthening.","minimum_requirements_pl":"Temblak przez cały czas z wyjątkiem higieny i fizjoterapii przez 6 tygodni; przez 4 tygodnie nie unosić ramienia powyżej 90°; przez 6 tygodni nie podnosić operowaną kończyną ciężaru większego niż 3 lb; prysznic dozwolony od 2. doby po zabiegu po zdjęciu dużego opatrunku; bez ćwiczeń wzmacniających.","additional_notes_original":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness. Progression criteria: tolerates PROM and is at least 4 weeks postoperative.","therapeutic_content_original":"Passive ROM 0-90° flexion and abduction and external rotation 0-30° for 4 weeks; in supine, support the elbow with a towel roll or pillow in neutral; no support of body weight through the surgical extremity for 6 weeks; full elbow ROM without resistance with the arm at the side; modalities as needed; pain and edema control; periscapular strengthening; neck stretching and ROM; soft-tissue mobilization; ball squeezes; pendulums; scapular isometrics; cryotherapy; Grade I-II joint mobilizations and oscillations for pain relief.","minimum_requirements_original":"Sling at all times except hygiene and physical therapy for 6 weeks; no arm elevation above 90° for 4 weeks; no lifting more than 3 lb with the surgical limb for 6 weeks; showering allowed from postoperative day 2 after removing the bulky dressing; no strengthening.","structured_content_v2":"$undefined"},{"id":"ae04b495-2da0-505c-acf2-4e40f1fa0759","name_de":"Phase II: Wochen 5–6","name_en":"Phase II: Weeks 5-6","name_pl":"Faza II: tygodnie 5–6","source_page":1,"module_number":2,"name_original":"Phase II: Weeks 5-6","service_codes":[],"structured_content":{"de":{"goals":["Bewegungsumfang steigern, Schmerzen und Muskelatrophie begrenzen, die Rekonstruktion schützen und mit der neuromuskulären Kontrolle beginnen."],"exercises":["Zum vollständigen passiven Bewegungsumfang fortschreiten","Schmerz und Entzündung kontrollieren","aktiv-assistierte Bewegungen in Rückenlage beginnen","Haltungs- und Rumpfübungen","nach 4 Wochen submaximale Isometrie für Schulterflexion, Abduktion, Extension und Außenrotation möglich","Rudern in Bauchlage bis neutral","Ausdauertraining: Gehen und Fahrradergometer, kein Laufband, Crosstrainer, Stepper oder Rennrad."],"applies_when":["Wochen 5–6"],"restrictions":["heilendes Gewebe nicht überlasten","kein Laufband, Crosstrainer, Stepper oder Rennrad."],"progression_criteria":["vollständiger passiver Bewegungsumfang wird toleriert, passive Vorwärtsflexion bis 135° und mindestens 6 Wochen postoperativ."],"dosage_and_progression":["Übungen aus Phase I fortsetzen"],"physiotherapist_actions":["Armschlinge 6 Wochen durchgehend außer bei Körperpflege und Physiotherapie","mit der operierten Extremität 6 Wochen nicht mehr als 3 lb heben.","Haltungsstörungen korrigieren und heilendes Gewebe nicht überlasten"]},"en":{"goals":["progress ROM, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control."],"exercises":["Progress to full passive ROM","initiate supine AAROM","postural exercises","core strengthening","after 4 weeks may begin submaximal isometrics for shoulder flexion, abduction, extension and external rotation","prone row to neutral","cardiovascular exercise: walking and stationary bike only, no treadmill, elliptical, stair climber or road bike."],"applies_when":["Weeks 5-6"],"restrictions":["no lifting more than 3 lb with the surgical limb for 6 weeks.","avoid overstressing healing tissues","no treadmill, elliptical, stair climber or road bike."],"progression_criteria":["full PROM is tolerated, passive forward flexion reaches 135° and the patient is at least 6 weeks postoperative."],"dosage_and_progression":["continue Phase I exercises"],"physiotherapist_actions":["Sling at all times except hygiene and physical therapy for 6 weeks","correct postural dysfunction","control pain and inflammation"]},"pl":{"goals":["zwiększanie zakresu ruchu, ograniczenie bólu i zaniku mięśni, ochrona naprawy i rozpoczęcie kontroli nerwowo-mięśniowej."],"exercises":["Dążyć do pełnego biernego zakresu ruchu","rozpocząć czynny wspomagany zakres ruchu w leżeniu tyłem","ćwiczenia posturalne i mięśni tułowia","po 4 tygodniach można rozpocząć submaksymalną izometrię zgięcia, odwodzenia, wyprostu i rotacji zewnętrznej barku","wiosłowanie w leżeniu przodem do pozycji neutralnej","trening wydolnościowy: marsz i rower stacjonarny, bez bieżni, orbitreka, steppera i roweru szosowego."],"applies_when":["tygodnie 5–6"],"restrictions":["przez 6 tygodni nie podnosić operowaną kończyną ciężaru większego niż 3 lb.","nie przeciążać gojących się tkanek","bez bieżni, orbitreka, steppera i roweru szosowego."],"progression_criteria":["tolerowany pełny bierny zakres ruchu, bierne zgięcie do przodu 135° i co najmniej 6 tygodni od zabiegu."],"dosage_and_progression":["kontynuować ćwiczenia fazy I"],"physiotherapist_actions":["Temblak przez cały czas z wyjątkiem higieny i fizjoterapii przez 6 tygodni","korygować zaburzenia postawy i nie przeciążać gojących się tkanek","kontrolować ból i stan zapalny"]},"original":{"goals":["progress ROM, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control."],"exercises":["Progress to full passive ROM","initiate supine AAROM","postural exercises","core strengthening","after 4 weeks may begin submaximal isometrics for shoulder flexion, abduction, extension and external rotation","prone row to neutral","cardiovascular exercise: walking and stationary bike only, no treadmill, elliptical, stair climber or road bike."],"applies_when":["Weeks 5-6"],"restrictions":["no lifting more than 3 lb with the surgical limb for 6 weeks.","avoid overstressing healing tissues","no treadmill, elliptical, stair climber or road bike."],"progression_criteria":["full PROM is tolerated, passive forward flexion reaches 135° and the patient is at least 6 weeks postoperative."],"dosage_and_progression":["continue Phase I exercises"],"physiotherapist_actions":["Sling at all times except hygiene and physical therapy for 6 weeks","correct postural dysfunction","control pain and inflammation"]}},"additional_notes_de":"Ziele: Bewegungsumfang steigern, Schmerzen und Muskelatrophie begrenzen, die Rekonstruktion schützen und mit der neuromuskulären Kontrolle beginnen. Progressionskriterien: vollständiger passiver Bewegungsumfang wird toleriert, passive Vorwärtsflexion bis 135° und mindestens 6 Wochen postoperativ.","additional_notes_en":"Goals: progress ROM, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control. Progression criteria: full PROM is tolerated, passive forward flexion reaches 135° and the patient is at least 6 weeks postoperative.","additional_notes_pl":"Cele: zwiększanie zakresu ruchu, ograniczenie bólu i zaniku mięśni, ochrona naprawy i rozpoczęcie kontroli nerwowo-mięśniowej. Kryteria progresji: tolerowany pełny bierny zakres ruchu, bierne zgięcie do przodu 135° i co najmniej 6 tygodni od zabiegu.","minimum_patient_share":null,"therapeutic_content_de":"Zum vollständigen passiven Bewegungsumfang fortschreiten; Haltungsstörungen korrigieren und heilendes Gewebe nicht überlasten; Schmerz und Entzündung kontrollieren; aktiv-assistierte Bewegungen in Rückenlage beginnen; Haltungs- und Rumpfübungen; nach 4 Wochen submaximale Isometrie für Schulterflexion, Abduktion, Extension und Außenrotation möglich; Rudern in Bauchlage bis neutral; Ausdauertraining: Gehen und Fahrradergometer, kein Laufband, Crosstrainer, Stepper oder Rennrad.","therapeutic_content_en":"Progress to full passive ROM; correct postural dysfunction; avoid overstressing healing tissues; control pain and inflammation; initiate supine AAROM; postural exercises; core strengthening; after 4 weeks may begin submaximal isometrics for shoulder flexion, abduction, extension and external rotation; prone row to neutral; cardiovascular exercise: walking and stationary bike only, no treadmill, elliptical, stair climber or road bike.","therapeutic_content_pl":"Dążyć do pełnego biernego zakresu ruchu; korygować zaburzenia postawy i nie przeciążać gojących się tkanek; kontrolować ból i stan zapalny; rozpocząć czynny wspomagany zakres ruchu w leżeniu tyłem; ćwiczenia posturalne i mięśni tułowia; po 4 tygodniach można rozpocząć submaksymalną izometrię zgięcia, odwodzenia, wyprostu i rotacji zewnętrznej barku; wiosłowanie w leżeniu przodem do pozycji neutralnej; trening wydolnościowy: marsz i rower stacjonarny, bez bieżni, orbitreka, steppera i roweru szosowego.","minimum_requirements_de":"Armschlinge 6 Wochen durchgehend außer bei Körperpflege und Physiotherapie; Übungen aus Phase I fortsetzen; mit der operierten Extremität 6 Wochen nicht mehr als 3 lb heben.","minimum_requirements_en":"Sling at all times except hygiene and physical therapy for 6 weeks; continue Phase I exercises; no lifting more than 3 lb with the surgical limb for 6 weeks.","minimum_requirements_pl":"Temblak przez cały czas z wyjątkiem higieny i fizjoterapii przez 6 tygodni; kontynuować ćwiczenia fazy I; przez 6 tygodni nie podnosić operowaną kończyną ciężaru większego niż 3 lb.","additional_notes_original":"Goals: progress ROM, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control. Progression criteria: full PROM is tolerated, passive forward flexion reaches 135° and the patient is at least 6 weeks postoperative.","therapeutic_content_original":"Progress to full passive ROM; correct postural dysfunction; avoid overstressing healing tissues; control pain and inflammation; initiate supine AAROM; postural exercises; core strengthening; after 4 weeks may begin submaximal isometrics for shoulder flexion, abduction, extension and external rotation; prone row to neutral; cardiovascular exercise: walking and stationary bike only, no treadmill, elliptical, stair climber or road bike.","minimum_requirements_original":"Sling at all times except hygiene and physical therapy for 6 weeks; continue Phase I exercises; no lifting more than 3 lb with the surgical limb for 6 weeks.","structured_content_v2":"$undefined"},{"id":"4e18c04a-70f3-54e5-943d-9372d39227a5","name_de":"Phase III: Wochen 7–9","name_en":"Phase III: Weeks 7-9","name_pl":"Faza III: tygodnie 7–9","source_page":2,"module_number":3,"name_original":"Phase III: Weeks 7-9","service_codes":[],"structured_content":{"de":{"goals":["voller Bewegungsumfang, minimale Schmerzen sowie bessere neuromuskuläre Kontrolle und Mechanik."],"exercises":["Nach Erreichen des vollständigen passiven Bewegungsumfangs zu aktiven und aktiv-assistierten Bewegungen übergehen","Fokus auf neuromuskuläre Kontrolle und korrekte Mechanik","Skapulastabilisation und -kräftigung","aktive Bewegungen kontrolliert steigern","Skaption und aktive Schulterbewegungen beginnen","Ausdauertraining: Gehen und Fahrradergometer, kein Laufband, Crosstrainer, Stepper oder Rennrad."],"applies_when":["Wochen 7–9"],"restrictions":["keine Kräftigung","kein Laufband, Crosstrainer, Stepper oder Rennrad."],"progression_criteria":["aktiver Bewegungsumfang wird toleriert, aktive Flexion bis 120° mit guter Mechanik und mindestens 8 Wochen postoperativ."],"dosage_and_progression":["Armschlinge ablegen","Übungen aus Phase I und II fortsetzen"],"physiotherapist_actions":["mit der operierten Extremität nicht mehr als 5 lb heben."]},"en":{"goals":["full ROM, minimal pain, improve neuromuscular control and mechanics."],"exercises":["After full passive ROM is achieved, progress to active and active-assisted ROM","focus on neuromuscular control and correct mechanics","scapular stabilization and strengthening","controlled progression of AROM","initiate scaption and shoulder AROM","cardiovascular exercise: walking and stationary bike only, no treadmill, elliptical, stair climber or road bike."],"applies_when":["Weeks 7-9"],"restrictions":["no strengthening","no lifting more than 5 lb with the surgical limb.","no treadmill, elliptical, stair climber or road bike."],"progression_criteria":["tolerates AROM, active flexion reaches 120° with good mechanics and the patient is at least 8 weeks postoperative."],"dosage_and_progression":["Discontinue sling","continue Phase I and II exercises"]},"pl":{"goals":["pełny zakres ruchu, minimalny ból oraz poprawa kontroli nerwowo-mięśniowej i mechaniki."],"exercises":["Po uzyskaniu pełnego biernego zakresu ruchu przejść do zakresu czynnego i czynnego wspomaganego","skupić się na kontroli nerwowo-mięśniowej i prawidłowej mechanice","stabilizacja i wzmacnianie łopatki","kontrolowana progresja czynnego zakresu ruchu","rozpocząć unoszenie w płaszczyźnie łopatki i czynne ruchy barku","trening wydolnościowy: marsz i rower stacjonarny, bez bieżni, orbitreka, steppera i roweru szosowego."],"applies_when":["tygodnie 7–9"],"restrictions":["bez wzmacniania","nie podnosić operowaną kończyną ciężaru większego niż 5 lb.","bez bieżni, orbitreka, steppera i roweru szosowego."],"progression_criteria":["tolerowany czynny zakres ruchu, czynne zgięcie do 120° z prawidłową mechaniką i co najmniej 8 tygodni od zabiegu."],"dosage_and_progression":["Odstawić temblak","kontynuować ćwiczenia faz I i II"]},"original":{"goals":["full ROM, minimal pain, improve neuromuscular control and mechanics."],"exercises":["After full passive ROM is achieved, progress to active and active-assisted ROM","focus on neuromuscular control and correct mechanics","scapular stabilization and strengthening","controlled progression of AROM","initiate scaption and shoulder AROM","cardiovascular exercise: walking and stationary bike only, no treadmill, elliptical, stair climber or road bike."],"applies_when":["Weeks 7-9"],"restrictions":["no strengthening","no lifting more than 5 lb with the surgical limb.","no treadmill, elliptical, stair climber or road bike."],"progression_criteria":["tolerates AROM, active flexion reaches 120° with good mechanics and the patient is at least 8 weeks postoperative."],"dosage_and_progression":["Discontinue sling","continue Phase I and II exercises"]}},"additional_notes_de":"Ziele: voller Bewegungsumfang, minimale Schmerzen sowie bessere neuromuskuläre Kontrolle und Mechanik. Progressionskriterien: aktiver Bewegungsumfang wird toleriert, aktive Flexion bis 120° mit guter Mechanik und mindestens 8 Wochen postoperativ.","additional_notes_en":"Goals: full ROM, minimal pain, improve neuromuscular control and mechanics. Progression criteria: tolerates AROM, active flexion reaches 120° with good mechanics and the patient is at least 8 weeks postoperative.","additional_notes_pl":"Cele: pełny zakres ruchu, minimalny ból oraz poprawa kontroli nerwowo-mięśniowej i mechaniki. Kryteria progresji: tolerowany czynny zakres ruchu, czynne zgięcie do 120° z prawidłową mechaniką i co najmniej 8 tygodni od zabiegu.","minimum_patient_share":null,"therapeutic_content_de":"Nach Erreichen des vollständigen passiven Bewegungsumfangs zu aktiven und aktiv-assistierten Bewegungen übergehen; Fokus auf neuromuskuläre Kontrolle und korrekte Mechanik; Skapulastabilisation und -kräftigung; aktive Bewegungen kontrolliert steigern; Skaption und aktive Schulterbewegungen beginnen; Ausdauertraining: Gehen und Fahrradergometer, kein Laufband, Crosstrainer, Stepper oder Rennrad.","therapeutic_content_en":"After full passive ROM is achieved, progress to active and active-assisted ROM; focus on neuromuscular control and correct mechanics; scapular stabilization and strengthening; controlled progression of AROM; initiate scaption and shoulder AROM; cardiovascular exercise: walking and stationary bike only, no treadmill, elliptical, stair climber or road bike.","therapeutic_content_pl":"Po uzyskaniu pełnego biernego zakresu ruchu przejść do zakresu czynnego i czynnego wspomaganego; skupić się na kontroli nerwowo-mięśniowej i prawidłowej mechanice; stabilizacja i wzmacnianie łopatki; kontrolowana progresja czynnego zakresu ruchu; rozpocząć unoszenie w płaszczyźnie łopatki i czynne ruchy barku; trening wydolnościowy: marsz i rower stacjonarny, bez bieżni, orbitreka, steppera i roweru szosowego.","minimum_requirements_de":"Armschlinge ablegen; Übungen aus Phase I und II fortsetzen; keine Kräftigung; mit der operierten Extremität nicht mehr als 5 lb heben.","minimum_requirements_en":"Discontinue sling; continue Phase I and II exercises; no strengthening; no lifting more than 5 lb with the surgical limb.","minimum_requirements_pl":"Odstawić temblak; kontynuować ćwiczenia faz I i II; bez wzmacniania; nie podnosić operowaną kończyną ciężaru większego niż 5 lb.","additional_notes_original":"Goals: full ROM, minimal pain, improve neuromuscular control and mechanics. Progression criteria: tolerates AROM, active flexion reaches 120° with good mechanics and the patient is at least 8 weeks postoperative.","therapeutic_content_original":"After full passive ROM is achieved, progress to active and active-assisted ROM; focus on neuromuscular control and correct mechanics; scapular stabilization and strengthening; controlled progression of AROM; initiate scaption and shoulder AROM; cardiovascular exercise: walking and stationary bike only, no treadmill, elliptical, stair climber or road bike.","minimum_requirements_original":"Discontinue sling; continue Phase I and II exercises; no strengthening; no lifting more than 5 lb with the surgical limb.","structured_content_v2":"$undefined"},{"id":"89bf1fc0-63d8-559d-972e-c64dc88db137","name_de":"Phase IV: Wochen 10–12","name_en":"Phase IV: Weeks 10-12","name_pl":"Faza IV: tygodnie 10–12","source_page":2,"module_number":4,"name_original":"Phase IV: Weeks 10-12","service_codes":[],"structured_content":{"de":{"goals":["voller Bewegungsumfang, Schmerzfreiheit, korrekte Mechanik und Beginn der Kräftigung."],"exercises":["Übungen aus Phase II und III fortsetzen","multiplanare Bewegungen steigern","leichte Kräftigung beginnen","schmerzfreien aktiven Bewegungsumfang, fortgeschrittene Schulterbewegungen und neuromuskuläre Kontrolle steigern","PNF-Muster mit leichtem Widerstand","skapulothorakale Kontrolle","Übungen in geschlossener Kette mit Ball an der Wand","Außenrotation in verschiedenen Abduktionswinkeln steigern","Übungen in Bauchlage um Kräftigung erweitern und Rumpfkräftigung ausbauen."],"applies_when":["Wochen 10–12"],"progression_criteria":["alle funktionellen Aktivitäten ohne Einschränkung oder Schmerz und aktive Schulterflexion bis 140° im Stand mit guter Mechanik."],"dosage_and_progression":["Übungen aus Phase II und III fortsetzen, jedoch keine schwere Kräftigung."]},"en":{"goals":["full ROM, no pain, good mechanics, begin strengthening."],"exercises":["Continue phase II and III exercises","progress multi‑planar movements","initiate light strengthening exercises","progress non‑painful AROM","advanced shoulder motions and neuromuscular control","PNF patterns with light resistance","good scapulothoracic awareness","closed chain exercises: ball on the wall","progress external rotation ROM in varying angles of abduction","progress prone exercises to include strengthening","core strengthening progression."],"applies_when":["Weeks 10-12"],"restrictions":["no heavy strengthening.","no heavy strengthening"],"progression_criteria":["able to perform all functional activities without limitations or pain","able to actively flex shoulder to 140° in standing position with good mechanics."],"dosage_and_progression":["Continue phase II and III exercises","progress multi‑planar movements"]},"pl":{"goals":["pełny zakres ruchu, brak bólu, prawidłowa mechanika i rozpoczęcie wzmacniania."],"exercises":["Kontynuować ćwiczenia faz II i III","rozwijać ruchy wielopłaszczyznowe","rozpocząć lekkie wzmacnianie","zwiększać bezbolesny czynny zakres ruchu, zaawansowane ruchy barku i kontrolę nerwowo-mięśniową","wzorce PNF z lekkim oporem","kontrola łopatkowo-żebrowa","ćwiczenia w łańcuchu zamkniętym z piłką na ścianie","zwiększać rotację zewnętrzną w różnych kątach odwodzenia","rozwijać ćwiczenia w leżeniu przodem z elementami wzmacniania oraz wzmacnianie mięśni tułowia."],"applies_when":["tygodnie 10–12"],"progression_criteria":["wszystkie czynności funkcjonalne bez ograniczeń i bólu oraz czynne zgięcie barku do 140° w staniu z prawidłową mechaniką."],"dosage_and_progression":["Kontynuować ćwiczenia faz II i III, ale bez ciężkiego wzmacniania."]},"original":{"goals":["full ROM, no pain, good mechanics, begin strengthening."],"exercises":["Continue phase II and III exercises","progress multi‑planar movements","initiate light strengthening exercises","progress non‑painful AROM","advanced shoulder motions and neuromuscular control","PNF patterns with light resistance","good scapulothoracic awareness","closed chain exercises: ball on the wall","progress external rotation ROM in varying angles of abduction","progress prone exercises to include strengthening","core strengthening progression."],"applies_when":["Weeks 10-12"],"restrictions":["no heavy strengthening.","no heavy strengthening"],"progression_criteria":["able to perform all functional activities without limitations or pain","able to actively flex shoulder to 140° in standing position with good mechanics."],"dosage_and_progression":["Continue phase II and III exercises","progress multi‑planar movements"]}},"additional_notes_de":"Ziele: voller Bewegungsumfang, Schmerzfreiheit, korrekte Mechanik und Beginn der Kräftigung. Progressionskriterien: alle funktionellen Aktivitäten ohne Einschränkung oder Schmerz und aktive Schulterflexion bis 140° im Stand mit guter Mechanik.","additional_notes_en":"Goals: full ROM, no pain, good mechanics, begin strengthening. Criteria for progression: able to perform all functional activities without limitations or pain; able to actively flex shoulder to 140° in standing position with good mechanics.","additional_notes_pl":"Cele: pełny zakres ruchu, brak bólu, prawidłowa mechanika i rozpoczęcie wzmacniania. Kryteria progresji: wszystkie czynności funkcjonalne bez ograniczeń i bólu oraz czynne zgięcie barku do 140° w staniu z prawidłową mechaniką.","minimum_patient_share":null,"therapeutic_content_de":"Übungen aus Phase II und III fortsetzen; multiplanare Bewegungen steigern; leichte Kräftigung beginnen; schmerzfreien aktiven Bewegungsumfang, fortgeschrittene Schulterbewegungen und neuromuskuläre Kontrolle steigern; PNF-Muster mit leichtem Widerstand; skapulothorakale Kontrolle; Übungen in geschlossener Kette mit Ball an der Wand; Außenrotation in verschiedenen Abduktionswinkeln steigern; Übungen in Bauchlage um Kräftigung erweitern und Rumpfkräftigung ausbauen.","therapeutic_content_en":"Continue phase II and III exercises; progress multi‑planar movements; no heavy strengthening; initiate light strengthening exercises; progress non‑painful AROM; advanced shoulder motions and neuromuscular control; PNF patterns with light resistance; good scapulothoracic awareness; closed chain exercises: ball on the wall; progress external rotation ROM in varying angles of abduction; progress prone exercises to include strengthening; core strengthening progression.","therapeutic_content_pl":"Kontynuować ćwiczenia faz II i III; rozwijać ruchy wielopłaszczyznowe; rozpocząć lekkie wzmacnianie; zwiększać bezbolesny czynny zakres ruchu, zaawansowane ruchy barku i kontrolę nerwowo-mięśniową; wzorce PNF z lekkim oporem; kontrola łopatkowo-żebrowa; ćwiczenia w łańcuchu zamkniętym z piłką na ścianie; zwiększać rotację zewnętrzną w różnych kątach odwodzenia; rozwijać ćwiczenia w leżeniu przodem z elementami wzmacniania oraz wzmacnianie mięśni tułowia.","minimum_requirements_de":"Übungen aus Phase II und III fortsetzen, jedoch keine schwere Kräftigung.","minimum_requirements_en":"Continue phase II and III exercises; progress multi‑planar movements; no heavy strengthening.","minimum_requirements_pl":"Kontynuować ćwiczenia faz II i III, ale bez ciężkiego wzmacniania.","additional_notes_original":"Goals: full ROM, no pain, good mechanics, begin strengthening. Criteria for progression: able to perform all functional activities without limitations or pain; able to actively flex shoulder to 140° in standing position with good mechanics.","therapeutic_content_original":"Continue phase II and III exercises; progress multi‑planar movements; no heavy strengthening; initiate light strengthening exercises; progress non‑painful AROM; advanced shoulder motions and neuromuscular control; PNF patterns with light resistance; good scapulothoracic awareness; closed chain exercises: ball on the wall; progress external rotation ROM in varying angles of abduction; progress prone exercises to include strengthening; core strengthening progression.","minimum_requirements_original":"Continue phase II and III exercises; progress multi‑planar movements; no heavy strengthening.","structured_content_v2":"$undefined"},{"id":"c7eed61d-0350-51eb-81b3-00165d1f0bcc","name_de":"Phase V: ab Woche 12","name_en":"Phase V: Week 12 and onward","name_pl":"Faza V: od 12. tygodnia","source_page":2,"module_number":5,"name_original":"Phase V: Week 12 and onward","service_codes":[],"structured_content":{"de":{"exercises":["Sport- oder berufsspezifisches Training und Rückkehr zu Freizeitaktivitäten","Kraft und Ausdauer normalisieren","Schulterbewegungen mit unterschiedlichen Geschwindigkeiten und Winkeln ohne Kompensation","Rotatorenmanschette in verschiedenen Winkeln und Geschwindigkeiten progressiv kräftigen","Krafttraining von vielen Wiederholungen mit geringer Last zu weniger Wiederholungen mit höherer Last steigern","Wurfprogression oder Überkopfprogramm, falls indiziert."],"applies_when":["ab Woche 12"],"progression_criteria":["Kraftdefizit <10 %","Limb-Symmetry-Index ≥90 %","45/50 Punkte in biomechanischen Funktionstests, sofern durchgeführt","keine Schmerzen und keine berichtete Instabilität.","Rückkehr zum Sport nach Freigabe durch Physiotherapeut und Operateur"],"dosage_and_progression":["vollständige Rückkehr zur Aktivität üblicherweise etwa 5 Monate postoperativ."]},"en":{"exercises":["Sport or work specific training","return to recreational activities","normalize strength and endurance","continue to work on shoulder motion in varying speeds and angles without compensation","progress rotator cuff strengthening in different angles and velocities","progress weight strengthening with high reps low weight to low reps higher weight","throwing progression or overhead program if indicated."],"applies_when":["Week 12 and onward"],"progression_criteria":["may return to sports after clearance from therapist and surgeon","full return to activity typically at 5 months s/p.","Criteria for discharge: <10% strength deficit","limb similarly index ≥90%","45/50 on biomechanical functional tests (if performed)","no pain or complaints of instability."],"dosage_and_progression":["return to recreational activities"],"physiotherapist_actions":["Sport or work specific training","normalize strength and endurance."]},"pl":{"exercises":["Trening specyficzny dla sportu lub pracy i powrót do aktywności rekreacyjnych","normalizacja siły i wytrzymałości","ruchy barku z różną prędkością i pod różnymi kątami bez kompensacji","progresywne wzmacnianie stożka rotatorów w różnych kątach i prędkościach","trening siłowy od dużej liczby powtórzeń z małym obciążeniem do mniejszej liczby powtórzeń z większym obciążeniem","progresja rzutów lub program pracy nad głową, jeżeli wskazany."],"applies_when":["od 12. tygodnia"],"progression_criteria":["deficyt siły <10%","wskaźnik podobieństwa kończyn ≥90%","wynik 45/50 w biomechanicznych testach funkcjonalnych, jeżeli wykonano","brak bólu i zgłaszanej niestabilności."],"dosage_and_progression":["Powrót do sportu po zgodzie fizjoterapeuty i chirurga","pełny powrót do aktywności zwykle około 5. miesiąca po zabiegu."]},"original":{"exercises":["Sport or work specific training","return to recreational activities","normalize strength and endurance","continue to work on shoulder motion in varying speeds and angles without compensation","progress rotator cuff strengthening in different angles and velocities","progress weight strengthening with high reps low weight to low reps higher weight","throwing progression or overhead program if indicated."],"applies_when":["Week 12 and onward"],"progression_criteria":["may return to sports after clearance from therapist and surgeon","full return to activity typically at 5 months s/p.","Criteria for discharge: <10% strength deficit","limb similarly index ≥90%","45/50 on biomechanical functional tests (if performed)","no pain or complaints of instability."],"dosage_and_progression":["return to recreational activities"],"physiotherapist_actions":["Sport or work specific training","normalize strength and endurance."]}},"additional_notes_de":"Entlassungskriterien: Kraftdefizit <10 %; Limb-Symmetry-Index ≥90 %; 45/50 Punkte in biomechanischen Funktionstests, sofern durchgeführt; keine Schmerzen und keine berichtete Instabilität.","additional_notes_en":"Criteria for progression: may return to sports after clearance from therapist and surgeon; full return to activity typically at 5 months s/p. Criteria for discharge: <10% strength deficit; limb similarly index ≥90%; 45/50 on biomechanical functional tests (if performed); no pain or complaints of instability.","additional_notes_pl":"Kryteria wypisu: deficyt siły <10%; wskaźnik podobieństwa kończyn ≥90%; wynik 45/50 w biomechanicznych testach funkcjonalnych, jeżeli wykonano; brak bólu i zgłaszanej niestabilności.","minimum_patient_share":null,"therapeutic_content_de":"Sport- oder berufsspezifisches Training und Rückkehr zu Freizeitaktivitäten; Kraft und Ausdauer normalisieren; Schulterbewegungen mit unterschiedlichen Geschwindigkeiten und Winkeln ohne Kompensation; Rotatorenmanschette in verschiedenen Winkeln und Geschwindigkeiten progressiv kräftigen; Krafttraining von vielen Wiederholungen mit geringer Last zu weniger Wiederholungen mit höherer Last steigern; Wurfprogression oder Überkopfprogramm, falls indiziert.","therapeutic_content_en":"Sport or work specific training; return to recreational activities; normalize strength and endurance; continue to work on shoulder motion in varying speeds and angles without compensation; progress rotator cuff strengthening in different angles and velocities; progress weight strengthening with high reps low weight to low reps higher weight; throwing progression or overhead program if indicated.","therapeutic_content_pl":"Trening specyficzny dla sportu lub pracy i powrót do aktywności rekreacyjnych; normalizacja siły i wytrzymałości; ruchy barku z różną prędkością i pod różnymi kątami bez kompensacji; progresywne wzmacnianie stożka rotatorów w różnych kątach i prędkościach; trening siłowy od dużej liczby powtórzeń z małym obciążeniem do mniejszej liczby powtórzeń z większym obciążeniem; progresja rzutów lub program pracy nad głową, jeżeli wskazany.","minimum_requirements_de":"Rückkehr zum Sport nach Freigabe durch Physiotherapeut und Operateur; vollständige Rückkehr zur Aktivität üblicherweise etwa 5 Monate postoperativ.","minimum_requirements_en":"Sport or work specific training; return to recreational activities; normalize strength and endurance.","minimum_requirements_pl":"Powrót do sportu po zgodzie fizjoterapeuty i chirurga; pełny powrót do aktywności zwykle około 5. miesiąca po zabiegu.","additional_notes_original":"Criteria for progression: may return to sports after clearance from therapist and surgeon; full return to activity typically at 5 months s/p. Criteria for discharge: <10% strength deficit; limb similarly index ≥90%; 45/50 on biomechanical functional tests (if performed); no pain or complaints of instability.","therapeutic_content_original":"Sport or work specific training; return to recreational activities; normalize strength and endurance; continue to work on shoulder motion in varying speeds and angles without compensation; progress rotator cuff strengthening in different angles and velocities; progress weight strengthening with high reps low weight to low reps higher weight; throwing progression or overhead program if indicated.","minimum_requirements_original":"Sport or work specific training; return to recreational activities; normalize strength and endurance.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["shoulder","upper_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"c53bc19b-dad5-5e76-b3ab-b5d1fb7f8bc5","slug":"us-jared-lee-03-thumb-ucl-repair","title_pl":"Protokół rehabilitacji po naprawie UCL kciuka","title_de":"Rehabilitationsprotokoll nach Rekonstruktion des ulnaren Daumenseitenbands","title_en":"Thumb UCL Repair Rehabilitation Protocol","title_original":"Thumb UCL Repair Rehabiliation","summary_pl":"Pooperacyjny protokół rehabilitacji po naprawie lub rekonstrukcji więzadła pobocznego łokciowego kciuka, obejmujący cztery fazy od ochrony naprawy do powrotu do sportu i pracy fizycznej.","summary_de":"Postoperatives Rehabilitationsprotokoll nach Naht oder Rekonstruktion des ulnaren Daumenseitenbands in vier Phasen – vom Schutz der Rekonstruktion bis zur Rückkehr zu Sport und körperlicher Arbeit.","summary_en":"Post‑operative rehabilitation protocol for thumb ulnar collateral ligament repair divided into four phases.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"940f86ed-e0a7-50de-8978-750a3a4c91f7","condition_slug":"thumb-ucl-repair","condition_name_pl":"Naprawa więzadła pobocznego łokciowego kciuka","condition_name_de":"Rekonstruktion des ulnaren Daumenseitenbands","condition_name_en":"Thumb UCL Repair","condition_name_original":"Thumb UCL Repair","icd_codes":[],"category_key":"hand-wrist","category_pl":"Ręka i nadgarstek","category_de":"Hand und Handgelenk","category_en":"Hand Wrist","body_regions_pl":["Ręka i nadgarstek"],"body_regions_de":["Hand und Handgelenk"],"body_regions_en":["Hand Wrist"],"search_terms_pl":["naprawa UCL kciuka","więzadło poboczne łokciowe kciuka","kciuk narciarza","orteza kciuka"],"search_terms_de":["Daumen-UCL-Rekonstruktion","ulnares Daumenseitenband","Skidaumen","Daumenorthese"],"search_terms_en":["thumb UCL repair","ulnar collateral ligament thumb"],"source_document_id":"0db3d684-893e-5c96-8bb6-54ab48aa3fce","source_title":"Thumb UCL Repair Rehabiliation","issuer":"Jared Lee, MD","source_country_code":"US","jurisdiction_code":"US-CO","authority_level":"clinic","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_requires_review","official_url":"https://jaredleemd.com/wp-content/uploads/2025/06/Thumb-UCL-Repair-Rehabiliation-Protocol.pdf","source_sha256":"b1cd41372ea3da072e9f1b0ffcb364e53d51f983d26ec91104aa201f68aff9b0","authorization_required":false,"license_note":"Public source file retained locally for source verification.","modules":[{"id":"745775f6-005a-5144-bedf-b4dcd612b7c1","name_de":"Phase 1: Wochen 0–2","name_en":"Phase 1: Weeks 0-2","name_pl":"Faza 1: tygodnie 0–2","source_page":1,"module_number":1,"name_original":"Phase 1: Weeks 0-2","service_codes":[],"structured_content":{"de":{"goals":["Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, die chirurgische Rekonstruktion schützen und Steifigkeit vermeiden."],"exercises":["Bewegungsübungen für Finger, Ellenbogen und Schulter beginnen."],"applies_when":["Wochen 0–2"],"physiotherapist_actions":["Die Daumen-Spica-Schiene bis zum ersten postoperativen Termin beziehungsweise bis zum ersten Ergotherapie-Termin belassen","den Arm beim Duschen bis zur Entfernung der Schiene mit einem Kunststoffbeutel schützen","die betroffene obere Extremität nicht belasten."]},"en":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect surgical repair, avoid stiffness."],"exercises":["Begin finger, elbow, shoulder ROM."],"applies_when":["Weeks 0-2"],"restrictions":["no weight bearing with involved UE."],"physiotherapist_actions":["Leave thumb spica splint in place until first post-op/OT appointment","bag on arm to shower until splint removed"]},"pl":{"goals":["zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona naprawy chirurgicznej oraz zapobieganie sztywności."],"exercises":["Rozpocząć ćwiczenia zakresu ruchu palców, łokcia i barku."],"applies_when":["tygodnie 0–2"],"restrictions":["nie obciążać operowanej kończyny górnej."],"physiotherapist_actions":["Pozostawić szynę kciukową typu spica do pierwszej wizyty pooperacyjnej lub pierwszej wizyty w terapii zajęciowej","podczas prysznica zabezpieczyć kończynę foliowym workiem do czasu zdjęcia szyny"]},"original":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect surgical repair, avoid stiffness."],"exercises":["Begin finger, elbow, shoulder ROM."],"applies_when":["Weeks 0-2"],"restrictions":["no weight bearing with involved UE."],"physiotherapist_actions":["Leave thumb spica splint in place until first post-op/OT appointment","bag on arm to shower until splint removed"]}},"additional_notes_de":"Ziele: Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, die chirurgische Rekonstruktion schützen und Steifigkeit vermeiden.","additional_notes_en":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect surgical repair, avoid stiffness.","additional_notes_pl":"Cele: zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona naprawy chirurgicznej oraz zapobieganie sztywności.","minimum_patient_share":null,"therapeutic_content_de":"Bewegungsübungen für Finger, Ellenbogen und Schulter beginnen.","therapeutic_content_en":"Begin finger, elbow, shoulder ROM.","therapeutic_content_pl":"Rozpocząć ćwiczenia zakresu ruchu palców, łokcia i barku.","minimum_requirements_de":"Die Daumen-Spica-Schiene bis zum ersten postoperativen Termin beziehungsweise bis zum ersten Ergotherapie-Termin belassen; den Arm beim Duschen bis zur Entfernung der Schiene mit einem Kunststoffbeutel schützen; die betroffene obere Extremität nicht belasten.","minimum_requirements_en":"Leave thumb spica splint in place until first post-op/OT appointment; bag on arm to shower until splint removed; no weight bearing with involved UE.","minimum_requirements_pl":"Pozostawić szynę kciukową typu spica do pierwszej wizyty pooperacyjnej lub pierwszej wizyty w terapii zajęciowej; podczas prysznica zabezpieczyć kończynę foliowym workiem do czasu zdjęcia szyny; nie obciążać operowanej kończyny górnej.","additional_notes_original":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect surgical repair, avoid stiffness.","therapeutic_content_original":"Begin finger, elbow, shoulder ROM.","minimum_requirements_original":"Leave thumb spica splint in place until first post-op/OT appointment; bag on arm to shower until splint removed; no weight bearing with involved UE.","structured_content_v2":"$undefined"},{"id":"d1264336-0550-5ad2-82a7-fb87f22efaae","name_de":"Phase 2: Wochen 3–6","name_en":"Phase 2: Weeks 3-6","name_pl":"Faza 2: tygodnie 3–6","source_page":1,"module_number":2,"name_original":"Phase 2: Weeks 3-6","service_codes":[],"structured_content":{"de":{"goals":["Bewegungsumfang steigern, Schmerzen und Muskelatrophie begrenzen, die Rekonstruktion schützen und mit der neuromuskulären Kontrolle beginnen."],"exercises":["aktiven, passiven und aktiv-assistierten Bewegungsumfang von Handgelenk sowie CMC- und DP-Gelenk üben","sanfte passive Bewegung des MP-Gelenks ohne Valgusstress beginnen."],"applies_when":["Wochen 3–6"],"restrictions":["die Orthese nur zur Körperpflege und während der Ergotherapie abnehmen","kein Pinzettengriff und kein kräftiges Greifen","nicht mehr als 5 lb heben."],"physiotherapist_actions":["Die Daumen-Spica-Schiene entfernen und auf eine handbasierte Exos-Daumenorthese umstellen","nach Entfernung der Schiene ist Duschen erlaubt, die Hand jedoch bis 4 Wochen postoperativ nicht eintauchen und vorsichtig trocken tupfen","Bei Bedarf überstehende Fadenenden an der Haut kürzen und Steri-Strips ersetzen","Narbenmassage und Desensibilisierung durchführen"]},"en":{"goals":["progress ROM, minimize pain, retard muscle atrophy, protect repair, begin neuromuscular control."],"exercises":["Remove thumb spica splint and transition to hand‑based thumb spica Exos brace","Exos brace worn except hygiene and OT","may shower after splint removed","pat dry","Trim suture tails","active, passive, active assisted ROM of wrist, CMC, DP joint","begin gentle passive ROM of MP joint (no valgus stress)."],"applies_when":["Weeks 3-6"],"restrictions":["no soaking until 4 weeks s/p","no pinching or grabbing","no lifting >5 lb."],"dosage_and_progression":["Remove thumb spica splint and transition to hand‑based thumb spica Exos brace","may shower after splint removed"],"physiotherapist_actions":["Exos brace worn except hygiene and OT","pat dry","scar massage/desensitization"]},"pl":{"goals":["zwiększanie zakresu ruchu, ograniczenie bólu i zaniku mięśni, ochrona naprawy oraz rozpoczęcie kontroli nerwowo-mięśniowej."],"exercises":["wykonywać czynny, bierny i czynny wspomagany zakres ruchu nadgarstka oraz stawów CMC i DP","rozpocząć delikatny bierny zakres ruchu stawu MP bez naprężenia koślawego."],"applies_when":["tygodnie 3–6"],"restrictions":["zdejmować ortezę wyłącznie do higieny i podczas terapii zajęciowej","bez chwytu szczypcowego i mocnego chwytania","nie podnosić ciężaru większego niż 5 lb."],"dosage_and_progression":["Zdjąć szynę kciukową typu spica i przejść do krótkiej ortezy Exos obejmującej dłoń i kciuk","po zdjęciu szyny można brać prysznic, ale nie zanurzać ręki do 4. tygodnia po zabiegu i osuszać ją przez delikatne przykładanie ręcznika"],"physiotherapist_actions":["W razie potrzeby skrócić wystające końce nici przy skórze i wymienić paski Steri-Strip","prowadzić masaż blizny i desensytyzację"]},"original":{"goals":["progress ROM, minimize pain, retard muscle atrophy, protect repair, begin neuromuscular control."],"exercises":["Remove thumb spica splint and transition to hand‑based thumb spica Exos brace","Exos brace worn except hygiene and OT","may shower after splint removed","pat dry","Trim suture tails","active, passive, active assisted ROM of wrist, CMC, DP joint","begin gentle passive ROM of MP joint (no valgus stress)."],"applies_when":["Weeks 3-6"],"restrictions":["no soaking until 4 weeks s/p","no pinching or grabbing","no lifting >5 lb."],"dosage_and_progression":["Remove thumb spica splint and transition to hand‑based thumb spica Exos brace","may shower after splint removed"],"physiotherapist_actions":["Exos brace worn except hygiene and OT","pat dry","scar massage/desensitization"]}},"additional_notes_de":"Ziele: Bewegungsumfang steigern, Schmerzen und Muskelatrophie begrenzen, die Rekonstruktion schützen und mit der neuromuskulären Kontrolle beginnen.","additional_notes_en":"Goals: progress ROM, minimize pain, retard muscle atrophy, protect repair, begin neuromuscular control.","additional_notes_pl":"Cele: zwiększanie zakresu ruchu, ograniczenie bólu i zaniku mięśni, ochrona naprawy oraz rozpoczęcie kontroli nerwowo-mięśniowej.","minimum_patient_share":null,"therapeutic_content_de":"Bei Bedarf überstehende Fadenenden an der Haut kürzen und Steri-Strips ersetzen; Narbenmassage und Desensibilisierung durchführen; aktiven, passiven und aktiv-assistierten Bewegungsumfang von Handgelenk sowie CMC- und DP-Gelenk üben; sanfte passive Bewegung des MP-Gelenks ohne Valgusstress beginnen.","therapeutic_content_en":"Remove thumb spica splint and transition to hand‑based thumb spica Exos brace; Exos brace worn except hygiene and OT; may shower after splint removed; no soaking until 4 weeks s/p; pat dry; no pinching or grabbing; no lifting >5 lb. Trim suture tails; scar massage/desensitization; active, passive, active assisted ROM of wrist, CMC, DP joint; begin gentle passive ROM of MP joint (no valgus stress).","therapeutic_content_pl":"W razie potrzeby skrócić wystające końce nici przy skórze i wymienić paski Steri-Strip; prowadzić masaż blizny i desensytyzację; wykonywać czynny, bierny i czynny wspomagany zakres ruchu nadgarstka oraz stawów CMC i DP; rozpocząć delikatny bierny zakres ruchu stawu MP bez naprężenia koślawego.","minimum_requirements_de":"Die Daumen-Spica-Schiene entfernen und auf eine handbasierte Exos-Daumenorthese umstellen; die Orthese nur zur Körperpflege und während der Ergotherapie abnehmen; nach Entfernung der Schiene ist Duschen erlaubt, die Hand jedoch bis 4 Wochen postoperativ nicht eintauchen und vorsichtig trocken tupfen; kein Pinzettengriff und kein kräftiges Greifen; nicht mehr als 5 lb heben.","minimum_requirements_en":"Remove thumb spica splint and transition to hand‑based thumb spica Exos brace; Exos brace worn except hygiene and OT; may shower after splint removed; no soaking until 4 weeks s/p; pat dry; no pinching or grabbing; no lifting >5 lb.","minimum_requirements_pl":"Zdjąć szynę kciukową typu spica i przejść do krótkiej ortezy Exos obejmującej dłoń i kciuk; zdejmować ortezę wyłącznie do higieny i podczas terapii zajęciowej; po zdjęciu szyny można brać prysznic, ale nie zanurzać ręki do 4. tygodnia po zabiegu i osuszać ją przez delikatne przykładanie ręcznika; bez chwytu szczypcowego i mocnego chwytania; nie podnosić ciężaru większego niż 5 lb.","additional_notes_original":"Goals: progress ROM, minimize pain, retard muscle atrophy, protect repair, begin neuromuscular control.","therapeutic_content_original":"Remove thumb spica splint and transition to hand‑based thumb spica Exos brace; Exos brace worn except hygiene and OT; may shower after splint removed; no soaking until 4 weeks s/p; pat dry; no pinching or grabbing; no lifting >5 lb. Trim suture tails; scar massage/desensitization; active, passive, active assisted ROM of wrist, CMC, DP joint; begin gentle passive ROM of MP joint (no valgus stress).","minimum_requirements_original":"Remove thumb spica splint and transition to hand‑based thumb spica Exos brace; Exos brace worn except hygiene and OT; may shower after splint removed; no soaking until 4 weeks s/p; pat dry; no pinching or grabbing; no lifting >5 lb.","structured_content_v2":"$undefined"},{"id":"f6c3c93d-8786-5982-9aad-e87b8b3d423b","name_de":"Phase 3: Wochen 7–12","name_en":"Phase 3: Weeks 7-12","name_pl":"Faza 3: tygodnie 7–12","source_page":1,"module_number":3,"name_original":"Phase 3: Weeks 7-12","service_codes":[],"structured_content":{"de":{"goals":["voller Bewegungsumfang, minimale Schmerzen, Verbesserung von Kraft und Ausdauer sowie Steigerung der neuromuskulären Kontrolle, dynamischen Stabilität und Kraft der Skapulamuskulatur."],"exercises":["Hand und Handgelenk dehnen","ab Woche 8 die intrinsische Handmuskulatur kräftigen","am MP-Gelenk den vollständigen passiven Bewegungsumfang aufbauen und nach Verträglichkeit zum vollständigen aktiven und aktiv-assistierten Bewegungsumfang übergehen","leichte feinmotorische Tätigkeiten beginnen","ab Woche 8 progressive Widerstandsübungen und schrittweise Kräftigung einleiten."],"applies_when":["Wochen 7–12"],"restrictions":["Die Orthese schrittweise nur noch bei Aktivitäten tragen","kein kräftiger Pinzettengriff und kein starkes Greifen"],"physiotherapist_actions":["mit der betroffenen Extremität nicht mehr als 5 lb heben."]},"en":{"goals":["full ROM, minimal pain, improve power and endurance, increase neuromuscular control, dynamic stability, scapular muscle strength."],"exercises":["Hand and wrist stretching","intrinsic hand strengthening at week 8","full passive ROM progressing to full active and active assisted as tolerated at MP joint","begin light fine motor activity","week 8: begin progressive resistance exercises","week 8: begin strengthening and progress as tolerated."],"applies_when":["Weeks 7-12"],"restrictions":["no heavy pinching, gripping","no lifting >5 lb with affected extremity."],"dosage_and_progression":["Wean to brace for activity only"]},"pl":{"goals":["pełny zakres ruchu, minimalny ból, poprawa siły i wytrzymałości, zwiększenie kontroli nerwowo-mięśniowej, stabilności dynamicznej oraz siły mięśni stabilizujących łopatkę."],"exercises":["Rozciąganie dłoni i nadgarstka","od 8. tygodnia wzmacnianie mięśni wewnętrznych dłoni","pełny bierny zakres ruchu stawu MP z progresją do pełnego zakresu czynnego i czynnego wspomaganego według tolerancji","rozpoczęcie lekkich czynności motoryki precyzyjnej","od 8. tygodnia ćwiczenia z progresywnym oporem i stopniowo rozwijane wzmacnianie."],"applies_when":["tygodnie 7–12"],"restrictions":["Stopniowo ograniczyć używanie ortezy wyłącznie do aktywności","bez silnego chwytu szczypcowego i mocnego chwytania","nie podnosić operowaną kończyną ciężaru większego niż 5 lb."]},"original":{"goals":["full ROM, minimal pain, improve power and endurance, increase neuromuscular control, dynamic stability, scapular muscle strength."],"exercises":["Hand and wrist stretching","intrinsic hand strengthening at week 8","full passive ROM progressing to full active and active assisted as tolerated at MP joint","begin light fine motor activity","week 8: begin progressive resistance exercises","week 8: begin strengthening and progress as tolerated."],"applies_when":["Weeks 7-12"],"restrictions":["no heavy pinching, gripping","no lifting >5 lb with affected extremity."],"dosage_and_progression":["Wean to brace for activity only"]}},"additional_notes_de":"Ziele: voller Bewegungsumfang, minimale Schmerzen, Verbesserung von Kraft und Ausdauer sowie Steigerung der neuromuskulären Kontrolle, dynamischen Stabilität und Kraft der Skapulamuskulatur.","additional_notes_en":"Goals: full ROM, minimal pain, improve power and endurance, increase neuromuscular control, dynamic stability, scapular muscle strength.","additional_notes_pl":"Cele: pełny zakres ruchu, minimalny ból, poprawa siły i wytrzymałości, zwiększenie kontroli nerwowo-mięśniowej, stabilności dynamicznej oraz siły mięśni stabilizujących łopatkę.","minimum_patient_share":null,"therapeutic_content_de":"Hand und Handgelenk dehnen; ab Woche 8 die intrinsische Handmuskulatur kräftigen; am MP-Gelenk den vollständigen passiven Bewegungsumfang aufbauen und nach Verträglichkeit zum vollständigen aktiven und aktiv-assistierten Bewegungsumfang übergehen; leichte feinmotorische Tätigkeiten beginnen; ab Woche 8 progressive Widerstandsübungen und schrittweise Kräftigung einleiten.","therapeutic_content_en":"Hand and wrist stretching; intrinsic hand strengthening at week 8; full passive ROM progressing to full active and active assisted as tolerated at MP joint; begin light fine motor activity; week 8: begin progressive resistance exercises; week 8: begin strengthening and progress as tolerated.","therapeutic_content_pl":"Rozciąganie dłoni i nadgarstka; od 8. tygodnia wzmacnianie mięśni wewnętrznych dłoni; pełny bierny zakres ruchu stawu MP z progresją do pełnego zakresu czynnego i czynnego wspomaganego według tolerancji; rozpoczęcie lekkich czynności motoryki precyzyjnej; od 8. tygodnia ćwiczenia z progresywnym oporem i stopniowo rozwijane wzmacnianie.","minimum_requirements_de":"Die Orthese schrittweise nur noch bei Aktivitäten tragen; kein kräftiger Pinzettengriff und kein starkes Greifen; mit der betroffenen Extremität nicht mehr als 5 lb heben.","minimum_requirements_en":"Wean to brace for activity only; no heavy pinching, gripping; no lifting >5 lb with affected extremity.","minimum_requirements_pl":"Stopniowo ograniczyć używanie ortezy wyłącznie do aktywności; bez silnego chwytu szczypcowego i mocnego chwytania; nie podnosić operowaną kończyną ciężaru większego niż 5 lb.","additional_notes_original":"Goals: full ROM, minimal pain, improve power and endurance, increase neuromuscular control, dynamic stability, scapular muscle strength.","therapeutic_content_original":"Hand and wrist stretching; intrinsic hand strengthening at week 8; full passive ROM progressing to full active and active assisted as tolerated at MP joint; begin light fine motor activity; week 8: begin progressive resistance exercises; week 8: begin strengthening and progress as tolerated.","minimum_requirements_original":"Wean to brace for activity only; no heavy pinching, gripping; no lifting >5 lb with affected extremity.","structured_content_v2":"$undefined"},{"id":"f73494e3-6c63-56a2-85e3-b3e52c3140e3","name_de":"Phase 4: ab Woche 13","name_en":"Phase 4: Week 13 and onward","name_pl":"Faza 4: od 13. tygodnia","source_page":1,"module_number":4,"name_original":"Phase 4: Week 13 and onward","service_codes":[],"structured_content":{"de":{"exercises":["Statische und dynamische Kräftigung steigern","den Bewegungsumfang erhalten","das Krafttraining bei stabilen Verhältnissen progressiv belasten","in Woche 16 Rückkehr zu voller sportlicher Aktivität oder körperlicher Arbeit."],"applies_when":["ab Woche 13"],"progression_criteria":["Kraftdefizit <10 %","Limb-Symmetry-Index ≥90 %","45/50 Punkte in biomechanischen Funktionstests, sofern durchgeführt","keine Schmerzen und keine berichtete Instabilität."],"dosage_and_progression":["Alle Orthesen ablegen"],"physiotherapist_actions":["bis Woche 16 anhaltenden kräftigen Pinzettengriff und Belastungen des UCL vermeiden."]},"en":{"exercises":["Progress strengthening","static and dynamic strengthening exercises","maintain ROM","advance weight training as stable","return to full sport/labor work at week 16."],"applies_when":["Week 13 and onward"],"restrictions":["avoid sustained, heavy pinch and stress across UCL until 16 weeks."],"progression_criteria":["<10% strength deficit","limb similarity index ≥90%","45/50 on biomechanical functional tests (if performed)","no pain or complaints of instability."],"physiotherapist_actions":["Discharge all orthoses"]},"pl":{"exercises":["Rozwijać wzmacnianie statyczne i dynamiczne","utrzymywać zakres ruchu","zwiększać obciążenie treningu siłowego przy zachowanej stabilności","w 16. tygodniu powrót do pełnej aktywności sportowej lub pracy fizycznej."],"applies_when":["od 13. tygodnia"],"restrictions":["do 16. tygodnia unikać długotrwałego, silnego chwytu szczypcowego oraz obciążenia więzadła UCL."],"progression_criteria":["deficyt siły <10%","wskaźnik podobieństwa kończyn ≥90%","wynik 45/50 w biomechanicznych testach funkcjonalnych, jeżeli zostały wykonane","brak bólu i zgłaszanej niestabilności."],"dosage_and_progression":["Odstawić wszystkie ortezy"]},"original":{"exercises":["Progress strengthening","static and dynamic strengthening exercises","maintain ROM","advance weight training as stable","return to full sport/labor work at week 16."],"applies_when":["Week 13 and onward"],"restrictions":["avoid sustained, heavy pinch and stress across UCL until 16 weeks."],"progression_criteria":["<10% strength deficit","limb similarity index ≥90%","45/50 on biomechanical functional tests (if performed)","no pain or complaints of instability."],"physiotherapist_actions":["Discharge all orthoses"]}},"additional_notes_de":"Entlassungskriterien: Kraftdefizit <10 %; Limb-Symmetry-Index ≥90 %; 45/50 Punkte in biomechanischen Funktionstests, sofern durchgeführt; keine Schmerzen und keine berichtete Instabilität.","additional_notes_en":"Criteria for discharge: <10% strength deficit; limb similarity index ≥90%; 45/50 on biomechanical functional tests (if performed); no pain or complaints of instability.","additional_notes_pl":"Kryteria wypisu: deficyt siły <10%; wskaźnik podobieństwa kończyn ≥90%; wynik 45/50 w biomechanicznych testach funkcjonalnych, jeżeli zostały wykonane; brak bólu i zgłaszanej niestabilności.","minimum_patient_share":null,"therapeutic_content_de":"Statische und dynamische Kräftigung steigern; den Bewegungsumfang erhalten; das Krafttraining bei stabilen Verhältnissen progressiv belasten; in Woche 16 Rückkehr zu voller sportlicher Aktivität oder körperlicher Arbeit.","therapeutic_content_en":"Progress strengthening; static and dynamic strengthening exercises; maintain ROM; advance weight training as stable; return to full sport/labor work at week 16.","therapeutic_content_pl":"Rozwijać wzmacnianie statyczne i dynamiczne; utrzymywać zakres ruchu; zwiększać obciążenie treningu siłowego przy zachowanej stabilności; w 16. tygodniu powrót do pełnej aktywności sportowej lub pracy fizycznej.","minimum_requirements_de":"Alle Orthesen ablegen; bis Woche 16 anhaltenden kräftigen Pinzettengriff und Belastungen des UCL vermeiden.","minimum_requirements_en":"Discharge all orthoses; avoid sustained, heavy pinch and stress across UCL until 16 weeks.","minimum_requirements_pl":"Odstawić wszystkie ortezy; do 16. tygodnia unikać długotrwałego, silnego chwytu szczypcowego oraz obciążenia więzadła UCL.","additional_notes_original":"Criteria for discharge: <10% strength deficit; limb similarity index ≥90%; 45/50 on biomechanical functional tests (if performed); no pain or complaints of instability.","therapeutic_content_original":"Progress strengthening; static and dynamic strengthening exercises; maintain ROM; advance weight training as stable; return to full sport/labor work at week 16.","minimum_requirements_original":"Discharge all orthoses; avoid sustained, heavy pinch and stress across UCL until 16 weeks.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["hand_wrist","upper_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"bdfb2e05-6204-51e6-a129-f9f0a4769c12","slug":"nl-kngf-spav-2014","title_pl":"KNGF: fizjoterapia w objawowej chorobie tętnic obwodowych","title_de":"KNGF: Physiotherapie bei symptomatischer peripherer arterieller Verschlusskrankheit","title_en":"KNGF: Physical Therapy for Symptomatic Peripheral Arterial Disease","title_original":"KNGF-richtlijn Symptomatisch perifeer arterieel vaatlijden — Praktijkrichtlijn","summary_pl":"Krajowa wytyczna KNGF opisująca diagnostykę fizjoterapeutyczną i terapię pacjentów z objawową chorobą tętnic obwodowych, z naciskiem na zwiększenie funkcjonalnego dystansu chodu.","summary_de":"Nationale KNGF-Leitlinie zur physiotherapeutischen Diagnostik und Therapie bei symptomatischer peripherer arterieller Verschlusskrankheit mit Schwerpunkt auf der funktionellen Gehstrecke.","summary_en":"National KNGF guideline describing physiotherapy assessment and treatment for symptomatic peripheral arterial disease, focusing on increasing functional walking distance.","country_code":"NL","source_language":"nl","publication_year":2014,"version_label":"2014 · update klinimetrie 2017","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"guideline","patient_populations":["adults with symptomatic peripheral arterial disease"],"clinical_contexts":["first-line","second-line"],"care_pathways":["referred physiotherapy","vascular rehabilitation"],"physician_clearance_required":true,"condition_id":"58673c05-78ec-5b97-97fc-ad7c61ce8083","condition_slug":"symptomatic-peripheral-arterial-disease","condition_name_pl":"Objawowa choroba tętnic obwodowych","condition_name_de":"Symptomatische periphere arterielle Verschlusskrankheit","condition_name_en":"Symptomatic Peripheral Arterial Disease","condition_name_original":"Symptomatic Peripheral Arterial Disease","icd_codes":[],"category_key":"lower-extremity","category_pl":"Fizjoterapia naczyniowa","category_de":"Gefäßphysiotherapie","category_en":"Vascular physical therapy","body_regions_pl":["Kończyna dolna","Chód"],"body_regions_de":["Untere Extremität","Gehen"],"body_regions_en":["Lower extremity","Walking"],"search_terms_pl":["miażdżyca","PAD","PAV","chromanie","bóle łydek","trening chodu"],"search_terms_de":["PAV","pAVK","Claudicatio","Gehtraining"],"search_terms_en":["PAD","claudication","walking training","atherosclerosis"],"source_document_id":"5c208971-c45a-5ce1-a425-f8eb6ff345d6","source_title":"KNGF-richtlijn Symptomatisch perifeer arterieel vaatlijden — Praktijkrichtlijn","issuer":"Koninklijk Nederlands Genootschap voor Fysiotherapie (KNGF)","source_country_code":"NL","jurisdiction_code":"NL","authority_level":"national_professional_society","document_type":"physiotherapy_cpg","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"requires_update_review","official_url":"https://kngf-richtlijnen.wpacc01.yard.nl/app/uploads/sites/2/2024/11/spav-praktijkrichtlijn.pdf","source_sha256":"cee18cc23db9469bdae4e7c65849cc368f630d6a6717ea1f5c051ec5aeac124f","authorization_required":false,"license_note":"Public source file retained locally for source verification.","modules":[{"id":"ae6a1a4e-8b18-5c87-b15a-e459a26bbcb9","name_de":"Funktionelle Untersuchung und Laufbandtest","name_en":"Functional Assessment and Treadmill Test","name_pl":"Ocena funkcjonalna i test na bieżni","source_page":13,"module_number":1,"name_original":"Funktionelle Untersuchung und Laufbandtest","service_codes":[],"structured_content":{"de":{"warnings":["ACSM-Schmerzskala und Ganganalyse berücksichtigen."],"exercises":["Die Leitlinie empfiehlt den Laufbandtest zur Bestimmung der funktionellen und maximalen Gehstrecke","ein Test mit zunehmender Belastung ist zuverlässiger zur Schweregradbestimmung."],"physiotherapist_actions":["Untersuchung entsprechend Patientensicherheit und Überweisung durchführen."]},"en":{"warnings":["Consider the ACSM pain scale and gait analysis."],"exercises":["The guideline recommends treadmill testing to determine functional and maximal walking distance","an incremental-load test is more reliable for symptom severity."],"physiotherapist_actions":["Perform assessment according to patient safety and referral."]},"pl":{"warnings":["Uwzględnij skalę bólu ACSM i analizę wzorca chodu."],"exercises":["Wytyczna zaleca test na bieżni do określenia funkcjonalnego i maksymalnego dystansu chodu","test z narastającym obciążeniem jest bardziej wiarygodny dla oceny nasilenia objawów."],"physiotherapist_actions":["Wykonuj ocenę zgodnie z bezpieczeństwem pacjenta i skierowaniem."]},"original":{"warnings":["Consider the ACSM pain scale and gait analysis."],"exercises":["The guideline recommends treadmill testing to determine functional and maximal walking distance","an incremental-load test is more reliable for symptom severity."],"physiotherapist_actions":["Perform assessment according to patient safety and referral."]}},"additional_notes_de":"ACSM-Schmerzskala und Ganganalyse berücksichtigen.","additional_notes_en":"Consider the ACSM pain scale and gait analysis.","additional_notes_pl":"Uwzględnij skalę bólu ACSM i analizę wzorca chodu.","minimum_patient_share":null,"therapeutic_content_de":"Die Leitlinie empfiehlt den Laufbandtest zur Bestimmung der funktionellen und maximalen Gehstrecke; ein Test mit zunehmender Belastung ist zuverlässiger zur Schweregradbestimmung.","therapeutic_content_en":"The guideline recommends treadmill testing to determine functional and maximal walking distance; an incremental-load test is more reliable for symptom severity.","therapeutic_content_pl":"Wytyczna zaleca test na bieżni do określenia funkcjonalnego i maksymalnego dystansu chodu; test z narastającym obciążeniem jest bardziej wiarygodny dla oceny nasilenia objawów.","minimum_requirements_de":"Untersuchung entsprechend Patientensicherheit und Überweisung durchführen.","minimum_requirements_en":"Perform assessment according to patient safety and referral.","minimum_requirements_pl":"Wykonuj ocenę zgodnie z bezpieczeństwem pacjenta i skierowaniem.","additional_notes_original":"ACSM-Schmerzskala und Ganganalyse berücksichtigen.","therapeutic_content_original":"Laufbandtest; Laufbandtest mit zunehmender Belastung; ACSM-Skala; Evaluation des Gangbildes.","minimum_requirements_original":"Perform assessment according to patient safety and referral.","structured_content_v2":"$undefined"},{"id":"95e678db-a044-5663-b8e6-83e275dd306b","name_de":"Training zur Vergrößerung der Gehstrecke","name_en":"Exercise to Increase Walking Distance","name_pl":"Ćwiczenia zwiększające dystans chodu","source_page":13,"module_number":2,"name_original":"Training zur Vergrößerung der Gehstrecke","service_codes":[],"structured_content":{"de":{"warnings":["Ziel ist die funktionelle Gehstrecke."],"exercises":["Zur Vergrößerung der Gehstrecke wird Bewegungstherapie dringend empfohlen: Gehen, aktive Beinübungen, körperliches Training oder Laufbandtraining, gegebenenfalls mit Muskelkräftigung."],"progression_criteria":["Gehtraining bevorzugen, wenn der Patient es toleriert."]},"en":{"warnings":["The target is functional walking distance."],"exercises":["Exercise therapy to increase walking distance is strongly recommended and may include walking, active leg exercises, physical training, or treadmill training, optionally combined with strengthening."],"progression_criteria":["Prefer walking training when tolerated."]},"pl":{"warnings":["Celem jest funkcjonalny dystans chodu."],"exercises":["Silnie zalecana jest terapia ćwiczeniami zwiększająca dystans chodu.","Może obejmować chodzenie, aktywne ćwiczenia nóg, trening fizyczny lub trening na bieżni, z możliwością połączenia ze wzmacnianiem mięśni."],"progression_criteria":["Preferuj trening chodu, jeśli pacjent go toleruje."]},"original":{"warnings":["The target is functional walking distance."],"exercises":["Exercise therapy to increase walking distance is strongly recommended and may include walking, active leg exercises, physical training, or treadmill training, optionally combined with strengthening."],"progression_criteria":["Prefer walking training when tolerated."]}},"additional_notes_de":"Ziel ist die funktionelle Gehstrecke.","additional_notes_en":"The target is functional walking distance.","additional_notes_pl":"Celem jest funkcjonalny dystans chodu.","minimum_patient_share":null,"therapeutic_content_de":"Zur Vergrößerung der Gehstrecke wird Bewegungstherapie dringend empfohlen: Gehen, aktive Beinübungen, körperliches Training oder Laufbandtraining, gegebenenfalls mit Muskelkräftigung.","therapeutic_content_en":"Exercise therapy to increase walking distance is strongly recommended and may include walking, active leg exercises, physical training, or treadmill training, optionally combined with strengthening.","therapeutic_content_pl":"Silnie zalecana jest terapia ćwiczeniami zwiększająca dystans chodu. Może obejmować chodzenie, aktywne ćwiczenia nóg, trening fizyczny lub trening na bieżni, z możliwością połączenia ze wzmacnianiem mięśni.","minimum_requirements_de":"Gehtraining bevorzugen, wenn der Patient es toleriert.","minimum_requirements_en":"Prefer walking training when tolerated.","minimum_requirements_pl":"Preferuj trening chodu, jeśli pacjent go toleruje.","additional_notes_original":"Ziel ist die funktionelle Gehstrecke.","therapeutic_content_original":"Training; Bewegungstherapie zur Vergrößerung der Gehstrecke.","minimum_requirements_original":"Prefer walking training when tolerated.","structured_content_v2":"$undefined"},{"id":"ae8e5ec5-5ab5-5704-aeb7-80a496c781a9","name_de":"Vorrang des Gehtrainings","name_en":"Preference for Walking Training","name_pl":"Preferencja treningu chodu","source_page":13,"module_number":3,"name_original":"Vorrang des Gehtrainings","service_codes":[],"structured_content":{"de":{"warnings":["Eine alternative Belastungsform ersetzt nicht die Indikationsprüfung."],"exercises":["Zur Vergrößerung der funktionellen Gehstrecke hat Gehtraining Vorrang.","Wenn Gehen zu belastend ist, können zu Beginn insbesondere Fahrradtraining oder andere Belastungsformen eingesetzt werden."],"physiotherapist_actions":["Belastung an Verträglichkeit und Komorbiditäten anpassen."]},"en":{"warnings":["An alternative mode does not replace indication assessment."],"exercises":["Walking training is preferred to increase functional distance.","If walking is too demanding, cycling or another loading mode can be used, especially at treatment onset."],"physiotherapist_actions":["Adapt loading to tolerance and comorbidities."]},"pl":{"warnings":["Alternatywna forma nie zastępuje oceny wskazań."],"exercises":["Jeżeli chodzenie jest zbyt obciążające, szczególnie na początku można zastosować jazdę na ergometrze lub inną formę obciążenia."],"physiotherapist_actions":["Dobierz obciążenie do tolerancji i chorób współistniejących.","Trening chodu jest preferowany dla zwiększania funkcjonalnego dystansu."]},"original":{"warnings":["An alternative mode does not replace indication assessment."],"exercises":["Walking training is preferred to increase functional distance.","If walking is too demanding, cycling or another loading mode can be used, especially at treatment onset."],"physiotherapist_actions":["Adapt loading to tolerance and comorbidities."]}},"additional_notes_de":"Eine alternative Belastungsform ersetzt nicht die Indikationsprüfung.","additional_notes_en":"An alternative mode does not replace indication assessment.","additional_notes_pl":"Alternatywna forma nie zastępuje oceny wskazań.","minimum_patient_share":null,"therapeutic_content_de":"Zur Vergrößerung der funktionellen Gehstrecke hat Gehtraining Vorrang. Wenn Gehen zu belastend ist, können zu Beginn insbesondere Fahrradtraining oder andere Belastungsformen eingesetzt werden.","therapeutic_content_en":"Walking training is preferred to increase functional distance. If walking is too demanding, cycling or another loading mode can be used, especially at treatment onset.","therapeutic_content_pl":"Trening chodu jest preferowany dla zwiększania funkcjonalnego dystansu. Jeżeli chodzenie jest zbyt obciążające, szczególnie na początku można zastosować jazdę na ergometrze lub inną formę obciążenia.","minimum_requirements_de":"Belastung an Verträglichkeit und Komorbiditäten anpassen.","minimum_requirements_en":"Adapt loading to tolerance and comorbidities.","minimum_requirements_pl":"Dobierz obciążenie do tolerancji i chorób współistniejących.","additional_notes_original":"Eine alternative Belastungsform ersetzt nicht die Indikationsprüfung.","therapeutic_content_original":"Gehtraining hat Vorrang; Fahrradtraining als Alternative bei zu hoher Belastung.","minimum_requirements_original":"Adapt loading to tolerance and comorbidities.","structured_content_v2":"$undefined"},{"id":"059efd9d-3bbf-573b-b579-3756b9e62a04","name_de":"Dauer des Trainingsprogramms","name_en":"Training Program Duration","name_pl":"Czas trwania programu","source_page":13,"module_number":4,"name_original":"Dauer des Trainingsprogramms","service_codes":[],"structured_content":{"de":{"warnings":["Dies bedeutet keine ununterbrochene Therapie mit gleicher Frequenz."],"exercises":["Die Patienten sollen mindestens sechs Monate trainieren."],"progression_criteria":["Langfristige Planung und regelmäßige Evaluation erforderlich."]},"en":{"warnings":["This does not mean uninterrupted therapy at an unchanged frequency."],"exercises":["Patients should train for at least six months."],"physiotherapist_actions":["Long-term planning and periodic evaluation are required."]},"pl":{"warnings":["Nie oznacza to nieprzerwanej terapii o tej samej częstotliwości."],"exercises":["Zalecany jest trening pacjentów z sPAV przez co najmniej sześć miesięcy."],"physiotherapist_actions":["Wymaga długoterminowego planu i okresowej oceny."]},"original":{"warnings":["This does not mean uninterrupted therapy at an unchanged frequency."],"exercises":["Patients should train for at least six months."],"physiotherapist_actions":["Long-term planning and periodic evaluation are required."]}},"additional_notes_de":"Dies bedeutet keine ununterbrochene Therapie mit gleicher Frequenz.","additional_notes_en":"This does not mean uninterrupted therapy at an unchanged frequency.","additional_notes_pl":"Nie oznacza to nieprzerwanej terapii o tej samej częstotliwości.","minimum_patient_share":null,"therapeutic_content_de":"Die Patienten sollen mindestens sechs Monate trainieren.","therapeutic_content_en":"Patients should train for at least six months.","therapeutic_content_pl":"Zalecany jest trening pacjentów z sPAV przez co najmniej sześć miesięcy.","minimum_requirements_de":"Langfristige Planung und regelmäßige Evaluation erforderlich.","minimum_requirements_en":"Long-term planning and periodic evaluation are required.","minimum_requirements_pl":"Wymaga długoterminowego planu i okresowej oceny.","additional_notes_original":"Dies bedeutet keine ununterbrochene Therapie mit gleicher Frequenz.","therapeutic_content_original":"Mindestens sechs Monate trainieren.","minimum_requirements_original":"Long-term planning and periodic evaluation are required.","structured_content_v2":"$undefined"},{"id":"19eb8f00-19e2-58da-800d-9f621f3edac5","name_de":"Trainingsfrequenz und Sitzungsdauer","name_en":"Training Frequency and Session Duration","name_pl":"Częstotliwość i czas sesji","source_page":13,"module_number":5,"name_original":"Trainingsfrequenz und Sitzungsdauer","service_codes":[],"structured_content":{"de":{"warnings":["Für die Intensität wird keine einheitliche Empfehlung formuliert."],"exercises":["Die Leitlinie empfiehlt dreimal w pro Woche zu trainieren, mindestens 30 Minuten pro Sitzung, um eine möglichst große Verbesserung der Gehstrecke zu erreichen."],"physiotherapist_actions":["Belastungsverträglichkeit und Symptome in jeder Sitzung überwachen."]},"en":{"warnings":["No single intensity level is recommended."],"exercises":["The guideline recommends training three times per week, for at least 30 minutes per session, to achieve the greatest possible improvement in walking distance."],"physiotherapist_actions":["Monitor exercise tolerance and symptoms in every session."]},"pl":{"warnings":["Wytyczna nie formułuje jednego poziomu intensywności."],"exercises":["Wytyczna zaleca trening trzy razy w tygodniu, przez co najmniej 30 minut na sesję, aby uzyskać możliwie największą poprawę dystansu chodu."],"physiotherapist_actions":["Monitoruj tolerancję wysiłku i objawy podczas każdej sesji."]},"original":{"warnings":["No single intensity level is recommended."],"exercises":["The guideline recommends training three times per week, for at least 30 minutes per session, to achieve the greatest possible improvement in walking distance."],"physiotherapist_actions":["Monitor exercise tolerance and symptoms in every session."]}},"additional_notes_de":"Für die Intensität wird keine einheitliche Empfehlung formuliert.","additional_notes_en":"No single intensity level is recommended.","additional_notes_pl":"Wytyczna nie formułuje jednego poziomu intensywności.","minimum_patient_share":null,"therapeutic_content_de":"Die Leitlinie empfiehlt dreimal w pro Woche zu trainieren, mindestens 30 Minuten pro Sitzung, um eine möglichst große Verbesserung der Gehstrecke zu erreichen.","therapeutic_content_en":"The guideline recommends training three times per week, for at least 30 minutes per session, to achieve the greatest possible improvement in walking distance.","therapeutic_content_pl":"Wytyczna zaleca trening trzy razy w tygodniu, przez co najmniej 30 minut na sesję, aby uzyskać możliwie największą poprawę dystansu chodu.","minimum_requirements_de":"Belastungsverträglichkeit und Symptome in jeder Sitzung überwachen.","minimum_requirements_en":"Monitor exercise tolerance and symptoms in every session.","minimum_requirements_pl":"Monitoruj tolerancję wysiłku i objawy podczas każdej sesji.","additional_notes_original":"Für die Intensität wird keine einheitliche Empfehlung formuliert.","therapeutic_content_original":"Dreimal pro Woche; mindestens 30 Minuten pro Sitzung.","minimum_requirements_original":"Monitor exercise tolerance and symptoms in every session.","structured_content_v2":"$undefined"},{"id":"3dd3bf8d-c83c-581b-8e1d-40c187ec3be3","name_de":"Begleitung des Trainingsprogramms","name_en":"Supervision of the Program","name_pl":"Nadzorowanie programu","source_page":13,"module_number":6,"name_original":"Begleitung des Trainingsprogramms","service_codes":[],"structured_content":{"de":{"warnings":["Begleitung ersetzt nicht die selbstständige Aktivität des Patienten."],"exercises":["Begleitete Trainingsprogramme werden zur Vergrößerung der Gehstrecke deutlich bevorzugt","die optimale Zahl begleiteter Sitzungen ist nicht festgelegt."],"physiotherapist_actions":["Umfang der Begleitung individuell festlegen."]},"en":{"warnings":["Supervision does not replace the patient’s independent activity."],"exercises":["Supervised training programs are strongly preferred to increase walking distance","the optimal number of supervised sessions is not specified."],"physiotherapist_actions":["Set the supervision level individually."]},"pl":{"warnings":["Nadzór nie zastępuje samodzielnej aktywności pacjenta."],"exercises":["Nadzorowane programy treningowe są zdecydowanie preferowane dla zwiększania dystansu chodu","wytyczna nie określa optymalnej liczby sesji nadzorowanych."],"physiotherapist_actions":["Zakres nadzoru ustal indywidualnie."]},"original":{"warnings":["Supervision does not replace the patient’s independent activity."],"exercises":["Supervised training programs are strongly preferred to increase walking distance","the optimal number of supervised sessions is not specified."],"physiotherapist_actions":["Set the supervision level individually."]}},"additional_notes_de":"Begleitung ersetzt nicht die selbstständige Aktivität des Patienten.","additional_notes_en":"Supervision does not replace the patient’s independent activity.","additional_notes_pl":"Nadzór nie zastępuje samodzielnej aktywności pacjenta.","minimum_patient_share":null,"therapeutic_content_de":"Begleitete Trainingsprogramme werden zur Vergrößerung der Gehstrecke deutlich bevorzugt; die optimale Zahl begleiteter Sitzungen ist nicht festgelegt.","therapeutic_content_en":"Supervised training programs are strongly preferred to increase walking distance; the optimal number of supervised sessions is not specified.","therapeutic_content_pl":"Nadzorowane programy treningowe są zdecydowanie preferowane dla zwiększania dystansu chodu; wytyczna nie określa optymalnej liczby sesji nadzorowanych.","minimum_requirements_de":"Umfang der Begleitung individuell festlegen.","minimum_requirements_en":"Set the supervision level individually.","minimum_requirements_pl":"Zakres nadzoru ustal indywidualnie.","additional_notes_original":"Begleitung ersetzt nicht die selbstständige Aktivität des Patienten.","therapeutic_content_original":"Begeleide trainingsprogramma's genieten sterk de voorkeur.","minimum_requirements_original":"Set the supervision level individually.","structured_content_v2":"$undefined"},{"id":"d0689562-cd05-5892-9d33-97e1cf14c9b8","name_de":"Komorbiditäten","name_en":"Comorbidities","name_pl":"Choroby współistniejące","source_page":13,"module_number":7,"name_original":"Komorbiditäten","service_codes":[],"structured_content":{"de":{"warnings":["Dies ersetzt keine medizinische Indikationsstellung."],"exercises":["Bewegungstherapie kann auch bei Komorbiditäten angezeigt sein.","Der Physiotherapeut passt das Programm an","bei stark beeinträchtigtem Erfolgsaussicht ist Rücksprache mit dem Überweiser angezeigt."],"physiotherapist_actions":["Kardiovaskuläres Risiko und Überweisungsinformationen berücksichtigen."]},"en":{"warnings":["This is not a standalone medical clearance."],"exercises":["Exercise therapy may also be indicated with comorbidities.","The physiotherapist should adapt the program","if comorbidities substantially affect treatment success, consult the referrer."],"physiotherapist_actions":["Consider cardiovascular risk and referral information."]},"pl":{"warnings":["To nie jest samodzielna kwalifikacja medyczna."],"exercises":["Ćwiczenia mogą być wskazane także przy chorobach współistniejących.","Fizjoterapeuta powinien tak ułożyć program, aby uwzględnić obecne choroby","przy istotnym wpływie na możliwość powodzenia potrzebna jest konsultacja z osobą kierującą."],"physiotherapist_actions":["Uwzględnij ryzyko sercowo-naczyniowe i informacje ze skierowania."]},"original":{"warnings":["This is not a standalone medical clearance."],"exercises":["Exercise therapy may also be indicated with comorbidities.","The physiotherapist should adapt the program","if comorbidities substantially affect treatment success, consult the referrer."],"physiotherapist_actions":["Consider cardiovascular risk and referral information."]}},"additional_notes_de":"Dies ersetzt keine medizinische Indikationsstellung.","additional_notes_en":"This is not a standalone medical clearance.","additional_notes_pl":"To nie jest samodzielna kwalifikacja medyczna.","minimum_patient_share":null,"therapeutic_content_de":"Bewegungstherapie kann auch bei Komorbiditäten angezeigt sein. Der Physiotherapeut passt das Programm an; bei stark beeinträchtigtem Erfolgsaussicht ist Rücksprache mit dem Überweiser angezeigt.","therapeutic_content_en":"Exercise therapy may also be indicated with comorbidities. The physiotherapist should adapt the program; if comorbidities substantially affect treatment success, consult the referrer.","therapeutic_content_pl":"Ćwiczenia mogą być wskazane także przy chorobach współistniejących. Fizjoterapeuta powinien tak ułożyć program, aby uwzględnić obecne choroby; przy istotnym wpływie na możliwość powodzenia potrzebna jest konsultacja z osobą kierującą.","minimum_requirements_de":"Kardiovaskuläres Risiko und Überweisungsinformationen berücksichtigen.","minimum_requirements_en":"Consider cardiovascular risk and referral information.","minimum_requirements_pl":"Uwzględnij ryzyko sercowo-naczyniowe i informacje ze skierowania.","additional_notes_original":"Dies ersetzt keine medizinische Indikationsstellung.","therapeutic_content_original":"Oefentherapie ook bij comorbiditeit; programma aanpassen; overleg met verwijzer.","minimum_requirements_original":"Consider cardiovascular risk and referral information.","structured_content_v2":"$undefined"},{"id":"dff88827-44c2-5663-a6d4-0c065e1d23a5","name_de":"Evaluation und Abschluss","name_en":"Evaluation and Discharge","name_pl":"Ewaluacja i zakończenie","source_page":16,"module_number":8,"name_original":"Evaluation und Abschluss","service_codes":[],"structured_content":{"de":{"warnings":["Komplikationen erfordern Rücksprache mit dem Überweiser."],"exercises":["Bewerte funktionelle und maximale Gehstrecke, Gangbild, kardiovaskuläre Risikofaktoren und Lebensqualität.","Die Leitlinie nennt Kontrollen nach 3, 6, 9 und 12 Monaten","bei fehlender Verbesserung oder Komplikationen Frequenz reduzieren, beenden oder zurücküberweisen."],"physiotherapist_actions":["Ziele, Behandlungsanzahl, Gehstrecken und Schlussfolgerung für den Überweiser dokumentieren."]},"en":{"warnings":["Complications require contact with the referrer."],"exercises":["Evaluate functional and maximal walking distance, gait pattern, cardiovascular risk factors, and quality of life.","The guideline specifies reviews at 3, 6, 9, and 12 months","with no improvement or complications, reduce frequency, end treatment, or refer back."],"physiotherapist_actions":["Document goals, number of treatments, distances, and conclusions for the referrer."]},"pl":{"warnings":["Powikłania wymagają ponownego kontaktu z osobą kierującą."],"exercises":["Oceniaj dystans funkcjonalny i maksymalny, wzorzec chodu, czynniki ryzyka sercowo-naczyniowego oraz jakość życia.","Wytyczna wskazuje kontrolę po 3, 6, 9 i 12 miesiącach","przy braku poprawy lub powikłaniach rozważ zmniejszenie częstotliwości, zakończenie lub ponowne skierowanie."],"physiotherapist_actions":["Dokumentuj cele, liczbę zabiegów, dystanse i wnioski dla osoby kierującej."]},"original":{"warnings":["Complications require contact with the referrer."],"exercises":["Evaluate functional and maximal walking distance, gait pattern, cardiovascular risk factors, and quality of life.","The guideline specifies reviews at 3, 6, 9, and 12 months","with no improvement or complications, reduce frequency, end treatment, or refer back."],"physiotherapist_actions":["Document goals, number of treatments, distances, and conclusions for the referrer."]}},"additional_notes_de":"Komplikationen erfordern Rücksprache mit dem Überweiser.","additional_notes_en":"Complications require contact with the referrer.","additional_notes_pl":"Powikłania wymagają ponownego kontaktu z osobą kierującą.","minimum_patient_share":null,"therapeutic_content_de":"Bewerte funktionelle und maximale Gehstrecke, Gangbild, kardiovaskuläre Risikofaktoren und Lebensqualität. Die Leitlinie nennt Kontrollen nach 3, 6, 9 und 12 Monaten; bei fehlender Verbesserung oder Komplikationen Frequenz reduzieren, beenden oder zurücküberweisen.","therapeutic_content_en":"Evaluate functional and maximal walking distance, gait pattern, cardiovascular risk factors, and quality of life. The guideline specifies reviews at 3, 6, 9, and 12 months; with no improvement or complications, reduce frequency, end treatment, or refer back.","therapeutic_content_pl":"Oceniaj dystans funkcjonalny i maksymalny, wzorzec chodu, czynniki ryzyka sercowo-naczyniowego oraz jakość życia. Wytyczna wskazuje kontrolę po 3, 6, 9 i 12 miesiącach; przy braku poprawy lub powikłaniach rozważ zmniejszenie częstotliwości, zakończenie lub ponowne skierowanie.","minimum_requirements_de":"Ziele, Behandlungsanzahl, Gehstrecken und Schlussfolgerung für den Überweiser dokumentieren.","minimum_requirements_en":"Document goals, number of treatments, distances, and conclusions for the referrer.","minimum_requirements_pl":"Dokumentuj cele, liczbę zabiegów, dystanse i wnioski dla osoby kierującej.","additional_notes_original":"Komplikationen erfordern Rücksprache mit dem Überweiser.","therapeutic_content_original":"Evaluatie 3, 6, 9 en 12 maanden; functionele en maximale loopafstanden; terugverwijzen bij complicaties.","minimum_requirements_original":"Document goals, number of treatments, distances, and conclusions for the referrer.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"clinical_practice_guideline","content_role":"core_protocol","classification_status":"verified","clinical_domain":"cardiovascular_vascular","clinical_entity_type":"condition","body_region_codes":["lower_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["care_process","recommendation_set","schedule_table"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"c2ea876d-cf95-5679-a4ed-244696d85818","slug":"us-south-shore-21-shoulder-range-of-motion","title_pl":"Ćwiczenia zakresu ruchu barku (South Shore)","title_de":"Schulterbeweglichkeitsübungen (South Shore)","title_en":"Shoulder Range of Motion Exercises (South Shore)","title_original":"Shoulder Range of Motion Exercises","summary_pl":"Zestaw ćwiczeń mających na celu poprawę ruchomości stawu ramiennego.","summary_de":"Übungsprogramm zur Verbesserung der Beweglichkeit des Schultergelenks.","summary_en":"Exercise program to improve shoulder joint mobility.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"exercise_program","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"e0b51c3d-3595-50c4-b22c-e11ec7049998","condition_slug":"shoulder-range-of-motion","condition_name_pl":"Ograniczenie zakresu ruchu barku","condition_name_de":"Eingeschränkter Schulterbewegungsumfang","condition_name_en":"Shoulder Range of Motion Limitation","condition_name_original":"Shoulder Range of Motion Limitation","icd_codes":[],"category_key":"shoulder","category_pl":"Bark","category_de":"Schulter","category_en":"Shoulder","body_regions_pl":["bark","obręcz barkowa"],"body_regions_de":["Schulter","Schultergürtel"],"body_regions_en":["shoulder","shoulder girdle"],"search_terms_pl":["zakres ruchu","ROM","mobilizacja","bark","fizjoterapia","ćwiczenia"],"search_terms_de":["Bewegungsumfang","ROM","Mobilisation","Schulter","Physiotherapie","Übungen"],"search_terms_en":["range of motion","ROM","mobilization","shoulder","physiotherapy","exercises"],"source_document_id":"060f972d-6ba2-52fa-bbee-e5392fc947e0","source_title":"Shoulder Range of Motion Exercises","issuer":"South Shore Orthopedics","source_country_code":"US","jurisdiction_code":"US-MA","authority_level":"hospital","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_unknown_requires_review","official_url":"https://octanecdn.com/southshoreorthopedicscom/southshoreorthopedicscom_886963377.pdf","source_sha256":"5dc0cc59e618e198daa87e05e00f7779651dbc9b28ea127768023dd0a1336354","authorization_required":false,"license_note":"Public source file retained locally for source verification.","modules":[{"id":"db024810-1b67-5774-8856-6ec6ead54cb0","name_de":"Einleitung / Programmregeln","name_en":"Introduction / Program rules","name_pl":"Wprowadzenie / zasady programu","source_page":1,"module_number":1,"name_original":"Introduction:","service_codes":[],"structured_content":{"de":{"restrictions":["Führe nur die von der behandelnden Person mit YES markierten Übungen durch.","Nimm ausschließlich ein vom Arzt empfohlenes Medikament ein."],"dosage_and_progression":["Führe das Programm mindestens 1-mal täglich, aber höchstens 2-mal täglich durch."],"physiotherapist_actions":["Die behandelnde Person sollte die durchzuführenden Übungen mit YES markieren; die übrigen Übungen nicht durchführen.","Eine Kühlung der Schulter nach den Übungen sollte erwogen werden."]},"en":{"restrictions":["Perform only the exercises checked YES by the clinician.","Take only medication recommended by your doctor."],"dosage_and_progression":["Perform the program at least once per day, but no more than twice in one day."],"physiotherapist_actions":["The clinician should mark the exercises to perform as YES; do not perform the others.","Consider icing the shoulder after the exercises."]},"pl":{"restrictions":["Wykonuj tylko ćwiczenia zaznaczone przez klinicystę jako YES.","Przyjmuj wyłącznie lek zalecony przez lekarza."],"dosage_and_progression":["Wykonuj program co najmniej 1 raz dziennie, ale nie więcej niż 2 razy dziennie."],"physiotherapist_actions":["Klinicysta powinien zaznaczyć ćwiczenia do wykonania jako YES; pozostałych nie wykonuj.","Rozważ schłodzenie barku po ćwiczeniach."]},"original":{"restrictions":["Perform only the exercises which are checked YES below.","take only medication recommended by your doctor."],"dosage_and_progression":["These should be done at least once per day but not more than twice in one day."],"physiotherapist_actions":["These exercises are recommended by us for you to perform on your own to regain your shoulder range of motion.","You should consider icing the shoulder after the exercises."]}},"additional_notes_de":"Nach den Übungen sollte eine Kühlung der Schulter erwogen werden. Die YES/NO-Regel stammt direkt aus der Quelle.","additional_notes_en":"Consider icing the shoulder after the exercises. The YES/NO rule is taken directly from the source.","additional_notes_pl":"Po ćwiczeniach rozważ schłodzenie barku. Zasada YES/NO pochodzi bezpośrednio ze źródła.","minimum_patient_share":null,"therapeutic_content_de":"Die Übungen werden zur selbstständigen Wiederherstellung des Bewegungsumfangs der Schulter empfohlen. Führe sie mindestens 1-mal täglich, aber höchstens 2-mal täglich durch. Vor den Übungen kann ein Schmerzmittel eingenommen werden, jedoch ausschließlich ein vom Arzt empfohlenes Medikament. Eine Kühlung der Schulter nach den Übungen sollte erwogen werden. Führe nur die von der behandelnden Person mit YES markierten Übungen durch.","therapeutic_content_en":"These exercises are recommended for independent performance to regain shoulder range of motion. Perform them at least once per day, but no more than twice in one day. A pain medicine may be taken before the exercises, but only medication recommended by your doctor. Consider icing the shoulder after the exercises. Perform only the exercises checked YES by the clinician.","therapeutic_content_pl":"Ćwiczenia są zalecane do samodzielnego wykonywania w celu odzyskania zakresu ruchu barku. Wykonuj je co najmniej 1 raz dziennie, ale nie częściej niż 2 razy dziennie. Przed ćwiczeniami można przyjąć lek przeciwbólowy, ale wyłącznie lek zalecony przez lekarza. Rozważ schłodzenie barku po ćwiczeniach. Wykonuj tylko ćwiczenia zaznaczone przez klinicystę jako YES.","minimum_requirements_de":"Dosierung des Programms: mindestens 1-mal täglich und höchstens 2-mal täglich. Medikamente ausschließlich nach ärztlicher Empfehlung.","minimum_requirements_en":"Program dosage: at least once per day and no more than twice per day. Medication only as recommended by the doctor.","minimum_requirements_pl":"Dawkowanie programu: co najmniej 1 raz dziennie i nie więcej niż 2 razy dziennie. Lek wyłącznie zgodnie z zaleceniem lekarza.","additional_notes_original":"Consider icing the shoulder after the exercises. Perform only the exercises which are checked YES below.","therapeutic_content_original":"Introduction: These exercises are recommended by us for you to perform on your own to regain your shoulder range of motion. Perform only the exercises which are checked YES below.","minimum_requirements_original":"At least once per day but no more than twice in one day. Take only medication recommended by your doctor.","structured_content_v2":"$undefined"},{"id":"5204e987-2c88-50ed-9684-014ce3a9eddd","name_de":"Armheben","name_en":"Arm Elevation","name_pl":"Unoszenie ramienia","source_page":1,"module_number":2,"name_original":"ARM ELEVATION","service_codes":[],"structured_content":{"de":{"exercises":["Im Liegen führt die andere Hand den operierten Arm beim Anheben."]},"en":{"exercises":["While lying down, the other hand guides the operated arm during elevation."]},"pl":{"exercises":["W leżeniu druga ręka prowadzi operowaną rękę podczas unoszenia."]},"original":{"exercises":["Start / Finish"]}},"additional_notes_de":"Visuelle Verifikation der Abbildung; die Quelle enthält keine satzförmige Anleitung.","additional_notes_en":"Visual verification of the illustration; the source contains no sentence-level instruction.","additional_notes_pl":"Weryfikacja wizualna ilustracji; źródło nie zawiera zdaniowej instrukcji.","minimum_patient_share":null,"therapeutic_content_de":"Auf Grundlage der Start/Finish-Abbildung: Im Liegen führt die andere Hand den operierten Arm beim Anheben. Die Quelle enthält keine satzförmige Anleitung.","therapeutic_content_en":"Based on the Start/Finish illustration: while lying down, the other hand guides the operated arm during elevation. The source contains no sentence-level instruction.","therapeutic_content_pl":"Na podstawie ilustracji Start/Finish: w leżeniu druga ręka prowadzi operowaną rękę podczas unoszenia. Źródło nie zawiera zdaniowej instrukcji.","minimum_requirements_de":"","minimum_requirements_en":"","minimum_requirements_pl":"","additional_notes_original":"Start / Finish","therapeutic_content_original":"Start / Finish","minimum_requirements_original":"","structured_content_v2":"$undefined"},{"id":"dfcb69af-35ef-576d-9ad9-5a75daf8339f","name_de":"Tischgleiten","name_en":"Table Slide","name_pl":"Ślizg po stole","source_page":1,"module_number":3,"name_original":"TABLE SLIDE","service_codes":[],"structured_content":{"de":{"exercises":["Im Sitzen liegt die Hand auf dem Tisch und gleitet über seine Oberfläche."]},"en":{"exercises":["While sitting, the hand rests on the table and slides across its surface."]},"pl":{"exercises":["W pozycji siedzącej ręka opiera się na stole i przesuwa po jego powierzchni."]},"original":{"exercises":["Start / Finish"]}},"additional_notes_de":"Visuelle Verifikation der Abbildung; die Quelle enthält keine satzförmige Anleitung.","additional_notes_en":"Visual verification of the illustration; the source contains no sentence-level instruction.","additional_notes_pl":"Weryfikacja wizualna ilustracji; źródło nie zawiera zdaniowej instrukcji.","minimum_patient_share":null,"therapeutic_content_de":"Auf Grundlage der Start/Finish-Abbildung: Im Sitzen liegt die Hand auf dem Tisch und gleitet über dessen Oberfläche. Die Quelle enthält keine satzförmige Anleitung.","therapeutic_content_en":"Based on the Start/Finish illustration: while sitting, the hand rests on the table and slides across its surface. The source contains no sentence-level instruction.","therapeutic_content_pl":"Na podstawie ilustracji Start/Finish: w pozycji siedzącej ręka opiera się na stole i przesuwa po jego powierzchni. Źródło nie zawiera zdaniowej instrukcji.","minimum_requirements_de":"","minimum_requirements_en":"","minimum_requirements_pl":"","additional_notes_original":"Start / Finish","therapeutic_content_original":"Start / Finish","minimum_requirements_original":"","structured_content_v2":"$undefined"},{"id":"7f9a7476-a0d7-5e3a-9990-d6ad69a94964","name_de":"Wandklettern","name_en":"Wall Climb","name_pl":"Wspinaczka po ścianie","source_page":2,"module_number":4,"name_original":"WALL CLIMB","service_codes":[],"structured_content":{"de":{"exercises":["Im Stand zur Wand die Finger an der Wand nach oben führen."]},"en":{"exercises":["Standing facing the wall, guide the fingers upward along the wall."]},"pl":{"exercises":["Stojąc przodem do ściany, przesuwaj palce ku górze po ścianie."]},"original":{"exercises":["Start / Finish"]}},"additional_notes_de":"Visuelle Verifikation der Abbildung; die Quelle enthält keine satzförmige Anleitung.","additional_notes_en":"Visual verification of the illustration; the source contains no sentence-level instruction.","additional_notes_pl":"Weryfikacja wizualna ilustracji; źródło nie zawiera zdaniowej instrukcji.","minimum_patient_share":null,"therapeutic_content_de":"Auf Grundlage der Start/Finish-Abbildung: Im Stand zur Wand führen die Finger die Hand an der Wand nach oben. Die Quelle enthält keine satzförmige Anleitung.","therapeutic_content_en":"Based on the Start/Finish illustration: standing facing the wall, the fingers guide the hand upward along the wall. The source contains no sentence-level instruction.","therapeutic_content_pl":"Na podstawie ilustracji Start/Finish: stojąc przodem do ściany, palce przesuwają rękę ku górze po ścianie. Źródło nie zawiera zdaniowej instrukcji.","minimum_requirements_de":"","minimum_requirements_en":"","minimum_requirements_pl":"","additional_notes_original":"Start / Finish","therapeutic_content_original":"Start / Finish","minimum_requirements_original":"","structured_content_v2":"$undefined"},{"id":"eb396405-b62a-56b6-a207-50a5cf7790f5","name_de":"Innenrotation hinter den Rücken mit Handtuch","name_en":"Internal Rotation Up Back with Towel","name_pl":"Rotacja wewnętrzna za plecy z ręcznikiem","source_page":2,"module_number":5,"name_original":"INTERNAL ROTATION UP BACK WITH TOWEL","service_codes":[],"structured_content":{"de":{"exercises":["Der gesunde Arm zieht das Handtuch nach oben und führt die andere Hand hinter den Rücken."]},"en":{"exercises":["The healthy arm pulls the towel upward, guiding the other hand behind the back."]},"pl":{"exercises":["Zdrowa ręka ciągnie ręcznik w górę, prowadząc drugą rękę za plecy."]},"original":{"exercises":["Start / Finish"]}},"additional_notes_de":"Visuelle Verifikation der Abbildung; die Quelle enthält keine satzförmige Anleitung.","additional_notes_en":"Visual verification of the illustration; the source contains no sentence-level instruction.","additional_notes_pl":"Weryfikacja wizualna ilustracji; źródło nie zawiera zdaniowej instrukcji.","minimum_patient_share":null,"therapeutic_content_de":"Auf Grundlage der Start/Finish-Abbildung: Der gesunde Arm zieht das Handtuch nach oben und führt die andere Hand hinter den Rücken. Die Quelle enthält keine satzförmige Anleitung.","therapeutic_content_en":"Based on the Start/Finish illustration: the healthy arm pulls the towel upward, guiding the other hand behind the back. The source contains no sentence-level instruction.","therapeutic_content_pl":"Na podstawie ilustracji Start/Finish: zdrowa ręka ciągnie ręcznik w górę, prowadząc drugą rękę za plecy. Źródło nie zawiera zdaniowej instrukcji.","minimum_requirements_de":"","minimum_requirements_en":"","minimum_requirements_pl":"","additional_notes_original":"Start / Finish","therapeutic_content_original":"Start / Finish","minimum_requirements_original":"","structured_content_v2":"$undefined"},{"id":"de39c7a5-5883-5bd7-b8e8-97a2d06b8e19","name_de":"Innenrotation hinter den Rücken mit dem Arm","name_en":"Internal Rotation Up Back with Arm","name_pl":"Rotacja wewnętrzna za plecy ramieniem","source_page":2,"module_number":6,"name_original":"INTERNAL ROTATION UP BACK WITH ARM","service_codes":[],"structured_content":{"de":{"exercises":["Den operierten Arm in Innenrotation hinter den Rücken führen."]},"en":{"exercises":["Move the operated arm behind the back in internal rotation."]},"pl":{"exercises":["Ręka operowana przesuwa się za plecy w rotacji wewnętrznej."]},"original":{"exercises":["Start / Finish"]}},"additional_notes_de":"Visuelle Verifikation der Abbildung; die Quelle enthält keine satzförmige Anleitung.","additional_notes_en":"Visual verification of the illustration; the source contains no sentence-level instruction.","additional_notes_pl":"Weryfikacja wizualna ilustracji; źródło nie zawiera zdaniowej instrukcji.","minimum_patient_share":null,"therapeutic_content_de":"Auf Grundlage der Start/Finish-Abbildung: Der operierte Arm wird in Innenrotation hinter den Rücken geführt. Die Quelle enthält keine satzförmige Anleitung.","therapeutic_content_en":"Based on the Start/Finish illustration: the operated arm moves behind the back in internal rotation. The source contains no sentence-level instruction.","therapeutic_content_pl":"Na podstawie ilustracji Start/Finish: ręka operowana przesuwa się za plecy w rotacji wewnętrznej. Źródło nie zawiera zdaniowej instrukcji.","minimum_requirements_de":"","minimum_requirements_en":"","minimum_requirements_pl":"","additional_notes_original":"Start / Finish","therapeutic_content_original":"Start / Finish","minimum_requirements_original":"","structured_content_v2":"$undefined"},{"id":"ab840c0e-881b-58d2-a96a-4ca67abf3e99","name_de":"Armheben mit Stab","name_en":"Arm Elevation","name_pl":"Unoszenie ramienia z kijem","source_page":3,"module_number":7,"name_original":"ARM ELEVATION","service_codes":[],"structured_content":{"de":{"exercises":["Im Liegen führt der andere Arm den Stab beim Anheben des operierten Arms."],"physiotherapist_actions":["Einen beliebigen Stab vorbereiten: Gehstock, Besenstiel oder Golfschläger."]},"en":{"exercises":["While lying down, the other arm guides the stick as the operated arm is elevated."],"physiotherapist_actions":["Prepare any stick: a cane, broomstick, or golf club."]},"pl":{"exercises":["W leżeniu druga ręka prowadzi kij podczas unoszenia operowanej ręki."],"physiotherapist_actions":["Przygotuj dowolny kij: laskę, kij od miotły lub kij golfowy."]},"original":{"exercises":["Start / Finish"],"physiotherapist_actions":["You can use any stick (cane, broomstick or golf club) to do these exercises."]}},"additional_notes_de":"Visuelle Verifikation der Abbildung; die Quelle enthält keine satzförmige Anleitung.","additional_notes_en":"Visual verification of the illustration; the source contains no sentence-level instruction.","additional_notes_pl":"Weryfikacja wizualna ilustracji; źródło nie zawiera zdaniowej instrukcji.","minimum_patient_share":null,"therapeutic_content_de":"Auf Grundlage der Start/Finish-Abbildung: Im Liegen führt der andere Arm den Stab beim Anheben des operierten Arms. Die Quelle enthält keine satzförmige Anleitung.","therapeutic_content_en":"Based on the Start/Finish illustration: while lying down, the other arm guides the stick as the operated arm is elevated. The source contains no sentence-level instruction.","therapeutic_content_pl":"Na podstawie ilustracji Start/Finish: w leżeniu druga ręka prowadzi kij podczas unoszenia operowanej ręki. Źródło nie zawiera zdaniowej instrukcji.","minimum_requirements_de":"","minimum_requirements_en":"","minimum_requirements_pl":"","additional_notes_original":"Start / Finish","therapeutic_content_original":"Start / Finish","minimum_requirements_original":"","structured_content_v2":"$undefined"},{"id":"d179d4ec-4c19-5fbd-b59c-d74df1a9cdba","name_de":"Armheben mit gebeugten Ellbogen","name_en":"Arm Elevation Elbows Bent","name_pl":"Unoszenie ramienia z ugiętymi łokciami","source_page":3,"module_number":8,"name_original":"ARM ELEVATION ELBOWS BENT","service_codes":[],"structured_content":{"de":{"exercises":["Im Liegen werden die Arme mit gebeugten Ellbogen mithilfe eines Stabs geführt."],"physiotherapist_actions":["Einen beliebigen Stab vorbereiten: Gehstock, Besenstiel oder Golfschläger."]},"en":{"exercises":["While lying down, guide the arms with bent elbows using a stick."],"physiotherapist_actions":["Prepare any stick: a cane, broomstick, or golf club."]},"pl":{"exercises":["W leżeniu ramiona są prowadzone z ugiętymi łokciami przy użyciu kija."],"physiotherapist_actions":["Przygotuj dowolny kij: laskę, kij od miotły lub kij golfowy."]},"original":{"exercises":["Start / Finish"],"physiotherapist_actions":["You can use any stick (cane, broomstick or golf club) to do these exercises."]}},"additional_notes_de":"Visuelle Verifikation der Abbildung; die Quelle enthält keine satzförmige Anleitung.","additional_notes_en":"Visual verification of the illustration; the source contains no sentence-level instruction.","additional_notes_pl":"Weryfikacja wizualna ilustracji; źródło nie zawiera zdaniowej instrukcji.","minimum_patient_share":null,"therapeutic_content_de":"Auf Grundlage der Start/Finish-Abbildung: Im Liegen werden die Arme mit gebeugten Ellbogen mithilfe eines Stabs geführt. Die Quelle enthält keine satzförmige Anleitung.","therapeutic_content_en":"Based on the Start/Finish illustration: while lying down, the arms are guided with bent elbows using a stick. The source contains no sentence-level instruction.","therapeutic_content_pl":"Na podstawie ilustracji Start/Finish: w leżeniu ramiona są prowadzone z ugiętymi łokciami przy użyciu kija. Źródło nie zawiera zdaniowej instrukcji.","minimum_requirements_de":"","minimum_requirements_en":"","minimum_requirements_pl":"","additional_notes_original":"Start / Finish","therapeutic_content_original":"Start / Finish","minimum_requirements_original":"","structured_content_v2":"$undefined"},{"id":"dc6b09e0-5bf3-51e7-9db5-6ea440d72e29","name_de":"Innen- und Außenrotation mit abgesenkten Armen","name_en":"Internal and External Rotation Arms Down","name_pl":"Rotacja wewnętrzna i zewnętrzna z ramionami opuszczonymi","source_page":3,"module_number":9,"name_original":"INTERNAL AND EXTERNAL ROTATION ARMS DOWN","service_codes":[],"structured_content":{"de":{"exercises":["Der andere Arm führt den Stab bei Innen- und Außenrotation mit abgesenkten Armen."],"physiotherapist_actions":["Einen beliebigen Stab vorbereiten: Gehstock, Besenstiel oder Golfschläger."]},"en":{"exercises":["The other arm guides the stick during internal and external rotation with the arms down."],"physiotherapist_actions":["Prepare any stick: a cane, broomstick, or golf club."]},"pl":{"exercises":["Druga ręka prowadzi kij podczas rotacji wewnętrznej i zewnętrznej z ramionami opuszczonymi."],"physiotherapist_actions":["Przygotuj dowolny kij: laskę, kij od miotły lub kij golfowy."]},"original":{"exercises":["Start / Finish"],"physiotherapist_actions":["You can use any stick (cane, broomstick or golf club) to do these exercises."]}},"additional_notes_de":"Visuelle Verifikation der Abbildung; die Quelle enthält keine satzförmige Anleitung.","additional_notes_en":"Visual verification of the illustration; the source contains no sentence-level instruction.","additional_notes_pl":"Weryfikacja wizualna ilustracji; źródło nie zawiera zdaniowej instrukcji.","minimum_patient_share":null,"therapeutic_content_de":"Auf Grundlage der Start/Finish-Abbildung: Der andere Arm führt den Stab bei Innen- und Außenrotation mit abgesenkten Armen. Die Quelle enthält keine satzförmige Anleitung.","therapeutic_content_en":"Based on the Start/Finish illustration: the other arm guides the stick during internal and external rotation with the arms down. The source contains no sentence-level instruction.","therapeutic_content_pl":"Na podstawie ilustracji Start/Finish: druga ręka prowadzi kij podczas rotacji wewnętrznej i zewnętrznej z ramionami opuszczonymi. Źródło nie zawiera zdaniowej instrukcji.","minimum_requirements_de":"","minimum_requirements_en":"","minimum_requirements_pl":"","additional_notes_original":"Start / Finish","therapeutic_content_original":"Start / Finish","minimum_requirements_original":"","structured_content_v2":"$undefined"},{"id":"87c1a7b6-4d00-5884-9023-e2168d42bd8d","name_de":"Innen- und Außenrotation mit angehobenen Armen","name_en":"Internal and External Rotation Arms Up","name_pl":"Rotacja wewnętrzna i zewnętrzna z ramionami uniesionymi","source_page":4,"module_number":10,"name_original":"INTERNAL AND EXTERNAL ROTATION ARMS UP","service_codes":[],"structured_content":{"de":{"exercises":["Der andere Arm führt den Stab bei Innen- und Außenrotation mit angehobenen Armen."],"physiotherapist_actions":["Einen beliebigen Stab vorbereiten: Gehstock, Besenstiel oder Golfschläger."]},"en":{"exercises":["The other arm guides the stick during internal and external rotation with the arms up."],"physiotherapist_actions":["Prepare any stick: a cane, broomstick, or golf club."]},"pl":{"exercises":["Druga ręka prowadzi kij podczas rotacji wewnętrznej i zewnętrznej z ramionami uniesionymi."],"physiotherapist_actions":["Przygotuj dowolny kij: laskę, kij od miotły lub kij golfowy."]},"original":{"exercises":["Start / Finish"],"physiotherapist_actions":["You can use any stick (cane, broomstick or golf club) to do these exercises."]}},"additional_notes_de":"Visuelle Verifikation der Abbildung; die Quelle enthält keine satzförmige Anleitung.","additional_notes_en":"Visual verification of the illustration; the source contains no sentence-level instruction.","additional_notes_pl":"Weryfikacja wizualna ilustracji; źródło nie zawiera zdaniowej instrukcji.","minimum_patient_share":null,"therapeutic_content_de":"Auf Grundlage der Start/Finish-Abbildung: Der andere Arm führt den Stab bei Innen- und Außenrotation mit angehobenen Armen. Die Quelle enthält keine satzförmige Anleitung.","therapeutic_content_en":"Based on the Start/Finish illustration: the other arm guides the stick during internal and external rotation with the arms up. The source contains no sentence-level instruction.","therapeutic_content_pl":"Na podstawie ilustracji Start/Finish: druga ręka prowadzi kij podczas rotacji wewnętrznej i zewnętrznej z ramionami uniesionymi. Źródło nie zawiera zdaniowej instrukcji.","minimum_requirements_de":"","minimum_requirements_en":"","minimum_requirements_pl":"","additional_notes_original":"Start / Finish","therapeutic_content_original":"Start / Finish","minimum_requirements_original":"","structured_content_v2":"$undefined"},{"id":"a4d114ae-ffb4-56ba-9f3e-ec8ec286c7d6","name_de":"Armheben in Rückenlage","name_en":"Arm Elevation on Back","name_pl":"Unoszenie ramienia w leżeniu na plecach","source_page":4,"module_number":11,"name_original":"ARM ELEVATION ON BACK","service_codes":[],"structured_content":{"de":{"exercises":["In Rückenlage führt der andere Arm den Stab beim Anheben des operierten Arms."],"physiotherapist_actions":["Einen beliebigen Stab vorbereiten: Gehstock, Besenstiel oder Golfschläger."]},"en":{"exercises":["While lying on the back, the other arm guides the stick during elevation of the operated arm."],"physiotherapist_actions":["Prepare any stick: a cane, broomstick, or golf club."]},"pl":{"exercises":["W leżeniu na plecach druga ręka prowadzi kij podczas unoszenia operowanej ręki."],"physiotherapist_actions":["Przygotuj dowolny kij: laskę, kij od miotły lub kij golfowy."]},"original":{"exercises":["Start / Finish"],"physiotherapist_actions":["You can use any stick (cane, broomstick or golf club) to do these exercises."]}},"additional_notes_de":"Visuelle Verifikation der Abbildung; die Quelle enthält keine satzförmige Anleitung.","additional_notes_en":"Visual verification of the illustration; the source contains no sentence-level instruction.","additional_notes_pl":"Weryfikacja wizualna ilustracji; źródło nie zawiera zdaniowej instrukcji.","minimum_patient_share":null,"therapeutic_content_de":"Auf Grundlage der Start/Finish-Abbildung: In Rückenlage führt der andere Arm den Stab beim Anheben des operierten Arms. Die Quelle enthält keine satzförmige Anleitung.","therapeutic_content_en":"Based on the Start/Finish illustration: while lying on the back, the other arm guides the stick during elevation of the operated arm. The source contains no sentence-level instruction.","therapeutic_content_pl":"Na podstawie ilustracji Start/Finish: w leżeniu na plecach druga ręka prowadzi kij podczas unoszenia operowanej ręki. Źródło nie zawiera zdaniowej instrukcji.","minimum_requirements_de":"","minimum_requirements_en":"","minimum_requirements_pl":"","additional_notes_original":"Start / Finish","therapeutic_content_original":"Start / Finish","minimum_requirements_original":"","structured_content_v2":"$undefined"},{"id":"7ce32866-3c62-579e-ba94-9058409bc197","name_de":"Armheben im Stehen","name_en":"Arm Elevation Standing","name_pl":"Unoszenie ramienia w pozycji stojącej","source_page":4,"module_number":12,"name_original":"ARM ELEVATION STANDING","service_codes":[],"structured_content":{"de":{"exercises":["Im Stand führt der andere Arm den Stab beim Anheben des operierten Arms."],"physiotherapist_actions":["Einen beliebigen Stab vorbereiten: Gehstock, Besenstiel oder Golfschläger."]},"en":{"exercises":["While standing, the other arm guides the stick during elevation of the operated arm."],"physiotherapist_actions":["Prepare any stick: a cane, broomstick, or golf club."]},"pl":{"exercises":["W pozycji stojącej druga ręka prowadzi kij podczas unoszenia operowanej ręki."],"physiotherapist_actions":["Przygotuj dowolny kij: laskę, kij od miotły lub kij golfowy."]},"original":{"exercises":["Start / Finish"],"physiotherapist_actions":["You can use any stick (cane, broomstick or golf club) to do these exercises."]}},"additional_notes_de":"Visuelle Verifikation der Abbildung; die Quelle enthält keine satzförmige Anleitung.","additional_notes_en":"Visual verification of the illustration; the source contains no sentence-level instruction.","additional_notes_pl":"Weryfikacja wizualna ilustracji; źródło nie zawiera zdaniowej instrukcji.","minimum_patient_share":null,"therapeutic_content_de":"Auf Grundlage der Start/Finish-Abbildung: Im Stand führt der andere Arm den Stab beim Anheben des operierten Arms. Die Quelle enthält keine satzförmige Anleitung.","therapeutic_content_en":"Based on the Start/Finish illustration: while standing, the other arm guides the stick during elevation of the operated arm. The source contains no sentence-level instruction.","therapeutic_content_pl":"Na podstawie ilustracji Start/Finish: w pozycji stojącej druga ręka prowadzi kij podczas unoszenia operowanej ręki. Źródło nie zawiera zdaniowej instrukcji.","minimum_requirements_de":"","minimum_requirements_en":"","minimum_requirements_pl":"","additional_notes_original":"Start / Finish","therapeutic_content_original":"Start / Finish","minimum_requirements_original":"","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"exercise_or_intervention_program","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"functional_problem","body_region_codes":["shoulder","upper_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["instruction_set"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"d7906ece-2f49-587f-a38a-e84446cf878d","slug":"au-nz-csanz-cardiac-rehab-exercise-2023","title_pl":"CSANZ — karta metadanych referencyjnych","title_de":"CSANZ — Referenz-Metadatenkarte","title_en":"CSANZ — reference metadata card","title_original":"A Clinical Guide for Assessment and Prescription of Exercise and Physical Activity in Cardiac Rehabilitation. A CSANZ Position Statement","summary_pl":"Wyłącznie metadane referencyjne; treść kliniczna nie jest publicznie udostępniona.","summary_de":"Nur Referenzmetadaten; klinische Inhalte werden nicht öffentlich bereitgestellt.","summary_en":"Reference metadata only; clinical content is not publicly provided.","country_code":"AU","source_language":"en","publication_year":2023,"version_label":"2023 · Heart, Lung and Circulation 32(9):1035–1048","target_professions":["physiotherapist","multidisciplinary_team"],"clinical_scope":"multidisciplinary","structure_type":"guideline","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"949b5296-7905-5fa2-ac13-78fdd3ac8fc8","condition_slug":"cardiac-rehabilitation-population","condition_name_pl":"Populacja rehabilitacji kardiologicznej","condition_name_de":"Population der kardiologischen Rehabilitation","condition_name_en":"Cardiac rehabilitation population","condition_name_original":"Cardiac rehabilitation population","icd_codes":[],"category_key":"cardiology","category_pl":"Choroby układu krążenia","category_de":"Herz-Kreislauf-Erkrankungen","category_en":"Cardiovascular conditions","body_regions_pl":["całe ciało"],"body_regions_de":["Ganzkörper"],"body_regions_en":["whole body"],"search_terms_pl":["rehabilitacja kardiologiczna"],"search_terms_de":["kardiologische Rehabilitation"],"search_terms_en":["cardiac rehabilitation"],"source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_title":"A Clinical Guide for Assessment and Prescription of Exercise and Physical Activity in Cardiac Rehabilitation. A CSANZ Position Statement","issuer":"CSANZ / ANZSCTS","source_country_code":"AU","jurisdiction_code":"AU-NZ","authority_level":"international_professional_society","document_type":"position_statement","source_clinical_scope":"multidisciplinary","source_target_professions":["physiotherapist","multidisciplinary_team"],"freshness_status":"current_2023","official_url":"https://doi.org/10.1016/j.hlc.2023.06.854","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","authorization_required":false,"license_note":"CC BY 4.0; attribution and change notice required. Adapted Table 1, figures, full table reproductions and graphical scales are excluded from the local clinical staging.","modules":[{"id":"2c6b5340-728d-5d76-9e69-582c1e2817c8","name_de":"Beurteilung bei Aufnahme und Entlassung","name_en":"Assessment at enrolment and discharge","name_pl":"Ocena przy włączeniu i wypisie","source_page":2,"module_number":1,"name_original":"Assessment at enrolment and discharge","service_codes":[],"structured_content":{},"additional_notes_de":"","additional_notes_en":"","additional_notes_pl":"","minimum_patient_share":null,"therapeutic_content_de":"Aerobe Leistungsfähigkeit, Muskelkraft und körperliche Aktivität mit wiederholbaren Methoden beurteilen, um Training zu individualisieren und die Reaktion zu bewerten.","therapeutic_content_en":"Assess aerobic capacity, muscle strength and physical activity with repeatable methods to individualise exercise and evaluate response.","therapeutic_content_pl":"Oceń wydolność aerobową, siłę mięśniową i aktywność fizyczną powtarzalnymi metodami, aby indywidualizować ćwiczenia i ocenić odpowiedź.","minimum_requirements_de":"","minimum_requirements_en":"","minimum_requirements_pl":"","additional_notes_original":"","therapeutic_content_original":"Assess aerobic capacity, muscle strength and physical activity with repeatable methods to individualise exercise and evaluate response.","minimum_requirements_original":"","module_kind":"assessment","structured_content_v2":{"evidence":{"items":[],"status":"not_reported"},"exercises":{"items":[],"status":"not_reported"},"assessment":{"items":[{"id":"98cd4618-1999-5966-82b9-113c14be90e2","name":{"de":"Aerobe Leistungsfähigkeit","en":"Aerobic exercise capacity","pl":"Wydolność aerobowa","original":"Aerobic exercise capacity"},"text":{"de":"Eine sichere individuelle Ausdauerverordnung ableiten.","en":"Guide a safe individualised aerobic prescription.","pl":"Dobór bezpiecznej, indywidualnej recepty aerobowej.","original":"Guide a safe individualised aerobic prescription."},"timing":{"de":"Bei Aufnahme und Entlassung","en":"At enrolment and discharge","pl":"Przy włączeniu i wypisie","original":"At enrolment and discharge"},"purpose":{"de":"Eine sichere individuelle Ausdauerverordnung ableiten.","en":"Guide a safe individualised aerobic prescription.","pl":"Dobór bezpiecznej, indywidualnej recepty aerobowej.","original":"Guide a safe individualised aerobic prescription."},"procedure":{"de":"Wenn verfügbar, CPET mit Atemgasanalyse einsetzen; andernfalls einen standardisierten Belastungs- oder Feldtest passend zu Patient und Setting wählen.","en":"Use CPET with gas analysis when available; otherwise choose a standardised graded or functional field test appropriate to the patient and setting.","pl":"Jeśli jest dostępny, zastosuj CPET z analizą gazów oddechowych; w przeciwnym razie dobierz standaryzowany test stopniowany lub terenowy odpowiedni do pacjenta i warunków.","original":"Use CPET with gas analysis when available; otherwise choose a standardised graded or functional field test appropriate to the patient and setting."},"decision_rule":null,"provenance_ids":["0a0314ac-794e-5eb2-b7ef-c70e1dc87aaf","879a5204-3c44-510e-aded-a8b6bc9e1c20","7d07475b-a0e4-50ef-b3fd-ef982e940901","49343689-82df-5bfb-8db8-d22bf2736ee4"],"threshold_or_interpretation":null},{"id":"3013b898-e4d8-5029-a650-01ba0aae712b","name":{"de":"Stufenförmiger Belastungstest","en":"Graded exercise test","pl":"Stopniowana próba wysiłkowa","original":"Graded exercise test"},"text":{"de":"Hämodynamische Reaktion beurteilen und Training dosieren.","en":"Assess haemodynamic response and guide exercise prescription.","pl":"Ocena odpowiedzi hemodynamicznej i dobór obciążenia.","original":"Assess haemodynamic response and guide exercise prescription."},"timing":{"de":"Bei Aufnahme und Entlassung","en":"At enrolment and discharge","pl":"Przy włączeniu i wypisie","original":"At enrolment and discharge"},"purpose":{"de":"Hämodynamische Reaktion beurteilen und Training dosieren.","en":"Assess haemodynamic response and guide exercise prescription.","pl":"Ocena odpowiedzi hemodynamicznej i dobór obciążenia.","original":"Assess haemodynamic response and guide exercise prescription."},"procedure":{"de":"Ein standardisiertes Laufband- oder Bein-/Arm-Ergometerprotokoll verwenden. Der Test kann bei 85 % der altersbezogenen HRmax bzw. 65 % unter gut eingestellter Betablockertherapie oder früher bei Brustschmerz, Dyspnoe, Benommenheit oder Ermüdung beendet werden.","en":"Use a standard treadmill or leg/arm-ergometer protocol. The test may be stopped at 85% of age-predicted HRmax, or 65% with well-controlled beta-blockade, or earlier for clinical indications such as chest pain, dyspnoea, light-headedness or fatigue.","pl":"Zastosuj standardowy protokół bieżni albo ergometru nożnego/ręcznego. Próbę można zakończyć przy 85% HRmax przewidywanego dla wieku albo 65% przy dobrze kontrolowanej terapii beta-adrenolitykiem, lub wcześniej z powodu bólu w klatce, duszności, zawrotów głowy albo zmęczenia.","original":"Use a standard treadmill or leg/arm-ergometer protocol. The test may be stopped at 85% of age-predicted HRmax, or 65% with well-controlled beta-blockade, or earlier for clinical indications such as chest pain, dyspnoea, light-headedness or fatigue."},"decision_rule":null,"provenance_ids":["af85e4ac-5bf4-5761-b72c-4aed1d927063"],"threshold_or_interpretation":null},{"id":"81cc6b1f-e7cc-5daa-b62b-a5e5727c9bd0","name":{"de":"Incrementeller Shuttle-Walk-Test","en":"Incremental shuttle walk test","pl":"Stopniowany wahadłowy test marszowy","original":"Incremental shuttle walk test"},"text":{"de":"Funktionelle Leistungsfähigkeit mit einem extern getakteten Feldtest messen.","en":"Measure functional exercise capacity with an externally paced field test.","pl":"Pomiar funkcjonalnej wydolności w zewnętrznie sterowanym teście terenowym.","original":"Measure functional exercise capacity with an externally paced field test."},"timing":{"de":"Bei Aufnahme und Entlassung","en":"At enrolment and discharge","pl":"Przy włączeniu i wypisie","original":"At enrolment and discharge"},"purpose":{"de":"Funktionelle Leistungsfähigkeit mit einem extern getakteten Feldtest messen.","en":"Measure functional exercise capacity with an externally paced field test.","pl":"Pomiar funkcjonalnej wydolności w zewnętrznie sterowanym teście terenowym.","original":"Measure functional exercise capacity with an externally paced field test."},"procedure":{"de":"Zwei Kegel im Abstand von 10 m aufstellen. Der Patient geht nach Audiosignalen so lange wie möglich oder bis das Tempo nicht mehr gehalten werden kann.","en":"Place two cones 10 m apart. The patient walks to audio signals for as long as possible or until unable to keep pace.","pl":"Ustaw dwa pachołki w odległości 10 m. Pacjent chodzi zgodnie z sygnałami dźwiękowymi tak długo, jak może, albo do chwili, gdy nie nadąża za tempem.","original":"Place two cones 10 m apart. The patient walks to audio signals for as long as possible or until unable to keep pace."},"decision_rule":null,"provenance_ids":["727b88f4-82fe-5246-8e1c-ca6d92b7d0b8"],"threshold_or_interpretation":null},{"id":"a9956ce9-abbc-50d7-a10f-1cc58add3ec7","name":{"de":"Sechs-Minuten-Gehtest","en":"Six-minute walk test","pl":"Sześciominutowy test marszowy","original":"Six-minute walk test"},"text":{"de":"Funktionelle Leistungsfähigkeit mit wenig Ausrüstung messen und mittlere Gehgeschwindigkeit ableiten.","en":"Measure functional capacity with minimal equipment and derive average walking speed.","pl":"Pomiar funkcjonalnej wydolności przy minimalnym sprzęcie i wyliczenie średniej prędkości chodu.","original":"Measure functional capacity with minimal equipment and derive average walking speed."},"timing":{"de":"Bei Aufnahme und Entlassung","en":"At enrolment and discharge","pl":"Przy włączeniu i wypisie","original":"At enrolment and discharge"},"purpose":{"de":"Funktionelle Leistungsfähigkeit mit wenig Ausrüstung messen und mittlere Gehgeschwindigkeit ableiten.","en":"Measure functional capacity with minimal equipment and derive average walking speed.","pl":"Pomiar funkcjonalnej wydolności przy minimalnym sprzęcie i wyliczenie średniej prędkości chodu.","original":"Measure functional capacity with minimal equipment and derive average walking speed."},"procedure":{"de":"Der Patient geht 6 Minuten auf einer flachen 20–30-m-Strecke so weit wie möglich. Mittlere Geschwindigkeit in km/h: (Distanz in Metern × 10) / 1000.","en":"The patient walks as far as possible for 6 minutes on a flat 20–30 m track. Calculate average speed in km/h as (distance in metres × 10) / 1000.","pl":"Pacjent idzie jak najdalej przez 6 minut po płaskim odcinku 20–30 m. Oblicz średnią prędkość w km/h: (dystans w metrach × 10) / 1000.","original":"The patient walks as far as possible for 6 minutes on a flat 20–30 m track. Calculate average speed in km/h as (distance in metres × 10) / 1000."},"decision_rule":null,"provenance_ids":["d4b75853-955b-5ace-9914-ea1816f36058"],"threshold_or_interpretation":null},{"id":"6c5e6d1a-24bf-54db-934a-cabb7640e3d4","name":{"de":"Muskelkraft","en":"Muscle strength","pl":"Siła mięśniowa","original":"Muscle strength"},"text":{"de":"Ausgangskraft quantifizieren, Krafttraining dosieren und Veränderungen beurteilen.","en":"Quantify baseline strength, guide resistance prescription and evaluate change.","pl":"Określenie siły wyjściowej, dobór treningu oporowego i ocena zmiany.","original":"Quantify baseline strength, guide resistance prescription and evaluate change."},"timing":{"de":"Bei Aufnahme und Entlassung","en":"At enrolment and discharge","pl":"Przy włączeniu i wypisie","original":"At enrolment and discharge"},"purpose":{"de":"Ausgangskraft quantifizieren, Krafttraining dosieren und Veränderungen beurteilen.","en":"Quantify baseline strength, guide resistance prescription and evaluate change.","pl":"Określenie siły wyjściowej, dobór treningu oporowego i ocena zmiany.","original":"Quantify baseline strength, guide resistance prescription and evaluate change."},"procedure":{"de":"1RM über den vollen Bewegungsumfang mit korrekter Technik messen und nach zwei aufeinanderfolgenden nicht korrekt möglichen Wiederholungen beenden; alternativ 1RM aus einem 3–6RM-Test schätzen oder fünf Aufstehbewegungen auf Zeit bzw. maximale Aufstehbewegungen in 30 Sekunden erfassen. Funktionstests bestimmen die Gerätelast nicht direkt.","en":"Use measured 1RM with full range and acceptable technique, ending after two consecutive failed acceptable repetitions; alternatively estimate 1RM from a 3–6RM test or use five sit-to-stands for time or maximum sit-to-stands in 30 seconds. Functional tests do not directly set equipment load.","pl":"Zmierz 1RM w pełnym zakresie i z prawidłową techniką, kończąc po dwóch kolejnych nieudanych prawidłowych powtórzeniach; alternatywnie oszacuj 1RM z próby 3–6RM albo wykonaj pięć wstań na czas lub maksymalną liczbę wstań w 30 sekund. Testy funkcjonalne nie wyznaczają bezpośrednio obciążenia na sprzęcie.","original":"Use measured 1RM with full range and acceptable technique, ending after two consecutive failed acceptable repetitions; alternatively estimate 1RM from a 3–6RM test or use five sit-to-stands for time or maximum sit-to-stands in 30 seconds. Functional tests do not directly set equipment load."},"decision_rule":null,"provenance_ids":["c601ea3c-cc04-5bfa-ac3f-f05e4de8e358","49343689-82df-5bfb-8db8-d22bf2736ee4","077d82e1-f174-52ca-bb76-12df6223bb65","810cc307-feb9-5965-914a-4d58dd4ec7d1","e36acbc3-923c-516f-b24c-351922a0499a"],"threshold_or_interpretation":null},{"id":"a51b0fc1-7667-5032-ad0e-258fef352a3e","name":{"de":"Körperliche Aktivität und Sitzverhalten","en":"Physical activity and sedentary behaviour","pl":"Aktywność fizyczna i zachowania siedzące","original":"Physical activity and sedentary behaviour"},"text":{"de":"Aktivitätsberatung anpassen und Programmreaktion messen.","en":"Tailor activity counselling and measure program response.","pl":"Dostosowanie poradnictwa aktywności i pomiar odpowiedzi na program.","original":"Tailor activity counselling and measure program response."},"timing":{"de":"Bei Aufnahme und Entlassung","en":"At enrolment and discharge","pl":"Przy włączeniu i wypisie","original":"At enrolment and discharge"},"purpose":{"de":"Aktivitätsberatung anpassen und Programmreaktion messen.","en":"Tailor activity counselling and measure program response.","pl":"Dostosowanie poradnictwa aktywności i pomiar odpowiedzi na program.","original":"Tailor activity counselling and measure program response."},"procedure":{"de":"Eine wiederholbare objektive oder subjektive Methode nutzen: Schritte, MVPA-Minuten, Fragebogen oder Aktivitätstagebuch.","en":"Use a repeatable objective or subjective method: steps, MVPA minutes, questionnaire or activity diary.","pl":"Użyj powtarzalnej metody obiektywnej lub subiektywnej: kroków, minut MVPA, kwestionariusza albo dzienniczka.","original":"Use a repeatable objective or subjective method: steps, MVPA minutes, questionnaire or activity diary."},"decision_rule":null,"provenance_ids":["5fe9ed9d-3f9a-592a-8336-14d2de8a40b3","49343689-82df-5bfb-8db8-d22bf2736ee4"],"threshold_or_interpretation":null}],"status":"reported"},"provenance":[{"id":"0a0314ac-794e-5eb2-b7ef-c70e1dc87aaf","pdf_page_to":2,"original_text":"An aerobic exercise assessment should be conducted to assess the patient’s aerobic exercise capacity.","pdf_page_from":2,"section_label":"Assessment","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"text","source_page_label_to":"2","source_page_label_from":"2","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"879a5204-3c44-510e-aded-a8b6bc9e1c20","pdf_page_to":2,"original_text":"The gold-standard assessment for aerobic exercise capacity is a cardiopulmonary exercise test (CPET) conducted on either a treadmill or cycle ergometer with gas analysis.","pdf_page_from":2,"section_label":"Assessment","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"text","source_page_label_to":"2","source_page_label_from":"2","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"7d07475b-a0e4-50ef-b3fd-ef982e940901","pdf_page_to":4,"original_text":"Six-Minute Walk Test (6MWT): Low-resource test that involves walking as far as possible in 6 minutes, along a 20–30m flat track.","pdf_page_from":4,"section_label":"Table 2 — Functional Exercise Capacity/Field Tests","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"table","source_page_label_to":"4","source_page_label_from":"4","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"c601ea3c-cc04-5bfa-ac3f-f05e4de8e358","pdf_page_to":5,"original_text":"1RM assessments: Defined as the maximum weight that can be lifted for one-repetition, through the full available range of motion and with an acceptable level of technical proficiency.","pdf_page_from":5,"section_label":"Table 2 — Muscle 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HRpeak","en":"active recovery at approximately 60% HRpeak","pl":"aktywna regeneracja przy około 60% HRpeak","original":"active recovery at approximately 60% HRpeak"},"provenance_ids":["61983d87-af58-56eb-aa0a-580becebb177"]}]},"label":{"de":"HIIT-Belastung und aktive Erholung","en":"HIIT work and active recovery","pl":"Wysiłek HIIT i aktywna regeneracja","original":"HIIT work and active recovery"},"provenance_ids":["61983d87-af58-56eb-aa0a-580becebb177"]}],"period_label":{"de":"Ausgewählter stabiler Patient","en":"Selected stable patient","pl":"Wybrany stabilny pacjent","original":"Selected stable patient"},"exercise_refs":["9e212d23-6831-5405-baa8-8a1120d05a3b"],"provenance_ids":["61983d87-af58-56eb-aa0a-580becebb177"]}],"status":"reported","variants":{"items":[{"id":"fb4989bf-eb88-56bb-9290-15e331119478","text":{"de":"MICT breit einsetzen; HIIT ausgewählten stabilen Patienten vorbehalten.","en":"Use MICT broadly; reserve HIIT for selected stable patients.","pl":"Stosuj MICT szeroko; HIIT zachowaj dla wybranych stabilnych pacjentów.","original":"Use MICT broadly; reserve HIIT for selected stable patients."},"provenance_ids":["61983d87-af58-56eb-aa0a-580becebb177"]}],"status":"reported"},"schedule_type":"source_table","entry_criteria":{"items":[{"id":"a6f81b92-7130-591e-b051-5586f97b3b87","text":{"de":"Verordnung auf Leistungsdiagnostik und individuellem Risiko aufbauen.","en":"Base prescription on aerobic-capacity assessment and individual risk.","pl":"Oprzyj receptę na ocenie wydolności i indywidualnego ryzyka.","original":"Base prescription on aerobic-capacity assessment and individual risk."},"provenance_ids":["ff4a3cc9-f431-57ad-abf4-b411c3d54a3c"]}],"status":"reported"},"regression_rules":{"items":[{"id":"14a1bff5-d2b1-5581-9011-fa1b07b1518f","text":{"de":"Kurze leichte bis moderate Intervalle mit Erholung nutzen; HIIT-Länge oder Intensität bei Bedarf reduzieren.","en":"Use short light-to-moderate bouts with recovery; reduce HIIT interval length or intensity when needed.","pl":"Stosuj krótkie lekkie lub umiarkowane odcinki z regeneracją; w razie potrzeby skróć interwały HIIT lub zmniejsz intensywność.","original":"Use short light-to-moderate bouts with recovery; reduce HIIT interval length or intensity when needed."},"provenance_ids":["336db83c-ec64-57be-8c03-b7f57f2ad430","61983d87-af58-56eb-aa0a-580becebb177"]}],"status":"reported"},"progression_rules":{"items":[{"id":"a3feb5db-ed1a-531b-8187-897b7e65d585","text":{"de":"Dauer vor Intensität steigern; bei guter Verträglichkeit meist 5–10 % alle 1–2 Wochen.","en":"Increase duration before intensity; usually 5%–10% every 1–2 weeks if tolerated.","pl":"Zwiększaj czas przed intensywnością; zwykle o 5–10% co 1–2 tygodnie przy dobrej tolerancji.","original":"Increase duration before intensity; usually 5%–10% every 1–2 weeks if tolerated."},"provenance_ids":["9efb5835-6e5c-510b-9825-8eec688576a2"]}],"status":"reported"}},"exercises":{"items":[{"id":"83e1f585-4afc-53ef-b391-0dcb50ccfd6e","dose":{"status":"reported","components":[{"id":"8593bf99-7b27-56e8-8aa7-1620f223af2f","kind":"frequency","unit":"per_week","basis":"per_week","value":3,"qualifier":{"de":"mindestens 3 Tage pro Woche","en":"3 or more days per week","pl":"co najmniej 3 dni w tygodniu","original":"3 or more days per 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Min./Woche","en":"minimum; ideal target >210 min/week","pl":"minimum; cel optymalny ponad 210 min/tydzień","original":"minimum; ideal target >210 min/week"},"provenance_ids":["def2ef4c-d3ee-5158-bf5a-803b7c54b9ae"]}]},"name":{"de":"Aerobes Training großer Muskelgruppen","en":"Aerobic exercise using large muscle groups","pl":"Ćwiczenia aerobowe angażujące duże grupy mięśni","original":"Aerobic exercise using large muscle groups"},"purpose":{"de":"Verbesserung der aeroben Leistungsfähigkeit durch individuelle kardiale Trainingsverordnung.","en":"Improve aerobic capacity with an individualised cardiac prescription.","pl":"Poprawa wydolności aerobowej w indywidualnej rehabilitacji kardiologicznej.","original":"Improve aerobic capacity with an individualised cardiac prescription."},"equipment":{"items":[{"id":"4e930578-075e-5e17-91f7-17a7d6276e37","text":{"de":"Gerät für die gewählte Ausdauerform","en":"Equipment for the selected aerobic mode","pl":"Sprzęt do wybranej formy aerobowej","original":"Equipment for the selected aerobic mode"},"provenance_ids":["834d5574-c760-56b6-abc8-8cf38207dff1"]}],"status":"reported"},"regression":{"items":[],"status":"not_reported"},"progression":{"items":[{"id":"94359bcf-c34c-568b-82cf-ec1e24348b35","text":{"de":"Zuerst die Dauer auf 30 Minuten steigern; bei guter Verträglichkeit Dauer oder Intensität alle 1–2 Wochen um 5–10 % erhöhen.","en":"Increase duration to 30 minutes before intensity; if tolerated, increase duration or intensity by 5%–10% every 1–2 weeks.","pl":"Najpierw wydłużaj czas do 30 minut; przy dobrej tolerancji zwiększaj czas lub intensywność o 5–10% co 1–2 tygodnie.","original":"Increase duration to 30 minutes before intensity; if tolerated, increase duration or intensity by 5%–10% every 1–2 weeks."},"provenance_ids":["9efb5835-6e5c-510b-9825-8eec688576a2"]}],"status":"reported"},"supervision":"mixed","instructions":{"items":[{"id":"ad6ef077-e86c-5798-82e8-fec03bc13edc","text":{"de":"Gehen, Joggen, Radfahren, Schwimmen, Rudern oder Treppensteigen; bei Einschränkungen der Beine Arm-Ergometer nutzen.","en":"Use walking, jogging, cycling, swimming, rowing or stair climbing; use arm ergometry when lower-limb problems limit use.","pl":"Stosuj marsz, trucht, rower, pływanie, wiosłowanie lub schody; przy ograniczeniach kończyn dolnych użyj ergometru ręcznego.","original":"Use walking, jogging, cycling, swimming, rowing or stair climbing; use arm ergometry when lower-limb problems limit use."},"provenance_ids":["834d5574-c760-56b6-abc8-8cf38207dff1"]}],"status":"reported"},"response_rule":{"items":[{"id":"83f631de-e211-5f89-b1d8-34363a86efaf","text":{"de":"Intensität nach gemessener Leistungsfähigkeit und Reaktion festlegen.","en":"Set intensity from assessed capacity and response.","pl":"Dobierz intensywność do ocenionej wydolności i odpowiedzi.","original":"Set intensity from assessed capacity and response."},"provenance_ids":["ff4a3cc9-f431-57ad-abf4-b411c3d54a3c"]}],"status":"reported"},"provenance_ids":["ff4a3cc9-f431-57ad-abf4-b411c3d54a3c","834d5574-c760-56b6-abc8-8cf38207dff1","def2ef4c-d3ee-5158-bf5a-803b7c54b9ae","9efb5835-6e5c-510b-9825-8eec688576a2"],"start_position":null,"movement_limits":null},{"id":"bbff5913-03da-5ce3-91ae-19ae7d157c60","dose":{"status":"reported","components":[{"id":"25eee859-fc3b-539c-a680-22b0aaa01a43","kind":"work_duration","unit":"minute","basis":"per_exercise","qualifier":null,"value_max":10,"value_min":5,"provenance_ids":["336db83c-ec64-57be-8c03-b7f57f2ad430"]},{"id":"6e254053-8753-5faa-ac76-7974b54a710c","kind":"repetitions","unit":"repetition","basis":"per_session","qualifier":{"de":"Intervalle","en":"bouts","pl":"odcinki","original":"bouts"},"value_max":3,"value_min":2,"provenance_ids":["336db83c-ec64-57be-8c03-b7f57f2ad430"]}]},"name":{"de":"Kurze Ausdauerintervalle bei geringer Leistungsfähigkeit","en":"Short aerobic bouts for low capacity","pl":"Krótkie odcinki aerobowe przy małej wydolności","original":"Short aerobic bouts for low capacity"},"purpose":{"de":"Verträgliche Ausdauerbelastung sammeln, wenn kontinuierliches Training noch nicht möglich ist.","en":"Accumulate tolerated aerobic work when continuous exercise is not yet feasible.","pl":"Zgromadzenie tolerowanej dawki wysiłku, gdy ćwiczenie ciągłe nie jest jeszcze możliwe.","original":"Accumulate tolerated aerobic work when continuous exercise is not yet feasible."},"equipment":{"items":[],"status":"not_reported"},"regression":{"items":[],"status":"not_reported"},"progression":{"items":[{"id":"e37d8d5e-c3ed-5785-a55b-91d62b570b24","text":{"de":"Schrittweise auf 30 Minuten kontinuierliche Aktivität steigern.","en":"Progress toward 30 minutes of continuous activity.","pl":"Stopniowo dąż do 30 minut ciągłej aktywności.","original":"Progress toward 30 minutes of continuous activity."},"provenance_ids":["336db83c-ec64-57be-8c03-b7f57f2ad430"]}],"status":"reported"},"supervision":"therapist_supervised","instructions":{"items":[{"id":"7de5756f-4ff8-5fda-9c0d-cfad707b4491","text":{"de":"Leichte bis moderate kontinuierliche Intervalle mit vollständiger Erholung dazwischen einsetzen.","en":"Use light-to-moderate continuous bouts with full recovery between bouts.","pl":"Stosuj lekkie lub umiarkowane odcinki ciągłe z pełną regeneracją pomiędzy nimi.","original":"Use light-to-moderate continuous bouts with full recovery between bouts."},"provenance_ids":["336db83c-ec64-57be-8c03-b7f57f2ad430"]}],"status":"reported"},"response_rule":{"items":[{"id":"d3f65331-547a-5f2d-b59e-6b5334df02ae","text":{"de":"Pausen nach Bedarf bis zur vollständigen Erholung einlegen.","en":"Add breaks as required until full recovery.","pl":"Dodawaj przerwy zależnie od potrzeby, aż do pełnej regeneracji.","original":"Add breaks as required until full recovery."},"provenance_ids":["336db83c-ec64-57be-8c03-b7f57f2ad430"]}],"status":"reported"},"provenance_ids":["336db83c-ec64-57be-8c03-b7f57f2ad430"],"start_position":null,"movement_limits":null},{"id":"9e212d23-6831-5405-baa8-8a1120d05a3b","dose":{"status":"reported","components":[{"id":"418ca6eb-14ba-59cb-95d2-b73b735905d4","kind":"frequency","unit":"per_week","basis":"per_week","value":2,"qualifier":{"de":"bei HIIT mindestens zwei hochintensive Einheiten pro Woche","en":"at least two high-intensity sessions per week when completing HIIT","pl":"przy HIIT co najmniej dwie sesje o wysokiej intensywności w tygodniu","original":"at least two high-intensity sessions per week when completing HIIT"},"provenance_ids":["ff4a3cc9-f431-57ad-abf4-b411c3d54a3c"]},{"id":"cca07f69-e94e-57e0-83c7-3a0ff3457cf4","kind":"repetitions","unit":"repetition","basis":"per_session","value":4,"qualifier":{"de":"Belastungsintervalle","en":"work intervals","pl":"odcinki wysiłkowe","original":"work 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Intervalltraining","en":"Conditional high-intensity interval training","pl":"Warunkowy trening interwałowy o wysokiej intensywności","original":"Conditional high-intensity interval training"},"purpose":{"de":"Höher intensive Option für ausgewählte stabile Patienten mit ausreichender aerober Leistungsfähigkeit.","en":"Higher-intensity option for selected stable patients with adequate aerobic capacity.","pl":"Opcja o wyższej intensywności dla wybranych stabilnych pacjentów z odpowiednią wydolnością.","original":"Higher-intensity option for selected stable patients with adequate aerobic capacity."},"equipment":{"items":[],"status":"not_reported"},"regression":{"items":[{"id":"9f535584-c7f2-5026-8671-ad3081037e10","text":{"de":"Bei geringer Leistungsfähigkeit kürzere Intervalle und/oder geringere Intensität nutzen.","en":"Use shorter intervals and/or lower intensity for reduced aerobic capacity.","pl":"Przy małej wydolności skróć interwały i/lub zmniejsz intensywność.","original":"Use shorter intervals and/or lower intensity for reduced aerobic capacity."},"provenance_ids":["61983d87-af58-56eb-aa0a-580becebb177"]}],"status":"reported"},"progression":{"items":[{"id":"0317e0c9-aa24-56a5-b1b2-d90b1d872ae8","text":{"de":"Erst nach kurzer moderater Trainingsphase steigern, wenn die Leistungsfähigkeit dies zulässt.","en":"Progress after a brief period of moderate training only when capacity supports it.","pl":"Przejdź po krótkim okresie treningu umiarkowanego tylko przy odpowiedniej wydolności.","original":"Progress after a brief period of moderate training only when capacity supports it."},"provenance_ids":["61983d87-af58-56eb-aa0a-580becebb177"]}],"status":"reported"},"supervision":"therapist_supervised","instructions":{"items":[{"id":"2fb1275c-b05d-57f0-ae51-5f5150b4b986","text":{"de":"Aufwärmen, vier Belastungsintervalle mit aktiver Erholung und Abkühlen; Länge und Intensität anpassen.","en":"Use warm-up, four work intervals with active recovery and cool-down; tailor interval length and intensity.","pl":"Zastosuj rozgrzewkę, cztery odcinki wysiłkowe z aktywną regeneracją i schłodzenie; dopasuj długość oraz intensywność.","original":"Use warm-up, four work intervals with active recovery and cool-down; tailor interval length and intensity."},"provenance_ids":["61983d87-af58-56eb-aa0a-580becebb177"]}],"status":"reported"},"response_rule":{"items":[{"id":"6d1253f6-adee-5239-b36e-834b9fc2c82f","text":{"de":"HIIT nur bei ausgewählten stabilen Patienten einsetzen; nicht allgemein anwenden.","en":"Use HIIT only for selected stable patients; it is not universal.","pl":"Stosuj HIIT tylko u wybranych stabilnych pacjentów; nie jest uniwersalny.","original":"Use HIIT only for selected stable patients; it is not universal."},"provenance_ids":["61983d87-af58-56eb-aa0a-580becebb177"]}],"status":"reported"},"provenance_ids":["61983d87-af58-56eb-aa0a-580becebb177"],"start_position":null,"movement_limits":null}],"status":"reported"},"assessment":{"items":[],"status":"not_reported"},"provenance":[{"id":"ff4a3cc9-f431-57ad-abf4-b411c3d54a3c","pdf_page_to":8,"original_text":"3 or more days per week. Moderate-to-high intensity (e.g., 55%–90% HRmax, RPE 12–16) based on assessment of aerobic capacity. Session duration >30 min of total aerobic exercise.","pdf_page_from":8,"section_label":"Table 3 — Aerobic Exercise","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"table","source_page_label_to":"8","source_page_label_from":"8","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"336db83c-ec64-57be-8c03-b7f57f2ad430","pdf_page_to":8,"original_text":"For patients who are severely deconditioned or have symptoms at low workloads, it is recommended to start with bouts of light-moderate continuous exercise of 5–10 min in duration with breaks as required, to allow full recovery and repeat 2–3 times.","pdf_page_from":8,"section_label":"Table 3 — Aerobic Exercise: Time","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"table","source_page_label_to":"8","source_page_label_from":"8","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"834d5574-c760-56b6-abc8-8cf38207dff1","pdf_page_to":8,"original_text":"A variety of aerobic modes of exercise are recommended that use large muscle groups such as walking, jogging, cycling, swimming, rowing, stair climbing.","pdf_page_from":8,"section_label":"Table 3 — Aerobic Exercise: Type","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"table","source_page_label_to":"8","source_page_label_from":"8","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"def2ef4c-d3ee-5158-bf5a-803b7c54b9ae","pdf_page_to":8,"original_text":"A minimum of 150 minutes of moderate-high intensity aerobic exercise, with an ideal target of >210 min per week for increased cardiometabolic benefit.","pdf_page_from":8,"section_label":"Table 3 — Aerobic Exercise: Volume","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"table","source_page_label_to":"8","source_page_label_from":"8","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"61983d87-af58-56eb-aa0a-580becebb177","pdf_page_to":7,"original_text":"The most commonly used HIIT model is a warm-up, followed by 4x4-min intervals at 75%–90% peak heart rate (HRpeak) with an active recovery phase of 3-min between bouts at approximately 60% HRpeak, followed by a cool-down.","pdf_page_from":7,"section_label":"Moderate-Intensity Continuous Training Versus High-Intensity Interval Training","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"text","source_page_label_to":"7","source_page_label_from":"7","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"9efb5835-6e5c-510b-9825-8eec688576a2","pdf_page_to":9,"original_text":"Start slowly and progress gradually, increasing duration to meet 30 min before increasing intensity. Increases in intensity and duration of 5%–10% every 1–2 weeks are typically well-tolerated within cardiac patients.","pdf_page_from":9,"section_label":"Table 3 — Aerobic Exercise: Progression","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"table","source_page_label_to":"9","source_page_label_from":"9","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}}],"content_kind":"exercise_schedule","contract_version":"1.2","therapist_actions":{"items":[{"id":"cda7b25e-f43f-5fd1-a687-82b9f62a8740","text":{"de":"Häufigkeit, relative Intensität, Sitzungsdauer, Trainingsart und Wochenumfang anhand von Ausdauerbefund, Bedürfnissen, Präferenzen und Risiko verordnen.","en":"Prescribe frequency, relative intensity, session time, mode and weekly volume from aerobic assessment, 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possible.","pl":"Stosuj ćwiczenia całego ciała, jedno- lub wielostawowe, w miarę możliwości obustronne.","original":"Use whole-body, single- or multi-joint exercises, bilaterally where possible."},"provenance_ids":["e16f2759-1ac7-5c87-b20b-06dd957e159b"]},{"id":"ef13f3bd-8557-55d6-96fc-447ba25634db","text":{"de":"Atemanhalten und Valsalva-Manöver vermeiden. Erklären, dass Muskelspannung normal ist und anfänglicher Muskelkater bei weiteren Einheiten meist abnimmt.","en":"Avoid breath-holding and the Valsalva manoeuvre. Explain that muscle tension is normal and early muscle soreness commonly reduces with subsequent sessions.","pl":"Unikaj wstrzymywania oddechu i manewru Valsalvy. Wyjaśnij, że napięcie mięśni jest prawidłowym odczuciem, a wczesna bolesność mięśni zwykle zmniejsza się podczas kolejnych sesji.","original":"Avoid breath-holding and the Valsalva manoeuvre. 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Recommend 48 hours between sessions, where possible, to maximise muscular recovery. Moderate-to-high intensity (e.g., 50%–80% 1RM or 5–7 RPE). Session duration: >20 min. Duration of muscle contraction >4 second per repetition (>1 s concentric phase, >3 s eccentric phase). Rest between sets: 60 s.","pdf_page_from":8,"section_label":"Table 3 — Resistance Exercise","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"table","source_page_label_to":"8","source_page_label_from":"8","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"e16f2759-1ac7-5c87-b20b-06dd957e159b","pdf_page_to":8,"original_text":"Whole body, single- or multi-joint exercises, performed bilaterally where possible. May include a range of modalities including bodyweight, free-weights, machine weights and elastic resistance bands.","pdf_page_from":8,"section_label":"Table 3 — Resistance Exercise: Type","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"table","source_page_label_to":"8","source_page_label_from":"8","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"437b8e1f-26ef-5ce4-a0ea-ef255b8fb2fe","pdf_page_to":8,"original_text":"Total session volume per major muscle group = 15–36 repetitions, arranged as 1–3 sets of 8–15 repetitions.","pdf_page_from":8,"section_label":"Table 3 — Resistance Exercise: Volume","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"table","source_page_label_to":"8","source_page_label_from":"8","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"dcd62d6c-b08c-53ee-b6e3-d90d526cf242","pdf_page_to":9,"original_text":"Progress repetitions before sets or intensity, up to a maximum of 15. Once 15 reps can be completed with ease, then intensity should be progressed to 4–6 on RPE scale at a new target of 8–10 reps.","pdf_page_from":9,"section_label":"Table 3 — Resistance Exercise: Progression","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"table","source_page_label_to":"9","source_page_label_from":"9","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"dc389244-1753-5255-b1a4-bf579872d804","pdf_page_to":9,"original_text":"Clinicians should embed clear, concise instructions for each exercise and simple, consistent feedback at the conclusion of each set.","pdf_page_from":9,"section_label":"Prescribing and Progressing Resistance Exercise","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"text","source_page_label_to":"9","source_page_label_from":"9","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"85a06665-db47-5f28-9d8b-c1884090fbf7","pdf_page_to":10,"original_text":"The recommendation for preliminary sessions is to commence at lower ranges of the recommended intensity so that patients can primarily focus on technique without being hampered by muscular fatigue.","pdf_page_from":10,"section_label":"Prescribing and Progressing Resistance Exercise","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"text","source_page_label_to":"10","source_page_label_from":"10","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"b9e65b11-2cab-5424-bb58-c66788560270","pdf_page_to":9,"original_text":"Patients should be advised that breath-holding (Valsalva manoeuvre) should be avoided during resistance exercise; muscle tension is a normal sensation; and muscle soreness is common in the first few days but reduces with subsequent exposures.","pdf_page_from":9,"section_label":"Prescribing and Progressing Resistance 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not hinder technique learning."},"target":{"de":"Fachperson der kardiologischen Rehabilitation oder Bewegungsspezialist","en":"Cardiac rehabilitation clinician or exercise specialist","pl":"Klinicysta rehabilitacji kardiologicznej lub specjalista terapii ruchem","original":"Cardiac rehabilitation clinician or exercise specialist"},"performer":"other_reported","provenance_ids":["85a06665-db47-5f28-9d8b-c1884090fbf7"]}],"status":"reported"},"monitoring_and_safety":{"items":[{"id":"b787a350-9d60-5759-90a3-ec23c7249273","text":{"de":"Den Patienten anweisen, beim Krafttraining den Atem nicht anzuhalten und kein Valsalva-Manöver auszuführen.","en":"Teach the patient not to hold breath or perform the Valsalva manoeuvre during resistance exercise.","pl":"Naucz pacjenta, aby nie wstrzymywał oddechu ani nie wykonywał manewru Valsalvy podczas ćwiczeń oporowych.","original":"Teach the patient not to hold breath or perform the Valsalva manoeuvre during resistance 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short bouts when baseline activity is very low.","therapeutic_content_pl":"Przełóż cele tygodniowe na lubianą aktywność codzienną, ograniczaj siedzenie i przy bardzo małej aktywności zaczynaj od krótkich odcinków.","minimum_requirements_de":"","minimum_requirements_en":"","minimum_requirements_pl":"","additional_notes_original":"","therapeutic_content_original":"Turn weekly targets into enjoyable daily activity, reduce sitting and start with short bouts when baseline activity is very low.","minimum_requirements_original":"","module_kind":"intervention","structured_content_v2":{"evidence":{"items":[],"status":"not_reported"},"exercises":{"items":[{"id":"aea521e1-6b5a-5caf-a217-0a860e1f379a","dose":{"status":"reported","components":[{"id":"72e32dd8-e7d1-5889-8e40-5d199bb5be57","kind":"session_duration","unit":"minute","basis":"per_week","qualifier":null,"value_max":300,"value_min":150,"provenance_ids":["4f3ae249-1e33-53cd-81bb-4c9321597f37"]},{"id":"faf4ea4c-099b-59a4-9046-f31953f87295","kind":"session_duration","unit":"minute","basis":"per_week","value":150,"qualifier":{"de":"MVPA-Minimum","en":"minimum MVPA","pl":"minimum MVPA","original":"minimum MVPA"},"provenance_ids":["578eafbf-b1cd-5837-90fc-3eaeeb7cb474"]},{"id":"86875289-f1a5-5e14-9cb0-39e0ff667518","kind":"other","unit":"step","basis":"per_day","value":7500,"qualifier":{"de":"mindestens 7.500 Schritte täglich","en":"at least 7,500 steps per day","pl":"co najmniej 7500 kroków dziennie","original":"at least 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days."},"provenance_ids":["55a0164d-d2cd-5707-a0ff-a30f8c50ee00"]}],"status":"reported"},"response_rule":{"items":[],"status":"not_reported"},"provenance_ids":["55a0164d-d2cd-5707-a0ff-a30f8c50ee00","4f3ae249-1e33-53cd-81bb-4c9321597f37","578eafbf-b1cd-5837-90fc-3eaeeb7cb474"],"start_position":null,"movement_limits":null},{"id":"b3645f37-944a-5a7c-803b-075b1df8107b","dose":{"status":"reported","components":[{"id":"52cb027a-1f98-5707-bf63-a40783e320d3","kind":"session_duration","unit":"minute","basis":"per_week","qualifier":null,"value_max":150,"value_min":75,"provenance_ids":["4f3ae249-1e33-53cd-81bb-4c9321597f37"]}]},"name":{"de":"Körperliche Aktivität hoher Intensität — alternatives Wochenziel","en":"Vigorous-intensity physical activity — alternative weekly target","pl":"Aktywność o dużej intensywności — alternatywny cel tygodniowy","original":"Vigorous-intensity physical activity — alternative weekly target"},"purpose":{"de":"Nach geeigneter Beurteilung als hochintensive Alternative 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patients"},"purpose":{"de":"Belastbarkeit mit kurzen Einheiten aufbauen.","en":"Build tolerance from short bouts.","pl":"Budowanie tolerancji od krótkich odcinków.","original":"Build tolerance from short bouts."},"equipment":{"items":[],"status":"not_reported"},"regression":{"items":[],"status":"not_reported"},"progression":{"items":[{"id":"45df7524-d88e-5a7a-bac2-8d3a33bacbdb","text":{"de":"Auf 30 Minuten moderate Aktivität oder 7.500 Schritte an den meisten Tagen steigern.","en":"Progress toward 30 minutes of moderate activity or 7,500 steps on most days.","pl":"Dąż do 30 minut umiarkowanej aktywności lub 7500 kroków przez większość dni.","original":"Progress toward 30 minutes of moderate activity or 7,500 steps on most days."},"provenance_ids":["f5218d9a-f35c-5924-8935-08890790f67b"]}],"status":"reported"},"supervision":"mixed","instructions":{"items":[{"id":"9948bb10-d40b-5f62-a7b3-5f4660df35be","text":{"de":"Kurze Einheiten bei Bedarf über den Tag verteilen.","en":"Spread short 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A variety of MVPA is recommended including domestic, occupational, transportation and leisure activities.","pdf_page_from":8,"section_label":"Table 3 — Physical Activity","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"table","source_page_label_to":"8","source_page_label_from":"8","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"f5218d9a-f35c-5924-8935-08890790f67b","pdf_page_to":9,"original_text":"If appropriate, individuals may start with as little as 2–5 minutes of activity, 3–4 times a day. Progress towards 30 min of moderate intensity physical activity or 7,500 steps on most days.","pdf_page_from":9,"section_label":"Table 3 — Physical Activity: Progression","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"table","source_page_label_to":"9","source_page_label_from":"9","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"4f3ae249-1e33-53cd-81bb-4c9321597f37","pdf_page_to":10,"original_text":"Individuals should complete 150–300 minutes of moderate intensity aerobic physical activity; or 75–150 minutes of vigorous intensity aerobic physical activity or a combination of both per week.","pdf_page_from":10,"section_label":"Physical Activity","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"text","source_page_label_to":"10","source_page_label_from":"10","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"e403c533-0d0a-58a9-be5f-0655d483c69c","pdf_page_to":11,"original_text":"An individual’s goals, motivation and confidence to increase physical activity in everyday life should be reviewed as part of a comprehensive assessment, with each patient receiving an individually tailored physical activity program based on these findings.","pdf_page_from":11,"section_label":"Prescribing and Progressing Physical Activity","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"text","source_page_label_to":"11","source_page_label_from":"11","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"578eafbf-b1cd-5837-90fc-3eaeeb7cb474","pdf_page_to":8,"original_text":"Aim for at least 150 minutes of MVPA per week or at least 7,500 steps per day. Weekly activity does not need to be accumulated in 10-minute bouts; break up long sedentary periods with activity of any intensity, including light intensity.","pdf_page_from":8,"section_label":"Table 3 — Physical Activity: Volume","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"table","source_page_label_to":"8","source_page_label_from":"8","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"dac90c5d-f817-50d8-ab0e-443ae734d6af","pdf_page_to":10,"original_text":"Muscle strengthening should be completed on at least two days per week and varied functional balance and strength activities should be completed three days per week.","pdf_page_from":10,"section_label":"Physical Activity","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"text","source_page_label_to":"10","source_page_label_from":"10","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}}],"content_kind":"intervention","contract_version":"1.2","therapist_actions":{"items":[{"id":"166a6c1a-36a4-5d9d-a866-cedd32a1373d","text":{"de":"Ziele, Motivation und Zutrauen prüfen und Aktivität an Fähigkeiten, Präferenzen, funktionelle Einschränkungen, Medikation und Behandlung anpassen.","en":"Review goals, motivation and confidence, then tailor activity to abilities, preferences, functional limitations, medication and treatment.","pl":"Oceń cele, motywację i pewność pacjenta, a następnie dostosuj aktywność do możliwości, preferencji, ograniczeń funkcjonalnych, leków i leczenia.","original":"Review goals, motivation and confidence, then tailor activity to abilities, preferences, functional limitations, medication and treatment."},"target":{"de":"Fachperson der kardiologischen Rehabilitation oder Bewegungsspezialist","en":"Cardiac rehabilitation clinician or exercise specialist","pl":"Klinicysta rehabilitacji kardiologicznej lub specjalista terapii ruchem","original":"Cardiac rehabilitation clinician or exercise specialist"},"performer":"other_reported","provenance_ids":["e403c533-0d0a-58a9-be5f-0655d483c69c"]},{"id":"ec749306-a10d-517e-8d0a-bcfe74137fab","text":{"de":"Angenehme Aktivität in Haushalt, Beruf, Transport und Freizeit integrieren. Langes Sitzen durch Aktivität beliebiger Intensität unterbrechen; die Einheiten müssen nicht 10 Minuten dauern.","en":"Add enjoyable activity to existing domestic, occupational, transport and leisure routines. Break up long sitting periods with activity of any intensity; bouts do not need to last 10 minutes.","pl":"Włączaj lubianą aktywność do obowiązków domowych, pracy, transportu i czasu wolnego. Przerywaj długie siedzenie aktywnością o dowolnej intensywności; odcinki nie muszą trwać 10 minut.","original":"Add enjoyable activity to existing domestic, occupational, transport and leisure routines. Break up long sitting periods with activity of any intensity; bouts do not need to last 10 minutes."},"target":{"de":"Fachperson der kardiologischen Rehabilitation oder Bewegungsspezialist","en":"Cardiac rehabilitation clinician or exercise specialist","pl":"Klinicysta rehabilitacji kardiologicznej lub specjalista terapii ruchem","original":"Cardiac rehabilitation clinician or exercise specialist"},"performer":"other_reported","provenance_ids":["55a0164d-d2cd-5707-a0ff-a30f8c50ee00","578eafbf-b1cd-5837-90fc-3eaeeb7cb474"]}],"status":"reported"},"monitoring_and_safety":{"items":[],"status":"not_reported"},"protection_and_loading":{"items":[],"status":"not_applicable"},"unmapped_source_content":{"items":[],"status":"not_applicable"},"progression_and_completion":{"items":[],"status":"not_reported"}}},{"id":"dc80b96d-e551-5f5e-a86b-a1aedd759b6d","name_de":"Sicherheit, Kontraindikationen und Monitoring","name_en":"Safety, contraindications and monitoring","name_pl":"Bezpieczeństwo, przeciwwskazania i monitorowanie","source_page":3,"module_number":6,"name_original":"Safety, contraindications and monitoring","service_codes":[],"structured_content":{},"additional_notes_de":"","additional_notes_en":"","additional_notes_pl":"","minimum_patient_share":null,"therapeutic_content_de":"Vor überwachten Übungen screenen, Reaktion überwachen, Notfallmaßnahmen vermitteln und Vorsicht nach Sternotomie individualisieren.","therapeutic_content_en":"Screen before supervised exercise, monitor response, teach emergency action and individualise precautions after sternotomy.","therapeutic_content_pl":"Wykonuj screening przed ćwiczeniami nadzorowanymi, monitoruj odpowiedź, ucz postępowania alarmowego i indywidualizuj środki ostrożności po sternotomii.","minimum_requirements_de":"","minimum_requirements_en":"","minimum_requirements_pl":"","additional_notes_original":"","therapeutic_content_original":"Screen before supervised exercise, monitor response, teach emergency action and individualise precautions after sternotomy.","minimum_requirements_original":"","module_kind":"safety","structured_content_v2":{"evidence":{"items":[],"status":"not_reported"},"exercises":{"items":[],"status":"not_reported"},"assessment":{"items":[],"status":"not_reported"},"provenance":[{"id":"d171a4c2-6684-52db-a1bc-92b1ecfa0008","pdf_page_to":3,"original_text":"Relative contraindications are a guide only and should be combined with clinical judgement at every session. If in doubt, medical advice should be sought before commencing an exercise or physical activity assessment or session.","pdf_page_from":3,"section_label":"Table 1 — contraindications note","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"table","source_page_label_to":"3","source_page_label_from":"3","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"192b926d-262d-5538-95c8-d232e0c5b44e","pdf_page_to":11,"original_text":"Prior to each supervised exercise session, it is recommended to assess the patient’s contraindications to exercise, measuring pre-exercise heart rate and blood pressure, to ensure that they are within an acceptable range at rest.","pdf_page_from":11,"section_label":"Safety and Monitoring","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"text","source_page_label_to":"11","source_page_label_from":"11","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"9c6e2a6f-1991-5642-bc50-0d76dcbf6006","pdf_page_to":11,"original_text":"During exercise it is recommended to monitor the patient’s heart rate and RPE (or Borg Scale for Dyspnoea in patients with heart failure).","pdf_page_from":11,"section_label":"Safety and Monitoring","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"text","source_page_label_to":"11","source_page_label_from":"11","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"2be92e8c-d155-50b6-9d2d-48f317779bc2","pdf_page_to":11,"original_text":"A warm-up and cool-down should be included in all exercise sessions and physical activity for 5–10 minutes.","pdf_page_from":11,"section_label":"Safety and Monitoring","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"text","source_page_label_to":"11","source_page_label_from":"11","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"7a83cbe8-e54a-5c73-95f6-447fc3d0fd54","pdf_page_to":11,"original_text":"Keep your move in the tube is a paradigm shift that promotes upper limb activity and exercise using short lever arms by performing activities close to the body.","pdf_page_from":11,"section_label":"Safety and Monitoring","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"text","source_page_label_to":"11","source_page_label_from":"11","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"5e17f2c3-9c75-54d2-a9b1-f0ac452c147b","pdf_page_to":11,"original_text":"During unsupervised exercise and physical activity, individuals should monitor their intensity and symptoms (i.e., chest pain, dizziness, nausea, feeling unwell, excessive sweatiness). If patients experience any warning signs of a cardiac event, then they should be encouraged to call an ambulance immediately.","pdf_page_from":11,"section_label":"Safety and Monitoring","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"text","source_page_label_to":"11","source_page_label_from":"11","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"80162da9-aaac-5540-87a0-879768bfd90e","pdf_page_to":9,"original_text":"Clinicians should consider all relevant contraindications before resistance exercise testing, including the sternal stability of post-sternotomy patients before commencing upper-body resistance training.","pdf_page_from":9,"section_label":"Resistance Exercise — Assessment","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"text","source_page_label_to":"9","source_page_label_from":"9","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"5105da3d-0f40-5718-84ba-b6ad006b029c","pdf_page_to":11,"original_text":"As patients progress and cardiac disease is stable with no symptoms, pre-exercise heart-rate and blood-pressure measurements are not necessary and may be counterproductive to confidence around unsupervised activity.","pdf_page_from":11,"section_label":"Safety and Monitoring","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"text","source_page_label_to":"11","source_page_label_from":"11","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"61d442f4-5d3d-5f4e-8006-9382dae7210a","pdf_page_to":11,"original_text":"Centre-based exercise sessions should have basic safety standards and procedures, including a defibrillator and resuscitative and first-aid equipment on site.","pdf_page_from":11,"section_label":"Safety and Monitoring","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"text","source_page_label_to":"11","source_page_label_from":"11","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"d322d812-f01e-5ebe-b974-c3a11d1f1854","pdf_page_to":11,"original_text":"Medical review is generally unnecessary before light-to-moderate physical activity unless contraindications are known. Vigorous or high-intensity physical activity requires full clinical assessment and medical review.","pdf_page_from":11,"section_label":"Prescribing and Progressing Physical Activity","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"text","source_page_label_to":"11","source_page_label_from":"11","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"8918d09f-1e72-57ca-ad30-ff422f6f4a3e","pdf_page_to":11,"original_text":"For community activity advise comfortable clothing and footwear, adequate fluid intake, and avoiding activity after heavy meals, during illness and in extreme temperatures.","pdf_page_from":11,"section_label":"Safety and Monitoring","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"text","source_page_label_to":"11","source_page_label_from":"11","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"58897216-f344-5758-9d0f-89ccfc49c813","pdf_page_to":11,"original_text":"Continuous ECG monitoring is not essential in supervised exercise; it can be beneficial in circumstances such as atrial fibrillation or a history of significant ventricular arrhythmias when signs or symptoms require further investigation.","pdf_page_from":11,"section_label":"Safety and Monitoring","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"text","source_page_label_to":"11","source_page_label_from":"11","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}}],"content_kind":"safety","contract_version":"1.2","therapist_actions":{"items":[{"id":"8a252e06-99ab-5c43-a0cc-1eb73273e70d","text":{"de":"Vor jeder überwachten Einheit Kontraindikationen, Ruhepuls und Blutdruck prüfen; bei Unsicherheit ärztlichen Rat einholen. Bei stabiler Erkrankung und Symptomfreiheit können wiederholte Messungen vor jeder Einheit entfallen.","en":"Before each supervised session check contraindications, resting heart rate and blood pressure; seek medical advice when uncertain. Once disease is stable and the patient remains asymptomatic, repeated pre-session measurements may no longer be needed.","pl":"Przed każdą nadzorowaną sesją sprawdź przeciwwskazania, spoczynkowe tętno i ciśnienie; przy wątpliwościach zasięgnij porady lekarskiej. Gdy choroba jest stabilna, a pacjent pozostaje bezobjawowy, powtarzanie pomiarów przed każdą sesją może nie być już potrzebne.","original":"Before each supervised session check contraindications, resting heart rate and blood pressure; seek medical advice when uncertain. Once disease is stable and the patient remains asymptomatic, repeated pre-session measurements may no longer be needed."},"target":{"de":"Fachperson der kardiologischen Rehabilitation oder Bewegungsspezialist","en":"Cardiac rehabilitation clinician or exercise specialist","pl":"Klinicysta rehabilitacji kardiologicznej lub specjalista terapii ruchem","original":"Cardiac rehabilitation clinician or exercise specialist"},"performer":"other_reported","provenance_ids":["d171a4c2-6684-52db-a1bc-92b1ecfa0008","192b926d-262d-5538-95c8-d232e0c5b44e","5105da3d-0f40-5718-84ba-b6ad006b029c"]},{"id":"2116faba-466a-5f0b-a436-f2beab0f7254","text":{"de":"Während des Ausdauertrainings Herzfrequenz und RPE überwachen; bei Herzinsuffizienz die Borg-Dyspnoe-Skala verwenden. Ein EKG ist nicht routinemäßig erforderlich, aber bei Vorhofflimmern, bedeutsamen ventrikulären Arrhythmien in der Vorgeschichte oder auffälligen Zeichen sinnvoll.","en":"During aerobic exercise monitor heart rate and RPE; use the Borg Dyspnoea Scale for heart failure. ECG is not routinely essential, but use it when circumstances such as atrial fibrillation, significant ventricular arrhythmia history or concerning signs warrant it.","pl":"Podczas wysiłku aerobowego monitoruj tętno i RPE; w niewydolności serca używaj skali duszności Borga. EKG nie jest rutynowo konieczne, ale zastosuj je, gdy wskazują na to np. migotanie przedsionków, istotne arytmie komorowe w wywiadzie lub niepokojące objawy.","original":"During aerobic exercise monitor heart rate and RPE; use the Borg Dyspnoea Scale for heart failure. ECG is not routinely essential, but use it when circumstances such as atrial fibrillation, significant ventricular arrhythmia history or concerning signs warrant it."},"target":{"de":"Fachperson der kardiologischen Rehabilitation oder Bewegungsspezialist","en":"Cardiac rehabilitation clinician or exercise specialist","pl":"Klinicysta rehabilitacji kardiologicznej lub specjalista terapii ruchem","original":"Cardiac rehabilitation clinician or exercise specialist"},"performer":"other_reported","provenance_ids":["9c6e2a6f-1991-5642-bc50-0d76dcbf6006","58897216-f344-5758-9d0f-89ccfc49c813"]},{"id":"d96a2da8-0487-51fe-ae22-52be75045e18","text":{"de":"In jede Sitzung 5–10 Minuten Aufwärmen und 5–10 Minuten Abkühlen einbauen.","en":"Include 5–10 minutes of warm-up and 5–10 minutes of cool-down in every session.","pl":"W każdej sesji uwzględnij 5–10 minut rozgrzewki i 5–10 minut schłodzenia.","original":"Include 5–10 minutes of warm-up and 5–10 minutes of cool-down in every session."},"target":{"de":"Fachperson der kardiologischen Rehabilitation oder Bewegungsspezialist","en":"Cardiac rehabilitation clinician or exercise specialist","pl":"Klinicysta rehabilitacji kardiologicznej lub specjalista terapii ruchem","original":"Cardiac rehabilitation clinician or exercise specialist"},"performer":"other_reported","provenance_ids":["2be92e8c-d155-50b6-9d2d-48f317779bc2"]},{"id":"8a81eb40-8bea-5f95-a979-a2cfc50e7533","text":{"de":"Nach frischer Sternotomie vor Krafttraining des Oberkörpers die Sternumstabilität prüfen. Körpernahe Armaktivität mit kurzen Hebeln innerhalb sicherer Schmerzgrenzen anleiten.","en":"After recent sternotomy assess sternal stability before upper-body resistance exercise. Teach upper-limb activity close to the body with short lever arms, within safe pain limits.","pl":"Po niedawnej sternotomii oceń stabilność mostka przed treningiem oporowym górnej części ciała. Ucz aktywności kończyn górnych blisko ciała, z krótkimi dźwigniami, w bezpiecznych granicach bólu.","original":"After recent sternotomy assess sternal stability before upper-body resistance exercise. Teach upper-limb activity close to the body with short lever arms, within safe pain limits."},"target":{"de":"Fachperson der kardiologischen Rehabilitation oder Bewegungsspezialist","en":"Cardiac rehabilitation clinician or exercise specialist","pl":"Klinicysta rehabilitacji kardiologicznej lub specjalista terapii ruchem","original":"Cardiac rehabilitation clinician or exercise specialist"},"performer":"other_reported","provenance_ids":["7a83cbe8-e54a-5c73-95f6-447fc3d0fd54","80162da9-aaac-5540-87a0-879768bfd90e"]},{"id":"226d5c44-bf67-553a-94a4-47026b45bc2f","text":{"de":"Bei zentrumsbasierten Einheiten Defibrillator sowie Reanimations- und Erste-Hilfe-Ausrüstung vor Ort sicherstellen.","en":"For centre-based sessions ensure a defibrillator plus resuscitation and first-aid equipment are available on site.","pl":"Podczas sesji w ośrodku zapewnij na miejscu defibrylator oraz sprzęt do resuscytacji i pierwszej pomocy.","original":"For centre-based sessions ensure a defibrillator plus resuscitation and first-aid equipment are available on site."},"target":{"de":"Fachperson der kardiologischen Rehabilitation oder Bewegungsspezialist","en":"Cardiac rehabilitation clinician or exercise specialist","pl":"Klinicysta rehabilitacji kardiologicznej lub specjalista terapii ruchem","original":"Cardiac rehabilitation clinician or exercise specialist"},"performer":"other_reported","provenance_ids":["61d442f4-5d3d-5f4e-8006-9382dae7210a"]},{"id":"ddef3d7a-44b6-5474-b025-97e8b264243a","text":{"de":"Leichte bis moderate Aktivität erfordert im Allgemeinen keine ärztliche Beurteilung, sofern keine Kontraindikationen bekannt sind; vor intensiver oder hochintensiver Aktivität vollständige klinische und ärztliche Beurteilung einholen.","en":"Light-to-moderate activity generally does not require medical review unless contraindications are known; obtain a full clinical assessment and medical review before vigorous or high-intensity activity.","pl":"Aktywność lekka lub umiarkowana zwykle nie wymaga konsultacji lekarskiej, chyba że występują znane przeciwwskazania; przed aktywnością intensywną lub o dużej intensywności wykonaj pełną ocenę kliniczną i uzyskaj konsultację lekarską.","original":"Light-to-moderate activity generally does not require medical review unless contraindications are known; obtain a full clinical assessment and medical review before vigorous or high-intensity activity."},"target":{"de":"Fachperson der kardiologischen Rehabilitation oder Bewegungsspezialist","en":"Cardiac rehabilitation clinician or exercise specialist","pl":"Klinicysta rehabilitacji kardiologicznej lub specjalista terapii ruchem","original":"Cardiac rehabilitation clinician or exercise specialist"},"performer":"other_reported","provenance_ids":["d322d812-f01e-5ebe-b974-c3a11d1f1854"]},{"id":"3158a921-4da3-579e-9734-04c46f77d357","text":{"de":"Für Aktivität außerhalb des Zentrums bequeme Kleidung und Schuhe sowie ausreichende Flüssigkeitszufuhr empfehlen; nicht nach schweren Mahlzeiten, bei Erkrankung oder extremen Temperaturen trainieren.","en":"For community activity advise comfortable clothing and footwear, adequate fluid intake, and no exercise after heavy meals, during illness or in extreme temperatures.","pl":"Przy aktywności poza ośrodkiem zaleć wygodną odzież i obuwie, odpowiednie nawodnienie oraz niewykonywanie ćwiczeń po ciężkim posiłku, podczas choroby ani przy skrajnych temperaturach.","original":"For community activity advise comfortable clothing and footwear, adequate fluid intake, and no exercise after heavy meals, during illness or in extreme temperatures."},"target":{"de":"Fachperson der kardiologischen Rehabilitation oder Bewegungsspezialist","en":"Cardiac rehabilitation clinician or exercise specialist","pl":"Klinicysta rehabilitacji kardiologicznej lub specjalista terapii ruchem","original":"Cardiac rehabilitation clinician or exercise specialist"},"performer":"other_reported","provenance_ids":["8918d09f-1e72-57ca-ad30-ff422f6f4a3e"]}],"status":"reported"},"monitoring_and_safety":{"items":[{"id":"f5ececfb-b2e1-511b-884c-38f3086ebde5","text":{"de":"Vor Untersuchung oder Training Kontraindikationen prüfen und klinisch beurteilen.","en":"Screen contraindications and use clinical judgement before assessment or exercise.","pl":"Przed oceną lub ćwiczeniami sprawdź przeciwwskazania i zastosuj ocenę kliniczną.","original":"Screen contraindications and use clinical judgement before assessment or exercise."},"response":{"de":"Vor Beurteilung nicht beginnen; bei Zweifel ärztlichen Rat einholen.","en":"Do not commence until assessed; seek medical advice when in doubt.","pl":"Nie rozpoczynaj przed oceną; przy wątpliwościach zasięgnij porady lekarskiej.","original":"Do not commence until assessed; seek medical advice when in doubt."},"recipient":null,"provenance_ids":["d171a4c2-6684-52db-a1bc-92b1ecfa0008","192b926d-262d-5538-95c8-d232e0c5b44e"],"trigger_or_sign":{"de":"Bekannte oder vermutete Kontraindikation oder Unsicherheit","en":"Known or suspected contraindication or uncertainty","pl":"Znane lub podejrzewane przeciwwskazanie albo wątpliwość","original":"Known or suspected contraindication or uncertainty"}},{"id":"6c0fe249-4bb6-5f4a-8813-166c6ef302a7","text":{"de":"Herzfrequenz, Belastungsempfinden und Symptome überwachen, um eine angemessene Trainingsreaktion zu bestätigen.","en":"Monitor heart rate, perceived exertion and symptoms to confirm an appropriate exercise response.","pl":"Monitoruj tętno, odczuwany wysiłek i objawy, aby potwierdzać prawidłową odpowiedź na ćwiczenia.","original":"Monitor heart rate, perceived exertion and symptoms to confirm an appropriate exercise response."},"response":{"de":"Bei Warnzeichen eines kardialen Ereignisses sofort den Rettungsdienst rufen.","en":"If warning signs suggest a cardiac event, call an ambulance immediately.","pl":"Jeśli objawy alarmowe sugerują zdarzenie sercowe, natychmiast wezwij pogotowie.","original":"If warning signs suggest a cardiac event, call an ambulance immediately."},"recipient":null,"provenance_ids":["9c6e2a6f-1991-5642-bc50-0d76dcbf6006","5e17f2c3-9c75-54d2-a9b1-f0ac452c147b"],"trigger_or_sign":{"de":"Brustschmerz, Schwindel, Übelkeit, Unwohlsein, starkes Schwitzen oder anderes Warnzeichen","en":"Chest pain, dizziness, nausea, feeling unwell, excessive sweating or another warning sign","pl":"Ból w klatce, zawroty głowy, nudności, złe samopoczucie, nadmierne pocenie lub inny objaw alarmowy","original":"Chest pain, dizziness, nausea, feeling unwell, excessive sweating or another warning sign"}},{"id":"68cbb4cc-9620-5f79-96a1-1ac420630f07","text":{"de":"Selbstkontrolle von Symptomen und Intensität bei unbeaufsichtigter Aktivität vermitteln.","en":"Teach symptom and intensity self-monitoring for unsupervised activity.","pl":"Naucz samokontroli objawów i intensywności podczas aktywności bez nadzoru.","original":"Teach symptom and intensity self-monitoring for unsupervised activity."},"response":{"de":"Bei Zeichen eines kardialen Ereignisses sofort den Rettungsdienst rufen.","en":"If signs suggest a cardiac event, call an ambulance immediately.","pl":"Jeśli objawy sugerują zdarzenie sercowe, natychmiast wezwij pogotowie.","original":"If signs suggest a cardiac event, call an ambulance immediately."},"recipient":null,"provenance_ids":["5e17f2c3-9c75-54d2-a9b1-f0ac452c147b"],"trigger_or_sign":{"de":"Brustschmerz, Schwindel, Übelkeit, Unwohlsein oder starkes Schwitzen","en":"Chest pain, dizziness, nausea, feeling unwell or excessive sweating","pl":"Ból w klatce, zawroty głowy, nudności, złe samopoczucie lub nadmierne pocenie","original":"Chest pain, dizziness, nausea, feeling unwell or excessive sweating"}}],"status":"reported"},"protection_and_loading":{"items":[],"status":"not_applicable"},"unmapped_source_content":{"items":[{"id":"1f8a7f0e-b1c3-590a-920c-20aa0acadca3","text":{"de":"Tabelle 1 ist aus Drittquellen adaptiert; sie wird referenziert, aber nicht reproduziert.","en":"Table 1 is adapted from third-party sources and is referenced but not reproduced.","pl":"Tabela 1 jest zaadaptowana ze źródeł zewnętrznych; pozostaje odwołaniem i nie jest reprodukowana.","original":"Table 1 is adapted from third-party sources and is referenced but not reproduced."},"provenance_ids":["d171a4c2-6684-52db-a1bc-92b1ecfa0008"]}],"status":"reported"},"progression_and_completion":{"items":[],"status":"not_reported"}}},{"id":"e080d2bf-638e-5b7c-a4c5-9b6f61a5da1c","name_de":"Progression und erneute Beurteilung","name_en":"Progression and reassessment","name_pl":"Progresja i ponowna ocena","source_page":9,"module_number":7,"name_original":"Progression and reassessment","service_codes":[],"structured_content":{},"additional_notes_de":"","additional_notes_en":"","additional_notes_pl":"","minimum_patient_share":null,"therapeutic_content_de":"Dauer, Umfang und Intensität in quellenbasierter Reihenfolge nach Verträglichkeit steigern und bei Entlassung vergleichbar erneut beurteilen.","therapeutic_content_en":"Progress duration, volume and intensity in the source-defined order from tolerance, then repeat comparable assessments at discharge.","therapeutic_content_pl":"Zwiększaj czas, objętość i intensywność w kolejności źródłowej zgodnie z tolerancją, a przy wypisie powtórz porównywalne oceny.","minimum_requirements_de":"","minimum_requirements_en":"","minimum_requirements_pl":"","additional_notes_original":"","therapeutic_content_original":"Progress duration, volume and intensity in the source-defined order from tolerance, then repeat comparable assessments at discharge.","minimum_requirements_original":"","module_kind":"recommendation","structured_content_v2":{"evidence":{"items":[],"status":"not_reported"},"exercises":{"items":[],"status":"not_reported"},"assessment":{"items":[],"status":"not_reported"},"provenance":[{"id":"5ba20afa-493c-5aca-88e5-7144fdddd213","pdf_page_to":9,"original_text":"Start slowly and progress gradually, increasing duration to meet 30 min before increasing intensity. Increases in intensity and duration of 5%–10% every 1–2 weeks are typically well-tolerated within cardiac patients.","pdf_page_from":9,"section_label":"Table 3 — Aerobic Exercise: Progression","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"table","source_page_label_to":"9","source_page_label_from":"9","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"fefe8c35-6c36-5167-918b-cf8611d20354","pdf_page_to":9,"original_text":"Progress at least one of volume, intensity, type or frequency; progress volume and intensity before other variables. Progress repetitions before sets or intensity up to 15. When 15 repetitions are easy, increase intensity to RPE 4–6 with a new target of 8–10 repetitions, then progress toward the highest tolerable intensity and three sets per major muscle group.","pdf_page_from":9,"section_label":"Table 3 — Resistance Exercise: Progression","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"table","source_page_label_to":"9","source_page_label_from":"9","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"274af462-c4d3-5373-a918-b384818e7818","pdf_page_to":9,"original_text":"Start slowly and progress gradually, increasing duration before intensity. If appropriate, start with 2–5 minutes 3–4 times daily and progress toward 30 minutes of moderate-intensity physical activity or 7,500 steps on most days.","pdf_page_from":9,"section_label":"Table 3 — Physical Activity: Progression","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"table","source_page_label_to":"9","source_page_label_from":"9","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"8ee30144-4f04-5c7f-b661-d6bcb6a0f06e","pdf_page_to":12,"original_text":"Aerobic exercise capacity, muscle strength and physical activity assessments should be conducted at enrolment and at discharge to allow for a more detailed analysis of a patient’s response.","pdf_page_from":12,"section_label":"Summary of Recommendations","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"text","source_page_label_to":"12","source_page_label_from":"12","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}}],"content_kind":"recommendation","recommendation":{"id":"cff3ab4b-507f-5187-a302-c21037bbcdb5","polarity":"conditional","statement":{"items":[{"id":"86f78b5a-3e4e-5dbb-a339-675065ade332","text":{"de":"Schrittweise nach Verträglichkeit steigern und Ergebnisbeurteilung bei Entlassung wiederholen.","en":"Progress gradually from observed tolerance and repeat outcome assessment at discharge.","pl":"Zwiększaj stopniowo na podstawie tolerancji i powtórz ocenę wyników przy wypisie.","original":"Progress gradually from observed tolerance and repeat outcome assessment at discharge."},"provenance_ids":["5ba20afa-493c-5aca-88e5-7144fdddd213","fefe8c35-6c36-5167-918b-cf8611d20354","274af462-c4d3-5373-a918-b384818e7818","8ee30144-4f04-5c7f-b661-d6bcb6a0f06e"]}],"status":"reported"},"applicability":{"items":[{"id":"0a4a9e89-51f3-5fa0-bb9e-705005455b9a","text":{"de":"Ausdauertraining, Krafttraining und körperliche Aktivität","en":"Aerobic exercise, resistance exercise and physical activity","pl":"Trening aerobowy, oporowy i aktywność fizyczna","original":"Aerobic exercise, resistance exercise and physical activity"},"provenance_ids":["5ba20afa-493c-5aca-88e5-7144fdddd213","fefe8c35-6c36-5167-918b-cf8611d20354","274af462-c4d3-5373-a918-b384818e7818"]}],"status":"reported"},"conditionality":{"items":[{"id":"d5a79e34-808c-5d84-959b-2f120bc049c2","text":{"de":"Nur steigern, wenn aktuelle Dosis vertragen und Reaktion angemessen ist.","en":"Progress only when the current dose is tolerated and response is appropriate.","pl":"Zwiększaj tylko przy tolerancji obecnej dawki i prawidłowej odpowiedzi.","original":"Progress only when the current dose is tolerated and response is appropriate."},"provenance_ids":["5ba20afa-493c-5aca-88e5-7144fdddd213"]}],"status":"reported"},"intervention_categories":{"items":[{"id":"7c15fc0b-36b0-5bd9-b0c7-7e76e549b0c5","text":{"de":"Progression von Training und Aktivität","en":"Exercise and physical activity progression","pl":"Progresja ćwiczeń i aktywności","original":"Exercise and physical activity progression"},"provenance_ids":["5ba20afa-493c-5aca-88e5-7144fdddd213","fefe8c35-6c36-5167-918b-cf8611d20354","274af462-c4d3-5373-a918-b384818e7818"]}],"status":"reported"}},"contract_version":"1.2","therapist_actions":{"items":[{"id":"623343e3-7ebc-571f-82c6-30ad39388b3f","text":{"de":"Bei Entlassung vergleichbare Messungen von Ausdauer, Kraft und Aktivität wiederholen und Reaktion sowie Programmwirksamkeit dokumentieren.","en":"Repeat comparable aerobic-capacity, muscle-strength and physical-activity assessments at discharge and document response and program effectiveness.","pl":"Przy wypisie powtórz porównywalne oceny wydolności aerobowej, siły i aktywności oraz udokumentuj odpowiedź i skuteczność programu.","original":"Repeat comparable aerobic-capacity, muscle-strength and physical-activity assessments at discharge and document response and program effectiveness."},"target":{"de":"Fachperson der kardiologischen Rehabilitation oder Bewegungsspezialist","en":"Cardiac rehabilitation clinician or exercise specialist","pl":"Klinicysta rehabilitacji kardiologicznej lub specjalista terapii ruchem","original":"Cardiac rehabilitation clinician or exercise specialist"},"performer":"other_reported","provenance_ids":["8ee30144-4f04-5c7f-b661-d6bcb6a0f06e"]}],"status":"reported"},"monitoring_and_safety":{"items":[],"status":"not_reported"},"protection_and_loading":{"items":[],"status":"not_applicable"},"unmapped_source_content":{"items":[],"status":"not_applicable"},"progression_and_completion":{"items":[{"id":"8360fb5c-cf52-5019-ac85-2a3e1ff16605","text":{"de":"Aerobe Dauer vor Intensität auf 30 Minuten steigern; bei Verträglichkeit Dauer oder Intensität alle 1–2 Wochen um 5–10 % erhöhen.","en":"Increase aerobic duration to 30 minutes before intensity; if tolerated, increase duration or intensity by 5%–10% every 1–2 weeks.","pl":"Zwiększ czas aerobowy do 30 minut przed intensywnością; przy tolerancji zwiększaj czas lub intensywność o 5–10% co 1–2 tygodnie.","original":"Increase aerobic duration to 30 minutes before intensity; if tolerated, increase duration or intensity by 5%–10% every 1–2 weeks."},"action":{"de":"Dauer, dann Intensität steigern","en":"Increase duration, then intensity","pl":"Zwiększ czas, potem intensywność","original":"Increase duration, then intensity"},"timing":{"de":"Alle 1–2 Wochen","en":"Every 1–2 weeks","pl":"Co 1–2 tygodnie","original":"Every 1–2 weeks"},"criterion":{"de":"Aktuelle Dosis vertragen","en":"Current dose tolerated","pl":"Obecna dawka tolerowana","original":"Current dose tolerated"},"milestone":{"de":"30 Minuten kontinuierlich","en":"30 minutes continuous","pl":"30 minut ciągle","original":"30 minutes continuous"},"provenance_ids":["5ba20afa-493c-5aca-88e5-7144fdddd213"]},{"id":"c4a7d8e1-c77e-55bd-8a0d-5fd0131dffe8","text":{"de":"Mindestens einen Parameter steigern: Umfang, Intensität, Art oder Häufigkeit, mit Vorrang für Umfang und Intensität. Wiederholungen vor Sätzen oder Intensität steigern; wenn 15 Wiederholungen problemlos möglich sind, Last erhöhen und auf 8–10 zurücksetzen.","en":"Progress at least one of volume, intensity, type or frequency, prioritising volume and intensity. Progress repetitions before sets or intensity; when the patient completes 15 repetitions with ease, increase load and reset to 8–10 repetitions.","pl":"Zwiększaj co najmniej jeden parametr: objętość, intensywność, rodzaj lub częstotliwość, z pierwszeństwem objętości i intensywności. Zwiększaj powtórzenia przed seriami lub intensywnością; gdy pacjent z łatwością wykonuje 15 powtórzeń, zwiększ obciążenie i wróć do 8–10.","original":"Progress at least one of volume, intensity, type or frequency, prioritising volume and intensity. Progress repetitions before sets or intensity; when the patient completes 15 repetitions with ease, increase load and reset to 8–10 repetitions."},"action":{"de":"Last erhöhen; Ziel 8–10 Wiederholungen bei RPE 4–6","en":"Increase load; target 8–10 repetitions at RPE 4–6","pl":"Zwiększ obciążenie; cel 8–10 powtórzeń przy RPE 4–6","original":"Increase load; target 8–10 repetitions at RPE 4–6"},"timing":{"de":"Nach Verträglichkeit","en":"According to tolerance","pl":"Zgodnie z tolerancją","original":"According to tolerance"},"criterion":{"de":"15 Wiederholungen lassen sich problemlos ausführen","en":"The patient completes 15 repetitions with ease","pl":"Pacjent z łatwością wykonuje 15 powtórzeń","original":"The patient completes 15 repetitions with ease"},"milestone":{"de":"Bis 3 Sätze je großer Muskelgruppe","en":"Up to 3 sets per major muscle group","pl":"Do 3 serii na dużą grupę mięśniową","original":"Up to 3 sets per major muscle group"},"provenance_ids":["fefe8c35-6c36-5167-918b-cf8611d20354"]},{"id":"11a7972e-72c1-5767-900a-9e8db2c26a06","text":{"de":"Dauer körperlicher Aktivität vor Intensität steigern.","en":"Increase physical-activity duration before intensity.","pl":"Zwiększaj czas aktywności przed intensywnością.","original":"Increase physical-activity duration before intensity."},"action":{"de":"Aktivität verlängern","en":"Lengthen activity","pl":"Wydłuż aktywność","original":"Lengthen activity"},"timing":{"de":"Schrittweise","en":"Gradually","pl":"Stopniowo","original":"Gradually"},"criterion":{"de":"Aktuelle Aktivität vertragen","en":"Current activity tolerated","pl":"Obecna aktywność tolerowana","original":"Current activity tolerated"},"milestone":{"de":"30 Minuten moderate Aktivität oder 7.500 Schritte an den meisten Tagen","en":"30 minutes moderate activity or 7,500 steps on most days","pl":"30 minut umiarkowanej aktywności lub 7500 kroków przez większość dni","original":"30 minutes moderate activity or 7,500 steps on most days"},"provenance_ids":["274af462-c4d3-5373-a918-b384818e7818"]}],"status":"reported"}}},{"id":"685492f0-47d0-57de-809e-b405dfbd2ec3","name_de":"Telemedizin und Aktivitätstracker","name_en":"Telehealth and wearable activity trackers","name_pl":"Teleopieka i urządzenia monitorujące aktywność","source_page":11,"module_number":8,"name_original":"Telehealth and wearable activity trackers","service_codes":[],"structured_content":{},"additional_notes_de":"","additional_notes_en":"","additional_notes_pl":"","minimum_patient_share":null,"therapeutic_content_de":"Persönliche Untersuchung bevorzugen; bei Fernversorgung Sicherheit und Wiederholbarkeit sichern und individuell verordnen. Vor Wearables Gerät und Patient prüfen.","therapeutic_content_en":"Prefer in-person assessment; for remote care verify safety, use repeatable tests and keep prescription individualised. Review device and patient factors before wearables.","therapeutic_content_pl":"Preferuj ocenę osobistą; w opiece zdalnej sprawdź bezpieczeństwo, stosuj powtarzalne testy i zachowaj indywidualną receptę. Przed urządzeniami oceń sprzęt i pacjenta.","minimum_requirements_de":"","minimum_requirements_en":"","minimum_requirements_pl":"","additional_notes_original":"","therapeutic_content_original":"Prefer in-person assessment; for remote care verify safety, use repeatable tests and keep prescription individualised. Review device and patient factors before wearables.","minimum_requirements_original":"","module_kind":"intervention","structured_content_v2":{"evidence":{"items":[],"status":"not_reported"},"exercises":{"items":[],"status":"not_reported"},"assessment":{"items":[{"id":"194bf849-25be-5e55-a268-73650128e094","name":{"de":"Eignung für Telemedizin","en":"Telehealth readiness","pl":"Gotowość do teleopieki","original":"Telehealth readiness"},"text":{"de":"Feststellen, ob Fernuntersuchung sicher, durchführbar und wiederholbar ist.","en":"Determine whether remote assessment is safe, feasible and repeatable.","pl":"Ustal, czy ocena zdalna jest bezpieczna, wykonalna i powtarzalna.","original":"Determine whether remote assessment is safe, feasible and repeatable."},"timing":{"de":"Vor Fernuntersuchung","en":"Before remote assessment","pl":"Przed oceną zdalną","original":"Before remote assessment"},"purpose":{"de":"Feststellen, ob Fernuntersuchung sicher, durchführbar und wiederholbar ist.","en":"Determine whether remote assessment is safe, feasible and repeatable.","pl":"Ustal, czy ocena zdalna jest bezpieczna, wykonalna i powtarzalna.","original":"Determine whether remote assessment is safe, feasible and repeatable."},"procedure":{"de":"Standort, Aktionsplan, Medikamente, Monitoringgeräte und Raum prüfen; Standardanamnese und wiederholbaren virtuellen Test nutzen.","en":"Verify location, action plan, medicines, monitoring equipment and exercise space; take a standard history and choose a repeatable virtual test.","pl":"Potwierdź lokalizację, plan działania, leki, sprzęt monitorujący i przestrzeń; zbierz standardowy wywiad i wybierz powtarzalny test zdalny.","original":"Verify location, action plan, medicines, monitoring equipment and exercise space; take a standard history and choose a repeatable virtual test."},"decision_rule":{"de":"Persönlich untersuchen, wenn kognitive Einschränkung oder geringe Digitalkompetenz Telemedizin ungeeignet macht.","en":"Use in-person review if cognitive impairment or low digital literacy makes telehealth unsuitable.","pl":"Zastosuj wizytę osobistą, jeśli zaburzenia poznawcze lub małe kompetencje cyfrowe wykluczają teleopiekę.","original":"Use in-person review if cognitive impairment or low digital literacy makes telehealth unsuitable."},"provenance_ids":["48757753-67cf-55bc-b789-ae4354a0c86b","cd77ec85-4039-5a49-a281-bded94f6af60","cf28ab08-834e-5475-b3cc-bc12390c5a8a"],"threshold_or_interpretation":null}],"status":"reported"},"provenance":[{"id":"8e0e25b8-f08c-576b-b4e1-6ea5fe189e08","pdf_page_to":11,"original_text":"The use of wearable activity trackers can be successfully incorporated within clinical settings after reviewing some device and individual factors.","pdf_page_from":11,"section_label":"Wearable Activity Trackers","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"text","source_page_label_to":"11","source_page_label_from":"11","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"bdcc8592-b1e9-5234-94bf-73328e24502a","pdf_page_to":12,"original_text":"Clinicians can maximise the effectiveness of wearable activity trackers through encouraging, educating, monitoring, and providing effective feedback loops.","pdf_page_from":12,"section_label":"Wearable Activity Trackers","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"text","source_page_label_to":"12","source_page_label_from":"12","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"0faa48df-7085-5831-a3d5-8d04d6d533b3","pdf_page_to":12,"original_text":"Ideally, it is recommended that exercise and physical activity assessments are done in-person to ensure a safe and standardised assessment. However, when this is not possible, telehealth exercise assessments are recommended to allow individually tailored exercise and physical activity prescription.","pdf_page_from":12,"section_label":"Using Telehealth to Assess and Prescribe Exercise and Physical Activity","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"text","source_page_label_to":"12","source_page_label_from":"12","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"48757753-67cf-55bc-b789-ae4354a0c86b","pdf_page_to":12,"original_text":"Before assessing exercise and physical activity using telehealth, safety needs to be considered, including verifying the patient’s location in case you need to call an ambulance or checking whether they have an action plan and medications nearby if required.","pdf_page_from":12,"section_label":"Using Telehealth to Assess and Prescribe Exercise and Physical Activity","source_sha256":"01fc7700f0066bfa130314fb429a03b578ae28017c0f9234428db90d92ff784d","source_document_id":"dbb9db3b-3d99-59f1-a2d0-f3ac5c28a933","source_content_kind":"text","source_page_label_to":"12","source_page_label_from":"12","translation_verification":{"de":"agent_checked_pending_clinical_review","en":"source_aligned","pl":"agent_checked_pending_clinical_review","original":"source"}},{"id":"cd77ec85-4039-5a49-a281-bded94f6af60","pdf_page_to":12,"original_text":"Selection of a suitable exercise test is dependent on the space and equipment available, ensuring that the test can be repeated at the end of the program using the same methods.","pdf_page_from":12,"section_label":"Using Telehealth to Assess and Prescribe Exercise and Physical 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establishment, daily walking, gentle ROM and core activation.","therapeutic_content_pl":"Kontrola bólu i stanu zapalnego, redukcja napięcia mięśniowego, ustalenie pozycji przeciwbólowych, codzienne spacery, delikatna mobilizacja i aktywacja core.","minimum_requirements_de":"Vermeidung von Aktivitäten, die Symptome verschlimmern.","minimum_requirements_en":"Avoid activities worsening symptoms.","minimum_requirements_pl":"Unikanie aktywności zaostrzających objawy.","additional_notes_original":"No more than one day of rest.","therapeutic_content_original":"Pain and inflammation control, reduction of muscle spasms, pain-free posture establishment, daily walking, gentle ROM and core activation.","minimum_requirements_original":"Avoid activities worsening symptoms.","structured_content_v2":"$undefined"},{"id":"4a841c94-5739-5583-a4d9-14b1d81d6f93","name_de":"Subakute Phase","name_en":"Sub-acute Phase","name_pl":"Faza podostra","source_page":4,"module_number":2,"name_original":"Sub-acute Phase","service_codes":[],"structured_content":{"de":{"goals":["Steigerung der Aktivität und Gehdistanz, Verbesserung der Beweglichkeit von Wirbelsäule und unteren Extremitäten, Rumpf- und Beckenstabilisierung."],"exercises":["Stärkung der unteren Extremitäten 3-mal pro Woche.","Stabilisations- und Dehnübungen täglich."],"applies_when":["Subakute Phase"]},"en":{"goals":["Progressive activity and walking, spinal and lower extremity flexibility, core stabilization (transversus abdominis, multifidi)."],"exercises":["Lower extremity strengthening 3 times per week.","Daily stabilization and stretching."],"applies_when":["Sub-acute Phase"]},"pl":{"goals":["Zwiększenie aktywności i dystansu chodzenia, poprawa elastyczności kręgosłupa i kończyn dolnych, stabilizacja miednicy i tułowia (m. wielodzielne, m. poprzeczny brzucha)."],"exercises":["Wzmacnianie kończyn dolnych 3 razy w tygodniu.","Ćwiczenia stabilizacyjne i rozciąganie wykonywane codziennie."],"applies_when":["Faza podostra"]},"original":{"goals":["Progressive activity and walking, spinal and lower extremity flexibility, core stabilization (transversus abdominis, multifidi)."],"exercises":["Lower extremity strengthening 3 times per week.","Daily stabilization and stretching."],"applies_when":["Sub-acute Phase"]}},"additional_notes_de":"Stabilisations- und Dehnübungen täglich.","additional_notes_en":"Daily stabilization and stretching.","additional_notes_pl":"Ćwiczenia stabilizacyjne i rozciąganie wykonywane codziennie.","minimum_patient_share":null,"therapeutic_content_de":"Steigerung der Aktivität und Gehdistanz, Verbesserung der Beweglichkeit von Wirbelsäule und unteren Extremitäten, Rumpf- und Beckenstabilisierung.","therapeutic_content_en":"Progressive activity and walking, spinal and lower extremity flexibility, core stabilization (transversus abdominis, multifidi).","therapeutic_content_pl":"Zwiększenie aktywności i dystansu chodzenia, poprawa elastyczności kręgosłupa i kończyn dolnych, stabilizacja miednicy i tułowia (m. wielodzielne, m. poprzeczny brzucha).","minimum_requirements_de":"Stärkung der unteren Extremitäten 3-mal pro Woche.","minimum_requirements_en":"Lower extremity strengthening 3 times per week.","minimum_requirements_pl":"Wzmacnianie kończyn dolnych 3 razy w tygodniu.","additional_notes_original":"Daily stabilization and stretching.","therapeutic_content_original":"Progressive activity and walking, spinal and lower extremity flexibility, core stabilization (transversus abdominis, multifidi).","minimum_requirements_original":"Lower extremity strengthening 3 times per week.","structured_content_v2":"$undefined"},{"id":"460ea813-3048-5c16-acd1-04444f6178a1","name_de":"Rehabilitationsphase","name_en":"Rehabilitation Phase","name_pl":"Faza rehabilitacji","source_page":4,"module_number":3,"name_original":"Rehabilitation Phase","service_codes":[],"structured_content":{"de":{"exercises":["Aerobes Training, Wiederherstellung der Kraft, funktionelles Heben/Bücken/Greifen mit leichtem Widerstand, Krafttraining an Geräten.","Cardio 3-5-mal pro Woche (20-45 Min.)."],"applies_when":["Rehabilitationsphase"],"dosage_and_progression":["Dehnung 30 Sekunden halten, 2-3 Wiederholungen täglich."],"physiotherapist_actions":["Kraft 3-mal pro Woche (2-3 Sätze, 15-20 Wdh.)."]},"en":{"exercises":["Aerobic conditioning, strength restoration, functional lifting/bending/reaching with light resistance, machine-based strengthening.","Cardio 3-5 times weekly (20-45 min)."],"applies_when":["Rehabilitation Phase"],"dosage_and_progression":["Daily stretches, 30s hold, 2-3 reps."],"physiotherapist_actions":["Strengthening 3 times weekly (2-3 sets of 15-20 reps)."]},"pl":{"exercises":["Trening aerobowy, przywracanie siły mięśniowej, funkcjonalne podnoszenie, schylanie i sięganie z lekkim oporem, maszyny siłowe.","Trening cardio 3-5 razy w tygodniu (20-45 min)."],"applies_when":["Faza rehabilitacji"],"dosage_and_progression":["Rozciąganie 30 sekund na pozycję, 2-3 powtórzenia dziennie."],"physiotherapist_actions":["Wzmocnienie 3 razy w tygodniu (2-3 serie po 15-20 powtórzeń)."]},"original":{"exercises":["Aerobic conditioning, strength restoration, functional lifting/bending/reaching with light resistance, machine-based strengthening.","Cardio 3-5 times weekly (20-45 min)."],"applies_when":["Rehabilitation Phase"],"dosage_and_progression":["Daily stretches, 30s hold, 2-3 reps."],"physiotherapist_actions":["Strengthening 3 times weekly (2-3 sets of 15-20 reps)."]}},"additional_notes_de":"Dehnung 30 Sekunden halten, 2-3 Wiederholungen täglich.","additional_notes_en":"Daily stretches, 30s hold, 2-3 reps.","additional_notes_pl":"Rozciąganie 30 sekund na pozycję, 2-3 powtórzenia dziennie.","minimum_patient_share":null,"therapeutic_content_de":"Aerobes Training, Wiederherstellung der Kraft, funktionelles Heben/Bücken/Greifen mit leichtem Widerstand, Krafttraining an Geräten.","therapeutic_content_en":"Aerobic conditioning, strength restoration, functional lifting/bending/reaching with light resistance, machine-based strengthening.","therapeutic_content_pl":"Trening aerobowy, przywracanie siły mięśniowej, funkcjonalne podnoszenie, schylanie i sięganie z lekkim oporem, maszyny siłowe.","minimum_requirements_de":"Cardio 3-5-mal pro Woche (20-45 Min.). Kraft 3-mal pro Woche (2-3 Sätze, 15-20 Wdh.).","minimum_requirements_en":"Cardio 3-5 times weekly (20-45 min). Strengthening 3 times weekly (2-3 sets of 15-20 reps).","minimum_requirements_pl":"Trening cardio 3-5 razy w tygodniu (20-45 min). Wzmocnienie 3 razy w tygodniu (2-3 serie po 15-20 powtórzeń).","additional_notes_original":"Daily stretches, 30s hold, 2-3 reps.","therapeutic_content_original":"Aerobic conditioning, strength restoration, functional lifting/bending/reaching with light resistance, machine-based strengthening.","minimum_requirements_original":"Cardio 3-5 times weekly (20-45 min). Strengthening 3 times weekly (2-3 sets of 15-20 reps).","structured_content_v2":"$undefined"},{"id":"4ba3199a-5495-506d-bb5e-9cfab006b4ff","name_de":"Return-to-Sport-Phase","name_en":"Return to Sport Phase","name_pl":"Powrót do sportu","source_page":5,"module_number":4,"name_original":"Return to Sport Phase","service_codes":[],"structured_content":{"de":{"exercises":["Weiteres aerobes Training, sportartspezifische Anforderungen, mehrdimensionale Stabilisation, maximale Kraft- und Beweglichkeitsentwicklung.","Training nach Anleitung durch PT oder Arzt."],"applies_when":["Return-to-Sport-Phase"],"dosage_and_progression":["Fortführung täglicher Dehnübungen."]},"en":{"exercises":["Continued aerobic training, sport-specific challenges, multiplanar stabilization, max strength and flexibility.","Follow instructions by PT or physician."],"applies_when":["Return to Sport Phase"],"dosage_and_progression":["Continue daily stretching."]},"pl":{"exercises":["Dalszy trening aerobowy, wyzwania sportowo-specyficzne, stabilizacja wielopłaszczyznowa, praca nad maksymalną siłą i elastycznością.","Trening wg zaleceń PT lub lekarza."],"applies_when":["Powrót do sportu"],"dosage_and_progression":["Kontynuacja codziennego rozciągania."]},"original":{"exercises":["Continued aerobic training, sport-specific challenges, multiplanar stabilization, max strength and flexibility.","Follow instructions by PT or physician."],"applies_when":["Return to Sport Phase"],"dosage_and_progression":["Continue daily stretching."]}},"additional_notes_de":"Fortführung täglicher Dehnübungen.","additional_notes_en":"Continue daily stretching.","additional_notes_pl":"Kontynuacja codziennego rozciągania.","minimum_patient_share":null,"therapeutic_content_de":"Weiteres aerobes Training, sportartspezifische Anforderungen, mehrdimensionale Stabilisation, maximale Kraft- und Beweglichkeitsentwicklung.","therapeutic_content_en":"Continued aerobic training, sport-specific challenges, multiplanar stabilization, max strength and flexibility.","therapeutic_content_pl":"Dalszy trening aerobowy, wyzwania sportowo-specyficzne, stabilizacja wielopłaszczyznowa, praca nad maksymalną siłą i elastycznością.","minimum_requirements_de":"Training nach Anleitung durch PT oder Arzt.","minimum_requirements_en":"Follow instructions by PT or physician.","minimum_requirements_pl":"Trening wg zaleceń PT lub lekarza.","additional_notes_original":"Continue daily stretching.","therapeutic_content_original":"Continued aerobic training, sport-specific challenges, multiplanar stabilization, max strength and flexibility.","minimum_requirements_original":"Follow instructions by PT or physician.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"condition","body_region_codes":["spine_lumbar"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"5f8b5c67-6a13-5b4f-9de7-442cde403af2","slug":"us-south-shore-38-cervical-radiculopathy","title_pl":"Protokół rehabilitacji w radikulopatii szyjnej (South Shore Orthopedics)","title_de":"Rehabilitationsprotokoll bei zervikaler Radikulopathie (South Shore Orthopedics)","title_en":"Rehabilitation Protocol for Cervical Radiculopathy (South Shore Orthopedics)","title_original":"Cervical Radiculopathy","summary_pl":"Konserwatywny program rehabilitacji obejmujący progresję od fazy ostrej do powrotu do aktywności sportowej.","summary_de":"Konservatives Rehabilitationsprogramm mit Progression von der akuten Phase bis zur Rückkehr zum Sport.","summary_en":"Conservative rehabilitation program encompassing progression from acute phase to return to sport.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"ef62382e-dd6b-5679-9285-9a78730f775a","condition_slug":"cervical-radiculopathy","condition_name_pl":"Radikulopatia szyjna","condition_name_de":"Zervikale Radikulopathie","condition_name_en":"Cervical Radiculopathy","condition_name_original":"Cervical Radiculopathy","icd_codes":[],"category_key":"spine","category_pl":"Kręgosłup","category_de":"Wirbelsäule","category_en":"Spine","body_regions_pl":["odcinek szyjny kręgosłupa","obręcz barkowa"],"body_regions_de":["Halswirbelsäule","Schultergürtel"],"body_regions_en":["cervical spine","shoulder girdle"],"search_terms_pl":["ból szyi","ucisk nerwu","przepuklina dysku","drętwienie rąk","fizjoterapia szyi"],"search_terms_de":["Nackenschmerzen","Nervenkompression","Bandscheibenvorfall","Taubheitsgefühl","Physiotherapie HWS"],"search_terms_en":["neck pain","nerve compression","herniated disc","radicular symptoms","cervical PT"],"source_document_id":"d0501004-4f0c-59d9-9633-d791482c4b4d","source_title":"Cervical Radiculopathy","issuer":"South Shore Orthopedics","source_country_code":"US","jurisdiction_code":"US-MA","authority_level":"hospital","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"stale_requires_clinical_update_check","official_url":"https://octanecdn.com/southshoreorthopedicscom/southshoreorthopedicscom_936651034.pdf","source_sha256":"026590daba2630e85a6ed14c6a391a814804edc0e7896cdc1b63a5cfb61bccc5","authorization_required":true,"license_note":"All Rights Reserved. Authorization is required before final public release. Current development and staging remain allowed by the owner's decision.","modules":[{"id":"d9056120-db1d-5052-b3e5-b780876d5395","name_de":"Phase 1: Akute Phase","name_en":"Phase 1: Acute Phase","name_pl":"Faza 1: Faza ostra","source_page":2,"module_number":1,"name_original":"Phase 1: Acute Phase","service_codes":[],"structured_content":{"de":{"goals":["Reduktion von Schmerzen und Entzündung, Schutz des verletzten Nervs und der Halswirbelsäule, Verbesserung des Bewegungsumfangs der Hals- und Brustwirbelsäule sowie der Körperhaltung."],"warnings":["Wenn verträglich, Aktivierung der tiefen Nackenflexoren beginnen."],"exercises":["Übungen: aktiver HWS-ROM im schmerzfreien Bereich, aktiver BWS-ROM, Schulterblattretraktion, Brustmuskeldehnung, längs liegende Schaumstoffrolle mit gestütztem Kopf.","Die Wiederherstellung der Kraft der tiefen Stabilisatoren verbessert die posturale Ausdauer.","ROM-Übungen sanft durchführen, um Muskelspannung und Schmerzen zu reduzieren."],"applies_when":["Akute Phase"],"progression_criteria":["Keine Zunahme radikulärer Symptome bei Bewegung"],"physiotherapist_actions":["Bedingt können manuelle oder mechanische Traktion der Halswirbelsäule, Wärme- oder Elektrostimulationsmodalitäten zur Schmerzlinderung und Reduktion der muskulären Schutzspannung, manuelle Techniken zur Verbesserung der Beweglichkeit von Gelenken und Muskeln der Halswirbelsäule und des oberen Rückens sowie Haltungsschulung eingesetzt werden."]},"en":{"goals":["Reduce pain and inflammation, protect the injured nerve and cervical spine, improve cervical and thoracic ROM, and improve posture."],"warnings":["If tolerated, initiate deep neck flexor activation."],"exercises":["Exercises: active cervical ROM within a pain-free range, active thoracic ROM, scapular retraction, pectoral stretches, and lengthwise foam roller use with head supported.","Restoring strength to the deep stabilizing muscles improves postural endurance.","perform ROM exercises gently with the goal of reducing muscle guarding and pain."],"applies_when":["Acute Phase"],"progression_criteria":["No increase in radicular symptoms with movement"],"physiotherapist_actions":["Conditional options include manual or mechanical traction to the neck, heat or electrical stimulation modalities to reduce pain and muscle guarding, hands-on manual techniques to loosen stiff neck and upper back joints and muscles, and postural correction and retraining."]},"pl":{"goals":["Redukcja bólu i stanu zapalnego, ochrona uszkodzonego nerwu i kręgosłupa szyjnego, poprawa ROM kręgosłupa szyjnego i piersiowego oraz postawy."],"warnings":["Jeśli tolerowane, rozpocząć aktywację głębokich zginaczy szyi."],"exercises":["Ćwiczenia: aktywny ROM szyjny w bezbolesnym zakresie, aktywny ROM piersiowy, retrakcja łopatek, rozciąganie mięśni piersiowych, wałek piankowy wzdłużnie z podparciem głowy.","Przywracanie siły głębokich stabilizatorów poprawia wytrzymałość posturalną.","ćwiczenia ROM wykonuj delikatnie, aby zmniejszać ochronne napięcie mięśni i ból."],"applies_when":["Faza ostra"],"progression_criteria":["Brak wzrostu objawów korzeniowych podczas ruchu"],"physiotherapist_actions":["Warunkowo można zastosować trakcję manualną lub mechaniczną szyi, modalności ciepła lub elektrostymulacji w celu zmniejszenia bólu i ochronnego napięcia mięśni, techniki manualne dla zwiększenia ruchomości stawów i mięśni szyi oraz górnej części pleców, a także reedukację postawy."]},"original":{"goals":["Reduce pain and inflammation, protect the injured nerve and cervical spine, improve cervical and thoracic ROM, and improve posture."],"warnings":["If tolerated, initiate deep neck flexor activation."],"exercises":["Exercises: active cervical ROM within a pain-free range, active thoracic ROM, scapular retraction, pectoral stretches, and lengthwise foam roller use with head supported.","Restoring strength to the deep stabilizing muscles improves postural endurance.","perform ROM exercises gently with the goal of reducing muscle guarding and pain."],"applies_when":["Acute Phase"],"progression_criteria":["No increase in radicular symptoms with movement"],"physiotherapist_actions":["Conditional options include manual or mechanical traction to the neck, heat or electrical stimulation modalities to reduce pain and muscle guarding, hands-on manual techniques to loosen stiff neck and upper back joints and muscles, and postural correction and retraining."]}},"additional_notes_de":"Wenn verträglich, Aktivierung der tiefen Nackenflexoren beginnen. Bedingt können manuelle oder mechanische Traktion der Halswirbelsäule, Wärme- oder Elektrostimulationsmodalitäten zur Schmerzlinderung und Reduktion der muskulären Schutzspannung, manuelle Techniken zur Verbesserung der Beweglichkeit von Gelenken und Muskeln der Halswirbelsäule und des oberen Rückens sowie Haltungsschulung eingesetzt werden.","additional_notes_en":"If tolerated, initiate deep neck flexor activation. Conditional options include manual or mechanical traction to the neck, heat or electrical stimulation modalities to reduce pain and muscle guarding, hands-on manual techniques to loosen stiff neck and upper back joints and muscles, and postural correction and retraining.","additional_notes_pl":"Jeśli tolerowane, rozpocząć aktywację głębokich zginaczy szyi. Warunkowo można zastosować trakcję manualną lub mechaniczną szyi, modalności ciepła lub elektrostymulacji w celu zmniejszenia bólu i ochronnego napięcia mięśni, techniki manualne dla zwiększenia ruchomości stawów i mięśni szyi oraz górnej części pleców, a także reedukację postawy.","minimum_patient_share":null,"therapeutic_content_de":"Reduktion von Schmerzen und Entzündung, Schutz des verletzten Nervs und der Halswirbelsäule, Verbesserung des Bewegungsumfangs der Hals- und Brustwirbelsäule sowie der Körperhaltung. Übungen: aktiver HWS-ROM im schmerzfreien Bereich, aktiver BWS-ROM, Schulterblattretraktion, Brustmuskeldehnung, längs liegende Schaumstoffrolle mit gestütztem Kopf. Die Wiederherstellung der Kraft der tiefen Stabilisatoren verbessert die posturale Ausdauer.","therapeutic_content_en":"Reduce pain and inflammation, protect the injured nerve and cervical spine, improve cervical and thoracic ROM, and improve posture. Exercises: active cervical ROM within a pain-free range, active thoracic ROM, scapular retraction, pectoral stretches, and lengthwise foam roller use with head supported. Restoring strength to the deep stabilizing muscles improves postural endurance.","therapeutic_content_pl":"Redukcja bólu i stanu zapalnego, ochrona uszkodzonego nerwu i kręgosłupa szyjnego, poprawa ROM kręgosłupa szyjnego i piersiowego oraz postawy. Ćwiczenia: aktywny ROM szyjny w bezbolesnym zakresie, aktywny ROM piersiowy, retrakcja łopatek, rozciąganie mięśni piersiowych, wałek piankowy wzdłużnie z podparciem głowy. Przywracanie siły głębokich stabilizatorów poprawia wytrzymałość posturalną.","minimum_requirements_de":"Keine Zunahme radikulärer Symptome bei Bewegung; ROM-Übungen sanft durchführen, um Muskelspannung und Schmerzen zu reduzieren.","minimum_requirements_en":"No increase in radicular symptoms with movement; perform ROM exercises gently with the goal of reducing muscle guarding and pain.","minimum_requirements_pl":"Brak wzrostu objawów korzeniowych podczas ruchu; ćwiczenia ROM wykonuj delikatnie, aby zmniejszać ochronne napięcie mięśni i ból.","additional_notes_original":"If tolerated, initiate deep neck flexor activation. Conditional options include manual or mechanical traction to the neck, heat or electrical stimulation modalities to reduce pain and muscle guarding, hands-on manual techniques to loosen stiff neck and upper back joints and muscles, and postural correction and retraining.","therapeutic_content_original":"Reduce pain and inflammation, protect the injured nerve and cervical spine, improve cervical and thoracic ROM, and improve posture. Exercises: active cervical ROM within a pain-free range, active thoracic ROM, scapular retraction, pectoral stretches, and lengthwise foam roller use with head supported. Restoring strength to the deep stabilizing muscles improves postural endurance.","minimum_requirements_original":"No increase in radicular symptoms with movement; perform ROM exercises gently with the goal of reducing muscle guarding and pain.","structured_content_v2":"$undefined"},{"id":"5a9e3be7-fab3-570e-8372-749c53b94fc8","name_de":"Phase 2: Subakute Phase","name_en":"Phase 2: Subacute Phase","name_pl":"Faza 2: Faza podostra","source_page":3,"module_number":2,"name_original":"Phase 2: Subacute Phase","service_codes":[],"structured_content":{"de":{"goals":["Schutz verletzter oder heilender Gewebe, Steigerung des passiven und aktiven Bewegungsumfangs der Hals- und Brustwirbelsäule, Verbesserung der Ausdauer der zervikalen und periskapulären Muskulatur durch längere Haltezeiten, Verringerung axialer Symptome und Beseitigung radikulärer Symptome."],"exercises":["Übungen: aktiver HWS- und BWS-ROM in Richtung Endbereich, Schulterblattretraktion mit Widerstand, Brustmuskeldehnung, Schaumstoffrolle mit gestütztem Kopf, tiefe Nackenflexoren und Kräftigung der Nackenextensoren mit geringem Widerstand und langen Haltezeiten."],"applies_when":["Subakute Phase"],"restrictions":["Jede Aktivität oder Übung vermeiden, die radikuläre Symptome reproduziert."],"progression_criteria":["Progressionskriterien vor dem Übergang zur subakuten Phase: weniger Schmerzen im Nacken und bei ausstrahlenden Symptomen in Ruhe und bei Bewegung","vollständige Progressionskriterien der Phase 2: radikuläre Symptome abgeklungen"],"dosage_and_progression":["Schmerzen bei passivem ROM hauptsächlich im Endbereich und weniger bei Bewegungsbeginn","leichter axialer Nackenschmerz kann verbleiben"],"physiotherapist_actions":["Aktivierung der tiefen Nackenflexoren erreicht","gute Kenntnis der Haltungskorrektur und symptomlindernder Aktivitäten","der Großteil des verfügbaren ROM wiedererlangt","Kräftigung gut verträglich","Spurling-Test und ULTT negativ."]},"en":{"goals":["Protect injured or healing tissue, increase passive and active cervical and thoracic ROM, increase cervical and periscapular muscle endurance with longer duration holds, decrease axial symptoms, and abolish radicular symptoms."],"exercises":["Exercises: active cervical and thoracic ROM working toward end range, resisted scapular retraction, pectoral stretches, foam roller with head supported, deep neck flexors, and neck extensor strengthening with low resistance and long duration holds."],"applies_when":["Subacute Phase"],"restrictions":["Avoid any activity or exercise that reproduces radicular symptoms."],"progression_criteria":["Progression criteria before progressing to the subacute phase: neck and radiating symptoms less painful at rest and with movement","full Phase 2 progression criteria: resolution of radicular symptoms"],"dosage_and_progression":["pain with passive ROM mainly at end range and less with initiation of movement","mild axial cervical pain may remain"],"physiotherapist_actions":["deep neck flexor activation achieved","good knowledge of postural correction techniques and symptom-relieving activities","majority of available ROM regained","strengthening well tolerated","negative Spurling test and ULTT."]},"pl":{"goals":["Ochrona uszkodzonych lub gojących się tkanek, zwiększenie biernego i czynnego ROM szyi i odcinka piersiowego, zwiększenie wytrzymałości mięśni szyjnych i okołołopatkowych przez dłuższe utrzymania, zmniejszenie objawów osiowych i zniesienie objawów korzeniowych."],"exercises":["Ćwiczenia: aktywny ROM szyjny i piersiowy w kierunku końcowego zakresu, retrakcja łopatek z oporem, rozciąganie mięśni piersiowych, wałek piankowy z podparciem głowy, głębokie zginacze szyi i wzmacnianie prostowników szyi przy niskim oporze i długich utrzymaniach."],"applies_when":["Faza podostra"],"restrictions":["Unikać każdej aktywności lub ćwiczenia reprodukującego objawy korzeniowe."],"progression_criteria":["Kryteria progresji przed przejściem do fazy podostrej: ból szyi i objawy promieniujące są mniej nasilone w spoczynku i podczas ruchu","pełne kryteria progresji fazy 2: ustąpienie objawów korzeniowych"],"dosage_and_progression":["ból przy biernym ROM głównie w końcowym zakresie i mniejszy przy rozpoczęciu ruchu","może utrzymywać się łagodny ból osiowy szyi"],"physiotherapist_actions":["uzyskana aktywacja głębokich zginaczy szyi","dobra znajomość korekcji postawy i aktywności łagodzących objawy","odzyskana większość dostępnego ROM","dobra tolerancja wzmacniania","ujemny test Spurlinga i ULTT."]},"original":{"goals":["Protect injured or healing tissue, increase passive and active cervical and thoracic ROM, increase cervical and periscapular muscle endurance with longer duration holds, decrease axial symptoms, and abolish radicular symptoms."],"exercises":["Exercises: active cervical and thoracic ROM working toward end range, resisted scapular retraction, pectoral stretches, foam roller with head supported, deep neck flexors, and neck extensor strengthening with low resistance and long duration holds."],"applies_when":["Subacute Phase"],"restrictions":["Avoid any activity or exercise that reproduces radicular symptoms."],"progression_criteria":["Progression criteria before progressing to the subacute phase: neck and radiating symptoms less painful at rest and with movement","full Phase 2 progression criteria: resolution of radicular symptoms"],"dosage_and_progression":["pain with passive ROM mainly at end range and less with initiation of movement","mild axial cervical pain may remain"],"physiotherapist_actions":["deep neck flexor activation achieved","good knowledge of postural correction techniques and symptom-relieving activities","majority of available ROM regained","strengthening well tolerated","negative Spurling test and ULTT."]}},"additional_notes_de":"Jede Aktivität oder Übung vermeiden, die radikuläre Symptome reproduziert.","additional_notes_en":"Avoid any activity or exercise that reproduces radicular symptoms.","additional_notes_pl":"Unikać każdej aktywności lub ćwiczenia reprodukującego objawy korzeniowe.","minimum_patient_share":null,"therapeutic_content_de":"Schutz verletzter oder heilender Gewebe, Steigerung des passiven und aktiven Bewegungsumfangs der Hals- und Brustwirbelsäule, Verbesserung der Ausdauer der zervikalen und periskapulären Muskulatur durch längere Haltezeiten, Verringerung axialer Symptome und Beseitigung radikulärer Symptome. Übungen: aktiver HWS- und BWS-ROM in Richtung Endbereich, Schulterblattretraktion mit Widerstand, Brustmuskeldehnung, Schaumstoffrolle mit gestütztem Kopf, tiefe Nackenflexoren und Kräftigung der Nackenextensoren mit geringem Widerstand und langen Haltezeiten.","therapeutic_content_en":"Protect injured or healing tissue, increase passive and active cervical and thoracic ROM, increase cervical and periscapular muscle endurance with longer duration holds, decrease axial symptoms, and abolish radicular symptoms. Exercises: active cervical and thoracic ROM working toward end range, resisted scapular retraction, pectoral stretches, foam roller with head supported, deep neck flexors, and neck extensor strengthening with low resistance and long duration holds.","therapeutic_content_pl":"Ochrona uszkodzonych lub gojących się tkanek, zwiększenie biernego i czynnego ROM szyi i odcinka piersiowego, zwiększenie wytrzymałości mięśni szyjnych i okołołopatkowych przez dłuższe utrzymania, zmniejszenie objawów osiowych i zniesienie objawów korzeniowych. Ćwiczenia: aktywny ROM szyjny i piersiowy w kierunku końcowego zakresu, retrakcja łopatek z oporem, rozciąganie mięśni piersiowych, wałek piankowy z podparciem głowy, głębokie zginacze szyi i wzmacnianie prostowników szyi przy niskim oporze i długich utrzymaniach.","minimum_requirements_de":"Progressionskriterien vor dem Übergang zur subakuten Phase: weniger Schmerzen im Nacken und bei ausstrahlenden Symptomen in Ruhe und bei Bewegung; Schmerzen bei passivem ROM hauptsächlich im Endbereich und weniger bei Bewegungsbeginn; Aktivierung der tiefen Nackenflexoren erreicht; gute Kenntnis der Haltungskorrektur und symptomlindernder Aktivitäten; vollständige Progressionskriterien der Phase 2: radikuläre Symptome abgeklungen; leichter axialer Nackenschmerz kann verbleiben; der Großteil des verfügbaren ROM wiedererlangt; Kräftigung gut verträglich; Spurling-Test und ULTT negativ.","minimum_requirements_en":"Progression criteria before progressing to the subacute phase: neck and radiating symptoms less painful at rest and with movement; pain with passive ROM mainly at end range and less with initiation of movement; deep neck flexor activation achieved; good knowledge of postural correction techniques and symptom-relieving activities; full Phase 2 progression criteria: resolution of radicular symptoms; mild axial cervical pain may remain; majority of available ROM regained; strengthening well tolerated; negative Spurling test and ULTT.","minimum_requirements_pl":"Kryteria progresji przed przejściem do fazy podostrej: ból szyi i objawy promieniujące są mniej nasilone w spoczynku i podczas ruchu; ból przy biernym ROM głównie w końcowym zakresie i mniejszy przy rozpoczęciu ruchu; uzyskana aktywacja głębokich zginaczy szyi; dobra znajomość korekcji postawy i aktywności łagodzących objawy; pełne kryteria progresji fazy 2: ustąpienie objawów korzeniowych; może utrzymywać się łagodny ból osiowy szyi; odzyskana większość dostępnego ROM; dobra tolerancja wzmacniania; ujemny test Spurlinga i ULTT.","additional_notes_original":"Avoid any activity or exercise that reproduces radicular symptoms.","therapeutic_content_original":"Protect injured or healing tissue, increase passive and active cervical and thoracic ROM, increase cervical and periscapular muscle endurance with longer duration holds, decrease axial symptoms, and abolish radicular symptoms. Exercises: active cervical and thoracic ROM working toward end range, resisted scapular retraction, pectoral stretches, foam roller with head supported, deep neck flexors, and neck extensor strengthening with low resistance and long duration holds.","minimum_requirements_original":"Progression criteria before progressing to the subacute phase: neck and radiating symptoms less painful at rest and with movement; pain with passive ROM mainly at end range and less with initiation of movement; deep neck flexor activation achieved; good knowledge of postural correction techniques and symptom-relieving activities; full Phase 2 progression criteria: resolution of radicular symptoms; mild axial cervical pain may remain; majority of available ROM regained; strengthening well tolerated; negative Spurling test and ULTT.","structured_content_v2":"$undefined"},{"id":"ea043599-c79c-573d-9bc8-f81d4f507504","name_de":"Phase 3: Rehabilitationsphase","name_en":"Phase 3: Rehab Phase","name_pl":"Faza 3: Faza rehabilitacji","source_page":4,"module_number":3,"name_original":"Phase 3: Rehab Phase","service_codes":[],"structured_content":{"de":{"exercises":["Wiederherstellung des normalen Bewegungsumfangs, wenn der Bewegungsumfang weiterhin eingeschränkt ist, progressive Kräftigung der periskapulären Muskulatur mit zunehmendem Widerstand und Wiederherstellung der funktionellen Nutzung von Arm und Hals.","Übungen: Dehnung der Halsmuskulatur, weitere Mobilität der Brustwirbelsäule, Brustmuskeldehnung, Progression von 'T', 'Y' und 'I' mit Theraband oder Hantel sowie zervikale Isometrien in allen Ebenen.","Die Kräftigung mit zunehmendem Widerstand progressieren."],"applies_when":["Rehabilitationsphase"],"restrictions":["Jede Aktivität oder Übung vermeiden, die radikuläre Symptome reproduziert."],"progression_criteria":["Schmerzfreiheit der Halswirbelsäule im vollen Bewegungsumfang in allen Ebenen"],"physiotherapist_actions":["sehr gute Muskelkraft","Hals- und Armsymptome sind abgeklungen."]},"en":{"exercises":["Continue to acquire normal ROM if deficient, progressively strengthen periscapular muscle groups with increased resistance, and restore functional use of the arm and neck.","Exercises: cervical spine muscle stretches, thoracic mobility exercises, pectoral stretching, T/Y/I progression with Theraband or dumbbell, and cervical isometrics in all planes.","Progress strengthening with increased resistance."],"applies_when":["Rehab Phase"],"restrictions":["Avoid any activity or exercise that reproduces radicular symptoms."],"progression_criteria":["Cervical spine pain-free in all planes of motion"],"physiotherapist_actions":["very good strength","neck and arm symptoms are gone."]},"pl":{"exercises":["Dalsze odzyskiwanie prawidłowego ROM, jeśli nadal jest ograniczony, progresywne wzmacnianie mięśni okołołopatkowych ze zwiększanym oporem oraz przywrócenie funkcjonalnego użycia ręki i szyi.","Ćwiczenia: rozciąganie mięśni szyi, dalsza mobilność odcinka piersiowego, rozciąganie mięśni piersiowych, progresja 'T', 'Y' i 'I' z taśmą lub hantlem oraz izometria szyi we wszystkich płaszczyznach.","Wzmacnianie progresować z większym oporem."],"applies_when":["Faza rehabilitacji"],"restrictions":["Unikać każdej aktywności lub ćwiczenia reprodukującego objawy korzeniowe."],"progression_criteria":["Brak bólu w pełnym zakresie ruchu szyi we wszystkich płaszczyznach"],"physiotherapist_actions":["bardzo dobra siła","objawy szyi i ręki ustąpiły."]},"original":{"exercises":["Continue to acquire normal ROM if deficient, progressively strengthen periscapular muscle groups with increased resistance, and restore functional use of the arm and neck.","Exercises: cervical spine muscle stretches, thoracic mobility exercises, pectoral stretching, T/Y/I progression with Theraband or dumbbell, and cervical isometrics in all planes.","Progress strengthening with increased resistance."],"applies_when":["Rehab Phase"],"restrictions":["Avoid any activity or exercise that reproduces radicular symptoms."],"progression_criteria":["Cervical spine pain-free in all planes of motion"],"physiotherapist_actions":["very good strength","neck and arm symptoms are gone."]}},"additional_notes_de":"Jede Aktivität oder Übung vermeiden, die radikuläre Symptome reproduziert. Die Kräftigung mit zunehmendem Widerstand progressieren.","additional_notes_en":"Avoid any activity or exercise that reproduces radicular symptoms. Progress strengthening with increased resistance.","additional_notes_pl":"Unikać każdej aktywności lub ćwiczenia reprodukującego objawy korzeniowe. Wzmacnianie progresować z większym oporem.","minimum_patient_share":null,"therapeutic_content_de":"Wiederherstellung des normalen Bewegungsumfangs, wenn der Bewegungsumfang weiterhin eingeschränkt ist, progressive Kräftigung der periskapulären Muskulatur mit zunehmendem Widerstand und Wiederherstellung der funktionellen Nutzung von Arm und Hals. Übungen: Dehnung der Halsmuskulatur, weitere Mobilität der Brustwirbelsäule, Brustmuskeldehnung, Progression von 'T', 'Y' und 'I' mit Theraband oder Hantel sowie zervikale Isometrien in allen Ebenen.","therapeutic_content_en":"Continue to acquire normal ROM if deficient, progressively strengthen periscapular muscle groups with increased resistance, and restore functional use of the arm and neck. Exercises: cervical spine muscle stretches, thoracic mobility exercises, pectoral stretching, T/Y/I progression with Theraband or dumbbell, and cervical isometrics in all planes.","therapeutic_content_pl":"Dalsze odzyskiwanie prawidłowego ROM, jeśli nadal jest ograniczony, progresywne wzmacnianie mięśni okołołopatkowych ze zwiększanym oporem oraz przywrócenie funkcjonalnego użycia ręki i szyi. Ćwiczenia: rozciąganie mięśni szyi, dalsza mobilność odcinka piersiowego, rozciąganie mięśni piersiowych, progresja 'T', 'Y' i 'I' z taśmą lub hantlem oraz izometria szyi we wszystkich płaszczyznach.","minimum_requirements_de":"Schmerzfreiheit der Halswirbelsäule im vollen Bewegungsumfang in allen Ebenen; sehr gute Muskelkraft; Hals- und Armsymptome sind abgeklungen.","minimum_requirements_en":"Cervical spine pain-free in all planes of motion; very good strength; neck and arm symptoms are gone.","minimum_requirements_pl":"Brak bólu w pełnym zakresie ruchu szyi we wszystkich płaszczyznach; bardzo dobra siła; objawy szyi i ręki ustąpiły.","additional_notes_original":"Avoid any activity or exercise that reproduces radicular symptoms. Progress strengthening with increased resistance.","therapeutic_content_original":"Continue to acquire normal ROM if deficient, progressively strengthen periscapular muscle groups with increased resistance, and restore functional use of the arm and neck. Exercises: cervical spine muscle stretches, thoracic mobility exercises, pectoral stretching, T/Y/I progression with Theraband or dumbbell, and cervical isometrics in all planes.","minimum_requirements_original":"Cervical spine pain-free in all planes of motion; very good strength; neck and arm symptoms are gone.","structured_content_v2":"$undefined"},{"id":"5c54a994-7740-506b-b419-c3e3d6a8dbe4","name_de":"Phase 4: Sportartspezifische Phase","name_en":"Phase 4: Sport Specific Phase","name_pl":"Faza 4: Powrót do sportu","source_page":4,"module_number":4,"name_original":"Phase 4: Sport Specific Phase","service_codes":[],"structured_content":{"de":{"goals":["Wiederherstellung des normalen Bewegungsumfangs und der Kraft sowie weitere Nutzung der Halswirbelsäule bei funktionellen Aktivitäten und der Rückkehr zum Sport."],"warnings":["Den spezifischen Plan mit Orthopäden oder Physiotherapeuten abstimmen."],"applies_when":["Sportartspezifische Phase"],"dosage_and_progression":["Die Rückkehr zu Sport und hochintensiver Aktivität soll langsam erfolgen."]},"en":{"goals":["Restore normal ROM and strength and continue to encourage cervical spine use for functional activity and return to sport."],"warnings":["Work with the orthopedic doctor or physical therapist on the specific plan."],"applies_when":["Sport Specific Phase"],"dosage_and_progression":["Encourage slow progression back to sport and high-level activity."]},"pl":{"goals":["Przywrócenie prawidłowego ROM i siły oraz dalsze używanie szyi w aktywności funkcjonalnej i powrocie do sportu."],"warnings":["Szczegółowy plan ustalić z lekarzem ortopedą lub fizjoterapeutą."],"applies_when":["Powrót do sportu"],"dosage_and_progression":["Powrót do sportu i aktywności o dużej intensywności powinien przebiegać powoli."]},"original":{"goals":["Restore normal ROM and strength and continue to encourage cervical spine use for functional activity and return to sport."],"warnings":["Work with the orthopedic doctor or physical therapist on the specific plan."],"applies_when":["Sport Specific Phase"],"dosage_and_progression":["Encourage slow progression back to sport and high-level activity."]}},"additional_notes_de":"Den spezifischen Plan mit Orthopäden oder Physiotherapeuten abstimmen.","additional_notes_en":"Work with the orthopedic doctor or physical therapist on the specific plan.","additional_notes_pl":"Szczegółowy plan ustalić z lekarzem ortopedą lub fizjoterapeutą.","minimum_patient_share":null,"therapeutic_content_de":"Wiederherstellung des normalen Bewegungsumfangs und der Kraft sowie weitere Nutzung der Halswirbelsäule bei funktionellen Aktivitäten und der Rückkehr zum Sport.","therapeutic_content_en":"Restore normal ROM and strength and continue to encourage cervical spine use for functional activity and return to sport.","therapeutic_content_pl":"Przywrócenie prawidłowego ROM i siły oraz dalsze używanie szyi w aktywności funkcjonalnej i powrocie do sportu.","minimum_requirements_de":"Die Rückkehr zu Sport und hochintensiver Aktivität soll langsam erfolgen.","minimum_requirements_en":"Encourage slow progression back to sport and high-level activity.","minimum_requirements_pl":"Powrót do sportu i aktywności o dużej intensywności powinien przebiegać powoli.","additional_notes_original":"Work with the orthopedic doctor or physical therapist on the specific plan.","therapeutic_content_original":"Restore normal ROM and strength and continue to encourage cervical spine use for functional activity and return to sport.","minimum_requirements_original":"Encourage slow progression back to sport and high-level activity.","structured_content_v2":"$undefined"},{"id":"45c57e2e-021d-5966-9cf0-102423fd65e9","name_de":"Einzigartige Hinweise zur Rückkehr zur Aktivität — Seite 5","name_en":"Unique return-to-activity guidance — page 5","name_pl":"Unikalne wskazówki powrotu do aktywności — strona 5","source_page":5,"module_number":5,"name_original":"Unique return-to-activity guidance — page 5","service_codes":[],"structured_content":{"de":{"progression_criteria":["Schrittweise Progression soll die allmähliche Rückkehr zu hochintensiver Aktivität ermöglichen.","Den spezifischen Plan für die Rückkehr zu Sport und Aktivität mit Arzt oder Physiotherapeut abstimmen."],"dosage_and_progression":["Kräftigung der Phase 3 2–3-mal wöchentlich fortführen."],"physiotherapist_actions":["Übungen der Phasen 2 und 3 nach Anweisung des Physiotherapeuten fortführen.","Mit dem Physiotherapeuten zusammenarbeiten, um festzulegen, welche Übungen fortgeführt werden sollen."]},"en":{"progression_criteria":["Step-by-step progressions should allow for gradual return to high-level activities.","Work with physician or physical therapist for specific plan for return to sport and activity."],"dosage_and_progression":["Continue Phase 3 strengthening 2–3 times a week."],"physiotherapist_actions":["Continue Phase 2 and 3 exercises as directed by the physical therapist.","Work with the physical therapist to determine which exercises should be continued."]},"pl":{"progression_criteria":["Progresja krok po kroku powinna umożliwić stopniowy powrót do aktywności o dużej intensywności.","Szczegółowy plan powrotu do sportu i aktywności ustalić z lekarzem lub fizjoterapeutą."],"dosage_and_progression":["Kontynuować wzmacnianie fazy 3 2–3 razy w tygodniu."],"physiotherapist_actions":["Kontynuować ćwiczenia faz 2 i 3 zgodnie ze wskazaniami fizjoterapeuty.","Współpracować z fizjoterapeutą, aby ustalić, które ćwiczenia należy kontynuować."]},"original":{"progression_criteria":["Step-by-step progressions should allow for gradual return to high-level activities.","Work with physician or physical therapist for specific plan for return to sport and activity."],"dosage_and_progression":["Continue Phase 3 strengthening 2–3 times a week."],"physiotherapist_actions":["Continue Phase 2 and 3 exercises as directed by the physical therapist.","Work with the physical therapist to determine which exercises should be continued."]}},"additional_notes_de":"Keine zusätzlichen Sätze, Wiederholungen oder im Original nicht genannten Techniken.","additional_notes_en":"No additional sets, repetitions, or techniques not stated in the source.","additional_notes_pl":"Brak dodatkowych serii, powtórzeń lub technik niewskazanych w źródle.","minimum_patient_share":null,"therapeutic_content_de":"Übungen der Phasen 2 und 3 nach Anweisung des Physiotherapeuten fortführen; Kräftigung der Phase 3 2–3-mal wöchentlich fortführen; mit dem Physiotherapeuten zusammenarbeiten, um festzulegen, welche Übungen fortgeführt werden sollen; die Rückkehr soll schrittweise erfolgen.","therapeutic_content_en":"Continue Phase 2 and 3 exercises as directed by the physical therapist; continue Phase 3 strengthening 2–3 times a week; work with the physical therapist to determine which exercises should be continued; step-by-step progressions should allow for gradual return to high-level activities.","therapeutic_content_pl":"Kontynuować ćwiczenia faz 2 i 3 zgodnie ze wskazaniami fizjoterapeuty; kontynuować wzmacnianie fazy 3 2–3 razy w tygodniu; współpracować z fizjoterapeutą, aby ustalić, które ćwiczenia należy kontynuować; powrót ma przebiegać stopniowo, krok po kroku.","minimum_requirements_de":"Den spezifischen Rückkehrplan mit Arzt oder Physiotherapeut abstimmen.","minimum_requirements_en":"Work with physician or physical therapist for specific plan for return to sport and activity.","minimum_requirements_pl":"Szczegółowy plan powrotu ustalić z lekarzem lub fizjoterapeutą.","additional_notes_original":"No additional sets, repetitions, or techniques not stated in the source.","therapeutic_content_original":"Continue Phase 2 and 3 exercises as directed by the physical therapist; continue Phase 3 strengthening 2–3 times a week; work with the physical therapist to determine which exercises should be continued; step-by-step progressions should allow for gradual return to high-level activities.","minimum_requirements_original":"Work with physician or physical therapist for specific plan for return to sport and activity.","structured_content_v2":"$undefined"},{"id":"6f0e0b22-ef8b-574c-a98a-8d6d24fc631a","name_de":"Einzigartige Dosierung und Rückkehrkriterien — Seite 6","name_en":"Unique dosage and return criteria — page 6","name_pl":"Unikalne dawkowanie i kryteria powrotu — strona 6","source_page":6,"module_number":6,"name_original":"Unique dosage and return criteria — page 6","service_codes":[],"structured_content":{"de":{"exercises":["Funktionelles Ausdauertraining.","Dynamische Progressionen.","Propriozeptive Übungen."],"progression_criteria":["Rückkehr nach der Beurteilung durch Chirurgen/Physiotherapeuten.","Voller schmerzfreier Bewegungsumfang und exzellente Kraft vor der Rückkehr zum Sport."],"dosage_and_progression":["Theraband- und periskapuläre Progressionen: 3-mal wöchentlich nach Bedarf.","Propriozeptive Übungen: 2–3-mal wöchentlich."],"physiotherapist_actions":["Globale Kräftigung des Halses.","Kräftigung der periskapulären Muskeln und der thorakalen Extensoren."]},"en":{"exercises":["Functional endurance training.","Dynamic progressions.","Proprioceptive drills."],"progression_criteria":["Return according to Surgeon/Physical Therapist Evaluation.","Full Pain Free ROM and Excellent Strength before Progression Back to Sport."],"dosage_and_progression":["T-band and periscapular progressions: 3 times per week as needed.","Proprioceptive drills: 2–3 times per week."],"physiotherapist_actions":["Global neck strengthening.","Strengthening of periscapular muscles and thoracic extensors."]},"pl":{"exercises":["Trening wytrzymałości funkcjonalnej.","Progresje dynamiczne.","Ćwiczenia propriocepcji."],"progression_criteria":["Powrót zgodnie z oceną chirurga/fizjoterapeuty.","Pełny bezbolesny ROM i doskonała siła przed powrotem do sportu."],"dosage_and_progression":["Wzmacnianie z taśmą i progresja okołołopatkowa: 3 razy w tygodniu według potrzeb.","Ćwiczenia propriocepcji: 2–3 razy w tygodniu."],"physiotherapist_actions":["Wzmacnianie globalne szyi.","Wzmacnianie mięśni okołołopatkowych i prostowników odcinka piersiowego."]},"original":{"exercises":["Functional endurance training.","Dynamic Progressions: Continue Proprioceptive Drills During Return to Sport 2-3 x/Week."],"progression_criteria":["Return to Sports and Physical Activity per Surgeon/Physical Therapist Evaluation.","Achieve Full Pain Free ROM and Excellent Strength Before Progression Back to Sport."],"dosage_and_progression":["Continue T-band and Peri-scapular Progressions 3 x/Week as Needed.","Continue Proprioceptive Drills During Return to Sport 2-3 x/Week."],"physiotherapist_actions":["Global neck strengthening.","Strengthening of periscapular muscles and thoracic extensors."]}},"additional_notes_de":"","additional_notes_en":"","additional_notes_pl":"","minimum_patient_share":null,"therapeutic_content_de":"Einzigartige Ergänzungen der Quellentabelle: funktionelles Ausdauertraining, globale Kräftigung des Halses, Kräftigung der periskapulären Muskeln und der thorakalen Extensoren, dynamische Progressionen und propriozeptive Übungen. Theraband- und periskapuläre Progressionen 3-mal wöchentlich nach Bedarf. Propriozeptive Übungen 2–3-mal wöchentlich. Rückkehr nach der Beurteilung durch Chirurgen/Physiotherapeuten; voller schmerzfreier Bewegungsumfang und exzellente Kraft vor der Rückkehr zum Sport.","therapeutic_content_en":"Unique additions from the source table: functional endurance training, global neck strengthening, and strengthening of periscapular muscles and thoracic extensors. Continue T-band and Peri-scapular Progressions 3 x/Week as Needed. Continue Proprioceptive Drills During Return to Sport 2-3 x/Week. Return to Sports and Physical Activity per Surgeon/Physical Therapist Evaluation; Achieve Full Pain Free ROM and Excellent Strength Before Progression Back to Sport.","therapeutic_content_pl":"Unikalne uzupełnienia tabeli źródłowej: trening wytrzymałości funkcjonalnej, wzmacnianie globalne szyi, wzmacnianie mięśni okołołopatkowych i prostowników odcinka piersiowego, progresje dynamiczne oraz ćwiczenia propriocepcji. Wzmacnianie z taśmą i progresja okołołopatkowa 3 razy w tygodniu według potrzeb. Ćwiczenia propriocepcji 2–3 razy w tygodniu. Powrót zgodnie z oceną chirurga/fizjoterapeuty; pełny bezbolesny ROM i doskonała siła przed powrotem do sportu.","minimum_requirements_de":"Voller schmerzfreier Bewegungsumfang und exzellente Kraft vor der Rückkehr zum Sport; Rückkehr nach der Beurteilung durch Chirurgen/Physiotherapeuten.","minimum_requirements_en":"Full pain-free ROM and excellent strength before return to sport; return according to Surgeon/Physical Therapist Evaluation.","minimum_requirements_pl":"Pełny bezbolesny ROM i doskonała siła przed powrotem do sportu; powrót zgodnie z oceną chirurga/fizjoterapeuty.","additional_notes_original":"","therapeutic_content_original":"Unique additions from the source table: functional endurance training, global neck strengthening, and strengthening of periscapular muscles and thoracic extensors. Continue T-band and Peri-scapular Progressions 3 x/Week as Needed. Continue Proprioceptive Drills During Return to Sport 2-3 x/Week. 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verification.","modules":[{"id":"f8a8a74a-fc3c-5de4-99fe-62fb2593c46f","name_de":"Multifaktorielles Sturzrisikomanagement","name_en":"Multifactorial Fall-Risk Management","name_pl":"Wieloczynnikowe zarządzanie ryzykiem upadku","source_page":3,"module_number":1,"name_original":"Multifaktorielles Sturzrisikomanagement","service_codes":[],"structured_content":{"de":{"warnings":["Evidenzlevel I, Empfehlungsstärke Strong."],"exercises":["Physiotherapeuten sollen an Programmen mit Screening, Untersuchung, Überweisung und PT-Interventionen teilnehmen.","Mobilität, Gleichgewicht, Gang, ADL, Aktivität, Beinkraft, Schuhwerk und Umweltgefahren untersuchen."],"physiotherapist_actions":["Intervention an das Risikoprofil anpassen und Probleme außerhalb des PT-Bereichs weiterleiten."]},"en":{"warnings":["Evidence Level I, recommendation strength Strong."],"exercises":["Physical therapists should participate in programs including screening, examination, referral, and PT interventions.","Examine mobility, balance, gait, ADLs, activity, lower-extremity strength, footwear, and environmental hazards."],"physiotherapist_actions":["Tailor intervention to the risk profile and refer issues outside PT scope."]},"pl":{"warnings":["Poziom dowodów I, siła Strong."],"exercises":["Fizjoterapeuta powinien uczestniczyć w programie obejmującym screening, ocenę, skierowanie i interwencje PT.","Oceniaj mobilność, równowagę, chód, ADL, aktywność, siłę kończyn dolnych, obuwie i zagrożenia środowiskowe."],"physiotherapist_actions":["Dopasuj interwencję do profilu ryzyka i kieruj problemy poza zakresem PT do właściwego specjalisty."]},"original":{"warnings":["Evidence Level I, recommendation strength Strong."],"exercises":["Physical therapists should participate in programs including screening, examination, referral, and PT interventions.","Examine mobility, balance, gait, ADLs, activity, lower-extremity strength, footwear, and environmental hazards."],"physiotherapist_actions":["Tailor intervention to the risk profile and refer issues outside PT scope."]}},"additional_notes_de":"Evidenzlevel I, Empfehlungsstärke Strong.","additional_notes_en":"Evidence Level I, recommendation strength Strong.","additional_notes_pl":"Poziom dowodów I, siła Strong.","minimum_patient_share":null,"therapeutic_content_de":"Physiotherapeuten sollen an Programmen mit Screening, Untersuchung, Überweisung und PT-Interventionen teilnehmen. Mobilität, Gleichgewicht, Gang, ADL, Aktivität, Beinkraft, Schuhwerk und Umweltgefahren untersuchen.","therapeutic_content_en":"Physical therapists should participate in programs including screening, examination, referral, and PT interventions. Examine mobility, balance, gait, ADLs, activity, lower-extremity strength, footwear, and environmental hazards.","therapeutic_content_pl":"Fizjoterapeuta powinien uczestniczyć w programie obejmującym screening, ocenę, skierowanie i interwencje PT. Oceniaj mobilność, równowagę, chód, ADL, aktywność, siłę kończyn dolnych, obuwie i zagrożenia środowiskowe.","minimum_requirements_de":"Intervention an das Risikoprofil anpassen und Probleme außerhalb des PT-Bereichs weiterleiten.","minimum_requirements_en":"Tailor intervention to the risk profile and refer issues outside PT scope.","minimum_requirements_pl":"Dopasuj interwencję do profilu ryzyka i kieruj problemy poza zakresem PT do właściwego specjalisty.","additional_notes_original":"Evidenzlevel I, Empfehlungsstärke Strong.","therapeutic_content_original":"Physical therapists should participate in multifactorial management programs addressing falls and fall risk for older adults.","minimum_requirements_original":"Tailor intervention to the risk profile and refer issues outside PT scope.","structured_content_v2":"$undefined"},{"id":"1caba560-ad54-5286-8784-7567d8189ea3","name_de":"Multikomponentes Training","name_en":"Multicomponent Exercise","name_pl":"Ćwiczenia wieloskładnikowe","source_page":3,"module_number":2,"name_original":"Multikomponentes Training","service_codes":[],"structured_content":{"de":{"warnings":["Level I, Stärke Strong."],"exercises":["Ein multikomponentes Programm mit Gleichgewichtstraining und weiteren Übungsformen wie Krafttraining oder Tai Chi einsetzen oder verordnen."],"progression_criteria":["Das Programm muss progressiv und sicherheitsgerecht angepasst sein."]},"en":{"warnings":["Level I, strength Strong."],"exercises":["Provide or prescribe multicomponent exercise including balance training and other modes such as resistance training or Tai Chi to reduce falls and fall risk."],"progression_criteria":["The program must be progressive and adapted to patient safety."]},"pl":{"warnings":["Poziom I, siła Strong."],"exercises":["Stosuj lub zlecaj program wieloskładnikowy zawierający trening równowagi oraz inne formy ćwiczeń, np. oporowe lub Tai Chi, aby zmniejszać ryzyko i częstość upadków."],"progression_criteria":["Program musi być progresywny i dostosowany do bezpieczeństwa pacjenta."]},"original":{"warnings":["Level I, strength Strong."],"exercises":["Provide or prescribe multicomponent exercise including balance training and other modes such as resistance training or Tai Chi to reduce falls and fall risk."],"progression_criteria":["The program must be progressive and adapted to patient safety."]}},"additional_notes_de":"Level I, Stärke Strong.","additional_notes_en":"Level I, strength Strong.","additional_notes_pl":"Poziom I, siła Strong.","minimum_patient_share":null,"therapeutic_content_de":"Ein multikomponentes Programm mit Gleichgewichtstraining und weiteren Übungsformen wie Krafttraining oder Tai Chi einsetzen oder verordnen.","therapeutic_content_en":"Provide or prescribe multicomponent exercise including balance training and other modes such as resistance training or Tai Chi to reduce falls and fall risk.","therapeutic_content_pl":"Stosuj lub zlecaj program wieloskładnikowy zawierający trening równowagi oraz inne formy ćwiczeń, np. oporowe lub Tai Chi, aby zmniejszać ryzyko i częstość upadków.","minimum_requirements_de":"Das Programm muss progressiv und sicherheitsgerecht angepasst sein.","minimum_requirements_en":"The program must be progressive and adapted to patient safety.","minimum_requirements_pl":"Program musi być progresywny i dostosowany do bezpieczeństwa pacjenta.","additional_notes_original":"Level I, Stärke Strong.","therapeutic_content_original":"Physical therapists must provide or prescribe multicomponent exercise to older adults; it must include balance training and may include other exercise modes.","minimum_requirements_original":"The program must be progressive and adapted to patient safety.","structured_content_v2":"$undefined"},{"id":"a2119fb9-498d-5ce0-b76d-220ab8ac2e7c","name_de":"Dosierung und Progression des Gleichgewichtstrainings","name_en":"Balance Dosage and Progression","name_pl":"Dawkowanie i progresja równowagi","source_page":3,"module_number":3,"name_original":"Dosierung und Progression des Gleichgewichtstrainings","service_codes":[],"structured_content":{"de":{"warnings":["Level I, Stärke Strong."],"exercises":["Übungen mindestens 150 Minuten bis 3 Stunden pro Woche über 6–12 Monate verordnen.","Gleichgewichtstraining soll progressiv und ausreichend anspruchsvoll sein: Bewegungen in mehrere Richtungen, Veränderung der Unterstützungsfläche und weniger Unterstützung der oberen Extremitäten."],"physiotherapist_actions":["Sicherung und individuelles Risikoniveau berücksichtigen."]},"en":{"warnings":["Level I, strength Strong."],"exercises":["Prescribe exercise 150 minutes to 3 hours per week for 6–12 months.","Balance training must be progressive and sufficiently challenging through multidirectional limb and whole-body movement, changing base of support, and reducing upper-limb support."],"physiotherapist_actions":["Provide supervision and account for individual risk."]},"pl":{"warnings":["Poziom I, siła Strong."],"exercises":["Zalecaj ćwiczenia co najmniej 150 minut do 3 godzin tygodniowo przez 6–12 miesięcy.","Trening równowagi powinien być progresywny i wystarczająco wymagający: ruch kończyn i całego ciała w wielu kierunkach, zmiana podstawy podparcia i ograniczanie podparcia kończyn górnych."],"physiotherapist_actions":["Uwzględnij asekurację i indywidualny poziom ryzyka."]},"original":{"warnings":["Level I, strength Strong."],"exercises":["Prescribe exercise 150 minutes to 3 hours per week for 6–12 months.","Balance training must be progressive and sufficiently challenging through multidirectional limb and whole-body movement, changing base of support, and reducing upper-limb support."],"physiotherapist_actions":["Provide supervision and account for individual risk."]}},"additional_notes_de":"Level I, Stärke Strong.","additional_notes_en":"Level I, strength Strong.","additional_notes_pl":"Poziom I, siła Strong.","minimum_patient_share":null,"therapeutic_content_de":"Übungen mindestens 150 Minuten bis 3 Stunden pro Woche über 6–12 Monate verordnen. Gleichgewichtstraining soll progressiv und ausreichend anspruchsvoll sein: Bewegungen in mehrere Richtungen, Veränderung der Unterstützungsfläche und weniger Unterstützung der oberen Extremitäten.","therapeutic_content_en":"Prescribe exercise 150 minutes to 3 hours per week for 6–12 months. Balance training must be progressive and sufficiently challenging through multidirectional limb and whole-body movement, changing base of support, and reducing upper-limb support.","therapeutic_content_pl":"Zalecaj ćwiczenia co najmniej 150 minut do 3 godzin tygodniowo przez 6–12 miesięcy. Trening równowagi powinien być progresywny i wystarczająco wymagający: ruch kończyn i całego ciała w wielu kierunkach, zmiana podstawy podparcia i ograniczanie podparcia kończyn górnych.","minimum_requirements_de":"Sicherung und individuelles Risikoniveau berücksichtigen.","minimum_requirements_en":"Provide supervision and account for individual risk.","minimum_requirements_pl":"Uwzględnij asekurację i indywidualny poziom ryzyka.","additional_notes_original":"Level I, Stärke Strong.","therapeutic_content_original":"Physical therapists must prescribe exercise at least 150 minutes to 3 hours per week, lasting 6 to 12 months, including progressive and sufficiently challenging balance training.","minimum_requirements_original":"Provide supervision and account for individual risk.","structured_content_v2":"$undefined"},{"id":"99b516a3-ffe0-5756-a811-b3c5086cb094","name_de":"Schritt- und Gangadaptationstraining","name_en":"Step and Gait Adaptability Training","name_pl":"Trening kroku i adaptacji chodu","source_page":3,"module_number":4,"name_original":"Schritt- und Gangadaptationstraining","service_codes":[],"structured_content":{"de":{"warnings":["Willentliche Schritte: Level I/Strong","Perturbationen: Level II/Weak."],"exercises":["Gleichgewichtstraining soll willentliches Schritttraining und/oder Gangadaptation enthalten.","Reaktives Schritttraining nach Perturbationen kann ergänzt werden, hat aber schwächere Evidenz."],"dosage_and_progression":["Schwierigkeit stufenweise steigern und gegen Stürze sichern."]},"en":{"warnings":["Volitional steps: Level I/Strong","perturbations: Level II/Weak."],"exercises":["Balance training must include volitional step training and/or gait adaptability training.","Reactive step (perturbation) training may also be included but has weaker evidence."],"dosage_and_progression":["Progress difficulty and guard against falls."]},"pl":{"warnings":["Celowe kroki: Level I/Strong","perturbacje: Level II/Weak."],"exercises":["Trening równowagi powinien obejmować celowe ćwiczenia kroku i/lub adaptacji chodu.","Reaktywne ćwiczenia kroku po perturbacji mogą być dodatkiem, ale mają słabszą podstawę dowodową."],"physiotherapist_actions":["Stopniuj trudność i zabezpieczaj przed upadkiem."]},"original":{"warnings":["Volitional steps: Level I/Strong","perturbations: Level II/Weak."],"exercises":["Balance training must include volitional step training and/or gait adaptability training.","Reactive step (perturbation) training may also be included but has weaker evidence."],"dosage_and_progression":["Progress difficulty and guard against falls."]}},"additional_notes_de":"Willentliche Schritte: Level I/Strong; Perturbationen: Level II/Weak.","additional_notes_en":"Volitional steps: Level I/Strong; perturbations: Level II/Weak.","additional_notes_pl":"Celowe kroki: Level I/Strong; perturbacje: Level II/Weak.","minimum_patient_share":null,"therapeutic_content_de":"Gleichgewichtstraining soll willentliches Schritttraining und/oder Gangadaptation enthalten. Reaktives Schritttraining nach Perturbationen kann ergänzt werden, hat aber schwächere Evidenz.","therapeutic_content_en":"Balance training must include volitional step training and/or gait adaptability training. Reactive step (perturbation) training may also be included but has weaker evidence.","therapeutic_content_pl":"Trening równowagi powinien obejmować celowe ćwiczenia kroku i/lub adaptacji chodu. Reaktywne ćwiczenia kroku po perturbacji mogą być dodatkiem, ale mają słabszą podstawę dowodową.","minimum_requirements_de":"Schwierigkeit stufenweise steigern und gegen Stürze sichern.","minimum_requirements_en":"Progress difficulty and guard against falls.","minimum_requirements_pl":"Stopniuj trudność i zabezpieczaj przed upadkiem.","additional_notes_original":"Willentliche Schritte: Level I/Strong; Perturbationen: Level II/Weak.","therapeutic_content_original":"Balance training must include volitional step training and/or gait adaptability training; reactive step training may also be included.","minimum_requirements_original":"Progress difficulty and guard against falls.","structured_content_v2":"$undefined"},{"id":"1ec2c64e-b9cd-575f-b9ea-7000210fea42","name_de":"Krafttraining und Tai Chi","name_en":"Resistance Training and Tai Chi","name_pl":"Trening oporowy i Tai Chi","source_page":3,"module_number":5,"name_original":"Krafttraining und Tai Chi","service_codes":[],"structured_content":{"de":{"warnings":["Krafttraining allein: Level II/Moderate","Tai Chi: Level I/Strong."],"exercises":["Krafttraining nicht als alleinige Sturzintervention einsetzen.","Mit Gleichgewicht in einem multikomponentem Programm kombinieren.","Tai Chi wird zur Sturzreduktion stark empfohlen."],"physiotherapist_actions":["Belastung an Funktion und Komorbiditäten anpassen."]},"en":{"warnings":["Resistance alone: Level II/Moderate","Tai Chi: Level I/Strong."],"exercises":["combine it with balance in a multicomponent program.","Tai Chi is strongly recommended to reduce falls."],"restrictions":["Do not use resistance training alone to reduce falls"],"physiotherapist_actions":["Adapt loading to function and comorbidities."]},"pl":{"warnings":["Trening oporowy sam: Level II/Moderate","Tai Chi: Level I/Strong."],"exercises":["Możesz łączyć go z równowagą w programie wieloskładnikowym.","Tai Chi jest silnie zalecane jako forma redukcji ryzyka upadku."],"restrictions":["Nie stosuj samego treningu oporowego jako jedynej interwencji zapobiegania upadkom."],"physiotherapist_actions":["Dobierz obciążenie do stanu funkcjonalnego i chorób współistniejących."]},"original":{"warnings":["Resistance alone: Level II/Moderate","Tai Chi: Level I/Strong."],"exercises":["combine it with balance in a multicomponent program.","Tai Chi is strongly recommended to reduce falls."],"restrictions":["Do not use resistance training alone to reduce falls"],"physiotherapist_actions":["Adapt loading to function and comorbidities."]}},"additional_notes_de":"Krafttraining allein: Level II/Moderate; Tai Chi: Level I/Strong.","additional_notes_en":"Resistance alone: Level II/Moderate; Tai Chi: Level I/Strong.","additional_notes_pl":"Trening oporowy sam: Level II/Moderate; Tai Chi: Level I/Strong.","minimum_patient_share":null,"therapeutic_content_de":"Krafttraining nicht als alleinige Sturzintervention einsetzen. Mit Gleichgewicht in einem multikomponentem Programm kombinieren. Tai Chi wird zur Sturzreduktion stark empfohlen.","therapeutic_content_en":"Do not use resistance training alone to reduce falls; combine it with balance in a multicomponent program. Tai Chi is strongly recommended to reduce falls.","therapeutic_content_pl":"Nie stosuj samego treningu oporowego jako jedynej interwencji zapobiegania upadkom. Możesz łączyć go z równowagą w programie wieloskładnikowym. Tai Chi jest silnie zalecane jako forma redukcji ryzyka upadku.","minimum_requirements_de":"Belastung an Funktion und Komorbiditäten anpassen.","minimum_requirements_en":"Adapt loading to function and comorbidities.","minimum_requirements_pl":"Dobierz obciążenie do stanu funkcjonalnego i chorób współistniejących.","additional_notes_original":"Krafttraining allein: Level II/Moderate; Tai Chi: Level I/Strong.","therapeutic_content_original":"Physical therapists should NOT provide or prescribe resistance training ALONE; they should prescribe Tai Chi for older adults.","minimum_requirements_original":"Adapt loading to function and comorbidities.","structured_content_v2":"$undefined"},{"id":"430be224-a699-52be-9b1c-a48da42d7518","name_de":"Aufklärung und Umweltanpassung","name_en":"Education and Environmental Modification","name_pl":"Edukacja i modyfikacja środowiska","source_page":3,"module_number":6,"name_original":"Aufklärung und Umweltanpassung","service_codes":[],"structured_content":{"de":{"warnings":["Aufklärung allein: Level I/Strong","Umweltanpassung: Level I/Strong."],"exercises":["Personalisierte Aufklärung mit individuellem Training kombinieren.","Risikofaktoren, Wohnungsgefahren sowie Kraft- und Gleichgewichtsdefizite behandeln und externe Faktoren weiterleiten.","Bei hohem Risiko Umwelt beurteilen und Anpassungen empfehlen."],"physiotherapist_actions":["Aufklärung nicht als alleinige Sturzintervention einsetzen."]},"en":{"warnings":["Education alone: Level I/Strong","environmental modification: Level I/Strong."],"exercises":["Address risk factors, home hazards, strength and balance impairments, and refer issues outside PT scope.","For high-risk adults, assess the environment and recommend modifications."],"restrictions":["Do not use education alone to prevent falls."],"physiotherapist_actions":["Combine tailored education with individualized exercise."]},"pl":{"warnings":["Edukacja sama: Level I/Strong","modyfikacja środowiska: Level I/Strong."],"exercises":["Omawiaj czynniki ryzyka, zagrożenia w domu, deficyty siły i równowagi oraz kieruj problemy poza zakresem PT.","U osób wysokiego ryzyka wykonuj ocenę środowiska i zalecaj modyfikacje."],"restrictions":["Nie stosuj samej edukacji jako interwencji zapobiegającej upadkom."],"physiotherapist_actions":["Łącz spersonalizowaną edukację z indywidualnym programem ćwiczeń."]},"original":{"warnings":["Education alone: Level I/Strong","environmental modification: Level I/Strong."],"exercises":["Address risk factors, home hazards, strength and balance impairments, and refer issues outside PT scope.","For high-risk adults, assess the environment and recommend modifications."],"restrictions":["Do not use education alone to prevent falls."],"physiotherapist_actions":["Combine tailored education with individualized exercise."]}},"additional_notes_de":"Aufklärung allein: Level I/Strong; Umweltanpassung: Level I/Strong.","additional_notes_en":"Education alone: Level I/Strong; environmental modification: Level I/Strong.","additional_notes_pl":"Edukacja sama: Level I/Strong; modyfikacja środowiska: Level I/Strong.","minimum_patient_share":null,"therapeutic_content_de":"Personalisierte Aufklärung mit individuellem Training kombinieren. Risikofaktoren, Wohnungsgefahren sowie Kraft- und Gleichgewichtsdefizite behandeln und externe Faktoren weiterleiten. Bei hohem Risiko Umwelt beurteilen und Anpassungen empfehlen.","therapeutic_content_en":"Combine tailored education with individualized exercise. Address risk factors, home hazards, strength and balance impairments, and refer issues outside PT scope. For high-risk adults, assess the environment and recommend modifications.","therapeutic_content_pl":"Łącz spersonalizowaną edukację z indywidualnym programem ćwiczeń. Omawiaj czynniki ryzyka, zagrożenia w domu, deficyty siły i równowagi oraz kieruj problemy poza zakresem PT. U osób wysokiego ryzyka wykonuj ocenę środowiska i zalecaj modyfikacje.","minimum_requirements_de":"Aufklärung nicht als alleinige Sturzintervention einsetzen.","minimum_requirements_en":"Do not use education alone to prevent falls.","minimum_requirements_pl":"Nie stosuj samej edukacji jako interwencji zapobiegającej upadkom.","additional_notes_original":"Aufklärung allein: Level I/Strong; Umweltanpassung: Level I/Strong.","therapeutic_content_original":"Physical therapists should provide tailored education combined with individualized exercise and should provide environmental assessment and recommend modifications to older adults at high risk of falls.","minimum_requirements_original":"Do not use education alone to prevent 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(ostra, wzmacnianie, funkcjonalna) wykorzystujący wytyczne PRICE oraz progresję ćwiczeń propriocepcji i siły.","summary_de":"Phasenorientiertes Protokoll (Akut, Kräftigung, Funktionell) mit PRICE-Richtlinien und Progression von Propriozeption und Kraft.","summary_en":"Phase-based protocol (Acute, Strengthening, Functional) utilizing PRICE guidelines and progression of proprioception and strength exercises.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"c79efa17-ec01-5987-9175-fd09f314a623","condition_slug":"lateral-ankle-sprain","condition_name_pl":"Skręcenie stawu skokowego bocznego","condition_name_de":"Laterale Sprunggelenksdistorsion","condition_name_en":"Lateral Ankle Sprain","condition_name_original":"Lateral Ankle 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Authorization is required before final public release. Current development and staging remain allowed by the owner's decision.","modules":[{"id":"4e00e9a9-7ead-5002-b400-469056c5d83b","name_de":"Phase 1: Wochen 0–6","name_en":"Phase 1: Weeks 0-6","name_pl":"Faza 1: tygodnie 0–6","source_page":1,"module_number":1,"name_original":"Phase 1: Weeks 0-6","service_codes":[],"structured_content":{"de":{"goals":["früher geschützter Bewegungsumfang, Verringerung von Schmerzen und Schwellung, Flüssigkeitsmobilisation sowie Aktivierung der Gluteal- und Quadrizepsmuskulatur."],"exercises":["CPM ab 0–60°, wöchentlich um 10° bis 90° steigern","passiver Bewegungsumfang bei vollständiger Entspannung von Adduktoren, Iliopsoas und TFL","partnerassistierter Bewegungsumfang zu Hause 2× täglich je 15 Minuten: je 5 Minuten Zirkumduktion im und gegen den Uhrzeigersinn bei 30° Hüftflexion sowie Log Rolls in voller Extension","therapeutisch assistierte Zirkumduktion 10 Minuten in beide Richtungen bei 70° Flexion","tägliche Längstraktion","ab Woche 2 Quadrizeps-, 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Für 3 Wochen: keine Flexion >90°, Außenrotation >15°, Extension nur bis neutral und Abduktion bis 40°. TFL, Adductor longus und Iliopsoas nicht aktivieren und nicht in den Schmerz hinein arbeiten, besonders nicht bei klemmendem Leistenschmerz. Progressionskriterien: normales Gangbild.","minimum_requirements_en":"Use protected range of motion and touch-down weight-bearing for 4 weeks and a hip brace while walking for 3 weeks; transition to 50% weight-bearing at week 3 and wean crutches at week 4. For 3 weeks: no flexion beyond 90°, external rotation beyond 15°, extension beyond neutral or abduction beyond 40°. Avoid activation of the TFL, adductor longus and iliopsoas, and do not push through pain, especially pinching groin pain. Progression criteria: normal gait.","minimum_requirements_pl":"Chroniony zakres ruchu i obciążanie touch-down przez 4 tygodnie; orteza biodra podczas chodzenia przez 3 tygodnie; następnie 50% obciążania w 3. tygodniu i odstawianie kul w 4. tygodniu. Przez 3 tygodnie: bez zgięcia >90°, rotacji zewnętrznej >15°, wyprost tylko do pozycji neutralnej i odwodzenie do 40°. Nie aktywować TFL, przywodziciela długiego ani mięśnia biodrowo-lędźwiowego i nie przechodzić przez ból, szczególnie szczypiący ból pachwiny. Kryteria progresji: prawidłowy chód.","additional_notes_original":"Goals: early protected range of motion, decreased soreness and swelling, fluid mobilization, and activation of the gluteal and quadriceps muscles.","therapeutic_content_original":"$23","minimum_requirements_original":"Use protected range of motion and touch-down weight-bearing for 4 weeks and a hip brace while walking for 3 weeks; transition to 50% weight-bearing at week 3 and wean crutches at week 4. For 3 weeks: no flexion beyond 90°, external rotation beyond 15°, extension beyond neutral or abduction beyond 40°. Avoid activation of the TFL, adductor longus and iliopsoas, and do not push through pain, especially pinching groin pain. Progression criteria: normal gait.","structured_content_v2":"$undefined"},{"id":"1fd00df9-9a82-59e1-86ee-73242bd5618b","name_de":"Phase 2: Wochen 6–12","name_en":"Phase 2: Weeks 6-12","name_pl":"Faza 2: tygodnie 6–12","source_page":2,"module_number":2,"name_original":"Phase 2: Weeks 6-12","service_codes":[],"structured_content":{"de":{"goals":["Fortsetzung der manuellen Therapie bei individuellen Bewegungseinschränkungen und Gelenksteifigkeit."],"exercises":["laterale Distraktion mit Gurt bei 90° Knieflexion, laterale Distraktion durch den Therapeuten und Längstraktion 2× täglich","Bewegungsumfang wiederherstellen","Dehnung von Quadratus lumborum und Rectus femoris","Rumpfrotation im Einbeinstand","kardiovaskuläres Training und Rumpfkräftigung","seitliche Ausfallschritte, kurze Kniebeugen, Psoaskräftigung, Front- und Side-Plank sowie Abduktion in Seitenlage."],"applies_when":["Wochen 6–12"],"restrictions":["Keine Orthese verwenden."],"dosage_and_progression":["Funktionsstörungen der Lendenwirbelsäule oder des Beckens behandeln, Bewegungsumfang wiederherstellen und Kräftigung steigern."],"physiotherapist_actions":["Manuelle Therapie mit Weichteil- und Gelenkmobilisation entsprechend individuellen Bewegungseinschränkungen sowie Steifigkeit und Klemmgefühl an der vorderen Hüfte fortsetzen"]},"en":{"goals":["continue manual therapy for patient-specific range-of-motion limitations and joint tightness."],"exercises":["lateral belt distraction with the knee at 90°, therapist-applied lateral distraction and inline distraction twice daily","restore range of motion","quadratus-lumborum and rectus-femoris stretching","trunk rotation in single-leg stance","cardiovascular rehabilitation and core strengthening","lateral lunges, short squats, psoas strengthening, standard and side planks, and side-lying abduction."],"applies_when":["Weeks 6-12"],"restrictions":["Do not use a brace."],"dosage_and_progression":["Address lumbar or pelvic dysfunction, restore range of motion and increase strengthening."],"physiotherapist_actions":["Continue manual therapy with soft-tissue and joint mobilization for patient-specific range-of-motion limits, surgical-site stiffness and anterior-hip pinching"]},"pl":{"goals":["kontynuacja terapii manualnej dla indywidualnych ograniczeń ROM i sztywności stawu."],"exercises":["dystrakcja boczna z pasem przy kolanie zgiętym do 90°, dystrakcja boczna przez terapeutę i trakcja w osi kończyny 2× dziennie","odtworzenie ROM","rozciąganie mięśnia czworobocznego lędźwi i prostego uda","rotacja tułowia w staniu jednonóż","trening krążeniowy i centralny","wykroki boczne, krótkie przysiady, wzmacnianie mięśnia lędźwiowo-biodrowego (psoas), plank przodem i bokiem oraz odwodzenie w leżeniu bokiem."],"applies_when":["tygodnie 6–12"],"restrictions":["Nie stosować ortezy."],"dosage_and_progression":["Ocenić i leczyć dysfunkcję odcinka lędźwiowego lub miednicy, odtworzyć zakres ruchu i zwiększać wzmacnianie."],"physiotherapist_actions":["Kontynuować terapię manualną z mobilizacją tkanek miękkich i stawu według indywidualnych ograniczeń oraz sztywności i szczypania przedniej części biodra"]},"original":{"goals":["continue manual therapy for patient-specific range-of-motion limitations and joint tightness."],"exercises":["lateral belt distraction with the knee at 90°, therapist-applied lateral distraction and inline distraction twice daily","restore range of motion","quadratus-lumborum and rectus-femoris stretching","trunk rotation in single-leg stance","cardiovascular rehabilitation and core strengthening","lateral lunges, short squats, psoas strengthening, standard and side planks, and side-lying abduction."],"applies_when":["Weeks 6-12"],"restrictions":["Do not use a brace."],"dosage_and_progression":["Address lumbar or pelvic dysfunction, restore range of motion and increase strengthening."],"physiotherapist_actions":["Continue manual therapy with soft-tissue and joint mobilization for patient-specific range-of-motion limits, surgical-site stiffness and anterior-hip pinching"]}},"additional_notes_de":"Ziel: Fortsetzung der manuellen Therapie bei individuellen Bewegungseinschränkungen und Gelenksteifigkeit.","additional_notes_en":"Goal: continue manual therapy for patient-specific range-of-motion limitations and joint tightness.","additional_notes_pl":"Cel: kontynuacja terapii manualnej dla indywidualnych ograniczeń ROM i sztywności stawu.","minimum_patient_share":null,"therapeutic_content_de":"Manuelle Therapie mit Weichteil- und Gelenkmobilisation entsprechend individuellen Bewegungseinschränkungen sowie Steifigkeit und Klemmgefühl an der vorderen Hüfte fortsetzen; laterale Distraktion mit Gurt bei 90° Knieflexion, laterale Distraktion durch den Therapeuten und Längstraktion 2× täglich; Bewegungsumfang wiederherstellen; Dehnung von Quadratus lumborum und Rectus femoris; Rumpfrotation im Einbeinstand; kardiovaskuläres Training und Rumpfkräftigung; seitliche Ausfallschritte, kurze Kniebeugen, Psoaskräftigung, Front- und Side-Plank sowie Abduktion in Seitenlage.","therapeutic_content_en":"Continue manual therapy with soft-tissue and joint mobilization for patient-specific range-of-motion limits, surgical-site stiffness and anterior-hip pinching; lateral belt distraction with the knee at 90°, therapist-applied lateral distraction and inline distraction twice daily; restore range of motion; quadratus-lumborum and rectus-femoris stretching; trunk rotation in single-leg stance; cardiovascular rehabilitation and core strengthening; lateral lunges, short squats, psoas strengthening, standard and side planks, and side-lying abduction.","therapeutic_content_pl":"Kontynuować terapię manualną z mobilizacją tkanek miękkich i stawu według indywidualnych ograniczeń oraz sztywności i szczypania przedniej części biodra; dystrakcja boczna z pasem przy kolanie zgiętym do 90°, dystrakcja boczna przez terapeutę i trakcja w osi kończyny 2× dziennie; odtworzenie ROM; rozciąganie mięśnia czworobocznego lędźwi i prostego uda; rotacja tułowia w staniu jednonóż; trening krążeniowy i centralny; wykroki boczne, krótkie przysiady, wzmacnianie mięśnia lędźwiowo-biodrowego (psoas), plank przodem i bokiem oraz odwodzenie w leżeniu bokiem.","minimum_requirements_de":"Keine Orthese verwenden. Funktionsstörungen der Lendenwirbelsäule oder des Beckens behandeln, Bewegungsumfang wiederherstellen und Kräftigung steigern.","minimum_requirements_en":"Do not use a brace. Address lumbar or pelvic dysfunction, restore range of motion and increase strengthening.","minimum_requirements_pl":"Nie stosować ortezy. Ocenić i leczyć dysfunkcję odcinka lędźwiowego lub miednicy, odtworzyć zakres ruchu i zwiększać wzmacnianie.","additional_notes_original":"Goal: continue manual therapy for patient-specific range-of-motion limitations and joint tightness.","therapeutic_content_original":"Continue manual therapy with soft-tissue and joint mobilization for patient-specific range-of-motion limits, surgical-site stiffness and anterior-hip pinching; lateral belt distraction with the knee at 90°, therapist-applied lateral distraction and inline distraction twice daily; restore range of motion; quadratus-lumborum and rectus-femoris stretching; trunk rotation in single-leg stance; cardiovascular rehabilitation and core strengthening; lateral lunges, short squats, psoas strengthening, standard and side planks, and side-lying abduction.","minimum_requirements_original":"Do not use a brace. Address lumbar or pelvic dysfunction, restore range of motion and increase strengthening.","structured_content_v2":"$undefined"},{"id":"e713824b-fdad-5dab-a01e-572209937ec0","name_de":"Phase 3: Monate 3–8","name_en":"Phase 3: Months 3-8","name_pl":"Faza 3: miesiące 3–8","source_page":2,"module_number":3,"name_original":"Phase 3: Months 3-8","service_codes":[],"structured_content":{"de":{"goals":["voller Bewegungsumfang, minimale Schmerzen, Kräftigung, Schutz der Rekonstruktion und Progression funktioneller, sportlicher und freizeitbezogener Aktivität nach Maßgabe des Operateurs."],"exercises":["Einbeinige Kniebeuge","kontrollierte seitliche Hüftbewegungen","Monster Walks","Radfahren","Laufprogression beginnend mit 1-Minuten-Intervallen und Steigerung nach Verträglichkeit","ballistische Übungen","Box Jump, diagonaler Sprung und dynamischer Sprung mit Rotation","Wassertherapie nach Indikation fortsetzen."],"applies_when":["Monate 3–8"],"restrictions":["Kein schweres Krafttraining bis Woche 16."],"progression_criteria":["Kraftdefizit <10 %","Limb Symmetry Index ≥90 %","45/50 Punkte in biomechanischen Tests, sofern durchgeführt","keine Schmerzen oder Instabilität."]},"en":{"goals":["full range of motion, minimal pain, strengthening, protection of the repair, and progression of functional, sport and recreational activity as directed by the surgeon."],"exercises":["Single-leg knee bend","controlled side-to-side hip movement","monster walks","cycling","running progression beginning with 1-minute intervals and increasing as tolerated","ballistic exercises","box jump, diagonal jump and dynamic hop with rotation","continue aquatic therapy as indicated."],"applies_when":["Months 3-8"],"restrictions":["No heavy weightlifting until week 16."],"progression_criteria":["<10% strength deficit","limb symmetry index ≥90%","45/50 on biomechanical functional tests, if performed","no pain or instability."]},"pl":{"goals":["pełny zakres ruchu, minimalny ból, wzmacnianie, ochrona naprawy oraz progresja aktywności funkcjonalnej, sportowej i rekreacyjnej zgodnie z decyzją chirurga."],"exercises":["Ugięcie kolana jednonóż","kontrolowane ruchy biodra na boki","monster walk","rower","progresja biegu rozpoczynana od interwałów 1-minutowych i zwiększana według tolerancji","ćwiczenia balistyczne","skok na skrzynię, skok diagonalny i dynamiczny skok z rotacją","kontynuacja terapii w wodzie według wskazań."],"applies_when":["miesiące 3–8"],"restrictions":["Bez ciężkiego treningu siłowego do 16. tygodnia."],"progression_criteria":["deficyt siły <10%","wskaźnik symetrii kończyn ≥90%","wynik 45/50 w testach biomechanicznych, jeśli wykonano","brak bólu lub niestabilności."]},"original":{"goals":["full range of motion, minimal pain, strengthening, protection of the repair, and progression of functional, sport and recreational activity as directed by the surgeon."],"exercises":["Single-leg knee bend","controlled side-to-side hip movement","monster walks","cycling","running progression beginning with 1-minute intervals and increasing as tolerated","ballistic exercises","box jump, diagonal jump and dynamic hop with rotation","continue aquatic therapy as indicated."],"applies_when":["Months 3-8"],"restrictions":["No heavy weightlifting until week 16."],"progression_criteria":["<10% strength deficit","limb symmetry index ≥90%","45/50 on biomechanical functional tests, if performed","no pain or instability."]}},"additional_notes_de":"Ziele: voller Bewegungsumfang, minimale Schmerzen, Kräftigung, Schutz der Rekonstruktion und Progression funktioneller, sportlicher und freizeitbezogener Aktivität nach Maßgabe des Operateurs. Entlassungskriterien: Kraftdefizit <10 %; Limb Symmetry Index ≥90 %; 45/50 Punkte in biomechanischen Tests, sofern durchgeführt; keine Schmerzen oder Instabilität.","additional_notes_en":"Goals: full range of motion, minimal pain, strengthening, protection of the repair, and progression of functional, sport and recreational activity as directed by the surgeon. Discharge criteria: <10% strength deficit; limb symmetry index ≥90%; 45/50 on biomechanical functional tests, if performed; no pain or instability.","additional_notes_pl":"Cele: pełny zakres ruchu, minimalny ból, wzmacnianie, ochrona naprawy oraz progresja aktywności funkcjonalnej, sportowej i rekreacyjnej zgodnie z decyzją chirurga. Kryteria wypisu: deficyt siły <10%; wskaźnik symetrii kończyn ≥90%; wynik 45/50 w testach biomechanicznych, jeśli wykonano; brak bólu lub niestabilności.","minimum_patient_share":null,"therapeutic_content_de":"Einbeinige Kniebeuge; kontrollierte seitliche Hüftbewegungen; Monster Walks; Radfahren; Laufprogression beginnend mit 1-Minuten-Intervallen und Steigerung nach Verträglichkeit; ballistische Übungen; Box Jump, diagonaler Sprung und dynamischer Sprung mit Rotation; Wassertherapie nach Indikation fortsetzen.","therapeutic_content_en":"Single-leg knee bend; controlled side-to-side hip movement; monster walks; cycling; running progression beginning with 1-minute intervals and increasing as tolerated; ballistic exercises; box jump, diagonal jump and dynamic hop with rotation; continue aquatic therapy as indicated.","therapeutic_content_pl":"Ugięcie kolana jednonóż; kontrolowane ruchy biodra na boki; monster walk; rower; progresja biegu rozpoczynana od interwałów 1-minutowych i zwiększana według tolerancji; ćwiczenia balistyczne; skok na skrzynię, skok diagonalny i dynamiczny skok z rotacją; kontynuacja terapii w wodzie według wskazań.","minimum_requirements_de":"Kein schweres Krafttraining bis Woche 16.","minimum_requirements_en":"No heavy weightlifting until week 16.","minimum_requirements_pl":"Bez ciężkiego treningu siłowego do 16. tygodnia.","additional_notes_original":"Goals: full range of motion, minimal pain, strengthening, protection of the repair, and progression of functional, sport and recreational activity as directed by the surgeon. Discharge criteria: <10% strength deficit; limb symmetry index ≥90%; 45/50 on biomechanical functional tests, if performed; no pain or instability.","therapeutic_content_original":"Single-leg knee bend; controlled side-to-side hip movement; monster walks; cycling; running progression beginning with 1-minute intervals and increasing as tolerated; ballistic exercises; box jump, diagonal jump and dynamic hop with rotation; continue aquatic therapy as indicated.","minimum_requirements_original":"No heavy weightlifting until week 16.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["hip_pelvis","lower_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"1ce001e0-94c0-54ef-8264-af8219e361f1","slug":"us-jared-lee-33-partial-knee-arthroplasty","title_pl":"Protokół rehabilitacji po częściowej endoprotezoplastyce stawu kolanowego","title_de":"Rehabilitationsprotokoll nach Knie-Teilendoprothese","title_en":"Partial Knee Arthroplasty Rehabilitation Protocol","title_original":"Partial Knee Arthroplasty Rehabilitation","summary_pl":"Trzyfazowy protokół po częściowej endoprotezoplastyce stawu kolanowego, obejmujący odzyskanie zakresu ruchu, normalizację chodu i progresję funkcjonalną.","summary_de":"Dreiphasiges Protokoll nach Knie-Teilendoprothese zur Wiederherstellung des Bewegungsumfangs, Normalisierung des Gangbilds und funktionellen Progression.","summary_en":"Three-phase protocol after partial knee arthroplasty covering range-of-motion restoration, gait normalization and functional progression.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"ad93b7dc-de07-598c-8929-b6900e7f24d6","condition_slug":"partial-knee-arthroplasty","condition_name_pl":"Stan po częściowej endoprotezoplastyce stawu kolanowego","condition_name_de":"Zustand nach Knie-Teilendoprothese","condition_name_en":"Status Post Partial Knee Arthroplasty","condition_name_original":"Status Post Partial Knee Arthroplasty","icd_codes":[],"category_key":"knee","category_pl":"Kolano","category_de":"Knie","category_en":"Knee","body_regions_pl":["Kolano"],"body_regions_de":["Knie"],"body_regions_en":["Knee"],"search_terms_pl":["częściowa endoprotezoplastyka kolana","częściowa endoproteza kolana","PKA"],"search_terms_de":["Knie-Teilendoprothese","partielle Knieendoprothese","PKA"],"search_terms_en":["partial knee arthroplasty","partial knee replacement","PKA"],"source_document_id":"936c92a5-acc7-5d5d-8071-884a9f43bfcd","source_title":"Partial Knee Arthroplasty Rehabilitation","issuer":"Jared T. Lee, MD","source_country_code":"US","jurisdiction_code":"US-CO","authority_level":"clinic","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_requires_review","official_url":"https://jaredleemd.com/wp-content/uploads/2025/06/Partial-Knee-Arthroplasty-Rehabilitation-Protocol.pdf","source_sha256":"35cfb84ed7579ba3fd41989bd34f355583ca6e14a08d1a2cd3625f5022ed83e1","authorization_required":true,"license_note":"All Rights Reserved. Authorization is required before final public release. Current development and staging remain allowed by the owner's decision.","modules":[{"id":"d9d5430b-1be8-5ea2-a505-42631522ddb0","name_de":"Phase 1: Wochen 0–2","name_en":"Phase 1: Weeks 0-2","name_pl":"Faza 1: tygodnie 0–2","source_page":1,"module_number":1,"name_original":"Phase 1: Weeks 0-2","service_codes":[],"structured_content":{"de":{"goals":["Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, den schmerzfreien Bewegungsumfang verbessern, tiefe Venenthrombosen verhindern und selbstständiges Gehen erreichen."],"exercises":["Wiederherstellung des vollständigen Bewegungsumfangs, wobei die vollständige Extension bis zum 14. postoperativen Tag erreicht sein muss","isometrische Quadrizepskräftigung","Fersengleiten, SAQ, LAQ, Anheben des gestreckten Beins und Fußpumpen","Fahrradergometer für den Bewegungsumfang ohne Widerstand","Rumpfkräftigung"],"applies_when":["Wochen 0–2"],"restrictions":["Den Aquacel-Verband nicht entfernen, außer er ist beschädigt oder durchnässt.","Kein Autofahren bis zum Absetzen der Opioidanalgetika."],"progression_criteria":["Ziel: Bewegungsumfang 0–90° bis zum 14. postoperativen Tag, mit besonderem Fokus auf vollständige Extension."],"dosage_and_progression":["Belastung nach Verträglichkeit.","Gehhilfe nach Verträglichkeit schrittweise ablegen."],"physiotherapist_actions":["TED-Kompressionsstrümpfe durchgehend tragen.","Ödemkontrolle","neuromuskuläre Elektrostimulation","manuelle Mobilisation der Patella und des Tibiofemoralgelenks","physikalische Maßnahmen nach Bedarf."]},"en":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, improve pain-free range of motion, prevent deep-vein thrombosis and achieve independent ambulation."],"exercises":["restore full range of motion, with full extension required by postoperative day 14","isometric quadriceps strengthening","heel slides, SAQ, LAQ, straight-leg raises and ankle pumps","stationary cycling for range of motion without resistance","core strengthening","manual patellar and tibiofemoral mobility"],"applies_when":["Weeks 0-2"],"restrictions":["Do not remove the Aquacel dressing unless compromised or saturated.","Do not drive until narcotic pain medication is discontinued."],"progression_criteria":["Goal: range of motion 0-90° by postoperative day 14, with emphasis on full extension."],"dosage_and_progression":["Weight-bearing as tolerated.","Wean from the assistive device as tolerated."],"physiotherapist_actions":["Wear TED compression stockings at all times.","Edema control","neuromuscular electrical stimulation","modalities as needed."]},"pl":{"goals":["zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, poprawa bezbolesnego zakresu ruchu, zapobieganie zakrzepicy żył głębokich i samodzielne chodzenie."],"exercises":["odtworzenie pełnego zakresu ruchu, z obowiązkowym uzyskaniem pełnego wyprostu do 14. dnia po zabiegu","izometryczne wzmacnianie mięśnia czworogłowego","ślizgi pięty, SAQ, LAQ, unoszenie wyprostowanej kończyny i pompki stopy","rower stacjonarny dla zakresu ruchu bez oporu","wzmacnianie centralne"],"applies_when":["tygodnie 0–2"],"restrictions":["Nie usuwać opatrunku Aquacel, chyba że jest uszkodzony lub przesiąknięty.","Nie prowadzić pojazdów do odstawienia leków opioidowych."],"progression_criteria":["Cel: zakres ruchu 0–90° do 14. dnia po zabiegu, ze szczególnym naciskiem na pełny wyprost."],"dosage_and_progression":["Obciążanie według tolerancji.","Stopniowo odstawiać pomoc do chodzenia według tolerancji."],"physiotherapist_actions":["Pończochy uciskowe TED przez cały czas.","Kontrola obrzęku","elektrostymulacja nerwowo-mięśniowa","manualna mobilizacja rzepki i stawu piszczelowo-udowego","fizykoterapia według potrzeb."]},"original":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, improve pain-free range of motion, prevent deep-vein thrombosis and achieve independent ambulation."],"exercises":["restore full range of motion, with full extension required by postoperative day 14","isometric quadriceps strengthening","heel slides, SAQ, LAQ, straight-leg raises and ankle pumps","stationary cycling for range of motion without resistance","core strengthening","manual patellar and tibiofemoral mobility"],"applies_when":["Weeks 0-2"],"restrictions":["Do not remove the Aquacel dressing unless compromised or saturated.","Do not drive until narcotic pain medication is discontinued."],"progression_criteria":["Goal: range of motion 0-90° by postoperative day 14, with emphasis on full extension."],"dosage_and_progression":["Weight-bearing as tolerated.","Wean from the assistive device as tolerated."],"physiotherapist_actions":["Wear TED compression stockings at all times.","Edema control","neuromuscular electrical stimulation","modalities as needed."]}},"additional_notes_de":"Ziele: Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, den schmerzfreien Bewegungsumfang verbessern, tiefe Venenthrombosen verhindern und selbstständiges Gehen erreichen.","additional_notes_en":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, improve pain-free range of motion, prevent deep-vein thrombosis and achieve independent ambulation.","additional_notes_pl":"Cele: zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, poprawa bezbolesnego zakresu ruchu, zapobieganie zakrzepicy żył głębokich i samodzielne chodzenie.","minimum_patient_share":null,"therapeutic_content_de":"Ödemkontrolle; Wiederherstellung des vollständigen Bewegungsumfangs, wobei die vollständige Extension bis zum 14. postoperativen Tag erreicht sein muss; neuromuskuläre Elektrostimulation; isometrische Quadrizepskräftigung; Fersengleiten, SAQ, LAQ, Anheben des gestreckten Beins und Fußpumpen; Fahrradergometer für den Bewegungsumfang ohne Widerstand; Rumpfkräftigung; manuelle Mobilisation der Patella und des Tibiofemoralgelenks; physikalische Maßnahmen nach Bedarf.","therapeutic_content_en":"Edema control; restore full range of motion, with full extension required by postoperative day 14; neuromuscular electrical stimulation; isometric quadriceps strengthening; heel slides, SAQ, LAQ, straight-leg raises and ankle pumps; stationary cycling for range of motion without resistance; core strengthening; manual patellar and tibiofemoral mobility; modalities as needed.","therapeutic_content_pl":"Kontrola obrzęku; odtworzenie pełnego zakresu ruchu, z obowiązkowym uzyskaniem pełnego wyprostu do 14. dnia po zabiegu; elektrostymulacja nerwowo-mięśniowa; izometryczne wzmacnianie mięśnia czworogłowego; ślizgi pięty, SAQ, LAQ, unoszenie wyprostowanej kończyny i pompki stopy; rower stacjonarny dla zakresu ruchu bez oporu; wzmacnianie centralne; manualna mobilizacja rzepki i stawu piszczelowo-udowego; fizykoterapia według potrzeb.","minimum_requirements_de":"Belastung nach Verträglichkeit. TED-Kompressionsstrümpfe durchgehend tragen. Den Aquacel-Verband nicht entfernen, außer er ist beschädigt oder durchnässt. Kein Autofahren bis zum Absetzen der Opioidanalgetika. Gehhilfe nach Verträglichkeit schrittweise ablegen. Ziel: Bewegungsumfang 0–90° bis zum 14. postoperativen Tag, mit besonderem Fokus auf vollständige Extension.","minimum_requirements_en":"Weight-bearing as tolerated. Wear TED compression stockings at all times. Do not remove the Aquacel dressing unless compromised or saturated. Do not drive until narcotic pain medication is discontinued. Wean from the assistive device as tolerated. Goal: range of motion 0-90° by postoperative day 14, with emphasis on full extension.","minimum_requirements_pl":"Obciążanie według tolerancji. Pończochy uciskowe TED przez cały czas. Nie usuwać opatrunku Aquacel, chyba że jest uszkodzony lub przesiąknięty. Nie prowadzić pojazdów do odstawienia leków opioidowych. Stopniowo odstawiać pomoc do chodzenia według tolerancji. Cel: zakres ruchu 0–90° do 14. dnia po zabiegu, ze szczególnym naciskiem na pełny wyprost.","additional_notes_original":"Goals: Reduce swelling and edema, minimize pain, retard muscle atrophy, improve pain-free ROM, DVT prevention, independent ambulation","therapeutic_content_original":"Edema control; restore full range of motion, with full extension required by postoperative day 14; neuromuscular electrical stimulation; isometric quadriceps strengthening; heel slides, SAQ, LAQ, straight-leg raises and ankle pumps; stationary cycling for range of motion without resistance; core strengthening; manual patellar and tibiofemoral mobility; modalities as needed.","minimum_requirements_original":"Weight-bearing as tolerated. Wear TED compression stockings at all times. Do not remove the Aquacel dressing unless compromised or saturated. Do not drive until narcotic pain medication is discontinued. Wean from the assistive device as tolerated. Goal: range of motion 0-90° by postoperative day 14, with emphasis on full extension.","structured_content_v2":"$undefined"},{"id":"3af9e45a-e6b0-5766-9b9f-7b78ff89d040","name_de":"Phase 2: Wochen 2–6","name_en":"Phase 2: Weeks 2-6","name_pl":"Faza 2: tygodnie 2–6","source_page":1,"module_number":2,"name_original":"Phase 2: Weeks 2-6","service_codes":[],"structured_content":{"de":{"goals":["Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, den Bewegungsumfang wiederherstellen und Selbstständigkeit bei Alltagsaktivitäten erreichen."],"exercises":["Vollständigen Bewegungsumfang wiederherstellen und das Übungsprogramm steigern","Einbeinstand, Vorwärts- und Seitwärts-Step-ups, Kniebeugung in Bauchlage für die ischiokruralen Muskeln und Fersenheben","Wassertherapie nach Abheilung der Inzision, etwa in der 4. postoperativen Woche","Schwerpunkt auf Bewegungsumfang des Knies, Gangnormalisierung sowie Hüftkraft und -stabilität","Rückkehr zu lockerem Bahnenschwimmen ohne Rollwende und Brustschwimmen möglich","Fahrradergometer oder Liege-Stepper mit minimalem Widerstand","Rumpfkräftigung."],"applies_when":["Wochen 2–6"],"restrictions":["Kein Autofahren bis zum Absetzen der Opioidanalgetika."],"progression_criteria":["Ziel: Bewegungsumfang 0–120° bis zur 6. postoperativen Woche und Erhalt der vollständigen Extension.","normalisiertes Gangbild","normalisierte Knieextension und Knieflexion bis mindestens 120°","Anheben des gestreckten Beins 2×10 ohne Extensionsdefizit","minimale oder keine reaktive Schmerz- und Schwellungszunahme bei Alltagsaktivitäten und Übungen","normalisierte Muskelaktivierung und -isolation."],"dosage_and_progression":["Belastung nach Verträglichkeit."]},"en":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, restore range of motion and achieve independence with activities of daily living."],"exercises":["Restore full range of motion and progress the exercise program","single-leg balance, forward and side step-ups, prone hamstring curls and heel raises","aquatic therapy after the incision has healed, at about 4 weeks postoperatively","focus on knee range of motion, gait normalization, and hip strength and stability","may return to easy lap swimming without flip turns or breaststroke","stationary bike or recumbent stepper with minimal resistance","core strengthening."],"applies_when":["Weeks 2-6"],"restrictions":["Do not drive until narcotic pain medication is discontinued."],"progression_criteria":["Goal: range of motion 0-120° by 6 weeks postoperatively and maintenance of full extension.","normalized gait pattern","normalized knee extension and knee flexion to at least 120°","straight-leg raise 2×10 without quadriceps lag","minimal to no reactive pain and swelling with activities of daily living and therapy exercises","normalized muscle activation and isolation."],"dosage_and_progression":["Weight-bearing as tolerated."]},"pl":{"goals":["zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, odtworzenie zakresu ruchu oraz samodzielność w czynnościach dnia codziennego."],"exercises":["Odtworzyć pełny zakres ruchu i progresywnie rozwijać program ćwiczeń","równowaga jednonóż, wejścia na stopień w przód i bokiem, zginanie kolana w leżeniu przodem dla mięśni kulszowo-goleniowych oraz wspięcia na palce","terapia w wodzie po wygojeniu cięcia, około 4. tygodnia po zabiegu","nacisk na zakres ruchu kolana, normalizację chodu, siłę i stabilność biodra","możliwy powrót do spokojnego pływania bez nawrotów koziołkowych i stylu klasycznego","rower stacjonarny lub stepper poziomy z minimalnym oporem","wzmacnianie centralne."],"applies_when":["tygodnie 2–6"],"restrictions":["Nie prowadzić pojazdów do odstawienia leków opioidowych."],"progression_criteria":["Cel: zakres ruchu 0–120° do 6. tygodnia po zabiegu i utrzymanie pełnego wyprostu.","znormalizowany wzorzec chodu","znormalizowany wyprost i zgięcie kolana do co najmniej 120°","unoszenie wyprostowanej kończyny 2×10 bez deficytu wyprostu","minimalny lub nieobecny reaktywny ból i obrzęk podczas czynności dnia codziennego i ćwiczeń","znormalizowana aktywacja i izolacja mięśni."],"dosage_and_progression":["Obciążanie według tolerancji."]},"original":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, restore range of motion and achieve independence with activities of daily living."],"exercises":["Restore full range of motion and progress the exercise program","single-leg balance, forward and side step-ups, prone hamstring curls and heel raises","aquatic therapy after the incision has healed, at about 4 weeks postoperatively","focus on knee range of motion, gait normalization, and hip strength and stability","may return to easy lap swimming without flip turns or breaststroke","stationary bike or recumbent stepper with minimal resistance","core strengthening."],"applies_when":["Weeks 2-6"],"restrictions":["Do not drive until narcotic pain medication is discontinued."],"progression_criteria":["Goal: range of motion 0-120° by 6 weeks postoperatively and maintenance of full extension.","normalized gait pattern","normalized knee extension and knee flexion to at least 120°","straight-leg raise 2×10 without quadriceps lag","minimal to no reactive pain and swelling with activities of daily living and therapy exercises","normalized muscle activation and isolation."],"dosage_and_progression":["Weight-bearing as tolerated."]}},"additional_notes_de":"Ziele: Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, den Bewegungsumfang wiederherstellen und Selbstständigkeit bei Alltagsaktivitäten erreichen.","additional_notes_en":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, restore range of motion and achieve independence with activities of daily living.","additional_notes_pl":"Cele: zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, odtworzenie zakresu ruchu oraz samodzielność w czynnościach dnia codziennego.","minimum_patient_share":null,"therapeutic_content_de":"Vollständigen Bewegungsumfang wiederherstellen und das Übungsprogramm steigern; Einbeinstand, Vorwärts- und Seitwärts-Step-ups, Kniebeugung in Bauchlage für die ischiokruralen Muskeln und Fersenheben; Wassertherapie nach Abheilung der Inzision, etwa in der 4. postoperativen Woche; Schwerpunkt auf Bewegungsumfang des Knies, Gangnormalisierung sowie Hüftkraft und -stabilität; Rückkehr zu lockerem Bahnenschwimmen ohne Rollwende und Brustschwimmen möglich; Fahrradergometer oder Liege-Stepper mit minimalem Widerstand; Rumpfkräftigung.","therapeutic_content_en":"Restore full range of motion and progress the exercise program; single-leg balance, forward and side step-ups, prone hamstring curls and heel raises; aquatic therapy after the incision has healed, at about 4 weeks postoperatively; focus on knee range of motion, gait normalization, and hip strength and stability; may return to easy lap swimming without flip turns or breaststroke; stationary bike or recumbent stepper with minimal resistance; core strengthening.","therapeutic_content_pl":"Odtworzyć pełny zakres ruchu i progresywnie rozwijać program ćwiczeń; równowaga jednonóż, wejścia na stopień w przód i bokiem, zginanie kolana w leżeniu przodem dla mięśni kulszowo-goleniowych oraz wspięcia na palce; terapia w wodzie po wygojeniu cięcia, około 4. tygodnia po zabiegu; nacisk na zakres ruchu kolana, normalizację chodu, siłę i stabilność biodra; możliwy powrót do spokojnego pływania bez nawrotów koziołkowych i stylu klasycznego; rower stacjonarny lub stepper poziomy z minimalnym oporem; wzmacnianie centralne.","minimum_requirements_de":"Belastung nach Verträglichkeit. Kein Autofahren bis zum Absetzen der Opioidanalgetika. Ziel: Bewegungsumfang 0–120° bis zur 6. postoperativen Woche und Erhalt der vollständigen Extension. Progressionskriterien: normalisiertes Gangbild; normalisierte Knieextension und Knieflexion bis mindestens 120°; Anheben des gestreckten Beins 2×10 ohne Extensionsdefizit; minimale oder keine reaktive Schmerz- und Schwellungszunahme bei Alltagsaktivitäten und Übungen; normalisierte Muskelaktivierung und -isolation.","minimum_requirements_en":"Weight-bearing as tolerated. Do not drive until narcotic pain medication is discontinued. Goal: range of motion 0-120° by 6 weeks postoperatively and maintenance of full extension. Progression criteria: normalized gait pattern; normalized knee extension and knee flexion to at least 120°; straight-leg raise 2×10 without quadriceps lag; minimal to no reactive pain and swelling with activities of daily living and therapy exercises; normalized muscle activation and isolation.","minimum_requirements_pl":"Obciążanie według tolerancji. Nie prowadzić pojazdów do odstawienia leków opioidowych. Cel: zakres ruchu 0–120° do 6. tygodnia po zabiegu i utrzymanie pełnego wyprostu. Kryteria progresji: znormalizowany wzorzec chodu; znormalizowany wyprost i zgięcie kolana do co najmniej 120°; unoszenie wyprostowanej kończyny 2×10 bez deficytu wyprostu; minimalny lub nieobecny reaktywny ból i obrzęk podczas czynności dnia codziennego i ćwiczeń; znormalizowana aktywacja i izolacja mięśni.","additional_notes_original":"Goals: Reduce swelling and edema, minimize pain, retard muscle atrophy, range of motion restoration, independent with ADLs","therapeutic_content_original":"Restore full range of motion and progress the exercise program; single-leg balance, forward and side step-ups, prone hamstring curls and heel raises; aquatic therapy after the incision has healed, at about 4 weeks postoperatively; focus on knee range of motion, gait normalization, and hip strength and stability; may return to easy lap swimming without flip turns or breaststroke; stationary bike or recumbent stepper with minimal resistance; core strengthening.","minimum_requirements_original":"Weight-bearing as tolerated. Do not drive until narcotic pain medication is discontinued. Goal: range of motion 0-120° by 6 weeks postoperatively and maintenance of full extension. Progression criteria: normalized gait pattern; normalized knee extension and knee flexion to at least 120°; straight-leg raise 2×10 without quadriceps lag; minimal to no reactive pain and swelling with activities of daily living and therapy exercises; normalized muscle activation and isolation.","structured_content_v2":"$undefined"},{"id":"8224cd37-cec4-5d6e-bd82-033905327703","name_de":"Phase 3: Wochen 6–12","name_en":"Phase 3: Weeks 6-12","name_pl":"Faza 3: tygodnie 6–12","source_page":2,"module_number":3,"name_original":"Phase 3: Weeks 6-12","service_codes":[],"structured_content":{"de":{"goals":["vollständiger Bewegungsumfang, minimale Schmerzen, Steigerung des Übungswiderstands und Normalisierung der posturalen, Becken- und Bein-Kontrolle bei beid- und einbeinigen Aufgaben."],"exercises":["Wandkniebeugen, kleine Ausfallschritte, Progression der Step-ups bis einbeinig, Step-downs, Hüftübungen in 4 Richtungen, Beinpresse mit geringem Widerstand und hohen Wiederholungszahlen sowie Übungen für das Knie in offener Kette.","Ab Woche 8: vollständige Kniebeuge bis 70°, Seitwärtsschritte mit Band, Heel Taps, Gehen gegen Widerstand, fortgeschrittene Brücken sowie Progression von Einbeinstand und Gleichgewicht.","Rumpfkräftigung","Progression der Kräftigung der unteren Extremität zu multiplanaren Bewegungen mit Rumpf-, Hüft- und Kniekontrolle","Propriozeptionsprogression mit wechselnden Untergründen, Perturbationen und Bewegungen der oberen Extremität oder des Rumpfs","Progression zu sportartspezifischen Aufgaben","Richtungswechsel, Crossover und Carioca","zielgerechte plyometrische Übungen mit Medizinball und Schlitten","Seitwärtsschritte, Koordinationsleiter, Hütchen, Z- und W-Cuts sowie multiplanare sportartspezifische Übungen."],"applies_when":["Wochen 6–12"],"restrictions":["Kräftigungsübungen und funktionelle Aufgaben dürfen gesteigert werden, sofern keine reaktiven Schmerzen oder kein Erguss auftreten."],"progression_criteria":["Freigabe durch den Operateur","Hamstring-Kraftindex >90 % gegenüber der Gegenseite","Quadrizeps-Kraftindex >90 % im Vergleich zur Gegenseite","anteriore Reichweite im Y-Balance-Test <4 cm","keine Schmerzen oder Instabilität."],"dosage_and_progression":["Aerobe Kondition und Ausdauer steigern und dabei reaktive Ödeme überwachen."]},"en":{"goals":["full range of motion, minimal pain, increased exercise resistance, and normalized postural, pelvic and lower-extremity control during double- and single-leg tasks."],"exercises":["Wall squats, mini lunges, step-ups progressing to single-leg, step-downs, 4-way hip exercises, leg press with low resistance and high repetitions, and open-chain knee exercises.","At week 8: full squat to 70°, side steps with a band, heel taps, resisted walking, advanced bridges, and single-leg stance and balance progressions.","Core strengthening","progress lower-extremity strengthening to multiplanar movements emphasizing core stability and hip and knee control","progress proprioception with varied surfaces, perturbations, and upper-extremity or trunk movements","progress toward sport-specific tasks","cutting, crossover and carioca","goal-appropriate plyometric exercises with medicine-ball work and sled drills","shuffles, ladder footwork, cone drills, Z-cuts, W-cuts and multiplanar sport-specific drills."],"applies_when":["Weeks 6-12"],"progression_criteria":["surgeon clearance","hamstring strength index >90% versus the contralateral limb","quadriceps strength index >90%","Y-Balance anterior-reach difference <4 cm","no pain or instability.","Strengthening exercises and functional tasks may be progressed when there is no reactive pain or effusion."],"dosage_and_progression":["Increase aerobic conditioning and endurance while monitoring reactive edema."]},"pl":{"goals":["pełny zakres ruchu, minimalny ból, zwiększanie oporu ćwiczeń oraz normalizacja kontroli posturalnej, miednicy i kończyny dolnej w zadaniach obunóż i jednonóż."],"exercises":["Przysiady przy ścianie, małe wykroki, progresja wejść na stopień do wariantu jednonóż, zejścia ze stopnia, ćwiczenia biodra w 4 kierunkach, suwnica z małym oporem i dużą liczbą powtórzeń oraz ćwiczenia kolana w łańcuchu otwartym.","Od 8. tygodnia: pełny przysiad do 70°, kroki bokiem z taśmą, dotknięcia piętą, chód z oporem, zaawansowane mosty oraz progresja stania jednonóż i równowagi.","Wzmacnianie centralne","progresja wzmacniania kończyn dolnych do ruchów wielopłaszczyznowych z kontrolą tułowia, biodra i kolana","progresja propriocepcji przez zmienne podłoża, perturbacje i ruchy kończyn górnych lub tułowia","progresja do zadań specyficznych dla sportu","zmiany kierunku, crossover i carioca","odpowiednie do celów ćwiczenia plyometryczne z piłką lekarską i sankami","kroki odstawno-dostawne, drabinka koordynacyjna, pachołki, cięcia po torze Z i W oraz wielopłaszczyznowe ćwiczenia sportowe."],"applies_when":["tygodnie 6–12"],"progression_criteria":["zgoda chirurga","wskaźnik siły mięśni kulszowo-goleniowych >90% względem kończyny przeciwnej","wskaźnik siły mięśnia czworogłowego >90% względem kończyny przeciwnej","przedni zasięg Y-Balance <4 cm","brak bólu lub niestabilności.","Można zwiększać trudność ćwiczeń wzmacniających i zadań funkcjonalnych, jeśli nie występuje reaktywny ból ani wysięk."],"dosage_and_progression":["Zwiększać kondycję tlenową i wytrzymałość, monitorując reaktywny obrzęk."]},"original":{"goals":["full range of motion, minimal pain, increased exercise resistance, and normalized postural, pelvic and lower-extremity control during double- and single-leg tasks."],"exercises":["Wall squats, mini lunges, step-ups progressing to single-leg, step-downs, 4-way hip exercises, leg press with low resistance and high repetitions, and open-chain knee exercises.","At week 8: full squat to 70°, side steps with a band, heel taps, resisted walking, advanced bridges, and single-leg stance and balance progressions.","Core strengthening","progress lower-extremity strengthening to multiplanar movements emphasizing core stability and hip and knee control","progress proprioception with varied surfaces, perturbations, and upper-extremity or trunk movements","progress toward sport-specific tasks","cutting, crossover and carioca","goal-appropriate plyometric exercises with medicine-ball work and sled drills","shuffles, ladder footwork, cone drills, Z-cuts, W-cuts and multiplanar sport-specific drills."],"applies_when":["Weeks 6-12"],"progression_criteria":["surgeon clearance","hamstring strength index >90% versus the contralateral limb","quadriceps strength index >90%","Y-Balance anterior-reach difference <4 cm","no pain or instability.","Strengthening exercises and functional tasks may be progressed when there is no reactive pain or effusion."],"dosage_and_progression":["Increase aerobic conditioning and endurance while monitoring reactive edema."]}},"additional_notes_de":"Ziele: vollständiger Bewegungsumfang, minimale Schmerzen, Steigerung des Übungswiderstands und Normalisierung der posturalen, Becken- und Bein-Kontrolle bei beid- und einbeinigen Aufgaben. Entlassungskriterien: Freigabe durch den Operateur; Hamstring-Kraftindex >90 % gegenüber der Gegenseite; Quadrizeps-Kraftindex >90 %; Differenz der anterioren Reichweite im Y-Balance-Test <4 cm; keine Schmerzen oder Instabilität.","additional_notes_en":"Goals: full range of motion, minimal pain, increased exercise resistance, and normalized postural, pelvic and lower-extremity control during double- and single-leg tasks. Discharge criteria: surgeon clearance; hamstring strength index >90% versus the contralateral limb; quadriceps strength index >90%; Y-Balance anterior-reach difference <4 cm; no pain or instability.","additional_notes_pl":"Cele: pełny zakres ruchu, minimalny ból, zwiększanie oporu ćwiczeń oraz normalizacja kontroli posturalnej, miednicy i kończyny dolnej w zadaniach obunóż i jednonóż. Kryteria wypisu: zgoda chirurga; wskaźnik siły mięśni kulszowo-goleniowych >90% względem kończyny przeciwnej; wskaźnik siły mięśnia czworogłowego >90%; różnica przedniego zasięgu Y-Balance <4 cm; brak bólu lub niestabilności.","minimum_patient_share":null,"therapeutic_content_de":"Wandkniebeugen, kleine Ausfallschritte, Progression der Step-ups bis einbeinig, Step-downs, Hüftübungen in 4 Richtungen, Beinpresse mit geringem Widerstand und hohen Wiederholungszahlen sowie Übungen für das Knie in offener Kette. Ab Woche 8: vollständige Kniebeuge bis 70°, Seitwärtsschritte mit Band, Heel Taps, Gehen gegen Widerstand, fortgeschrittene Brücken sowie Progression von Einbeinstand und Gleichgewicht. Rumpfkräftigung; Progression der Kräftigung der unteren Extremität zu multiplanaren Bewegungen mit Rumpf-, Hüft- und Kniekontrolle; Propriozeptionsprogression mit wechselnden Untergründen, Perturbationen und Bewegungen der oberen Extremität oder des Rumpfs; Progression zu sportartspezifischen Aufgaben; Richtungswechsel, Crossover und Carioca; zielgerechte plyometrische Übungen mit Medizinball und Schlitten; Seitwärtsschritte, Koordinationsleiter, Hütchen, Z- und W-Cuts sowie multiplanare sportartspezifische Übungen.","therapeutic_content_en":"Wall squats, mini lunges, step-ups progressing to single-leg, step-downs, 4-way hip exercises, leg press with low resistance and high repetitions, and open-chain knee exercises. At week 8: full squat to 70°, side steps with a band, heel taps, resisted walking, advanced bridges, and single-leg stance and balance progressions. Core strengthening; progress lower-extremity strengthening to multiplanar movements emphasizing core stability and hip and knee control; progress proprioception with varied surfaces, perturbations, and upper-extremity or trunk movements; progress toward sport-specific tasks; cutting, crossover and carioca; goal-appropriate plyometric exercises with medicine-ball work and sled drills; shuffles, ladder footwork, cone drills, Z-cuts, W-cuts and multiplanar sport-specific drills.","therapeutic_content_pl":"Przysiady przy ścianie, małe wykroki, progresja wejść na stopień do wariantu jednonóż, zejścia ze stopnia, ćwiczenia biodra w 4 kierunkach, suwnica z małym oporem i dużą liczbą powtórzeń oraz ćwiczenia kolana w łańcuchu otwartym. Od 8. tygodnia: pełny przysiad do 70°, kroki bokiem z taśmą, dotknięcia piętą, chód z oporem, zaawansowane mosty oraz progresja stania jednonóż i równowagi. Wzmacnianie centralne; progresja wzmacniania kończyn dolnych do ruchów wielopłaszczyznowych z kontrolą tułowia, biodra i kolana; progresja propriocepcji przez zmienne podłoża, perturbacje i ruchy kończyn górnych lub tułowia; progresja do zadań specyficznych dla sportu; zmiany kierunku, crossover i carioca; odpowiednie do celów ćwiczenia plyometryczne z piłką lekarską i sankami; kroki odstawno-dostawne, drabinka koordynacyjna, pachołki, cięcia po torze Z i W oraz wielopłaszczyznowe ćwiczenia sportowe.","minimum_requirements_de":"Kräftigungsübungen und funktionelle Aufgaben dürfen gesteigert werden, sofern keine reaktiven Schmerzen oder kein Erguss auftreten. Aerobe Kondition und Ausdauer steigern und dabei reaktive Ödeme überwachen.","minimum_requirements_en":"Strengthening exercises and functional tasks may be progressed when there is no reactive pain or effusion. Increase aerobic conditioning and endurance while monitoring reactive edema.","minimum_requirements_pl":"Można zwiększać trudność ćwiczeń wzmacniających i zadań funkcjonalnych, jeśli nie występuje reaktywny ból ani wysięk. Zwiększać kondycję tlenową i wytrzymałość, monitorując reaktywny obrzęk.","additional_notes_original":"Goals: Full range of motion, minimal pain, increase resistance exercises, normalize postural/pelvic and LE control with DL and SL activities\n\nCriteria for discharge:\n- Surgeon clearance\n- Hamstring strength index >90% as compared to contralateral limb\n- Quadriceps strength index >90% compared to contralateral limb\n- Y-Balance anterior reach < 4cm\n- No complaints of pain or instability","therapeutic_content_original":"Wall squats, mini lunges, step-ups progressing to single-leg, step-downs, 4-way hip exercises, leg press with low resistance and high repetitions, and open-chain knee exercises. 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verification.","modules":[{"id":"bf787576-1957-5105-8909-9ef30dcfc087","name_de":"Phase 1: Schutz und Beweglichkeit (0-2 Wochen)","name_en":"Phase 1: Protection and ROM (0-2 Weeks)","name_pl":"Faza 1: Ochrona i zakres ruchu (0-2 tygodnie)","source_page":4,"module_number":1,"name_original":"Phase 1: Protection and ROM (0-2 Weeks)","service_codes":[],"structured_content":{"de":{"applies_when":["Schutz und Beweglichkeit (0-2 Wochen)"],"dosage_and_progression":["Eistherapie 3-5 mal täglich."],"physiotherapist_actions":["Schmerzkontrolle, Gewebeschutz, passive Übungen (Pendelübungen, passive Extension, Flexion, Rotation), Vermeidung aktiver Armhebung.","Tragen der Schlinge, Heben vermeiden."]},"en":{"applies_when":["Protection and ROM (0-2 Weeks)"],"dosage_and_progression":["Ice 3-5 times daily."],"physiotherapist_actions":["Pain control, tissue protection, passive exercises (pendulums, passive flexion/extension, rotation), avoid active arm elevation.","Sling use, avoid lifting."]},"pl":{"applies_when":["Ochrona i zakres ruchu (0-2 tygodnie)"],"dosage_and_progression":["Stosowanie lodu 3-5 razy dziennie."],"physiotherapist_actions":["Kontrola bólu, ochrona tkanek, ćwiczenia bierne (wahadłowe, pasywne wyprosty, zgięcia, rotacje), unikanie aktywnego unoszenia ramienia.","Używanie temblaka, unikanie dźwigania."]},"original":{"applies_when":["Protection and ROM (0-2 Weeks)"],"dosage_and_progression":["Ice 3-5 times daily."],"physiotherapist_actions":["Pain control, tissue protection, passive exercises (pendulums, passive flexion/extension, rotation), avoid active arm elevation.","Sling use, avoid lifting."]}},"additional_notes_de":"Eistherapie 3-5 mal täglich.","additional_notes_en":"Ice 3-5 times daily.","additional_notes_pl":"Stosowanie lodu 3-5 razy dziennie.","minimum_patient_share":null,"therapeutic_content_de":"Schmerzkontrolle, Gewebeschutz, passive Übungen (Pendelübungen, passive Extension, Flexion, Rotation), Vermeidung aktiver 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ruchu, wprowadzenie aktywnego wspomagania (table slides), początek wzmacniania mięśni okołoparkowych (prone row, extension).","minimum_requirements_de":"Gute Skapulakontrolle.","minimum_requirements_en":"Good scapular control.","minimum_requirements_pl":"Dobra kontrola łopatki.","additional_notes_original":"Gradual weaning from sling.","therapeutic_content_original":"Continue passive ROM, introduce active assisted ROM (table slides), initiate peri-scapular strengthening (prone row, extension).","minimum_requirements_original":"Good scapular control.","structured_content_v2":"$undefined"},{"id":"118c38f7-468b-5620-9329-cbcf5a64e0a0","name_de":"Phase 3: Kräftigung (6-12 Wochen)","name_en":"Phase 3: Strengthening (6-12 Weeks)","name_pl":"Faza 3: Wzmacnianie (6-12 tygodni)","source_page":5,"module_number":3,"name_original":"Phase 3: Strengthening (6-12 Weeks)","service_codes":[],"structured_content":{"de":{"applies_when":["Kräftigung (6-12 Wochen)"],"restrictions":["Vermeidung von 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Scapular stabilization.","minimum_requirements_original":"No AROM of shoulder/elbow, no lifting >5 lbs, no friction massage to biceps site.","structured_content_v2":"$undefined"},{"id":"ce2e06a9-cbcb-5716-9153-a6ddc5cd80ee","name_de":"Phase II: Woche 4-8","name_en":"Phase II: Weeks 4-8","name_pl":"Faza II: Tygodnie 4-8","source_page":1,"module_number":2,"name_original":"Phase II: Weeks 4-8","service_codes":[],"structured_content":{"de":{"exercises":["Ellbogenübungen ohne Widerstand."],"applies_when":["Woche 4-8"],"dosage_and_progression":["Fortschreitende PROM- und AAROM-Übungen.","Einführung von AROM in der Skapulaebene.","Skapulastabilisierung."],"physiotherapist_actions":["Sanftes Dehnen und Gelenkmobilisationen."]},"en":{"exercises":["Elbow exercises without resistance."],"applies_when":["Weeks 4-8"],"dosage_and_progression":["Advance PROM and AAROM.","Start AROM in scapular plane.","Continue scapular strengthening."],"physiotherapist_actions":["Gentle stretching or joint mobilizations as appropriate."]},"pl":{"exercises":["Ćwiczenia łokcia bez oporu."],"applies_when":["Tygodnie 4-8"],"dosage_and_progression":["Progresja PROM i AAROM.","Wprowadzenie AROM w płaszczyźnie łopatki.","Kontynuacja stabilizacji łopatki."],"physiotherapist_actions":["Delikatny stretching i mobilizacje stawowe."]},"original":{"exercises":["Elbow exercises without resistance."],"applies_when":["Weeks 4-8"],"dosage_and_progression":["Advance PROM and AAROM.","Start AROM in scapular plane.","Continue scapular strengthening."],"physiotherapist_actions":["Gentle stretching or joint mobilizations as appropriate."]}},"additional_notes_de":"Sanftes Dehnen und Gelenkmobilisationen.","additional_notes_en":"Gentle stretching or joint mobilizations as appropriate.","additional_notes_pl":"Delikatny stretching i mobilizacje stawowe.","minimum_patient_share":null,"therapeutic_content_de":"Fortschreitende PROM- und AAROM-Übungen. Einführung von AROM in der Skapulaebene. Ellbogenübungen ohne Widerstand. Skapulastabilisierung.","therapeutic_content_en":"Advance PROM and AAROM. Start AROM in scapular plane. Elbow exercises without resistance. Continue scapular strengthening.","therapeutic_content_pl":"Progresja PROM i AAROM. Wprowadzenie AROM w płaszczyźnie łopatki. Ćwiczenia łokcia bez oporu. Kontynuacja stabilizacji łopatki.","minimum_requirements_de":"","minimum_requirements_en":"","minimum_requirements_pl":"","additional_notes_original":"Gentle stretching or joint mobilizations as appropriate.","therapeutic_content_original":"Advance PROM and AAROM. Start AROM in scapular plane. Elbow exercises without resistance. Continue scapular strengthening.","minimum_requirements_original":"","structured_content_v2":"$undefined"},{"id":"bdde3e84-12cb-5830-a53c-f2267f5e010b","name_de":"Phase III: Woche 8-12","name_en":"Phase III: Weeks 8-12","name_pl":"Faza III: Tygodnie 8-12","source_page":2,"module_number":3,"name_original":"Phase III: Weeks 8-12","service_codes":[],"structured_content":{"de":{"exercises":["Kräftigung der Rotatorenmanschette, des Deltoideus und der Skapulastabilisatoren.","Widerstandsübungen mit Bändern."],"applies_when":["Woche 8-12"],"progression_criteria":["Ausreichender Bewegungsumfang (ROM) erforderlich."],"dosage_and_progression":["Progression der Dehnung der Innenrotation hinter dem Rücken."]},"en":{"exercises":["Strengthening of rotator cuff, deltoid, and scapular stabilizers.","Resistance exercises with bands."],"applies_when":["Weeks 8-12"],"progression_criteria":["Adequate ROM required before initiation."],"dosage_and_progression":["Progress IR stretch behind back."]},"pl":{"exercises":["Wzmacnianie mięśni stożka rotatorów, deltoideus i stabilizatorów łopatki.","Ćwiczenia oporowe z taśmami."],"applies_when":["Tygodnie 8-12"],"progression_criteria":["Wymagany odpowiedni zakres ruchu (ROM) przed rozpoczęciem."],"dosage_and_progression":["Progresja rozciągania rotacji wewnętrznej za plecami."]},"original":{"exercises":["Strengthening of rotator cuff, deltoid, and scapular stabilizers.","Resistance exercises with bands."],"applies_when":["Weeks 8-12"],"progression_criteria":["Adequate ROM required before initiation."],"dosage_and_progression":["Progress IR stretch behind back."]}},"additional_notes_de":"Progression der Dehnung der Innenrotation hinter dem Rücken.","additional_notes_en":"Progress IR stretch behind back.","additional_notes_pl":"Progresja rozciągania rotacji wewnętrznej za plecami.","minimum_patient_share":null,"therapeutic_content_de":"Kräftigung der Rotatorenmanschette, des Deltoideus und der Skapulastabilisatoren. Widerstandsübungen mit Bändern.","therapeutic_content_en":"Strengthening of rotator cuff, deltoid, and scapular stabilizers. Resistance exercises with bands.","therapeutic_content_pl":"Wzmacnianie mięśni stożka rotatorów, deltoideus i stabilizatorów łopatki. Ćwiczenia oporowe z taśmami.","minimum_requirements_de":"Ausreichender Bewegungsumfang (ROM) erforderlich.","minimum_requirements_en":"Adequate ROM required before initiation.","minimum_requirements_pl":"Wymagany odpowiedni zakres ruchu (ROM) przed rozpoczęciem.","additional_notes_original":"Progress IR stretch behind back.","therapeutic_content_original":"Strengthening of rotator cuff, deltoid, and scapular stabilizers. Resistance exercises with bands.","minimum_requirements_original":"Adequate ROM required before initiation.","structured_content_v2":"$undefined"},{"id":"85859eaa-4f4d-560e-96d9-420890e12e4a","name_de":"Phase IV: Über 12 Wochen","name_en":"Phase IV: Beyond 12 weeks","name_pl":"Faza IV: Powyżej 12 tygodnia","source_page":2,"module_number":4,"name_original":"Phase IV: Beyond 12 weeks","service_codes":[],"structured_content":{"de":{"warnings":["Erwartete Genesungszeit: 6-9 Monate."],"exercises":["Fortgeschrittene Kräftigung."],"applies_when":["Über 12 Wochen"],"restrictions":["Nicht vor der 12. Woche beginnen."],"dosage_and_progression":["Rückkehr zu funktionellen Aktivitäten, Freizeitsport und Arbeit."]},"en":{"warnings":["Expected recovery time: 6-9 months."],"exercises":["Advanced strengthening."],"applies_when":["Beyond 12 weeks"],"restrictions":["Do not begin before 12 weeks."],"dosage_and_progression":["Return to functional activities, recreational sports, and work."]},"pl":{"warnings":["Oczekiwany czas powrotu do pełnej sprawności: 6-9 miesięcy."],"exercises":["Zaawansowane wzmacnianie."],"applies_when":["Powyżej 12 tygodnia"],"restrictions":["Nie zaczynać przed 12 tygodniem."],"dosage_and_progression":["Powrót do aktywności funkcjonalnych, sportów rekreacyjnych i pracy."]},"original":{"warnings":["Expected recovery time: 6-9 months."],"exercises":["Advanced strengthening."],"applies_when":["Beyond 12 weeks"],"restrictions":["Do not begin before 12 weeks."],"dosage_and_progression":["Return to functional activities, recreational sports, and work."]}},"additional_notes_de":"Erwartete Genesungszeit: 6-9 Monate.","additional_notes_en":"Expected recovery time: 6-9 months.","additional_notes_pl":"Oczekiwany czas powrotu do pełnej sprawności: 6-9 miesięcy.","minimum_patient_share":null,"therapeutic_content_de":"Fortgeschrittene Kräftigung. Rückkehr zu funktionellen Aktivitäten, Freizeitsport und Arbeit.","therapeutic_content_en":"Advanced strengthening. Return to functional activities, recreational sports, and work.","therapeutic_content_pl":"Zaawansowane wzmacnianie. Powrót do aktywności funkcjonalnych, sportów rekreacyjnych i pracy.","minimum_requirements_de":"Nicht vor der 12. Woche beginnen.","minimum_requirements_en":"Do not begin before 12 weeks.","minimum_requirements_pl":"Nie zaczynać przed 12 tygodniem.","additional_notes_original":"Expected recovery time: 6-9 months.","therapeutic_content_original":"Advanced strengthening. Return to functional activities, recreational sports, and work.","minimum_requirements_original":"Do not begin before 12 weeks.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["shoulder","elbow","upper_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"c69c3d24-51d0-5db3-a7ad-0a034bb4fb78","slug":"us-jared-lee-40-distal-biceps-repair","title_pl":"Protokół rehabilitacji po naprawie dystalnego ścięgna bicepsa — Jared Lee","title_de":"Rehabilitationsprotokoll nach Refixation der distalen Bizepssehne — Jared Lee","title_en":"Distal Biceps Tendon Repair Rehabilitation Protocol — Jared Lee","title_original":"Distal Biceps Repair Rehabilitation","summary_pl":"Czterofazowy protokół po naprawie dystalnego ścięgna bicepsa z progresją ortezy i zakresu ruchu, wzmacnianiem oraz powrotem do sportu od 16. tygodnia.","summary_de":"Vierphasiges Protokoll nach Refixation der distalen Bizepssehne mit Orthesen- und Bewegungsprogression, Kräftigung und Sportrückkehr ab Woche 16.","summary_en":"Four-phase protocol after distal biceps tendon repair with brace and range-of-motion progression, strengthening, and return to sport from week 16.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":["return_to_sport"],"physician_clearance_required":false,"condition_id":"400c1410-8c1e-5e96-86ac-06136c7c517b","condition_slug":"distal-biceps-repair","condition_name_pl":"Stan po naprawie dystalnego ścięgna bicepsa","condition_name_de":"Zustand nach Refixation der distalen Bizepssehne","condition_name_en":"Status Post Distal Biceps Tendon Repair","condition_name_original":"Status Post Distal Biceps Tendon Repair","icd_codes":[],"category_key":"elbow","category_pl":"Łokieć","category_de":"Ellenbogen","category_en":"Elbow","body_regions_pl":["Łokieć","Ramię"],"body_regions_de":["Ellenbogen","Oberarm"],"body_regions_en":["Elbow","Upper arm"],"search_terms_pl":["dystalne ścięgno bicepsa","naprawa bicepsa","rehabilitacja łokcia"],"search_terms_de":["distale Bizepssehne","Bizepssehnenrefixation","Ellenbogenrehabilitation"],"search_terms_en":["distal biceps tendon","biceps repair","elbow rehabilitation"],"source_document_id":"3678622c-2a73-5efe-a98a-b7aa2a20c595","source_title":"Distal Biceps Repair Rehabilitation","issuer":"Jared Lee, MD","source_country_code":"US","jurisdiction_code":"US-CO","authority_level":"clinic","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_requires_review","official_url":"https://jaredleemd.com/wp-content/uploads/2025/06/Distal-Biceps-Repair-Rehabilitation-Protocol.pdf","source_sha256":"00eb941092dc60bc0fbb32f9415349879cc684754274b5a6c9bbb0c0f88271eb","authorization_required":false,"license_note":"Public source file retained locally for source verification.","modules":[{"id":"d852ea50-6187-56c6-97f6-391523617726","name_de":"Phase 1: Wochen 0–2","name_en":"Phase 1: Weeks 0-2","name_pl":"Faza 1: tygodnie 0–2","source_page":1,"module_number":1,"name_original":"Phase 1: Weeks 0-2","service_codes":[],"structured_content":{"de":{"goals":["Schutz der Sehnenrefixation."],"exercises":["Uneingeschränkter Bewegungsumfang von Hand und Fingern","Bewegungsumfang der Schulter ohne Außenrotation","Bewegungsumfang und Dehnung der Halswirbelsäule","submaximale schmerzfreie Isometrie für Trizeps und Schultermuskulatur."],"applies_when":["Wochen 0–2"],"restrictions":["nicht mehr als 3 lb heben","keine aktive Supination oder Pronation des Unterarms."],"dosage_and_progression":["Physiotherapie ab Woche 2 beginnen"],"physiotherapist_actions":["Hintere Armschiene für 2 Wochen"]},"en":{"goals":["protect the repair."],"exercises":["Unrestricted hand and finger range of motion","shoulder range of motion while avoiding external rotation","neck range of motion and stretching","submaximal pain-free isometrics for the triceps and shoulder musculature."],"applies_when":["Weeks 0-2"],"restrictions":["do not lift more than 3 lb","no active forearm supination or pronation."],"dosage_and_progression":["begin physical therapy at week 2"],"physiotherapist_actions":["Use a posterior arm splint for 2 weeks"]},"pl":{"goals":["ochrona naprawionego ścięgna."],"exercises":["Nieograniczony zakres ruchu ręki i palców","zakres ruchu barku bez rotacji zewnętrznej","zakres ruchu i rozciąganie szyi","submaksymalne bezbolesne ćwiczenia izometryczne tricepsa i mięśni barku."],"applies_when":["tygodnie 0–2"],"restrictions":["nie podnosić więcej niż 3 lb","bez czynnej supinacji i pronacji przedramienia."],"dosage_and_progression":["rozpocząć fizjoterapię w 2. tygodniu"],"physiotherapist_actions":["Tylna szyna ramienna przez 2 tygodnie"]},"original":{"goals":["protect the repair."],"exercises":["Unrestricted hand and finger range of motion","shoulder range of motion while avoiding external rotation","neck range of motion and stretching","submaximal pain-free isometrics for the triceps and shoulder musculature."],"applies_when":["Weeks 0-2"],"restrictions":["do not lift more than 3 lb","no active forearm supination or pronation."],"dosage_and_progression":["begin physical therapy at week 2"],"physiotherapist_actions":["Use a posterior arm splint for 2 weeks"]}},"additional_notes_de":"Ziel: Schutz der Sehnenrefixation.","additional_notes_en":"Goal: protect the repair.","additional_notes_pl":"Cel: ochrona naprawionego ścięgna.","minimum_patient_share":null,"therapeutic_content_de":"Uneingeschränkter Bewegungsumfang von Hand und Fingern; Bewegungsumfang der Schulter ohne Außenrotation; Bewegungsumfang und Dehnung der Halswirbelsäule; submaximale schmerzfreie Isometrie für Trizeps und Schultermuskulatur.","therapeutic_content_en":"Unrestricted hand and finger range of motion; shoulder range of motion while avoiding external rotation; neck range of motion and stretching; submaximal pain-free isometrics for the triceps and shoulder musculature.","therapeutic_content_pl":"Nieograniczony zakres ruchu ręki i palców; zakres ruchu barku bez rotacji zewnętrznej; zakres ruchu i rozciąganie szyi; submaksymalne bezbolesne ćwiczenia izometryczne tricepsa i mięśni barku.","minimum_requirements_de":"Hintere Armschiene für 2 Wochen; Physiotherapie ab Woche 2 beginnen; nicht mehr als 3 lb heben; keine aktive Supination oder Pronation des Unterarms.","minimum_requirements_en":"Use a posterior arm splint for 2 weeks; begin physical therapy at week 2; do not lift more than 3 lb; no active forearm supination or pronation.","minimum_requirements_pl":"Tylna szyna ramienna przez 2 tygodnie; rozpocząć fizjoterapię w 2. tygodniu; nie podnosić więcej niż 3 lb; bez czynnej supinacji i pronacji przedramienia.","additional_notes_original":"Goal: protect the repair.","therapeutic_content_original":"Unrestricted hand and finger range of motion; shoulder range of motion while avoiding external rotation; neck range of motion and stretching; submaximal pain-free isometrics for the triceps and shoulder musculature.","minimum_requirements_original":"Use a posterior arm splint for 2 weeks; begin physical therapy at week 2; do not lift more than 3 lb; no active forearm supination or pronation.","structured_content_v2":"$undefined"},{"id":"5a882b08-5136-544c-ba30-80911a416c30","name_de":"Phase 2: Wochen 2–10","name_en":"Phase 2: Weeks 2-10","name_pl":"Faza 2: tygodnie 2–10","source_page":1,"module_number":2,"name_original":"Phase 2: Weeks 2-10","service_codes":[],"structured_content":{"de":{"goals":["Schutz der Sehnenrefixation, Wiederherstellung des Bewegungsumfangs sowie Begrenzung von Muskelatrophie und Schmerzen."],"exercises":["Passive Supination und Pronation des Unterarms ohne aktive Bewegung","passive Ellenbogenflexion von 60° bis zur vollen Flexion bis Woche 4","ab Woche 4 Orthese einstellen: 50° in Woche 4, 40° in Woche 5, 30° in Woche 6, 20° in Woche 7, 10° in Woche 8 und voller Bewegungsumfang in Woche 9–10","Woche 2–4: passive Ellenbogenflexion und Supination","Woche 4–6: aktiv-assistierte Ellenbogenflexion beginnen, assistierte Extension fortsetzen und zur passiven Extension übergehen","Woche 6–8: aktive Ellenbogenflexion und -extension","Woche 8–10: Programm fortsetzen und kombinierte Bewegungen beginnen, z. B.","Extension mit Pronation","Woche 2–4: submaximale schmerzfreie Bizepsisometrie bei neutralem Unterarm","Woche 4–6: aktive Bewegung in einer Ebene für Ellenbogenflexion, -extension, Supination und Pronation","Woche 6–8: progressives Widerstandsprogramm für Flexion, Extension, Supination und Pronation beginnen."],"applies_when":["Wochen 2–10"],"restrictions":["bis 6 Wochen postoperativ nicht mehr als 3 lb heben."],"physiotherapist_actions":["Die Ellenbogenbewegungsorthese außer bei Hygiene, Physiotherapie und Ankleiden ständig tragen","anfangs von 60° bis zur vollen Flexion einstellen"]},"en":{"goals":["protect the repair, restore range of motion, retard muscle atrophy and minimize pain."],"exercises":["Passive forearm supination and pronation with no active movement","passive elbow flexion from 60° to full flexion until week 4","from week 4 set the brace to 50° in week 4, 40° in week 5, 30° in week 6, 20° in week 7, 10° in week 8 and full range of motion in weeks 9-10","weeks 2-4: passive elbow flexion and wrist supination","weeks 4-6: initiate active-assisted elbow flexion, continue assisted extension and progress to passive extension","weeks 6-8: active elbow flexion and extension","weeks 8-10: continue the program and combined motions may begin, such as extension with pronation","weeks 2-4: submaximal pain-free biceps isometrics with the forearm neutral","weeks 4-6: single-plane active range of motion for elbow flexion, extension, supination and pronation","weeks 6-8: initiate progressive resisted exercise for flexion, extension, supination and pronation."],"applies_when":["Weeks 2-10"],"restrictions":["do not lift more than 3 lb until 6 weeks postoperative."],"physiotherapist_actions":["Wear the hinged elbow brace at all times except hygiene, physical therapy and dressing","initially set it from 60° to full flexion"]},"pl":{"goals":["ochrona naprawionego ścięgna, odzyskiwanie zakresu ruchu, ograniczenie zaniku mięśni i bólu."],"exercises":["Bierna supinacja i pronacja przedramienia bez ruchu czynnego","bierne zgięcie łokcia od 60° do pełnego do 4. tygodnia","od 4. tygodnia ustawiać ortezę: 50° w tygodniu 4., 40° w 5., 30° w 6., 20° w 7., 10° w 8. i pełny ROM w tygodniach 9–10","tygodnie 2–4: bierne zgięcie łokcia i supinacja","tygodnie 4–6: rozpocząć czynne wspomagane zgięcie łokcia, kontynuować wspomagany wyprost i przejść do wyprostu biernego","tygodnie 6–8: czynne zgięcie i wyprost łokcia","tygodnie 8–10: kontynuować program i można rozpocząć ruchy złożone, np. wyprost z pronacją","tygodnie 2–4: submaksymalne bezbolesne napięcia izometryczne bicepsa z przedramieniem neutralnie","tygodnie 4–6: czynny ROM w jednej płaszczyźnie dla zgięcia i wyprostu łokcia oraz supinacji i pronacji","tygodnie 6–8: rozpocząć progresywny program oporowy dla zgięcia, wyprostu, supinacji i pronacji."],"applies_when":["tygodnie 2–10"],"restrictions":["nie podnosić więcej niż 3 lb do 6. tygodnia po operacji."],"physiotherapist_actions":["Zawiasową ortezę łokcia nosić stale poza higieną, fizjoterapią i ubieraniem","początkowo ustawić od 60° do pełnego zgięcia"]},"original":{"goals":["protect the repair, restore range of motion, retard muscle atrophy and minimize pain."],"exercises":["Passive forearm supination and pronation with no active movement","passive elbow flexion from 60° to full flexion until week 4","from week 4 set the brace to 50° in week 4, 40° in week 5, 30° in week 6, 20° in week 7, 10° in week 8 and full range of motion in weeks 9-10","weeks 2-4: passive elbow flexion and wrist supination","weeks 4-6: initiate active-assisted elbow flexion, continue assisted extension and progress to passive extension","weeks 6-8: active elbow flexion and extension","weeks 8-10: continue the program and combined motions may begin, such as extension with pronation","weeks 2-4: submaximal pain-free biceps isometrics with the forearm neutral","weeks 4-6: single-plane active range of motion for elbow flexion, extension, supination and pronation","weeks 6-8: initiate progressive resisted exercise for flexion, extension, supination and pronation."],"applies_when":["Weeks 2-10"],"restrictions":["do not lift more than 3 lb until 6 weeks postoperative."],"physiotherapist_actions":["Wear the hinged elbow brace at all times except hygiene, physical therapy and dressing","initially set it from 60° to full flexion"]}},"additional_notes_de":"Ziele: Schutz der Sehnenrefixation, Wiederherstellung des Bewegungsumfangs sowie Begrenzung von Muskelatrophie und Schmerzen.","additional_notes_en":"Goals: protect the repair, restore range of motion, retard muscle atrophy and minimize pain.","additional_notes_pl":"Cele: ochrona naprawionego ścięgna, odzyskiwanie zakresu ruchu, ograniczenie zaniku mięśni i bólu.","minimum_patient_share":null,"therapeutic_content_de":"Passive Supination und Pronation des Unterarms ohne aktive Bewegung; passive Ellenbogenflexion von 60° bis zur vollen Flexion bis Woche 4; ab Woche 4 Orthese einstellen: 50° in Woche 4, 40° in Woche 5, 30° in Woche 6, 20° in Woche 7, 10° in Woche 8 und voller Bewegungsumfang in Woche 9–10; Woche 2–4: passive Ellenbogenflexion und Supination; Woche 4–6: aktiv-assistierte Ellenbogenflexion beginnen, assistierte Extension fortsetzen und zur passiven Extension übergehen; Woche 6–8: aktive Ellenbogenflexion und -extension; Woche 8–10: Programm fortsetzen und kombinierte Bewegungen beginnen, z. B. Extension mit Pronation; Woche 2–4: submaximale schmerzfreie Bizepsisometrie bei neutralem Unterarm; Woche 4–6: aktive Bewegung in einer Ebene für Ellenbogenflexion, -extension, Supination und Pronation; Woche 6–8: progressives Widerstandsprogramm für Flexion, Extension, Supination und Pronation beginnen.","therapeutic_content_en":"Passive forearm supination and pronation with no active movement; passive elbow flexion from 60° to full flexion until week 4; from week 4 set the brace to 50° in week 4, 40° in week 5, 30° in week 6, 20° in week 7, 10° in week 8 and full range of motion in weeks 9-10; weeks 2-4: passive elbow flexion and wrist supination; weeks 4-6: initiate active-assisted elbow flexion, continue assisted extension and progress to passive extension; weeks 6-8: active elbow flexion and extension; weeks 8-10: continue the program and combined motions may begin, such as extension with pronation; weeks 2-4: submaximal pain-free biceps isometrics with the forearm neutral; weeks 4-6: single-plane active range of motion for elbow flexion, extension, supination and pronation; weeks 6-8: initiate progressive resisted exercise for flexion, extension, supination and pronation.","therapeutic_content_pl":"Bierna supinacja i pronacja przedramienia bez ruchu czynnego; bierne zgięcie łokcia od 60° do pełnego do 4. tygodnia; od 4. tygodnia ustawiać ortezę: 50° w tygodniu 4., 40° w 5., 30° w 6., 20° w 7., 10° w 8. i pełny ROM w tygodniach 9–10; tygodnie 2–4: bierne zgięcie łokcia i supinacja; tygodnie 4–6: rozpocząć czynne wspomagane zgięcie łokcia, kontynuować wspomagany wyprost i przejść do wyprostu biernego; tygodnie 6–8: czynne zgięcie i wyprost łokcia; tygodnie 8–10: kontynuować program i można rozpocząć ruchy złożone, np. wyprost z pronacją; tygodnie 2–4: submaksymalne bezbolesne napięcia izometryczne bicepsa z przedramieniem neutralnie; tygodnie 4–6: czynny ROM w jednej płaszczyźnie dla zgięcia i wyprostu łokcia oraz supinacji i pronacji; tygodnie 6–8: rozpocząć progresywny program oporowy dla zgięcia, wyprostu, supinacji i pronacji.","minimum_requirements_de":"Die Ellenbogenbewegungsorthese außer bei Hygiene, Physiotherapie und Ankleiden ständig tragen; anfangs von 60° bis zur vollen Flexion einstellen; bis 6 Wochen postoperativ nicht mehr als 3 lb heben.","minimum_requirements_en":"Wear the hinged elbow brace at all times except hygiene, physical therapy and dressing; initially set it from 60° to full flexion; do not lift more than 3 lb until 6 weeks postoperative.","minimum_requirements_pl":"Zawiasową ortezę łokcia nosić stale poza higieną, fizjoterapią i ubieraniem; początkowo ustawić od 60° do pełnego zgięcia; nie podnosić więcej niż 3 lb do 6. tygodnia po operacji.","additional_notes_original":"Goals: protect the repair, restore range of motion, retard muscle atrophy and minimize pain.","therapeutic_content_original":"Passive forearm supination and pronation with no active movement; passive elbow flexion from 60° to full flexion until week 4; from week 4 set the brace to 50° in week 4, 40° in week 5, 30° in week 6, 20° in week 7, 10° in week 8 and full range of motion in weeks 9-10; weeks 2-4: passive elbow flexion and wrist supination; weeks 4-6: initiate active-assisted elbow flexion, continue assisted extension and progress to passive extension; weeks 6-8: active elbow flexion and extension; weeks 8-10: continue the program and combined motions may begin, such as extension with pronation; weeks 2-4: submaximal pain-free biceps isometrics with the forearm neutral; weeks 4-6: single-plane active range of motion for elbow flexion, extension, supination and pronation; weeks 6-8: initiate progressive resisted exercise for flexion, extension, supination and pronation.","minimum_requirements_original":"Wear the hinged elbow brace at all times except hygiene, physical therapy and dressing; initially set it from 60° to full flexion; do not lift more than 3 lb until 6 weeks postoperative.","structured_content_v2":"$undefined"},{"id":"8d36fa09-1fe1-5b95-9749-5c02406d5e6f","name_de":"Phase 3: Wochen 10–14","name_en":"Phase 3: Weeks 10-14","name_pl":"Faza 3: tygodnie 10–14","source_page":2,"module_number":3,"name_original":"Phase 3: Weeks 10-14","service_codes":[],"structured_content":{"de":{"goals":["voller Bewegungsumfang, minimale Schmerzen, Beginn der Muskelaktivierung und Kräftigung sowie Schutz der Sehnenrefixation."],"exercises":["Voller passiver, aktiver und aktiv-assistierter Bewegungsumfang ohne Widerstand","Skapulakräftigung steigern","PNF-Muster ab Woche 7","Oberkörperergometer mit Widerstand","Halswirbelsäule dehnen und kräftigen","Rumpfstabilisation","ab Woche 12 Kräftigung und beidarmige Plyometrie weiter vom Körper entfernt sowie Seitwärts-, Überkopf- und Seitenwürfe steigern."],"applies_when":["Wochen 10–14"],"restrictions":["keine Gegenstände über 10 lb heben."],"physiotherapist_actions":["Orthese absetzen","voller Bewegungsumfang","ab Woche 10 exzentrische Ellenbogenflexion und -extension, isotonisches Unterarm- und Handgelenkprogramm, manuell widerstandene diagonale Muster sowie Plyometrie mit Brustpass und seitlichem Wurf körpernah"]},"en":{"goals":["full range of motion, minimal pain, begin muscular activation and strengthening, and protect the repair."],"exercises":["Full passive, active and active-assisted range of motion without resistance","progress scapular strengthening","initiate PNF patterns at week 7","upper-body ergometer with resistance","from week 10 use eccentric elbow flexion and extension, an isotonic forearm and wrist program, manually resisted diagonal patterns and plyometrics with chest passes and side throws close to the body","neck stretching and strengthening","core stabilization","from week 12 increase strengthening and two-hand plyometrics away from the body, side-to-side throws, soccer throws and side throws."],"applies_when":["Weeks 10-14"],"restrictions":["do not lift objects heavier than 10 lb."],"dosage_and_progression":["Discontinue the orthosis"],"physiotherapist_actions":["use full range of motion"]},"pl":{"goals":["pełny zakres ruchu, minimalny ból, rozpoczęcie aktywacji i wzmacniania mięśni oraz ochrona naprawionego ścięgna."],"exercises":["Pełny bierny, czynny i czynny wspomagany zakres ruchu bez oporu","zwiększać wzmacnianie łopatki","wzorce PNF od 7. tygodnia","ergometr kończyn górnych z oporem","od 10. tygodnia ekscentryczne zginanie i prostowanie łokcia, izotoniczny program przedramienia i nadgarstka, manualnie oporowane wzorce diagonalne oraz plyometria z podaniem piłki sprzed klatki i rzutem bokiem blisko ciała","rozciąganie i wzmacnianie szyi","stabilizacja centralna","od 12. tygodnia zwiększać wzmacnianie i plyometrię oburącz dalej od ciała, rzuty bok–bok, znad głowy i bokiem."],"applies_when":["tygodnie 10–14"],"restrictions":["nie podnosić przedmiotów cięższych niż 10 lb."],"dosage_and_progression":["Odstawić ortezę"],"physiotherapist_actions":["pełny zakres ruchu"]},"original":{"goals":["full range of motion, minimal pain, begin muscular activation and strengthening, and protect the repair."],"exercises":["Full passive, active and active-assisted range of motion without resistance","progress scapular strengthening","initiate PNF patterns at week 7","upper-body ergometer with resistance","from week 10 use eccentric elbow flexion and extension, an isotonic forearm and wrist program, manually resisted diagonal patterns and plyometrics with chest passes and side throws close to the body","neck stretching and strengthening","core stabilization","from week 12 increase strengthening and two-hand plyometrics away from the body, side-to-side throws, soccer throws and side throws."],"applies_when":["Weeks 10-14"],"restrictions":["do not lift objects heavier than 10 lb."],"dosage_and_progression":["Discontinue the orthosis"],"physiotherapist_actions":["use full range of motion"]}},"additional_notes_de":"Ziele: voller Bewegungsumfang, minimale Schmerzen, Beginn der Muskelaktivierung und Kräftigung sowie Schutz der Sehnenrefixation.","additional_notes_en":"Goals: full range of motion, minimal pain, begin muscular activation and strengthening, and protect the repair.","additional_notes_pl":"Cele: pełny zakres ruchu, minimalny ból, rozpoczęcie aktywacji i wzmacniania mięśni oraz ochrona naprawionego ścięgna.","minimum_patient_share":null,"therapeutic_content_de":"Voller passiver, aktiver und aktiv-assistierter Bewegungsumfang ohne Widerstand; Skapulakräftigung steigern; PNF-Muster ab Woche 7; Oberkörperergometer mit Widerstand; ab Woche 10 exzentrische Ellenbogenflexion und -extension, isotonisches Unterarm- und Handgelenkprogramm, manuell widerstandene diagonale Muster sowie Plyometrie mit Brustpass und seitlichem Wurf körpernah; Halswirbelsäule dehnen und kräftigen; Rumpfstabilisation; ab Woche 12 Kräftigung und beidarmige Plyometrie weiter vom Körper entfernt sowie Seitwärts-, Überkopf- und Seitenwürfe steigern.","therapeutic_content_en":"Full passive, active and active-assisted range of motion without resistance; progress scapular strengthening; initiate PNF patterns at week 7; upper-body ergometer with resistance; from week 10 use eccentric elbow flexion and extension, an isotonic forearm and wrist program, manually resisted diagonal patterns and plyometrics with chest passes and side throws close to the body; neck stretching and strengthening; core stabilization; from week 12 increase strengthening and two-hand plyometrics away from the body, side-to-side throws, soccer throws and side throws.","therapeutic_content_pl":"Pełny bierny, czynny i czynny wspomagany zakres ruchu bez oporu; zwiększać wzmacnianie łopatki; wzorce PNF od 7. tygodnia; ergometr kończyn górnych z oporem; od 10. tygodnia ekscentryczne zginanie i prostowanie łokcia, izotoniczny program przedramienia i nadgarstka, manualnie oporowane wzorce diagonalne oraz plyometria z podaniem piłki sprzed klatki i rzutem bokiem blisko ciała; rozciąganie i wzmacnianie szyi; stabilizacja centralna; od 12. tygodnia zwiększać wzmacnianie i plyometrię oburącz dalej od ciała, rzuty bok–bok, znad głowy i bokiem.","minimum_requirements_de":"Orthese absetzen; voller Bewegungsumfang; keine Gegenstände über 10 lb heben.","minimum_requirements_en":"Discontinue the orthosis; use full range of motion; do not lift objects heavier than 10 lb.","minimum_requirements_pl":"Odstawić ortezę; pełny zakres ruchu; nie podnosić przedmiotów cięższych niż 10 lb.","additional_notes_original":"Goals: full range of motion, minimal pain, begin muscular activation and strengthening, and protect the repair.","therapeutic_content_original":"Full passive, active and active-assisted range of motion without resistance; progress scapular strengthening; initiate PNF patterns at week 7; upper-body ergometer with resistance; from week 10 use eccentric elbow flexion and extension, an isotonic forearm and wrist program, manually resisted diagonal patterns and plyometrics with chest passes and side throws close to the body; neck stretching and strengthening; core stabilization; from week 12 increase strengthening and two-hand plyometrics away from the body, side-to-side throws, soccer throws and side throws.","minimum_requirements_original":"Discontinue the orthosis; use full range of motion; do not lift objects heavier than 10 lb.","structured_content_v2":"$undefined"},{"id":"de4a681d-1ec5-5a0a-aa24-4b1e81b12024","name_de":"Phase 4: Wochen 14–20","name_en":"Phase 4: Weeks 14-20","name_pl":"Faza 4: tygodnie 14–20","source_page":2,"module_number":4,"name_original":"Phase 4: Weeks 14-20","service_codes":[],"structured_content":{"de":{"goals":["Progression funktioneller sowie fortgeschrittener sportlicher und freizeitbezogener Aktivitäten nach Maßgabe des Operateurs."],"exercises":["Kräftigungsprogramm steigern","Schwerpunkt auf Kraft- und Beweglichkeitsübungen für Ellenbogen und Handgelenk","vollen Ellenbogenbewegungsumfang erhalten","einarmiges plyometrisches Werfen und einarmiges Prellen gegen die Wand beginnen","ab Woche 16 schrittweise Sportrückkehr mit Intervall-Wurfprogramm nach Indikation beginnen."],"applies_when":["Wochen 14–20"],"restrictions":["Kein schweres Krafttraining bis Woche 16."],"progression_criteria":["Kraftdefizit <10 %","Limb-Similarity-Index ≥90 %","45/50 Punkte in biomechanischen Funktionstests, sofern durchgeführt","keine Schmerzen oder Instabilität."]},"en":{"goals":["progress functional activities and advanced sport and recreational activity as directed by the surgeon."],"exercises":["Progress the strengthening program","emphasize elbow and wrist power and flexibility exercises","maintain full elbow range of motion","initiate one-hand plyometric throwing and one-hand wall dribbling","at week 16 begin gradual return to sport with an interval throwing program as indicated."],"applies_when":["Weeks 14-20"],"restrictions":["No heavy weightlifting until week 16."],"progression_criteria":["<10% strength deficit","limb similarity index ≥90%","45/50 on biomechanical functional tests, if performed","no pain or instability."]},"pl":{"goals":["progresja aktywności funkcjonalnej oraz zaawansowanej aktywności sportowej i rekreacyjnej zgodnie z decyzją chirurga."],"exercises":["Zwiększać program wzmacniania","skoncentrować ćwiczenia na mocy i elastyczności łokcia oraz nadgarstka","utrzymywać pełny zakres ruchu łokcia","rozpocząć plyometryczny rzut jednorącz i kozłowanie piłki o ścianę jedną ręką","od 16. tygodnia rozpocząć stopniowy powrót do sportu z interwałowym programem rzutowym według wskazań."],"applies_when":["tygodnie 14–20"],"restrictions":["Bez ciężkiego treningu siłowego do 16. tygodnia."],"progression_criteria":["deficyt siły <10%","wskaźnik podobieństwa kończyn ≥90%","45/50 w biomechanicznych testach funkcjonalnych, jeśli wykonano","brak bólu lub niestabilności."]},"original":{"goals":["progress functional activities and advanced sport and recreational activity as directed by the surgeon."],"exercises":["Progress the strengthening program","emphasize elbow and wrist power and flexibility exercises","maintain full elbow range of motion","initiate one-hand plyometric throwing and one-hand wall dribbling","at week 16 begin gradual return to sport with an interval throwing program as indicated."],"applies_when":["Weeks 14-20"],"restrictions":["No heavy weightlifting until week 16."],"progression_criteria":["<10% strength deficit","limb similarity index ≥90%","45/50 on biomechanical functional tests, if performed","no pain or instability."]}},"additional_notes_de":"Ziel: Progression funktioneller sowie fortgeschrittener sportlicher und freizeitbezogener Aktivitäten nach Maßgabe des Operateurs. Entlassungskriterien: Kraftdefizit <10 %; Limb-Similarity-Index ≥90 %; 45/50 Punkte in biomechanischen Funktionstests, sofern durchgeführt; keine Schmerzen oder Instabilität.","additional_notes_en":"Goal: progress functional activities and advanced sport and recreational activity as directed by the surgeon. Discharge criteria: <10% strength deficit; limb similarity index ≥90%; 45/50 on biomechanical functional tests, if performed; no pain or instability.","additional_notes_pl":"Cel: progresja aktywności funkcjonalnej oraz zaawansowanej aktywności sportowej i rekreacyjnej zgodnie z decyzją chirurga. Kryteria wypisu: deficyt siły <10%; wskaźnik podobieństwa kończyn ≥90%; 45/50 w biomechanicznych testach funkcjonalnych, jeśli wykonano; brak bólu lub niestabilności.","minimum_patient_share":null,"therapeutic_content_de":"Kräftigungsprogramm steigern; Schwerpunkt auf Kraft- und Beweglichkeitsübungen für Ellenbogen und Handgelenk; vollen Ellenbogenbewegungsumfang erhalten; einarmiges plyometrisches Werfen und einarmiges Prellen gegen die Wand beginnen; ab Woche 16 schrittweise Sportrückkehr mit Intervall-Wurfprogramm nach Indikation beginnen.","therapeutic_content_en":"Progress the strengthening program; emphasize elbow and wrist power and flexibility exercises; maintain full elbow range of motion; initiate one-hand plyometric throwing and one-hand wall dribbling; at week 16 begin gradual return to sport with an interval throwing program as indicated.","therapeutic_content_pl":"Zwiększać program wzmacniania; skoncentrować ćwiczenia na mocy i elastyczności łokcia oraz nadgarstka; utrzymywać pełny zakres ruchu łokcia; rozpocząć plyometryczny rzut jednorącz i kozłowanie piłki o ścianę jedną ręką; od 16. tygodnia rozpocząć stopniowy powrót do sportu z interwałowym programem rzutowym według wskazań.","minimum_requirements_de":"Kein schweres Krafttraining bis Woche 16.","minimum_requirements_en":"No heavy weightlifting until week 16.","minimum_requirements_pl":"Bez ciężkiego treningu siłowego do 16. tygodnia.","additional_notes_original":"Goal: progress functional activities and advanced sport and recreational activity as directed by the surgeon. Discharge criteria: <10% strength deficit; limb similarity index ≥90%; 45/50 on biomechanical functional tests, if performed; no pain or instability.","therapeutic_content_original":"Progress the strengthening program; emphasize elbow and wrist power and flexibility exercises; maintain full elbow range of motion; initiate one-hand plyometric throwing and one-hand wall dribbling; at week 16 begin gradual return to sport with an interval throwing program as indicated.","minimum_requirements_original":"No heavy weightlifting until week 16.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["elbow","upper_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"4942ab95-8ccd-51e1-9283-cfb027d37c60","slug":"us-south-shore-12-distal-biceps-repair","title_pl":"Protokół rehabilitacji po naprawie ścięgna dystalnego bicepsa","title_de":"Rehabilitationsprotokoll nach distaler Bizepssehnenreparatur","title_en":"Rehabilitation protocol after distal biceps tendon repair","title_original":"Distal Biceps Repair","summary_pl":"Protokół pooperacyjny oparty na czasie i kryteriach, koncentrujący się na ochronie naprawy i stopniowym przywracaniu funkcji.","summary_de":"Postoperatives Protokoll basierend auf Zeit- und Kriterienvorgaben, fokussiert auf den Schutz der Reparatur und schrittweise Wiederherstellung der Funktion.","summary_en":"Post-operative protocol based on time and criteria, focusing on protection of the repair and gradual restoration of function.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":["return_to_sport"],"physician_clearance_required":true,"condition_id":"400c1410-8c1e-5e96-86ac-06136c7c517b","condition_slug":"distal-biceps-repair","condition_name_pl":"Stan po naprawie dystalnego ścięgna bicepsa","condition_name_de":"Zustand nach Refixation der distalen Bizepssehne","condition_name_en":"Status Post Distal Biceps Tendon Repair","condition_name_original":"Status Post Distal Biceps Tendon Repair","icd_codes":[],"category_key":"elbow","category_pl":"Łokieć","category_de":"Ellenbogen","category_en":"Elbow","body_regions_pl":["Łokieć","Ramię"],"body_regions_de":["Ellenbogen","Oberarm"],"body_regions_en":["Elbow","Upper arm"],"search_terms_pl":["dystalne ścięgno bicepsa","naprawa bicepsa","rehabilitacja łokcia"],"search_terms_de":["distale Bizepssehne","Bizepssehnenrefixation","Ellenbogenrehabilitation"],"search_terms_en":["distal biceps tendon","biceps repair","elbow rehabilitation"],"source_document_id":"c0892cdd-7410-5698-9877-552cddf7fef3","source_title":"Distal Biceps Repair","issuer":"South Shore Orthopedics","source_country_code":"US","jurisdiction_code":"US-MA","authority_level":"hospital","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_unknown_requires_review","official_url":"https://octanecdn.com/southshoreorthopedicscom/southshoreorthopedicscom_484761925.pdf","source_sha256":"94ede7bd3580dcedda217d5600c83b91af03691c1f457c55e8e7be25cced67a4","authorization_required":false,"license_note":"Public source file retained locally for source verification.","modules":[{"id":"f02ba79c-97c3-5400-8340-34a6d4817070","name_de":"Phase I: Unmittelbare postoperative Phase (0-1 Woche)","name_en":"Phase I: Immediate post-op (Day 0-1 week)","name_pl":"Faza I: Bezpośrednia pooperacyjna (0-1 tydzień)","source_page":1,"module_number":1,"name_original":"PHASE I: IMMEDIATE POST-OP (Day 0-1 WEEK AFTER SURGERY)","service_codes":[],"structured_content":{"de":{"goals":["Postoperative Schmerzen reduzieren.","Postoperatives Ödem reduzieren.","Die chirurgische Reparatur schützen.","Den Patienten zu Vorsichtsmaßnahmen und erwarteter Progression schulen.","Die Umgebung für die Gewebeheilung optimieren."],"exercises":["Griffkräftigung mit Unterarm und Handgelenk in Neutralstellung.","Passiver ROM der Ellenbogenflexion sowie Unterarmpronation/-supination innerhalb der Gelenkorthese."],"restrictions":["Keine Belastung der operierten oberen Extremität.","Aktive Ellenbogenflexion und Unterarmsupination bis Woche 4 vermeiden.","Bis Woche 8 nichts mit der operierten oberen Extremität heben."],"progression_criteria":["Ausreichende Kontrolle von Schmerzen und Ödem erhalten.","Die PROM-Progression in der Orthese richtet sich nach der Beurteilung der Reparatur durch den überweisenden Chirurgen."],"dosage_and_progression":["Hintere Ellenbogenorthese: 90° Flexion, Unterarm in 0° Pro-/Supination für 5–7 Tage, sofern der Chirurg nichts anderes anordnet.","Nach 5–7 Tagen Gelenkorthese von 90° bis zur vollen Flexion; PROM der Ellenbogenflexion und Pro-/Supination beginnen."],"physiotherapist_actions":["Modalitäten zur Reduktion von Schmerzen und Ödem anwenden.","Narbenmassage durchführen.","Den Patienten schulen, die Reparatur schützen und die Progression an die Beurteilung des Chirurgen anpassen."]},"en":{"goals":["Reduce post-operative pain.","Reduce post-operative edema.","Protect the surgical repair.","Educate the patient on surgical precautions and expected progression.","Optimize the tissue-healing environment."],"exercises":["Grip strengthening with the forearm and wrist in neutral.","Passive ROM of elbow flexion and forearm pronation/supination within the hinged orthosis."],"restrictions":["No weight bearing on the repaired upper extremity.","Avoid active elbow flexion and forearm supination until Week 4.","No lifting with the repaired upper extremity until Week 8."],"progression_criteria":["Adequate maintenance of post-operative pain and edema control.","PROM progression within the orthosis is based on the referring surgeon’s assessment of the repair."],"dosage_and_progression":["Posterior elbow orthosis: elbow at 90° flexion and forearm at 0° pronation/supination for 5–7 days unless otherwise directed by the surgeon.","At 5–7 days, use a hinged brace locked from 90° to full flexion and begin elbow-flexion and forearm pronation/supination PROM."],"physiotherapist_actions":["Use modalities to reduce post-operative edema and control pain.","Perform scar massage.","Educate the patient, protect the repair and align progression with the surgeon’s assessment."]},"pl":{"goals":["Zmniejszyć ból pooperacyjny.","Zmniejszyć obrzęk pooperacyjny.","Chronić naprawę chirurgiczną.","Wyedukować pacjenta o środkach ostrożności i oczekiwanej progresji.","Optymalizować środowisko gojenia tkanek."],"exercises":["Wzmacnianie chwytu z przedramieniem i nadgarstkiem w pozycji neutralnej.","Bierny ROM zgięcia łokcia oraz pronacji/supinacji przedramienia w granicach ortezy zawiasowej."],"restrictions":["Bez obciążania operowanej kończyny górnej.","Unikać aktywnego zgięcia łokcia i supinacji przedramienia do 4. tygodnia.","Nie podnosić operowaną kończyną górną do 8. tygodnia."],"progression_criteria":["Utrzymana odpowiednia kontrola bólu i obrzęku.","Progresja PROM w ortezie zależy od oceny naprawy przez chirurga kierującego."],"dosage_and_progression":["Tylna orteza łokcia: 90° zgięcia, przedramię w 0° pronacji/supinacji przez 5–7 dni, chyba że chirurg zaleci inaczej.","Po 5–7 dniach orteza zawiasowa zablokowana od 90° do pełnego zgięcia; rozpocząć PROM zgięcia łokcia i pronacji/supinacji."],"physiotherapist_actions":["Stosować modalności zmniejszające ból i obrzęk.","Wykonać masaż blizny.","Edukując pacjenta, chronić naprawę i dopasować progresję do oceny chirurga."]},"original":{"goals":["Reduce post-operative pain","Reduce post-operative edema","Protect surgical repair","Patient education of surgical precautions and expectations of progression","Optimize tissue healing environment"],"exercises":["Grip strengthening with forearm/wrist in neutral position","elbow flexion and forearm pronation/supination passive range of motion (PROM)"],"restrictions":["Non-weight bearing on repaired upper extremity.","AVOID active elbow flexion and forearm supination until Week 4","NO LIFTING with repaired upper extremity until Week 8"],"progression_criteria":["Adequate maintenance of post-operative pain and edema control","Progression of elbow passive range of PROM in elbow flexion and forearm pronation/supination within confines of hinged elbow orthosis is based upon referring surgeon’s assessment of surgical repair."],"dosage_and_progression":["posterior elbow orthosis with elbow in 90 degrees flexion with forearm in 0 degrees of pronation/supination for 5-7 days","Hinged elbow brace: with brace set locked from 90 degrees of flexion to full flexion, initiate elbow flexion and forearm pronation/supination passive range of motion (PROM) at 5-7 days post-operative"],"physiotherapist_actions":["Modalities to reduce post-operative edema and pain control","Scar massage","Patient education of surgical precautions and expectations of progression"]}},"additional_notes_de":"Initiale Immobilisation: hintere Ellenbogenorthese bei 90° Ellenbogenflexion und 0° Pronation/Supination des Unterarms für 5–7 Tage, sofern der Chirurg nichts anderes anordnet; Gelenkorthese von 90° Flexion bis zur vollständigen Flexion verriegelt, ab dem 5.–7. postoperativen Tag passive Beweglichkeit von Ellenbogenflexion und Unterarmpronation/-supination beginnen; Maßnahmen zur Reduktion von Ödem und Schmerzen; Griffkräftigung mit Unterarm und Handgelenk in Neutralstellung; Narbenmassage; die Progression des PROM für Ellenbogenflexion und Pronation/Supination innerhalb der Orthese richtet sich nach der Beurteilung des Chirurgen.","additional_notes_en":"Initial immobilization: posterior elbow orthosis with elbow in 90 degrees flexion and forearm in 0 degrees of pronation/supination for 5-7 days unless otherwise indicated by surgeon; hinged elbow brace locked from 90 degrees of flexion to full flexion, initiate elbow flexion and forearm pronation/supination PROM at 5-7 days post-operative; modalities to reduce post-operative edema and pain control; grip strengthening with forearm/wrist in neutral position; scar massage; progression of elbow passive ROM and forearm pronation/supination within the hinged orthosis is based upon referring surgeon's assessment of surgical repair.","additional_notes_pl":"Początkowe unieruchomienie: tylna orteza łokcia przy zgięciu łokcia 90° i przedramieniu w 0° pronacji/supinacji przez 5–7 dni, chyba że chirurg zaleci inaczej; orteza zawiasowa ustawiona od 90° zgięcia do pełnego zgięcia, od 5.–7. dnia rozpocznij bierny zakres ruchu zgięcia łokcia oraz pronacji/supinacji przedramienia; stosuj modalności zmniejszające obrzęk i ból; ćwiczenia chwytu z przedramieniem i nadgarstkiem w pozycji neutralnej; masaż blizny; progresja PROM zgięcia łokcia i pronacji/supinacji w granicach ortezy zależy od oceny chirurga.","minimum_patient_share":null,"therapeutic_content_de":"Reduktion der postoperativen Schmerzen; Reduktion des postoperativen Ödems; Schutz der chirurgischen Reparatur; Patientenschulung zu postoperativen Vorsichtsmaßnahmen und dem erwarteten Verlauf; Optimierung der Bedingungen für die Gewebeheilung.","therapeutic_content_en":"Reduce post-operative pain; Reduce post-operative edema; Protect surgical repair; Patient education of surgical precautions and expectations of progression; Optimize tissue healing environment.","therapeutic_content_pl":"Redukcja bólu pooperacyjnego; redukcja obrzęku pooperacyjnego; ochrona naprawy chirurgicznej; edukacja pacjenta o środkach ostrożności i oczekiwanej progresji; optymalizacja warunków gojenia tkanek.","minimum_requirements_de":"Keine Belastung der reparierten oberen Extremität; aktive Ellenbogenflexion und Unterarmsupination bis zur 4. Woche vermeiden; mit der reparierten oberen Extremität bis zur 8. Woche nichts heben.","minimum_requirements_en":"Non-weight bearing on repaired upper extremity; AVOID active elbow flexion and forearm supination until Week 4; NO LIFTING with repaired upper extremity until Week 8.","minimum_requirements_pl":"Brak obciążania naprawionej kończyny górnej; unikaj aktywnego zginania łokcia i supinacji przedramienia do 4. tygodnia; nie podnoś naprawioną kończyną górną do 8. tygodnia.","additional_notes_original":"Initial immobilization: posterior elbow orthosis with elbow in 90 degrees flexion with forearm in 0 degrees of pronation/supination for 5-7 days (unless otherwise indicated by surgeon); Hinged elbow brace: with brace set locked from 90 degrees of flexion to full flexion, initiate elbow flexion and forearm pronation/supination passive range of motion (PROM) at 5-7 days post-operative; Adequate maintenance of post-operative pain and edema control; Progression of elbow passive range of PROM in elbow flexion and forearm pronation/supination within confines of hinged elbow orthosis is based upon referring surgeon’s assessment of surgical repair.","therapeutic_content_original":"Reduce post-operative pain; Reduce post-operative edema; Protect surgical repair; Patient education of surgical precautions and expectations of progression; Optimize tissue healing environment; Modalities to reduce post-operative edema and pain control; Grip strengthening with forearm/wrist in neutral position; Scar massage.","minimum_requirements_original":"Non-weight bearing on repaired upper extremity.; AVOID active elbow flexion and forearm supination until Week 4; NO LIFTING with repaired upper extremity until Week 8.","structured_content_v2":"$undefined"},{"id":"3d12bacb-4560-5764-9772-41ce91cd2980","name_de":"Phase II: Zwischenphase (2-6 Wochen)","name_en":"Phase II: Intermediate post-op (2-6 weeks)","name_pl":"Faza II: Pośrednia (2-6 tygodni)","source_page":2,"module_number":2,"name_original":"PHASE II: INTERMEDIATE POST-OP (2-6 WEEKS AFTER SURGERY)","service_codes":[],"structured_content":{"de":{"goals":["Postoperative Schmerzen reduzieren.","Postoperatives Ödem reduzieren.","Die chirurgische Reparatur schützen.","Den Patienten zu Vorsichtsmaßnahmen und erwarteter Progression schulen.","Die Heilung durch Vermeiden von Nikotin und Koffein optimieren.","PROM der Ellenbogenflexion und Pro-/Supination in der Orthese verbessern.","AAROM und AROM der Ellenbogenflexion und Pro-/Supination in der Orthese beginnen."],"exercises":["Woche 2: PROM der Ellenbogenflexion/-extension innerhalb der Gelenkorthese.","Woche 2: PROM der Unterarmpro-/supination bei 90° Ellenbogenflexion in der Orthese.","Schulter-AROM nach Bedarf ohne Hyperextension.","AROM von Handgelenk und Hand.","Woche 3: PROM der Ellenbogenflexion/-extension und Pro-/Supination bei 90° in der Orthese.","Woche 4: AROM der Ellenbogenflexion/-extension in schwerkraftreduzierter Ebene in der Orthese.","Woche 4: AROM der Pro-/Supination bei 90° Ellenbogenflexion und gestütztem Unterarm.","Woche 5: AROM der Ellenbogenflexion von schwerkraftreduziert bis gegen die Schwerkraft; Orthese abnehmen, wenn der Bewegungsumfang gegen die Schwerkraft vollständig und schmerzfrei ist.","Woche 5: AROM der Pro-/Supination bei 90° Ellenbogenflexion ohne Unterstützung."],"restrictions":["Keine Belastung der operierten oberen Extremität.","Nichts mit der operierten oberen Extremität heben.","Hyperextension der Schulter vermeiden."],"progression_criteria":["Ausreichende Kontrolle von Schmerzen und Ödem.","Volle AROM der Ellenbogenflexion und Pro-/Supination gegen die Schwerkraft, ohne Orthese und ohne Zunahme von Schmerzen oder Schwellung."],"dosage_and_progression":["Woche 2: Orthese von 90° bis zur vollen Flexion.","Woche 3: Orthese von 45° bis zur vollen Flexion.","Woche 4: Orthese von 30° bis zur vollen Flexion.","Woche 5: Orthese von 20° bis zur vollen Flexion.","Woche 6: Gelenkorthese absetzen."],"physiotherapist_actions":["Ödem mit Eis, Kompression und Hochlagerung behandeln; Kältetherapie mit dem Arzt abstimmen.","Retrograde Massage durchführen und angezeigte Interventionen aus Phase I fortsetzen."]},"en":{"goals":["Reduce post-operative pain.","Reduce post-operative edema.","Protect the surgical repair.","Educate the patient about surgical precautions and expected progression.","Optimize healing by avoiding nicotine and caffeine.","Improve elbow-flexion and forearm pronation/supination PROM in the hinged brace.","Initiate elbow-flexion and forearm pronation/supination AAROM and AROM in the brace."],"exercises":["Week 2: elbow flexion/extension PROM within the hinged brace.","Week 2: forearm pronation/supination PROM with the elbow at 90° in the brace.","Shoulder AROM as needed, avoiding hyperextension.","Wrist and hand AROM.","Week 3: elbow flexion/extension and forearm pronation/supination PROM with the elbow at 90° in the brace.","Week 4: elbow flexion/extension AROM in a gravity-eliminated plane in the brace.","Week 4: forearm pronation/supination AROM with the elbow at 90° and forearm supported.","Week 5: elbow-flexion AROM from a gravity-eliminated plane to against gravity; remove the brace for AROM if motion against gravity is full and painless.","Week 5: forearm pronation/supination AROM with the elbow at 90° without support."],"restrictions":["No weight bearing on the repaired upper extremity.","No lifting with the repaired upper extremity.","Avoid shoulder hyperextension."],"progression_criteria":["Adequate maintenance of post-operative pain and edema control.","Full elbow-flexion and forearm pronation/supination AROM against gravity, without the brace and without increased pain or swelling."],"dosage_and_progression":["Week 2: brace from 90° to full flexion.","Week 3: brace from 45° to full flexion.","Week 4: brace from 30° to full flexion.","Week 5: brace from 20° to full flexion.","Week 6: discharge the hinged elbow brace."],"physiotherapist_actions":["Manage swelling with ice, compression and elevation; check with the physician regarding cold therapy.","Perform retrograde massage and continue indicated Phase I interventions."]},"pl":{"goals":["Zmniejszyć ból pooperacyjny.","Zmniejszyć obrzęk pooperacyjny.","Chronić naprawę chirurgiczną.","Edukując pacjenta, wyjaśnić środki ostrożności i oczekiwaną progresję.","Optymalizować gojenie, unikając nikotyny i kofeiny.","Poprawić PROM zgięcia łokcia i pronacji/supinacji w ortezie.","Rozpocząć AAROM i AROM zgięcia łokcia oraz pronacji/supinacji w ortezie."],"exercises":["Tydzień 2: PROM zgięcia/wyprostu łokcia w granicach ortezy zawiasowej.","Tydzień 2: PROM pronacji/supinacji przy łokciu zgiętym 90° w ortezie.","AROM barku według potrzeby, bez nadmiernego wyprostu.","AROM nadgarstka i dłoni.","Tydzień 3: PROM zgięcia/wyprostu łokcia oraz pronacji/supinacji przy 90° w ortezie.","Tydzień 4: AROM zgięcia/wyprostu łokcia w płaszczyźnie odciążonej w ortezie.","Tydzień 4: AROM pronacji/supinacji przy łokciu 90° i podpartym przedramieniu.","Tydzień 5: AROM zgięcia łokcia od płaszczyzny odciążonej do ruchu przeciw grawitacji; zdjąć ortezę do AROM, jeśli ruch przeciw grawitacji jest pełny i bezbolesny.","Tydzień 5: AROM pronacji/supinacji przy łokciu 90° bez podparcia."],"restrictions":["Bez obciążania operowanej kończyny górnej.","Nie podnosić operowaną kończyną górną.","Unikać nadmiernego wyprostu barku."],"progression_criteria":["Odpowiednio utrzymana kontrola bólu i obrzęku.","Pełny AROM zgięcia łokcia i pronacji/supinacji przeciw grawitacji, bez ortezy i bez nasilenia bólu lub obrzęku."],"dosage_and_progression":["Tydzień 2: orteza od 90° do pełnego zgięcia.","Tydzień 3: orteza od 45° do pełnego zgięcia.","Tydzień 4: orteza od 30° do pełnego zgięcia.","Tydzień 5: orteza od 20° do pełnego zgięcia.","Tydzień 6: odstawić ortezę zawiasową."],"physiotherapist_actions":["Zarządzać obrzękiem lodem, kompresją i elewacją; krioterapię uzgodnić z lekarzem.","Wykonać masaż retrogradacyjny i kontynuować wskazane interwencje Fazy I."]},"original":{"goals":["Reduce post-operative pain","Reduce post-operative edema","Protect surgical repair","Patient education of surgical precautions and expectations of progression","Optimize tissue healing environment (avoid nicotine and caffeine)","Improve elbow flexion and forearm pronation/supination PROM in hinged brace","Initiate elbow flexion and forearm pronation/supination active-assisted range of motion (AAROM) and active range of motion (AROM) in hinged brace"],"exercises":["Week 2: Elbow flexion/extension PROM within confines of hinged elbow brace","Week 2: Forearm pronation/supination PROM with elbow at 90 degrees, in hinged elbow brace","Shoulder AROM as needed, avoiding hyper-extension","Wrist and hand AROM","Week 3: Elbow flexion/extension PROM within confines of hinged brace and Forearm pronation/supination PROM with elbow at 90 degrees flexion in hinged elbow brace","Week 4: Elbow flexion/extension AROM in gravity-eliminated plane in hinged elbow brace","Week 4: Forearm pronation/supination AROM with elbow at 90 degrees flexion and forearm supported","Week 5: Elbow flexion AROM in gravity-eliminated plane in hinged elbow brace, progressing to against gravity in hinged elbow brace, with removal of brace for AROM if full and painless against gravity","Week 5: Forearm pronation/supination AROM with elbow at 90 degrees flexion without support"],"restrictions":["Non-weight bearing on repaired upper extremity","No lifting with repaired upper extremity","avoiding hyper-extension"],"progression_criteria":["Adequate maintenance of post-operative pain and edema control","Full elbow flexion AROM and forearm pronation/supination AROM against gravity, without brace, and without increased pain or swelling"],"dosage_and_progression":["2nd week: 90 degrees to full flexion","3rd week: 45 degrees to full flexion","4th week: 30 degrees to full flexion","5th week: 20 degrees to full flexion","6th week: discharge hinged elbow brace"],"physiotherapist_actions":["Ice, compression, elevation (check with MD re: cold therapy)","Retrograde massage; Continue with Phase I interventions as indicated"]}},"additional_notes_de":"$24","additional_notes_en":"$25","additional_notes_pl":"$26","minimum_patient_share":null,"therapeutic_content_de":"Reduktion der postoperativen Schmerzen; Reduktion des postoperativen Ödems; Schutz der chirurgischen Reparatur; Patientenschulung zu postoperativen Vorsichtsmaßnahmen und dem erwarteten Verlauf; Optimierung der Bedingungen für die Gewebeheilung; Verbesserung der Ellenbogenflexion sowie des PROM für Pronation/Supination des Unterarms in der Gelenkorthese; Beginn von AAROM und AROM der Ellenbogenflexion sowie der Unterarmpronation/-supination in der Gelenkorthese.","therapeutic_content_en":"Reduce post-operative pain; Reduce post-operative edema; Protect surgical repair; Patient education of surgical precautions and expectations of progression; Optimize tissue healing environment (avoid nicotine and caffeine); Improve elbow flexion and forearm pronation/supination PROM in hinged brace; Initiate elbow flexion and forearm pronation/supination active-assisted range of motion (AAROM) and active range of motion (AROM) in hinged brace.","therapeutic_content_pl":"Redukcja bólu pooperacyjnego; redukcja obrzęku pooperacyjnego; ochrona naprawy chirurgicznej; edukacja pacjenta o środkach ostrożności i oczekiwanej progresji; optymalizacja warunków gojenia tkanek; poprawa zgięcia łokcia oraz PROM pronacji/supinacji przedramienia w ortezie zawiasowej; rozpoczęcie AAROM i AROM zgięcia łokcia oraz pronacji/supinacji przedramienia w ortezie.","minimum_requirements_de":"Keine Belastung der reparierten oberen Extremität; mit der reparierten oberen Extremität nichts heben; den Extensionsumfang in der Gelenkorthese schrittweise erweitern.","minimum_requirements_en":"Non-weight bearing on repaired upper extremity; No lifting with repaired upper extremity; progressive extension ROM in hinged brace.","minimum_requirements_pl":"Brak obciążania naprawionej kończyny górnej; nie podnoś naprawioną kończyną górną; stopniowo zwiększaj zakres wyprostu w ortezie zawiasowej.","additional_notes_original":"$27","therapeutic_content_original":"Reduce post-operative pain; Reduce post-operative edema; Protect surgical repair; Patient education of surgical precautions and expectations of progression; Optimize tissue healing environment (avoid nicotine and caffeine); Improve elbow flexion and forearm pronation/supination PROM in hinged brace; Initiate elbow flexion and forearm pronation/supination active-assisted range of motion (AAROM) and active range of motion (AROM) in hinged brace.","minimum_requirements_original":"Non-weight bearing on repaired upper extremity; No lifting with repaired upper extremity; Hinged Elbow Brace (set locked to allow restricted extension ROM).","structured_content_v2":"$undefined"},{"id":"a1f64901-73a6-5cfb-b2c9-19b6470062db","name_de":"Phase III: Spätphase (7-10 Wochen)","name_en":"Phase III: Late post-op (7-10 weeks)","name_pl":"Faza III: Późna (7-10 tygodni)","source_page":3,"module_number":3,"name_original":"PHASE III: LATE POST-OP (7-10 WEEKS AFTER SURGERY)","service_codes":[],"structured_content":{"de":{"goals":["Die chirurgische Reparatur schützen.","Muskuläre Inhibition verhindern.","Kardiovaskuläre Ausdauer verbessern.","Skapulothorakale Ausdauer erhalten."],"exercises":["Kombinierte Bewegungen, z. B. Extension mit Pronation.","Wandliegestütze.","Liegestütze auf erhöhtem Tisch.","Modifizierter Unterarmstütz mit gebeugten Ellenbogen.","Vierfüßlerprogression mit gestreckten Ellenbogen.","Skapulagleiten in Bauchlage mit Schulterextension bis neutral.","Serratus-Wall-Slides.","Skapularetraktion im Sitzen.","Skapulaprotraktion/-retraktion an der Wand mit gestreckten Ellenbogen.","Gehen und Laufen auf dem Laufband.","Stationäres Fahrrad."],"restrictions":["Keine Belastung der operierten oberen Extremität bis Woche 8.","Bis Woche 8 nichts mit der operierten oberen Extremität heben.","Die Belastung mit gebeugtem Ellenbogen beginnen."],"progression_criteria":["Voller schmerzfreier ROM von Schulter, Ellenbogen, Handgelenk und Hand.","Korrekte skapulothorakale Mechanik.","Voller A/PROM des operierten Ellenbogens und Unterarms bei normaler Griffkraft."],"dosage_and_progression":["Ab Woche 8 Belastung mit gebeugtem Ellenbogen beginnen und bis Woche 10 zur Streckung fortschreiten.","Am Fahrrad die Belastung der operierten oberen Extremität in Woche 7–10 schrittweise vom gebeugten zum gestreckten Ellenbogen steigern."],"physiotherapist_actions":["Bei erheblichen ROM-Defiziten in Woche 8 eine aggressivere PROM-Progression mit dem überweisenden Orthopäden besprechen."]},"en":{"goals":["Protect the surgical repair.","Prevent muscle inhibition.","Improve cardiovascular endurance.","Maintain scapulothoracic endurance."],"exercises":["Combined/composite motions, such as extension with pronation.","Wall push-ups.","Push-ups on an elevated table.","Modified forearm plank with elbows bent.","Quadruped progression with elbows extended.","Prone scapular slides with shoulder extension to neutral.","Serratus wall slides.","Seated scapular retraction.","Wall scapular protraction/retraction with elbows extended.","Treadmill walking and running.","Stationary bike."],"restrictions":["No weight bearing on the repaired upper extremity until Week 8.","No lifting with the repaired upper extremity until Week 8.","Begin weight bearing with the elbow flexed."],"progression_criteria":["Full, pain-free ROM of the shoulder, elbow, wrist and hand.","Proper scapulothoracic mechanics.","Full A/PROM of the repaired elbow and forearm with normal grip strength."],"dosage_and_progression":["At Week 8 begin gradual weight bearing with the elbow flexed and progress to elbow extension by Week 10.","On the stationary bike, gradually progress upper-extremity weight bearing over Weeks 7–10 from elbow flexion to extension."],"physiotherapist_actions":["If significant ROM deficits are present at Week 8, discuss more aggressive PROM with the referring orthopedic surgeon."]},"pl":{"goals":["Chronić naprawę chirurgiczną.","Zapobiegać inhibicji mięśni.","Poprawić wydolność sercowo-naczyniową.","Utrzymać wytrzymałość łopatkowo-piersiową."],"exercises":["Ruchy złożone, np. wyprost z pronacją.","Pompki przy ścianie.","Pompki na podwyższonym stole.","Zmodyfikowana deska przedramienna z łokciami zgiętymi.","Progresja w podporze czworaczym z wyprostowanymi łokciami.","Ślizgi łopatki w leżeniu przodem z wyprostem barku do pozycji neutralnej.","Ślizgi zębatego przedniego przy ścianie.","Retrakcja łopatki w siadzie.","Protrakcja/retrakcja łopatki przy ścianie z wyprostowanymi łokciami.","Marsz i bieg na bieżni.","Rower stacjonarny."],"restrictions":["Bez obciążania operowanej kończyny do 8. tygodnia.","Nie podnosić operowaną kończyną do 8. tygodnia.","Obciążanie rozpoczynać z łokciem zgiętym."],"progression_criteria":["Pełny, bezbolesny ROM barku, łokcia, nadgarstka i dłoni.","Prawidłowa mechanika łopatkowo-piersiowa.","Pełny A/PROM operowanego łokcia i przedramienia z prawidłową siłą chwytu."],"dosage_and_progression":["Od 8. tygodnia stopniowo obciążać z łokciem zgiętym i do 10. tygodnia przechodzić do wyprostu.","Na rowerze stopniowo zwiększać obciążanie operowanej kończyny w tygodniach 7–10, od łokcia zgiętego do wyprostowanego."],"physiotherapist_actions":["Jeśli w 8. tygodniu występują istotne deficyty ROM, omówić bardziej agresywny PROM z chirurgiem ortopedą kierującym."]},"original":{"goals":["Protect surgical repair","Prevent muscle inhibition","Improve cardiovascular endurance","Maintain scapulothoracic endurance"],"exercises":["Begin combined/composite motions (i.e. extension with pronation)","Wall push ups","Push-ups on elevated table","Modified forearm plank (elbows bent)","Quadruped progression with elbows extended","Prone scapular slides with shoulder extension to neutral","Serratus wall slides","Seated scapular retraction","Wall scapular protraction/retraction with elbows extended","Treadmill walking and running","Stationary bike"],"restrictions":["Non-weight bearing to repaired upper extremity until Week 8","No lifting with repaired upper extremity until week 8","beginning with elbow flexed"],"progression_criteria":["Full, pain-free ROM of shoulder, elbow, wrist, and hand","Proper scapulothoracic mechanics","Full A/PROM to repaired elbow and forearm with normal grip strength"],"dosage_and_progression":["Begin gradual weight bearing with the elbow flexed at week 8, progress to extend elbow by weeks 10","Stationary bike (gradually progress weight bearing on involved upper extremity over Weeks 7- 10 beginning with elbow flexed and progressing to elbow extended"],"physiotherapist_actions":["If significant ROM deficits present at week 8, discuss progression to more aggressive PROM with referring orthopedic surgeon"]}},"additional_notes_de":"Kombinierte Bewegungen beginnen, beispielsweise Extension mit Pronation; bei deutlichen Beweglichkeitsdefiziten in Woche 8 eine aggressivere PROM-Progression mit dem überweisenden Orthopäden besprechen; Wandliegestütze; Liegestütze auf erhöhtem Tisch; modifizierter Unterarmstütz mit gebeugten Ellenbogen; Quadruped-Progression mit gestreckten Ellenbogen; Schulterblattgleiten in Bauchlage mit Schulterextension bis neutral; Serratus-Wall-Slides; Skapularetraktion im Sitzen; Protraktion/Retraktion des Schulterblatts an der Wand mit gestreckten Ellenbogen; Woche 10: Laufbandgehen und -laufen sowie stationäres Fahrrad, die Belastung der betroffenen oberen Extremität über die Wochen 7–10 schrittweise steigern, vom gebeugten zum gestreckten Ellenbogen; Progressionskriterien: vollständiger schmerzfreier Bewegungsumfang von Schulter, Ellenbogen, Handgelenk und Hand, korrekte skapulothorakale Mechanik sowie vollständiger A/PROM von Ellenbogen und Unterarm mit normaler Griffkraft.","additional_notes_en":"Begin combined/composite motions, i.e. extension with pronation; if significant ROM deficits are present at week 8, discuss progression to more aggressive PROM with referring orthopedic surgeon; wall push ups; push-ups on elevated table; modified forearm plank with elbows bent; quadruped progression with elbows extended; prone scapular slides with shoulder extension to neutral; serratus wall slides; seated scapular retraction; wall scapular protraction/retraction with elbows extended; Week 10 conditioning: treadmill walking and running and stationary bike, gradually progress weight bearing on the involved upper extremity over Weeks 7-10 beginning with elbow flexed and progressing to elbow extended; progression criteria: full, pain-free ROM of shoulder, elbow, wrist, and hand, proper scapulothoracic mechanics, and full A/PROM to repaired elbow and forearm with normal grip strength.","additional_notes_pl":"Rozpocznij ruchy złożone, np. wyprost z pronacją; jeśli w 8. tygodniu występują istotne deficyty zakresu ruchu, omów bardziej agresywny PROM z chirurgiem ortopedą; pompki przy ścianie; pompki na podwyższonym stole; zmodyfikowana deska przedramienna z łokciami zgiętymi; progresja w podporze czworacznym z wyprostowanymi łokciami; ślizgi łopatki w leżeniu przodem z wyprostem barku do pozycji neutralnej; ślizgi zębatego przedniego przy ścianie; retrakcja łopatki w siadzie; protrakcja/retrakcja łopatki przy ścianie z wyprostowanymi łokciami; tydzień 10: marsz i bieg na bieżni oraz rower stacjonarny, stopniowo zwiększając obciążanie operowanej kończyny górnej od tygodni 7–10, od łokcia zgiętego do wyprostowanego; kryteria progresji: pełny bezbolesny zakres barku, łokcia, nadgarstka i dłoni, prawidłowa mechanika piersiowo-łopatkowa oraz pełny A/PROM naprawionego łokcia i przedramienia z prawidłową siłą chwytu.","minimum_patient_share":null,"therapeutic_content_de":"Schutz der chirurgischen Reparatur; Vermeidung muskulärer Inhibition; Verbesserung der kardiovaskulären Ausdauer; Erhaltung der skapulothorakalen Ausdauer; Einführung einer progressiven Belastung; Training der Skapulastabilität; Verbesserung der Ausdauer.","therapeutic_content_en":"Protect surgical repair; Prevent muscle inhibition; Improve cardiovascular endurance; Maintain scapulothoracic endurance; Introduction of progressive weight bearing; scapular stability training; endurance improvement.","therapeutic_content_pl":"Ochrona naprawy chirurgicznej; zapobieganie inhibicji mięśni; poprawa wydolności sercowo-naczyniowej; utrzymanie wytrzymałości piersiowo-łopatkowej; wprowadzenie progresywnego obciążania kończyny; trening stabilizacji łopatki; poprawa wytrzymałości.","minimum_requirements_de":"Keine Belastung der reparierten oberen Extremität bis Woche 8; ab Woche 8 schrittweise Belastung mit gebeugtem Ellenbogen beginnen und bis Woche 10 zur Ellenbogenstreckung fortschreiten; mit der reparierten oberen Extremität bis Woche 8 nichts heben.","minimum_requirements_en":"Non-weight bearing to repaired upper extremity until Week 8; begin gradual weight bearing with the elbow flexed at week 8 and progress to extend elbow by weeks 10; no lifting with repaired upper extremity until week 8.","minimum_requirements_pl":"Brak obciążania naprawionej kończyny górnej do 8. tygodnia; od 8. tygodnia rozpocznij stopniowe obciążanie z łokciem zgiętym i do 10. tygodnia przechodź do wyprostu; nie podnoś naprawioną kończyną górną do 8. tygodnia.","additional_notes_original":"If significant ROM deficits present at week 8, discuss progression to more aggressive PROM with referring orthopedic surgeon; Stationary bike (gradually progress weight bearing on involved upper extremity over Weeks 7- 10 beginning with elbow flexed and progressing to elbow extended); Full, pain-free ROM of shoulder, elbow, wrist, and hand; Proper scapulothoracic mechanics; Full A/PROM to repaired elbow and forearm with normal grip strength.","therapeutic_content_original":"Protect surgical repair; Prevent muscle inhibition; Improve cardiovascular endurance; Maintain scapulothoracic endurance; Begin combined/composite motions (i.e. extension with pronation); Wall push ups; Push-ups on elevated table; Modified forearm plank (elbows bent); Quadruped progression with elbows extended; Prone scapular slides with shoulder extension to neutral; Serratus wall slides; Seated scapular retraction; Wall scapular protraction/retraction with elbows extended; Treadmill walking and running; Stationary bike.","minimum_requirements_original":"Non-weight bearing to repaired upper extremity until Week 8; Begin gradual weight bearing with the elbow flexed at week 8, progress to extend elbow by weeks 10; No lifting with repaired upper extremity until week 8.","structured_content_v2":"$undefined"},{"id":"e09d6fbe-3a79-5888-ad9a-4d30924456ec","name_de":"Phase IV: Übergangsphase (11-15 Wochen)","name_en":"Phase IV: Transitional (11-15 weeks)","name_pl":"Faza IV: Przejściowa (11-15 tygodni)","source_page":4,"module_number":4,"name_original":"PHASE IV: TRANSITIONAL (11-15 WEEKS AFTER SURGERY)","service_codes":[],"structured_content":{"de":{"goals":["Die funktionelle Kraft der operierten oberen Extremität steigern."],"exercises":["Kombinierte Bewegungen mit korrekter Mechanik von Schulter, Ellenbogen, Handgelenk und Hand.","Submaximale Isometrien der Ellenbogenflexoren und -extensoren sowie Supinatoren und Pronatoren.","Widerständige Bizepscurls mit proniertem, neutralem und supiniertem Griff.","Widerständige Pronation und Supination.","Widerständige Trizepsstreckung.","Widerständige Schulterelevation im Stand.","Schulter-PNF-Diagonalen im Stand.","Widerständige Prone I, Prone Y und Prone T.","Rudern.","Widerständige Außen- und Innenrotation der Schulter.","Schulterprotraktion in Rückenlage.","Wandliegestütz.","Progression der Stabilität im Vierfüßlerstand."],"restrictions":[],"progression_criteria":["Voller schmerzfreier ROM von Schulter, Ellenbogen, Handgelenk und Hand.","Korrekte skapulothorakale Mechanik."],"dosage_and_progression":["In Woche 10 submaximale Isometrien beginnen.","In Woche 10–12 von submaximalen Isometrien zu submaximalen Isotonien und leichtem Training der oberen Extremität übergehen."],"physiotherapist_actions":["Bei kombinierten Bewegungen die korrekte Mechanik von Schulter, Ellenbogen, Handgelenk und Hand kontrollieren."]},"en":{"goals":["Increase functional strength of the operated upper extremity."],"exercises":["Combined/composite ROM with proper mechanics of the shoulder, elbow, wrist and hand.","Submaximal isometrics of the elbow flexors, extensors, supinators and pronators.","Resisted biceps curl with pronated, neutral and supinated grips.","Resisted pronation and supination.","Resisted triceps extension.","Standing resisted shoulder elevation.","Standing shoulder PNF diagonals.","Resisted prone I, prone Y and prone T.","Rows.","Resisted shoulder ER and IR.","Supine shoulder protraction.","Wall push-ups.","Quadruped stability progression."],"restrictions":[],"progression_criteria":["Full, pain-free ROM of the shoulder, elbow, wrist and hand.","Proper scapulothoracic mechanics."],"dosage_and_progression":["At Week 10, begin submaximal isometrics.","Over Weeks 10–12, progress from submaximal isometrics to submaximal isotonics and light upper-extremity weight training."],"physiotherapist_actions":["Monitor proper mechanics of the shoulder, elbow, wrist and hand during combined motions."]},"pl":{"goals":["Zwiększyć siłę funkcjonalną operowanej kończyny górnej."],"exercises":["Ruchy złożone z prawidłową mechaniką barku, łokcia, nadgarstka i dłoni.","Submaksymalne izometrie zginaczy i prostowników łokcia oraz supinatorów i pronatorów.","Oporowe uginanie bicepsa w pronacji, chwycie neutralnym i supinacji.","Oporowa pronacja i supinacja.","Oporowy wyprost tricepsa.","Oporowe unoszenie barku w staniu.","Diagonale PNF barku w staniu.","Oporowe prone I, prone Y i prone T.","Wiosłowanie.","Oporowa rotacja zewnętrzna i wewnętrzna barku.","Protrakcja barku w leżeniu tyłem.","Pompki przy ścianie.","Progresja stabilizacji w podporze czworaczym."],"restrictions":[],"progression_criteria":["Pełny, bezbolesny ROM barku, łokcia, nadgarstka i dłoni.","Prawidłowa mechanika łopatkowo-piersiowa."],"dosage_and_progression":["W 10. tygodniu rozpocząć submaksymalne izometrie.","W tygodniach 10–12 przejść od submaksymalnych izometrii do submaksymalnych ćwiczeń izotonicznych i lekkiego treningu kończyny górnej."],"physiotherapist_actions":["Kontrolować prawidłową mechanikę barku, łokcia, nadgarstka i dłoni podczas ruchów złożonych."]},"original":{"goals":["Increase functional strength of operated upper extremity"],"exercises":["Continue with combined/composite range of motion, focusing on proper mechanics of shoulder, elbow, wrist, and hand","At Week 10, initiate submaximal isometrics of elbow flexors, extensors, supinators, and pronators at Week 10.","Resisted bicep curl (pronated, neutral, and supinated grip)","Resisted pronation and supination","Resisted tricep extension","Standing resisted shoulder elevation","Standing shoulder PNF diagonals","Resisted Prone I, Prone Y, Prone T","Rows","Resisted shoulder ER, Resisted shoulder IR","Supine shoulder protraction","Wall push ups","Quadruped stability progression"],"restrictions":[],"progression_criteria":["Full, pain free ROM of shoulder, elbow, wrist, and hand","Proper scapulothoracic mechanics"],"dosage_and_progression":["Initiate strengthening at Week 10","Over Weeks 10-12, progress from submaximal isometrics to submaximal isotonics"],"physiotherapist_actions":["focusing on proper mechanics of shoulder, elbow, wrist, and hand"]}},"additional_notes_de":"Ziel: funktionelle Kraft der operierten oberen Extremität steigern; die Kräftigung beginnt in Woche 10.","additional_notes_en":"Goal: increase functional strength of the operated upper extremity; strengthening begins at Week 10.","additional_notes_pl":"Cel: zwiększyć siłę funkcjonalną operowanej kończyny górnej; wzmacnianie rozpoczyna się w 10. tygodniu.","minimum_patient_share":null,"therapeutic_content_de":"Kombinierte Bewegungen mit korrekter Mechanik von Schulter, Ellenbogen, Handgelenk und Hand fortsetzen; ab Woche 10 submaximale Isometrien der Ellenbogenflexoren und -extensoren sowie Supinatoren und Pronatoren beginnen; in Woche 10–12 zu submaximalen Isotonien übergehen; Bizepscurls mit proniertem, neutralem und supiniertem Griff, widerständige Pro-/Supination und Trizepsstreckung ausführen; leichtes Schultertraining mit Elevation, PNF-Diagonalen, Prone I/Y/T, Rudern, ER/IR, Protraktion in Rückenlage, Wandliegestütz und Vierfüßlerstabilität steigern.","therapeutic_content_en":"Continue combined motions with proper mechanics of the shoulder, elbow, wrist and hand; at Week 10 begin submaximal isometrics of the elbow flexors, extensors, supinators and pronators; over Weeks 10–12 progress to submaximal isotonics; perform resisted biceps curls with pronated, neutral and supinated grips, resisted pronation/supination and triceps extension; progress light shoulder strengthening with elevation, PNF diagonals, prone I/Y/T, rows, ER/IR, supine protraction, wall push-ups and quadruped stability.","therapeutic_content_pl":"Kontynuuj ruchy złożone z prawidłową mechaniką barku, łokcia, nadgarstka i dłoni; od 10. tygodnia rozpocznij submaksymalne izometrie zginaczy i prostowników łokcia oraz supinatorów i pronatorów; w tygodniach 10–12 przejdź do submaksymalnych ćwiczeń izotonicznych; wykonuj uginanie bicepsa w pronacji, chwycie neutralnym i supinacji, oporową pronację/supinację oraz wyprost tricepsa; progresuj lekki trening barku: unoszenie, diagonale PNF, prone I/Y/T, wiosłowanie, ER/IR, protrakcję w leżeniu, pompki przy ścianie i stabilizację w podporze czworaczym.","minimum_requirements_de":"Voller schmerzfreier ROM von Schulter, Ellenbogen, Handgelenk und Hand; korrekte skapulothorakale Mechanik.","minimum_requirements_en":"Full, pain-free ROM of the shoulder, elbow, wrist and hand; proper scapulothoracic mechanics.","minimum_requirements_pl":"Pełny, bezbolesny ROM barku, łokcia, nadgarstka i dłoni; prawidłowa mechanika łopatkowo-piersiowa.","additional_notes_original":"Increase functional strength of operated upper extremity; Initiate strengthening at Week 10.","therapeutic_content_original":"Continue with combined/composite range of motion, focusing on proper mechanics of shoulder, elbow, wrist, and hand; At Week 10, initiate submaximal isometrics of elbow flexors, extensors, supinators, and pronators at Week 10.; Over Weeks 10-12, progress from submaximal isometrics to submaximal isotonics: Resisted bicep curl (pronated, neutral, and supinated grip); Resisted pronation and supination; Resisted tricep extension; Progress shoulder strengthening program with light upper extremity weight training: Standing resisted shoulder elevation; Standing shoulder PNF diagonals; Resisted Prone I, Prone Y, Prone T; Rows; Resisted shoulder ER, Resisted shoulder IR; Supine shoulder protraction; Wall push ups; Quadruped stability progression.","minimum_requirements_original":"Full, pain free ROM of shoulder, elbow, wrist, and hand; Proper scapulothoracic mechanics.","structured_content_v2":"$undefined"},{"id":"ca510dcc-7653-5430-b180-5615d2bde2a2","name_de":"Phase V: Frühe Rückkehr zum Sport (4-6 Monate)","name_en":"Phase V: Early return to sport (4-6 months)","name_pl":"Faza V: Wczesny powrót do sportu (4-6 miesięcy)","source_page":5,"module_number":5,"name_original":"PHASE V: EARLY RETURN TO SPORT (4-6 MONTHS AFTER SURGERY)","service_codes":[],"structured_content":{"de":{"goals":["Kraft und Ausdauer der operierten oberen Extremität steigern."],"exercises":["Übungen aus Phase IV fortsetzen.","Rhythmische Stabilisation.","Stabilitätsprogression im hohen Plank.","Beidarmige Plyometrie.","Einarmige Plyometrie."],"restrictions":[],"progression_criteria":["Voller schmerzfreier AROM von Schulter, Ellenbogen, Handgelenk und Hand.","Korrekte skapulothorakale Mechanik.","Schmerzfreie Durchführung des HEP."],"dosage_and_progression":["Beidarmige Plyometrie nach Woche 16, abhängig von Kontrolle und Reaktion.","Einarmige Plyometrie nach Woche 20–22, abhängig von Kontrolle und Reaktion."],"physiotherapist_actions":["Angezeigte Interventionen aus Phase II–IV fortsetzen und Kontrolle sowie Reaktion auf Plyometrie beurteilen."]},"en":{"goals":["Increase strength and endurance of the repaired upper extremity."],"exercises":["Continue Phase IV exercises.","Rhythmic stabilizations.","High-plank stability progression.","Bilateral upper-extremity plyometrics.","Single-arm plyometrics."],"restrictions":[],"progression_criteria":["Full, pain-free AROM of the shoulder, elbow, wrist and hand.","Proper scapulothoracic mechanics.","Pain-free performance of HEP."],"dosage_and_progression":["Bilateral upper-extremity plyometrics after Week 16, based on control and response.","Single-arm plyometrics after Week 20–22, based on control and response."],"physiotherapist_actions":["Continue indicated Phase II–IV interventions and assess control and response to plyometrics."]},"pl":{"goals":["Zwiększyć siłę i wytrzymałość operowanej kończyny górnej."],"exercises":["Kontynuacja ćwiczeń Fazy IV.","Stabilizacja rytmiczna.","Progresja stabilności w wysokiej desce.","Pliometria oburącz.","Pliometria jednorącz."],"restrictions":[],"progression_criteria":["Pełny, bezbolesny AROM barku, łokcia, nadgarstka i dłoni.","Prawidłowa mechanika łopatkowo-piersiowa.","Bezbolesne wykonanie HEP."],"dosage_and_progression":["Pliometria oburącz po 16. tygodniu, zależnie od kontroli i reakcji.","Pliometria jednorącz po 20–22. tygodniu, zależnie od kontroli i reakcji."],"physiotherapist_actions":["Kontynuować wskazane interwencje Faz II–IV i oceniać kontrolę oraz reakcję na plyometrię."]},"original":{"goals":["Increase strength and endurance of repaired upper extremity"],"exercises":["Continue Phase IV exercises","Rhythmic stabilizations","High plank stability progression","Bilateral upper extremity plyometrics","Single arm plyometrics"],"restrictions":[],"progression_criteria":["Full, pain-free A/ROM of shoulder, elbow, wrist, and hand","Proper scapulothoracic mechanics","Pain-free performance of HEP"],"dosage_and_progression":["Bilateral upper extremity plyometrics after Week 16 (based on control and response)","Single arm plyometrics after Week 20-22 (based on control and response)"],"physiotherapist_actions":["Continue with Phase II-IV interventions as indicated"]}},"additional_notes_de":"Ziel: Kraft und Ausdauer der operierten oberen Extremität steigern.","additional_notes_en":"Goal: increase strength and endurance of the repaired upper extremity.","additional_notes_pl":"Cel: zwiększyć siłę i wytrzymałość operowanej kończyny górnej.","minimum_patient_share":null,"therapeutic_content_de":"Übungen aus Phase IV fortsetzen; rhythmische Stabilisation; Stabilitätsprogression im hohen Plank; beidarmige Plyometrie nach Woche 16 abhängig von Kontrolle und Reaktion; einarmige Plyometrie nach Woche 20–22 abhängig von Kontrolle und Reaktion.","therapeutic_content_en":"Continue Phase IV exercises; rhythmic stabilizations; high-plank stability progression; bilateral upper-extremity plyometrics after Week 16 based on control and response; single-arm plyometrics after Week 20–22 based on control and response.","therapeutic_content_pl":"Kontynuuj ćwiczenia Fazy IV; stabilizacja rytmiczna; progresja stabilności w wysokiej desce; pliometria oburącz po 16. tygodniu zależnie od kontroli i reakcji; pliometria jednorącz po 20–22. tygodniu zależnie od kontroli i reakcji.","minimum_requirements_de":"Voller schmerzfreier AROM von Schulter, Ellenbogen, Handgelenk und Hand; korrekte skapulothorakale Mechanik; schmerzfreie Durchführung des HEP.","minimum_requirements_en":"Full, pain-free AROM of the shoulder, elbow, wrist and hand; proper scapulothoracic mechanics; pain-free performance of HEP.","minimum_requirements_pl":"Pełny, bezbolesny AROM barku, łokcia, nadgarstka i dłoni; prawidłowa mechanika łopatkowo-piersiowa; bezbolesne wykonanie HEP.","additional_notes_original":"Increase strength and endurance of repaired upper extremity.","therapeutic_content_original":"Continue Phase IV exercises; Rhythmic stabilizations; High plank stability progression; Bilateral upper extremity plyometrics after Week 16 (based on control and response); Single arm plyometrics after Week 20-22 (based on control and response).","minimum_requirements_original":"Full, pain-free A/ROM of shoulder, elbow, wrist, and hand; Proper scapulothoracic mechanics; Pain-free performance of HEP.","structured_content_v2":"$undefined"},{"id":"437df4dd-0bcc-52a0-8608-5df70f6ba683","name_de":"Phase VI: Volle Rückkehr zum Sport (6+ Monate)","name_en":"Phase VI: Unrestricted return to sport (6+ months)","name_pl":"Faza VI: Pełny powrót do sportu (6+ miesięcy)","source_page":5,"module_number":6,"name_original":"PHASE VI: UNRESTRICTED RETURN TO SPORT (6+ MONTHS AFTER SURGERY)","service_codes":[],"structured_content":{"de":{"goals":["Kraft der operierten oberen Extremität steigern.","Zum Sport zurückkehren."],"exercises":["Progression sportartspezifischer Bewegungen.","Stufenweise Teilnahme am Training."],"restrictions":["Keine Wettkampfteilnahme vor vollständigem schmerzfreiem Training."],"progression_criteria":["Voller schmerzfreier ROM von Ellenbogen und Handgelenk.","Gesamt-ROM der Schulter innerhalb 5° der nicht werfenden Schulter.",">40° horizontale Adduktion der Wurfschulter."],"dosage_and_progression":["Die Phase der uneingeschränkten Rückkehr beginnt nach 6+ Monaten; vor einem Wettkampf ist vollständiges schmerzfreies Training erforderlich."],"physiotherapist_actions":["Angezeigte Interventionen aus Phase II–V fortsetzen und die Trainingsteilnahme stufenweise steigern."]},"en":{"goals":["Increase strength of the operated upper extremity.","Return to sport."],"exercises":["Progression of sport-specific movements.","Graded participation in practice."],"restrictions":["Do not participate in competition before full, pain-free practice."],"progression_criteria":["Full, painless elbow/wrist ROM.","Shoulder total ROM within 5° of the non-throwing shoulder.",">40° horizontal adduction of the throwing shoulder."],"dosage_and_progression":["The unrestricted-return phase begins at 6+ months; full, pain-free practice is required before competition."],"physiotherapist_actions":["Continue indicated Phase II–V interventions and grade participation in practice."]},"pl":{"goals":["Zwiększyć siłę operowanej kończyny górnej.","Wrócić do sportu."],"exercises":["Progresja ruchów specyficznych dla sportu.","Stopniowany udział w treningu."],"restrictions":["Nie dopuszczać do zawodów przed pełnym, bezbolesnym udziałem w treningu."],"progression_criteria":["Pełny, bezbolesny ROM łokcia i nadgarstka.","Całkowity ROM barku w granicy 5° względem barku nieprzerzucającego.",">40° przywiedzenia poziomego barku rzucającego."],"dosage_and_progression":["Faza nieograniczonego powrotu rozpoczyna się po 6+ miesiącach; przed zawodami wymagany jest pełny, bezbolesny trening."],"physiotherapist_actions":["Kontynuować wskazane interwencje Faz II–V i stopniować udział w treningu."]},"original":{"goals":["Increase strength of operated upper extremity","Return to sport"],"exercises":["Focus on progression of sport-specific movements","Graded participation in practice"],"restrictions":["full, pain-free practice prior to participation in competition"],"progression_criteria":["Full, painless elbow/wrist ROM","Shoulder total ROM within 5° of non-throwing shoulder","> 40° horizontal adduction of throwing shoulder"],"dosage_and_progression":["6+ MONTHS AFTER SURGERY; full, pain-free practice prior to participation in competition"],"physiotherapist_actions":["Continue with Phase II-V interventions as indicated"]}},"additional_notes_de":"Ziele: Kraft der operierten oberen Extremität steigern; zum Sport zurückkehren; angezeigte Interventionen aus Phase II–V fortsetzen.","additional_notes_en":"Goals: increase strength of the operated upper extremity; return to sport; continue indicated Phase II–V interventions.","additional_notes_pl":"Cele: zwiększyć siłę operowanej kończyny górnej; wrócić do sportu; kontynuować wskazane interwencje Faz II–V.","minimum_patient_share":null,"therapeutic_content_de":"Sportartspezifische Bewegungen steigern; die Teilnahme am Training stufenweise erhöhen; erst nach vollständigem schmerzfreiem Training am Wettkampf teilnehmen.","therapeutic_content_en":"Progress sport-specific movements; use graded participation in practice; require full, pain-free practice before participation in competition.","therapeutic_content_pl":"Progresuj ruchy specyficzne dla sportu; stopniowo zwiększaj udział w treningu; dopuść udział w zawodach dopiero po pełnym, bezbolesnym treningu.","minimum_requirements_de":"Voller schmerzfreier ROM von Ellenbogen und Handgelenk; Gesamt-ROM der Schulter innerhalb 5° der nicht werfenden Schulter; >40° horizontale Adduktion der Wurfschulter.","minimum_requirements_en":"Full, painless elbow/wrist ROM; shoulder total ROM within 5° of the non-throwing shoulder; >40° horizontal adduction of the throwing shoulder.","minimum_requirements_pl":"Pełny, bezbolesny ROM łokcia i nadgarstka; całkowity ROM barku w granicy 5° względem barku nieprzerzucającego; >40° przywiedzenia poziomego barku rzucającego.","additional_notes_original":"Increase strength of operated upper extremity; Return to sport; Continue with Phase II-V interventions as indicated.","therapeutic_content_original":"Focus on progression of sport-specific movements; Graded participation in practice, with full, pain-free practice prior to participation in competition.","minimum_requirements_original":"Full, painless elbow/wrist ROM; Shoulder total ROM within 5° of non-throwing shoulder; > 40° horizontal adduction of throwing shoulder.","structured_content_v2":"$undefined"},{"id":"7678a49a-8cb5-5143-8bd1-92e30689bae5","name_de":"Phase VI — weitere Entlasskriterien und Return-to-Sport-Entscheidung","name_en":"Phase VI continued — discharge criteria and return-to-sport decision","name_pl":"Faza VI — dalsze kryteria wypisu i decyzja o powrocie do sportu","source_page":6,"module_number":7,"name_original":"Criteria to Discharge; Return-to-Sport","service_codes":[],"structured_content":{"de":{"goals":[],"exercises":[],"restrictions":[],"progression_criteria":["Glenohumerales IR-Defizit <15°.","ER/IR-Verhältnis 72–76%.","ER/ABD-Verhältnis 68–73%.","IR der Wurfschulter >115% der nicht werfenden Schulter.","ER der Wurfschulter >95% der nicht werfenden Schulter.","Ellenbogenflexion/-extension 100–115% der nicht werfenden Seite.","Handgelenkflexion/-extension 100–115% der nicht werfenden Seite.","Prone-Drop-Ball-Test 110% der nicht werfenden Seite.","Einarmige Würfe gegen die Wand in 90/90: 2-lb-Ball, 30 s schmerzfrei, 115% der Wurfseite.","Single-Arm-Step-Down: 8 Zoll, 30 s.","Zufriedenstellender KJOC-Wert für Werfer.","Ärztliche Freigabe.","Selbstständigkeit im HEP."],"dosage_and_progression":[],"physiotherapist_actions":["Kraft von Ellenbogen, Schulter und Handgelenk mit MMT, HHD oder Isokinetik beurteilen und Funktionstests durchführen.","Die RTS-Entscheidung nach Verletzungsvorgeschichte, Belastungsanforderung, Kontaktsport und Teilnahmehäufigkeit individualisieren und vor der Progression eng mit dem überweisenden Chirurgen besprechen."]},"en":{"goals":[],"exercises":[],"restrictions":[],"progression_criteria":["Glenohumeral IR deficit <15°.","ER/IR ratio 72–76%.","ER/ABD ratio 68–73%.","Throwing-shoulder IR >115% of the non-throwing shoulder.","Throwing-shoulder ER >95% of the non-throwing shoulder.","Elbow flexion/extension 100–115% of the non-throwing side.","Wrist flexion/extension 100–115% of the non-throwing side.","Prone drop-ball test 110% of the non-throwing side.","One-arm balls against the wall at 90/90: 2-lb ball, 30 s without pain, 115% of the throwing side.","Single-arm step-down test: 8 inches, 30 s.","Satisfactory KJOC throwers-assessment score.","Physician clearance.","Independent with HEP."],"dosage_and_progression":[],"physiotherapist_actions":["Assess elbow, shoulder and wrist strength with MMT, HHD or isokinetics and administer functional tests.","Individualize RTS by injury history, upper-extremity demand, contact status and participation frequency; discuss closely with the referring surgeon before progression."]},"pl":{"goals":[],"exercises":[],"restrictions":[],"progression_criteria":["Deficyt rotacji wewnętrznej stawu ramiennego <15°.","Stosunek ER/IR 72–76%.","Stosunek ER/ABD 68–73%.","IR barku rzucającego >115% barku nieprzerzucającego.","ER barku rzucającego >95% barku nieprzerzucającego.","Zgięcie/wyprost łokcia 100–115% strony nieprzerzucającej.","Zgięcie/wyprost nadgarstka 100–115% strony nieprzerzucającej.","Prone drop ball test 110% strony nieprzerzucającej.","Rzuty jednorącz o ścianę w 90/90: piłka 2 lb, 30 s bez bólu, 115% strony rzucającej.","Single-arm step-down: 8 cali, 30 s.","Satysfakcjonujący wynik KJOC dla zawodników rzucających.","Zgoda lekarza.","Samodzielność w HEP."],"dosage_and_progression":[],"physiotherapist_actions":["Ocenić siłę łokcia, barku i nadgarstka przez MMT, HHD lub izokinetycznie oraz przeprowadzić testy funkcjonalne.","Zindywidualizować decyzję RTS według historii urazów, wymagań kończyny, kontaktowości i częstości udziału; przed progresją ściśle omówić ją z chirurgiem kierującym."]},"original":{"goals":[],"exercises":[],"restrictions":[],"progression_criteria":["< 15° Glenohumeral IR deficit.","ER/IR ratio: 72-76%","ER/ABD ratio: 68-73%","Throwing shoulder IR: > 115% of non-throwing shoulder","Throwing shoulder ER: > 95% of non-throwing shoulder","Elbow flexion/extension: 100-115% of non-throwing shoulder","Wrist flexion/extension: 100-115% of non-throwing shoulder","Prone Drop ball test – 110% of non-throwing side","1-arm balls against wall @ 90/90: 2lb ball; 30 seconds with no pain; 115% of throwing side","Single arm step down test: 8-inch, 30 sec","Satisfactory score on Kerlan-Jobe Orthopedic Clinic shoulder and elbow score (KJOC) throwers assessment","Physician Clearance","Independent with HEP"],"dosage_and_progression":[],"physiotherapist_actions":["Elbow, shoulder and wrist strength with MMT, HHD or isokinetic; Functional test Scores","Close discussion with the referring surgeon is strongly recommended prior to advancing to a return-to-sport rehabilitation program."]}},"additional_notes_de":"Die RTS-Entscheidung anhand von Verletzungsvorgeschichte, Beanspruchung der oberen Extremität, Kontaktcharakter und Teilnahmehäufigkeit individualisieren; vor dem RTS-Programm wird ein enger Austausch mit dem überweisenden Chirurgen empfohlen.","additional_notes_en":"Individualize RTS by injury history, upper-extremity demand, contact versus non-contact sport and participation frequency; close discussion with the referring surgeon is strongly recommended before the RTS program.","additional_notes_pl":"Decyzję RTS indywidualizuj według historii urazów, wymagań dla kończyny górnej, kontaktowości sportu i częstości udziału; przed programem RTS zalecana jest ścisła rozmowa z chirurgiem kierującym.","minimum_patient_share":null,"therapeutic_content_de":"ROM und Kraft mit MMT, HHD oder isokinetisch beurteilen; Prone-Drop-Ball-Test, einarmige Würfe gegen die Wand in 90/90 und Single-Arm-Step-Down durchführen; die RTS-Entscheidung individualisieren und die Progression mit dem überweisenden Chirurgen besprechen.","therapeutic_content_en":"Assess ROM and strength with MMT, HHD or isokinetics; perform the prone drop-ball, one-arm 90/90 wall-ball and single-arm step-down tests; individualize return-to-sport decisions and discuss progression with the referring surgeon.","therapeutic_content_pl":"Oceń ROM i siłę metodą MMT, HHD lub izokinetycznie; wykonaj test prone drop ball, rzuty jednorącz o ścianę w 90/90 i single-arm step-down; zindywidualizuj decyzję RTS i omów progresję z chirurgiem kierującym.","minimum_requirements_de":"Alle quantitativen ROM-, Kraft- und Funktionstest-Schwellen erfüllen; einen zufriedenstellenden KJOC-Wert erreichen; ärztliche Freigabe erhalten und im HEP selbstständig sein.","minimum_requirements_en":"Meet all quantitative ROM, strength and functional-test thresholds; achieve a satisfactory KJOC score; obtain physician clearance and independence with HEP.","minimum_requirements_pl":"Spełnić wszystkie ilościowe progi ROM, siły i testów funkcjonalnych; uzyskać satysfakcjonujący wynik KJOC; uzyskać zgodę lekarza i samodzielność w HEP.","additional_notes_original":"Return-to-sport decision making should be individualized and based upon factors including but not limited to previous injury history, the level of demand on the upper extremity, contact vs non-contact, and frequency of participation.; Close discussion with the referring surgeon is strongly recommended prior to advancing to a return-to-sport rehabilitation program.","therapeutic_content_original":"Elbow, shoulder and wrist strength with MMT, HHD or isokinetic; Functional test Scores: Prone Drop ball test; 1-arm balls against wall @ 90/90; Single arm step down test; Return-to-sport decision making should be individualized; Close discussion with the referring surgeon is strongly recommended prior to advancing to a return-to-sport rehabilitation program.","minimum_requirements_original":"< 15° Glenohumeral IR deficit.; Elbow, shoulder and wrist strength with MMT, HHD or isokinetic; ER/IR ratio: 72-76%; ER/ABD ratio: 68-73%; Throwing shoulder IR: > 115% of non-throwing shoulder; Throwing shoulder ER: > 95% of non-throwing shoulder; Elbow flexion/extension: 100-115% of non-throwing shoulder; Wrist flexion/extension: 100-115% of non-throwing shoulder; Prone Drop ball test – 110% of non-throwing side; 1-arm balls against wall @ 90/90: 2lb ball, 30 seconds with no pain, 115% of throwing side; Single arm step down test: 8-inch, 30 sec; Satisfactory score on Kerlan-Jobe Orthopedic Clinic shoulder and elbow score (KJOC) throwers assessment; Physician Clearance; Independent with HEP.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["elbow","upper_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"326718ce-ff77-5deb-be34-ce3132029b16","slug":"us-jared-lee-36-meniscus-repair","title_pl":"Protokół rehabilitacji po naprawie łąkotki","title_de":"Rehabilitationsprotokoll nach Meniskusnaht","title_en":"Meniscus Repair Rehabilitation Protocol","title_original":"Meniscus Repair Rehabilitation","summary_pl":"Czterofazowy protokół po naprawie łąkotki z sześciotygodniową ochroną obciążania i zakresu ruchu oraz stopniowym powrotem do sportu.","summary_de":"Vierphasiges Protokoll nach Meniskusnaht mit sechswöchigem Belastungs- und Bewegungsschutz sowie schrittweiser Rückkehr zum Sport.","summary_en":"Four-phase protocol after meniscus repair with six weeks of protected weight-bearing and range of motion followed by gradual return to sport.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"26d7be6a-43bb-5899-9d1c-f8c33f3586b2","condition_slug":"meniscus-repair","condition_name_pl":"Stan po naprawie łąkotki","condition_name_de":"Zustand nach Meniskusnaht","condition_name_en":"Status Post Meniscus Repair","condition_name_original":"Status Post Meniscus Repair","icd_codes":[],"category_key":"knee","category_pl":"Kolano","category_de":"Knie","category_en":"Knee","body_regions_pl":["Kolano","Łąkotka"],"body_regions_de":["Knie","Meniskus"],"body_regions_en":["Knee","Meniscus"],"search_terms_pl":["naprawa łąkotki","szycie łąkotki","rehabilitacja łąkotki"],"search_terms_de":["Meniskusnaht","Meniskusrekonstruktion","Meniskusrehabilitation"],"search_terms_en":["meniscus repair","meniscal repair","meniscus rehabilitation"],"source_document_id":"a699f28a-e2ae-54ac-93c4-d43511c5e221","source_title":"Meniscus Repair Rehabilitation","issuer":"Jared Lee, MD","source_country_code":"US","jurisdiction_code":"US-CO","authority_level":"clinic","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_requires_review","official_url":"https://jaredleemd.com/wp-content/uploads/2025/06/Meniscus-Repair-Rehabilitation-Protocol.pdf","source_sha256":"4f333593ecd8c520475ad4bcd7619a7e2cc6c1e3128f6e00202561dcc04d0c76","authorization_required":true,"license_note":"All Rights Reserved. Authorization is required before final public release. Current development and staging remain allowed by the owner's decision.","modules":[{"id":"b92ae5db-8bec-560d-87de-dea885eaebee","name_de":"Phase 1: Wochen 0–2","name_en":"Phase 1: Weeks 0-2","name_pl":"Faza 1: tygodnie 0–2","source_page":1,"module_number":1,"name_original":"Phase 1: Weeks 0-2","service_codes":[],"structured_content":{"de":{"goals":["Schwellung und Schmerzen reduzieren, Muskelatrophie begrenzen, die operative Reparatur schützen und den Bewegungsumfang wiederherstellen."],"exercises":["Passiver, aktiver und aktiv-assistierter Bewegungsumfang 0–90°","Ödem- und Schmerzmanagement","Patellagleiten in alle Richtungen","Quadrizepsanspannungen, Anheben des gestreckten Beins sowie Kräftigung der Hüftabduktion und -adduktion"],"applies_when":["Wochen 0–2"],"progression_criteria":["vollständige Extension und minimale Schmerzen."],"physiotherapist_actions":["Flat-Foot-Touch-down-Belastung für 6 Wochen.","Bewegungsumfang 0–90°.","T-Scope-Orthese und Unterarmgehstützen für 6 Wochen.","Bis zur 2. postoperativen Woche vollständige Extension von 0° anstreben.","physikalische Maßnahmen nach Bedarf."]},"en":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and restore range of motion."],"exercises":["Passive, active and active-assisted range of motion 0-90°","edema and pain management","patellar glides in all directions","quadriceps sets, straight-leg raises and hip abduction and adduction strengthening"],"applies_when":["Weeks 0-2"],"progression_criteria":["full extension and minimal pain."],"physiotherapist_actions":["Flat-foot touch-down weight-bearing for 6 weeks.","Range of motion 0-90°.","Use a T-Scope brace and crutches for 6 weeks.","Achieve full knee extension to 0° by 2 weeks postoperatively.","modalities as needed."]},"pl":{"goals":["zmniejszenie obrzęku i bólu, ograniczenie zaniku mięśni, ochrona naprawy chirurgicznej i odtworzenie zakresu ruchu."],"exercises":["Bierny, czynny i czynny wspomagany zakres ruchu 0–90°","ślizgi rzepki we wszystkich kierunkach","napięcia mięśnia czworogłowego, unoszenie wyprostowanej kończyny oraz wzmacnianie odwodzenia i przywodzenia biodra"],"applies_when":["tygodnie 0–2"],"progression_criteria":["pełny wyprost i minimalny ból."],"physiotherapist_actions":["Obciążanie flat-foot touch-down przez 6 tygodni.","Zakres ruchu 0–90°.","Orteza T-Scope i kule przez 6 tygodni.","Dążyć do pełnego wyprostu 0° do 2. tygodnia po zabiegu.","kontrola obrzęku i bólu","fizykoterapia według potrzeb."]},"original":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and restore range of motion."],"exercises":["Passive, active and active-assisted range of motion 0-90°","edema and pain management","patellar glides in all directions","quadriceps sets, straight-leg raises and hip abduction and adduction strengthening"],"applies_when":["Weeks 0-2"],"progression_criteria":["full extension and minimal pain."],"physiotherapist_actions":["Flat-foot touch-down weight-bearing for 6 weeks.","Range of motion 0-90°.","Use a T-Scope brace and crutches for 6 weeks.","Achieve full knee extension to 0° by 2 weeks postoperatively.","modalities as needed."]}},"additional_notes_de":"Ziele: Schwellung und Schmerzen reduzieren, Muskelatrophie begrenzen, die operative Rekonstruktion schützen und den Bewegungsumfang wiederherstellen.","additional_notes_en":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and restore range of motion.","additional_notes_pl":"Cele: zmniejszenie obrzęku i bólu, ograniczenie zaniku mięśni, ochrona naprawy chirurgicznej i odtworzenie zakresu ruchu.","minimum_patient_share":null,"therapeutic_content_de":"Passiver, aktiver und aktiv-assistierter Bewegungsumfang 0–90°; Ödem- und Schmerzmanagement; Patellagleiten in alle Richtungen; Quadrizepsanspannungen, Anheben des gestreckten Beins sowie Kräftigung der Hüftabduktion und -adduktion; physikalische Maßnahmen nach Bedarf.","therapeutic_content_en":"Passive, active and active-assisted range of motion 0-90°; edema and pain management; patellar glides in all directions; quadriceps sets, straight-leg raises and hip abduction and adduction strengthening; modalities as needed.","therapeutic_content_pl":"Bierny, czynny i czynny wspomagany zakres ruchu 0–90°; kontrola obrzęku i bólu; ślizgi rzepki we wszystkich kierunkach; napięcia mięśnia czworogłowego, unoszenie wyprostowanej kończyny oraz wzmacnianie odwodzenia i przywodzenia biodra; fizykoterapia według potrzeb.","minimum_requirements_de":"Flat-Foot-Touch-down-Belastung für 6 Wochen. Bewegungsumfang 0–90°. T-Scope-Orthese und Unterarmgehstützen für 6 Wochen. Bis zur 2. postoperativen Woche vollständige Extension von 0° anstreben. Progressionskriterien: vollständige Extension und minimale Schmerzen.","minimum_requirements_en":"Flat-foot touch-down weight-bearing for 6 weeks. Range of motion 0-90°. Use a T-Scope brace and crutches for 6 weeks. Achieve full knee extension to 0° by 2 weeks postoperatively. Progression criteria: full extension and minimal pain.","minimum_requirements_pl":"Obciążanie flat-foot touch-down przez 6 tygodni. Zakres ruchu 0–90°. Orteza T-Scope i kule przez 6 tygodni. Dążyć do pełnego wyprostu 0° do 2. tygodnia po zabiegu. Kryteria progresji: pełny wyprost i minimalny ból.","additional_notes_original":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and restore range of motion.","therapeutic_content_original":"Passive, active and active-assisted range of motion 0-90°; edema and pain management; patellar glides in all directions; quadriceps sets, straight-leg raises and hip abduction and adduction strengthening; modalities as needed.","minimum_requirements_original":"Flat-foot touch-down weight-bearing for 6 weeks. Range of motion 0-90°. Use a T-Scope brace and crutches for 6 weeks. Achieve full knee extension to 0° by 2 weeks postoperatively. Progression criteria: full extension and minimal pain.","structured_content_v2":"$undefined"},{"id":"2e419483-4926-551a-8af0-b9914139dfec","name_de":"Phase 2: Wochen 3–6","name_en":"Phase 2: Weeks 3-6","name_pl":"Faza 2: tygodnie 3–6","source_page":1,"module_number":2,"name_original":"Phase 2: Weeks 3-6","service_codes":[],"structured_content":{"de":{"goals":["Schwellung und Schmerzen reduzieren, Muskelatrophie begrenzen, die operative Reparatur schützen und den Bewegungsumfang wiederherstellen."],"exercises":["Passiver, aktiver und aktiv-assistierter Bewegungsumfang 0–90°","Quadrizepsanspannungen, Anheben des gestreckten Beins sowie Kräftigung der Hüftabduktion, -adduktion, Gluteal- und Rumpfmuskulatur"],"applies_when":["Wochen 3–6"],"progression_criteria":["Bewegungsumfang 0–90°, keine Zunahme von Schmerzen oder Erguss und Quadrizepskontrolle 4/5 im MMT."],"physiotherapist_actions":["Flat-Foot-Touch-down-Belastung für 6 Wochen.","Bewegungsumfang 0–90°.","T-Scope-Orthese und Unterarmgehstützen für 6 Wochen.","Bis zur 4. postoperativen Woche 90° Flexion anstreben.","Weichteilmobilisation und Patellagleiten","physikalische Maßnahmen nach Bedarf."]},"en":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and restore range of motion."],"exercises":["Passive, active and active-assisted range of motion 0-90°","quadriceps sets, straight-leg raises, hip abduction and adduction, gluteal and core strengthening"],"applies_when":["Weeks 3-6"],"progression_criteria":["range of motion 0-90°, no increase in pain or effusion and quadriceps control 4/5 on manual muscle testing."],"physiotherapist_actions":["Flat-foot touch-down weight-bearing for 6 weeks.","Range of motion 0-90°.","Use a T-Scope brace and crutches for 6 weeks.","Achieve 90° knee flexion by 4 weeks postoperatively.","soft-tissue mobilization and patellar glides","modalities as needed."]},"pl":{"goals":["zmniejszenie obrzęku i bólu, ograniczenie zaniku mięśni, ochrona naprawy chirurgicznej i odtworzenie zakresu ruchu."],"exercises":["Bierny, czynny i czynny wspomagany zakres ruchu 0–90°","napięcia mięśnia czworogłowego, unoszenie wyprostowanej kończyny, wzmacnianie odwodzenia i przywodzenia biodra, mięśni pośladkowych i mięśni tułowia"],"applies_when":["tygodnie 3–6"],"progression_criteria":["zakres ruchu 0–90°, brak zwiększenia bólu lub wysięku i kontrola mięśnia czworogłowego 4/5 w MMT."],"physiotherapist_actions":["Obciążanie flat-foot touch-down przez 6 tygodni.","Zakres ruchu 0–90°.","Orteza T-Scope i kule przez 6 tygodni.","Dążyć do zgięcia 90° do 4. tygodnia po zabiegu.","mobilizacja tkanek miękkich i ślizgi rzepki","fizykoterapia według potrzeb."]},"original":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and restore range of motion."],"exercises":["Passive, active and active-assisted range of motion 0-90°","quadriceps sets, straight-leg raises, hip abduction and adduction, gluteal and core strengthening"],"applies_when":["Weeks 3-6"],"progression_criteria":["range of motion 0-90°, no increase in pain or effusion and quadriceps control 4/5 on manual muscle testing."],"physiotherapist_actions":["Flat-foot touch-down weight-bearing for 6 weeks.","Range of motion 0-90°.","Use a T-Scope brace and crutches for 6 weeks.","Achieve 90° knee flexion by 4 weeks postoperatively.","soft-tissue mobilization and patellar glides","modalities as needed."]}},"additional_notes_de":"Ziele: Schwellung und Schmerzen reduzieren, Muskelatrophie begrenzen, die operative Rekonstruktion schützen und den Bewegungsumfang wiederherstellen.","additional_notes_en":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and restore range of motion.","additional_notes_pl":"Cele: zmniejszenie obrzęku i bólu, ograniczenie zaniku mięśni, ochrona naprawy chirurgicznej i odtworzenie zakresu ruchu.","minimum_patient_share":null,"therapeutic_content_de":"Passiver, aktiver und aktiv-assistierter Bewegungsumfang 0–90°; Weichteilmobilisation und Patellagleiten; Quadrizepsanspannungen, Anheben des gestreckten Beins sowie Kräftigung der Hüftabduktion, -adduktion, Gluteal- und Rumpfmuskulatur; physikalische Maßnahmen nach Bedarf.","therapeutic_content_en":"Passive, active and active-assisted range of motion 0-90°; soft-tissue mobilization and patellar glides; quadriceps sets, straight-leg raises, hip abduction and adduction, gluteal and core strengthening; modalities as needed.","therapeutic_content_pl":"Bierny, czynny i czynny wspomagany zakres ruchu 0–90°; mobilizacja tkanek miękkich i ślizgi rzepki; napięcia mięśnia czworogłowego, unoszenie wyprostowanej kończyny, wzmacnianie odwodzenia i przywodzenia biodra, mięśni pośladkowych i mięśni tułowia; fizykoterapia według potrzeb.","minimum_requirements_de":"Flat-Foot-Touch-down-Belastung für 6 Wochen. Bewegungsumfang 0–90°. T-Scope-Orthese und Unterarmgehstützen für 6 Wochen. Bis zur 4. postoperativen Woche 90° Flexion anstreben. Progressionskriterien: Bewegungsumfang 0–90°, keine Zunahme von Schmerzen oder Erguss und Quadrizepskontrolle 4/5 im MMT.","minimum_requirements_en":"Flat-foot touch-down weight-bearing for 6 weeks. Range of motion 0-90°. Use a T-Scope brace and crutches for 6 weeks. Achieve 90° knee flexion by 4 weeks postoperatively. Progression criteria: range of motion 0-90°, no increase in pain or effusion and quadriceps control 4/5 on manual muscle testing.","minimum_requirements_pl":"Obciążanie flat-foot touch-down przez 6 tygodni. Zakres ruchu 0–90°. Orteza T-Scope i kule przez 6 tygodni. Dążyć do zgięcia 90° do 4. tygodnia po zabiegu. Kryteria progresji: zakres ruchu 0–90°, brak zwiększenia bólu lub wysięku i kontrola mięśnia czworogłowego 4/5 w MMT.","additional_notes_original":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and restore range of motion.","therapeutic_content_original":"Passive, active and active-assisted range of motion 0-90°; soft-tissue mobilization and patellar glides; quadriceps sets, straight-leg raises, hip abduction and adduction, gluteal and core strengthening; modalities as needed.","minimum_requirements_original":"Flat-foot touch-down weight-bearing for 6 weeks. Range of motion 0-90°. Use a T-Scope brace and crutches for 6 weeks. Achieve 90° knee flexion by 4 weeks postoperatively. Progression criteria: range of motion 0-90°, no increase in pain or effusion and quadriceps control 4/5 on manual muscle testing.","structured_content_v2":"$undefined"},{"id":"a66cdaf6-490c-54a2-8f63-1c40c040faca","name_de":"Phase 3: Wochen 7–10","name_en":"Phase 3: Weeks 7-10","name_pl":"Faza 3: tygodnie 7–10","source_page":1,"module_number":3,"name_original":"Phase 3: Weeks 7-10","service_codes":[],"structured_content":{"de":{"goals":["voller Bewegungsumfang, minimale Schmerzen, Steigerung des Übungswiderstands, Wiederherstellung des normalen Gangbilds und Schutz der Fixation."],"exercises":["Progression zum vollen passiven, aktiven und aktiv-assistierten Bewegungsumfang","progressive Widerstandsübungen mit 1–5 lb","Übungen in geschlossener Kette beginnen","Zehenstände, kleine Kniebeugen bis 90°, PNF gegen Widerstand und Dehnung der unteren Extremität","Gleichgewichtsübungen","Hamstring Curls und Dehnung der ischiokruralen Muskulatur","Wassertherapie mit Gangnormalisierung und Aquajogging ohne Froschbeinschlag","Fahrradergometer und Treppenstepper."],"applies_when":["Wochen 7–10"],"progression_criteria":["voller schmerzfreier Bewegungsumfang, keine Schmerzen oder Druckempfindlichkeit, zufriedenstellende klinische Untersuchung, Anheben des gestreckten Beins ohne Extensionsdefizit und normales Gangbild."],"dosage_and_progression":["T-Scope-Orthese und Unterarmgehstützen ablegen.","Zu Vollbelastung, vollem Bewegungsumfang und gesteigerter Kräftigung übergehen."]},"en":{"goals":["full range of motion, minimal pain, increased resistance exercise, restoration of normal gait and protection of fixation."],"exercises":["Progress to full passive, active and active-assisted range of motion","progressive resistance exercises with 1-5 lb","initiate closed-chain exercises","toe raises, mini squats to 90°, resisted PNF and lower-extremity stretching","balance exercises","hamstring curls and stretches","aquatic therapy emphasizing gait normalization and pool running without frog kicking","stationary cycling and stair stepper."],"applies_when":["Weeks 7-10"],"progression_criteria":["full pain-free range of motion, no pain or tenderness, satisfactory clinical examination, straight-leg raise without lag and normal gait."],"dosage_and_progression":["Discontinue the T-Scope brace and crutches.","Progress to full weight-bearing, full range of motion and increased strengthening."]},"pl":{"goals":["pełny zakres ruchu, minimalny ból, zwiększanie oporu ćwiczeń, odtworzenie prawidłowego chodu i ochrona fiksacji."],"exercises":["Progresja do pełnego biernego, czynnego i czynnego wspomaganego zakresu ruchu","progresywne ćwiczenia oporowe 1–5 lb","rozpoczęcie ćwiczeń w zamkniętym łańcuchu","wspięcia na palce, małe przysiady do 90°, PNF z oporem i rozciąganie kończyny dolnej","ćwiczenia równowagi","zginanie kolana i rozciąganie mięśni kulszowo-goleniowych","terapia w wodzie z normalizacją chodu i biegiem w basenie bez kopnięcia żabką","rower stacjonarny i stepper schodowy."],"applies_when":["tygodnie 7–10"],"progression_criteria":["pełny bezbolesny zakres ruchu, brak bólu lub tkliwości, zadowalające badanie kliniczne, unoszenie wyprostowanej kończyny bez deficytu wyprostu i prawidłowy chód."],"dosage_and_progression":["Odstawić ortezę T-Scope i kule.","Przejść do pełnego obciążania, pełnego zakresu ruchu i zwiększania wzmacniania."]},"original":{"goals":["full range of motion, minimal pain, increased resistance exercise, restoration of normal gait and protection of fixation."],"exercises":["Progress to full passive, active and active-assisted range of motion","progressive resistance exercises with 1-5 lb","initiate closed-chain exercises","toe raises, mini squats to 90°, resisted PNF and lower-extremity stretching","balance exercises","hamstring curls and stretches","aquatic therapy emphasizing gait normalization and pool running without frog kicking","stationary cycling and stair stepper."],"applies_when":["Weeks 7-10"],"progression_criteria":["full pain-free range of motion, no pain or tenderness, satisfactory clinical examination, straight-leg raise without lag and normal gait."],"dosage_and_progression":["Discontinue the T-Scope brace and crutches.","Progress to full weight-bearing, full range of motion and increased strengthening."]}},"additional_notes_de":"Ziele: voller Bewegungsumfang, minimale Schmerzen, Steigerung des Übungswiderstands, Wiederherstellung des normalen Gangbilds und Schutz der Fixation.","additional_notes_en":"Goals: full range of motion, minimal pain, increased resistance exercise, restoration of normal gait and protection of fixation.","additional_notes_pl":"Cele: pełny zakres ruchu, minimalny ból, zwiększanie oporu ćwiczeń, odtworzenie prawidłowego chodu i ochrona stabilizacji.","minimum_patient_share":null,"therapeutic_content_de":"Progression zum vollen passiven, aktiven und aktiv-assistierten Bewegungsumfang; progressive Widerstandsübungen mit 1–5 lb; Übungen in geschlossener Kette beginnen; Zehenstände, kleine Kniebeugen bis 90°, PNF gegen Widerstand und Dehnung der unteren Extremität; Gleichgewichtsübungen; Hamstring Curls und Dehnung der ischiokruralen Muskulatur; Wassertherapie mit Gangnormalisierung und Aquajogging ohne Froschbeinschlag; Fahrradergometer und Treppenstepper.","therapeutic_content_en":"Progress to full passive, active and active-assisted range of motion; progressive resistance exercises with 1-5 lb; initiate closed-chain exercises; toe raises, mini squats to 90°, resisted PNF and lower-extremity stretching; balance exercises; hamstring curls and stretches; aquatic therapy emphasizing gait normalization and pool running without frog kicking; stationary cycling and stair stepper.","therapeutic_content_pl":"Progresja do pełnego biernego, czynnego i czynnego wspomaganego zakresu ruchu; progresywne ćwiczenia oporowe 1–5 lb; rozpoczęcie ćwiczeń w zamkniętym łańcuchu; wspięcia na palce, małe przysiady do 90°, PNF z oporem i rozciąganie kończyny dolnej; ćwiczenia równowagi; zginanie kolana i rozciąganie mięśni kulszowo-goleniowych; terapia w wodzie z normalizacją chodu i biegiem w basenie bez kopnięcia żabką; rower stacjonarny i stepper schodowy.","minimum_requirements_de":"T-Scope-Orthese und Unterarmgehstützen ablegen. Zu Vollbelastung, vollem Bewegungsumfang und gesteigerter Kräftigung übergehen. Progressionskriterien: voller schmerzfreier Bewegungsumfang, keine Schmerzen oder Druckempfindlichkeit, zufriedenstellende klinische Untersuchung, Anheben des gestreckten Beins ohne Extensionsdefizit und normales Gangbild.","minimum_requirements_en":"Discontinue the T-Scope brace and crutches. Progress to full weight-bearing, full range of motion and increased strengthening. Progression criteria: full pain-free range of motion, no pain or tenderness, satisfactory clinical examination, straight-leg raise without lag and normal gait.","minimum_requirements_pl":"Odstawić ortezę T-Scope i kule. Przejść do pełnego obciążania, pełnego zakresu ruchu i zwiększania wzmacniania. Kryteria progresji: pełny bezbolesny zakres ruchu, brak bólu lub tkliwości, zadowalające badanie kliniczne, unoszenie wyprostowanej kończyny bez deficytu wyprostu i prawidłowy chód.","additional_notes_original":"Goals: full range of motion, minimal pain, increased resistance exercise, restoration of normal gait and protection of fixation.","therapeutic_content_original":"Progress to full passive, active and active-assisted range of motion; progressive resistance exercises with 1-5 lb; initiate closed-chain exercises; toe raises, mini squats to 90°, resisted PNF and lower-extremity stretching; balance exercises; hamstring curls and stretches; aquatic therapy emphasizing gait normalization and pool running without frog kicking; stationary cycling and stair stepper.","minimum_requirements_original":"Discontinue the T-Scope brace and crutches. Progress to full weight-bearing, full range of motion and increased strengthening. Progression criteria: full pain-free range of motion, no pain or tenderness, satisfactory clinical examination, straight-leg raise without lag and normal gait.","structured_content_v2":"$undefined"},{"id":"fcedb817-c8c6-52f8-8c49-6b8761b57a4b","name_de":"Phase 4: Wochen 11–16","name_en":"Phase 4: Weeks 11-16","name_pl":"Faza 4: tygodnie 11–16","source_page":2,"module_number":4,"name_original":"Phase 4: Weeks 11-16","service_codes":[],"structured_content":{"de":{"goals":["korrekte Gangmechanik, Verbesserung der Kraft der unteren Extremität, voller Bewegungsumfang, neuromuskuläre Kontrolle sowie Steigerung von Leistung und Ausdauer."],"exercises":["Progression von Beweglichkeit und Kräftigung einschließlich exzentrischer Kräftigung","fortgeschrittene Übungen in geschlossener Kette mit Beinpresse, einbeinigen Kniebeugen und Step-up-Progression","Propriozeptionsprogression mit Slide Board und anspruchsvollen Gleichgewichtsaufgaben","vorherige Übungen fortsetzen","Walk-Jog-Run-Progression sowie Vorwärts- und Rückwärtslaufen mit ½, ¾ und voller Geschwindigkeit","Richtungswechsel, Crossover und Carioca","zielgerechte Plyometrie und sportartspezifische Übungen","sichere schrittweise Rückkehr zum Sport nach erfolgreicher funktioneller Progression und sportlicher Testung","Erhaltungsprogramm für Kraft und Ausdauer."],"applies_when":["Wochen 11–16"],"progression_criteria":["Kriterien für die Rückkehr zur Aktivität: voller schmerzfreier Bewegungsumfang und zufriedenstellende klinische Untersuchung.","nicht-antalgisches Gangbild","voller schmerzfreier Bewegungsumfang","Kraft der unteren Extremität mindestens 4/5","selbstständiges Heimprogramm","altersentsprechend normales Gleichgewicht und Propriozeption","abgeklungenes palpables Ödem.","Die Kraft der operierten Extremität muss mindestens 90 % der Gegenseite erreichen."],"dosage_and_progression":["Alle Übungen fortsetzen, Plyometrie und Wasserprogramm steigern und Laufprogramm beginnen."]},"en":{"goals":["proper gait mechanics, improved lower-extremity strength, full range of motion, neuromuscular control, and increased power and endurance."],"exercises":["Progress flexibility and strengthening, including eccentric strengthening","advanced closed-chain activities with leg press, single-leg squats and step-up progression","progress proprioception with slide-board and challenging balance activities","continue prior exercises","functional walk-jog-run progression and forward and backward running at half, three-quarter and full speed","cutting, crossover and carioca","goal-appropriate plyometrics and sport-specific drills","safe gradual return to sport after successful functional progression and sport testing","maintenance program for strength and endurance."],"applies_when":["Weeks 11-16"],"progression_criteria":["Return-to-activity criteria: full pain-free range of motion and satisfactory clinical examination.","non-antalgic gait","full pain-free range of motion","lower-extremity strength at least 4/5","independence with the home program","normal age-appropriate balance and proprioception","resolved palpable edema.","Surgical-limb strength must reach at least 90% of the contralateral limb."],"dosage_and_progression":["Continue all exercises, increase plyometrics and the pool program, and initiate a running program."]},"pl":{"goals":["prawidłowa mechanika chodu, poprawa siły kończyny dolnej, pełny zakres ruchu, kontrola nerwowo-mięśniowa oraz zwiększenie mocy i wytrzymałości."],"exercises":["Progresja elastyczności i wzmacniania, w tym wzmacnianie ekscentryczne","zaawansowane ćwiczenia w zamkniętym łańcuchu — suwnica, przysiady jednonóż i progresja wejść na stopień","progresja propriocepcji na slide board i w trudnych zadaniach równoważnych","kontynuacja wcześniejszych ćwiczeń","progresja marsz–trucht–bieg oraz biegu w przód i w tył z prędkością ½, ¾ i pełną","zmiany kierunku, crossover i carioca","plyometria zgodnie z celami pacjenta i ćwiczenia specyficzne dla sportu","bezpieczny stopniowy powrót do sportu po ukończeniu progresji funkcjonalnej i testu sportowego","program podtrzymujący siłę i wytrzymałość."],"applies_when":["tygodnie 11–16"],"progression_criteria":["Kryteria powrotu do aktywności: pełny bezbolesny zakres ruchu i zadowalające badanie kliniczne.","chód bez utykania z bólu","pełny bezbolesny zakres ruchu","siła kończyny dolnej co najmniej 4/5","samodzielny program domowy","prawidłowa dla wieku równowaga i propriocepcja","ustąpienie wyczuwalnego obrzęku.","Siła operowanej kończyny musi osiągnąć co najmniej 90% siły kończyny przeciwnej."],"dosage_and_progression":["Kontynuować wszystkie ćwiczenia, zwiększać plyometrię i program w wodzie oraz rozpocząć program biegowy."]},"original":{"goals":["proper gait mechanics, improved lower-extremity strength, full range of motion, neuromuscular control, and increased power and endurance."],"exercises":["Progress flexibility and strengthening, including eccentric strengthening","advanced closed-chain activities with leg press, single-leg squats and step-up progression","progress proprioception with slide-board and challenging balance activities","continue prior exercises","functional walk-jog-run progression and forward and backward running at half, three-quarter and full speed","cutting, crossover and carioca","goal-appropriate plyometrics and sport-specific drills","safe gradual return to sport after successful functional progression and sport testing","maintenance program for strength and endurance."],"applies_when":["Weeks 11-16"],"progression_criteria":["Return-to-activity criteria: full pain-free range of motion and satisfactory clinical examination.","non-antalgic gait","full pain-free range of motion","lower-extremity strength at least 4/5","independence with the home program","normal age-appropriate balance and proprioception","resolved palpable edema.","Surgical-limb strength must reach at least 90% of the contralateral limb."],"dosage_and_progression":["Continue all exercises, increase plyometrics and the pool program, and initiate a running program."]}},"additional_notes_de":"Ziele: korrekte Gangmechanik, Verbesserung der Kraft der unteren Extremität, voller Bewegungsumfang, neuromuskuläre Kontrolle sowie Steigerung von Leistung und Ausdauer.","additional_notes_en":"Goals: proper gait mechanics, improved lower-extremity strength, full range of motion, neuromuscular control, and increased power and endurance.","additional_notes_pl":"Cele: prawidłowa mechanika chodu, poprawa siły kończyny dolnej, pełny zakres ruchu, kontrola nerwowo-mięśniowa oraz zwiększenie mocy i wytrzymałości.","minimum_patient_share":null,"therapeutic_content_de":"Progression von Beweglichkeit und Kräftigung einschließlich exzentrischer Kräftigung; fortgeschrittene Übungen in geschlossener Kette mit Beinpresse, einbeinigen Kniebeugen und Step-up-Progression; Propriozeptionsprogression mit Slide Board und anspruchsvollen Gleichgewichtsaufgaben; vorherige Übungen fortsetzen; Walk-Jog-Run-Progression sowie Vorwärts- und Rückwärtslaufen mit ½, ¾ und voller Geschwindigkeit; Richtungswechsel, Crossover und Carioca; zielgerechte Plyometrie und sportartspezifische Übungen; sichere schrittweise Rückkehr zum Sport nach erfolgreicher funktioneller Progression und sportlicher Testung; Erhaltungsprogramm für Kraft und Ausdauer.","therapeutic_content_en":"Progress flexibility and strengthening, including eccentric strengthening; advanced closed-chain activities with leg press, single-leg squats and step-up progression; progress proprioception with slide-board and challenging balance activities; continue prior exercises; functional walk-jog-run progression and forward and backward running at half, three-quarter and full speed; cutting, crossover and carioca; goal-appropriate plyometrics and sport-specific drills; safe gradual return to sport after successful functional progression and sport testing; maintenance program for strength and endurance.","therapeutic_content_pl":"Progresja elastyczności i wzmacniania, w tym wzmacnianie ekscentryczne; zaawansowane ćwiczenia w zamkniętym łańcuchu — suwnica, przysiady jednonóż i progresja wejść na stopień; progresja propriocepcji na slide board i w trudnych zadaniach równoważnych; kontynuacja wcześniejszych ćwiczeń; progresja marsz–trucht–bieg oraz biegu w przód i w tył z prędkością ½, ¾ i pełną; zmiany kierunku, crossover i carioca; plyometria zgodnie z celami pacjenta i ćwiczenia specyficzne dla sportu; bezpieczny stopniowy powrót do sportu po ukończeniu progresji funkcjonalnej i testu sportowego; program podtrzymujący siłę i wytrzymałość.","minimum_requirements_de":"Alle Übungen fortsetzen, Plyometrie und Wasserprogramm steigern und Laufprogramm beginnen. Kriterien für die Rückkehr zur Aktivität: voller schmerzfreier Bewegungsumfang und zufriedenstellende klinische Untersuchung. Entlassungskriterien: nicht-antalgisches Gangbild; voller schmerzfreier Bewegungsumfang; Kraft der unteren Extremität mindestens 4/5; selbstständiges Heimprogramm; altersentsprechend normales Gleichgewicht und Propriozeption; abgeklungenes palpables Ödem. Die Kraft der operierten Extremität muss mindestens 90 % der Gegenseite erreichen.","minimum_requirements_en":"Continue all exercises, increase plyometrics and the pool program, and initiate a running program. Return-to-activity criteria: full pain-free range of motion and satisfactory clinical examination. Discharge criteria: non-antalgic gait; full pain-free range of motion; lower-extremity strength at least 4/5; independence with the home program; normal age-appropriate balance and proprioception; resolved palpable edema. Surgical-limb strength must reach at least 90% of the contralateral limb.","minimum_requirements_pl":"Kontynuować wszystkie ćwiczenia, zwiększać plyometrię i program w wodzie oraz rozpocząć program biegowy. Kryteria powrotu do aktywności: pełny bezbolesny zakres ruchu i zadowalające badanie kliniczne. Kryteria wypisu: chód bez utykania z bólu; pełny bezbolesny zakres ruchu; siła kończyny dolnej co najmniej 4/5; samodzielny program domowy; prawidłowa dla wieku równowaga i propriocepcja; ustąpienie wyczuwalnego obrzęku. Siła operowanej kończyny musi osiągnąć co najmniej 90% siły kończyny przeciwnej.","additional_notes_original":"Goals: proper gait mechanics, improved lower-extremity strength, full range of motion, neuromuscular control, and increased power and endurance.","therapeutic_content_original":"Progress flexibility and strengthening, including eccentric strengthening; advanced closed-chain activities with leg press, single-leg squats and step-up progression; progress proprioception with slide-board and challenging balance activities; continue prior exercises; functional walk-jog-run progression and forward and backward running at half, three-quarter and full speed; cutting, crossover and carioca; goal-appropriate plyometrics and sport-specific drills; safe gradual return to sport after successful functional progression and sport testing; maintenance program for strength and endurance.","minimum_requirements_original":"Continue all exercises, increase plyometrics and the pool program, and initiate a running program. Return-to-activity criteria: full pain-free range of motion and satisfactory clinical examination. Discharge criteria: non-antalgic gait; full pain-free range of motion; lower-extremity strength at least 4/5; independence with the home program; normal age-appropriate balance and proprioception; resolved palpable edema. Surgical-limb strength must reach at least 90% of the contralateral limb.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["knee","lower_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"88bde68e-9981-5049-a6ca-0a7f1c502d46","slug":"us-jared-lee-25-quadriceps-tendon-repair","title_pl":"Protokół rehabilitacji po naprawie ścięgna mięśnia czworogłowego uda","title_de":"Rehabilitationsprotokoll nach Rekonstruktion der Quadrizepssehne","title_en":"Quadriceps Tendon Repair Rehabilitation Protocol","title_original":"Quadriceps Tendon Repair Rehabilitation","summary_pl":"Pięciofazowy protokół po naprawie ścięgna mięśnia czworogłowego uda, obejmujący ochronę naprawy, progresję zakresu ruchu i powrót funkcjonalny.","summary_de":"Fünfphasiges Protokoll nach Rekonstruktion der Quadrizepssehne mit Schutz der Rekonstruktion, Bewegungsaufbau und funktioneller Rückkehr.","summary_en":"Five-phase protocol after quadriceps tendon repair covering repair protection, range-of-motion progression and functional return.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"5abf04cc-bc17-56c6-a3f6-6ec5d1d31bde","condition_slug":"quadriceps-tendon-repair","condition_name_pl":"Stan po naprawie ścięgna mięśnia czworogłowego uda","condition_name_de":"Zustand nach Rekonstruktion der Quadrizepssehne","condition_name_en":"Status Post Quadriceps Tendon Repair","condition_name_original":"Status Post Quadriceps Tendon Repair","icd_codes":[],"category_key":"knee","category_pl":"Kolano","category_de":"Knie","category_en":"Knee","body_regions_pl":["Kolano","Ścięgno mięśnia czworogłowego"],"body_regions_de":["Knie","Quadrizepssehne"],"body_regions_en":["Knee","Quadriceps Tendon"],"search_terms_pl":["naprawa ścięgna mięśnia czworogłowego","rekonstrukcja ścięgna czworogłowego","rehabilitacja kolana po naprawie ścięgna"],"search_terms_de":["Quadrizepssehnenrekonstruktion","Quadrizepssehnennaht","Knierehabilitation nach Sehnenrekonstruktion"],"search_terms_en":["quadriceps tendon repair","quadriceps tendon reconstruction","postoperative knee tendon rehabilitation"],"source_document_id":"c7a5cd03-939b-5204-bb5e-404d799e4870","source_title":"Quadriceps Tendon Repair Rehabilitation","issuer":"Jared Lee, MD","source_country_code":"US","jurisdiction_code":"US-CO","authority_level":"clinic","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_requires_review","official_url":"https://jaredleemd.com/wp-content/uploads/2025/06/Quadriceps-Tendon-Repair-Rehabilitation-Protocol.pdf","source_sha256":"315791354c049e87cbe17898215438e4ebdb21ab7ffe471263cfba3756199e73","authorization_required":true,"license_note":"All Rights Reserved. Authorization is required before final public release. Current development and staging remain allowed by the owner's decision.","modules":[{"id":"e9bd622b-cbac-56ad-b88e-2ea255b28710","name_de":"Phase 1: Wochen 0–2","name_en":"Phase 1: Weeks 0-2","name_pl":"Faza 1: tygodnie 0–2","source_page":1,"module_number":1,"name_original":"Phase 1: Weeks 0-2","service_codes":[],"structured_content":{"de":{"goals":["Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, die Rekonstruktion schützen und eine Belastung der Patellarsehne vermeiden."],"exercises":["Passiver Bewegungsumfang 0–60°","Ödem- und Schmerzmanagement"],"applies_when":["Wochen 0–2"],"restrictions":["Kein aktiver Bewegungsumfang.","Keine Quadrizepskräftigung.","Keine Knieflexion unter Belastung.","Belastung nur mit in Extension verriegelter Orthese."],"physiotherapist_actions":["den Aquacel-Verband nur entfernen, wenn er durchnässt oder beschädigt ist","physikalische Maßnahmen nach Bedarf."]},"en":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid patellar-tendon stress."],"exercises":["Passive range of motion 0-60°","edema and pain management"],"applies_when":["Weeks 0-2"],"restrictions":["No active range of motion.","No quadriceps strengthening.","No knee flexion while weight-bearing.","Weight-bearing is allowed only with the brace locked in extension."],"physiotherapist_actions":["remove the Aquacel dressing only if saturated or compromised","modalities as needed."]},"pl":{"goals":["zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona naprawy oraz unikanie naprężenia ścięgna rzepki."],"exercises":["Bierny zakres ruchu 0–60°"],"applies_when":["tygodnie 0–2"],"restrictions":["Bez czynnego zakresu ruchu.","Bez wzmacniania mięśnia czworogłowego.","Bez zgięcia kolana podczas obciążania.","Obciążanie dozwolone wyłącznie z ortezą zablokowaną w wyproście."],"physiotherapist_actions":["kontrola obrzęku i bólu","opatrunek Aquacel usuwać wyłącznie, jeśli jest przesiąknięty lub uszkodzony","fizykoterapia według potrzeb."]},"original":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid patellar-tendon stress."],"exercises":["Passive range of motion 0-60°","edema and pain management"],"applies_when":["Weeks 0-2"],"restrictions":["No active range of motion.","No quadriceps strengthening.","No knee flexion while weight-bearing.","Weight-bearing is allowed only with the brace locked in extension."],"physiotherapist_actions":["remove the Aquacel dressing only if saturated or compromised","modalities as needed."]}},"additional_notes_de":"Ziele: Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, die Rekonstruktion schützen und eine Belastung der Patellarsehne vermeiden.","additional_notes_en":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid patellar-tendon stress.","additional_notes_pl":"Cele: zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona naprawy oraz unikanie naprężenia ścięgna rzepki.","minimum_patient_share":null,"therapeutic_content_de":"Passiver Bewegungsumfang 0–60°; Ödem- und Schmerzmanagement; den Aquacel-Verband nur entfernen, wenn er durchnässt oder beschädigt ist; physikalische Maßnahmen nach Bedarf.","therapeutic_content_en":"Passive range of motion 0-60°; edema and pain management; remove the Aquacel dressing only if saturated or compromised; modalities as needed.","therapeutic_content_pl":"Bierny zakres ruchu 0–60°; kontrola obrzęku i bólu; opatrunek Aquacel usuwać wyłącznie, jeśli jest przesiąknięty lub uszkodzony; fizykoterapia według potrzeb.","minimum_requirements_de":"Kein aktiver Bewegungsumfang. Keine Quadrizepskräftigung. Keine Knieflexion unter Belastung. Belastung nur mit in Extension verriegelter Orthese.","minimum_requirements_en":"No active range of motion. No quadriceps strengthening. No knee flexion while weight-bearing. Weight-bearing is allowed only with the brace locked in extension.","minimum_requirements_pl":"Bez czynnego zakresu ruchu. Bez wzmacniania mięśnia czworogłowego. Bez zgięcia kolana podczas obciążania. Obciążanie dozwolone wyłącznie z ortezą zablokowaną w wyproście.","additional_notes_original":"Goals: Reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair, and avoid patellar tendon stress","therapeutic_content_original":"Passive range of motion 0-60°; edema and pain management; remove the Aquacel dressing only if saturated or compromised; modalities as needed.","minimum_requirements_original":"No active range of motion. No quadriceps strengthening. No knee flexion while weight-bearing. Weight-bearing is allowed only with the brace locked in extension.","structured_content_v2":"$undefined"},{"id":"1ca7c76b-db98-5506-9afb-5dfc239da90f","name_de":"Phase 2: Wochen 2–6","name_en":"Phase 2: Weeks 2-6","name_pl":"Faza 2: tygodnie 2–6","source_page":1,"module_number":2,"name_original":"Phase 2: Weeks 2-6","service_codes":[],"structured_content":{"de":{"goals":["Progression des Bewegungsumfangs, Begrenzung von Schmerzen und Muskelatrophie, Schutz der Rekonstruktion und Beginn der neuromuskulären Kontrolle."],"exercises":["Passiver Bewegungsumfang 0–60°, wöchentlich um 10° steigern, bis 90° erreicht sind.","Nach Erreichen von 90° ist eine aktive Knieflexion von 0–90° erlaubt, weiterhin ohne aktive Knieextension.","Knieextension ausschließlich passiv fortführen","isometrische Quadrizepsaktivierung beginnen","Rumpfkräftigung"],"applies_when":["Wochen 2–6"],"restrictions":["Kein aktiver Bewegungsumfang.","Belastung und Gehen nur mit der Orthese in Extension oder zur Komfortsteigerung im Bereich 0–10°.","Keine aktive Knieextension."],"physiotherapist_actions":["physikalische Maßnahmen nach Bedarf."]},"en":{"goals":["progress range of motion, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control."],"exercises":["Passive range of motion 0-60°, increasing by 10° per week until 90° is achieved.","Once 90° is achieved, active knee flexion 0-90° is allowed, but no active knee extension.","Continue with passive knee extension only","begin isometric quadriceps activation","core strengthening"],"applies_when":["Weeks 2-6"],"restrictions":["No active range of motion.","Weight-bearing and ambulation are allowed only with the brace in extension or set at 0-10° for comfort.","No active knee extension."],"physiotherapist_actions":["modalities as needed."]},"pl":{"goals":["progresja zakresu ruchu, ograniczenie bólu i zaniku mięśni, ochrona naprawy oraz rozpoczęcie kontroli nerwowo-mięśniowej."],"exercises":["Bierny zakres ruchu 0–60°, zwiększany o 10° tygodniowo do uzyskania 90°.","Po uzyskaniu 90° można wykonywać czynne zgięcie kolana 0–90°, nadal bez czynnego wyprostu.","Kontynuować wyłącznie bierny wyprost kolana","rozpocząć izometryczną aktywację mięśnia czworogłowego","wzmacnianie centralne"],"applies_when":["tygodnie 2–6"],"restrictions":["Bez czynnego zakresu ruchu.","Obciążanie i chodzenie wyłącznie z ortezą w wyproście lub ustawioną dla komfortu w zakresie 0–10°.","Bez czynnego wyprostu kolana.","nadal bez czynnego wyprostu."],"physiotherapist_actions":["fizykoterapia według potrzeb."]},"original":{"goals":["progress range of motion, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control."],"exercises":["Passive range of motion 0-60°, increasing by 10° per week until 90° is achieved.","Once 90° is achieved, active knee flexion 0-90° is allowed, but no active knee extension.","Continue with passive knee extension only","begin isometric quadriceps activation","core strengthening"],"applies_when":["Weeks 2-6"],"restrictions":["No active range of motion.","Weight-bearing and ambulation are allowed only with the brace in extension or set at 0-10° for comfort.","No active knee extension."],"physiotherapist_actions":["modalities as needed."]}},"additional_notes_de":"Ziele: Progression des Bewegungsumfangs, Begrenzung von Schmerzen und Muskelatrophie, Schutz der Rekonstruktion und Beginn der neuromuskulären Kontrolle.","additional_notes_en":"Goals: progress range of motion, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control.","additional_notes_pl":"Cele: progresja zakresu ruchu, ograniczenie bólu i zaniku mięśni, ochrona naprawy oraz rozpoczęcie kontroli nerwowo-mięśniowej.","minimum_patient_share":null,"therapeutic_content_de":"Passiver Bewegungsumfang 0–60°, wöchentlich um 10° steigern, bis 90° erreicht sind. Nach Erreichen von 90° ist eine aktive Knieflexion von 0–90° erlaubt, weiterhin ohne aktive Knieextension. Knieextension ausschließlich passiv fortführen; isometrische Quadrizepsaktivierung beginnen; Rumpfkräftigung; physikalische Maßnahmen nach Bedarf.","therapeutic_content_en":"Passive range of motion 0-60°, increasing by 10° per week until 90° is achieved. Once 90° is achieved, active knee flexion 0-90° is allowed, but no active knee extension. Continue with passive knee extension only; begin isometric quadriceps activation; core strengthening; modalities as needed.","therapeutic_content_pl":"Bierny zakres ruchu 0–60°, zwiększany o 10° tygodniowo do uzyskania 90°. Po uzyskaniu 90° można wykonywać czynne zgięcie kolana 0–90°, nadal bez czynnego wyprostu. Kontynuować wyłącznie bierny wyprost kolana; rozpocząć izometryczną aktywację mięśnia czworogłowego; wzmacnianie centralne; fizykoterapia według potrzeb.","minimum_requirements_de":"Kein aktiver Bewegungsumfang. Belastung und Gehen nur mit der Orthese in Extension oder zur Komfortsteigerung im Bereich 0–10°. Keine aktive Knieextension.","minimum_requirements_en":"No active range of motion. Weight-bearing and ambulation are allowed only with the brace in extension or set at 0-10° for comfort. No active knee extension.","minimum_requirements_pl":"Bez czynnego zakresu ruchu. Obciążanie i chodzenie wyłącznie z ortezą w wyproście lub ustawioną dla komfortu w zakresie 0–10°. Bez czynnego wyprostu kolana.","additional_notes_original":"Goals: Progress range of motion, minimize pain, retard muscle atrophy, protect the repair, and begin neuromuscular control","therapeutic_content_original":"Passive range of motion 0-60°, increasing by 10° per week until 90° is achieved. Once 90° is achieved, active knee flexion 0-90° is allowed, but no active knee extension. Continue with passive knee extension only; begin isometric quadriceps activation; core strengthening; modalities as needed.","minimum_requirements_original":"No active range of motion. Weight-bearing and ambulation are allowed only with the brace in extension or set at 0-10° for comfort. No active knee extension.","structured_content_v2":"$undefined"},{"id":"bfd352c5-ecf3-5dd1-af06-c01c93b36af0","name_de":"Phase 3: Wochen 6–12","name_en":"Phase 3: Weeks 6-12","name_pl":"Faza 3: tygodnie 6–12","source_page":1,"module_number":3,"name_original":"Phase 3: Weeks 6-12","service_codes":[],"structured_content":{"de":{"goals":["vollständiger Bewegungsumfang, minimale Schmerzen, Beginn von Muskelaktivierung und Kräftigung sowie Schutz der Rekonstruktion."],"exercises":["Progression zum vollständigen passiven, aktiven und aktiv-assistierten Bewegungsumfang ohne Widerstand","kontrolliertes Anheben des gestreckten Beins","Beginn einer leichten Kräftigung von Hüfte und Glutealmuskulatur","Fahrradergometer ohne Widerstand ab Woche 10."],"applies_when":["Wochen 6–12"],"restrictions":["Kein Widerstand bei Bewegungsübungen."],"physiotherapist_actions":["Belastung und Gehen mit im Bereich 0–45° entriegelter Orthese fortführen.","Eigentliche Kräftigungsübungen bis Woche 12 vermeiden."]},"en":{"goals":["full range of motion, minimal pain, begin muscular activation and strengthening, and protect the repair."],"exercises":["Progress to full passive, active and active-assisted range of motion without resistance","controlled straight-leg raises","begin gentle hip and gluteal strengthening","stationary cycling without resistance at week 10."],"applies_when":["Weeks 6-12"],"restrictions":["No resistance during range-of-motion exercises.","Avoid true strengthening exercises until week 12."],"dosage_and_progression":["Continue weight-bearing and ambulation with the brace unlocked from 0-45°."]},"pl":{"goals":["pełny zakres ruchu, minimalny ból, rozpoczęcie aktywacji i wzmacniania mięśni oraz ochrona naprawy."],"exercises":["Progresja do pełnego biernego, czynnego i czynnego wspomaganego zakresu ruchu bez oporu","kontrolowane unoszenie wyprostowanej kończyny","rozpoczęcie łagodnego wzmacniania biodra i mięśni pośladkowych","rower stacjonarny bez oporu od 10. tygodnia."],"applies_when":["tygodnie 6–12"],"restrictions":["Bez oporu podczas ćwiczeń zakresu ruchu.","Unikać właściwych ćwiczeń wzmacniających do 12. tygodnia."],"dosage_and_progression":["Kontynuować obciążanie i chodzenie w ortezie odblokowanej w zakresie 0–45°."]},"original":{"goals":["full range of motion, minimal pain, begin muscular activation and strengthening, and protect the repair."],"exercises":["Progress to full passive, active and active-assisted range of motion without resistance","controlled straight-leg raises","begin gentle hip and gluteal strengthening","stationary cycling without resistance at week 10."],"applies_when":["Weeks 6-12"],"restrictions":["No resistance during range-of-motion exercises.","Avoid true strengthening exercises until week 12."],"dosage_and_progression":["Continue weight-bearing and ambulation with the brace unlocked from 0-45°."]}},"additional_notes_de":"Ziele: vollständiger Bewegungsumfang, minimale Schmerzen, Beginn von Muskelaktivierung und Kräftigung sowie Schutz der Rekonstruktion.","additional_notes_en":"Goals: full range of motion, minimal pain, begin muscular activation and strengthening, and protect the repair.","additional_notes_pl":"Cele: pełny zakres ruchu, minimalny ból, rozpoczęcie aktywacji i wzmacniania mięśni oraz ochrona naprawy.","minimum_patient_share":null,"therapeutic_content_de":"Progression zum vollständigen passiven, aktiven und aktiv-assistierten Bewegungsumfang ohne Widerstand; kontrolliertes Anheben des gestreckten Beins; Beginn einer leichten Kräftigung von Hüfte und Glutealmuskulatur; Fahrradergometer ohne Widerstand ab Woche 10.","therapeutic_content_en":"Progress to full passive, active and active-assisted range of motion without resistance; controlled straight-leg raises; begin gentle hip and gluteal strengthening; stationary cycling without resistance at week 10.","therapeutic_content_pl":"Progresja do pełnego biernego, czynnego i czynnego wspomaganego zakresu ruchu bez oporu; kontrolowane unoszenie wyprostowanej kończyny; rozpoczęcie łagodnego wzmacniania biodra i mięśni pośladkowych; rower stacjonarny bez oporu od 10. tygodnia.","minimum_requirements_de":"Belastung und Gehen mit im Bereich 0–45° entriegelter Orthese fortführen. Kein Widerstand bei Bewegungsübungen. Eigentliche Kräftigungsübungen bis Woche 12 vermeiden.","minimum_requirements_en":"Continue weight-bearing and ambulation with the brace unlocked from 0-45°. No resistance during range-of-motion exercises. Avoid true strengthening exercises until week 12.","minimum_requirements_pl":"Kontynuować obciążanie i chodzenie w ortezie odblokowanej w zakresie 0–45°. Bez oporu podczas ćwiczeń zakresu ruchu. Unikać właściwych ćwiczeń wzmacniających do 12. tygodnia.","additional_notes_original":"Goals: Full range of motion, minimal pain, begin muscular activation and strengthening, protect the repair","therapeutic_content_original":"Progress to full passive, active and active-assisted range of motion without resistance; controlled straight-leg raises; begin gentle hip and gluteal strengthening; stationary cycling without resistance at week 10.","minimum_requirements_original":"Continue weight-bearing and ambulation with the brace unlocked from 0-45°. No resistance during range-of-motion exercises. Avoid true strengthening exercises until week 12.","structured_content_v2":"$undefined"},{"id":"78221c71-f3d4-5faa-8900-1aecbdea12fd","name_de":"Phase 4: Wochen 12–18","name_en":"Phase 4: Weeks 12-18","name_pl":"Faza 4: tygodnie 12–18","source_page":1,"module_number":4,"name_original":"Phase 4: Weeks 12-18","service_codes":[],"structured_content":{"de":{"goals":["korrekte Gangmechanik, Verbesserung der Kraft der unteren Extremität und neuromuskuläre Kontrolle."],"exercises":["aktive Knieextension mit begrenztem Widerstand beginnen und nach Verträglichkeit steigern","Fahrradergometer mit begrenztem Widerstand","leichtes beidbeiniges Krafttraining mit kleinen Kniebeugen und Ausfallschritten"],"applies_when":["Wochen 12–18"],"restrictions":["Keine funktionellen Sportbewegungen"],"dosage_and_progression":["Orthese ablegen."],"physiotherapist_actions":["Pivotbewegungen, Richtungswechsel und Sprünge vermeiden.","Belastung und Gehen ohne Orthese","Gangtraining","Wassertherapie mit Beinbewegungen und Gangtraining."]},"en":{"goals":["proper gait mechanics, improved lower-extremity strength and neuromuscular control."],"exercises":["begin active knee extension with limited resistance and progress as tolerated","stationary cycling with limited resistance","gentle double-leg strengthening with mini squats and lunges"],"applies_when":["Weeks 12-18"],"restrictions":["No functional sports movements","avoid pivoting, cutting and jumping."],"dosage_and_progression":["Discontinue the brace."],"physiotherapist_actions":["Weight-bearing and ambulation without the brace","gait training","aquatic therapy with kicking and gait training."]},"pl":{"goals":["prawidłowa mechanika chodu, poprawa siły kończyny dolnej i kontrola nerwowo-mięśniowa."],"exercises":["rozpoczęcie czynnego wyprostu kolana z ograniczonym oporem i progresja według tolerancji","rower stacjonarny z ograniczonym oporem","łagodne wzmacnianie obunóż przez małe przysiady i wykroki"],"applies_when":["tygodnie 12–18"],"restrictions":["Bez funkcjonalnych ruchów sportowych","unikać zwrotów na obciążonej kończynie, zmian kierunku i skoków."],"dosage_and_progression":["Odstawić ortezę."],"physiotherapist_actions":["Obciążanie i chodzenie bez ortezy","trening chodu","terapia w wodzie obejmująca kopnięcia i trening chodu."]},"original":{"goals":["proper gait mechanics, improved lower-extremity strength and neuromuscular control."],"exercises":["begin active knee extension with limited resistance and progress as tolerated","stationary cycling with limited resistance","gentle double-leg strengthening with mini squats and lunges"],"applies_when":["Weeks 12-18"],"restrictions":["No functional sports movements","avoid pivoting, cutting and jumping."],"dosage_and_progression":["Discontinue the brace."],"physiotherapist_actions":["Weight-bearing and ambulation without the brace","gait training","aquatic therapy with kicking and gait training."]}},"additional_notes_de":"Ziele: korrekte Gangmechanik, Verbesserung der Kraft der unteren Extremität und neuromuskuläre Kontrolle.","additional_notes_en":"Goals: proper gait mechanics, improved lower-extremity strength and neuromuscular control.","additional_notes_pl":"Cele: prawidłowa mechanika chodu, poprawa siły kończyny dolnej i kontrola nerwowo-mięśniowa.","minimum_patient_share":null,"therapeutic_content_de":"Belastung und Gehen ohne Orthese; Gangtraining; aktive Knieextension mit begrenztem Widerstand beginnen und nach Verträglichkeit steigern; Fahrradergometer mit begrenztem Widerstand; leichtes beidbeiniges Krafttraining mit kleinen Kniebeugen und Ausfallschritten; Wassertherapie mit Beinbewegungen und Gangtraining.","therapeutic_content_en":"Weight-bearing and ambulation without the brace; gait training; begin active knee extension with limited resistance and progress as tolerated; stationary cycling with limited resistance; gentle double-leg strengthening with mini squats and lunges; aquatic therapy with kicking and gait training.","therapeutic_content_pl":"Obciążanie i chodzenie bez ortezy; trening chodu; rozpoczęcie czynnego wyprostu kolana z ograniczonym oporem i progresja według tolerancji; rower stacjonarny z ograniczonym oporem; łagodne wzmacnianie obunóż przez małe przysiady i wykroki; terapia w wodzie obejmująca kopnięcia i trening chodu.","minimum_requirements_de":"Orthese ablegen. Keine funktionellen Sportbewegungen; Pivotbewegungen, Richtungswechsel und Sprünge vermeiden.","minimum_requirements_en":"Discontinue the brace. No functional sports movements; avoid pivoting, cutting and jumping.","minimum_requirements_pl":"Odstawić ortezę. Bez funkcjonalnych ruchów sportowych; unikać zwrotów na obciążonej kończynie, zmian kierunku i skoków.","additional_notes_original":"Goals: Proper gait mechanics, improve lower extremity strength, neuromuscular control","therapeutic_content_original":"Weight-bearing and ambulation without the brace; gait training; begin active knee extension with limited resistance and progress as tolerated; stationary cycling with limited resistance; gentle double-leg strengthening with mini squats and lunges; aquatic therapy with kicking and gait training.","minimum_requirements_original":"Discontinue the brace. No functional sports movements; avoid pivoting, cutting and jumping.","structured_content_v2":"$undefined"},{"id":"201a46d3-e408-5446-8dd2-010d35b009b8","name_de":"Phase 5: Wochen 18–24","name_en":"Phase 5: Weeks 18-24","name_pl":"Faza 5: tygodnie 18–24","source_page":2,"module_number":5,"name_original":"Phase 5: Weeks 18-24","service_codes":[],"structured_content":{"de":{"goals":["Verbesserung der Kraft der unteren Extremität, Beginn des funktionellen Bewegungstrainings, Verbesserung der Propriozeption und exzentrische Kontrolle."],"exercises":["Abbremsen und einbeinige Sprünge beginnen","ab Woche 20 Richtungswechsel beginnen","ab Woche 20 Agility-Übungen mit Bodenleiter und Hütchen sowie sportartspezifische Aktivität beginnen."],"applies_when":["Wochen 18–24"],"progression_criteria":["Kraftdefizit von Quadrizeps und Glutealmuskulatur <10 %","Limb Symmetry Index ≥90 % bei funktionellen Sprung- und Y-Balance-Tests","45/50 Punkte in biomechanischen Funktionstests, sofern durchgeführt","keine Schmerzen oder berichtete Instabilität bei der Progression sportartspezifischer Fähigkeiten."],"dosage_and_progression":["Behutsam steigern, um ein Trauma der Rekonstruktion zu vermeiden.","Joggen beginnen.","Progression zu anspruchsvolleren und sportartspezifischen Aktivitäten."]},"en":{"goals":["improve lower-extremity strength, begin functional-movement training, improve proprioception and eccentric control."],"exercises":["Initiate deceleration and single-leg hopping","initiate cutting at week 20","initiate agility at week 20 with floor-ladder and cone drills, and begin sport-specific activity."],"applies_when":["Weeks 18-24"],"restrictions":["Progress gently to avoid trauma to the repair."],"progression_criteria":["<10% strength deficit in the quadriceps and gluteals","limb symmetry index ≥90% on functional hop and Y-Balance tests","45/50 on biomechanical functional assessment tests, if performed","no pain or complaints of instability during functional progression of sport-specific skills."],"dosage_and_progression":["Progress to higher-level and sport-specific activities."],"physiotherapist_actions":["Initiate jogging."]},"pl":{"goals":["poprawa siły kończyny dolnej, rozpoczęcie treningu ruchów funkcjonalnych, poprawa propriocepcji i kontrola ekscentryczna."],"exercises":["Rozpocząć hamowanie i skoki jednonóż","od 20. tygodnia rozpocząć zmiany kierunku","od 20. tygodnia rozpocząć ćwiczenia zwinnościowe na drabince podłogowej i z pachołkami oraz aktywność specyficzną dla sportu."],"applies_when":["tygodnie 18–24"],"progression_criteria":["deficyt siły mięśnia czworogłowego i mięśni pośladkowych <10%","wskaźnik symetrii kończyn ≥90% w funkcjonalnych testach skokowych i Y-Balance","wynik 45/50 w biomechanicznych testach funkcjonalnych, jeśli je wykonano","brak bólu i zgłaszanej niestabilności podczas progresji umiejętności specyficznych dla sportu."],"dosage_and_progression":["Progresję prowadzić łagodnie, aby uniknąć urazu naprawy.","Rozpocząć trucht.","Progresja do aktywności wyższego poziomu i aktywności specyficznych dla sportu."]},"original":{"goals":["improve lower-extremity strength, begin functional-movement training, improve proprioception and eccentric control."],"exercises":["Initiate deceleration and single-leg hopping","initiate cutting at week 20","initiate agility at week 20 with floor-ladder and cone drills, and begin sport-specific activity."],"applies_when":["Weeks 18-24"],"restrictions":["Progress gently to avoid trauma to the repair."],"progression_criteria":["<10% strength deficit in the quadriceps and gluteals","limb symmetry index ≥90% on functional hop and Y-Balance tests","45/50 on biomechanical functional assessment tests, if performed","no pain or complaints of instability during functional progression of sport-specific skills."],"dosage_and_progression":["Progress to higher-level and sport-specific activities."],"physiotherapist_actions":["Initiate jogging."]}},"additional_notes_de":"Ziele: Verbesserung der Kraft der unteren Extremität, Beginn des funktionellen Bewegungstrainings, Verbesserung der Propriozeption und exzentrische Kontrolle. Entlassungskriterien: Kraftdefizit von Quadrizeps und Glutealmuskulatur <10 %; Limb Symmetry Index ≥90 % bei funktionellen Sprung- und Y-Balance-Tests; 45/50 Punkte in biomechanischen Funktionstests, sofern durchgeführt; keine Schmerzen oder berichtete Instabilität bei der Progression sportartspezifischer Fähigkeiten.","additional_notes_en":"Goals: improve lower-extremity strength, begin functional-movement training, improve proprioception and eccentric control. Discharge criteria: <10% strength deficit in the quadriceps and gluteals; limb symmetry index ≥90% on functional hop and Y-Balance tests; 45/50 on biomechanical functional assessment tests, if performed; no pain or complaints of instability during functional progression of sport-specific skills.","additional_notes_pl":"Cele: poprawa siły kończyny dolnej, rozpoczęcie treningu ruchów funkcjonalnych, poprawa propriocepcji i kontrola ekscentryczna. Kryteria wypisu: deficyt siły mięśnia czworogłowego i mięśni pośladkowych <10%; wskaźnik symetrii kończyn ≥90% w funkcjonalnych testach skokowych i Y-Balance; wynik 45/50 w biomechanicznych testach funkcjonalnych, jeśli je wykonano; brak bólu i zgłaszanej niestabilności podczas progresji umiejętności specyficznych dla sportu.","minimum_patient_share":null,"therapeutic_content_de":"Abbremsen und einbeinige Sprünge beginnen; ab Woche 20 Richtungswechsel beginnen; ab Woche 20 Agility-Übungen mit Bodenleiter und Hütchen sowie sportartspezifische Aktivität beginnen.","therapeutic_content_en":"Initiate deceleration and single-leg hopping; initiate cutting at week 20; initiate agility at week 20 with floor-ladder and cone drills, and begin sport-specific activity.","therapeutic_content_pl":"Rozpocząć hamowanie i skoki jednonóż; od 20. tygodnia rozpocząć zmiany kierunku; od 20. tygodnia rozpocząć ćwiczenia zwinnościowe na drabince podłogowej i z pachołkami oraz aktywność specyficzną dla sportu.","minimum_requirements_de":"Behutsam steigern, um ein Trauma der Rekonstruktion zu vermeiden. Joggen beginnen. Progression zu anspruchsvolleren und sportartspezifischen Aktivitäten.","minimum_requirements_en":"Progress gently to avoid trauma to the repair. Initiate jogging. Progress to higher-level and sport-specific activities.","minimum_requirements_pl":"Progresję prowadzić łagodnie, aby uniknąć urazu naprawy. Rozpocząć trucht. Progresja do aktywności wyższego poziomu i aktywności specyficznych dla sportu.","additional_notes_original":"Goals: Improve lower extremity strength, begin functional movement training, proprioception improvement, eccentric control\nCriteria for Discharge:\n- <10% strength deficit in quads and gluteals\n- Limb similarity index of 90% or greater on\n functional hop and Y balance tests\n- 45/50 on biomechanical functional\n assessment tests (if performed)\n- No pain or complains of instability with\n functional progression of sports specific\n skills","therapeutic_content_original":"Initiate deceleration and single-leg hopping; initiate cutting at week 20; initiate agility at week 20 with floor-ladder and cone drills, and begin sport-specific activity.","minimum_requirements_original":"Progress gently to avoid trauma to the repair. Initiate jogging. Progress to higher-level and sport-specific activities.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["knee","lower_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"0cb4e2f9-2278-5ebb-93f7-e0f055f8bd69","slug":"us-jared-lee-31-patellar-tendon-repair","title_pl":"Protokół rehabilitacji po naprawie ścięgna rzepki","title_de":"Rehabilitationsprotokoll nach Rekonstruktion der Patellarsehne","title_en":"Patellar Tendon Repair Rehabilitation Protocol","title_original":"Patellar Tendon Repair Rehabilitation","summary_pl":"Pięciofazowy protokół po naprawie ścięgna rzepki, obejmujący ochronę naprawy, progresję zakresu ruchu i powrót funkcjonalny.","summary_de":"Fünfphasiges Protokoll nach Rekonstruktion der Patellarsehne mit Schutz der Rekonstruktion, Bewegungsaufbau und funktioneller Rückkehr.","summary_en":"Five-phase protocol after patellar tendon repair covering repair protection, range-of-motion progression and functional return.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"b402eeda-01e6-5ee0-a9c6-90cc93dcece6","condition_slug":"patellar-tendon-repair","condition_name_pl":"Stan po naprawie ścięgna rzepki","condition_name_de":"Zustand nach Rekonstruktion der Patellarsehne","condition_name_en":"Status Post Patellar Tendon Repair","condition_name_original":"Status Post Patellar Tendon Repair","icd_codes":[],"category_key":"knee","category_pl":"Kolano","category_de":"Knie","category_en":"Knee","body_regions_pl":["Kolano","Ścięgno rzepki"],"body_regions_de":["Knie","Patellarsehne"],"body_regions_en":["Knee","Patellar Tendon"],"search_terms_pl":["naprawa ścięgna rzepki","rekonstrukcja ścięgna rzepki","rehabilitacja kolana po naprawie ścięgna"],"search_terms_de":["Patellarsehnenrekonstruktion","Patellarsehnennaht","Knierehabilitation nach Sehnenrekonstruktion"],"search_terms_en":["patellar tendon repair","patellar tendon reconstruction","postoperative knee tendon rehabilitation"],"source_document_id":"034c5d9a-a7da-5ac4-b3c5-8c114bbe8619","source_title":"Patellar Tendon Repair Rehabilitation","issuer":"Jared Lee, MD","source_country_code":"US","jurisdiction_code":"US-CO","authority_level":"clinic","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_requires_review","official_url":"https://jaredleemd.com/wp-content/uploads/2025/06/Patellar-Tendon-Repair-Rehabilitation-Protocol.pdf","source_sha256":"a68aac45783cc20cf88ec7a0ccbd3ff4885838e894f5cf1abe78bd910d51bc43","authorization_required":true,"license_note":"All Rights Reserved. Authorization is required before final public release. Current development and staging remain allowed by the owner's decision.","modules":[{"id":"f0084ded-97a7-5d8b-b8fa-2a58c671f20e","name_de":"Phase 1: Wochen 0–2","name_en":"Phase 1: Weeks 0-2","name_pl":"Faza 1: tygodnie 0–2","source_page":1,"module_number":1,"name_original":"Phase 1: Weeks 0-2","service_codes":[],"structured_content":{"de":{"goals":["Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, die Rekonstruktion schützen und eine Belastung der Patellarsehne vermeiden."],"exercises":["Passiver Bewegungsumfang 0–60°","Ödem- und Schmerzmanagement"],"applies_when":["Wochen 0–2"],"restrictions":["Kein aktiver Bewegungsumfang.","Keine Quadrizepskräftigung.","Keine Knieflexion unter Belastung.","Belastung nur mit in Extension verriegelter Orthese."],"physiotherapist_actions":["den Aquacel-Verband nur entfernen, wenn er durchnässt oder beschädigt ist","physikalische Maßnahmen nach Bedarf."]},"en":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid patellar-tendon stress."],"exercises":["Passive range of motion 0-60°","edema and pain management"],"applies_when":["Weeks 0-2"],"restrictions":["No active range of motion.","No quadriceps strengthening.","No knee flexion while weight-bearing.","Weight-bearing is allowed only with the brace locked in extension."],"physiotherapist_actions":["remove the Aquacel dressing only if saturated or compromised","modalities as needed."]},"pl":{"goals":["zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona naprawy oraz unikanie naprężenia ścięgna rzepki."],"exercises":["Bierny zakres ruchu 0–60°"],"applies_when":["tygodnie 0–2"],"restrictions":["Bez czynnego zakresu ruchu.","Bez wzmacniania mięśnia czworogłowego.","Bez zgięcia kolana podczas obciążania.","Obciążanie dozwolone wyłącznie z ortezą zablokowaną w wyproście."],"physiotherapist_actions":["kontrola obrzęku i bólu","opatrunek Aquacel usuwać wyłącznie, jeśli jest przesiąknięty lub uszkodzony","fizykoterapia według potrzeb."]},"original":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid patellar-tendon stress."],"exercises":["Passive range of motion 0-60°","edema and pain management"],"applies_when":["Weeks 0-2"],"restrictions":["No active range of motion.","No quadriceps strengthening.","No knee flexion while weight-bearing.","Weight-bearing is allowed only with the brace locked in extension."],"physiotherapist_actions":["remove the Aquacel dressing only if saturated or compromised","modalities as needed."]}},"additional_notes_de":"Ziele: Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, die Rekonstruktion schützen und eine Belastung der Patellarsehne vermeiden.","additional_notes_en":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid patellar-tendon stress.","additional_notes_pl":"Cele: zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona naprawy oraz unikanie naprężenia ścięgna rzepki.","minimum_patient_share":null,"therapeutic_content_de":"Passiver Bewegungsumfang 0–60°; Ödem- und Schmerzmanagement; den Aquacel-Verband nur entfernen, wenn er durchnässt oder beschädigt ist; physikalische Maßnahmen nach Bedarf.","therapeutic_content_en":"Passive range of motion 0-60°; edema and pain management; remove the Aquacel dressing only if saturated or compromised; modalities as needed.","therapeutic_content_pl":"Bierny zakres ruchu 0–60°; kontrola obrzęku i bólu; opatrunek Aquacel usuwać wyłącznie, jeśli jest przesiąknięty lub uszkodzony; fizykoterapia według potrzeb.","minimum_requirements_de":"Kein aktiver Bewegungsumfang. Keine Quadrizepskräftigung. Keine Knieflexion unter Belastung. Belastung nur mit in Extension verriegelter Orthese.","minimum_requirements_en":"No active range of motion. No quadriceps strengthening. No knee flexion while weight-bearing. Weight-bearing is allowed only with the brace locked in extension.","minimum_requirements_pl":"Bez czynnego zakresu ruchu. Bez wzmacniania mięśnia czworogłowego. Bez zgięcia kolana podczas obciążania. Obciążanie dozwolone wyłącznie z ortezą zablokowaną w wyproście.","additional_notes_original":"Goals: Reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair, and avoid patellar tendon stress","therapeutic_content_original":"Passive range of motion 0-60°; edema and pain management; remove the Aquacel dressing only if saturated or compromised; modalities as needed.","minimum_requirements_original":"No active range of motion. No quadriceps strengthening. No knee flexion while weight-bearing. Weight-bearing is allowed only with the brace locked in extension.","structured_content_v2":"$undefined"},{"id":"03877497-d575-557b-b008-8dde7514aabf","name_de":"Phase 2: Wochen 2–6","name_en":"Phase 2: Weeks 2-6","name_pl":"Faza 2: tygodnie 2–6","source_page":1,"module_number":2,"name_original":"Phase 2: Weeks 2-6","service_codes":[],"structured_content":{"de":{"goals":["Progression des Bewegungsumfangs, Begrenzung von Schmerzen und Muskelatrophie, Schutz der Rekonstruktion und Beginn der neuromuskulären Kontrolle."],"exercises":["Passiver Bewegungsumfang 0–60°, wöchentlich um 10° steigern, bis 90° erreicht sind.","Nach Erreichen von 90° ist eine aktive Knieflexion von 0–90° erlaubt, weiterhin ohne aktive Knieextension.","Knieextension ausschließlich passiv fortführen","isometrische Quadrizepsaktivierung beginnen","Rumpfkräftigung"],"applies_when":["Wochen 2–6"],"restrictions":["Kein aktiver Bewegungsumfang.","Belastung und Gehen nur mit auf 10° Flexion eingestellter Orthese.","Keine aktive Knieextension."],"physiotherapist_actions":["physikalische Maßnahmen nach Bedarf."]},"en":{"goals":["progress range of motion, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control."],"exercises":["Passive range of motion 0-60°, increasing by 10° per week until 90° is achieved.","Once 90° is achieved, active knee flexion 0-90° is allowed, but no active knee extension.","Continue with passive knee extension only","begin isometric quadriceps activation","core strengthening"],"applies_when":["Weeks 2-6"],"restrictions":["No active range of motion.","Weight-bearing and ambulation are allowed only with the brace at 10° of flexion.","No active knee extension."],"physiotherapist_actions":["modalities as needed."]},"pl":{"goals":["progresja zakresu ruchu, ograniczenie bólu i zaniku mięśni, ochrona naprawy oraz rozpoczęcie kontroli nerwowo-mięśniowej."],"exercises":["Bierny zakres ruchu 0–60°, zwiększany o 10° tygodniowo do uzyskania 90°.","Po uzyskaniu 90° można wykonywać czynne zgięcie kolana 0–90°, nadal bez czynnego wyprostu.","Kontynuować wyłącznie bierny wyprost kolana","rozpocząć izometryczną aktywację mięśnia czworogłowego","wzmacnianie centralne"],"applies_when":["tygodnie 2–6"],"restrictions":["Bez czynnego zakresu ruchu.","Obciążanie i chodzenie wyłącznie z ortezą ustawioną w 10° zgięcia.","Bez czynnego wyprostu kolana.","nadal bez czynnego wyprostu."],"physiotherapist_actions":["fizykoterapia według potrzeb."]},"original":{"goals":["progress range of motion, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control."],"exercises":["Passive range of motion 0-60°, increasing by 10° per week until 90° is achieved.","Once 90° is achieved, active knee flexion 0-90° is allowed, but no active knee extension.","Continue with passive knee extension only","begin isometric quadriceps activation","core strengthening"],"applies_when":["Weeks 2-6"],"restrictions":["No active range of motion.","Weight-bearing and ambulation are allowed only with the brace at 10° of flexion.","No active knee extension."],"physiotherapist_actions":["modalities as needed."]}},"additional_notes_de":"Ziele: Progression des Bewegungsumfangs, Begrenzung von Schmerzen und Muskelatrophie, Schutz der Rekonstruktion und Beginn der neuromuskulären Kontrolle.","additional_notes_en":"Goals: progress range of motion, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control.","additional_notes_pl":"Cele: progresja zakresu ruchu, ograniczenie bólu i zaniku mięśni, ochrona naprawy oraz rozpoczęcie kontroli nerwowo-mięśniowej.","minimum_patient_share":null,"therapeutic_content_de":"Passiver Bewegungsumfang 0–60°, wöchentlich um 10° steigern, bis 90° erreicht sind. Nach Erreichen von 90° ist eine aktive Knieflexion von 0–90° erlaubt, weiterhin ohne aktive Knieextension. Knieextension ausschließlich passiv fortführen; isometrische Quadrizepsaktivierung beginnen; Rumpfkräftigung; physikalische Maßnahmen nach Bedarf.","therapeutic_content_en":"Passive range of motion 0-60°, increasing by 10° per week until 90° is achieved. Once 90° is achieved, active knee flexion 0-90° is allowed, but no active knee extension. Continue with passive knee extension only; begin isometric quadriceps activation; core strengthening; modalities as needed.","therapeutic_content_pl":"Bierny zakres ruchu 0–60°, zwiększany o 10° tygodniowo do uzyskania 90°. Po uzyskaniu 90° można wykonywać czynne zgięcie kolana 0–90°, nadal bez czynnego wyprostu. Kontynuować wyłącznie bierny wyprost kolana; rozpocząć izometryczną aktywację mięśnia czworogłowego; wzmacnianie centralne; fizykoterapia według potrzeb.","minimum_requirements_de":"Kein aktiver Bewegungsumfang. Belastung und Gehen nur mit auf 10° Flexion eingestellter Orthese. Keine aktive Knieextension.","minimum_requirements_en":"No active range of motion. Weight-bearing and ambulation are allowed only with the brace at 10° of flexion. No active knee extension.","minimum_requirements_pl":"Bez czynnego zakresu ruchu. Obciążanie i chodzenie wyłącznie z ortezą ustawioną w 10° zgięcia. Bez czynnego wyprostu kolana.","additional_notes_original":"Goals: Progress range of motion, minimize pain, retard muscle atrophy, protect the repair, and begin neuromuscular control","therapeutic_content_original":"Passive range of motion 0-60°, increasing by 10° per week until 90° is achieved. Once 90° is achieved, active knee flexion 0-90° is allowed, but no active knee extension. Continue with passive knee extension only; begin isometric quadriceps activation; core strengthening; modalities as needed.","minimum_requirements_original":"No active range of motion. Weight-bearing and ambulation are allowed only with the brace at 10° of flexion. No active knee extension.","structured_content_v2":"$undefined"},{"id":"54a79bfb-c06a-5e16-81f6-2ed59a51901f","name_de":"Phase 3: Wochen 6–12","name_en":"Phase 3: Weeks 6-12","name_pl":"Faza 3: tygodnie 6–12","source_page":1,"module_number":3,"name_original":"Phase 3: Weeks 6-12","service_codes":[],"structured_content":{"de":{"goals":["vollständiger Bewegungsumfang, minimale Schmerzen, Beginn von Muskelaktivierung und Kräftigung sowie Schutz der Rekonstruktion."],"exercises":["Progression zum vollständigen passiven, aktiven und aktiv-assistierten Bewegungsumfang ohne Widerstand","kontrolliertes Anheben des gestreckten Beins","Beginn einer leichten Kräftigung von Hüfte und Glutealmuskulatur","Fahrradergometer ohne Widerstand ab Woche 10."],"applies_when":["Wochen 6–12"],"restrictions":["Kein Widerstand bei Bewegungsübungen.","Eigentliche Kräftigungsübungen bis Woche 12 vermeiden."],"dosage_and_progression":["Belastung und Gehen mit im Bereich 0–45° entriegelter Orthese fortführen."]},"en":{"goals":["full range of motion, minimal pain, begin muscular activation and strengthening, and protect the repair."],"exercises":["Progress to full passive, active and active-assisted range of motion without resistance","controlled straight-leg raises","begin gentle hip and gluteal strengthening","stationary cycling without resistance at week 10."],"applies_when":["Weeks 6-12"],"restrictions":["No resistance during range-of-motion exercises.","Avoid true strengthening exercises until week 12."],"dosage_and_progression":["Continue weight-bearing and ambulation with the brace unlocked from 0-45°."]},"pl":{"goals":["pełny zakres ruchu, minimalny ból, rozpoczęcie aktywacji i wzmacniania mięśni oraz ochrona naprawy."],"exercises":["Progresja do pełnego biernego, czynnego i czynnego wspomaganego zakresu ruchu bez oporu","kontrolowane unoszenie wyprostowanej kończyny","rozpoczęcie łagodnego wzmacniania biodra i mięśni pośladkowych","rower stacjonarny bez oporu od 10. tygodnia."],"applies_when":["tygodnie 6–12"],"restrictions":["Bez oporu podczas ćwiczeń zakresu ruchu.","Unikać właściwych ćwiczeń wzmacniających do 12. tygodnia."],"dosage_and_progression":["Kontynuować obciążanie i chodzenie w ortezie odblokowanej w zakresie 0–45°."]},"original":{"goals":["full range of motion, minimal pain, begin muscular activation and strengthening, and protect the repair."],"exercises":["Progress to full passive, active and active-assisted range of motion without resistance","controlled straight-leg raises","begin gentle hip and gluteal strengthening","stationary cycling without resistance at week 10."],"applies_when":["Weeks 6-12"],"restrictions":["No resistance during range-of-motion exercises.","Avoid true strengthening exercises until week 12."],"dosage_and_progression":["Continue weight-bearing and ambulation with the brace unlocked from 0-45°."]}},"additional_notes_de":"Ziele: vollständiger Bewegungsumfang, minimale Schmerzen, Beginn von Muskelaktivierung und Kräftigung sowie Schutz der Rekonstruktion.","additional_notes_en":"Goals: full range of motion, minimal pain, begin muscular activation and strengthening, and protect the repair.","additional_notes_pl":"Cele: pełny zakres ruchu, minimalny ból, rozpoczęcie aktywacji i wzmacniania mięśni oraz ochrona naprawy.","minimum_patient_share":null,"therapeutic_content_de":"Progression zum vollständigen passiven, aktiven und aktiv-assistierten Bewegungsumfang ohne Widerstand; kontrolliertes Anheben des gestreckten Beins; Beginn einer leichten Kräftigung von Hüfte und Glutealmuskulatur; Fahrradergometer ohne Widerstand ab Woche 10.","therapeutic_content_en":"Progress to full passive, active and active-assisted range of motion without resistance; controlled straight-leg raises; begin gentle hip and gluteal strengthening; stationary cycling without resistance at week 10.","therapeutic_content_pl":"Progresja do pełnego biernego, czynnego i czynnego wspomaganego zakresu ruchu bez oporu; kontrolowane unoszenie wyprostowanej kończyny; rozpoczęcie łagodnego wzmacniania biodra i mięśni pośladkowych; rower stacjonarny bez oporu od 10. tygodnia.","minimum_requirements_de":"Belastung und Gehen mit im Bereich 0–45° entriegelter Orthese fortführen. Kein Widerstand bei Bewegungsübungen. Eigentliche Kräftigungsübungen bis Woche 12 vermeiden.","minimum_requirements_en":"Continue weight-bearing and ambulation with the brace unlocked from 0-45°. No resistance during range-of-motion exercises. Avoid true strengthening exercises until week 12.","minimum_requirements_pl":"Kontynuować obciążanie i chodzenie w ortezie odblokowanej w zakresie 0–45°. Bez oporu podczas ćwiczeń zakresu ruchu. Unikać właściwych ćwiczeń wzmacniających do 12. tygodnia.","additional_notes_original":"Goals: Full range of motion, minimal pain, begin muscular activation and strengthening, protect the repair","therapeutic_content_original":"Progress to full passive, active and active-assisted range of motion without resistance; controlled straight-leg raises; begin gentle hip and gluteal strengthening; stationary cycling without resistance at week 10.","minimum_requirements_original":"Continue weight-bearing and ambulation with the brace unlocked from 0-45°. No resistance during range-of-motion exercises. Avoid true strengthening exercises until week 12.","structured_content_v2":"$undefined"},{"id":"5da4adef-4a52-5bf4-bd79-7cf6c7b996fa","name_de":"Phase 4: Wochen 12–18","name_en":"Phase 4: Weeks 12-18","name_pl":"Faza 4: tygodnie 12–18","source_page":1,"module_number":4,"name_original":"Phase 4: Weeks 12-18","service_codes":[],"structured_content":{"de":{"goals":["korrekte Gangmechanik, Verbesserung der Kraft der unteren Extremität und neuromuskuläre Kontrolle."],"exercises":["aktive Knieextension mit begrenztem Widerstand beginnen und nach Verträglichkeit steigern","Fahrradergometer mit begrenztem Widerstand","leichtes beidbeiniges Krafttraining mit kleinen Kniebeugen und Ausfallschritten"],"applies_when":["Wochen 12–18"],"restrictions":["Keine funktionellen Sportbewegungen","Pivotbewegungen, Richtungswechsel und Sprünge vermeiden."],"dosage_and_progression":["Orthese ablegen."],"physiotherapist_actions":["Belastung und Gehen ohne Orthese","Gangtraining","Wassertherapie mit Beinbewegungen und Gangtraining."]},"en":{"goals":["proper gait mechanics, improved lower-extremity strength and neuromuscular control."],"exercises":["begin active knee extension with limited resistance and progress as tolerated","stationary cycling with limited resistance","gentle double-leg strengthening with mini squats and lunges"],"applies_when":["Weeks 12-18"],"restrictions":["No functional sports movements","avoid pivoting, cutting and jumping."],"dosage_and_progression":["Discontinue the brace."],"physiotherapist_actions":["Weight-bearing and ambulation without the brace","gait training","aquatic therapy with kicking and gait training."]},"pl":{"goals":["prawidłowa mechanika chodu, poprawa siły kończyny dolnej i kontrola nerwowo-mięśniowa."],"exercises":["rozpoczęcie czynnego wyprostu kolana z ograniczonym oporem i progresja według tolerancji","rower stacjonarny z ograniczonym oporem","łagodne wzmacnianie obunóż przez małe przysiady i wykroki"],"applies_when":["tygodnie 12–18"],"restrictions":["Bez funkcjonalnych ruchów sportowych","unikać zwrotów na obciążonej kończynie, zmian kierunku i skoków."],"dosage_and_progression":["Odstawić ortezę."],"physiotherapist_actions":["Obciążanie i chodzenie bez ortezy","trening chodu","terapia w wodzie obejmująca kopnięcia i trening chodu."]},"original":{"goals":["proper gait mechanics, improved lower-extremity strength and neuromuscular control."],"exercises":["begin active knee extension with limited resistance and progress as tolerated","stationary cycling with limited resistance","gentle double-leg strengthening with mini squats and lunges"],"applies_when":["Weeks 12-18"],"restrictions":["No functional sports movements","avoid pivoting, cutting and jumping."],"dosage_and_progression":["Discontinue the brace."],"physiotherapist_actions":["Weight-bearing and ambulation without the brace","gait training","aquatic therapy with kicking and gait training."]}},"additional_notes_de":"Ziele: korrekte Gangmechanik, Verbesserung der Kraft der unteren Extremität und neuromuskuläre Kontrolle.","additional_notes_en":"Goals: proper gait mechanics, improved lower-extremity strength and neuromuscular control.","additional_notes_pl":"Cele: prawidłowa mechanika chodu, poprawa siły kończyny dolnej i kontrola nerwowo-mięśniowa.","minimum_patient_share":null,"therapeutic_content_de":"Belastung und Gehen ohne Orthese; Gangtraining; aktive Knieextension mit begrenztem Widerstand beginnen und nach Verträglichkeit steigern; Fahrradergometer mit begrenztem Widerstand; leichtes beidbeiniges Krafttraining mit kleinen Kniebeugen und Ausfallschritten; Wassertherapie mit Beinbewegungen und Gangtraining.","therapeutic_content_en":"Weight-bearing and ambulation without the brace; gait training; begin active knee extension with limited resistance and progress as tolerated; stationary cycling with limited resistance; gentle double-leg strengthening with mini squats and lunges; aquatic therapy with kicking and gait training.","therapeutic_content_pl":"Obciążanie i chodzenie bez ortezy; trening chodu; rozpoczęcie czynnego wyprostu kolana z ograniczonym oporem i progresja według tolerancji; rower stacjonarny z ograniczonym oporem; łagodne wzmacnianie obunóż przez małe przysiady i wykroki; terapia w wodzie obejmująca kopnięcia i trening chodu.","minimum_requirements_de":"Orthese ablegen. Keine funktionellen Sportbewegungen; Pivotbewegungen, Richtungswechsel und Sprünge vermeiden.","minimum_requirements_en":"Discontinue the brace. No functional sports movements; avoid pivoting, cutting and jumping.","minimum_requirements_pl":"Odstawić ortezę. Bez funkcjonalnych ruchów sportowych; unikać zwrotów na obciążonej kończynie, zmian kierunku i skoków.","additional_notes_original":"Goals: Proper gait mechanics, improve lower extremity strength, neuromuscular control","therapeutic_content_original":"Weight-bearing and ambulation without the brace; gait training; begin active knee extension with limited resistance and progress as tolerated; stationary cycling with limited resistance; gentle double-leg strengthening with mini squats and lunges; aquatic therapy with kicking and gait training.","minimum_requirements_original":"Discontinue the brace. No functional sports movements; avoid pivoting, cutting and jumping.","structured_content_v2":"$undefined"},{"id":"e31fcd40-5bde-5068-8254-7da70aa23fe9","name_de":"Phase 5: Wochen 18–24","name_en":"Phase 5: Weeks 18-24","name_pl":"Faza 5: tygodnie 18–24","source_page":2,"module_number":5,"name_original":"Phase 5: Weeks 18-24","service_codes":[],"structured_content":{"de":{"goals":["Verbesserung der Kraft der unteren Extremität, Beginn des funktionellen Bewegungstrainings, Verbesserung der Propriozeption und exzentrische Kontrolle."],"exercises":["Abbremsen und einbeinige Sprünge beginnen","ab Woche 20 Richtungswechsel beginnen","ab Woche 20 Agility-Übungen mit Bodenleiter und Hütchen sowie sportartspezifische Aktivität beginnen."],"applies_when":["Wochen 18–24"],"progression_criteria":["Kraftdefizit von Quadrizeps und Glutealmuskulatur <10 %","Limb Symmetry Index ≥90 % bei funktionellen Sprung- und Y-Balance-Tests","45/50 Punkte in biomechanischen Funktionstests, sofern durchgeführt","keine Schmerzen oder berichtete Instabilität bei der Progression sportartspezifischer Fähigkeiten."],"dosage_and_progression":["Behutsame Progression zum Schutz der Rekonstruktion.","Joggen beginnen.","Progression zu anspruchsvolleren und sportartspezifischen Aktivitäten."]},"en":{"goals":["improve lower-extremity strength, begin functional-movement training, improve proprioception and eccentric control."],"exercises":["Initiate deceleration and single-leg hopping","initiate cutting at week 20","initiate agility at week 20 with floor-ladder and cone drills, and begin sport-specific activity."],"applies_when":["Weeks 18-24"],"progression_criteria":["<10% strength deficit in the quadriceps and gluteals","limb symmetry index ≥90% on functional hop and Y-Balance tests","45/50 on biomechanical functional assessment tests, if performed","no pain or complaints of instability during functional progression of sport-specific skills."],"dosage_and_progression":["Use a gentle progression to protect the repair.","Initiate jogging.","Progress to higher-level and sport-specific activities."]},"pl":{"goals":["poprawa siły kończyny dolnej, rozpoczęcie treningu ruchów funkcjonalnych, poprawa propriocepcji i kontrola ekscentryczna."],"exercises":["Rozpocząć hamowanie i skoki jednonóż","od 20. tygodnia rozpocząć zmiany kierunku","od 20. tygodnia rozpocząć ćwiczenia zwinnościowe na drabince podłogowej i z pachołkami oraz aktywność specyficzną dla sportu."],"applies_when":["tygodnie 18–24"],"progression_criteria":["deficyt siły mięśnia czworogłowego i mięśni pośladkowych <10%","wskaźnik symetrii kończyn ≥90% w funkcjonalnych testach skokowych i Y-Balance","wynik 45/50 w biomechanicznych testach funkcjonalnych, jeśli je wykonano","brak bólu i zgłaszanej niestabilności podczas progresji umiejętności specyficznych dla sportu."],"dosage_and_progression":["Progresję prowadzić łagodnie, aby uniknąć urazu naprawy.","Rozpocząć trucht.","Progresja do aktywności wyższego poziomu i aktywności specyficznych dla sportu."]},"original":{"goals":["improve lower-extremity strength, begin functional-movement training, improve proprioception and eccentric control."],"exercises":["Initiate deceleration and single-leg hopping","initiate cutting at week 20","initiate agility at week 20 with floor-ladder and cone drills, and begin sport-specific activity."],"applies_when":["Weeks 18-24"],"progression_criteria":["<10% strength deficit in the quadriceps and gluteals","limb symmetry index ≥90% on functional hop and Y-Balance tests","45/50 on biomechanical functional assessment tests, if performed","no pain or complaints of instability during functional progression of sport-specific skills."],"dosage_and_progression":["Use a gentle progression to protect the repair.","Initiate jogging.","Progress to higher-level and sport-specific activities."]}},"additional_notes_de":"Ziele: Verbesserung der Kraft der unteren Extremität, Beginn des funktionellen Bewegungstrainings, Verbesserung der Propriozeption und exzentrische Kontrolle. Entlassungskriterien: Kraftdefizit von Quadrizeps und Glutealmuskulatur <10 %; Limb Symmetry Index ≥90 % bei funktionellen Sprung- und Y-Balance-Tests; 45/50 Punkte in biomechanischen Funktionstests, sofern durchgeführt; keine Schmerzen oder berichtete Instabilität bei der Progression sportartspezifischer Fähigkeiten.","additional_notes_en":"Goals: improve lower-extremity strength, begin functional-movement training, improve proprioception and eccentric control. Discharge criteria: <10% strength deficit in the quadriceps and gluteals; limb symmetry index ≥90% on functional hop and Y-Balance tests; 45/50 on biomechanical functional assessment tests, if performed; no pain or complaints of instability during functional progression of sport-specific skills.","additional_notes_pl":"Cele: poprawa siły kończyny dolnej, rozpoczęcie treningu ruchów funkcjonalnych, poprawa propriocepcji i kontrola ekscentryczna. Kryteria wypisu: deficyt siły mięśnia czworogłowego i mięśni pośladkowych <10%; wskaźnik symetrii kończyn ≥90% w funkcjonalnych testach skokowych i Y-Balance; wynik 45/50 w biomechanicznych testach funkcjonalnych, jeśli je wykonano; brak bólu i zgłaszanej niestabilności podczas progresji umiejętności specyficznych dla sportu.","minimum_patient_share":null,"therapeutic_content_de":"Abbremsen und einbeinige Sprünge beginnen; ab Woche 20 Richtungswechsel beginnen; ab Woche 20 Agility-Übungen mit Bodenleiter und Hütchen sowie sportartspezifische Aktivität beginnen.","therapeutic_content_en":"Initiate deceleration and single-leg hopping; initiate cutting at week 20; initiate agility at week 20 with floor-ladder and cone drills, and begin sport-specific activity.","therapeutic_content_pl":"Rozpocząć hamowanie i skoki jednonóż; od 20. tygodnia rozpocząć zmiany kierunku; od 20. tygodnia rozpocząć ćwiczenia zwinnościowe na drabince podłogowej i z pachołkami oraz aktywność specyficzną dla sportu.","minimum_requirements_de":"Behutsame Progression zum Schutz der Rekonstruktion. Joggen beginnen. Progression zu anspruchsvolleren und sportartspezifischen Aktivitäten.","minimum_requirements_en":"Use a gentle progression to protect the repair. Initiate jogging. Progress to higher-level and sport-specific activities.","minimum_requirements_pl":"Progresję prowadzić łagodnie, aby uniknąć urazu naprawy. Rozpocząć trucht. Progresja do aktywności wyższego poziomu i aktywności specyficznych dla sportu.","additional_notes_original":"Goals: Improve lower extremity strength, begin functional movement training, proprioception improvement, eccentric control. Criteria for Discharge: <10% strength deficit in quads and gluteals; Limb similarity index of 90% or greater on functional hop and Y balance tests; 45/50 on biomechanical functional assessment tests (if performed); No pain or complains of instability with functional progression of sports specific skills","therapeutic_content_original":"Initiate deceleration and single-leg hopping; initiate cutting at week 20; initiate agility at week 20 with floor-ladder and cone drills, and begin sport-specific activity.","minimum_requirements_original":"Use a gentle progression to protect the repair. Initiate jogging. Progress to higher-level and sport-specific activities.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["knee","lower_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"5fed7dc2-3b93-56ac-8bab-57e6fcfd01fa","slug":"us-south-shore-23-triceps-tendon-repair","title_pl":"Protokół pooperacyjny naprawy ścięgna trójgłowego","title_de":"Postoperatives Rehabilitationsprotokoll Trizepssehne","title_en":"Triceps Tendon Repair Rehab Protocol","title_original":"Triceps Tendon Repair","summary_pl":"Protokół rehabilitacji po naprawie dystalnego ścięgna trójgłowego z wytycznymi zakresu ruchu i wzmacniania.","summary_de":"Rehabilitationsprotokoll nach distaler Trizepssehnenrekonstruktion mit Leitlinien für Bewegungsumfang und Kräftigung.","summary_en":"Rehab protocol following distal triceps tendon repair with guidelines for ROM progression and strengthening.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"ac5c5e52-a9f2-53f8-9d54-69e0d0daa673","condition_slug":"triceps-tendon-repair","condition_name_pl":"Stan po naprawie ścięgna trójgłowego ramienia","condition_name_de":"Zustand nach Trizepssehnenrekonstruktion","condition_name_en":"Triceps Tendon Repair","condition_name_original":"Triceps Tendon Repair","icd_codes":[],"category_key":"elbow","category_pl":"Łokieć","category_de":"Ellbogen","category_en":"Elbow","body_regions_pl":["łokieć"],"body_regions_de":["Ellbogen"],"body_regions_en":["elbow"],"search_terms_pl":["ścięgno trójgłowe","rehabilitacja pooperacyjna","triceps","łokieć","zakres ruchu"],"search_terms_de":["Trizepssehne","postoperative Rehabilitation","Trizeps","Ellbogen","Bewegungsumfang"],"search_terms_en":["triceps tendon","post-op rehab","triceps","elbow","range of motion"],"source_document_id":"81721d31-8f23-5385-a50e-77c2addbdbea","source_title":"Triceps Tendon Repair","issuer":"South Shore Orthopedics","source_country_code":"US","jurisdiction_code":"US-MA","authority_level":"hospital","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_unknown_requires_review","official_url":"https://octanecdn.com/southshoreorthopedicscom/southshoreorthopedicscom_954840561.pdf","source_sha256":"71bb0b46654e7b3a801b55a639dc5a92cf8f0c2ae83443630e8f7662bc74e5a5","authorization_required":false,"license_note":"Public source file retained locally for source verification.","modules":[{"id":"5883ca34-716a-5457-a8ef-bee58d0de98e","name_de":"Phase I: 0-12. Woche","name_en":"Phase I: 0-12 weeks","name_pl":"Faza I: 0-12 tydzień","source_page":1,"module_number":1,"name_original":"Phase I: 0-12 weeks","service_codes":[],"structured_content":{"de":{"exercises":["Einleitung des passiven Bewegungsumfangs (PROM) für Flexion: 2.-4. Woche bis 30°, 4.-5. Woche bis 50°, 5.-6. Woche bis 70°, 6.-7. Woche bis 90°, 7.-8. Woche bis 110°, 8.-12. Woche bis 130°.","Erreichung der vollen Streckung bis zur 8. Woche."],"applies_when":["0-12. Woche"],"restrictions":["Kein Ellbogenflexions-Stretching vor der 8.-10. Woche."],"dosage_and_progression":["Beginn der Bizeps-AROM im PROM-Bereich.","Orthese kann bei Erreichen des schmerzfreien vollen ROM abgesetzt werden."],"physiotherapist_actions":["Orthesenschulung."]},"en":{"exercises":["Implement PROM for flexion: 2-4 wks to 30°, 4-5 wks to 50°, 5-6 wks to 70°, 6-7 wks to 90°, 7-8 wks to 110°, 8-12 wks to 130°.","Achieve full extension by 8 weeks."],"applies_when":["0-12 weeks"],"restrictions":["No elbow flexion stretch until 8-10 weeks."],"dosage_and_progression":["Start bicep AROM within PROM.","Brace may be discontinued when tension-free full ROM is achieved."],"physiotherapist_actions":["Brace education."]},"pl":{"exercises":["Wdrożenie biernego zakresu ruchu (PROM) zgięcia: 2-4 tyg. do 30°, 4-5 tyg. do 50°, 5-6 tyg. do 70°, 6-7 tyg. do 90°, 7-8 tyg. do 110°, 8-12 tyg. do 130°.","Osiągnięcie pełnego wyprostu do 8 tygodnia."],"applies_when":["0-12 tydzień"],"restrictions":["Brak stretchingu zgięcia łokcia przed 8-10 tygodniem."],"dosage_and_progression":["Początek AROM bicepsa w zakresie PROM.","Możliwe odstawienie ortezy przy uzyskaniu pełnego zakresu bez napięcia."],"physiotherapist_actions":["Edukacja w zakresie ortezy."]},"original":{"exercises":["Implement PROM for flexion: 2-4 wks to 30°, 4-5 wks to 50°, 5-6 wks to 70°, 6-7 wks to 90°, 7-8 wks to 110°, 8-12 wks to 130°.","Achieve full extension by 8 weeks."],"applies_when":["0-12 weeks"],"restrictions":["No elbow flexion stretch until 8-10 weeks."],"dosage_and_progression":["Start bicep AROM within PROM.","Brace may be discontinued when tension-free full ROM is achieved."],"physiotherapist_actions":["Brace education."]}},"additional_notes_de":"Beginn der Bizeps-AROM im PROM-Bereich. Orthese kann bei Erreichen des schmerzfreien vollen ROM abgesetzt werden.","additional_notes_en":"Start bicep AROM within PROM. Brace may be discontinued when tension-free full ROM is achieved.","additional_notes_pl":"Początek AROM bicepsa w zakresie PROM. Możliwe odstawienie ortezy przy uzyskaniu pełnego zakresu bez napięcia.","minimum_patient_share":null,"therapeutic_content_de":"Orthesenschulung. Einleitung des passiven Bewegungsumfangs (PROM) für Flexion: 2.-4. Woche bis 30°, 4.-5. Woche bis 50°, 5.-6. Woche bis 70°, 6.-7. Woche bis 90°, 7.-8. Woche bis 110°, 8.-12. Woche bis 130°. Erreichung der vollen Streckung bis zur 8. Woche.","therapeutic_content_en":"Brace education. Implement PROM for flexion: 2-4 wks to 30°, 4-5 wks to 50°, 5-6 wks to 70°, 6-7 wks to 90°, 7-8 wks to 110°, 8-12 wks to 130°. Achieve full extension by 8 weeks.","therapeutic_content_pl":"Edukacja w zakresie ortezy. Wdrożenie biernego zakresu ruchu (PROM) zgięcia: 2-4 tyg. do 30°, 4-5 tyg. do 50°, 5-6 tyg. do 70°, 6-7 tyg. do 90°, 7-8 tyg. do 110°, 8-12 tyg. do 130°. Osiągnięcie pełnego wyprostu do 8 tygodnia.","minimum_requirements_de":"Kein Ellbogenflexions-Stretching vor der 8.-10. Woche.","minimum_requirements_en":"No elbow flexion stretch until 8-10 weeks.","minimum_requirements_pl":"Brak stretchingu zgięcia łokcia przed 8-10 tygodniem.","additional_notes_original":"Start bicep AROM within PROM. Brace may be discontinued when tension-free full ROM is achieved.","therapeutic_content_original":"Brace education. Implement PROM for flexion: 2-4 wks to 30°, 4-5 wks to 50°, 5-6 wks to 70°, 6-7 wks to 90°, 7-8 wks to 110°, 8-12 wks to 130°. Achieve full extension by 8 weeks.","minimum_requirements_original":"No elbow flexion stretch until 8-10 weeks.","structured_content_v2":"$undefined"},{"id":"229f2668-64ab-5db0-81eb-0faac5c952f9","name_de":"Phase II: 12.-16. Woche","name_en":"Phase II: 12-16 weeks","name_pl":"Faza II: 12-16 tydzień","source_page":1,"module_number":2,"name_original":"Phase II: 12-16 weeks","service_codes":[],"structured_content":{"de":{"exercises":["Steigerung des Bewegungsumfangs nach Toleranz."],"applies_when":["12.-16. Woche"],"restrictions":["Kein Widerstand für den Trizeps bis zur 16. Woche."]},"en":{"exercises":["Increase range of motion to tolerance."],"applies_when":["12-16 weeks"],"restrictions":["No triceps resistance until 16 weeks."]},"pl":{"exercises":["Zwiększanie zakresu ruchu do tolerancji."],"applies_when":["12-16 tydzień"],"restrictions":["Zakaz stosowania oporu dla tricepsa do 16. tygodnia."]},"original":{"exercises":["Increase range of motion to tolerance."],"applies_when":["12-16 weeks"],"restrictions":["No triceps resistance until 16 weeks."]}},"additional_notes_de":"","additional_notes_en":"","additional_notes_pl":"","minimum_patient_share":null,"therapeutic_content_de":"Steigerung des Bewegungsumfangs nach Toleranz.","therapeutic_content_en":"Increase range of motion to tolerance.","therapeutic_content_pl":"Zwiększanie zakresu ruchu do tolerancji.","minimum_requirements_de":"Kein Widerstand für den Trizeps bis zur 16. Woche.","minimum_requirements_en":"No triceps resistance until 16 weeks.","minimum_requirements_pl":"Zakaz stosowania oporu dla tricepsa do 16. tygodnia.","additional_notes_original":"","therapeutic_content_original":"Increase range of motion to tolerance.","minimum_requirements_original":"No triceps resistance until 16 weeks.","structured_content_v2":"$undefined"},{"id":"ab3c0e11-a39e-52c7-ab43-a461fe608afb","name_de":"Phase III: Nach der 16. Woche","name_en":"Phase III: Beyond 16 weeks","name_pl":"Faza III: Powyżej 16. tygodnia","source_page":1,"module_number":3,"name_original":"Phase III: Beyond 16 weeks","service_codes":[],"structured_content":{"de":{"exercises":["Voller Bewegungsumfang, Rückkehr zu ADLs.","Schulterkräftigung."],"applies_when":["Nach der 16. Woche"],"dosage_and_progression":["Graduelle Trizepskräftigung: Isometrie -> Isotonik -> Konzentrik -> Exzentrik.","Einführung von Wurfsportarten nach Genehmigung durch den Chirurgen."]},"en":{"exercises":["Full ROM, return to ADLs.","Shoulder strengthening."],"applies_when":["Beyond 16 weeks"],"dosage_and_progression":["Gradual triceps strengthening: isometrics -> isotonic -> concentric -> eccentric.","Gradual introduction of throwing activities as authorized by surgeon."]},"pl":{"exercises":["Pełny zakres ruchu, powrót do ADL.","Wzmacnianie barku."],"applies_when":["Powyżej 16. tygodnia"],"dosage_and_progression":["Stopniowe wzmacnianie tricepsa: izometria -> izotonika -> koncentryka -> ekscentryka.","Wprowadzenie aktywności rzutowych zgodnie z wytycznymi chirurga."]},"original":{"exercises":["Full ROM, return to ADLs.","Shoulder strengthening."],"applies_when":["Beyond 16 weeks"],"dosage_and_progression":["Gradual triceps strengthening: isometrics -> isotonic -> concentric -> eccentric.","Gradual introduction of throwing activities as authorized by surgeon."]}},"additional_notes_de":"","additional_notes_en":"","additional_notes_pl":"","minimum_patient_share":null,"therapeutic_content_de":"Voller Bewegungsumfang, Rückkehr zu ADLs. Graduelle Trizepskräftigung: Isometrie -> Isotonik -> Konzentrik -> Exzentrik. Schulterkräftigung.","therapeutic_content_en":"Full ROM, return to ADLs. Gradual triceps strengthening: isometrics -> isotonic -> concentric -> eccentric. Shoulder strengthening.","therapeutic_content_pl":"Pełny zakres ruchu, powrót do ADL. Stopniowe wzmacnianie tricepsa: izometria -> izotonika -> koncentryka -> ekscentryka. Wzmacnianie barku.","minimum_requirements_de":"Einführung von Wurfsportarten nach Genehmigung durch den Chirurgen.","minimum_requirements_en":"Gradual introduction of throwing activities as authorized by surgeon.","minimum_requirements_pl":"Wprowadzenie aktywności rzutowych zgodnie z wytycznymi chirurga.","additional_notes_original":"","therapeutic_content_original":"Full ROM, return to ADLs. Gradual triceps strengthening: isometrics -> isotonic -> concentric -> eccentric. Shoulder strengthening.","minimum_requirements_original":"Gradual introduction of throwing activities as authorized by surgeon.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["elbow","upper_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"3a8f9798-1769-59ad-a53d-d03b4b6b4693","slug":"us-jared-lee-20-triceps-tendon-repair","title_pl":"Protokół rehabilitacji po naprawie ścięgna mięśnia trójgłowego ramienia","title_de":"Rehabilitationsprotokoll nach Rekonstruktion der Trizepssehne","title_en":"Triceps Tendon Repair Rehabilitation Protocol","title_original":"Triceps Tendon Repair","summary_pl":"Protokół rehabilitacji po naprawie ścięgna mięśnia trójgłowego ramienia, zachowujący powtórzoną numerację faz ze źródła.","summary_de":"Rehabilitationsprotokoll nach Rekonstruktion der Trizepssehne unter Beibehaltung der wiederholten Phasennummerierung der Quelle.","summary_en":"Rehabilitation protocol after triceps tendon repair, preserving the repeated phase numbering in the source.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"ac5c5e52-a9f2-53f8-9d54-69e0d0daa673","condition_slug":"triceps-tendon-repair","condition_name_pl":"Stan po naprawie ścięgna trójgłowego ramienia","condition_name_de":"Zustand nach Trizepssehnenrekonstruktion","condition_name_en":"Triceps Tendon Repair","condition_name_original":"Triceps Tendon Repair","icd_codes":[],"category_key":"elbow","category_pl":"Łokieć","category_de":"Ellbogen","category_en":"Elbow","body_regions_pl":["łokieć"],"body_regions_de":["Ellbogen"],"body_regions_en":["elbow"],"search_terms_pl":["ścięgno trójgłowe","rehabilitacja pooperacyjna","triceps","łokieć","zakres ruchu"],"search_terms_de":["Trizepssehne","postoperative Rehabilitation","Trizeps","Ellbogen","Bewegungsumfang"],"search_terms_en":["triceps tendon","post-op rehab","triceps","elbow","range of motion"],"source_document_id":"7626325a-2da0-58b0-8678-40b5139eca9b","source_title":"Triceps Tendon Repair","issuer":"Jared Lee, MD","source_country_code":"US","jurisdiction_code":"US-CO","authority_level":"clinic","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_requires_review","official_url":"https://jaredleemd.com/wp-content/uploads/2025/06/Triceps-Tendon-Repair-Final.pdf","source_sha256":"ce1c243bb1aee8662b9cb167ec8e75331359eb96256149dcab5602eb8fb4042d","authorization_required":true,"license_note":"All Rights Reserved. Authorization is required before final public release. Current development and staging remain allowed by the owner's decision.","modules":[{"id":"e090da63-7d9d-5e03-8b4c-87dfc27db9aa","name_de":"Phase 1: Wochen 0–2","name_en":"Phase 1: Weeks 0-2","name_pl":"Faza 1: tygodnie 0–2","source_page":1,"module_number":1,"name_original":"Phase 1: Weeks 0-2","service_codes":[],"structured_content":{"de":{"goals":["Schutz der Rekonstruktion."],"exercises":["Uneingeschränkter Bewegungsumfang von Hand und Fingern","Bewegungsübungen und Dehnung der Halswirbelsäule","vollständiger Bewegungsumfang der Schulter bei angelegter Schiene."],"applies_when":["Wochen 0–2"],"restrictions":["Posteriore Armschiene durchgehend tragen","nicht mehr als 3 lb heben."],"dosage_and_progression":["Physiotherapie optional, Beginn nach 2 Wochen"]},"en":{"goals":["protect the repair."],"exercises":["Unrestricted hand and finger range of motion","neck range of motion and stretching","full shoulder range of motion with the splint in place."],"applies_when":["Weeks 0-2"],"restrictions":["Wear the posterior arm splint at all times","do not lift more than 3 lb."],"dosage_and_progression":["physical therapy is optional and begins at 2 weeks"]},"pl":{"goals":["ochrona naprawy."],"exercises":["Nieograniczony zakres ruchu ręki i palców","ruchy i rozciąganie odcinka szyjnego","pełny zakres ruchu barku z założoną szyną."],"applies_when":["tygodnie 0–2"],"restrictions":["Tylna szyna ramienna przez cały czas","nie podnosić więcej niż 3 lb."],"dosage_and_progression":["fizjoterapia opcjonalna, rozpoczęcie po 2 tygodniach"]},"original":{"goals":["protect the repair."],"exercises":["Unrestricted hand and finger range of motion","neck range of motion and stretching","full shoulder range of motion with the splint in place."],"applies_when":["Weeks 0-2"],"restrictions":["Wear the posterior arm splint at all times","do not lift more than 3 lb."],"dosage_and_progression":["physical therapy is optional and begins at 2 weeks"]}},"additional_notes_de":"Ziel: Schutz der Rekonstruktion.","additional_notes_en":"Goal: protect the repair.","additional_notes_pl":"Cel: ochrona naprawy.","minimum_patient_share":null,"therapeutic_content_de":"Uneingeschränkter Bewegungsumfang von Hand und Fingern; Bewegungsübungen und Dehnung der Halswirbelsäule; vollständiger Bewegungsumfang der Schulter bei angelegter Schiene.","therapeutic_content_en":"Unrestricted hand and finger range of motion; neck range of motion and stretching; full shoulder range of motion with the splint in place.","therapeutic_content_pl":"Nieograniczony zakres ruchu ręki i palców; ruchy i rozciąganie odcinka szyjnego; pełny zakres ruchu barku z założoną szyną.","minimum_requirements_de":"Posteriore Armschiene durchgehend tragen; Physiotherapie optional, Beginn nach 2 Wochen; nicht mehr als 3 lb heben.","minimum_requirements_en":"Wear the posterior arm splint at all times; physical therapy is optional and begins at 2 weeks; do not lift more than 3 lb.","minimum_requirements_pl":"Tylna szyna ramienna przez cały czas; fizjoterapia opcjonalna, rozpoczęcie po 2 tygodniach; nie podnosić więcej niż 3 lb.","additional_notes_original":"Goal: protect the repair.","therapeutic_content_original":"Unrestricted hand and finger range of motion; neck range of motion and stretching; full shoulder range of motion with the splint in place.","minimum_requirements_original":"Wear the posterior arm splint at all times; physical therapy is optional and begins at 2 weeks; do not lift more than 3 lb.","structured_content_v2":"$undefined"},{"id":"751cb2fc-eba9-570e-9dc4-69b4abaf8acc","name_de":"Phase 2: Wochen 2–5","name_en":"Phase 2: Weeks 2-5","name_pl":"Faza 2: tygodnie 2–5","source_page":1,"module_number":2,"name_original":"Phase 2: Weeks 2-5","service_codes":[],"structured_content":{"de":{"goals":["Schutz der Rekonstruktion, Wiederherstellung des Bewegungsumfangs sowie Begrenzung von Muskelatrophie und Schmerzen."],"exercises":["Passive, aktive und aktiv-assistierte Ellenbogenflexion","Flexionsumfang 0–60° bis zur 4. postoperativen Woche, danach Steigerung um 10° pro Woche bis zum vollständigen Bewegungsumfang","uneingeschränkter Bewegungsumfang von Handgelenk, Hand und Fingern","ab Woche 3 leichtes Skapulatraining und Schulterisometrie","Griffkräftigung"],"applies_when":["Wochen 2–5"],"restrictions":["Ellenbogenorthese mit Gelenk 2 Wochen lang auf 40° eingestellt tragen.","Keine aktive Extension für 6 Wochen.","Die Orthese durchgehend, auch beim Schlafen, tragen; ausgenommen sind Hygiene sowie Physio- oder Heimübungen.","Bis zur 6. postoperativen Woche nicht mehr als 3 lb heben."],"dosage_and_progression":["Physiotherapie beginnen."],"physiotherapist_actions":["Narbenmobilisation","physikalische Maßnahmen nach Bedarf"]},"en":{"goals":["protect the repair, restore range of motion, retard muscle atrophy and minimize pain."],"exercises":["Passive, active and active-assisted elbow flexion","flexion range of motion 0-60° until 4 weeks postoperatively, then increase by 10° per week until full range of motion is achieved","unrestricted wrist, hand and finger range of motion","initiate light scapular strengthening and shoulder isometrics at week 3","grip strengthening"],"applies_when":["Weeks 2-5"],"restrictions":["Wear a hinged elbow brace set to 40° for 2 weeks.","No active extension for 6 weeks.","Wear the brace at all times, including while sleeping, except for hygiene and physical therapy or home exercises.","Do not lift more than 3 lb until 6 weeks postoperatively."],"dosage_and_progression":["Begin physical therapy."],"physiotherapist_actions":["scar mobilization","modalities as needed."]},"pl":{"goals":["ochrona naprawy, odzyskiwanie zakresu ruchu, ograniczenie zaniku mięśni i bólu."],"exercises":["Bierne, czynne i czynne wspomagane zgięcie łokcia","zakres zgięcia 0–60° do 4. tygodnia po zabiegu, następnie zwiększanie o 10° tygodniowo do uzyskania pełnego zakresu","nieograniczony zakres ruchu nadgarstka, ręki i palców","od 3. tygodnia lekkie wzmacnianie mięśni łopatki i izometria barku","wzmacnianie chwytu"],"applies_when":["tygodnie 2–5"],"restrictions":["Nosić zawiasową ortezę łokcia ustawioną na 40° przez 2 tygodnie.","Bez czynnego wyprostu przez 6 tygodni.","Orteza przez cały czas, także podczas snu, z wyjątkiem higieny oraz fizjoterapii lub ćwiczeń domowych.","Nie podnosić więcej niż 3 lb do 6. tygodnia po zabiegu."],"dosage_and_progression":["Rozpocząć fizjoterapię."],"physiotherapist_actions":["mobilizacja blizny","fizykoterapia według potrzeb"]},"original":{"goals":["protect the repair, restore range of motion, retard muscle atrophy and minimize pain."],"exercises":["Passive, active and active-assisted elbow flexion","flexion range of motion 0-60° until 4 weeks postoperatively, then increase by 10° per week until full range of motion is achieved","unrestricted wrist, hand and finger range of motion","initiate light scapular strengthening and shoulder isometrics at week 3","grip strengthening"],"applies_when":["Weeks 2-5"],"restrictions":["Wear a hinged elbow brace set to 40° for 2 weeks.","No active extension for 6 weeks.","Wear the brace at all times, including while sleeping, except for hygiene and physical therapy or home exercises.","Do not lift more than 3 lb until 6 weeks postoperatively."],"dosage_and_progression":["Begin physical therapy."],"physiotherapist_actions":["scar mobilization","modalities as needed."]}},"additional_notes_de":"Ziele: Schutz der Rekonstruktion, Wiederherstellung des Bewegungsumfangs sowie Begrenzung von Muskelatrophie und Schmerzen.","additional_notes_en":"Goals: protect the repair, restore range of motion, retard muscle atrophy and minimize pain.","additional_notes_pl":"Cele: ochrona naprawy, odzyskiwanie zakresu ruchu, ograniczenie zaniku mięśni i bólu.","minimum_patient_share":null,"therapeutic_content_de":"Passive, aktive und aktiv-assistierte Ellenbogenflexion; Flexionsumfang 0–60° bis zur 4. postoperativen Woche, danach Steigerung um 10° pro Woche bis zum vollständigen Bewegungsumfang; uneingeschränkter Bewegungsumfang von Handgelenk, Hand und Fingern; Narbenmobilisation; ab Woche 3 leichtes Skapulatraining und Schulterisometrie; Griffkräftigung; physikalische Maßnahmen nach Bedarf.","therapeutic_content_en":"Passive, active and active-assisted elbow flexion; flexion range of motion 0-60° until 4 weeks postoperatively, then increase by 10° per week until full range of motion is achieved; unrestricted wrist, hand and finger range of motion; scar mobilization; initiate light scapular strengthening and shoulder isometrics at week 3; grip strengthening; modalities as needed.","therapeutic_content_pl":"Bierne, czynne i czynne wspomagane zgięcie łokcia; zakres zgięcia 0–60° do 4. tygodnia po zabiegu, następnie zwiększanie o 10° tygodniowo do uzyskania pełnego zakresu; nieograniczony zakres ruchu nadgarstka, ręki i palców; mobilizacja blizny; od 3. tygodnia lekkie wzmacnianie mięśni łopatki i izometria barku; wzmacnianie chwytu; fizykoterapia według potrzeb.","minimum_requirements_de":"Physiotherapie beginnen. Ellenbogenorthese mit Gelenk 2 Wochen lang auf 40° eingestellt tragen. Keine aktive Extension für 6 Wochen. Die Orthese durchgehend, auch beim Schlafen, tragen; ausgenommen sind Hygiene sowie Physio- oder Heimübungen. Bis zur 6. postoperativen Woche nicht mehr als 3 lb heben.","minimum_requirements_en":"Begin physical therapy. Wear a hinged elbow brace set to 40° for 2 weeks. No active extension for 6 weeks. Wear the brace at all times, including while sleeping, except for hygiene and physical therapy or home exercises. Do not lift more than 3 lb until 6 weeks postoperatively.","minimum_requirements_pl":"Rozpocząć fizjoterapię. Nosić zawiasową ortezę łokcia ustawioną na 40° przez 2 tygodnie. Bez czynnego wyprostu przez 6 tygodni. Orteza przez cały czas, także podczas snu, z wyjątkiem higieny oraz fizjoterapii lub ćwiczeń domowych. Nie podnosić więcej niż 3 lb do 6. tygodnia po zabiegu.","additional_notes_original":"Goals: protect the repair, restore range of motion, retard muscle atrophy and minimize pain.","therapeutic_content_original":"Passive, active and active-assisted elbow flexion; flexion range of motion 0-60° until 4 weeks postoperatively, then increase by 10° per week until full range of motion is achieved; unrestricted wrist, hand and finger range of motion; scar mobilization; initiate light scapular strengthening and shoulder isometrics at week 3; grip strengthening; modalities as needed.","minimum_requirements_original":"Begin physical therapy. Wear a hinged elbow brace set to 40° for 2 weeks. No active extension for 6 weeks. Wear the brace at all times, including while sleeping, except for hygiene and physical therapy or home exercises. Do not lift more than 3 lb until 6 weeks postoperatively.","structured_content_v2":"$undefined"},{"id":"ba96cfbe-6b26-567f-ab51-86f89e22838f","name_de":"Phase 3: Wochen 6–9","name_en":"Phase 3: Weeks 6-9","name_pl":"Faza 3: tygodnie 6–9","source_page":1,"module_number":3,"name_original":"Phase 3: Weeks 6-9","service_codes":[],"structured_content":{"de":{"goals":["vollständiger Bewegungsumfang, minimale Schmerzen, Beginn der Muskelaktivierung und Schutz der Rekonstruktion."],"exercises":["Vollständiger passiver, aktiver und aktiv-assistierter Bewegungsumfang ohne Widerstand","Progression des Skapulatrainings","Dehnung und Kräftigung der Halswirbelsäule","Beginn am Oberkörperergometer ohne Widerstand","Rumpfstabilisation","Fortführung der bisherigen Übungen"],"applies_when":["Wochen 6–9"],"restrictions":["Keine Einschränkungen des Bewegungsumfangs.","Keine Gegenstände über 10 lb heben."],"progression_criteria":["Die Ellenbogenorthese mit Gelenk ablegen, sobald der Bewegungsumfang vollständig und die motorische Kontrolle des Ellenbogens ausreichend ist."]},"en":{"goals":["full range of motion, minimal pain, begin muscular activation and protect the repair."],"exercises":["Full passive, active and active-assisted range of motion without resistance","progress scapular strengthening","neck stretching and strengthening","begin upper-body ergometer cycling without resistance","core stabilization","continue prior exercises"],"applies_when":["Weeks 6-9"],"restrictions":["No range-of-motion restrictions.","Do not lift objects heavier than 10 lb."],"progression_criteria":["Discontinue the hinged elbow brace when range of motion is full and elbow motor control is adequate."]},"pl":{"goals":["pełny zakres ruchu, minimalny ból, rozpoczęcie aktywacji mięśniowej i ochrona naprawy."],"exercises":["Pełny bierny, czynny i czynny wspomagany zakres ruchu bez oporu","progresja wzmacniania mięśni łopatki","rozciąganie i wzmacnianie odcinka szyjnego","rozpoczęcie ćwiczeń na ergometrze kończyn górnych bez oporu","stabilizacja centralna","kontynuacja wcześniejszych ćwiczeń"],"applies_when":["tygodnie 6–9"],"restrictions":["Bez ograniczeń zakresu ruchu.","Nie podnosić przedmiotów cięższych niż 10 lb."],"progression_criteria":["Odstawić zawiasową ortezę łokcia po uzyskaniu pełnego zakresu ruchu i odpowiedniej kontroli motorycznej łokcia."]},"original":{"goals":["full range of motion, minimal pain, begin muscular activation and protect the repair."],"exercises":["Full passive, active and active-assisted range of motion without resistance","progress scapular strengthening","neck stretching and strengthening","begin upper-body ergometer cycling without resistance","core stabilization","continue prior exercises"],"applies_when":["Weeks 6-9"],"restrictions":["No range-of-motion restrictions.","Do not lift objects heavier than 10 lb."],"progression_criteria":["Discontinue the hinged elbow brace when range of motion is full and elbow motor control is adequate."]}},"additional_notes_de":"Ziele: vollständiger Bewegungsumfang, minimale Schmerzen, Beginn der Muskelaktivierung und Schutz der Rekonstruktion.","additional_notes_en":"Goals: full range of motion, minimal pain, begin muscular activation and protect the repair.","additional_notes_pl":"Cele: pełny zakres ruchu, minimalny ból, rozpoczęcie aktywacji mięśniowej i ochrona naprawy.","minimum_patient_share":null,"therapeutic_content_de":"Vollständiger passiver, aktiver und aktiv-assistierter Bewegungsumfang ohne Widerstand; Progression des Skapulatrainings; Dehnung und Kräftigung der Halswirbelsäule; Beginn am Oberkörperergometer ohne Widerstand; Rumpfstabilisation; Fortführung der bisherigen Übungen.","therapeutic_content_en":"Full passive, active and active-assisted range of motion without resistance; progress scapular strengthening; neck stretching and strengthening; begin upper-body ergometer cycling without resistance; core stabilization; continue prior exercises.","therapeutic_content_pl":"Pełny bierny, czynny i czynny wspomagany zakres ruchu bez oporu; progresja wzmacniania mięśni łopatki; rozciąganie i wzmacnianie odcinka szyjnego; rozpoczęcie ćwiczeń na ergometrze kończyn górnych bez oporu; stabilizacja centralna; kontynuacja wcześniejszych ćwiczeń.","minimum_requirements_de":"Die Ellenbogenorthese mit Gelenk ablegen, sobald der Bewegungsumfang vollständig und die motorische Kontrolle des Ellenbogens ausreichend ist. Keine Einschränkungen des Bewegungsumfangs. Keine Gegenstände über 10 lb heben.","minimum_requirements_en":"Discontinue the hinged elbow brace when range of motion is full and elbow motor control is adequate. No range-of-motion restrictions. Do not lift objects heavier than 10 lb.","minimum_requirements_pl":"Odstawić zawiasową ortezę łokcia po uzyskaniu pełnego zakresu ruchu i odpowiedniej kontroli motorycznej łokcia. Bez ograniczeń zakresu ruchu. Nie podnosić przedmiotów cięższych niż 10 lb.","additional_notes_original":"Goals: full range of motion, minimal pain, begin muscular activation and protect the repair.","therapeutic_content_original":"Full passive, active and active-assisted range of motion without resistance; progress scapular strengthening; neck stretching and strengthening; begin upper-body ergometer cycling without resistance; core stabilization; continue prior exercises.","minimum_requirements_original":"Discontinue the hinged elbow brace when range of motion is full and elbow motor control is adequate. No range-of-motion restrictions. Do not lift objects heavier than 10 lb.","structured_content_v2":"$undefined"},{"id":"47c673b4-7abb-52f2-bd22-219004de482d","name_de":"Phase 3: Wochen 10–11","name_en":"Phase 3: Weeks 10-11","name_pl":"Faza 3: tygodnie 10–11","source_page":2,"module_number":4,"name_original":"Phase 3: Weeks 10-11","service_codes":[],"structured_content":{"de":{"goals":["vollständiger Bewegungsumfang, minimale Schmerzen, Beginn von Muskelaktivierung und Kräftigung sowie Schutz der Rekonstruktion."],"exercises":["Leichtes Krafttraining beginnen: exzentrische Ellenbogenflexion und -extension, isotonisches Programm für Unterarm und Handgelenk, diagonale Bewegungsmuster gegen manuellen Widerstand sowie plyometrische Übungen mit Brustpass und seitlichem Wurf körpernah","Dehnung und Kräftigung der Halswirbelsäule","vollständigen Bewegungsumfang des Ellenbogens fortführen"],"applies_when":["Wochen 10–11"],"restrictions":["Keine Gegenstände über 10 lb heben."],"progression_criteria":["Die Ellenbogenorthese mit Gelenk ablegen, sobald der Bewegungsumfang vollständig und die motorische Kontrolle des Ellenbogens ausreichend ist."]},"en":{"goals":["full range of motion, minimal pain, begin muscular activation and strengthening, and protect the repair."],"exercises":["Begin light strengthening: eccentric elbow flexion and extension, an isotonic forearm and wrist program, manual-resistance diagonal patterns and plyometric exercises with chest pass and side throw close to the body","neck stretching and strengthening","continue full elbow range of motion"],"applies_when":["Weeks 10-11"],"restrictions":["Do not lift objects heavier than 10 lb."],"progression_criteria":["Discontinue the hinged elbow brace when range of motion is full and elbow motor control is adequate."]},"pl":{"goals":["pełny zakres ruchu, minimalny ból, rozpoczęcie aktywacji i wzmacniania mięśni oraz ochrona naprawy."],"exercises":["Rozpocząć lekkie wzmacnianie: ekscentryczne zginanie i prostowanie łokcia, izotoniczny program dla przedramienia i nadgarstka, diagonalne wzorce z oporem manualnym oraz ćwiczenia plyometryczne — podanie sprzed klatki piersiowej i rzut bokiem blisko tułowia","rozciąganie i wzmacnianie odcinka szyjnego","kontynuacja pełnego zakresu ruchu łokcia"],"applies_when":["tygodnie 10–11"],"restrictions":["Nie podnosić przedmiotów cięższych niż 10 lb."],"progression_criteria":["Odstawić zawiasową ortezę łokcia po uzyskaniu pełnego zakresu ruchu i odpowiedniej kontroli motorycznej łokcia."]},"original":{"goals":["full range of motion, minimal pain, begin muscular activation and strengthening, and protect the repair."],"exercises":["Begin light strengthening: eccentric elbow flexion and extension, an isotonic forearm and wrist program, manual-resistance diagonal patterns and plyometric exercises with chest pass and side throw close to the body","neck stretching and strengthening","continue full elbow range of motion"],"applies_when":["Weeks 10-11"],"restrictions":["Do not lift objects heavier than 10 lb."],"progression_criteria":["Discontinue the hinged elbow brace when range of motion is full and elbow motor control is adequate."]}},"additional_notes_de":"Ziele: vollständiger Bewegungsumfang, minimale Schmerzen, Beginn von Muskelaktivierung und Kräftigung sowie Schutz der Rekonstruktion.","additional_notes_en":"Goals: full range of motion, minimal pain, begin muscular activation and strengthening, and protect the repair.","additional_notes_pl":"Cele: pełny zakres ruchu, minimalny ból, rozpoczęcie aktywacji i wzmacniania mięśni oraz ochrona naprawy.","minimum_patient_share":null,"therapeutic_content_de":"Leichtes Krafttraining beginnen: exzentrische Ellenbogenflexion und -extension, isotonisches Programm für Unterarm und Handgelenk, diagonale Bewegungsmuster gegen manuellen Widerstand sowie plyometrische Übungen mit Brustpass und seitlichem Wurf körpernah; Dehnung und Kräftigung der Halswirbelsäule; vollständigen Bewegungsumfang des Ellenbogens fortführen.","therapeutic_content_en":"Begin light strengthening: eccentric elbow flexion and extension, an isotonic forearm and wrist program, manual-resistance diagonal patterns and plyometric exercises with chest pass and side throw close to the body; neck stretching and strengthening; continue full elbow range of motion.","therapeutic_content_pl":"Rozpocząć lekkie wzmacnianie: ekscentryczne zginanie i prostowanie łokcia, izotoniczny program dla przedramienia i nadgarstka, diagonalne wzorce z oporem manualnym oraz ćwiczenia plyometryczne — podanie sprzed klatki piersiowej i rzut bokiem blisko tułowia; rozciąganie i wzmacnianie odcinka szyjnego; kontynuacja pełnego zakresu ruchu łokcia.","minimum_requirements_de":"Die Ellenbogenorthese mit Gelenk ablegen, sobald der Bewegungsumfang vollständig und die motorische Kontrolle des Ellenbogens ausreichend ist. Keine Gegenstände über 10 lb heben.","minimum_requirements_en":"Discontinue the hinged elbow brace when range of motion is full and elbow motor control is adequate. Do not lift objects heavier than 10 lb.","minimum_requirements_pl":"Odstawić zawiasową ortezę łokcia po uzyskaniu pełnego zakresu ruchu i odpowiedniej kontroli motorycznej łokcia. Nie podnosić przedmiotów cięższych niż 10 lb.","additional_notes_original":"Goals: full range of motion, minimal pain, begin muscular activation and strengthening, and protect the repair.","therapeutic_content_original":"Begin light strengthening: eccentric elbow flexion and extension, an isotonic forearm and wrist program, manual-resistance diagonal patterns and plyometric exercises with chest pass and side throw close to the body; neck stretching and strengthening; continue full elbow range of motion.","minimum_requirements_original":"Discontinue the hinged elbow brace when range of motion is full and elbow motor control is adequate. Do not lift objects heavier than 10 lb.","structured_content_v2":"$undefined"},{"id":"2420a82f-360b-537f-a1be-c1920c879507","name_de":"Phase 4: Wochen 12–13","name_en":"Phase 4: Weeks 12-13","name_pl":"Faza 4: tygodnie 12–13","source_page":2,"module_number":5,"name_original":"Phase 4: Weeks 12-13","service_codes":[],"structured_content":{"de":{"goals":["Progression funktioneller Aktivitäten sowie fortgeschrittener sportlicher und freizeitbezogener Aktivität nach Maßgabe des Operateurs."],"exercises":["Kräftigungsübungen steigern","Oberkörperergometer mit Widerstand beginnen","plyometrische Übungen einführen und nach Verträglichkeit steigern: Übungen mit 2 Händen fern vom Körper, Würfe von Seite zu Seite, Fußballwürfe und seitliche Würfe","Schwerpunkt auf Handgelenksleistung","Beweglichkeitsübungen für Ellenbogen und Handgelenk."],"applies_when":["Wochen 12–13"],"restrictions":["Kein schweres Krafttraining bis Woche 16."]},"en":{"goals":["progress functional activities and advanced sport and recreational activity as directed by the surgeon."],"exercises":["Increase strengthening exercises","begin upper-body ergometer cycling with resistance","introduce and progress plyometrics as tolerated: 2-hand drills away from the body, side-to-side throws, soccer throws and side throws","emphasize wrist power","elbow and wrist flexibility exercises."],"applies_when":["Weeks 12-13"],"restrictions":["No heavy weightlifting until week 16."]},"pl":{"goals":["progresja aktywności funkcjonalnych oraz zaawansowanej aktywności sportowej i rekreacyjnej zgodnie z decyzją chirurga."],"exercises":["Zwiększać ćwiczenia wzmacniające","rozpocząć ćwiczenia na ergometrze kończyn górnych z oporem","wprowadzić i zwiększać według tolerancji ćwiczenia plyometryczne: ćwiczenia 2 rękami z dala od tułowia, rzuty z boku na bok, rzuty piłkarskie i rzuty bokiem","nacisk na moc nadgarstka","ćwiczenia elastyczności łokcia i nadgarstka."],"applies_when":["tygodnie 12–13"],"restrictions":["Bez ciężkiego treningu siłowego do 16. tygodnia."]},"original":{"goals":["progress functional activities and advanced sport and recreational activity as directed by the surgeon."],"exercises":["Increase strengthening exercises","begin upper-body ergometer cycling with resistance","introduce and progress plyometrics as tolerated: 2-hand drills away from the body, side-to-side throws, soccer throws and side throws","emphasize wrist power","elbow and wrist flexibility exercises."],"applies_when":["Weeks 12-13"],"restrictions":["No heavy weightlifting until week 16."]}},"additional_notes_de":"Ziel: Progression funktioneller Aktivitäten sowie fortgeschrittener sportlicher und freizeitbezogener Aktivität nach Maßgabe des Operateurs.","additional_notes_en":"Goal: progress functional activities and advanced sport and recreational activity as directed by the surgeon.","additional_notes_pl":"Cel: progresja aktywności funkcjonalnych oraz zaawansowanej aktywności sportowej i rekreacyjnej zgodnie z decyzją chirurga.","minimum_patient_share":null,"therapeutic_content_de":"Kräftigungsübungen steigern; Oberkörperergometer mit Widerstand beginnen; plyometrische Übungen einführen und nach Verträglichkeit steigern: Übungen mit 2 Händen fern vom Körper, Würfe von Seite zu Seite, Fußballwürfe und seitliche Würfe; Schwerpunkt auf Handgelenksleistung; Beweglichkeitsübungen für Ellenbogen und Handgelenk.","therapeutic_content_en":"Increase strengthening exercises; begin upper-body ergometer cycling with resistance; introduce and progress plyometrics as tolerated: 2-hand drills away from the body, side-to-side throws, soccer throws and side throws; emphasize wrist power; elbow and wrist flexibility exercises.","therapeutic_content_pl":"Zwiększać ćwiczenia wzmacniające; rozpocząć ćwiczenia na ergometrze kończyn górnych z oporem; wprowadzić i zwiększać według tolerancji ćwiczenia plyometryczne: ćwiczenia 2 rękami z dala od tułowia, rzuty z boku na bok, rzuty piłkarskie i rzuty bokiem; nacisk na moc nadgarstka; ćwiczenia elastyczności łokcia i nadgarstka.","minimum_requirements_de":"Kein schweres Krafttraining bis Woche 16.","minimum_requirements_en":"No heavy weightlifting until week 16.","minimum_requirements_pl":"Bez ciężkiego treningu siłowego do 16. tygodnia.","additional_notes_original":"Goal: progress functional activities and advanced sport and recreational activity as directed by the surgeon.","therapeutic_content_original":"Increase strengthening exercises; begin upper-body ergometer cycling with resistance; introduce and progress plyometrics as tolerated: 2-hand drills away from the body, side-to-side throws, soccer throws and side throws; emphasize wrist power; elbow and wrist flexibility exercises.","minimum_requirements_original":"No heavy weightlifting until week 16.","structured_content_v2":"$undefined"},{"id":"55d82d88-71f7-5062-8399-365aa4e8e70a","name_de":"Phase 5: Wochen 14–15","name_en":"Phase 5: Weeks 14-15","name_pl":"Faza 5: tygodnie 14–15","source_page":2,"module_number":6,"name_original":"Phase 5: Weeks 14-15","service_codes":[],"structured_content":{"de":{"goals":["Progression funktioneller Aktivitäten sowie fortgeschrittener sportlicher und freizeitbezogener Aktivität nach Maßgabe des Operateurs."],"exercises":["Progressive Kräftigung","plyometrische Progression mit einhändigen plyometrischen Würfen und einhändigem Dribbeln gegen die Wand","Schwerpunkt auf Ellenbogenleistung."],"applies_when":["Wochen 14–15"],"restrictions":["Kein schweres Krafttraining bis Woche 16."]},"en":{"goals":["progress functional activities and advanced sport and recreational activity as directed by the surgeon."],"exercises":["Progressive strengthening","advance plyometrics by initiating one-hand plyometric throwing and one-hand wall dribbling","emphasize elbow power."],"applies_when":["Weeks 14-15"],"restrictions":["No heavy weightlifting until week 16."]},"pl":{"goals":["progresja aktywności funkcjonalnych oraz zaawansowanej aktywności sportowej i rekreacyjnej zgodnie z decyzją chirurga."],"exercises":["Progresywne wzmacnianie","progresja plyometrii poprzez rozpoczęcie jednorącz rzutów plyometrycznych i jednorącz kozłowania piłki o ścianę","nacisk na moc łokcia."],"applies_when":["tygodnie 14–15"],"restrictions":["Bez ciężkiego treningu siłowego do 16. tygodnia."]},"original":{"goals":["progress functional activities and advanced sport and recreational activity as directed by the surgeon."],"exercises":["Progressive strengthening","advance plyometrics by initiating one-hand plyometric throwing and one-hand wall dribbling","emphasize elbow power."],"applies_when":["Weeks 14-15"],"restrictions":["No heavy weightlifting until week 16."]}},"additional_notes_de":"Ziel: Progression funktioneller Aktivitäten sowie fortgeschrittener sportlicher und freizeitbezogener Aktivität nach Maßgabe des Operateurs.","additional_notes_en":"Goal: progress functional activities and advanced sport and recreational activity as directed by the surgeon.","additional_notes_pl":"Cel: progresja aktywności funkcjonalnych oraz zaawansowanej aktywności sportowej i rekreacyjnej zgodnie z decyzją chirurga.","minimum_patient_share":null,"therapeutic_content_de":"Progressive Kräftigung; plyometrische Progression mit einhändigen plyometrischen Würfen und einhändigem Dribbeln gegen die Wand; Schwerpunkt auf Ellenbogenleistung.","therapeutic_content_en":"Progressive strengthening; advance plyometrics by initiating one-hand plyometric throwing and one-hand wall dribbling; emphasize elbow power.","therapeutic_content_pl":"Progresywne wzmacnianie; progresja plyometrii poprzez rozpoczęcie jednorącz rzutów plyometrycznych i jednorącz kozłowania piłki o ścianę; nacisk na moc łokcia.","minimum_requirements_de":"Kein schweres Krafttraining bis Woche 16.","minimum_requirements_en":"No heavy weightlifting until week 16.","minimum_requirements_pl":"Bez ciężkiego treningu siłowego do 16. tygodnia.","additional_notes_original":"Goal: progress functional activities and advanced sport and recreational activity as directed by the surgeon.","therapeutic_content_original":"Progressive strengthening; advance plyometrics by initiating one-hand plyometric throwing and one-hand wall dribbling; emphasize elbow power.","minimum_requirements_original":"No heavy weightlifting until week 16.","structured_content_v2":"$undefined"},{"id":"65ed27f0-ec8e-5462-99f6-addc6c5b4724","name_de":"Phase 5: ab Woche 16","name_en":"Phase 5: Week 16 onward","name_pl":"Faza 5: od 16. tygodnia","source_page":2,"module_number":7,"name_original":"Phase 5: Week 16 onward","service_codes":[],"structured_content":{"de":{"exercises":["Schrittweise Rückkehr zum Sport beginnen","ein Intervall-Wurfprogramm für die sportartspezifischen Bewegungen des Patienten einleiten."],"applies_when":["ab Woche 16"],"restrictions":["Kein schweres Krafttraining bis Woche 16."],"progression_criteria":["Kraftdefizit <10 %","Limb Symmetry Index ≥90 %","45/50 Punkte in 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niestabilności.","minimum_patient_share":null,"therapeutic_content_de":"Schrittweise Rückkehr zum Sport beginnen; ein Intervall-Wurfprogramm für die sportartspezifischen Bewegungen des Patienten einleiten.","therapeutic_content_en":"Begin a gradual return to sport; initiate an interval throwing program for the patient's sport actions.","therapeutic_content_pl":"Rozpocząć stopniowy powrót do sportu; wdrożyć interwałowy program rzutowy dostosowany do czynności sportowych pacjenta.","minimum_requirements_de":"Kein schweres Krafttraining bis Woche 16.","minimum_requirements_en":"No heavy weightlifting until week 16.","minimum_requirements_pl":"Bez ciężkiego treningu siłowego do 16. tygodnia.","additional_notes_original":"Discharge criteria: <10% strength deficit; limb symmetry index ≥90%; 45/50 on biomechanical functional tests, if performed; no pain or complaints of instability.","therapeutic_content_original":"Begin a gradual return to sport; initiate an interval throwing program for the patient's sport actions.","minimum_requirements_original":"No heavy weightlifting until week 16.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["elbow","upper_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"cd6464bd-e3bf-5963-b0b2-91eef13aaf4b","slug":"us-south-shore-22-slap-repair","title_pl":"Protokół rehabilitacji po naprawie SLAP","title_de":"Rehabilitationsprotokoll nach SLAP-Repair","title_en":"SLAP Repair Rehab Protocol","title_original":"SLAP Repair","summary_pl":"Pooperacyjne wytyczne dotyczące progresywnego usprawniania po naprawie obrąbka stawowego typu SLAP.","summary_de":"Postoperative Richtlinien für die progressive Rehabilitation nach einer SLAP-Läsion-Reparatur.","summary_en":"Post-operative guidelines for progressive rehabilitation following SLAP lesion repair.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":["return_to_sport"],"physician_clearance_required":false,"condition_id":"ebc6a678-d760-5c32-87fd-c336696f63e3","condition_slug":"slap-repair","condition_name_pl":"Stan po naprawie SLAP","condition_name_de":"Status nach SLAP-Repair","condition_name_en":"Status post SLAP repair","condition_name_original":"Status post SLAP repair","icd_codes":[],"category_key":"shoulder","category_pl":"Ortopedia - bark","category_de":"Orthopädie - Schulter","category_en":"Orthopedics - shoulder","body_regions_pl":["bark"],"body_regions_de":["Schulter"],"body_regions_en":["shoulder"],"search_terms_pl":["SLAP","uszkodzenie obrąbka","artroskopia barku","fizjoterapia barku","obrąbek stawowy","rehabilitacja barku","uszkodzenie SLAP","reparacja obrąbka","Stan po operacji naprawy obrąbka stawowego typu SLAP"],"search_terms_de":["SLAP","Labrumläsion","Schulterarthroskopie","Physiotherapie Schulter","Labrum","SLAP-Läsion","Schulter-Reha","SLAP-Repair","Zustand nach SLAP-Repair"],"search_terms_en":["SLAP","labral tear","shoulder arthroscopy","physical therapy","labrum","SLAP lesion","labrum repair","shoulder rehab","post-op SLAP","Post-operative SLAP repair"],"source_document_id":"ee438598-8ad3-58bb-aac8-e98254b5ee39","source_title":"SLAP Repair","issuer":"South Shore Orthopedics","source_country_code":"US","jurisdiction_code":"US-MA","authority_level":"hospital","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_unknown_requires_review","official_url":"https://octanecdn.com/southshoreorthopedicscom/southshoreorthopedicscom_723450797.pdf","source_sha256":"12b79391eb12681c3d9dde3c589b4e99eb5985c8cb3775978fca31ed38e7fd01","authorization_required":false,"license_note":"Public source file retained locally for source verification.","modules":[{"id":"924f897f-f442-5288-9223-d8cd88a38af7","name_de":"Phase I: Schutz und Aufklärung","name_en":"Phase I: Protection and Education","name_pl":"Faza I: Ochrona i edukacja","source_page":1,"module_number":1,"name_original":"Phase I: Protection and Education","service_codes":[],"structured_content":{"de":{"goals":["PROM mit minimalen Schmerzen."],"exercises":["AROM Ellbogen, Handgelenk, Hand ohne Gewicht.","Scapula-Kräftigung."],"applies_when":["Schutz und Aufklärung"],"restrictions":["Keine aktive Schulterbewegung, keine Pendelübungen.","Kein Oberkörperergometer.","Kein Schulter- oder Bizepstraining."],"dosage_and_progression":["Fortschreitende PROM: Flexion 90°, Abduktion 75-85°, AR/IR in der Scapula-Ebene 30°."],"physiotherapist_actions":["Patientenaufklärung (Haltung, Gelenkschutz).","3-4 Wochen postoperativ."]},"en":{"goals":["PROM with minimal pain."],"exercises":["AROM of elbow, wrist, hand without weight.","Scapular strengthening."],"applies_when":["Protection and Education"],"restrictions":["No active shoulder movement or pendulums.","NO UPPER BODY ERGOMETER.","No shoulder or biceps strengthening."],"dosage_and_progression":["Progress PROM: Flexion 90°, abduction 75-85°, ER/IR in scapular plane 30°."],"physiotherapist_actions":["Patient education (posture, joint protection).","3-4 weeks post-surgery."]},"pl":{"goals":["PROM z minimalnym bólem."],"exercises":["AROM łokcia, nadgarstka i dłoni bez obciążeń.","Wzmacnianie łopatki."],"applies_when":["Ochrona i edukacja"],"restrictions":["Zakaz aktywnego ruchu barku i ćwiczeń wahadłowych.","Zakaz stosowania ergometru kończyn górnych.","Brak ćwiczeń barku i bicepsa."],"dosage_and_progression":["Progresja PROM do: zgięcie 90°, odwiedzenie 75-85°, ER/IR w płaszczyźnie łopatki 30°."],"physiotherapist_actions":["Edukacja pacjenta (postawa, ochrona stawu).","Tydzień 3-4 po operacji."]},"original":{"goals":["PROM with minimal pain."],"exercises":["AROM of elbow, wrist, hand without weight.","Scapular strengthening."],"applies_when":["Protection and Education"],"restrictions":["No active shoulder movement or pendulums.","NO UPPER BODY ERGOMETER.","No shoulder or biceps strengthening."],"dosage_and_progression":["Progress PROM: Flexion 90°, abduction 75-85°, ER/IR in scapular plane 30°."],"physiotherapist_actions":["Patient education (posture, joint protection).","3-4 weeks post-surgery."]}},"additional_notes_de":"ZIEL: PROM mit minimalen Schmerzen. Kein Schulter- oder Bizepstraining.","additional_notes_en":"GOAL: PROM with minimal pain. No shoulder or biceps strengthening.","additional_notes_pl":"CEL: PROM z minimalnym bólem. Brak ćwiczeń barku i bicepsa.","minimum_patient_share":null,"therapeutic_content_de":"Patientenaufklärung (Haltung, Gelenkschutz). Keine aktive Schulterbewegung, keine Pendelübungen. AROM Ellbogen, Handgelenk, Hand ohne Gewicht. Fortschreitende PROM: Flexion 90°, Abduktion 75-85°, AR/IR in der Scapula-Ebene 30°. Scapula-Kräftigung.","therapeutic_content_en":"Patient education (posture, joint protection). No active shoulder movement or pendulums. AROM of elbow, wrist, hand without weight. Progress PROM: Flexion 90°, abduction 75-85°, ER/IR in scapular plane 30°. Scapular strengthening.","therapeutic_content_pl":"Edukacja pacjenta (postawa, ochrona stawu). Zakaz aktywnego ruchu barku i ćwiczeń wahadłowych. AROM łokcia, nadgarstka i dłoni bez obciążeń. Progresja PROM do: zgięcie 90°, odwiedzenie 75-85°, ER/IR w płaszczyźnie łopatki 30°. Wzmacnianie łopatki.","minimum_requirements_de":"3-4 Wochen postoperativ. Kein Oberkörperergometer.","minimum_requirements_en":"3-4 weeks post-surgery. NO UPPER BODY ERGOMETER.","minimum_requirements_pl":"Tydzień 3-4 po operacji. Zakaz stosowania ergometru kończyn górnych.","additional_notes_original":"GOAL: PROM with minimal pain. No shoulder or biceps strengthening.","therapeutic_content_original":"Patient education (posture, joint protection). No active shoulder movement or pendulums. AROM of elbow, wrist, hand without weight. Progress PROM: Flexion 90°, abduction 75-85°, ER/IR in scapular plane 30°. Scapular strengthening.","minimum_requirements_original":"3-4 weeks post-surgery. NO UPPER BODY ERGOMETER.","structured_content_v2":"$undefined"},{"id":"3ce6871d-45ff-527f-8b8a-92e2c8606eef","name_de":"Phase II: Steigerung des Bewegungsumfangs","name_en":"Phase II: ROM Progression","name_pl":"Faza II: Zwiększanie zakresu ruchu","source_page":1,"module_number":2,"name_original":"Phase II: ROM Progression","service_codes":[],"structured_content":{"de":{"goals":["Dynamische Stabilität, Übergang zu AROM."],"exercises":["Flexion/Abduktion bis 145°, AR/IR bis 45°.","Sanfte Dehnübungen."],"applies_when":["Steigerung des Bewegungsumfangs"],"dosage_and_progression":["Steigerung von PROM zu AAROM und AROM in allen Ebenen.","Scapula-Kräftigung."],"physiotherapist_actions":["Woche 4-6."]},"en":{"goals":["Dynamic stability, transition to AROM."],"exercises":["Flexion/abduction to 145°, ER/IR to 45°.","Gentle stretching."],"applies_when":["ROM Progression"],"dosage_and_progression":["Progress PROM to AAROM and AROM in all planes.","Continue scapular strengthening."],"physiotherapist_actions":["Weeks 4-6."]},"pl":{"goals":["Dynamiczna stabilizacja i przejście do AROM."],"exercises":["Zgięcie i odwiedzenie do 145°, ER/IR do 45°.","Delikatne rozciąganie."],"applies_when":["Zwiększanie zakresu ruchu"],"dosage_and_progression":["Progresja PROM do AAROM i AROM we wszystkich płaszczyznach.","Kontynuacja wzmacniania łopatki."],"physiotherapist_actions":["Tygodnie 4-6."]},"original":{"goals":["Dynamic stability, transition to AROM."],"exercises":["Flexion/abduction to 145°, ER/IR to 45°.","Gentle stretching."],"applies_when":["ROM Progression"],"dosage_and_progression":["Progress PROM to AAROM and AROM in all planes.","Continue scapular strengthening."],"physiotherapist_actions":["Weeks 4-6."]}},"additional_notes_de":"ZIEL: Dynamische Stabilität, Übergang zu AROM.","additional_notes_en":"GOAL: Dynamic stability, transition to AROM.","additional_notes_pl":"CEL: Dynamiczna stabilizacja i przejście do AROM.","minimum_patient_share":null,"therapeutic_content_de":"Steigerung von PROM zu AAROM und AROM in allen Ebenen. Flexion/Abduktion bis 145°, AR/IR bis 45°. Sanfte Dehnübungen. Scapula-Kräftigung.","therapeutic_content_en":"Progress PROM to AAROM and AROM in all planes. Flexion/abduction to 145°, ER/IR to 45°. Gentle stretching. Continue scapular strengthening.","therapeutic_content_pl":"Progresja PROM do AAROM i AROM we wszystkich płaszczyznach. Zgięcie i odwiedzenie do 145°, ER/IR do 45°. Delikatne rozciąganie. Kontynuacja wzmacniania łopatki.","minimum_requirements_de":"Woche 4-6.","minimum_requirements_en":"Weeks 4-6.","minimum_requirements_pl":"Tygodnie 4-6.","additional_notes_original":"GOAL: Dynamic stability, transition to AROM.","therapeutic_content_original":"Progress PROM to AAROM and AROM in all planes. Flexion/abduction to 145°, ER/IR to 45°. Gentle stretching. Continue scapular strengthening.","minimum_requirements_original":"Weeks 4-6.","structured_content_v2":"$undefined"},{"id":"0141adcb-c4df-5ee1-8f56-93177ea281d4","name_de":"Phase III: Wiederherstellung des vollen Bewegungsausmaßes","name_en":"Phase III: Return to Full ROM","name_pl":"Faza III: Powrót do pełnej ruchomości","source_page":1,"module_number":3,"name_original":"Phase III: Return to Full ROM","service_codes":[],"structured_content":{"de":{"goals":["Schmerzfreie volle AROM."],"exercises":["Dehnung der hinteren Kapsel (Cross-Body).","Kräftigung von Scapula, Rücken und Bizeps mit leichtem Widerstand."],"applies_when":["Wiederherstellung des vollen Bewegungsausmaßes"],"dosage_and_progression":["Fortschreitende AROM bis zum schmerzfreien vollen Bewegungsausmaß."],"physiotherapist_actions":["Woche 6-12."]},"en":{"goals":["Pain-free full AROM."],"exercises":["Posterior capsule stretching (cross-body adduction).","Strengthening of scapula, back, and biceps with light resistance."],"applies_when":["Return to Full ROM"],"dosage_and_progression":["Progress AROM to pain-free full ROM."],"physiotherapist_actions":["Weeks 6-12."]},"pl":{"goals":["Bezbolesny pełny AROM."],"exercises":["Rozciąganie torebki tylnej (addukcja w poprzek ciała).","Wzmacnianie łopatki, pleców i bicepsa z lekkim oporem."],"applies_when":["Powrót do pełnej ruchomości"],"dosage_and_progression":["Progresja AROM do bezbolesnego pełnego zakresu."],"physiotherapist_actions":["Tygodnie 6-12."]},"original":{"goals":["Pain-free full AROM."],"exercises":["Posterior capsule stretching (cross-body adduction).","Strengthening of scapula, back, and biceps with light resistance."],"applies_when":["Return to Full ROM"],"dosage_and_progression":["Progress AROM to pain-free full ROM."],"physiotherapist_actions":["Weeks 6-12."]}},"additional_notes_de":"ZIEL: Schmerzfreie volle AROM.","additional_notes_en":"GOAL: Pain-free full AROM.","additional_notes_pl":"CEL: Bezbolesny pełny AROM.","minimum_patient_share":null,"therapeutic_content_de":"Fortschreitende AROM bis zum schmerzfreien vollen Bewegungsausmaß. Dehnung der hinteren Kapsel (Cross-Body). Kräftigung von Scapula, Rücken und Bizeps mit leichtem Widerstand.","therapeutic_content_en":"Progress AROM to pain-free full ROM. Posterior capsule stretching (cross-body adduction). Strengthening of scapula, back, and biceps with light resistance.","therapeutic_content_pl":"Progresja AROM do bezbolesnego pełnego zakresu. Rozciąganie torebki tylnej (addukcja w poprzek ciała). Wzmacnianie łopatki, pleców i bicepsa z lekkim oporem.","minimum_requirements_de":"Woche 6-12.","minimum_requirements_en":"Weeks 6-12.","minimum_requirements_pl":"Tygodnie 6-12.","additional_notes_original":"GOAL: Pain-free full AROM.","therapeutic_content_original":"Progress AROM to pain-free full ROM. Posterior capsule stretching (cross-body adduction). Strengthening of scapula, back, and biceps with light resistance.","minimum_requirements_original":"Weeks 6-12.","structured_content_v2":"$undefined"},{"id":"bc402af7-2eea-55a3-9554-d7b7a2f6e2f1","name_de":"Phase IV: Rückkehr zu Aktivitäten","name_en":"Phase IV: Return to Activity","name_pl":"Faza IV: Powrót do aktywności","source_page":2,"module_number":4,"name_original":"Phase IV: Return to Activity","service_codes":[],"structured_content":{"de":{"goals":["Rückkehr zu ADLs, Beruf und Sport."],"warnings":["Erholungszeit: ca. 9-12 Monate."],"exercises":["Kräftigung der Rotatorenmanschette.","Bei Sportlern: Throwers-Ten-Protokoll (nach 4 Monaten)."],"applies_when":["Rückkehr zu Aktivitäten"],"dosage_and_progression":["Progressive Steigerung der Belastung, dynamische Stabilisierungsübungen, geschlossene Kette."],"physiotherapist_actions":["Ab der 12. Woche."]},"en":{"goals":["Return to ADLs, work, and recreational activities."],"warnings":["Recovery: approx. 9-12 months."],"exercises":["RTC strengthening.","For athletes: Throwers Ten protocol (after 4 months)."],"applies_when":["Return to Activity"],"dosage_and_progression":["Progressive loading, dynamic stabilization, closed-chain activities."],"physiotherapist_actions":["Beyond 12 weeks."]},"pl":{"goals":["Powrót do ADL, pracy i sportu."],"warnings":["Czas powrotu: ok. 9-12 miesięcy."],"exercises":["Wzmocnienie stożka rotatorów.","U sportowców: protokół Throwers Ten (po 4 miesiącach)."],"applies_when":["Powrót do aktywności"],"dosage_and_progression":["Progresywne zwiększanie obciążeń, ćwiczenia stabilizacji dynamicznej, aktywność w łańcuchu zamkniętym."],"physiotherapist_actions":["Powyżej 12 tygodnia."]},"original":{"goals":["Return to ADLs, work, and recreational activities."],"warnings":["Recovery: approx. 9-12 months."],"exercises":["RTC strengthening.","For athletes: Throwers Ten protocol (after 4 months)."],"applies_when":["Return to Activity"],"dosage_and_progression":["Progressive loading, dynamic stabilization, closed-chain activities."],"physiotherapist_actions":["Beyond 12 weeks."]}},"additional_notes_de":"ZIEL: Rückkehr zu ADLs, Beruf und Sport. Erholungszeit: ca. 9-12 Monate.","additional_notes_en":"GOAL: Return to ADLs, work, and recreational activities. Recovery: approx. 9-12 months.","additional_notes_pl":"CEL: Powrót do ADL, pracy i sportu. Czas powrotu: ok. 9-12 miesięcy.","minimum_patient_share":null,"therapeutic_content_de":"Progressive Steigerung der Belastung, dynamische Stabilisierungsübungen, geschlossene Kette. Kräftigung der Rotatorenmanschette. Bei Sportlern: Throwers-Ten-Protokoll (nach 4 Monaten).","therapeutic_content_en":"Progressive loading, dynamic stabilization, closed-chain activities. RTC strengthening. For athletes: Throwers Ten protocol (after 4 months).","therapeutic_content_pl":"Progresywne zwiększanie obciążeń, ćwiczenia stabilizacji dynamicznej, aktywność w łańcuchu zamkniętym. Wzmocnienie stożka rotatorów. U sportowców: protokół Throwers Ten (po 4 miesiącach).","minimum_requirements_de":"Ab der 12. Woche.","minimum_requirements_en":"Beyond 12 weeks.","minimum_requirements_pl":"Powyżej 12 tygodnia.","additional_notes_original":"GOAL: Return to ADLs, work, and recreational activities. Recovery: approx. 9-12 months.","therapeutic_content_original":"Progressive loading, dynamic stabilization, closed-chain activities. RTC strengthening. For athletes: Throwers Ten protocol (after 4 months).","minimum_requirements_original":"Beyond 12 weeks.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["shoulder","upper_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"44bde1b8-af65-5381-9ea0-3296cb37af81","slug":"us-south-shore-07-slap-repair","title_pl":"Protokół rehabilitacji po naprawie SLAP (South Shore)","title_de":"Rehabilitationsprotokoll nach SLAP-Repair (South Shore)","title_en":"SLAP Repair Rehabilitation Protocol (South Shore)","title_original":"SLAP Repair","summary_pl":"Pooperacyjny protokół rehabilitacji dla pacjentów po artroskopowej naprawie obrąbka typu SLAP, dzielący proces na 5 faz funkcjonalnych.","summary_de":"Postoperatives Rehabilitationsprotokoll für Patienten nach arthroskopischer SLAP-Repair, unterteilt in 5 funktionelle Phasen.","summary_en":"Post-operative rehabilitation protocol for patients following arthroscopic SLAP repair, structured into 5 functional phases.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"ebc6a678-d760-5c32-87fd-c336696f63e3","condition_slug":"slap-repair","condition_name_pl":"Stan po naprawie SLAP","condition_name_de":"Status nach SLAP-Repair","condition_name_en":"Status post SLAP repair","condition_name_original":"Status post SLAP repair","icd_codes":[],"category_key":"shoulder","category_pl":"Ortopedia - 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Verbot: Aktive Streckung, Abduktion und Greifen hinter den Rücken/Kopf.","therapeutic_content_en":"Goals: pain/swelling control, tissue protection, initiate passive ROM. Avoid active reaching behind back, overhead, or behind head.","therapeutic_content_pl":"Cele: kontrola bólu/obrzęku, ochrona tkanek, inicjacja ruchu biernego. Zakaz aktywnego wyprostu, odwodzenia i sięgania za plecy/głowę.","minimum_requirements_de":"Tragen der Schlinge 0-4 Wo.; Keine Belastung.","minimum_requirements_en":"Sling wear 0-4 weeks. No lifting.","minimum_requirements_pl":"Noszenie temblaka przez 0-4 tyg.; Brak obciążeń.","additional_notes_original":"Recommended: pendulums, passive flexion, sub-maximal isometrics.","therapeutic_content_original":"Goals: pain/swelling control, tissue protection, initiate passive ROM. Avoid active reaching behind back, overhead, or behind head.","minimum_requirements_original":"Sling wear 0-4 weeks. No lifting.","structured_content_v2":"$undefined"},{"id":"4d01d6c0-4440-5e70-b41e-609a911764cd","name_de":"Phase 2: Aktive ROM (4-8 Wo.)","name_en":"Phase 2: Active ROM (4-8 weeks)","name_pl":"Faza 2: ROM aktywny (4-8 tyg.)","source_page":4,"module_number":2,"name_original":"Phase 2: Active ROM (4-8 weeks)","service_codes":[],"structured_content":{"de":{"goals":["ROM-Verbesserung, sanfte Kräftigung."],"applies_when":["Aktive ROM (4-8 Wo.)"],"restrictions":["Vermeidung von Heben und repetitiven Überkopfbewegungen."],"dosage_and_progression":["Einführung von Ruderübungen, rhythmische Stabilisation."],"physiotherapist_actions":["Kontrolle des Schulterblatts bei aktiver Bewegung."]},"en":{"goals":["improve ROM, gentle periscapular strengthening."],"applies_when":["Active ROM (4-8 weeks)"],"restrictions":["Avoid heavy lifting and repetitive overhead motions."],"dosage_and_progression":["Introduce rowing exercises, rhythmic stabilization."],"physiotherapist_actions":["Good scapular control with active ROM."]},"pl":{"goals":["poprawa ROM, delikatne wzmacnianie okołostawowe."],"applies_when":["ROM aktywny (4-8 tyg.)"],"restrictions":["Unikanie dźwigania i ruchów powtarzalnych nad głową."],"dosage_and_progression":["Wprowadzenie ćwiczeń typu row, stabilizacja rytmiczna."],"physiotherapist_actions":["Kontrola łopatki przy aktywnym ruchu."]},"original":{"goals":["improve ROM, gentle periscapular strengthening."],"applies_when":["Active ROM (4-8 weeks)"],"restrictions":["Avoid heavy lifting and repetitive overhead motions."],"dosage_and_progression":["Introduce rowing exercises, rhythmic stabilization."],"physiotherapist_actions":["Good scapular control with active ROM."]}},"additional_notes_de":"Einführung von Ruderübungen, rhythmische Stabilisation.","additional_notes_en":"Introduce rowing exercises, rhythmic stabilization.","additional_notes_pl":"Wprowadzenie ćwiczeń typu row, stabilizacja rytmiczna.","minimum_patient_share":null,"therapeutic_content_de":"Ziele: ROM-Verbesserung, sanfte Kräftigung. Vermeidung von Heben und repetitiven Überkopfbewegungen.","therapeutic_content_en":"Goals: improve ROM, gentle periscapular strengthening. Avoid heavy lifting and repetitive overhead motions.","therapeutic_content_pl":"Cele: poprawa ROM, delikatne wzmacnianie okołostawowe. Unikanie dźwigania i ruchów powtarzalnych nad głową.","minimum_requirements_de":"Kontrolle des Schulterblatts bei aktiver Bewegung.","minimum_requirements_en":"Good scapular control with active ROM.","minimum_requirements_pl":"Kontrola łopatki przy aktywnym ruchu.","additional_notes_original":"Introduce rowing exercises, rhythmic stabilization.","therapeutic_content_original":"Goals: improve ROM, gentle periscapular strengthening. Avoid heavy lifting and repetitive overhead motions.","minimum_requirements_original":"Good scapular control with active ROM.","structured_content_v2":"$undefined"},{"id":"75bab5e6-50a6-5888-a5d0-d15150c0fa50","name_de":"Phase 3: Kräftigung (8-12 Wo.)","name_en":"Phase 3: Strengthening (8-12 weeks)","name_pl":"Faza 3: Wzmacnianie (8-12 tyg.)","source_page":5,"module_number":3,"name_original":"Phase 3: Strengthening (8-12 weeks)","service_codes":[],"structured_content":{"de":{"goals":["Normalisierung des ROM, Kraftaufbau Rotatorenmanschette/Schulterblatt."],"exercises":["Funktionelle Nutzung des Arms.","Übungen: W-Drill, Bizeps-Curls, Hantelprogression."],"applies_when":["Kräftigung (8-12 Wo.)"],"restrictions":["Keine Überkopflast > 0,5-1kg.","Achten auf Schmerzsymptome."]},"en":{"goals":["restore normal ROM, progress rotator cuff and scapular strength."],"exercises":["Functional use of arm.","Exercises: W-drill, bicep curls, dumbbell progression."],"applies_when":["Strengthening (8-12 weeks)"],"restrictions":["No overhead lifting > 1-2 lbs.","Stop if pain occurs."]},"pl":{"goals":["normalizacja ROM, progresja siły rotatorów i łopatki."],"exercises":["Funkcjonalne wykorzystanie ramienia.","Ćwiczenia: W-drill, bicep curl, progresja hantli."],"applies_when":["Wzmacnianie (8-12 tyg.)"],"restrictions":["Brak obciążeń nad głową > 0.5-1kg.","Uwaga na objawy bólowe."]},"original":{"goals":["restore normal ROM, progress rotator cuff and scapular strength."],"exercises":["Functional use of arm.","Exercises: W-drill, bicep curls, dumbbell progression."],"applies_when":["Strengthening (8-12 weeks)"],"restrictions":["No overhead lifting > 1-2 lbs.","Stop if pain occurs."]}},"additional_notes_de":"Übungen: W-Drill, Bizeps-Curls, Hantelprogression.","additional_notes_en":"Exercises: W-drill, bicep curls, dumbbell progression.","additional_notes_pl":"Ćwiczenia: W-drill, bicep curl, progresja hantli.","minimum_patient_share":null,"therapeutic_content_de":"Ziele: Normalisierung des ROM, Kraftaufbau Rotatorenmanschette/Schulterblatt. 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Stop if pain occurs.","structured_content_v2":"$undefined"},{"id":"59fafb65-0131-5826-b146-8d083115c829","name_de":"Phase 4: Sport-spezifisch (12-16 Wo.)","name_en":"Phase 4: Sport specific (12-16 weeks)","name_pl":"Faza 4: Specyfika sportowa (12-16 tyg.)","source_page":6,"module_number":4,"name_original":"Phase 4: Sport specific (12-16 weeks)","service_codes":[],"structured_content":{"de":{"goals":["Voller ROM, Kraftprogression, Vorbereitung auf Belastung."],"applies_when":["Sport-spezifisch (12-16 Wo.)"],"restrictions":["Sportverbot bleibt."],"progression_criteria":["Zustimmung des Chirurgen für Widerstandstraining."],"dosage_and_progression":["Einführung von Plyometrie, Stabilisation bei 90 Grad Abduktion."]},"en":{"goals":["full ROM, strength progression, prepare for load."],"applies_when":["Sport specific (12-16 weeks)"],"restrictions":["Return to sport still restricted."],"progression_criteria":["Surgeon's clearance for weight training."],"dosage_and_progression":["Introduce plyometrics, stabilization at 90 deg abduction."]},"pl":{"goals":["pełny ROM, progresja siły, przygotowanie do obciążeń."],"applies_when":["Specyfika sportowa (12-16 tyg.)"],"restrictions":["Nadal zakaz sportu."],"progression_criteria":["Zgoda chirurga na trening oporowy."],"dosage_and_progression":["Wprowadzenie pliometrii, stabilizacja w 90 stopniach odwodzenia."]},"original":{"goals":["full ROM, strength progression, prepare for load."],"applies_when":["Sport specific (12-16 weeks)"],"restrictions":["Return to sport still restricted."],"progression_criteria":["Surgeon's clearance for weight training."],"dosage_and_progression":["Introduce plyometrics, stabilization at 90 deg abduction."]}},"additional_notes_de":"Einführung von Plyometrie, Stabilisation bei 90 Grad Abduktion.","additional_notes_en":"Introduce plyometrics, stabilization at 90 deg abduction.","additional_notes_pl":"Wprowadzenie pliometrii, stabilizacja w 90 stopniach odwodzenia.","minimum_patient_share":null,"therapeutic_content_de":"Ziele: Voller ROM, Kraftprogression, Vorbereitung auf Belastung. Sportverbot bleibt.","therapeutic_content_en":"Goals: full ROM, strength progression, prepare for load. Return to sport still restricted.","therapeutic_content_pl":"Cele: pełny ROM, progresja siły, przygotowanie do obciążeń. Nadal zakaz sportu.","minimum_requirements_de":"Zustimmung des Chirurgen für Widerstandstraining.","minimum_requirements_en":"Surgeon's clearance for weight training.","minimum_requirements_pl":"Zgoda chirurga na trening oporowy.","additional_notes_original":"Introduce plyometrics, stabilization at 90 deg abduction.","therapeutic_content_original":"Goals: full ROM, strength progression, prepare for load. 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Plan.","therapeutic_content_en":"Goals: maintain strength, return to sport via progression.","therapeutic_content_pl":"Cele: utrzymanie siły, powrót do sportu wg indywidualnego planu.","minimum_requirements_de":"Ärztliche Untersuchung vor Vollbelastung.","minimum_requirements_en":"Medical evaluation before full return to activity.","minimum_requirements_pl":"Ocena lekarska przed pełnym obciążeniem.","additional_notes_original":"Progressive sport-specific training implementation.","therapeutic_content_original":"Goals: maintain strength, return to sport via progression.","minimum_requirements_original":"Medical evaluation before full return to activity.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["shoulder","upper_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"cf6a5909-e771-51ab-949a-b70f75600863","slug":"us-jared-lee-10-latarjet-procedure","title_pl":"Protokół rehabilitacji po operacji Latarjet","title_de":"Rehabilitationsprotokoll nach Latarjet-Operation","title_en":"Latarjet Procedure Rehabilitation Protocol","title_original":"Latarjet Procedure Rehabilitation","summary_pl":"Czterofazowy protokół po operacji Latarjet, od ochrony rekonstrukcji do 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MD","source_country_code":"US","jurisdiction_code":"US-CO","authority_level":"clinic","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_requires_review","official_url":"https://jaredleemd.com/wp-content/uploads/2025/06/Latarjet-Procedure-Rehabilitation-Protocol.pdf","source_sha256":"d4fc12b66ac47b15806cb45e372474cb03042065011975bdeeeab3ac48448b52","authorization_required":false,"license_note":"Public source file retained locally for source verification.","modules":[{"id":"9509a075-2ae4-526d-9920-d6006f6efb00","name_de":"Phase I: Wochen 0–2","name_en":"Phase I: Weeks 0-2","name_pl":"Faza I: tygodnie 0–2","source_page":1,"module_number":1,"name_original":"Phase I: Weeks 0-2","service_codes":[],"structured_content":{"de":{"goals":["Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, die operierten Strukturen schützen und Schultersteife vermeiden."],"exercises":["Passiver Bewegungsumfang: Flexion 0–90°, Abduktion 0–90° und Außenrotation bis neutral","uneingeschränkter Bewegungsumfang von Ellenbogen, Handgelenk und Hand bei angelegtem Arm","Wall Slides","Pendelübungen","Skapularetraktion in der Armschlinge","Dehnung und Bewegungsübungen der Halswirbelsäule"],"applies_when":["Wochen 0–2"],"restrictions":["keine Kräftigung."],"physiotherapist_actions":["Einfache Armschlinge durchgehend außer bei Physiotherapie, Ankleiden und Körperpflege","mit dem betroffenen Arm keine Lasten über 3 lb heben","physikalische Maßnahmen nach Bedarf."]},"en":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness."],"exercises":["Passive range of motion 0-90° flexion, 0-90° abduction and external rotation to neutral","unrestricted elbow, wrist and hand range of motion with the arm at the side","wall slides","pendulums","scapular retraction in the sling","cervical stretching and range of motion"],"applies_when":["Weeks 0-2"],"restrictions":["no lifting greater than 3 lb with the affected arm","no strengthening."],"physiotherapist_actions":["Wear a simple sling at all times except during physical therapy, dressing and hygiene","modalities as needed."]},"pl":{"goals":["zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona operowanych struktur oraz zapobieganie sztywności barku."],"exercises":["Bierny zakres ruchu: zgięcie 0–90°, odwodzenie 0–90° i rotacja zewnętrzna do pozycji neutralnej","nieograniczony zakres ruchu łokcia, nadgarstka i ręki przy ramieniu ułożonym wzdłuż tułowia","ślizgi po ścianie","ćwiczenia wahadłowe","retrakcja łopatki w temblaku","rozciąganie i zakres ruchu odcinka szyjnego"],"applies_when":["tygodnie 0–2"],"restrictions":["nie podnosić operowaną kończyną ciężaru większego niż 3 lb","bez wzmacniania."],"physiotherapist_actions":["Prosty temblak przez cały czas z wyjątkiem fizjoterapii, ubierania się i 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zewnętrzna do pozycji neutralnej; nieograniczony zakres ruchu łokcia, nadgarstka i ręki przy ramieniu ułożonym wzdłuż tułowia; ślizgi po ścianie; ćwiczenia wahadłowe; retrakcja łopatki w temblaku; rozciąganie i zakres ruchu odcinka szyjnego; fizykoterapia według potrzeb.","minimum_requirements_de":"Einfache Armschlinge durchgehend außer bei Physiotherapie, Ankleiden und Körperpflege; mit dem betroffenen Arm keine Lasten über 3 lb heben; keine Kräftigung.","minimum_requirements_en":"Wear a simple sling at all times except during physical therapy, dressing and hygiene; no lifting greater than 3 lb with the affected arm; no strengthening.","minimum_requirements_pl":"Prosty temblak przez cały czas z wyjątkiem fizjoterapii, ubierania się i higieny; nie podnosić operowaną kończyną ciężaru większego niż 3 lb; bez wzmacniania.","additional_notes_original":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness.","therapeutic_content_original":"Passive range of motion 0-90° flexion, 0-90° abduction and external rotation to neutral; unrestricted elbow, wrist and hand range of motion with the arm at the side; wall slides; pendulums; scapular retraction in the sling; cervical stretching and range of motion; modalities as needed.","minimum_requirements_original":"Wear a simple sling at all times except during physical therapy, dressing and hygiene; no lifting greater than 3 lb with the affected arm; no strengthening.","structured_content_v2":"$undefined"},{"id":"934ff1b2-ba4e-5c36-abe6-0a39c35c400e","name_de":"Phase II: Wochen 3–6","name_en":"Phase II: Weeks 3-6","name_pl":"Faza II: tygodnie 3–6","source_page":1,"module_number":2,"name_original":"Phase II: Weeks 3-6","service_codes":[],"structured_content":{"de":{"goals":["Bewegungsumfang steigern, Schmerzen und Muskelatrophie begrenzen, die operierten Strukturen schützen und mit der neuromuskulären Kontrolle 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łopatki","ergometr kończyn górnych bez oporu"],"applies_when":["tygodnie 3–6"],"restrictions":["nie podnosić operowaną kończyną ciężaru większego niż 3 lb."],"physiotherapist_actions":["Prosty temblak przez cały czas z wyjątkiem fizjoterapii, ubierania się i higieny","mobilizacja blizny według potrzeb","fizykoterapia według potrzeb."]},"original":{"goals":["progress range of motion, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control."],"exercises":["Progress to full passive range of motion in all planes","unrestricted elbow, wrist and hand range of motion with the arm at the side","wall slides","pendulums","scapular retraction in the sling","cervical stretching and range of motion","continue previous exercises","initiate scapular strengthening","upper-body ergometer without resistance"],"applies_when":["Weeks 3-6"],"restrictions":["no lifting greater than 3 lb with the affected arm."],"physiotherapist_actions":["Wear a simple sling at all times 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Skapulakräftigung beginnen; Oberkörperergometer ohne Widerstand; Narbenmobilisation nach Bedarf; physikalische Maßnahmen nach Bedarf.","therapeutic_content_en":"Progress to full passive range of motion in all planes; unrestricted elbow, wrist and hand range of motion with the arm at the side; wall slides; pendulums; scapular retraction in the sling; cervical stretching and range of motion; continue previous exercises; initiate scapular strengthening; upper-body ergometer without resistance; scar-tissue mobilization as needed; modalities as needed.","therapeutic_content_pl":"Stopniowo uzyskać pełny bierny zakres ruchu we wszystkich płaszczyznach; nieograniczony zakres ruchu łokcia, nadgarstka i ręki przy ramieniu ułożonym wzdłuż tułowia; ślizgi po ścianie; ćwiczenia wahadłowe; retrakcja łopatki w temblaku; rozciąganie i zakres ruchu odcinka szyjnego; kontynuować wcześniejsze ćwiczenia; rozpocząć wzmacnianie łopatki; ergometr kończyn górnych bez oporu; mobilizacja blizny według potrzeb; fizykoterapia według potrzeb.","minimum_requirements_de":"Einfache Armschlinge durchgehend außer bei Physiotherapie, Ankleiden und Körperpflege; mit dem betroffenen Arm keine Lasten über 3 lb heben.","minimum_requirements_en":"Wear a simple sling at all times except during physical therapy, dressing and hygiene; no lifting greater than 3 lb with the affected arm.","minimum_requirements_pl":"Prosty temblak przez cały czas z wyjątkiem fizjoterapii, ubierania się i higieny; nie podnosić operowaną kończyną ciężaru większego niż 3 lb.","additional_notes_original":"Goals: progress range of motion, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control.","therapeutic_content_original":"Progress to full passive range of motion in all planes; unrestricted elbow, wrist and hand range of motion with the arm at the side; wall slides; pendulums; scapular retraction in the sling; cervical stretching and range of motion; continue previous exercises; initiate scapular strengthening; upper-body ergometer without resistance; scar-tissue mobilization as needed; modalities as needed.","minimum_requirements_original":"Wear a simple sling at all times except during physical therapy, dressing and hygiene; no lifting greater than 3 lb with the affected arm.","structured_content_v2":"$undefined"},{"id":"3d0c35d1-fc07-5044-be4d-4366dd424411","name_de":"Phase III: Wochen 7–12","name_en":"Phase III: Weeks 7-12","name_pl":"Faza III: tygodnie 7–12","source_page":1,"module_number":3,"name_original":"Phase III: Weeks 7-12","service_codes":[],"structured_content":{"de":{"goals":["voller Bewegungsumfang, minimale Schmerzen, Beginn der Muskelaktivierung und Kräftigung sowie Schutz der operierten Strukturen."],"exercises":["Schrittweise den vollständigen passiven Bewegungsumfang in allen Ebenen erreichen","danach aktive Bewegungen beginnen und bis zum vollen aktiven Bewegungsumfang gegen die Schwerkraft steigern","Kraft des M. pectoralis minor steigern","Skapularetraktoren kräftigen","vorsichtige isotonische Übungen und rhythmische Stabilisation der Rotatorenmanschette in offener und geschlossener Kette beginnen.","Wochen 8–10: das bisherige Kräftigungsprogramm steigern."],"applies_when":["Wochen 7–12"],"restrictions":["keine aggressive Mobilisation oder Dehnung","keine Lasten über 10 lb heben"],"dosage_and_progression":["Einfache Armschlinge schrittweise ablegen"],"physiotherapist_actions":["die vordere Kapsel nicht durch aggressive Überkopfkräftigung belasten.","Dehnung der hinteren Kapsel beginnen: Cross-Body-Stretch, Innenrotation in Seitenlage sowie posteriore und inferiore Mobilisation des Glenohumeralgelenks"]},"en":{"goals":["full range of motion, minimal pain, begin muscular activation and strengthening and protect the repair."],"exercises":["Progress to full passive range of motion in all planes","once full passive range is achieved, begin active range of motion and progress to full active range in gravity-resisted positions","enhance pectoralis minor strength","strengthen scapular retractors","begin gentle isotonic and rhythmic stabilization techniques for the rotator cuff in open and closed chains.","Weeks 8-10: progress the previous strengthening program."],"applies_when":["Weeks 7-12"],"restrictions":["no aggressive range of motion or stretching","no lifting greater than 10 lb","do not stress the anterior capsule with aggressive overhead strengthening."],"dosage_and_progression":["Wean from the simple sling"],"physiotherapist_actions":["begin posterior capsular stretching with cross-arm stretch, side-lying internal rotation stretch and posterior/inferior glenohumeral joint mobilization"]},"pl":{"goals":["pełny zakres ruchu, minimalny ból, rozpoczęcie aktywacji mięśniowej i wzmacniania oraz ochrona operowanych struktur."],"exercises":["Stopniowo uzyskać pełny bierny zakres ruchu we wszystkich płaszczyznach","po jego osiągnięciu rozpocząć czynny zakres ruchu i zwiększać go do pełnego w pozycjach przeciw grawitacji","zwiększać siłę mięśnia piersiowego mniejszego","wzmacnianie retraktorów łopatki","rozpocząć delikatne techniki izotoniczne i stabilizację rytmiczną stożka rotatorów w łańcuchu otwartym i zamkniętym.","Tygodnie 8–10: rozwijać wcześniejszy program wzmacniania."],"applies_when":["tygodnie 7–12"],"restrictions":["bez agresywnego zwiększania zakresu ruchu ani rozciągania","nie podnosić ciężaru większego niż 10 lb","nie obciążać przedniej torebki agresywnym wzmacnianiem nad głową."],"dosage_and_progression":["Stopniowo odstawić prosty temblak"],"physiotherapist_actions":["rozpocząć rozciąganie tylnej torebki: rozciąganie ramienia w poprzek tułowia, rotacja wewnętrzna w leżeniu bokiem oraz mobilizacja tylna i dolna stawu ramiennego"]},"original":{"goals":["full range of motion, minimal pain, begin muscular activation and strengthening and protect the repair."],"exercises":["Progress to full passive range of motion in all planes","once full passive range is achieved, begin active range of motion and progress to full active range in gravity-resisted positions","enhance pectoralis minor strength","strengthen scapular retractors","begin gentle isotonic and rhythmic stabilization techniques for the rotator cuff in open and closed chains.","Weeks 8-10: progress the previous strengthening program."],"applies_when":["Weeks 7-12"],"restrictions":["no aggressive range of motion or stretching","no lifting greater than 10 lb","do not stress the anterior capsule with aggressive overhead strengthening."],"dosage_and_progression":["Wean from the simple sling"],"physiotherapist_actions":["begin posterior capsular stretching with cross-arm stretch, side-lying internal rotation stretch and posterior/inferior glenohumeral joint mobilization"]}},"additional_notes_de":"Ziele: voller Bewegungsumfang, minimale Schmerzen, Beginn der Muskelaktivierung und Kräftigung sowie Schutz der operierten Strukturen.","additional_notes_en":"Goals: full range of motion, minimal pain, begin muscular activation and strengthening and protect the repair.","additional_notes_pl":"Cele: pełny zakres ruchu, minimalny ból, rozpoczęcie aktywacji mięśniowej i wzmacniania oraz ochrona operowanych struktur.","minimum_patient_share":null,"therapeutic_content_de":"Schrittweise den vollständigen passiven Bewegungsumfang in allen Ebenen erreichen; danach aktive Bewegungen beginnen und bis zum vollen aktiven Bewegungsumfang gegen die Schwerkraft steigern; Dehnung der hinteren Kapsel beginnen: Cross-Body-Stretch, Innenrotation in Seitenlage sowie posteriore und inferiore Mobilisation des Glenohumeralgelenks; Kraft des M. pectoralis minor steigern; Skapularetraktoren kräftigen; vorsichtige isotonische Übungen und rhythmische Stabilisation der Rotatorenmanschette in offener und geschlossener Kette beginnen. Wochen 8–10: das bisherige Kräftigungsprogramm steigern.","therapeutic_content_en":"Progress to full passive range of motion in all planes; once full passive range is achieved, begin active range of motion and progress to full active range in gravity-resisted positions; begin posterior capsular stretching with cross-arm stretch, side-lying internal rotation stretch and posterior/inferior glenohumeral joint mobilization; enhance pectoralis minor strength; strengthen scapular retractors; begin gentle isotonic and rhythmic stabilization techniques for the rotator cuff in open and closed chains. Weeks 8-10: progress the previous strengthening program.","therapeutic_content_pl":"Stopniowo uzyskać pełny bierny zakres ruchu we wszystkich płaszczyznach; po jego osiągnięciu rozpocząć czynny zakres ruchu i zwiększać go do pełnego w pozycjach przeciw grawitacji; rozpocząć rozciąganie tylnej torebki: rozciąganie ramienia w poprzek tułowia, rotacja wewnętrzna w leżeniu bokiem oraz mobilizacja tylna i dolna stawu ramiennego; zwiększać siłę mięśnia piersiowego mniejszego; wzmacnianie retraktorów łopatki; rozpocząć delikatne techniki izotoniczne i stabilizację rytmiczną stożka rotatorów w łańcuchu otwartym i zamkniętym. Tygodnie 8–10: rozwijać wcześniejszy program wzmacniania.","minimum_requirements_de":"Einfache Armschlinge schrittweise ablegen; keine aggressive Mobilisation oder Dehnung; keine Lasten über 10 lb heben; die vordere Kapsel nicht durch aggressive Überkopfkräftigung belasten.","minimum_requirements_en":"Wean from the simple sling; no aggressive range of motion or stretching; no lifting greater than 10 lb; do not stress the anterior capsule with aggressive overhead strengthening.","minimum_requirements_pl":"Stopniowo odstawić prosty temblak; bez agresywnego zwiększania zakresu ruchu ani rozciągania; nie podnosić ciężaru większego niż 10 lb; nie obciążać przedniej torebki agresywnym wzmacnianiem nad głową.","additional_notes_original":"Goals: full range of motion, minimal pain, begin muscular activation and strengthening and protect the repair.","therapeutic_content_original":"Progress to full passive range of motion in all planes; once full passive range is achieved, begin active range of motion and progress to full active range in gravity-resisted positions; begin posterior capsular stretching with cross-arm stretch, side-lying internal rotation stretch and posterior/inferior glenohumeral joint mobilization; enhance pectoralis minor strength; strengthen scapular retractors; begin gentle isotonic and rhythmic stabilization techniques for the rotator cuff in open and closed chains. Weeks 8-10: progress the previous strengthening program.","minimum_requirements_original":"Wean from the simple sling; no aggressive range of motion or stretching; no lifting greater than 10 lb; do not stress the anterior capsule with aggressive overhead strengthening.","structured_content_v2":"$undefined"},{"id":"3be9180c-5a42-50f2-9c82-071f0446a101","name_de":"Phase IV: Wochen 13–20","name_en":"Phase IV: Weeks 13-20","name_pl":"Faza IV: tygodnie 13–20","source_page":2,"module_number":4,"name_original":"Phase IV: Weeks 13-20","service_codes":[],"structured_content":{"de":{"goals":["funktionelle Aktivitäten sowie fortgeschrittene sportliche und Freizeitaktivitäten nach Vorgabe des Operateurs steigern."],"exercises":["Alle Kräftigungsübungen fortsetzen","vollen Bewegungsumfang erhalten","Außenrotation kräftigen","periskapuläre T- und Y-Übungen","progressive Ballstabilisation an der Wand und Ballprellen an der Wand","allgemeines Krafttraining der oberen Extremität mit geringer Last und vielen Wiederholungen beginnen, dabei Bankdrücken mit weitem Griff, Military Press und Latziehen hinter den Kopf vermeiden.","Woche 16: bei entsprechender Indikation ein Intervall-Sportprogramm beginnen."],"applies_when":["Wochen 13–20"],"restrictions":["Keine schwere Kräftigung oder Gewichtheben bis 4 Monate","keine Wurf- oder Überkopfbewegungen bis 4 Monate"],"progression_criteria":["Freigabe durch den Operateur","Kraftdefizit <10 %","Limb-Symmetry-Index ≥90 %","45/50 Punkte in biomechanischen Funktionstests, sofern durchgeführt","keine Schmerzen und keine berichtete Instabilität."],"dosage_and_progression":["schrittweise Rückkehr zu anstrengender Arbeit, Freizeit- und Sportaktivitäten."]},"en":{"goals":["progress functional activities and advanced sport and recreational activity per surgeon."],"exercises":["Continue all strengthening exercises","maintain full range of motion","external rotation strengthening","periscapular T's and Y's","progressive ball stabilization on the wall and wall-ball dribbles","begin generalized upper-extremity weightlifting with low weight and high repetitions, avoiding wide-grip bench press, military press and lat pull behind the head.","Week 16: initiate an interval sports program if appropriate."],"applies_when":["Weeks 13-20"],"restrictions":["No heavy strengthening or weightlifting until 4 months","no throwing or overhead movements until 4 months","avoiding wide-grip bench press, military press and lat pull behind the head."],"progression_criteria":["surgeon clearance","<10% strength deficit","limb similarity index ≥90%","45/50 on biomechanical functional tests, if performed","no pain or complaints of instability."],"dosage_and_progression":["gradual return to strenuous work, recreational activities and sports."]},"pl":{"goals":["rozwijanie aktywności funkcjonalnych oraz zaawansowanej aktywności sportowej i rekreacyjnej zgodnie z decyzją chirurga."],"exercises":["Kontynuować wszystkie ćwiczenia wzmacniające","utrzymywać pełny zakres ruchu","wzmacnianie rotacji zewnętrznej","ćwiczenia T i Y mięśni okoł łopatkowych","stopniowana stabilizacja piłki na ścianie i kozłowanie piłki o ścianę","rozpocząć ogólny trening siłowy kończyny górnej z małym obciążeniem i dużą liczbą powtórzeń, unikając wyciskania leżąc szerokim chwytem, wyciskania żołnierskiego i ściągania drążka za głowę.","Tydzień 16: rozpocząć interwałowy program sportowy, jeżeli wskazany."],"applies_when":["tygodnie 13–20"],"restrictions":["Bez ciężkiego wzmacniania ani treningu siłowego do 4 miesięcy","bez rzucania ani ruchów nad głową do 4 miesięcy","unikając wyciskania leżąc szerokim chwytem, wyciskania żołnierskiego i ściągania drążka za głowę."],"progression_criteria":["zgoda chirurga","deficyt siły <10%","wskaźnik podobieństwa kończyn ≥90%","wynik 45/50 w biomechanicznych testach funkcjonalnych, jeżeli wykonano","brak bólu i zgłaszanej niestabilności."],"dosage_and_progression":["stopniowy powrót do ciężkiej pracy, rekreacji i sportu."]},"original":{"goals":["progress functional activities and advanced sport and recreational activity per surgeon."],"exercises":["Continue all strengthening exercises","maintain full range of motion","external rotation strengthening","periscapular T's and Y's","progressive ball stabilization on the wall and wall-ball dribbles","begin generalized upper-extremity weightlifting with low weight and high repetitions, avoiding wide-grip bench press, military press and lat pull behind the head.","Week 16: initiate an interval sports program if appropriate."],"applies_when":["Weeks 13-20"],"restrictions":["No heavy strengthening or weightlifting until 4 months","no throwing or overhead movements until 4 months","avoiding wide-grip bench press, military press and lat pull behind the head."],"progression_criteria":["surgeon clearance","<10% strength deficit","limb similarity index ≥90%","45/50 on biomechanical functional tests, if performed","no pain or complaints of instability."],"dosage_and_progression":["gradual return to strenuous work, recreational activities and sports."]}},"additional_notes_de":"Ziele: funktionelle Aktivitäten sowie fortgeschrittene sportliche und Freizeitaktivitäten nach Vorgabe des Operateurs steigern. Entlassungskriterien: Freigabe durch den Operateur; Kraftdefizit <10 %; Limb-Symmetry-Index ≥90 %; 45/50 Punkte in biomechanischen Funktionstests, sofern durchgeführt; keine Schmerzen und keine berichtete Instabilität.","additional_notes_en":"Goals: progress functional activities and advanced sport and recreational activity per surgeon. Discharge criteria: surgeon clearance; <10% strength deficit; limb similarity index ≥90%; 45/50 on biomechanical functional tests, if performed; no pain or complaints of instability.","additional_notes_pl":"Cele: rozwijanie aktywności funkcjonalnych oraz zaawansowanej aktywności sportowej i rekreacyjnej zgodnie z decyzją chirurga. Kryteria wypisu: zgoda chirurga; deficyt siły <10%; wskaźnik podobieństwa kończyn ≥90%; wynik 45/50 w biomechanicznych testach funkcjonalnych, jeżeli wykonano; brak bólu i zgłaszanej niestabilności.","minimum_patient_share":null,"therapeutic_content_de":"Alle Kräftigungsübungen fortsetzen; vollen Bewegungsumfang erhalten; Außenrotation kräftigen; periskapuläre T- und Y-Übungen; progressive Ballstabilisation an der Wand und Ballprellen an der Wand; allgemeines Krafttraining der oberen Extremität mit geringer Last und vielen Wiederholungen beginnen, dabei Bankdrücken mit weitem Griff, Military Press und Latziehen hinter den Kopf vermeiden. Woche 16: bei entsprechender Indikation ein Intervall-Sportprogramm beginnen.","therapeutic_content_en":"Continue all strengthening exercises; maintain full range of motion; external rotation strengthening; periscapular T's and Y's; progressive ball stabilization on the wall and wall-ball dribbles; begin generalized upper-extremity weightlifting with low weight and high repetitions, avoiding wide-grip bench press, military press and lat pull behind the head. Week 16: initiate an interval sports program if appropriate.","therapeutic_content_pl":"Kontynuować wszystkie ćwiczenia wzmacniające; utrzymywać pełny zakres ruchu; wzmacnianie rotacji zewnętrznej; ćwiczenia T i Y mięśni okoł łopatkowych; stopniowana stabilizacja piłki na ścianie i kozłowanie piłki o ścianę; rozpocząć ogólny trening siłowy kończyny górnej z małym obciążeniem i dużą liczbą powtórzeń, unikając wyciskania leżąc szerokim chwytem, wyciskania żołnierskiego i ściągania drążka za głowę. Tydzień 16: rozpocząć interwałowy program sportowy, jeżeli wskazany.","minimum_requirements_de":"Keine schwere Kräftigung oder Gewichtheben bis 4 Monate; keine Wurf- oder Überkopfbewegungen bis 4 Monate; schrittweise Rückkehr zu anstrengender Arbeit, Freizeit- und Sportaktivitäten.","minimum_requirements_en":"No heavy strengthening or weightlifting until 4 months; no throwing or overhead movements until 4 months; gradual return to strenuous work, recreational activities and sports.","minimum_requirements_pl":"Bez ciężkiego wzmacniania ani treningu siłowego do 4 miesięcy; bez rzucania ani ruchów nad głową do 4 miesięcy; stopniowy powrót do ciężkiej pracy, rekreacji i sportu.","additional_notes_original":"Goals: progress functional activities and advanced sport and recreational activity per surgeon. Discharge criteria: surgeon clearance; <10% strength deficit; limb similarity index ≥90%; 45/50 on biomechanical functional tests, if performed; no pain or complaints of instability.","therapeutic_content_original":"Continue all strengthening exercises; maintain full range of motion; external rotation strengthening; periscapular T's and Y's; progressive ball stabilization on the wall and wall-ball dribbles; begin generalized upper-extremity weightlifting with low weight and high repetitions, avoiding wide-grip bench press, military press and lat pull behind the head. Week 16: initiate an interval sports program if appropriate.","minimum_requirements_original":"No heavy strengthening or weightlifting until 4 months; no throwing or overhead movements until 4 months; gradual return to strenuous work, recreational activities and sports.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["shoulder","upper_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"d1800f2c-9914-50b7-a89a-a948d139a38f","slug":"us-south-shore-16-pectoralis-major-repair","title_pl":"Protokół rehabilitacji po naprawie mięśnia piersiowego większego","title_de":"Rehabilitationsprotokoll nach Pectoralis-Major-Reparatur","title_en":"Rehabilitation protocol after pectoralis major repair","title_original":"Pec Major Repair","summary_pl":"Ogólne wytyczne rehabilitacji pooperacyjnej obejmujące 6 faz, od ochrony tkanki po powrót do sportu.","summary_de":"Allgemeine Richtlinien für die postoperative Rehabilitation in 6 Phasen, von Gewebeschutz bis zum Sport-Return.","summary_en":"General postoperative rehabilitation guidelines covering 6 phases, from tissue protection to return to sport.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"0c30f200-e2f3-58f0-8ff0-6cb7ece65864","condition_slug":"pectoralis-major-repair","condition_name_pl":"Stan po operacyjnej naprawie mięśnia piersiowego większego","condition_name_de":"Zustand nach Pectoralis-Major-Reparatur","condition_name_en":"Status post pectoralis major repair","condition_name_original":"Status post pectoralis major repair","icd_codes":[],"category_key":"shoulder","category_pl":"Rehabilitacja barku","category_de":"Schulter-Rehabilitation","category_en":"Shoulder rehabilitation","body_regions_pl":["bark","klatka piersiowa"],"body_regions_de":["Schulter","Brust"],"body_regions_en":["shoulder","chest"],"search_terms_pl":["naprawa piersiowego","protokół pooperacyjny barku","uszkodzenie mięśnia piersiowego","rehabilitacja po operacji"],"search_terms_de":["Pectoralis-Major-Riss","Nachbehandlung Pectoralis","Schulter-Reha","postoperative Rehabilitation"],"search_terms_en":["pec major repair","pectoralis major tear","shoulder rehab protocol","post-op pectoralis"],"source_document_id":"81567e50-9d9e-5c02-a931-4f4d26032a38","source_title":"Pec Major Repair","issuer":"South Shore Orthopedics","source_country_code":"US","jurisdiction_code":"US-MA","authority_level":"hospital","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_unknown_requires_review","official_url":"https://octanecdn.com/southshoreorthopedicscom/southshoreorthopedicscom_315979112.pdf","source_sha256":"123e923b5875e082a3ef0ec974ab81a9546e6089d71eccf9183a2aa663f33069","authorization_required":false,"license_note":"Public source file retained locally for source verification.","modules":[{"id":"aa0dafa7-03d7-5f5d-9d31-ec37cf61bb02","name_de":"Phase I: Gewebeschutz (Tage 1-14)","name_en":"Phase I: Tissue protection (days 1-14)","name_pl":"Faza I: Ochrona tkanki (dni 1-14)","source_page":1,"module_number":1,"name_original":"Phase I (Days 1-14)","service_codes":[],"structured_content":{"de":{"exercises":["Bewegungsübungen für Handgelenk und Ellenbogen mit besonderem Fokus auf die Ellenbogenstreckung."],"restrictions":["Die Schlinge in den ersten 6 Wochen ständig tragen und nur für Übungen/Therapie abnehmen.","Keine Gegenstände heben.","Keine aktive Abduktion, Vorwärtshebung oder Außenrotation.","Das Körpergewicht nicht mit den Händen abstützen.","Die Inzision sauber und trocken halten."],"progression_criteria":[],"dosage_and_progression":["Alle zwei Stunden 15–20 Minuten kühlen."],"physiotherapist_actions":["Abschwellende Massage durchführen.","Bei Bedarf die umgebende Muskulatur massieren: Bizeps, oberer Trapezmuskel, Levator scapulae usw."]},"en":{"exercises":["Wrist and elbow ROM, particularly focusing on elbow extension."],"restrictions":["Keep the arm in the sling at all times for the first 6 weeks, removing it only for exercise/therapy.","Do not lift any objects.","No active abduction, forward elevation, or external rotation.","Do not support body weight by the hands.","Keep the incision clean and dry."],"progression_criteria":[],"dosage_and_progression":["Ice every other hour for 15–20 minutes."],"physiotherapist_actions":["Perform decongestive massage.","If needed, perform soft tissue massage to surrounding musculature: biceps, upper trapezius, levator, etc."]},"pl":{"exercises":["Ruchomość nadgarstka i łokcia, ze szczególnym uwzględnieniem wyprostu łokcia."],"restrictions":["Temblak stale przez pierwsze 6 tygodni; zdejmować tylko na ćwiczenia/terapię.","Nie unosić żadnych przedmiotów.","Bez aktywnego odwodzenia, unoszenia do przodu ani rotacji zewnętrznej.","Nie podpierać ciężaru ciała rękami.","Utrzymywać ranę czystą i suchą."],"progression_criteria":[],"dosage_and_progression":["Chłodzenie co dwie godziny przez 15–20 minut."],"physiotherapist_actions":["Wykonać masaż przeciwobrzękowy.","W razie potrzeby wykonać masaż otaczających tkanek miękkich: bicepsa, górnego mięśnia czworobocznego, dźwigacza łopatki itd."]},"original":{"exercises":["Wrist and elbow ROM particularly focusing on elbow extension"],"restrictions":["Maintain arm in sling, remove only for exercise for first 6 wks.","No lifting of any objects","No active abduction, forward elevation, or external rotation","No supporting of body weight by hands","Keep incision clean and dry"],"progression_criteria":[],"dosage_and_progression":["Icing every other hour 15-20 minutes"],"physiotherapist_actions":["Decongestive massage","Soft tissue massage to surrounding musculature if needed: biceps, upper trapezius, levator, etc."]}},"additional_notes_de":"Kühlen alle zwei Stunden für 15–20 Minuten; keine Belastung der oberen Extremität; Ziele: den passiven Bewegungsumfang schrittweise steigern, Schmerzen und Entzündung vermindern sowie muskuläre Inhibition verhindern.","additional_notes_en":"Icing every other hour 15-20 minutes; no supporting weight through the upper extremity; goals: gradually increase passive ROM, diminish pain and inflammation, and prevent muscular inhibition.","additional_notes_pl":"Chłodzenie co dwie godziny przez 15–20 minut; brak obciążania kończyny górnej; cele: stopniowo zwiększać bierny zakres ruchu, zmniejszać ból i stan zapalny oraz zapobiegać inhibicji mięśni.","minimum_patient_share":null,"therapeutic_content_de":"Abschwellende Massage und bei Bedarf Weichteilmassage der umgebenden Muskulatur; Übungen für die Beweglichkeit von Handgelenk und Ellenbogen mit besonderem Fokus auf die Ellenbogenstreckung; Kühlen alle zwei Stunden für 15–20 Minuten; konsequentes Tragen der Schlinge in den ersten 6 Wochen, nur für Übungen abzunehmen.","therapeutic_content_en":"Decongestive massage; soft tissue massage to surrounding musculature if needed; wrist and elbow ROM particularly focusing on elbow extension; sling use at all times for first 6 wks, removing it only for exercise.","therapeutic_content_pl":"Masaż przeciwobrzękowy i masaż tkanek miękkich otaczających mięśni, jeśli potrzebny; ćwiczenia ruchomości nadgarstka i łokcia, ze szczególnym uwzględnieniem wyprostu łokcia; chłodzenie co dwie godziny przez 15–20 minut; stałe noszenie temblaka przez pierwsze 6 tygodni, zdejmowanego tylko na ćwiczenia.","minimum_requirements_de":"Integrität der Reparatur schützen; keine aktive Abduktion, Vorwärtshebung oder Außenrotation; keine Gegenstände heben; den Körper nicht mit den Händen abstützen; die Inzision sauber und trocken halten.","minimum_requirements_en":"Maintain integrity of the repair; No active abduction, forward elevation, or external rotation; No lifting of any objects; No supporting of body weight by hands; Keep the incision clean and dry.","minimum_requirements_pl":"Ochrona integralności naprawy; brak aktywnego odwodzenia, unoszenia do przodu i rotacji zewnętrznej; zakaz unoszenia jakichkolwiek przedmiotów; brak podpierania ciężaru ciała rękami; utrzymuj ranę czystą i suchą.","additional_notes_original":"Goals: Maintain integrity of repair; Gradually increase passive ROM; Diminish pain and inflammation; Prevent muscular inhibition.","therapeutic_content_original":"Sling use at all times (except therapy) for first 6 wks.; Decongestive massage; Icing every other hour 15-20 minutes; Wrist and elbow ROM particularly focusing on elbow extension; Soft tissue massage to surrounding musculature if needed: biceps, upper trapezius, levator, etc.","minimum_requirements_original":"Maintain arm in sling, remove only for exercise for first 6 wks.; No lifting of any objects; No active abduction, forward elevation, or external rotation; No supporting of body weight by hands; Keep incision clean and dry.","structured_content_v2":"$undefined"},{"id":"de420079-fec7-5b42-a05a-ab5f76145315","name_de":"Phase II: Steigerung der Beweglichkeit (Wochen 2-6)","name_en":"Phase II: Range of motion progression (weeks 2-6)","name_pl":"Faza II: Zwiększanie ruchomości (tygodnie 2-6)","source_page":1,"module_number":2,"name_original":"Phase II (Weeks 2-6)","service_codes":[],"structured_content":{"de":{"exercises":["Codman-Übungen: lange Armdistraktion; bei starker Schonhaltung den Arm in Bauchlage über die Bettkante hängen lassen.","Passive Vorwärtsflexion in Rückenlage bei adduziertem Arm: bei 45° beginnen und wöchentlich um 5–10° steigern.","Passive Außenrotation bei bis 0° adduziertem Arm: wöchentlich um 5–10° steigern, 30° ER nicht überschreiten.","Passive Abduktion bis 30° mit einer Progression um 5° pro Woche.","Übungen zur Skapulastabilisierung."],"restrictions":["Das heilende Gewebe nicht überlasten.","Keine übermäßige Schulterabduktion und keine Außenrotation >30° bei angelegtem Ellenbogen.","Kräftigung nicht vor der 12. postoperativen Woche beginnen.","Bis zur 12. Woche keine Bewegung hinter die Körperebene."],"progression_criteria":[],"dosage_and_progression":["Vorwärtsflexion: Start bei 45°, Progression 5–10°/Woche.","Außenrotation: Progression 5–10°/Woche, maximal 30°.","Abduktion: Start bei 30°, Progression 5°/Woche."],"physiotherapist_actions":["Weichteilmassage fortsetzen.","Volle Supination und Streckung des Ellenbogens prüfen; bei Defizit das Radioulnargelenk mobilisieren."]},"en":{"exercises":["Codman’s: long-arm distraction; if too guarded, use a prone arm hang over the edge of the bed.","Passive forward flexion in supine with the arm adducted: begin at 45° and increase 5–10° per week.","Passive ER with the arm adducted to 0°: increase 5–10° per week and do not exceed 30° ER.","Passive abduction to 30°, progressing 5° per week.","Scapular stabilization exercises."],"restrictions":["Do not overstress healing tissue.","No excessive shoulder abduction and no external rotation >30° with the elbow at the side.","Do not start strengthening until 12 weeks post-op.","Nothing behind the plane of the body until 12 weeks."],"progression_criteria":[],"dosage_and_progression":["Forward flexion: start at 45°, progress 5–10°/week.","External rotation: progress 5–10°/week, maximum 30°.","Abduction: start at 30°, progress 5°/week."],"physiotherapist_actions":["Continue soft tissue massage.","Ensure full elbow supination and extension; if limited, mobilize the radio-ulnar joint."]},"pl":{"exercises":["Ćwiczenia Codmana: długie odciągnięcie kończyny; przy nadmiernej ochronie zwis ramienia w leżeniu przodem nad krawędzią łóżka.","Bierne unoszenie do przodu w leżeniu tyłem z ramieniem przywiedzionym: rozpocząć od 45° i zwiększać o 5–10° tygodniowo.","Bierna rotacja zewnętrzna z ramieniem przywiedzionym do 0°: zwiększać o 5–10° tygodniowo, nie przekraczać 30° ER.","Bierne odwodzenie do 30° z progresją 5° tygodniowo.","Ćwiczenia stabilizacji łopatki."],"restrictions":["Nie przeciążać gojącej tkanki.","Bez nadmiernego odwodzenia barku i bez rotacji zewnętrznej >30° z łokciem przy boku.","Nie rozpoczynać wzmacniania przed 12. tygodniem po operacji.","Nie wykonywać ruchów za płaszczyzną ciała do 12. tygodnia."],"progression_criteria":[],"dosage_and_progression":["Unoszenie do przodu: start 45°, progresja 5–10°/tydzień.","Rotacja zewnętrzna: progresja 5–10°/tydzień, maksymalnie 30°.","Odwodzenie: start 30°, progresja 5°/tydzień."],"physiotherapist_actions":["Kontynuować masaż tkanek miękkich.","Sprawdzić pełną supinację i wyprost łokcia; przy deficycie mobilizować staw promieniowo-łokciowy."]},"original":{"exercises":["Begin Codman’s (long arm distraction – prone arm hang over edge of bed if too guarded).","Begin gradual passive forward flexion with arm adducted in supine position. Begin forward flexion to 45 degrees increasing 5-10 degrees per week.","Begin passive ER with arm adducted to 0 degrees and increase 5-10 degrees per week (do not exceed 30 degrees ER)","Begin passive abduction to 30 degrees progressing 5 degrees per week.","Scapular stabilization exercises"],"restrictions":["Do not overstress healing tissue","No excessive shoulder abduction, no external rotation past 30º with elbow at side","Strengthening exercises not started until 12 weeks post-op.","Nothing behind the plane of the body until 12 weeks."],"progression_criteria":[],"dosage_and_progression":["Begin forward flexion to 45 degrees increasing 5-10 degrees per week","increase 5-10 degrees per week (do not exceed 30 degrees ER)","passive abduction to 30 degrees progressing 5 degrees per week"],"physiotherapist_actions":["Continue with soft tissue massage.","Ensure full elbow supination and extension, if not, mobilize radio-ulnar joint."]}},"additional_notes_de":"Ziele: den vollständigen passiven Bewegungsumfang schrittweise wiederherstellen, heilendes Gewebe nicht überlasten, die Heilung der Weichteile ermöglichen und Schmerzen sowie Entzündung vermindern; bis zur 12. Woche keine Bewegungen hinter der Körperebene.","additional_notes_en":"Goals: gradually restore full passive ROM, do not overstress healing tissue, allow soft tissue healing, and decrease pain and inflammation; nothing behind the plane of the body until 12 weeks.","additional_notes_pl":"Cele: stopniowo przywracać pełny bierny zakres ruchu, nie przeciążać gojącej tkanki, umożliwić gojenie tkanek miękkich oraz zmniejszać ból i stan zapalny; nie wykonuj ruchów za płaszczyzną ciała do 12. tygodnia.","minimum_patient_share":null,"therapeutic_content_de":"Codman-Übungen: lange Distraktion und Pendeln des Arms in Bauchlage über die Bettkante, wenn der Patient zu vorsichtig ist; schrittweise passive Vorwärtsflexion bei adduziertem Arm, beginnend bei 45° mit einer Steigerung um 5–10° pro Woche; passive Außenrotation bei adduziertem Arm, Steigerung um 5–10° pro Woche und nicht über 30°; passive Abduktion bis 30°; Steigerung um 5° pro Woche; Weichteilmassage fortsetzen; vollständige Supination und Streckung des Ellenbogens sicherstellen und bei Bedarf das Radioulnargelenk mobilisieren; Übungen zur Skapulastabilisierung.","therapeutic_content_en":"Begin Codman's (long arm distraction – prone arm hang over edge of bed if too guarded); Begin gradual passive forward flexion with arm adducted in supine position. Begin forward flexion to 45 degrees increasing 5-10 degrees per week; Begin passive ER with arm adducted to 0 degrees and increase 5-10 degrees per week (do not exceed 30 degrees ER); Begin passive abduction to 30 degrees progressing 5 degrees per week; Continue with soft tissue massage; Ensure full elbow supination and extension, if not, mobilize radio-ulnar joint; Scapular stabilization exercises.","therapeutic_content_pl":"Ćwiczenia Codmana: długie odciągnięcie kończyny i zwis ręki w leżeniu przodem nad krawędzią łóżka, jeśli pacjent jest zbyt ostrożny; stopniowe bierne zginanie do przodu w przywiedzeniu, od 45° z progresją 5–10° tygodniowo; bierna rotacja zewnętrzna w przywiedzeniu, z progresją 5–10° tygodniowo i bez przekraczania 30°; bierne odwodzenie do 30°; zwiększaj o 5° tygodniowo; kontynuacja masażu tkanek miękkich; zapewnij pełną supinację i wyprost łokcia, a przy ograniczeniu mobilizuj staw promieniowo-łokciowy; ćwiczenia stabilizacji łopatki.","minimum_requirements_de":"Den Schutz des heilenden Gewebes fortsetzen; das Gewebe nicht überlasten; keine übermäßige Schulterabduktion und keine Außenrotation über 30° bei angelegtem Arm; Kräftigungsübungen erst ab der 12. postoperativen Woche beginnen.","minimum_requirements_en":"Continue protecting healing tissue; avoid overstressing healing tissue; no excessive shoulder abduction, no external rotation past 30º with elbow at side; Strengthening exercises not started until 12 weeks post-op.","minimum_requirements_pl":"Kontynuuj ochronę gojącej się tkanki; nie przeciążaj jej; nie wykonuj nadmiernego odwodzenia barku ani rotacji zewnętrznej powyżej 30° przy ramieniu przy boku; nie rozpoczynaj ćwiczeń wzmacniających przed 12. tygodniem.","additional_notes_original":"Goals: Gradually restore full passive ROM; Do not overstress healing tissue; Allow healing of soft tissue; No excessive shoulder abduction, no external rotation past 30º with elbow at side; Decrease pain and inflammation.","therapeutic_content_original":"Begin Codman’s (long arm distraction – prone arm hang over edge of bed if too guarded).; Begin gradual passive forward flexion with arm adducted in supine position. Begin forward flexion to 45 degrees increasing 5-10 degrees per week.; Begin passive ER with arm adducted to 0 degrees and increase 5-10 degrees per week (do not exceed 30 degrees ER).; Begin passive abduction to 30 degrees progressing 5 degrees per week.; Continue with soft tissue massage.; Ensure full elbow supination and extension, if not, mobilize radio-ulnar joint.; Scapular stabilization exercises.","minimum_requirements_original":"Do not overstress healing tissue; No excessive shoulder abduction, no external rotation past 30º with elbow at side; Avoid ER beyond 30 degrees with arm neutral.; Strengthening exercises not started until 12 weeks post-op.; Nothing behind the plane of the body until 12 weeks.","structured_content_v2":"$undefined"},{"id":"900883b7-dceb-5864-974c-1a93dc931975","name_de":"Phase III: Aktive Beweglichkeit und Isometrie (Wochen 6-12)","name_en":"Phase III: Active motion and isometrics (weeks 6-12)","name_pl":"Faza III: Aktywny zakres i izometria (tygodnie 6-12)","source_page":2,"module_number":3,"name_original":"Phase III (Weeks 6-12)","service_codes":[],"structured_content":{"de":{"exercises":["AAROM und AROM der Vorwärtshebung mit Progression zum vollen Bewegungsumfang.","Außenrotation schrittweise zum vollen Bewegungsumfang steigern.","Skapula-Isometrien.","Sanfte Kapseldehnung.","Aktive glenohumerale Retraktion und Depression während der Vorwärtshebung in Rückenlage.","Leichte Isometrien bei gebeugtem Ellenbogen am Körper."],"restrictions":["Kräftigungsübungen nicht vor der 12. postoperativen Woche beginnen.","Bis zur 12. Woche keine Bewegung hinter die Körperebene."],"progression_criteria":["Ziel in Woche 12 ist der volle Bewegungsumfang."],"dosage_and_progression":["Die Schlinge kann 6 Wochen nach der Operation abgesetzt werden."],"physiotherapist_actions":["Die skapulothorakale Beweglichkeit und die Beweglichkeit des Akromioklavikulargelenks dehnen und sicherstellen."]},"en":{"exercises":["AAROM and AROM forward elevation, progressing toward full forward elevation.","Gradually increase external rotation toward full ROM.","Scapular isometrics.","Gentle capsular stretching.","Active glenohumeral retraction and depression during forward elevation while supine.","Light isometrics with the elbow flexed at the side."],"restrictions":["Do not start strengthening exercises until 12 weeks post-op.","Nothing behind the plane of the body until 12 weeks."],"progression_criteria":["The goal at 12 weeks is full range of motion."],"dosage_and_progression":["The sling can be discontinued 6 weeks after surgery."],"physiotherapist_actions":["Stretch and ensure scapulothoracic and AC-joint mobility."]},"pl":{"exercises":["AAROM i AROM unoszenia do przodu z progresją do pełnego zakresu.","Stopniowe zwiększanie rotacji zewnętrznej do pełnego zakresu.","Izometria łopatki.","Delikatne rozciąganie torebki stawowej.","Aktywna retrakcja i depresja stawu ramiennego podczas unoszenia do przodu w leżeniu tyłem.","Lekkie izometrie z łokciem zgiętym przy boku."],"restrictions":["Nie rozpoczynać ćwiczeń wzmacniających przed 12. tygodniem po operacji.","Nie wykonywać ruchów za płaszczyzną ciała do 12. tygodnia."],"progression_criteria":["W 12. tygodniu celem jest pełny zakres ruchu."],"dosage_and_progression":["Temblak można odstawić 6 tygodni po operacji."],"physiotherapist_actions":["Rozciągać i zapewniać ruchomość piersiowo-łopatkową oraz stawu barkowo-obojczykowego."]},"original":{"exercises":["Begin AAROM, AROM with forward elevation continue toward full forward elevation.","Gradually increase external rotation toward full ROM","Scapular isometrics","Gentle capsular stretching","AROM: Glenohumeral retraction and depression during forward elevation (flexion) while supine","May begin light isometrics with elbow flexed to side"],"restrictions":["Strengthening exercises not started until 12 weeks post-op.","Nothing behind the plane of the body until 12 weeks."],"progression_criteria":["Goal at 12 weeks is full range of motion."],"dosage_and_progression":["Sling can be discontinued at 6 weeks after surgery."],"physiotherapist_actions":["Stretch/ensure scapular thoracic mobility, AC joint mobility."]}},"additional_notes_de":"Vollständiger AROM und schrittweise Wiederherstellung der muskulären Ausdauer der Schulter; vollständiger Bewegungsumfang in der 12. Woche.","additional_notes_en":"Goals: Full AROM, PROM, gradual restoration of shoulder muscular endurance; Goal at 12 weeks is full range of motion.","additional_notes_pl":"Pełny AROM i stopniowe przywrócenie wytrzymałości mięśni barku; pełny zakres ruchu w 12. tygodniu.","minimum_patient_share":null,"therapeutic_content_de":"Die Schlinge 6 Wochen nach der Operation absetzen; AAROM und AROM der Vorwärtshebung mit dem Ziel der vollständigen Vorwärtshebung beginnen; Außenrotation schrittweise zum vollen Bewegungsumfang steigern; Beweglichkeit der skapulothorakalen Region und des Akromioklavikulargelenks dehnen und sicherstellen; Skapula-Isometrien; sanfte Kapseldehnung; AROM von Retraktion und Depression des Glenohumeralgelenks während der Flexion in Rückenlage; leichte Isometrien bei gebeugtem Ellenbogen am Körper.","therapeutic_content_en":"Sling can be discontinued at 6 weeks after surgery; Begin AAROM, AROM with forward elevation continue toward full forward elevation; Gradually increase external rotation toward full ROM; Stretch/ensure scapular thoracic mobility, AC joint mobility; Scapular isometrics; Gentle capsular stretching; AROM: Glenohumeral retraction and depression during forward elevation (flexion) while supine; May begin light isometrics with elbow flexed to side.","therapeutic_content_pl":"Odstawienie temblaka po 6 tygodniach; rozpoczęcie AAROM i AROM zgięcia do przodu z dążeniem do pełnego unoszenia; stopniowe zwiększanie rotacji zewnętrznej; praca nad ruchomością piersiowo-łopatkową i stawu barkowo-obojczykowego; izometria łopatki; delikatne rozciąganie torebki; AROM retrakcji i depresji stawu ramienno-łopatkowego podczas zgięcia w leżeniu; lekkie izometrie z łokciem zgiętym przy boku.","minimum_requirements_de":"Kräftigungsübungen nicht vor der 12. postoperativen Woche beginnen; bis zur 12. Woche keine Bewegungen hinter der Körperebene.","minimum_requirements_en":"Do not start strengthening exercises until 12 weeks post-op; nothing behind the plane of the body until 12 weeks.","minimum_requirements_pl":"Nie rozpoczynaj ćwiczeń oporowych przed 12. tygodniem po operacji; nie wykonuj ruchów za płaszczyzną ciała przed 12. tygodniem.","additional_notes_original":"Goals: Full AROM, PROM, gradual restoration of shoulder muscular endurance.","therapeutic_content_original":"Sling can be discontinued at 6 weeks after surgery.; Begin AAROM, AROM with forward elevation continue toward full forward elevation.; Gradually increase external rotation toward full ROM; Stretch/ensure scapular thoracic mobility, AC joint mobility.; Scapular isometrics; Gentle capsular stretching; AROM: Glenohumeral retraction and depression during forward elevation (flexion) while supine; May begin light isometrics with elbow flexed to side; Goal at 12 weeks is full range of motion.","minimum_requirements_original":"Strengthening exercises not started until 12 weeks post-op. Nothing behind the plane of the body until 12 weeks.","structured_content_v2":"$undefined"},{"id":"91895bee-634e-5590-953d-81c2438099b2","name_de":"Phase IV: Frühe Belastung (Wochen 12-16)","name_en":"Phase IV: Early loading (weeks 12-16)","name_pl":"Faza IV: Wczesne obciążenie (tygodnie 12-16)","source_page":2,"module_number":4,"name_original":"Phase IV (Weeks 12-16)","service_codes":[],"structured_content":{"de":{"exercises":["Übungen in Seitenlage im Teilbewegungsumfang: Abduktion, ER, IR, Extension, Flexion und Adduktion; danach schrittweise Gewicht hinzufügen.","Rhomboiden sowie unteren und mittleren Trapezmuskel ohne Kompensation durch den oberen Trapezmuskel kräftigen.","Serratus anterior kräftigen: Bauchstütz, Wandliegestütz usw.","Rhythmische Stabilisation in Rückenlage, Seitenlage usw.","Überkopf-Ballübungen.","Brustpässe und leichtes Freizeitwerfen.","Stehende Flexions- und Adduktions-PRE mit sehr leichten freien Gewichten: von einzelnen Ebenen zu kombinierten Bewegungen.","Leichte Übungen am Widerstandszug."],"restrictions":["Keine Kompensation durch den oberen Trapezmuskel zulassen."],"progression_criteria":[],"dosage_and_progression":["Muskuläre Ausdauer mit leichtem Gewicht und vielen Wiederholungen ohne Kompensation durch den oberen Trapezmuskel einführen."],"physiotherapist_actions":["Griffkraft prüfen und die Belastung für Ellenbogen und Unterarm steigern.","Weichteilarbeit und Gelenkmobilisation fortsetzen."]},"en":{"exercises":["Side-lying exercises through partial ROM: abduction, ER, IR, extension, flexion and adduction; then gradually add weight.","Strengthen the rhomboids and lower/middle trapezius without upper-trapezius compensation.","Strengthen serratus anterior: prone prop, wall push-up, etc.","Rhythmic stabilization in supine, side lying, etc.","Overhead ball exercises.","Chest pass and light recreational throwing.","Standing flexion and adduction PREs with very light free weights: begin in single planes and advance to combined motions.","Light resistive-pulley exercises."],"restrictions":["Do not allow upper-trapezius compensation."],"progression_criteria":[],"dosage_and_progression":["Introduce muscular endurance with light weight and several repetitions without upper-trapezius compensation."],"physiotherapist_actions":["Check grip strength and increase weight for elbow and forearm work.","Continue soft tissue work and joint mobilization."]},"pl":{"exercises":["Ćwiczenia w leżeniu bokiem w częściowym zakresie: odwodzenie, rotacja zewnętrzna, rotacja wewnętrzna, wyprost, zgięcie i przywodzenie; następnie stopniowo dodawać obciążenie.","Wzmacnianie romboidów oraz dolnej i środkowej części mięśnia czworobocznego bez kompensacji jego górną częścią.","Wzmacnianie zębatego przedniego: podpór przodem, pompki przy ścianie itd.","Stabilizacja rytmiczna w leżeniu tyłem, bokiem itd.","Ćwiczenia z piłką nad głową.","Podania piłki z klatki piersiowej i lekkie rzuty rekreacyjne.","PRE zgięcia i przywodzenia w staniu z bardzo lekkimi ciężarami: od jednej płaszczyzny do ruchów łączonych.","Lekkie ćwiczenia na wyciągu oporowym."],"restrictions":["Nie dopuszczać do kompensacji górnym mięśniem czworobocznym."],"progression_criteria":[],"dosage_and_progression":["Wprowadzać wytrzymałość mięśniową lekkim ciężarem i wieloma powtórzeniami bez kompensacji górnym mięśniem czworobocznym."],"physiotherapist_actions":["Sprawdzić siłę chwytu i zwiększać obciążenie w pracy nad łokciem oraz przedramieniem.","Kontynuować pracę na tkankach miękkich i mobilizację stawową."]},"original":{"exercises":["Begin side lying exercises, partial range of motion (side lying abduction, ER, IR, extension, flexion, adduction then gradually adding weight)","Ensure rhomboids, lower and middle trap strong and able to withstand resistance without upper trap compensation","Strengthen serratus anterior: prone prop, wall push up, etc.","Rhythmic stabilization exercises in supine, side lying, etc.","Overhead ball exercises","Chest pass, light recreational throwing","Standing flexion, adduction PRE’s with very light free weights (begin with single planes and advance to combined motions)","Can do resistive pulleys- light weight"],"restrictions":["without upper trap compensation"],"progression_criteria":[],"dosage_and_progression":["Introduce muscular endurance with light weight and several repetitions without upper trap compensation."],"physiotherapist_actions":["Check grip strength – address elbow and forearm with increased weight","Continue soft tissue work/joint mobilization"]}},"additional_notes_de":"Einführung muskulärer Ausdauer mit leichtem Gewicht und mehreren Wiederholungen ohne Kompensation durch den oberen Trapezmuskel.","additional_notes_en":"Introduce muscular endurance with light weight and several repetitions without upper trap compensation.","additional_notes_pl":"Wprowadzenie wytrzymałości mięśniowej z lekkim ciężarem i kilkoma powtórzeniami bez kompensacji górnym mięśniem czworobocznym.","minimum_patient_share":null,"therapeutic_content_de":"Übungen in Seitenlage im Teilbewegungsumfang: Abduktion, Außenrotation, Innenrotation, Extension, Flexion und Adduktion, anschließend schrittweise Gewicht hinzufügen; Kräftigung des Serratus anterior: Bauchstütz und Wandliegestütze; Übungen zur rhythmischen Stabilisierung in Rücken- und Seitenlage; Überkopf-Ballübungen; Brustpässe und leichtes Freizeitwerfen; stehende Flexions- und Adduktions-PRE mit sehr leichten Hanteln, von einzelnen Ebenen zu kombinierten Bewegungen; Widerstandszüge mit leichtem Gewicht; Griffkraft prüfen und Ellenbogen sowie Unterarm mit zunehmendem Gewicht behandeln.","therapeutic_content_en":"Begin side lying exercises, partial range of motion (side lying abduction, ER, IR, extension, flexion, adduction then gradually adding weight); Strengthen serratus anterior: prone prop, wall push up, etc.; Rhythmic stabilization exercises in supine, side lying, etc.; Overhead ball exercises; Chest pass, light recreational throwing; Standing flexion, adduction PRE’s with very light free weights (begin with single planes and advance to combined motions); Can do resistive pulleys- light weight; Check grip strength – address elbow and forearm with increased weight.","therapeutic_content_pl":"Ćwiczenia w leżeniu bokiem w częściowym zakresie: odwodzenie, rotacja zewnętrzna, rotacja wewnętrzna, wyprost, zgięcie i przywodzenie, następnie stopniowe dodawanie obciążenia; wzmacnianie zębatego przedniego: podporu przodem i pompek przy ścianie; ćwiczenia stabilizacji rytmicznej w leżeniu tyłem i bokiem; ćwiczenia z piłką nad głową; podania piłki z klatki piersiowej i lekkie rzuty rekreacyjne; zgięcie i przywodzenie w staniu z bardzo lekkimi ciężarami, od pojedynczych płaszczyzn do ruchów złożonych; lekkie wyciągi oporowe; kontrola siły chwytu i zwiększanie obciążenia łokcia oraz przedramienia.","minimum_requirements_de":"Skapulakontrolle sicherstellen und eine Kompensation durch den oberen Trapezmuskel vermeiden; Weichteilarbeit und Gelenkmobilisation bei Bedarf fortsetzen.","minimum_requirements_en":"Ensure scapular control and avoid upper-trapezius compensation; continue soft tissue work and joint mobilization as necessary.","minimum_requirements_pl":"Zapewnij kontrolę łopatki i unikaj kompensacji górnym mięśniem czworobocznym; kontynuuj pracę na tkankach miękkich i mobilizację stawową w razie potrzeby.","additional_notes_original":"Goal: Introduce muscular endurance with light weight and several repetitions without upper trap compensation.","therapeutic_content_original":"Begin side lying exercises, partial range of motion (side lying abduction, ER, IR, extension, flexion, adduction then gradually adding weight); Ensure rhomboids, lower and middle trap strong and able to withstand resistance without upper trap compensation; Strengthen serratus anterior: prone prop, wall push up, etc.; Rhythmic stabilization exercises in supine, side lying, etc.; Overhead ball exercises; Chest pass, light recreational throwing; Standing flexion, adduction PRE’s with very light free weights (begin with single planes and advance to combined motions); Can do resistive pulleys- light weight; Check grip strength – address elbow and forearm with increased weight; Continue soft tissue work/joint mobilization.","minimum_requirements_original":"Ensure rhomboids, lower and middle trap strong and able to withstand resistance without upper trap compensation.","structured_content_v2":"$undefined"},{"id":"9d1328b9-f0b3-54dd-8673-cf9971e89160","name_de":"Phase V: Krafttraining (Wochen 16-20)","name_en":"Phase V: Strength training (weeks 16-20)","name_pl":"Faza V: Trening siłowy (tygodnie 16-20)","source_page":3,"module_number":5,"name_original":"Phase V (16-20 weeks)","service_codes":[],"structured_content":{"de":{"exercises":["Im Sitzen: Fliegende mit freien Gewichten und Latzug mit vorderem Griff zum Sternum.","Modifizierte Fliegende in Rückenlage mit gestreckten und gebeugten Ellenbogen im Teilbewegungsumfang.","Military Press mit freien Gewichten.","Bankdrücken mit freien Gewichten.","Partielle Liegestütze mit auf einem Ball abgestütztem Körpergewicht, mit Progression zu vollständigen Liegestützen.","Plyometrie gegen die Wand mit Progression nach Möglichkeit."],"restrictions":["Beim Latzug einen vorderen Griff zum Sternum verwenden und übermäßige Extension vermeiden."],"progression_criteria":["Vollen Bewegungsumfang sicherstellen."],"dosage_and_progression":["Modifizierte Fliegende: leichter Widerstand 1–2 Pfund, Teilbewegungsumfang, viele Wiederholungen.","Bankdrücken: sehr leichtes Gewicht von 10–20 Pfund.","Von partiellen zu vollständigen Liegestützen und die Plyometrie nach Verträglichkeit steigern."],"physiotherapist_actions":["Bei Bedarf Weichteilarbeit und Gelenkmobilisation fortsetzen."]},"en":{"exercises":["Seated free-weight pec fly and lat pull-down with a front grip to the sternum.","Supine modified pec fly with elbows straight and bent through partial ranges.","Military press with free weights.","Bench press with free weights.","Partial push-ups with body weight supported on a ball, progressing to full push-ups.","Plyometrics against the wall, advancing as able."],"restrictions":["For lat pull-down use a front grip to the sternum and avoid excessive extension."],"progression_criteria":["Ensure full range of motion."],"dosage_and_progression":["Modified pec fly: light resistance 1–2 lb, partial ranges, high repetitions.","Bench press: very light weight, 10–20 lb.","Progress from partial to full push-ups and advance plyometrics as able."],"physiotherapist_actions":["Continue soft tissue work and joint mobilization as necessary."]},"pl":{"exercises":["W siadzie: rozpiętki z wolnymi ciężarami i ściąganie drążka chwytem z przodu do mostka.","Zmodyfikowane rozpiętki w leżeniu tyłem z łokciami wyprostowanymi i zgiętymi, w częściowym zakresie.","Wyciskanie wojskowe z wolnymi ciężarami.","Wyciskanie na ławce z wolnymi ciężarami.","Częściowe pompki z ciężarem ciała podpartym na piłce, z progresją do pełnych pompek.","Pliometria przy ścianie z progresją według możliwości."],"restrictions":["Przy ściąganiu drążka używać chwytu z przodu do mostka i unikać nadmiernego wyprostu."],"progression_criteria":["Upewnić się, że pacjent ma pełny zakres ruchu."],"dosage_and_progression":["Zmodyfikowane rozpiętki: lekki opór 1–2 funty, częściowy zakres, dużo powtórzeń.","Wyciskanie na ławce: bardzo lekki ciężar 10–20 funtów.","Stopniowo przechodzić od częściowych do pełnych pompek i zwiększać pliometrię według tolerancji."],"physiotherapist_actions":["W razie potrzeby kontynuować pracę na tkankach miękkich i mobilizację stawową."]},"original":{"exercises":["Seated: free weights pec fly, lat pull down (front grip to sternum – avoid excessive extension)","Supine modified pec fly (elbows straight and bent)","Military press free weights","bench press free weights","Partial pushups while body weight is supported on ball progressing to full pushups.","Plyometrics against wall advancing as able"],"restrictions":["front grip to sternum – avoid excessive extension"],"progression_criteria":["Make sure full range of motion"],"dosage_and_progression":["light resistance 1-2 pounds partial ranges, high repetitions","very light weight – 10-20 pounds","Partial pushups while body weight is supported on ball progressing to full pushups; Plyometrics against wall advancing as able"],"physiotherapist_actions":["continue soft tissue, joint mobilization as necessary"]}},"additional_notes_de":"Ziel: dynamische und funktionelle sportartspezifische Bewegungen einführen.","additional_notes_en":"Introduce dynamic/functional movement sport-specific.","additional_notes_pl":"Cel: wprowadzić dynamiczny i funkcjonalny ruch specyficzny dla sportu.","minimum_patient_share":null,"therapeutic_content_de":"Im Sitzen: Fliegende mit freien Gewichten und Latzug von vorn bis zum Sternum, übermäßige Extension vermeiden; modifizierte Fliegende in Rückenlage mit gestreckten und gebeugten Ellenbogen, leichter Widerstand von 1–2 Pfund im Teilbewegungsumfang und mit vielen Wiederholungen; Military Press mit freien Gewichten; Bankdrücken mit freien Gewichten und sehr leichtem Gewicht von 10–20 Pfund; partielle Liegestütze mit durch einen Ball unterstütztem Körpergewicht, bis zu vollständigen Liegestützen; Plyometrie gegen die Wand mit Progression nach Verträglichkeit; Weichteilarbeit und Gelenkmobilisation bei Bedarf fortsetzen.","therapeutic_content_en":"Seated: free weights pec fly, lat pull down (front grip to sternum – avoid excessive extension); Supine modified pec fly (elbows straight and bent) light resistance 1-2 pounds partial ranges, high repetitions; Military press free weights; bench press free weights (very light weight – 10-20 pounds); Partial pushups while body weight is supported on ball progressing to full pushups; Plyometrics against wall advancing as able; Make sure full range of motion – continue soft tissue, joint mobilization as necessary.","therapeutic_content_pl":"W siadzie: rozpiętki z ciężarem wolnym i ściąganie drążka do mostka chwytem z przodu, z unikaniem nadmiernego wyprostu; zmodyfikowane rozpiętki w leżeniu tyłem z łokciami wyprostowanymi i zgiętymi, lekki opór 1–2 funty w częściowym zakresie i z dużą liczbą powtórzeń; wyciskanie wojskowe z ciężarem wolnym; wyciskanie na ławce z ciężarem wolnym, bardzo lekki ciężar 10–20 funtów; częściowe pompki z podparciem ciężaru ciała na piłce z progresją do pełnych pompek; pliometria przy ścianie z progresją zgodnie z tolerancją; kontynuacja pracy na tkankach miękkich i mobilizacji stawowej w razie potrzeby.","minimum_requirements_de":"Bei der Progression dynamischer Bewegungen den vollen Bewegungsumfang sicherstellen.","minimum_requirements_en":"Ensure full range of motion while progressing dynamic movement.","minimum_requirements_pl":"Podczas progresji ruchów dynamicznych zapewnij pełny zakres ruchu.","additional_notes_original":"Goal: Introduce dynamic/functional movement sport-specific.","therapeutic_content_original":"Seated: free weights pec fly, lat pull down (front grip to sternum – avoid excessive extension); Supine modified pec fly (elbows straight and bent) light resistance 1-2 pounds partial ranges, high repetitions.; Military press free weights; bench press free weights (very light weight – 10-20 pounds); Partial pushups while body weight is supported on ball progressing to full pushups.; Plyometrics against wall advancing as able; Make sure full range of motion – continue soft tissue, joint mobilization as necessary.","minimum_requirements_original":"Make sure full range of motion.","structured_content_v2":"$undefined"},{"id":"0c371398-4d8a-50bc-b564-6d319d8cdf6b","name_de":"Phase VI: Sport-Return (Wochen 20-25)","name_en":"Phase VI: Return to sport (weeks 20-25)","name_pl":"Faza VI: Powrót do sportu (tygodnie 20-25)","source_page":3,"module_number":6,"name_original":"Phase VI (20-25 weeks)","service_codes":[],"structured_content":{"de":{"exercises":["Fortgeschrittene Kräftigung und sportartspezifisches Training."],"restrictions":[],"progression_criteria":["Voller schmerzfreier Bewegungsumfang.","Zufriedenstellende Stabilität.","Zufriedenstellende isokinetisch geprüfte Kraft.","Keine Schmerzen oder Druckempfindlichkeit."],"dosage_and_progression":["Die Rückkehr zum Sport ist im Allgemeinen 6–9 Monate nach der Verletzung erlaubt."],"physiotherapist_actions":["Die Progression anhand von Untersuchung, Fortschritt und Komplikationen steuern; bei Unterstützungsbedarf den überweisenden Chirurgen konsultieren und individuelle Programmänderungen dem Arzt überlassen."]},"en":{"exercises":["Advance strengthening and sport-specific training."],"restrictions":[],"progression_criteria":["Full non-painful ROM.","Satisfactory stability.","Satisfactory strength assessed by isokinetics.","No pain or tenderness."],"dosage_and_progression":["Return to sport is generally allowed 6–9 months after injury."],"physiotherapist_actions":["Base progression on examination, progress and complications; consult the referring surgeon if assistance is needed, and leave individual program changes to the physician."]},"pl":{"exercises":["Zaawansowane wzmacnianie i trening specyficzny dla sportu."],"restrictions":[],"progression_criteria":["Pełny, bezbolesny zakres ruchu.","Satysfakcjonująca stabilność.","Satysfakcjonująca siła oceniona izokinetycznie.","Brak bólu lub tkliwości."],"dosage_and_progression":["Powrót do sportu jest zazwyczaj dozwolony 6–9 miesięcy po urazie."],"physiotherapist_actions":["Prowadzić progresję na podstawie badania, postępów i powikłań; przy potrzebie pomocy skonsultować się z chirurgiem kierującym, a indywidualne zmiany programu pozostawić lekarzowi."]},"original":{"exercises":["Advance strengthening and sport specific training"],"restrictions":[],"progression_criteria":["Full non-painful ROM","Satisfactory stability","Satisfactory strength (isokinetics)","No pain or tenderness"],"dosage_and_progression":["Return to sport is generally allowed 6-9 months after injury."],"physiotherapist_actions":["If a clinician requires assistance in the progression of a post-operative patient, they should consult with the referring surgeon. Specific changes in the program will be made by the physician as appropriate for the individual patient."]}},"additional_notes_de":"Die Rückkehr zum Sport ist üblicherweise 6–9 Monate nach der Verletzung erlaubt; Kräftigung und sportartspezifisches Training voranbringen.","additional_notes_en":"Return to sport is generally allowed 6-9 months after injury; advance strengthening and sport specific training.","additional_notes_pl":"Powrót do sportu jest zazwyczaj dozwolony 6–9 miesięcy po urazie; dalsze wzmacnianie i trening specyficzny dla sportu.","minimum_patient_share":null,"therapeutic_content_de":"Fortgeschrittenes sportartspezifisches Training; Steigerung der funktionellen Belastungen.","therapeutic_content_en":"Advanced sport-specific training; increasing functional loads.","therapeutic_content_pl":"Zaawansowany trening specyficzny dla sportu; zwiększanie obciążeń funkcjonalnych.","minimum_requirements_de":"Vollständiger schmerzfreier Bewegungsumfang; zufriedenstellende Stabilität; zufriedenstellende isokinetisch geprüfte Kraft; keine Schmerzen oder Druckempfindlichkeit.","minimum_requirements_en":"Full non-painful ROM; satisfactory stability; satisfactory strength by isokinetics; no pain or tenderness.","minimum_requirements_pl":"Pełny bezbolesny zakres ruchu; satysfakcjonująca stabilność; satysfakcjonująca siła oceniona testem izokinetycznym; brak bólu lub tkliwości.","additional_notes_original":"Return to sport is generally allowed 6-9 months after injury. Specific changes in the program will be made by the physician as appropriate for the individual patient.","therapeutic_content_original":"Goal: Advance strengthening and sport specific training.","minimum_requirements_original":"Progression to sport activities when: 1) Full non-painful ROM; 2) Satisfactory stability; 3) Satisfactory strength (isokinetics); 4) No pain or tenderness.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["shoulder","upper_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"f94c651a-877b-5098-82ce-954fec379da3","slug":"us-jared-lee-14-clavicle-orif","title_pl":"Protokół rehabilitacji po ORIF złamania obojczyka","title_de":"Rehabilitationsprotokoll nach ORIF einer Klavikulafraktur","title_en":"Clavicle ORIF Rehabilitation Protocol","title_original":"Clavicle ORIF Rehabilitation","summary_pl":"Czterofazowy protokół po zespoleniu złamania obojczyka.","summary_de":"Vierphasiges Protokoll nach interner Fixation einer Klavikulafraktur.","summary_en":"Four-phase rehabilitation protocol after clavicle fracture fixation.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"8d712a0c-cac3-560f-8799-2494451406d7","condition_slug":"clavicle-orif","condition_name_pl":"Stan po operacyjnej stabilizacji obojczyka (ORIF)","condition_name_de":"Zustand nach Clavicula-Osteosynthese (ORIF)","condition_name_en":"Postoperative Clavicle ORIF","condition_name_original":"Postoperative Clavicle ORIF","icd_codes":[],"category_key":"shoulder","category_pl":"Bark","category_de":"Schulter","category_en":"Shoulder","body_regions_pl":["bark"],"body_regions_de":["Schulter"],"body_regions_en":["shoulder"],"search_terms_pl":["obojczyk","złamanie obojczyka","stabilizacja obojczyka","orif","fizjoterapia barku"],"search_terms_de":["Schlüsselbein","Claviculafraktur","Clavicula-Osteosynthese","ORIF","Schulter-Reha"],"search_terms_en":["clavicle","broken collarbone","orif","clavicle fracture","shoulder rehabilitation"],"source_document_id":"68c3cbbf-c35b-567d-86a3-9817fc974304","source_title":"Clavicle ORIF Rehabilitation","issuer":"Jared Lee, MD","source_country_code":"US","jurisdiction_code":"US-CO","authority_level":"clinic","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_requires_review","official_url":"https://jaredleemd.com/wp-content/uploads/2025/06/Clavicle-ORIF-Rehabilitation-Protocol.pdf","source_sha256":"4179c39f45741e9f3ce1a1983eb76c158906e21c5a741108695fc41edddfe9ca","authorization_required":true,"license_note":"All Rights Reserved. Authorization is required before final public release. Current development and staging remain allowed by the owner's decision.","modules":[{"id":"89d62aa2-6a80-5354-8027-f58f133e41cd","name_de":"Phase I: Wochen 0–2","name_en":"Phase I: Weeks 0-2","name_pl":"Faza I: tygodnie 0–2","source_page":1,"module_number":1,"name_original":"Phase 1: Weeks 0-2","service_codes":[],"structured_content":{"de":{"goals":["Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, die Osteosynthese schützen und Schultersteife vermeiden."],"exercises":["Passiver, aktiver und aktiv-assistierter Bewegungsumfang: Flexion und Abduktion 0–90° sowie Außenrotation 0–30°","uneingeschränkter Bewegungsumfang und Kräftigung von Ellenbogen, Handgelenk und Hand","Dehnung und Bewegungsübungen der Halswirbelsäule"],"applies_when":["Wochen 0–2"],"restrictions":["Armschlinge tagsüber nach Komfort","in den ersten 2 Wochen in der Schlinge schlafen","4 Wochen keine Lasten über 3 lb heben."],"physiotherapist_actions":["physikalische Maßnahmen nach Bedarf."]},"en":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness."],"exercises":["Passive, active and active-assisted range of motion: 0-90° flexion and abduction and external rotation 0-30°","unrestricted elbow, wrist and hand range of motion and strengthening","cervical stretching and range of motion"],"applies_when":["Weeks 0-2"],"restrictions":["Use a sling for comfort during the day","sleep in the sling for the first 2 weeks","no lifting more than 3 lb for 4 weeks."],"physiotherapist_actions":["modalities as needed."]},"pl":{"goals":["zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona zespolenia oraz zapobieganie sztywności barku."],"exercises":["Bierny, czynny i czynny wspomagany zakres ruchu: zgięcie i odwodzenie 0–90° oraz rotacja zewnętrzna 0–30°","nieograniczony zakres ruchu i wzmacnianie łokcia, nadgarstka i ręki","rozciąganie i zakres ruchu odcinka szyjnego"],"applies_when":["tygodnie 0–2"],"restrictions":["Temblak dla komfortu w ciągu dnia","przez pierwsze 2 tygodnie spać w temblaku","przez 4 tygodnie nie podnosić ciężaru większego niż 3 lb."],"physiotherapist_actions":["fizykoterapia według potrzeb."]},"original":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness."],"exercises":["Passive, active and active-assisted range of motion: 0-90° flexion and abduction and external rotation 0-30°","unrestricted elbow, wrist and hand range of motion and strengthening","cervical stretching and range of motion"],"applies_when":["Weeks 0-2"],"restrictions":["Use a sling for comfort during the day","sleep in the sling for the first 2 weeks","no lifting more than 3 lb for 4 weeks."],"physiotherapist_actions":["modalities as needed."]}},"additional_notes_de":"Ziele: Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, die Osteosynthese schützen und Schultersteife vermeiden.","additional_notes_en":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness.","additional_notes_pl":"Cele: zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona zespolenia oraz zapobieganie sztywności barku.","minimum_patient_share":null,"therapeutic_content_de":"Passiver, aktiver und aktiv-assistierter Bewegungsumfang: Flexion und Abduktion 0–90° sowie Außenrotation 0–30°; uneingeschränkter Bewegungsumfang und Kräftigung von Ellenbogen, Handgelenk und Hand; Dehnung und Bewegungsübungen der Halswirbelsäule; physikalische Maßnahmen nach Bedarf.","therapeutic_content_en":"Passive, active and active-assisted range of motion: 0-90° flexion and abduction and external rotation 0-30°; unrestricted elbow, wrist and hand range of motion and strengthening; cervical stretching and range of motion; modalities as needed.","therapeutic_content_pl":"Bierny, czynny i czynny wspomagany zakres ruchu: zgięcie i odwodzenie 0–90° oraz rotacja zewnętrzna 0–30°; nieograniczony zakres ruchu i wzmacnianie łokcia, nadgarstka i ręki; rozciąganie i zakres ruchu odcinka szyjnego; fizykoterapia według potrzeb.","minimum_requirements_de":"Armschlinge tagsüber nach Komfort; in den ersten 2 Wochen in der Schlinge schlafen; 4 Wochen keine Lasten über 3 lb heben.","minimum_requirements_en":"Use a sling for comfort during the day; sleep in the sling for the first 2 weeks; no lifting more than 3 lb for 4 weeks.","minimum_requirements_pl":"Temblak dla komfortu w ciągu dnia; przez pierwsze 2 tygodnie spać w temblaku; przez 4 tygodnie nie podnosić ciężaru większego niż 3 lb.","additional_notes_original":"Goals: Reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair, and avoid shoulder stiffness","therapeutic_content_original":"Passive, active and active-assisted range of motion: 0-90° flexion and abduction and external rotation 0-30°; unrestricted elbow, wrist and hand range of motion and strengthening; cervical stretching and range of motion; modalities as needed.","minimum_requirements_original":"Use a sling for comfort during the day; sleep in the sling for the first 2 weeks; no lifting more than 3 lb for 4 weeks.","structured_content_v2":"$undefined"},{"id":"a555a44a-cc01-5d31-9994-98f62724397e","name_de":"Phase II: Wochen 3–6","name_en":"Phase II: Weeks 3-6","name_pl":"Faza II: tygodnie 3–6","source_page":1,"module_number":2,"name_original":"Phase 2: Weeks 3-6","service_codes":[],"structured_content":{"de":{"goals":["Bewegungsumfang steigern, Schmerzen und Muskelatrophie begrenzen, die Osteosynthese schützen und mit der neuromuskulären Kontrolle beginnen."],"exercises":["Schrittweise den vollständigen Bewegungsumfang in allen Ebenen erreichen","Skapulastabilisation in offener Kette beginnen","Oberkörperergometer beginnen und mit der Gegenseite antreiben."],"applies_when":["Wochen 3–6"],"restrictions":["Armschlinge tagsüber und nachts nach Komfort","4 Wochen keine Lasten über 3 lb heben.","Dehnungen der vorderen Schulter und Übungen in geschlossener Kette vermeiden"],"physiotherapist_actions":["Mobilisation der hinteren Kapsel"]},"en":{"goals":["progress range of motion, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control."],"exercises":["Progress to full range of motion in all planes","initiate open-chain scapular stabilization exercises","begin upper-body ergometer cycling powered by the contralateral side."],"applies_when":["Weeks 3-6"],"restrictions":["Use a sling for comfort during the day and at night","no lifting more than 3 lb for 4 weeks.","avoid anterior shoulder stretches and closed-chain exercises"],"physiotherapist_actions":["posterior capsule mobilization"]},"pl":{"goals":["zwiększanie zakresu ruchu, ograniczenie bólu i zaniku mięśni, ochrona zespolenia oraz rozpoczęcie kontroli nerwowo-mięśniowej."],"exercises":["Stopniowo uzyskać pełny zakres ruchu we wszystkich płaszczyznach","rozpocząć ćwiczenia stabilizacji łopatki w łańcuchu otwartym","rozpocząć ergometr kończyn górnych, napędzając go kończyną przeciwną."],"applies_when":["tygodnie 3–6"],"restrictions":["Temblak dla komfortu w dzień i w nocy","przez 4 tygodnie nie podnosić ciężaru większego niż 3 lb.","unikać rozciągania przedniej części barku i ćwiczeń w łańcuchu zamkniętym"],"physiotherapist_actions":["mobilizacja tylnej torebki"]},"original":{"goals":["progress range of motion, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control."],"exercises":["Progress to full range of motion in all planes","initiate open-chain scapular stabilization exercises","begin upper-body ergometer cycling powered by the contralateral side."],"applies_when":["Weeks 3-6"],"restrictions":["Use a sling for comfort during the day and at night","no lifting more than 3 lb for 4 weeks.","avoid anterior shoulder stretches and closed-chain exercises"],"physiotherapist_actions":["posterior capsule mobilization"]}},"additional_notes_de":"Ziele: Bewegungsumfang steigern, Schmerzen und Muskelatrophie begrenzen, die Osteosynthese schützen und mit der neuromuskulären Kontrolle beginnen.","additional_notes_en":"Goals: progress range of motion, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control.","additional_notes_pl":"Cele: zwiększanie zakresu ruchu, ograniczenie bólu i zaniku mięśni, ochrona zespolenia oraz rozpoczęcie kontroli nerwowo-mięśniowej.","minimum_patient_share":null,"therapeutic_content_de":"Schrittweise den vollständigen Bewegungsumfang in allen Ebenen erreichen; Mobilisation der hinteren Kapsel; Dehnungen der vorderen Schulter und Übungen in geschlossener Kette vermeiden; Skapulastabilisation in offener Kette beginnen; Oberkörperergometer beginnen und mit der Gegenseite antreiben.","therapeutic_content_en":"Progress to full range of motion in all planes; posterior capsule mobilization; avoid anterior shoulder stretches and closed-chain exercises; initiate open-chain scapular stabilization exercises; begin upper-body ergometer cycling powered by the contralateral side.","therapeutic_content_pl":"Stopniowo uzyskać pełny zakres ruchu we wszystkich płaszczyznach; mobilizacja tylnej torebki; unikać rozciągania przedniej części barku i ćwiczeń w łańcuchu zamkniętym; rozpocząć ćwiczenia stabilizacji łopatki w łańcuchu otwartym; rozpocząć ergometr kończyn górnych, napędzając go kończyną przeciwną.","minimum_requirements_de":"Armschlinge tagsüber und nachts nach Komfort; 4 Wochen keine Lasten über 3 lb heben.","minimum_requirements_en":"Use a sling for comfort during the day and at night; no lifting more than 3 lb for 4 weeks.","minimum_requirements_pl":"Temblak dla komfortu w dzień i w nocy; przez 4 tygodnie nie podnosić ciężaru większego niż 3 lb.","additional_notes_original":"Goals: Progress range of motion, minimize pain, retard muscle atrophy, protect the repair, and begin neuromuscular control","therapeutic_content_original":"Progress to full range of motion in all planes; posterior capsule mobilization; avoid anterior shoulder stretches and closed-chain exercises; initiate open-chain scapular stabilization exercises; begin upper-body ergometer cycling powered by the contralateral side.","minimum_requirements_original":"Use a sling for comfort during the day and at night; no lifting more than 3 lb for 4 weeks.","structured_content_v2":"$undefined"},{"id":"7fe26d23-7ce2-57b2-bd88-15f50c6de871","name_de":"Phase III: Wochen 7–12","name_en":"Phase III: Weeks 7-12","name_pl":"Faza III: tygodnie 7–12","source_page":1,"module_number":3,"name_original":"Phase 3: Weeks 7-12","service_codes":[],"structured_content":{"de":{"goals":["voller Bewegungsumfang, minimale Schmerzen, Beginn der Muskelaktivierung und Kräftigung sowie Schutz der Osteosynthese."],"exercises":["Vollständige passive, aktive und aktiv-assistierte Bewegungen ohne Widerstand fortsetzen","progressive Skapulakräftigung","in Woche 8 Propriozeptionsübungen der Schulter sowie vorsichtige Kräftigung von Rotatorenmanschette, Deltamuskel, Bizeps, Trizeps und Brustmuskulatur beginnen","Oberkörperergometer mit Widerstand beginnen."],"applies_when":["Wochen 7–12"],"restrictions":["Armschlinge ablegen","Kräftigung beginnen, aber schweres Heben vermeiden."]},"en":{"goals":["full range of motion, minimal pain, begin muscular activation and strengthening and protect the repair."],"exercises":["Continue full passive, active and active-assisted range of motion without resistance","progressive scapular strengthening","at week 8 initiate shoulder proprioceptive exercises and gentle strengthening of the rotator cuff, deltoid, biceps, triceps and pectoral muscles","begin upper-body ergometer cycling with resistance."],"applies_when":["Weeks 7-12"],"restrictions":["Discontinue the sling","begin strengthening but avoid heavy lifting."]},"pl":{"goals":["pełny zakres ruchu, minimalny ból, rozpoczęcie aktywacji mięśniowej i wzmacniania oraz ochrona zespolenia."],"exercises":["Kontynuować pełny bierny, czynny i czynny wspomagany zakres ruchu bez oporu","progresywne wzmacnianie łopatki","w 8. tygodniu rozpocząć ćwiczenia propriocepcji barku oraz delikatne wzmacnianie stożka rotatorów, mięśnia naramiennego, bicepsa, tricepsa i mięśni piersiowych","rozpocząć ergometr kończyn górnych z oporem."],"applies_when":["tygodnie 7–12"],"restrictions":["Odstawić temblak","rozpocząć wzmacnianie, ale unikać ciężkiego podnoszenia."]},"original":{"goals":["full range of motion, minimal pain, begin muscular activation and strengthening and protect the repair."],"exercises":["Continue full passive, active and active-assisted range of motion without resistance","progressive scapular strengthening","at week 8 initiate shoulder proprioceptive exercises and gentle strengthening of the rotator cuff, deltoid, biceps, triceps and pectoral muscles","begin upper-body ergometer cycling with resistance."],"applies_when":["Weeks 7-12"],"restrictions":["Discontinue the sling","begin strengthening but avoid heavy lifting."]}},"additional_notes_de":"Ziele: voller Bewegungsumfang, minimale Schmerzen, Beginn der Muskelaktivierung und Kräftigung sowie Schutz der Osteosynthese.","additional_notes_en":"Goals: full range of motion, minimal pain, begin muscular activation and strengthening and protect the repair.","additional_notes_pl":"Cele: pełny zakres ruchu, minimalny ból, rozpoczęcie aktywacji mięśniowej i wzmacniania oraz ochrona zespolenia.","minimum_patient_share":null,"therapeutic_content_de":"Vollständige passive, aktive und aktiv-assistierte Bewegungen ohne Widerstand fortsetzen; progressive Skapulakräftigung; in Woche 8 Propriozeptionsübungen der Schulter sowie vorsichtige Kräftigung von Rotatorenmanschette, Deltamuskel, Bizeps, Trizeps und Brustmuskulatur beginnen; Oberkörperergometer mit Widerstand beginnen.","therapeutic_content_en":"Continue full passive, active and active-assisted range of motion without resistance; progressive scapular strengthening; at week 8 initiate shoulder proprioceptive exercises and gentle strengthening of the rotator cuff, deltoid, biceps, triceps and pectoral muscles; begin upper-body ergometer cycling with resistance.","therapeutic_content_pl":"Kontynuować pełny bierny, czynny i czynny wspomagany zakres ruchu bez oporu; progresywne wzmacnianie łopatki; w 8. tygodniu rozpocząć ćwiczenia propriocepcji barku oraz delikatne wzmacnianie stożka rotatorów, mięśnia naramiennego, bicepsa, tricepsa i mięśni piersiowych; rozpocząć ergometr kończyn górnych z oporem.","minimum_requirements_de":"Armschlinge ablegen; Kräftigung beginnen, aber schweres Heben vermeiden.","minimum_requirements_en":"Discontinue the sling; begin strengthening but avoid heavy lifting.","minimum_requirements_pl":"Odstawić temblak; rozpocząć wzmacnianie, ale unikać ciężkiego podnoszenia.","additional_notes_original":"Goals: Full range of motion, minimal pain, begin muscular activation and strengthening, protect the repair","therapeutic_content_original":"Continue full passive, active and active-assisted range of motion without resistance; progressive scapular strengthening; at week 8 initiate shoulder proprioceptive exercises and gentle strengthening of the rotator cuff, deltoid, biceps, triceps and pectoral muscles; begin upper-body ergometer cycling with resistance.","minimum_requirements_original":"Discontinue the sling; begin strengthening but avoid heavy lifting.","structured_content_v2":"$undefined"},{"id":"db4e442e-ab5c-5521-907a-9911e7785c05","name_de":"Phase IV: Wochen 13–18","name_en":"Phase IV: Weeks 13-18","name_pl":"Faza IV: tygodnie 13–18","source_page":1,"module_number":4,"name_original":"Phase 4: Weeks 13-18","service_codes":[],"structured_content":{"de":{"goals":["funktionelle Aktivitäten sowie fortgeschrittene sportliche und Freizeitaktivitäten nach Vorgabe des Operateurs steigern."],"exercises":["Schulterbewegungsumfang wiederherstellen","Skapulakräftigung und Schulterpropriozeption steigern","in Woche 14 plyometrische Übungen beginnen."],"applies_when":["Wochen 13–18"],"restrictions":["kein schweres Gewichtheben bis Woche 16."],"progression_criteria":["Freigabe durch den Operateur","Kraftdefizit <10 %","Limb-Symmetry-Index ≥90 %","45/50 Punkte in biomechanischen Funktionstests, sofern durchgeführt","keine Schmerzen und keine berichtete Instabilität."],"dosage_and_progression":["Progressive Kräftigung"]},"en":{"goals":["progress functional activities and advanced sport and recreational activity per surgeon."],"exercises":["Restore shoulder range of motion","progress scapular strengthening and shoulder proprioceptive exercises","begin plyometric exercises at week 14."],"applies_when":["Weeks 13-18"],"restrictions":["no heavy weightlifting until week 16."],"progression_criteria":["surgeon clearance","<10% strength deficit","limb similarity index ≥90%","45/50 on biomechanical functional tests, if performed","no pain or complaints of instability."],"dosage_and_progression":["Progressive strengthening"]},"pl":{"goals":["rozwijanie aktywności funkcjonalnych oraz zaawansowanej aktywności sportowej i rekreacyjnej zgodnie z decyzją chirurga."],"exercises":["Odtworzyć zakres ruchu barku","rozwijać ćwiczenia wzmacniające łopatkę i propriocepcję barku","w 14. tygodniu rozpocząć ćwiczenia plyometryczne."],"applies_when":["tygodnie 13–18"],"restrictions":["bez ciężkiego treningu siłowego do 16. tygodnia."],"progression_criteria":["zgoda chirurga","deficyt siły <10%","wskaźnik podobieństwa kończyn ≥90%","wynik 45/50 w biomechanicznych testach funkcjonalnych, jeżeli wykonano","brak bólu i zgłaszanej niestabilności."],"dosage_and_progression":["Progresywne wzmacnianie"]},"original":{"goals":["progress functional activities and advanced sport and recreational activity per surgeon."],"exercises":["Restore shoulder range of motion","progress scapular strengthening and shoulder proprioceptive exercises","begin plyometric exercises at week 14."],"applies_when":["Weeks 13-18"],"restrictions":["no heavy weightlifting until week 16."],"progression_criteria":["surgeon clearance","<10% strength deficit","limb similarity index ≥90%","45/50 on biomechanical functional tests, if performed","no pain or complaints of instability."],"dosage_and_progression":["Progressive strengthening"]}},"additional_notes_de":"Ziele: funktionelle Aktivitäten sowie fortgeschrittene sportliche und Freizeitaktivitäten nach Vorgabe des Operateurs steigern. Entlassungskriterien: Freigabe durch den Operateur; Kraftdefizit <10 %; Limb-Symmetry-Index ≥90 %; 45/50 Punkte in biomechanischen Funktionstests, sofern durchgeführt; keine Schmerzen und keine berichtete Instabilität.","additional_notes_en":"Goals: progress functional activities and advanced sport and recreational activity per surgeon. Discharge criteria: surgeon clearance; <10% strength deficit; limb similarity index ≥90%; 45/50 on biomechanical functional tests, if performed; no pain or complaints of instability.","additional_notes_pl":"Cele: rozwijanie aktywności funkcjonalnych oraz zaawansowanej aktywności sportowej i rekreacyjnej zgodnie z decyzją chirurga. Kryteria wypisu: zgoda chirurga; deficyt siły <10%; wskaźnik podobieństwa kończyn ≥90%; wynik 45/50 w biomechanicznych testach funkcjonalnych, jeżeli wykonano; brak bólu i zgłaszanej niestabilności.","minimum_patient_share":null,"therapeutic_content_de":"Schulterbewegungsumfang wiederherstellen; Skapulakräftigung und Schulterpropriozeption steigern; in Woche 14 plyometrische Übungen beginnen.","therapeutic_content_en":"Restore shoulder range of motion; progress scapular strengthening and shoulder proprioceptive exercises; begin plyometric exercises at week 14.","therapeutic_content_pl":"Odtworzyć zakres ruchu barku; rozwijać ćwiczenia wzmacniające łopatkę i propriocepcję barku; w 14. tygodniu rozpocząć ćwiczenia plyometryczne.","minimum_requirements_de":"Progressive Kräftigung; kein schweres Gewichtheben bis Woche 16.","minimum_requirements_en":"Progressive strengthening; no heavy weightlifting until week 16.","minimum_requirements_pl":"Progresywne wzmacnianie; bez ciężkiego treningu siłowego do 16. tygodnia.","additional_notes_original":"Goals: Progression of functional activities, advanced sport and recreational activity per surgeon. Criteria for Discharge: Surgeon clearance; <10% strength deficit; Limb similarity index of 90% or greater; 45/50 on biomechanical functional tests (if performed); NO pain or complaints of instability","therapeutic_content_original":"Restore shoulder range of motion; progress scapular strengthening and shoulder proprioceptive exercises; begin plyometric exercises at week 14.","minimum_requirements_original":"Progressive strengthening; no heavy weightlifting until week 16.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["shoulder","upper_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"492d0e05-3b66-59a8-8ff5-3fbf72f5ec87","slug":"us-south-shore-11-clavicle-orif","title_pl":"Protokół rehabilitacji po stabilizacji obojczyka (ORIF)","title_de":"Rehabilitationsprotokoll nach Clavicula-ORIF","title_en":"Clavicle ORIF Rehabilitation Protocol","title_original":"Clavicle ORIF","summary_pl":"Wytyczne rehabilitacji po zabiegu ORIF obojczyka obejmujące progresję od mobilizacji biernej do zaawansowanego wzmacniania mięśni w okresie 4-6 miesięcy.","summary_de":"Rehabilitationsrichtlinien nach Clavicula-ORIF mit Fortschreiten von passiver Mobilisation bis hin zu fortgeschrittenem Krafttraining über 4-6 Monate.","summary_en":"Rehabilitation guidelines following Clavicle ORIF, progressing from passive mobilization to advanced strengthening over a 4-6 month period.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"8d712a0c-cac3-560f-8799-2494451406d7","condition_slug":"clavicle-orif","condition_name_pl":"Stan po operacyjnej stabilizacji obojczyka (ORIF)","condition_name_de":"Zustand nach Clavicula-Osteosynthese (ORIF)","condition_name_en":"Postoperative Clavicle ORIF","condition_name_original":"Postoperative Clavicle ORIF","icd_codes":[],"category_key":"shoulder","category_pl":"Bark","category_de":"Schulter","category_en":"Shoulder","body_regions_pl":["bark"],"body_regions_de":["Schulter"],"body_regions_en":["shoulder"],"search_terms_pl":["obojczyk","złamanie obojczyka","stabilizacja obojczyka","orif","fizjoterapia barku"],"search_terms_de":["Schlüsselbein","Claviculafraktur","Clavicula-Osteosynthese","ORIF","Schulter-Reha"],"search_terms_en":["clavicle","broken collarbone","orif","clavicle fracture","shoulder rehabilitation"],"source_document_id":"b82f675d-c44d-50c5-940e-adc876914a65","source_title":"Clavicle ORIF","issuer":"South Shore Orthopedics","source_country_code":"US","jurisdiction_code":"US-MA","authority_level":"hospital","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_unknown_requires_review","official_url":"https://octanecdn.com/southshoreorthopedicscom/southshoreorthopedicscom_203778332.pdf","source_sha256":"165288e88b3c32967535be9685241508982b457f0027948807358ae630ffa35b","authorization_required":false,"license_note":"Public source file retained locally for source verification.","modules":[{"id":"601a8154-a9ce-544e-bf26-1e29be6abbbe","name_de":"Phase I: Frühe Mobilisation (3.-4. Woche post-op)","name_en":"Phase I: Early mobilization (3-4 weeks post-op)","name_pl":"Faza I: Wczesna mobilizacja (3-4 tydzień po operacji)","source_page":1,"module_number":1,"name_original":"Phase I: Early mobilization (3-4 weeks post-op)","service_codes":[],"structured_content":{"de":{"exercises":["AROM von Ellbogen, Handgelenk und Hand erlaubt."],"applies_when":["Frühe Mobilisation (3.-4. Woche post-op)"],"restrictions":["Elevation über 90 Grad bis zur 6. Woche vermeiden.","Kein aktives (AROM) Schultertraining.","Keine Belastung des Arms (>5 lbs/2,2 kg).","Verbot von Oberkörper-Ergometern."],"physiotherapist_actions":["Passive (PROM) und aktiv-assistive (AAROM) Mobilisation der Schulter bis zur Schmerzgrenze."]},"en":{"exercises":["AROM of elbow, wrist, and hand permitted."],"applies_when":["Early mobilization (3-4 weeks post-op)"],"restrictions":["Avoid elevation above 90 degrees until 6 weeks post-op.","No AROM of shoulder.","No weight-bearing through arm (>5 lbs).","NO UPPER BODY ERGOMETER."],"physiotherapist_actions":["PROM and AAROM of the shoulder to tolerance."]},"pl":{"exercises":["AROM łokcia/nadgarstka/dłoni dozwolone."],"applies_when":["Wczesna mobilizacja (3-4 tydzień po operacji)"],"restrictions":["Unikanie elewacji powyżej 90 stopni do 6. tygodnia.","Brak czynnego ruchu (AROM) barku.","Brak obciążania kończyny (>5 lbs).","Zakaz używania rowerka (ergometru)."],"physiotherapist_actions":["Mobilizacja bierna (PROM) i wspomagana (AAROM) barku w pełnym zakresie do tolerancji."]},"original":{"exercises":["AROM of elbow, wrist, and hand permitted."],"applies_when":["Early mobilization (3-4 weeks post-op)"],"restrictions":["Avoid elevation above 90 degrees until 6 weeks post-op.","No AROM of shoulder.","No weight-bearing through arm (>5 lbs).","NO UPPER BODY ERGOMETER."],"physiotherapist_actions":["PROM and AAROM of the shoulder to tolerance."]}},"additional_notes_de":"AROM von Ellbogen, Handgelenk und Hand erlaubt.","additional_notes_en":"AROM of elbow, wrist, and hand permitted.","additional_notes_pl":"AROM łokcia/nadgarstka/dłoni dozwolone.","minimum_patient_share":null,"therapeutic_content_de":"Passive (PROM) und aktiv-assistive (AAROM) Mobilisation der Schulter bis zur Schmerzgrenze. Elevation über 90 Grad bis zur 6. Woche vermeiden.","therapeutic_content_en":"PROM and AAROM of the shoulder to tolerance. Avoid elevation above 90 degrees until 6 weeks post-op.","therapeutic_content_pl":"Mobilizacja bierna (PROM) i wspomagana (AAROM) barku w pełnym zakresie do tolerancji. Unikanie elewacji powyżej 90 stopni do 6. tygodnia.","minimum_requirements_de":"Kein aktives (AROM) Schultertraining. Keine Belastung des Arms (>5 lbs/2,2 kg). Verbot von Oberkörper-Ergometern.","minimum_requirements_en":"No AROM of shoulder. No weight-bearing through arm (>5 lbs). NO UPPER BODY ERGOMETER.","minimum_requirements_pl":"Brak czynnego ruchu (AROM) barku. Brak obciążania kończyny (>5 lbs). Zakaz używania rowerka (ergometru).","additional_notes_original":"AROM of elbow, wrist, and hand permitted.","therapeutic_content_original":"PROM and AAROM of the shoulder to tolerance. Avoid elevation above 90 degrees until 6 weeks post-op.","minimum_requirements_original":"No AROM of shoulder. No weight-bearing through arm (>5 lbs). NO UPPER BODY ERGOMETER.","structured_content_v2":"$undefined"},{"id":"607d071d-c032-5b03-8377-c79ffc092b09","name_de":"Phase II: Bereichserweiterung und Stabilisierung (Woche 4-8)","name_en":"Phase II: ROM progression and stabilization (Weeks 4-8)","name_pl":"Faza II: Zwiększanie zakresu i stabilizacja (4-8 tydzień)","source_page":1,"module_number":2,"name_original":"Phase II: ROM progression and stabilization (Weeks 4-8)","service_codes":[],"structured_content":{"de":{"applies_when":["Bereichserweiterung und Stabilisierung (Woche 4-8)"],"restrictions":["Kein Schulter-Krafttraining vor dem 4. Monat."],"dosage_and_progression":["Fortschreiten von PROM/AAROM und AROM in der Skapularebene.","Beginn der rhythmischen Stabilisierung."]},"en":{"applies_when":["ROM progression and stabilization (Weeks 4-8)"],"restrictions":["No shoulder strengthening until 4 months post-op."],"dosage_and_progression":["Progress PROM/AAROM and AROM in the scapular plane.","Initiate rhythmic stabilization."]},"pl":{"applies_when":["Zwiększanie zakresu i stabilizacja (4-8 tydzień)"],"restrictions":["Brak wzmacniania barku przed 4. miesiącem."],"dosage_and_progression":["Progresja PROM/AAROM i AROM w płaszczyźnie łopatkowej.","Wprowadzenie stabilizacji rytmicznej."]},"original":{"applies_when":["ROM progression and stabilization (Weeks 4-8)"],"restrictions":["No shoulder strengthening until 4 months post-op."],"dosage_and_progression":["Progress PROM/AAROM and AROM in the scapular plane.","Initiate rhythmic stabilization."]}},"additional_notes_de":"","additional_notes_en":"","additional_notes_pl":"","minimum_patient_share":null,"therapeutic_content_de":"Fortschreiten von PROM/AAROM und AROM in der Skapularebene. Beginn der rhythmischen Stabilisierung.","therapeutic_content_en":"Progress PROM/AAROM and AROM in the scapular plane. Initiate rhythmic stabilization.","therapeutic_content_pl":"Progresja PROM/AAROM i AROM w płaszczyźnie łopatkowej. Wprowadzenie stabilizacji rytmicznej.","minimum_requirements_de":"Kein Schulter-Krafttraining vor dem 4. Monat.","minimum_requirements_en":"No shoulder strengthening until 4 months post-op.","minimum_requirements_pl":"Brak wzmacniania barku przed 4. miesiącem.","additional_notes_original":"","therapeutic_content_original":"Progress PROM/AAROM and AROM in the scapular plane. 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Monat post-op."],"physiotherapist_actions":["Gelenkmobilisationen.","Gelenkmobilisationen sind erlaubt."]},"en":{"applies_when":["Strengthening (Weeks 8-12)"],"dosage_and_progression":["Begin progressive strengthening in the scapular plane, IR/ER strengthening.","Strengthening not to begin prior to 4 months post-op."],"physiotherapist_actions":["Joint mobilizations.","Joint mobilizations allowed."]},"pl":{"applies_when":["Wzmacnianie (8-12 tydzień)"],"dosage_and_progression":["Wprowadzenie progresywnego wzmacniania w płaszczyźnie łopatkowej, rotacji wewnętrznej i zewnętrznej.","Rozpoczęcie wzmacniania dopiero od 4. miesiąca po operacji."],"physiotherapist_actions":["Mobilizacje stawowe.","Dopuszczalne mobilizacje stawowe."]},"original":{"applies_when":["Strengthening (Weeks 8-12)"],"dosage_and_progression":["Begin progressive strengthening in the scapular plane, IR/ER strengthening.","Strengthening not to begin prior to 4 months post-op."],"physiotherapist_actions":["Joint mobilizations.","Joint mobilizations allowed."]}},"additional_notes_de":"Gelenkmobilisationen sind erlaubt.","additional_notes_en":"Joint mobilizations allowed.","additional_notes_pl":"Dopuszczalne mobilizacje stawowe.","minimum_patient_share":null,"therapeutic_content_de":"Beginn des progressiven Krafttrainings in der Skapularebene, Innen- und Außenrotation. 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aktiven Bewegungen, kein Heben/Ziehen/Drücken über 5 lbs (ca. 2,2 kg) bis Woche 6, keine aktive Innenrotation oder Adduktion quer zum Körper bis Woche 6."],"physiotherapist_actions":["Armschlinge (erste 2 Wochen permanent), keine aktive Schulter-ROM, Haltungsschulung, Kältetherapie, Pendelübungen, passive Bewegungen (PROM) bis 90° Flexion und 30-40° Außenrotation in Rückenlage.","Mobilisationen Grad I-II, Übungen für angrenzende Gelenke."]},"en":{"applies_when":["Protection and Education"],"restrictions":["No active movements, no lifting/pushing/pulling >5 lbs (approx. 2.2 kg) for 6 weeks, no active IR or cross-body adduction for 6 weeks."],"physiotherapist_actions":["Sling usage (first 2 weeks continuous), no active shoulder ROM, posture education, cryotherapy, pendulum exercises, PROM in supine up to 90° flexion and 30-40° external rotation.","Grade I-II joint mobs, adjacent joint exercises."]},"pl":{"applies_when":["Ochrona i edukacja"],"restrictions":["Brak aktywnych ruchów, brak 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komfortowo."],"physiotherapist_actions":["AAROM zgięcia do 90° i rotacji zewn. do 40° (progresja 20°/tydz.), użycie bloczków, retrakcja łopatki, mobilizacje stawu ramiennego (GH) i łopatkowo-żebrowego (ST) Grade I-II."]},"original":{"applies_when":["Mobilization Initiation"],"dosage_and_progression":["Sling may be discontinued if comfortable."],"physiotherapist_actions":["AAROM flexion to 90° and ER to 40° (progress 20°/week), pulley use, scapular retraction, Grade I-II GH and ST joint mobs."]}},"additional_notes_de":"","additional_notes_en":"","additional_notes_pl":"","minimum_patient_share":null,"therapeutic_content_de":"AAROM Flexion bis 90° und Außenrotation bis 40° (Progression 20°/Woche), Seilzug, Scapula-Retraktion, GH- und ST-Gelenkmobilisationen Grad I-II.","therapeutic_content_en":"AAROM flexion to 90° and ER to 40° (progress 20°/week), pulley use, scapular retraction, Grade I-II GH and ST joint mobs.","therapeutic_content_pl":"AAROM zgięcia do 90° i rotacji zewn. do 40° (progresja 20°/tydz.), użycie bloczków, retrakcja łopatki, mobilizacje stawu ramiennego (GH) i łopatkowo-żebrowego (ST) Grade I-II.","minimum_requirements_de":"Armschlinge kann bei Komfort abgesetzt werden.","minimum_requirements_en":"Sling may be discontinued if comfortable.","minimum_requirements_pl":"Można odstawić temblak, jeśli pacjent czuje się komfortowo.","additional_notes_original":"","therapeutic_content_original":"AAROM flexion to 90° and ER to 40° (progress 20°/week), pulley use, scapular retraction, Grade I-II GH and ST joint mobs.","minimum_requirements_original":"Sling may be discontinued if comfortable.","structured_content_v2":"$undefined"},{"id":"05240e05-af04-5121-8068-b41eb3189187","name_de":"Phase 8-12 Wochen: Kräftigung und Dehnung","name_en":"Phase 8-12 Weeks: Strengthening and Stretching","name_pl":"Faza 8-12 tygodni: Wzmocnienie i rozciąganie","source_page":1,"module_number":3,"name_original":"Phase 8-12 Weeks: Strengthening and Stretching","service_codes":[],"structured_content":{"de":{"exercises":["AROM im Stehen nach Wiederherstellung des PROM und guter Toleranz der AAROM in Rückenlage."],"applies_when":["Kräftigung und Dehnung"],"dosage_and_progression":["Fortführung PROM/AAROM, Dehnung der hinteren Kapsel und Brustwand, Innenrotation hinter dem Rücken, Scapula-Kräftigung (Schulterheben, Retraktion), Theraband-Übungen, Übergang zu AROM (im Stehen)."]},"en":{"exercises":["AROM standing once PROM restored and AAROM supine well tolerated."],"applies_when":["Strengthening and Stretching"],"dosage_and_progression":["Continue PROM/AAROM, posterior capsule and chest wall stretching, IR behind back, scapular strengthening (shrugs, retraction), Theraband exercises, transition to AROM (standing)."]},"pl":{"exercises":["AROM stojąc wprowadzane po uzyskaniu zakresu biernego i dobrej tolerancji AAROM w leżeniu."],"applies_when":["Wzmocnienie i rozciąganie"],"dosage_and_progression":["Kontynuacja PROM/AAROM, rozciąganie torebki tylnej i klatki piersiowej, rotacja wewnętrzna za plecami, wzmacnianie łopatki (wzruszanie ramion, retrakcja), ćwiczenia z taśmami, przejście do AROM (stojąc)."]},"original":{"exercises":["AROM standing once PROM restored and AAROM supine well tolerated."],"applies_when":["Strengthening and Stretching"],"dosage_and_progression":["Continue PROM/AAROM, posterior capsule and chest wall stretching, IR behind back, scapular strengthening (shrugs, retraction), Theraband exercises, transition to AROM (standing)."]}},"additional_notes_de":"","additional_notes_en":"","additional_notes_pl":"","minimum_patient_share":null,"therapeutic_content_de":"Fortführung PROM/AAROM, Dehnung der hinteren Kapsel und Brustwand, Innenrotation hinter dem Rücken, Scapula-Kräftigung (Schulterheben, Retraktion), Theraband-Übungen, Übergang zu AROM (im Stehen).","therapeutic_content_en":"Continue PROM/AAROM, posterior capsule and chest wall stretching, IR behind back, scapular strengthening (shrugs, retraction), Theraband exercises, transition to AROM (standing).","therapeutic_content_pl":"Kontynuacja PROM/AAROM, rozciąganie torebki tylnej i klatki piersiowej, rotacja wewnętrzna za plecami, wzmacnianie łopatki (wzruszanie ramion, retrakcja), ćwiczenia z taśmami, przejście do AROM (stojąc).","minimum_requirements_de":"AROM im Stehen nach Wiederherstellung des PROM und guter Toleranz der AAROM in Rückenlage.","minimum_requirements_en":"AROM standing once PROM restored and AAROM supine well tolerated.","minimum_requirements_pl":"AROM stojąc wprowadzane po uzyskaniu zakresu biernego i dobrej tolerancji AAROM w leżeniu.","additional_notes_original":"","therapeutic_content_original":"Continue PROM/AAROM, posterior capsule and chest wall stretching, IR behind back, scapular strengthening (shrugs, retraction), Theraband exercises, transition to AROM (standing).","minimum_requirements_original":"AROM standing once PROM restored and AAROM supine well 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base.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["shoulder","upper_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"0c8c95e9-333a-58d4-98e2-eb4d6a49629b","slug":"us-jared-lee-08-proximal-humerus-orif","title_pl":"Protokół rehabilitacji po ORIF złamania bliższego końca kości ramiennej","title_de":"Rehabilitationsprotokoll nach ORIF einer proximalen Humerusfraktur","title_en":"Proximal Humerus ORIF Rehabilitation Protocol","title_original":"Proximal Humerus ORIF Rehabilitation","summary_pl":"Sześciofazowy protokół po otwartej repozycji i 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ORIF","icd_codes":[],"category_key":"shoulder","category_pl":"Bark","category_de":"Schulter","category_en":"Shoulder","body_regions_pl":["obręcz barkowa"],"body_regions_de":["Schultergürtel"],"body_regions_en":["shoulder girdle"],"search_terms_pl":["złamanie bliższego końca kości ramiennej","ORIF","rehabilitacja barku","chirurgia barku"],"search_terms_de":["proximale Humerusfraktur","ORIF","Schulterrehabilitation","Schulterchirurgie"],"search_terms_en":["proximal humerus fracture","ORIF","shoulder rehabilitation","shoulder surgery"],"source_document_id":"13fda2c3-a3e4-59cf-9621-3a323af083bb","source_title":"Proximal Humerus ORIF Rehabilitation","issuer":"Jared Lee, MD","source_country_code":"US","jurisdiction_code":"US-CO","authority_level":"clinic","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_requires_review","official_url":"https://jaredleemd.com/wp-content/uploads/2025/06/Proximal-Humerus-ORIF-Rehabilitation-Protocol.pdf","source_sha256":"15d8afa122a34e66e221bdd42ee8ac19e24ded59224970d88e50e5b132b52825","authorization_required":false,"license_note":"Public source file retained locally for source verification.","modules":[{"id":"f10d899d-9163-5b2a-8a61-c3f6bfd85cce","name_de":"Phase I: Wochen 0–2","name_en":"Phase I: Weeks 0-2","name_pl":"Faza I: tygodnie 0–2","source_page":1,"module_number":1,"name_original":"Phase I: Weeks 0-2","service_codes":[],"structured_content":{"de":{"goals":["Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, die operierten Strukturen schützen und Schultersteife vermeiden."],"exercises":["Passiver Bewegungsumfang: Flexion und Abduktion 0–60° sowie Außenrotation 0–30°","in Rückenlage den Ellenbogen mit Handtuchrolle oder Kissen neutral unterstützen","6 Wochen keine Abstützung des Körpergewichts über die operierte Extremität","voller Ellenbogenbewegungsumfang ohne Widerstand bei angelegtem Arm","Kräftigung der periskapulären Muskulatur","Dehnung und Bewegungsübungen der Halswirbelsäule","Ballpressen","Pendelübungen","Skapulaisometrie","Kryotherapie."],"applies_when":["Wochen 0–2"],"restrictions":["kein aktiver Bewegungsumfang"],"physiotherapist_actions":["Armschlinge durchgehend außer bei Körperpflege und Physiotherapie","den Arm 2 Wochen nicht über 60° anheben","mit der operierten Extremität keine Lasten über 3 lb heben","Aquacel-Verband 14 Tage postoperativ entfernen, falls verwendet.","physikalische Maßnahmen nach Bedarf","Schmerz- und Ödemkontrolle","Weichteilmobilisation"]},"en":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness."],"exercises":["Passive range of motion 0-60° flexion and abduction and external rotation 0-30°","in supine, place a towel roll or pillow under the elbow to remain neutral","full elbow range of motion without resistance with the arm at the side","periscapular strengthening","neck stretching and range of motion","ball squeezes","pendulums","scapular isometrics","cryotherapy."],"applies_when":["Weeks 0-2"],"restrictions":["no active range of motion","no arm elevation above 60° for 2 weeks","no lifting greater than 3 lb with the surgical limb","no support of body weight through the surgical extremity for 6 weeks"],"progression_criteria":["remove the Aquacel dressing at 14 days postoperative if applicable."],"physiotherapist_actions":["Sling at all times except for hygiene and physical therapy","modalities as needed","pain and edema control","soft-tissue mobilization"]},"pl":{"goals":["zmniejszenie obrzęku, 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obrzęku","mobilizacja tkanek miękkich"]},"original":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness."],"exercises":["Passive range of motion 0-60° flexion and abduction and external rotation 0-30°","in supine, place a towel roll or pillow under the elbow to remain neutral","full elbow range of motion without resistance with the arm at the side","periscapular strengthening","neck stretching and range of motion","ball squeezes","pendulums","scapular isometrics","cryotherapy."],"applies_when":["Weeks 0-2"],"restrictions":["no active range of motion","no arm elevation above 60° for 2 weeks","no lifting greater than 3 lb with the surgical limb","no support of body weight through the surgical extremity for 6 weeks"],"progression_criteria":["remove the Aquacel dressing at 14 days postoperative if applicable."],"physiotherapist_actions":["Sling at all times except for hygiene and physical therapy","modalities 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Muskulatur; Dehnung und Bewegungsübungen der Halswirbelsäule; Weichteilmobilisation; Ballpressen; Pendelübungen; Skapulaisometrie; Kryotherapie.","therapeutic_content_en":"Passive range of motion 0-60° flexion and abduction and external rotation 0-30°; in supine, place a towel roll or pillow under the elbow to remain neutral; no support of body weight through the surgical extremity for 6 weeks; full elbow range of motion without resistance with the arm at the side; modalities as needed; pain and edema control; periscapular strengthening; neck stretching and range of motion; soft-tissue mobilization; ball squeezes; pendulums; scapular isometrics; cryotherapy.","therapeutic_content_pl":"Bierny zakres ruchu: zgięcie i odwodzenie 0–60° oraz rotacja zewnętrzna 0–30°; w leżeniu tyłem podłożyć wałek z ręcznika lub poduszkę pod łokieć, aby utrzymać pozycję neutralną; przez 6 tygodni bez podpierania ciężaru ciała operowaną kończyną; pełny zakres ruchu łokcia bez oporu przy ramieniu ułożonym wzdłuż tułowia; fizykoterapia według potrzeb; kontrola bólu i obrzęku; wzmacnianie mięśni okoł łopatkowych; rozciąganie i zakres ruchu odcinka szyjnego; mobilizacja tkanek miękkich; ściskanie piłki; ćwiczenia wahadłowe; izometria łopatki; krioterapia.","minimum_requirements_de":"Armschlinge durchgehend außer bei Körperpflege und Physiotherapie; kein aktiver Bewegungsumfang; den Arm 2 Wochen nicht über 60° anheben; mit der operierten Extremität keine Lasten über 3 lb heben; Aquacel-Verband 14 Tage postoperativ entfernen, falls verwendet.","minimum_requirements_en":"Sling at all times except for hygiene and physical therapy; no active range of motion; no arm elevation above 60° for 2 weeks; no lifting greater than 3 lb with the surgical limb; remove the Aquacel dressing at 14 days postoperative if applicable.","minimum_requirements_pl":"Temblak przez cały czas z wyjątkiem higieny i fizjoterapii; bez czynnego zakresu ruchu; przez 2 tygodnie nie unosić ramienia powyżej 60°; nie podnosić operowaną kończyną ciężaru większego niż 3 lb; opatrunek Aquacel usunąć 14 dni po zabiegu, jeżeli go zastosowano.","additional_notes_original":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness.","therapeutic_content_original":"Passive range of motion 0-60° flexion and abduction and external rotation 0-30°; in supine, place a towel roll or pillow under the elbow to remain neutral; no support of body weight through the surgical extremity for 6 weeks; full elbow range of motion without resistance with the arm at the side; modalities as needed; pain and edema control; periscapular strengthening; neck stretching and range of motion; soft-tissue mobilization; ball squeezes; pendulums; scapular isometrics; cryotherapy.","minimum_requirements_original":"Sling at all times except for hygiene and physical therapy; no active range of motion; no arm elevation above 60° for 2 weeks; no lifting greater than 3 lb with the surgical limb; remove the Aquacel dressing at 14 days postoperative if applicable.","structured_content_v2":"$undefined"},{"id":"e50b1083-02b0-5d20-8169-ebda9ed50f45","name_de":"Phase II: Wochen 2–4","name_en":"Phase II: Weeks 2-4","name_pl":"Faza II: tygodnie 2–4","source_page":1,"module_number":2,"name_original":"Phase II: Weeks 2-4","service_codes":[],"structured_content":{"de":{"goals":["Bewegungsumfang steigern, Schmerzen und Muskelatrophie begrenzen und die operierten Strukturen schützen."],"exercises":["Passiven Bewegungsumfang auf Flexion und Abduktion 0–90° sowie Außenrotation 0–30° steigern","in Rückenlage den Ellenbogen mit Handtuchrolle oder Kissen neutral unterstützen","6 Wochen keine Abstützung des Körpergewichts über die operierte Extremität","voller Ellenbogenbewegungsumfang ohne Widerstand bei angelegtem Arm","Kräftigung der periskapulären Muskulatur","Dehnung und Bewegungsübungen der 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isometrics","cryotherapy."],"applies_when":["Weeks 2-4"],"restrictions":["no active range of motion","no lifting greater than 3 lb with the surgical limb for 6 weeks.","no support of body weight through the surgical extremity for 6 weeks"],"dosage_and_progression":["continue Phase I exercises"],"physiotherapist_actions":["Sling at all times except for hygiene and physical therapy","correct postural dysfunction","modalities as needed","pain and edema control","soft-tissue mobilization"]},"pl":{"goals":["zwiększanie zakresu ruchu, ograniczenie bólu i zaniku mięśni oraz ochrona operowanych struktur."],"exercises":["Zwiększyć bierny zakres ruchu do zgięcia i odwodzenia 0–90° oraz rotacji zewnętrznej 0–30°","w leżeniu tyłem podłożyć wałek z ręcznika lub poduszkę pod łokieć w pozycji neutralnej","pełny zakres ruchu łokcia bez oporu przy ramieniu ułożonym wzdłuż tułowia","wzmacnianie mięśni okoł łopatkowych","rozciąganie i zakres ruchu odcinka szyjnego","ściskanie piłki","ćwiczenia 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squeezes","pendulums","scapular isometrics","cryotherapy."],"applies_when":["Weeks 2-4"],"restrictions":["no active range of motion","no lifting greater than 3 lb with the surgical limb for 6 weeks.","no support of body weight through the surgical extremity for 6 weeks"],"dosage_and_progression":["continue Phase I exercises"],"physiotherapist_actions":["Sling at all times except for hygiene and physical therapy","correct postural dysfunction","modalities as needed","pain and edema control","soft-tissue mobilization"]}},"additional_notes_de":"Ziele: Bewegungsumfang steigern, Schmerzen und Muskelatrophie begrenzen und die operierten Strukturen schützen.","additional_notes_en":"Goals: progress range of motion, minimize pain, retard muscle atrophy and protect the repair.","additional_notes_pl":"Cele: zwiększanie zakresu ruchu, ograniczenie bólu i zaniku mięśni oraz ochrona operowanych struktur.","minimum_patient_share":null,"therapeutic_content_de":"Passiven Bewegungsumfang auf Flexion und 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stretching and range of motion; soft-tissue mobilization; ball squeezes; pendulums; scapular isometrics; cryotherapy.","therapeutic_content_pl":"Zwiększyć bierny zakres ruchu do zgięcia i odwodzenia 0–90° oraz rotacji zewnętrznej 0–30°; korygować zaburzenia postawy; w leżeniu tyłem podłożyć wałek z ręcznika lub poduszkę pod łokieć w pozycji neutralnej; przez 6 tygodni bez podpierania ciężaru ciała operowaną kończyną; pełny zakres ruchu łokcia bez oporu przy ramieniu ułożonym wzdłuż tułowia; fizykoterapia według potrzeb; kontrola bólu i obrzęku; wzmacnianie mięśni okoł łopatkowych; rozciąganie i zakres ruchu odcinka szyjnego; mobilizacja tkanek miękkich; ściskanie piłki; ćwiczenia wahadłowe; izometria łopatki; krioterapia.","minimum_requirements_de":"Armschlinge durchgehend außer bei Körperpflege und Physiotherapie; Übungen aus Phase I fortsetzen; kein aktiver Bewegungsumfang; mit der operierten Extremität 6 Wochen keine Lasten über 3 lb heben.","minimum_requirements_en":"Sling at all times except for hygiene and physical therapy; continue Phase I exercises; no active range of motion; no lifting greater than 3 lb with the surgical limb for 6 weeks.","minimum_requirements_pl":"Temblak przez cały czas z wyjątkiem higieny i fizjoterapii; kontynuować ćwiczenia fazy I; bez czynnego zakresu ruchu; przez 6 tygodni nie podnosić operowaną kończyną ciężaru większego niż 3 lb.","additional_notes_original":"Goals: progress range of motion, minimize pain, retard muscle atrophy and protect the repair.","therapeutic_content_original":"Increase passive range of motion to 0-90° flexion and abduction and external rotation 0-30°; correct postural dysfunction; in supine, place a towel roll or pillow under the elbow to remain neutral; no support of body weight through the surgical extremity for 6 weeks; full elbow range of motion without resistance with the arm at the side; modalities as needed; pain and edema control; periscapular strengthening; neck stretching and range of motion; soft-tissue mobilization; ball squeezes; pendulums; scapular isometrics; cryotherapy.","minimum_requirements_original":"Sling at all times except for hygiene and physical therapy; continue Phase I exercises; no active range of motion; no lifting greater than 3 lb with the surgical limb for 6 weeks.","structured_content_v2":"$undefined"},{"id":"f9cd9deb-ee4f-527e-8ea5-8dc3f7504e6a","name_de":"Phase III: Wochen 4–6","name_en":"Phase III: Weeks 4-6","name_pl":"Faza III: tygodnie 4–6","source_page":2,"module_number":3,"name_original":"Phase III: Weeks 4-6","service_codes":[],"structured_content":{"de":{"goals":["Bewegungsumfang steigern, minimale Schmerzen sowie bessere neuromuskuläre Kontrolle und Mechanik."],"exercises":["Passiven Bewegungsumfang wöchentlich um 15° steigern, bis der volle Bewegungsumfang erreicht ist","6 Wochen keine Abstützung des Körpergewichts über die operierte Extremität","voller Ellenbogenbewegungsumfang ohne Widerstand bei angelegtem Arm","Kräftigung der periskapulären Muskulatur","Dehnung und Bewegungsübungen der Halswirbelsäule","Ballpressen","Pendelübungen","Skapulaisometrie","Kryotherapie","Ausdauertraining: Gehen und Fahrradergometer, kein Laufband, Crosstrainer, Stepper oder Rennrad."],"applies_when":["Wochen 4–6"],"restrictions":["kein aktiver Bewegungsumfang","keine Kräftigung","kein Laufband, Crosstrainer, Stepper oder Rennrad."],"dosage_and_progression":["Übungen aus Phase I und II fortsetzen"],"physiotherapist_actions":["Armschlinge durchgehend außer bei Körperpflege und Physiotherapie","mit der operierten Extremität keine Lasten über 5 lb heben.","Haltungsstörungen korrigieren","physikalische Maßnahmen nach Bedarf","Schmerz- und Ödemkontrolle","Weichteilmobilisation"]},"en":{"goals":["progress range of motion, minimal pain, improve neuromuscular control and mechanics."],"exercises":["Progress passive range of motion by 15° per week until full range of motion is achieved","full elbow range of motion without resistance with the arm at the side","periscapular strengthening","neck stretching and range of motion","ball squeezes","pendulums","scapular isometrics","cryotherapy","cardiovascular exercise: walking and stationary bike, no treadmill, elliptical, stair climber or road bike."],"applies_when":["Weeks 4-6"],"restrictions":["no active range of motion","no strengthening","no lifting greater than 5 lb with the surgical limb.","no support of body weight through the surgical extremity for 6 weeks","no treadmill, elliptical, stair climber or road bike."],"dosage_and_progression":["continue Phase I and II exercises"],"physiotherapist_actions":["Sling at all times except for hygiene and physical therapy","correct postural dysfunction","modalities as needed","pain and edema control","soft-tissue mobilization"]},"pl":{"goals":["zwiększanie zakresu ruchu, minimalny ból oraz poprawa kontroli nerwowo-mięśniowej i mechaniki."],"exercises":["Zwiększać bierny zakres ruchu o 15° tygodniowo aż do uzyskania pełnego zakresu","pełny zakres ruchu łokcia bez oporu przy ramieniu ułożonym wzdłuż tułowia","wzmacnianie mięśni okoł łopatkowych","rozciąganie i zakres ruchu odcinka szyjnego","ściskanie piłki","ćwiczenia wahadłowe","izometria łopatki","krioterapia","trening wydolnościowy: marsz i rower stacjonarny, bez bieżni, orbitreka, steppera i roweru szosowego."],"applies_when":["tygodnie 4–6"],"restrictions":["bez czynnego zakresu ruchu","bez wzmacniania","nie podnosić operowaną kończyną ciężaru większego niż 5 lb.","przez 6 tygodni bez podpierania ciężaru ciała operowaną kończyną","bez bieżni, orbitreka, steppera i roweru szosowego."],"dosage_and_progression":["kontynuować ćwiczenia faz I i II"],"physiotherapist_actions":["Temblak przez cały czas z wyjątkiem higieny i fizjoterapii","korygować zaburzenia postawy","fizykoterapia według potrzeb","kontrola bólu i obrzęku","mobilizacja tkanek miękkich"]},"original":{"goals":["progress range of motion, minimal pain, improve neuromuscular control and mechanics."],"exercises":["Progress passive range of motion by 15° per week until full range of motion is achieved","full elbow range of motion without resistance with the arm at the side","periscapular strengthening","neck stretching and range of motion","ball squeezes","pendulums","scapular isometrics","cryotherapy","cardiovascular exercise: walking and stationary bike, no treadmill, elliptical, stair climber or road bike."],"applies_when":["Weeks 4-6"],"restrictions":["no active range of motion","no strengthening","no lifting greater than 5 lb with the surgical limb.","no support of body weight through the surgical extremity for 6 weeks","no treadmill, elliptical, stair climber or road bike."],"dosage_and_progression":["continue Phase I and II exercises"],"physiotherapist_actions":["Sling at all times except for hygiene and physical therapy","correct postural dysfunction","modalities as needed","pain and edema control","soft-tissue mobilization"]}},"additional_notes_de":"Ziele: Bewegungsumfang steigern, minimale Schmerzen sowie bessere neuromuskuläre Kontrolle und Mechanik.","additional_notes_en":"Goals: progress range of motion, minimal pain, improve neuromuscular control and mechanics.","additional_notes_pl":"Cele: zwiększanie zakresu ruchu, minimalny ból oraz poprawa kontroli nerwowo-mięśniowej i mechaniki.","minimum_patient_share":null,"therapeutic_content_de":"Passiven Bewegungsumfang wöchentlich um 15° steigern, bis der volle Bewegungsumfang erreicht ist; Haltungsstörungen korrigieren; 6 Wochen keine Abstützung des Körpergewichts über die operierte Extremität; voller Ellenbogenbewegungsumfang ohne Widerstand bei angelegtem Arm; physikalische Maßnahmen nach Bedarf; Schmerz- und Ödemkontrolle; Kräftigung der periskapulären Muskulatur; Dehnung und Bewegungsübungen der Halswirbelsäule; Weichteilmobilisation; Ballpressen; Pendelübungen; Skapulaisometrie; Kryotherapie; Ausdauertraining: Gehen und Fahrradergometer, kein Laufband, Crosstrainer, Stepper oder Rennrad.","therapeutic_content_en":"Progress passive range of motion by 15° per week until full range of motion is achieved; correct postural dysfunction; no support of body weight through the surgical extremity for 6 weeks; full elbow range of motion without resistance with the arm at the side; modalities as needed; pain and edema control; periscapular strengthening; neck stretching and range of motion; soft-tissue mobilization; ball squeezes; pendulums; scapular isometrics; cryotherapy; cardiovascular exercise: walking and stationary bike, no treadmill, elliptical, stair climber or road bike.","therapeutic_content_pl":"Zwiększać bierny zakres ruchu o 15° tygodniowo aż do uzyskania pełnego zakresu; korygować zaburzenia postawy; przez 6 tygodni bez podpierania ciężaru ciała operowaną kończyną; pełny zakres ruchu łokcia bez oporu przy ramieniu ułożonym wzdłuż tułowia; fizykoterapia według potrzeb; kontrola bólu i obrzęku; wzmacnianie mięśni okoł łopatkowych; rozciąganie i zakres ruchu odcinka szyjnego; mobilizacja tkanek miękkich; ściskanie piłki; ćwiczenia wahadłowe; izometria łopatki; krioterapia; trening wydolnościowy: marsz i rower stacjonarny, bez bieżni, orbitreka, steppera i roweru szosowego.","minimum_requirements_de":"Armschlinge durchgehend außer bei Körperpflege und Physiotherapie; Übungen aus Phase I und II fortsetzen; kein aktiver Bewegungsumfang; keine Kräftigung; mit der operierten Extremität keine Lasten über 5 lb heben.","minimum_requirements_en":"Sling at all times except for hygiene and physical therapy; continue Phase I and II exercises; no active range of motion; no strengthening; no lifting greater than 5 lb with the surgical limb.","minimum_requirements_pl":"Temblak przez cały czas z wyjątkiem higieny i fizjoterapii; kontynuować ćwiczenia faz I i II; bez czynnego zakresu ruchu; bez wzmacniania; nie podnosić operowaną kończyną ciężaru większego niż 5 lb.","additional_notes_original":"Goals: progress range of motion, minimal pain, improve neuromuscular control and mechanics.","therapeutic_content_original":"Progress passive range of motion by 15° per week until full range of motion is achieved; correct postural dysfunction; no support of body weight through the surgical extremity for 6 weeks; full elbow range of motion without resistance with the arm at the side; modalities as needed; pain and edema control; periscapular strengthening; neck stretching and range of motion; soft-tissue mobilization; ball squeezes; pendulums; scapular isometrics; cryotherapy; cardiovascular exercise: walking and stationary bike, no treadmill, elliptical, stair climber or road bike.","minimum_requirements_original":"Sling at all times except for hygiene and physical therapy; continue Phase I and II exercises; no active range of motion; no strengthening; no lifting greater than 5 lb with the surgical limb.","structured_content_v2":"$undefined"},{"id":"bbbd5d0e-03d7-50ad-9106-466496f6f1d5","name_de":"Phase IV: Wochen 6–12","name_en":"Phase IV: Weeks 6-12","name_pl":"Faza IV: tygodnie 6–12","source_page":2,"module_number":4,"name_original":"Phase IV: Weeks 6-12","service_codes":[],"structured_content":{"de":{"goals":["voller Bewegungsumfang, Schmerzfreiheit, korrekte Mechanik und Beginn der Kräftigung."],"exercises":["Nach Erreichen des vollständigen passiven Bewegungsumfangs aktive und aktiv-assistierte Bewegungen beginnen","schmerzfreien aktiven Bewegungsumfang steigern","Skaption beginnen","isometrische Schulterkräftigung beginnen","Skapulastabilisation und Haltungskontrolle","leichte Kräftigungsübungen beginnen","fortgeschrittene Schulterbewegungen und neuromuskuläre Kontrolle","PNF-Muster mit leichtem Widerstand."],"applies_when":["Wochen 6–12"],"restrictions":["keine progressive Kräftigung bis 12 Wochen postoperativ"],"dosage_and_progression":["Übungen aus Phase II und III fortsetzen"],"physiotherapist_actions":["mit der operierten Extremität keine Lasten über 5 lb heben.","Gelenkmobilisationen Grad I–II und Oszillationen zur Schmerzlinderung"]},"en":{"goals":["full range of motion, no pain, good mechanics and begin strengthening."],"exercises":["Begin active and active-assisted range of motion once full passive range of motion is achieved","progress non-painful active range of motion","initiate scaption","initiate isometric shoulder strengthening","scapular stabilization and posture control","initiate light strengthening exercises","advanced shoulder motions and neuromuscular control","PNF patterns with light resistance."],"applies_when":["Weeks 6-12"],"restrictions":["no progressive strengthening until 12 weeks postoperative","no lifting greater than 5 lb with the surgical limb."],"dosage_and_progression":["Continue Phase II and III exercises"],"physiotherapist_actions":["Grade I-II joint mobilizations and oscillations for pain relief"]},"pl":{"goals":["pełny zakres ruchu, brak bólu, prawidłowa mechanika i rozpoczęcie wzmacniania."],"exercises":["Po uzyskaniu pełnego biernego zakresu ruchu rozpocząć zakres czynny i czynny wspomagany","zwiększać bezbolesny czynny zakres ruchu","rozpocząć unoszenie w płaszczyźnie łopatki","rozpocząć izometryczne wzmacnianie barku","stabilizacja łopatki i kontrola postawy","rozpocząć lekkie ćwiczenia wzmacniające","zaawansowane ruchy barku i kontrola nerwowo-mięśniowa","wzorce PNF z lekkim oporem."],"applies_when":["tygodnie 6–12"],"restrictions":["bez progresywnego wzmacniania do 12. tygodnia po zabiegu","nie podnosić operowaną kończyną ciężaru większego niż 5 lb."],"dosage_and_progression":["Kontynuować ćwiczenia faz II i III"],"physiotherapist_actions":["mobilizacje stawowe stopnia I–II i oscylacje przeciwbólowe"]},"original":{"goals":["full range of motion, no pain, good mechanics and begin strengthening."],"exercises":["Begin active and active-assisted range of motion once full passive range of motion is achieved","progress non-painful active range of motion","initiate scaption","initiate isometric shoulder strengthening","scapular stabilization and posture control","initiate light strengthening exercises","advanced shoulder motions and neuromuscular control","PNF patterns with light resistance."],"applies_when":["Weeks 6-12"],"restrictions":["no progressive strengthening until 12 weeks postoperative","no lifting greater than 5 lb with the surgical limb."],"dosage_and_progression":["Continue Phase II and III exercises"],"physiotherapist_actions":["Grade I-II joint mobilizations and oscillations for pain relief"]}},"additional_notes_de":"Ziele: voller Bewegungsumfang, Schmerzfreiheit, korrekte Mechanik und Beginn der Kräftigung.","additional_notes_en":"Goals: full range of motion, no pain, good mechanics and begin strengthening.","additional_notes_pl":"Cele: pełny zakres ruchu, brak bólu, prawidłowa mechanika i rozpoczęcie wzmacniania.","minimum_patient_share":null,"therapeutic_content_de":"Nach Erreichen des vollständigen passiven Bewegungsumfangs aktive und aktiv-assistierte Bewegungen beginnen; schmerzfreien aktiven Bewegungsumfang steigern; Skaption beginnen; isometrische Schulterkräftigung beginnen; Skapulastabilisation und Haltungskontrolle; Gelenkmobilisationen Grad I–II und Oszillationen zur Schmerzlinderung; leichte Kräftigungsübungen beginnen; fortgeschrittene Schulterbewegungen und neuromuskuläre Kontrolle; PNF-Muster mit leichtem Widerstand.","therapeutic_content_en":"Begin active and active-assisted range of motion once full passive range of motion is achieved; progress non-painful active range of motion; initiate scaption; initiate isometric shoulder strengthening; scapular stabilization and posture control; Grade I-II joint mobilizations and oscillations for pain relief; initiate light strengthening exercises; advanced shoulder motions and neuromuscular control; PNF patterns with light resistance.","therapeutic_content_pl":"Po uzyskaniu pełnego biernego zakresu ruchu rozpocząć zakres czynny i czynny wspomagany; zwiększać bezbolesny czynny zakres ruchu; rozpocząć unoszenie w płaszczyźnie łopatki; rozpocząć izometryczne wzmacnianie barku; stabilizacja łopatki i kontrola postawy; mobilizacje stawowe stopnia I–II i oscylacje przeciwbólowe; rozpocząć lekkie ćwiczenia wzmacniające; zaawansowane ruchy barku i kontrola nerwowo-mięśniowa; wzorce PNF z lekkim oporem.","minimum_requirements_de":"Übungen aus Phase II und III fortsetzen; keine progressive Kräftigung bis 12 Wochen postoperativ; mit der operierten Extremität keine Lasten über 5 lb heben.","minimum_requirements_en":"Continue Phase II and III exercises; no progressive strengthening until 12 weeks postoperative; no lifting greater than 5 lb with the surgical limb.","minimum_requirements_pl":"Kontynuować ćwiczenia faz II i III; bez progresywnego wzmacniania do 12. tygodnia po zabiegu; nie podnosić operowaną kończyną ciężaru większego niż 5 lb.","additional_notes_original":"Goals: full range of motion, no pain, good mechanics and begin strengthening.","therapeutic_content_original":"Begin active and active-assisted range of motion once full passive range of motion is achieved; progress non-painful active range of motion; initiate scaption; initiate isometric shoulder strengthening; scapular stabilization and posture control; Grade I-II joint mobilizations and oscillations for pain relief; initiate light strengthening exercises; advanced shoulder motions and neuromuscular control; PNF patterns with light resistance.","minimum_requirements_original":"Continue Phase II and III exercises; no progressive strengthening until 12 weeks postoperative; no lifting greater than 5 lb with the surgical limb.","structured_content_v2":"$undefined"},{"id":"4955a084-77db-55e0-a35d-dc50b913aa80","name_de":"Phase V: Wochen 12–16","name_en":"Phase V: Weeks 12-16","name_pl":"Faza V: tygodnie 12–16","source_page":2,"module_number":5,"name_original":"Phase V: Weeks 12-16","service_codes":[],"structured_content":{"de":{"goals":["voller Bewegungsumfang, zunehmende Kraft und sehr gute Mechanik.","Progressionskriterium: Rückkehr zum Sport nach Freigabe durch Physiotherapeut und Operateur."],"exercises":["Schulterbewegungen mit unterschiedlichen Geschwindigkeiten und Winkeln ohne Kompensation weiter trainieren","Übungen in geschlossener Kette, einschließlich Ball an der Wand","Kraft der Außenrotation in verschiedenen Abduktionswinkeln steigern","Kräftigung in Bauchlage ausbauen","Rumpfkräftigungsprogramm","Rotatorenmanschette in verschiedenen Winkeln und Geschwindigkeiten progressiv kräftigen","Krafttraining von vielen Wiederholungen mit geringer Last zu weniger Wiederholungen mit höherer Last steigern."],"applies_when":["Wochen 12–16"],"dosage_and_progression":["Progressive Kräftigung."]},"en":{"goals":["full range of motion, increased strength and great mechanics.","Progression criterion: may return to sports after clearance from the therapist and surgeon."],"exercises":["Continue shoulder motion at varying speeds and angles without compensation","closed-chain exercises including ball on the wall","progress external rotation strength at varying angles of abduction","progress prone strengthening exercises","core strengthening program","progress rotator cuff strengthening at different angles and velocities","progress weight strengthening from high repetitions with low weight to lower repetitions with higher weight."],"applies_when":["Weeks 12-16"],"dosage_and_progression":["Progressive strengthening."]},"pl":{"goals":["pełny zakres ruchu, zwiększanie siły i bardzo dobra mechanika.","Kryterium progresji: powrót do sportu po zgodzie fizjoterapeuty i chirurga."],"exercises":["Kontynuować pracę nad ruchem barku z różną prędkością i pod różnymi kątami bez kompensacji","ćwiczenia w łańcuchu zamkniętym, w tym piłka na ścianie","zwiększać siłę rotacji zewnętrznej w różnych kątach odwodzenia","rozwijać wzmacnianie w leżeniu przodem","program wzmacniania tułowia","rozwijać wzmacnianie stożka rotatorów pod różnymi kątami i z różną prędkością","progresja treningu siłowego od dużej liczby powtórzeń z małym obciążeniem do mniejszej liczby powtórzeń z większym obciążeniem."],"applies_when":["tygodnie 12–16"],"dosage_and_progression":["Progresywne wzmacnianie."]},"original":{"goals":["full range of motion, increased strength and great mechanics.","Progression criterion: may return to sports after clearance from the therapist and surgeon."],"exercises":["Continue shoulder motion at varying speeds and angles without compensation","closed-chain exercises including ball on the wall","progress external rotation strength at varying angles of abduction","progress prone strengthening exercises","core strengthening program","progress rotator cuff strengthening at different angles and velocities","progress weight strengthening from high repetitions with low weight to lower repetitions with higher weight."],"applies_when":["Weeks 12-16"],"dosage_and_progression":["Progressive strengthening."]}},"additional_notes_de":"Ziele: voller Bewegungsumfang, zunehmende Kraft und sehr gute Mechanik. Progressionskriterium: Rückkehr zum Sport nach Freigabe durch Physiotherapeut und Operateur.","additional_notes_en":"Goals: full range of motion, increased strength and great mechanics. Progression criterion: may return to sports after clearance from the therapist and surgeon.","additional_notes_pl":"Cele: pełny zakres ruchu, zwiększanie siły i bardzo dobra mechanika. Kryterium progresji: powrót do sportu po zgodzie fizjoterapeuty i chirurga.","minimum_patient_share":null,"therapeutic_content_de":"Schulterbewegungen mit unterschiedlichen Geschwindigkeiten und Winkeln ohne Kompensation weiter trainieren; Übungen in geschlossener Kette, einschließlich Ball an der Wand; Kraft der Außenrotation in verschiedenen Abduktionswinkeln steigern; Kräftigung in Bauchlage ausbauen; Rumpfkräftigungsprogramm; Rotatorenmanschette in verschiedenen Winkeln und Geschwindigkeiten progressiv kräftigen; Krafttraining von vielen Wiederholungen mit geringer Last zu weniger Wiederholungen mit höherer Last steigern.","therapeutic_content_en":"Continue shoulder motion at varying speeds and angles without compensation; closed-chain exercises including ball on the wall; progress external rotation strength at varying angles of abduction; progress prone strengthening exercises; core strengthening program; progress rotator cuff strengthening at different angles and velocities; progress weight strengthening from high repetitions with low weight to lower repetitions with higher weight.","therapeutic_content_pl":"Kontynuować pracę nad ruchem barku z różną prędkością i pod różnymi kątami bez kompensacji; ćwiczenia w łańcuchu zamkniętym, w tym piłka na ścianie; zwiększać siłę rotacji zewnętrznej w różnych kątach odwodzenia; rozwijać wzmacnianie w leżeniu przodem; program wzmacniania tułowia; rozwijać wzmacnianie stożka rotatorów pod różnymi kątami i z różną prędkością; progresja treningu siłowego od dużej liczby powtórzeń z małym obciążeniem do mniejszej liczby powtórzeń z większym obciążeniem.","minimum_requirements_de":"Progressive Kräftigung.","minimum_requirements_en":"Progressive strengthening.","minimum_requirements_pl":"Progresywne wzmacnianie.","additional_notes_original":"Goals: full range of motion, increased strength and great mechanics. Progression criterion: may return to sports after clearance from the therapist and surgeon.","therapeutic_content_original":"Continue shoulder motion at varying speeds and angles without compensation; closed-chain exercises including ball on the wall; progress external rotation strength at varying angles of abduction; progress prone strengthening exercises; core strengthening program; progress rotator cuff strengthening at different angles and velocities; progress weight strengthening from high repetitions with low weight to lower repetitions with higher weight.","minimum_requirements_original":"Progressive strengthening.","structured_content_v2":"$undefined"},{"id":"002e2b3a-4c3a-5d1e-a4fe-84e8d941849c","name_de":"Phase VI: ab Woche 16","name_en":"Phase VI: Week 16 and onward","name_pl":"Faza VI: od 16. tygodnia","source_page":3,"module_number":6,"name_original":"Phase VI: Week 16 and onward","service_codes":[],"structured_content":{"de":{"goals":["voller Bewegungsumfang, Schmerzfreiheit, progressive Kräftigung, keine mechanischen Defizite und Rückkehr zum Sport.","Rückkehr zum Sport nach Freigabe durch Physiotherapeut und Operateur","vollständige Rückkehr zur Aktivität üblicherweise 5 Monate postoperativ."],"exercises":["Das bisherige Kräftigungsprogramm progressiv ausbauen und verbessern","Heimübungsprogramm","Wurfprogression oder Überkopfprogramm, falls indiziert","ab Woche 16 können Laufband, Crosstrainer, Stepper und Rennrad genutzt werden."],"applies_when":["ab Woche 16"],"progression_criteria":["Kraftdefizit <10 %","Limb-Symmetry-Index ≥90 %","45/50 Punkte in biomechanischen Funktionstests, sofern durchgeführt","keine Schmerzen und keine berichtete Instabilität."],"dosage_and_progression":["Progression funktioneller Aktivitäten."]},"en":{"goals":["full range of motion, no pain, progressive strengthening, no mechanical deficits and return to sport.","May return to sports after clearance from the therapist and surgeon","full return to activity typically at 5 months postoperative."],"exercises":["Progress and improve the previous strengthening program","home exercise program","throwing progression or overhead program if indicated","treadmill, elliptical, stair climber and road bike may begin at week 16."],"applies_when":["Week 16 and onward"],"progression_criteria":["<10% strength deficit","limb similarity index ≥90%","45/50 on biomechanical functional tests, if performed","no pain or complaints of instability."],"dosage_and_progression":["Functional activity progression."]},"pl":{"goals":["pełny zakres ruchu, brak bólu, progresywne wzmacnianie, brak deficytów mechanicznych i powrót do sportu.","Powrót do sportu po zgodzie fizjoterapeuty i chirurga","pełny powrót do aktywności zwykle 5 miesięcy po zabiegu."],"exercises":["Stopniowo rozwijać i doskonalić wcześniejszy program wzmacniania","program ćwiczeń domowych","progresja rzutów lub program pracy nad głową, jeżeli wskazany","od 16. tygodnia można rozpocząć korzystanie z bieżni, orbitreka, steppera i roweru szosowego."],"applies_when":["od 16. tygodnia"],"progression_criteria":["deficyt siły <10%","wskaźnik podobieństwa kończyn ≥90%","wynik 45/50 w biomechanicznych testach funkcjonalnych, jeżeli wykonano","brak bólu i zgłaszanej niestabilności."],"dosage_and_progression":["Progresja aktywności funkcjonalnej."]},"original":{"goals":["full range of motion, no pain, progressive strengthening, no mechanical deficits and return to sport.","May return to sports after clearance from the therapist and surgeon","full return to activity typically at 5 months postoperative."],"exercises":["Progress and improve the previous strengthening program","home exercise program","throwing progression or overhead program if indicated","treadmill, elliptical, stair climber and road bike may begin at week 16."],"applies_when":["Week 16 and onward"],"progression_criteria":["<10% strength deficit","limb similarity index ≥90%","45/50 on biomechanical functional tests, if performed","no pain or complaints of instability."],"dosage_and_progression":["Functional activity progression."]}},"additional_notes_de":"Ziele: voller Bewegungsumfang, Schmerzfreiheit, progressive Kräftigung, keine mechanischen Defizite und Rückkehr zum Sport. Rückkehr zum Sport nach Freigabe durch Physiotherapeut und Operateur; vollständige Rückkehr zur Aktivität üblicherweise 5 Monate postoperativ. Entlassungskriterien: Kraftdefizit <10 %; Limb-Symmetry-Index ≥90 %; 45/50 Punkte in biomechanischen Funktionstests, sofern durchgeführt; keine Schmerzen und keine berichtete Instabilität.","additional_notes_en":"Goals: full range of motion, no pain, progressive strengthening, no mechanical deficits and return to sport. May return to sports after clearance from the therapist and surgeon; full return to activity typically at 5 months postoperative. Discharge criteria: <10% strength deficit; limb similarity index ≥90%; 45/50 on biomechanical functional tests, if performed; no pain or complaints of instability.","additional_notes_pl":"Cele: pełny zakres ruchu, brak bólu, progresywne wzmacnianie, brak deficytów mechanicznych i powrót do sportu. Powrót do sportu po zgodzie fizjoterapeuty i chirurga; pełny powrót do aktywności zwykle 5 miesięcy po zabiegu. Kryteria wypisu: deficyt siły <10%; wskaźnik podobieństwa kończyn ≥90%; wynik 45/50 w biomechanicznych testach funkcjonalnych, jeżeli wykonano; brak bólu i zgłaszanej niestabilności.","minimum_patient_share":null,"therapeutic_content_de":"Das bisherige Kräftigungsprogramm progressiv ausbauen und verbessern; Heimübungsprogramm; Wurfprogression oder Überkopfprogramm, falls indiziert; ab Woche 16 können Laufband, Crosstrainer, Stepper und Rennrad genutzt werden.","therapeutic_content_en":"Progress and improve the previous strengthening program; home exercise program; throwing progression or overhead program if indicated; treadmill, elliptical, stair climber and road bike may begin at week 16.","therapeutic_content_pl":"Stopniowo rozwijać i doskonalić wcześniejszy program wzmacniania; program ćwiczeń domowych; progresja rzutów lub program pracy nad głową, jeżeli wskazany; od 16. tygodnia można rozpocząć korzystanie z bieżni, orbitreka, steppera i roweru szosowego.","minimum_requirements_de":"Progression funktioneller Aktivitäten.","minimum_requirements_en":"Functional activity progression.","minimum_requirements_pl":"Progresja aktywności funkcjonalnej.","additional_notes_original":"Goals: full range of motion, no pain, progressive strengthening, no mechanical deficits and return to sport. May return to sports after clearance from the therapist and surgeon; full return to activity typically at 5 months postoperative. Discharge criteria: <10% strength deficit; limb similarity index ≥90%; 45/50 on biomechanical functional tests, if performed; no pain or complaints of instability.","therapeutic_content_original":"Progress and improve the previous strengthening program; home exercise program; throwing progression or overhead program if indicated; treadmill, elliptical, stair climber and road bike may begin at week 16.","minimum_requirements_original":"Functional activity progression.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["shoulder","upper_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"2b11e143-8b4c-5ee2-b681-4cded1e82263","slug":"us-jared-lee-38-high-tibial-osteotomy","title_pl":"Protokół rehabilitacji po osteotomii wysokiej kości piszczelowej","title_de":"Rehabilitationsprotokoll nach hoher Tibiakopfosteotomie","title_en":"High Tibial Osteotomy Rehabilitation Protocol","title_original":"High Tibial Osteotomy Rehabilitation","summary_pl":"Sześciofazowy protokół po osteotomii wysokiej kości piszczelowej, od sześciotygodniowej ochrony obciążania do progresji funkcjonalnej i sportowej.","summary_de":"Sechsphasiges Protokoll nach hoher Tibiakopfosteotomie, vom sechswöchigen Belastungsschutz bis zur funktionellen und sportlichen Progression.","summary_en":"Six-phase protocol after high tibial osteotomy, from six weeks of protected weight-bearing to functional and sport progression.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":["return_to_sport"],"physician_clearance_required":true,"condition_id":"83dd23ea-1895-5fc9-8ac5-0bb1f3e26cf6","condition_slug":"high-tibial-osteotomy","condition_name_pl":"Stan po osteotomii wysokiej kości piszczelowej","condition_name_de":"Zustand nach hoher Tibiakopfosteotomie","condition_name_en":"Status Post High Tibial Osteotomy","condition_name_original":"Status Post High Tibial Osteotomy","icd_codes":[],"category_key":"knee","category_pl":"Kolano","category_de":"Knie","category_en":"Knee","body_regions_pl":["Kolano","Kość piszczelowa"],"body_regions_de":["Knie","Schienbein"],"body_regions_en":["Knee","Tibia"],"search_terms_pl":["osteotomia wysoka kości piszczelowej","HTO","osteotomia kolana","rehabilitacja po osteotomii"],"search_terms_de":["hohe Tibiakopfosteotomie","HTO","Knieosteotomie","Rehabilitation nach Osteotomie"],"search_terms_en":["high tibial osteotomy","HTO","knee osteotomy","osteotomy rehabilitation"],"source_document_id":"3f0962e1-1eea-5f28-9fc8-7ff060eaf46e","source_title":"High Tibial Osteotomy Rehabilitation","issuer":"Jared Lee, MD","source_country_code":"US","jurisdiction_code":"US-CO","authority_level":"clinic","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_requires_review","official_url":"https://jaredleemd.com/wp-content/uploads/2025/06/High-Tibial-Osteotomy-Rehabilitation-Protocol.pdf","source_sha256":"d71429956907599097c47adb8f8539d7410c48d73b6d9425d95fe617dd3dc4ab","authorization_required":false,"license_note":"Public source file retained locally for source verification.","modules":[{"id":"aa97bb66-a4cf-505a-88a3-44dbc6ef7186","name_de":"Phase 1: Wochen 0–2","name_en":"Phase 1: Weeks 0-2","name_pl":"Faza 1: tygodnie 0–2","source_page":1,"module_number":1,"name_original":"Phase 1: Weeks 0-2","service_codes":[],"structured_content":{"de":{"goals":["Schwellung verringern, Schmerzen und Muskelatrophie begrenzen, die operierten Strukturen schützen und den Bewegungsumfang wiederherstellen."],"exercises":["Bewegungsumfang 0–90°","Schmerzbehandlung","Patellagleiten in alle Richtungen","Quadrizepsanspannungen, Anheben des gestreckten Beins sowie Kräftigung der Hüftabduktion und -adduktion","Dehnung der ischiokruralen Muskulatur und der Wade","Sprunggelenkpumpen und voller Bewegungsumfang des Sprunggelenks"],"applies_when":["Wochen 0–2"],"physiotherapist_actions":["Flat-foot-touch-down-Belastung für 6 Wochen","Bewegungsumfang 0–90°","T-Scope-Orthese und Gehstützen für 6 Wochen","Kniestreckung von 0° bis 2 Wochen postoperativ anstreben.","Ödemkontrolle","physikalische Maßnahmen nach Bedarf."]},"en":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and restore range of motion."],"exercises":["Range of motion 0-90°","pain management","patellar glides in all directions","quadriceps sets, straight leg raises and hip abduction/adduction strengthening","hamstring and calf stretching","ankle pumps and full ankle range of motion"],"applies_when":["Weeks 0-2"],"physiotherapist_actions":["Flat-foot touch-down weight-bearing for 6 weeks","range of motion 0-90°","T-Scope brace and crutches for 6 weeks","focus on knee extension to 0° by 2 weeks postoperative.","edema control","modalities as needed."]},"pl":{"goals":["zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona operowanych struktur oraz odtwarzanie zakresu ruchu."],"exercises":["Zakres ruchu 0–90°","leczenie bólu","ślizgi rzepki we wszystkich kierunkach","napięcia mięśnia czworogłowego, unoszenie wyprostowanej kończyny oraz wzmacnianie odwodzenia i przywodzenia biodra","rozciąganie mięśni kulszowo-goleniowych i łydki","pompki stawu skokowego i pełny zakres ruchu stawu skokowego"],"applies_when":["tygodnie 0–2"],"physiotherapist_actions":["Obciążanie flat-foot touch-down przez 6 tygodni","zakres ruchu 0–90°","orteza T-Scope i kule przez 6 tygodni","dążyć do wyprostu kolana 0° do 2. tygodnia po operacji.","kontrola obrzęku","fizykoterapia według potrzeb."]},"original":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and restore range of motion."],"exercises":["Range of motion 0-90°","pain management","patellar glides in all directions","quadriceps sets, straight leg raises and hip abduction/adduction strengthening","hamstring and calf stretching","ankle pumps and full ankle range of motion"],"applies_when":["Weeks 0-2"],"physiotherapist_actions":["Flat-foot touch-down weight-bearing for 6 weeks","range of motion 0-90°","T-Scope brace and crutches for 6 weeks","focus on knee extension to 0° by 2 weeks postoperative.","edema control","modalities as needed."]}},"additional_notes_de":"Ziele: Schwellung verringern, Schmerzen und Muskelatrophie begrenzen, die operierten Strukturen schützen und den Bewegungsumfang wiederherstellen.","additional_notes_en":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and restore range of motion.","additional_notes_pl":"Cele: zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona operowanych struktur oraz odtwarzanie zakresu ruchu.","minimum_patient_share":null,"therapeutic_content_de":"Bewegungsumfang 0–90°; Ödemkontrolle; Schmerzbehandlung; Patellagleiten in alle Richtungen; Quadrizepsanspannungen, Anheben des gestreckten Beins sowie Kräftigung der Hüftabduktion und -adduktion; Dehnung der ischiokruralen Muskulatur und der Wade; Sprunggelenkpumpen und voller Bewegungsumfang des Sprunggelenks; physikalische Maßnahmen nach Bedarf.","therapeutic_content_en":"Range of motion 0-90°; edema control; pain management; patellar glides in all directions; quadriceps sets, straight leg raises and hip abduction/adduction strengthening; hamstring and calf stretching; ankle pumps and full ankle range of motion; modalities as needed.","therapeutic_content_pl":"Zakres ruchu 0–90°; kontrola obrzęku; leczenie bólu; ślizgi rzepki we wszystkich kierunkach; napięcia mięśnia czworogłowego, unoszenie wyprostowanej kończyny oraz wzmacnianie odwodzenia i przywodzenia biodra; rozciąganie mięśni kulszowo-goleniowych i łydki; pompki stawu skokowego i pełny zakres ruchu stawu skokowego; fizykoterapia według potrzeb.","minimum_requirements_de":"Flat-foot-touch-down-Belastung für 6 Wochen; Bewegungsumfang 0–90°; T-Scope-Orthese und Gehstützen für 6 Wochen; Kniestreckung von 0° bis 2 Wochen postoperativ anstreben.","minimum_requirements_en":"Flat-foot touch-down weight-bearing for 6 weeks; range of motion 0-90°; T-Scope brace and crutches for 6 weeks; focus on knee extension to 0° by 2 weeks postoperative.","minimum_requirements_pl":"Obciążanie flat-foot touch-down przez 6 tygodni; zakres ruchu 0–90°; orteza T-Scope i kule przez 6 tygodni; dążyć do wyprostu kolana 0° do 2. tygodnia po operacji.","additional_notes_original":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and restore range of motion.","therapeutic_content_original":"Range of motion 0-90°; edema control; pain management; patellar glides in all directions; quadriceps sets, straight leg raises and hip abduction/adduction strengthening; hamstring and calf stretching; ankle pumps and full ankle range of motion; modalities as needed.","minimum_requirements_original":"Flat-foot touch-down weight-bearing for 6 weeks; range of motion 0-90°; T-Scope brace and crutches for 6 weeks; focus on knee extension to 0° by 2 weeks postoperative.","structured_content_v2":"$undefined"},{"id":"aac6c146-403e-5d9f-b10e-4cf5ee239a6f","name_de":"Phase 2: Wochen 2–6","name_en":"Phase 2: Weeks 2-6","name_pl":"Faza 2: tygodnie 2–6","source_page":1,"module_number":2,"name_original":"Phase 2: Weeks 2-6","service_codes":[],"structured_content":{"de":{"goals":["Schwellung weiter verringern, Schmerzen und Muskelatrophie begrenzen, die operierten Strukturen schützen und den Bewegungsumfang wiederherstellen."],"exercises":["Bewegungsumfang 0–90°","Quadrizepsanspannungen, Anheben des gestreckten Beins, Kräftigung der Hüftabduktion und -adduktion sowie Rumpfkräftigung","Gesäßkräftigung: Clamshells, Reverse Clamshells, Hüftabduktion in Seitenlage und Hüftextension in Bauchlage"],"applies_when":["Wochen 2–6"],"physiotherapist_actions":["Flat-foot-touch-down-Belastung für 6 Wochen","Bewegungsumfang 0–90°","T-Scope-Orthese und Gehstützen für 6 Wochen","Kniebeugung von 90° bis 4 Wochen postoperativ anstreben.","Weichteilmobilisation und Patellagleiten","physikalische Maßnahmen nach Bedarf."]},"en":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and restore range of motion."],"exercises":["Range of motion 0-90°","quadriceps sets, straight leg raises, hip abduction/adduction strengthening and core strengthening","gluteal strengthening with clams, reverse clams, side-lying hip abduction and prone hip extension"],"applies_when":["Weeks 2-6"],"physiotherapist_actions":["Flat-foot touch-down weight-bearing for 6 weeks","range of motion 0-90°","T-Scope brace and crutches for 6 weeks","focus on knee flexion to 90° by 4 weeks postoperative.","soft-tissue mobilization and patellar glides","modalities as needed."]},"pl":{"goals":["dalsze zmniejszanie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona operowanych struktur oraz odtwarzanie zakresu ruchu."],"exercises":["Zakres ruchu 0–90°","napięcia mięśnia czworogłowego, unoszenie wyprostowanej kończyny, wzmacnianie odwodzenia i przywodzenia biodra oraz mięśni centralnych","wzmacnianie pośladków: clamshell, reverse clamshell, odwodzenie biodra w leżeniu bokiem i wyprost biodra w leżeniu przodem"],"applies_when":["tygodnie 2–6"],"physiotherapist_actions":["Obciążanie flat-foot touch-down przez 6 tygodni","zakres ruchu 0–90°","orteza T-Scope i kule przez 6 tygodni","dążyć do zgięcia kolana 90° do 4. tygodnia po operacji.","mobilizacja tkanek miękkich i ślizgi rzepki","fizykoterapia według potrzeb."]},"original":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and restore range of motion."],"exercises":["Range of motion 0-90°","quadriceps sets, straight leg raises, hip abduction/adduction strengthening and core strengthening","gluteal strengthening with clams, reverse clams, side-lying hip abduction and prone hip extension"],"applies_when":["Weeks 2-6"],"physiotherapist_actions":["Flat-foot touch-down weight-bearing for 6 weeks","range of motion 0-90°","T-Scope brace and crutches for 6 weeks","focus on knee flexion to 90° by 4 weeks postoperative.","soft-tissue mobilization and patellar glides","modalities as needed."]}},"additional_notes_de":"Ziele: Schwellung weiter verringern, Schmerzen und Muskelatrophie begrenzen, die operierten Strukturen schützen und den Bewegungsumfang wiederherstellen.","additional_notes_en":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and restore range of motion.","additional_notes_pl":"Cele: dalsze zmniejszanie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona operowanych struktur oraz odtwarzanie zakresu ruchu.","minimum_patient_share":null,"therapeutic_content_de":"Bewegungsumfang 0–90°; Weichteilmobilisation und Patellagleiten; Quadrizepsanspannungen, Anheben des gestreckten Beins, Kräftigung der Hüftabduktion und -adduktion sowie Rumpfkräftigung; Gesäßkräftigung: Clamshells, Reverse Clamshells, Hüftabduktion in Seitenlage und Hüftextension in Bauchlage; physikalische Maßnahmen nach Bedarf.","therapeutic_content_en":"Range of motion 0-90°; soft-tissue mobilization and patellar glides; quadriceps sets, straight leg raises, hip abduction/adduction strengthening and core strengthening; gluteal strengthening with clams, reverse clams, side-lying hip abduction and prone hip extension; modalities as needed.","therapeutic_content_pl":"Zakres ruchu 0–90°; mobilizacja tkanek miękkich i ślizgi rzepki; napięcia mięśnia czworogłowego, unoszenie wyprostowanej kończyny, wzmacnianie odwodzenia i przywodzenia biodra oraz mięśni centralnych; wzmacnianie pośladków: clamshell, reverse clamshell, odwodzenie biodra w leżeniu bokiem i wyprost biodra w leżeniu przodem; fizykoterapia według potrzeb.","minimum_requirements_de":"Flat-foot-touch-down-Belastung für 6 Wochen; Bewegungsumfang 0–90°; T-Scope-Orthese und Gehstützen für 6 Wochen; Kniebeugung von 90° bis 4 Wochen postoperativ anstreben.","minimum_requirements_en":"Flat-foot touch-down weight-bearing for 6 weeks; range of motion 0-90°; T-Scope brace and crutches for 6 weeks; focus on knee flexion to 90° by 4 weeks postoperative.","minimum_requirements_pl":"Obciążanie flat-foot touch-down przez 6 tygodni; zakres ruchu 0–90°; orteza T-Scope i kule przez 6 tygodni; dążyć do zgięcia kolana 90° do 4. tygodnia po operacji.","additional_notes_original":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and restore range of motion.","therapeutic_content_original":"Range of motion 0-90°; soft-tissue mobilization and patellar glides; quadriceps sets, straight leg raises, hip abduction/adduction strengthening and core strengthening; gluteal strengthening with clams, reverse clams, side-lying hip abduction and prone hip extension; modalities as needed.","minimum_requirements_original":"Flat-foot touch-down weight-bearing for 6 weeks; range of motion 0-90°; T-Scope brace and crutches for 6 weeks; focus on knee flexion to 90° by 4 weeks postoperative.","structured_content_v2":"$undefined"},{"id":"c15ec94c-e703-5010-85a7-d946e6e55b82","name_de":"Phase 3: Wochen 6–12","name_en":"Phase 3: Weeks 6-12","name_pl":"Faza 3: tygodnie 6–12","source_page":1,"module_number":3,"name_original":"Phase 3: Weeks 6-12","service_codes":[],"structured_content":{"de":{"goals":["Voller Bewegungsumfang, minimale Schmerzen, Steigerung der Übungswiderstände, Wiederherstellung des normalen Gangbildes und Schutz der Transplantatfixation."],"exercises":["Den passiven, aktiven und aktiv-assistierten Bewegungsumfang wöchentlich um 10° bis zum vollen Bewegungsumfang steigern.","Gesäßkräftigung steigern.","Quadrizepskräftigung steigern.","Wassertherapie mit Schwerpunkt auf Gangnormalisierung.","Dehnung der ischiokruralen Muskulatur.","Nach Erreichen des vollen Bewegungsumfangs Ergometer ohne Widerstand, wobei das operierte Bein nur mitgeführt wird."],"applies_when":["Wochen 6–12"],"dosage_and_progression":["Belastung für 6 Wochen auf 50 % steigern.","Bewegungsumfang nach Indikation steigern.","Die T-Scope-Orthese entsprechend dem Fortschritt wöchentlich auf einen neuen Flexionswinkel entriegeln, z. B. 0–90°, 0–100°, 0–110°.","T-Scope nach Erreichen des vollen Bewegungsumfangs von mindestens 120° absetzen."]},"en":{"goals":["Full range of motion, minimal pain, increased resistance exercise, restoration of a normal gait pattern and protection of graft fixation."],"exercises":["Progress passive, active and active-assisted range of motion by 10° per week until full range is achieved.","Progress gluteal strengthening.","Progress quadriceps strengthening.","Aquatic therapy with emphasis on gait normalization.","Hamstring stretching.","Stationary cycling without resistance once full range of motion is achieved, with the operative leg along for the ride."],"applies_when":["Weeks 6-12"],"dosage_and_progression":["Progress to 50% weight-bearing for 6 weeks.","Progress range of motion as indicated.","Unlock the T-Scope to a new degree of flexion each week as the patient progresses, such as 0-90°, 0-100° and 0-110°.","Discontinue the T-Scope once full range of motion of at least 120° is achieved."]},"pl":{"goals":["Pełny zakres ruchu, minimalny ból, zwiększanie oporu ćwiczeń, przywrócenie prawidłowego wzorca chodu i ochrona stabilizacji przeszczepu."],"exercises":["Zwiększać bierny, czynny i czynny wspomagany zakres ruchu o 10° tygodniowo do uzyskania pełnego zakresu.","Zwiększać wzmacnianie mięśni pośladkowych.","Zwiększać wzmacnianie mięśnia czworogłowego.","Terapia w wodzie ze szczególnym uwzględnieniem normalizacji chodu.","Rozciąganie mięśni kulszowo-goleniowych.","Po uzyskaniu pełnego zakresu ruchu rower stacjonarny bez oporu, z biernym udziałem operowanej kończyny."],"applies_when":["tygodnie 6–12"],"dosage_and_progression":["Zwiększyć obciążanie do 50% przez 6 tygodni.","Zwiększać zakres ruchu według wskazań.","Co tydzień odblokowywać ortezę T-Scope do kolejnego kąta zgięcia wraz z progresją pacjenta, np. 0–90°, 0–100°, 0–110°.","Odstawić T-Scope po uzyskaniu pełnego zakresu ruchu, co najmniej 120°."]},"original":{"goals":["Full range of motion, minimal pain, increased resistance exercise, restoration of a normal gait pattern and protection of graft fixation."],"exercises":["Progress passive, active and active-assisted range of motion by 10° per week until full range is achieved.","Progress gluteal strengthening.","Progress quadriceps strengthening.","Aquatic therapy with emphasis on gait normalization.","Hamstring stretching.","Stationary cycling without resistance once full range of motion is achieved, with the operative leg along for the ride."],"applies_when":["Weeks 6-12"],"dosage_and_progression":["Progress to 50% weight-bearing for 6 weeks.","Progress range of motion as indicated.","Unlock the T-Scope to a new degree of flexion each week as the patient progresses, such as 0-90°, 0-100° and 0-110°.","Discontinue the T-Scope once full range of motion of at least 120° is achieved."]}},"additional_notes_de":"Ziele: voller Bewegungsumfang, minimale Schmerzen, Steigerung der Übungswiderstände, Wiederherstellung des normalen Gangbildes und Schutz der Transplantatfixation.","additional_notes_en":"Goals: full range of motion, minimal pain, increased resistance exercise, restoration of a normal gait pattern and protection of graft fixation.","additional_notes_pl":"Cele: pełny zakres ruchu, minimalny ból, zwiększanie oporu ćwiczeń, przywrócenie prawidłowego wzorca chodu i ochrona stabilizacji przeszczepu.","minimum_patient_share":null,"therapeutic_content_de":"Den passiven, aktiven und aktiv-assistierten Bewegungsumfang wöchentlich um 10° bis zum vollen Bewegungsumfang steigern; Gesäßkräftigung steigern; Quadrizepskräftigung steigern; Wassertherapie mit Schwerpunkt auf Gangnormalisierung; Dehnung der ischiokruralen Muskulatur; nach Erreichen des vollen Bewegungsumfangs Ergometer ohne Widerstand, wobei das operierte Bein nur mitgeführt wird.","therapeutic_content_en":"Progress passive, active and active-assisted range of motion by 10° per week until full range is achieved; progress gluteal strengthening; progress quadriceps strengthening; aquatic therapy with emphasis on gait normalization; hamstring stretching; stationary cycling without resistance once full range of motion is achieved, with the operative leg along for the ride.","therapeutic_content_pl":"Zwiększać bierny, czynny i czynny wspomagany zakres ruchu o 10° tygodniowo do uzyskania pełnego zakresu; zwiększać wzmacnianie mięśni pośladkowych; zwiększać wzmacnianie mięśnia czworogłowego; terapia w wodzie ze szczególnym uwzględnieniem normalizacji chodu; rozciąganie mięśni kulszowo-goleniowych; po uzyskaniu pełnego zakresu ruchu rower stacjonarny bez oporu, z biernym udziałem operowanej kończyny.","minimum_requirements_de":"Belastung für 6 Wochen auf 50 % steigern; Bewegungsumfang nach Indikation steigern; die T-Scope-Orthese entsprechend dem Fortschritt wöchentlich auf einen neuen Flexionswinkel entriegeln, z. B. 0–90°, 0–100°, 0–110°; T-Scope nach Erreichen des vollen Bewegungsumfangs von mindestens 120° absetzen.","minimum_requirements_en":"Progress to 50% weight-bearing for 6 weeks; progress range of motion as indicated; unlock the T-Scope to a new degree of flexion each week as the patient progresses, such as 0-90°, 0-100° and 0-110°; discontinue the T-Scope once full range of motion of at least 120° is achieved.","minimum_requirements_pl":"Zwiększyć obciążanie do 50% przez 6 tygodni; zwiększać zakres ruchu według wskazań; co tydzień odblokowywać ortezę T-Scope do kolejnego kąta zgięcia wraz z progresją pacjenta, np. 0–90°, 0–100°, 0–110°; odstawić T-Scope po uzyskaniu pełnego zakresu ruchu, co najmniej 120°.","additional_notes_original":"Goals: full range of motion, minimal pain, increased resistance exercise, restoration of a normal gait pattern and protection of graft fixation.","therapeutic_content_original":"Progress passive, active and active-assisted range of motion by 10° per week until full range is achieved; progress gluteal strengthening; progress quadriceps strengthening; aquatic therapy with emphasis on gait normalization; hamstring stretching; stationary cycling without resistance once full range of motion is achieved, with the operative leg along for the ride.","minimum_requirements_original":"Progress to 50% weight-bearing for 6 weeks; progress range of motion as indicated; unlock the T-Scope to a new degree of flexion each week as the patient progresses, such as 0-90°, 0-100° and 0-110°; discontinue the T-Scope once full range of motion of at least 120° is achieved.","structured_content_v2":"$undefined"},{"id":"816460a5-3c93-5cd1-9d58-43943762d03f","name_de":"Phase 4: Wochen 12–16","name_en":"Phase 4: Weeks 12-16","name_pl":"Faza 4: tygodnie 12–16","source_page":2,"module_number":4,"name_original":"Phase 4: Weeks 12-16","service_codes":[],"structured_content":{"de":{"goals":["Korrekte Gangmechanik, bessere Kraft der unteren Extremität, voller Bewegungsumfang und neuromuskuläre Kontrolle."],"exercises":["Kräftigungsprogramm steigern.","Kräftigung in geschlossener Kette beginnen: Zehenstände, Mini-Kniebeugen und PNF gegen Widerstand.","Progressive Widerstandsübungen mit 1–5 lb.","Gleichgewichtsübungen.","Beinbeugerübungen.","Ergometer mit zunehmendem Widerstand nach Verträglichkeit."],"applies_when":["Wochen 12–16"],"dosage_and_progression":["Belastung wöchentlich um 25 % bis zur Vollbelastung steigern.","Nach Erreichen der Vollbelastung Gehstützen abtrainieren.","T-Scope-Orthese absetzen."]},"en":{"goals":["Proper gait mechanics, improved lower-extremity strength, full range of motion and neuromuscular control."],"exercises":["Progress the strengthening program.","Begin closed-chain strengthening with toe raises, mini squats and PNF with resistance.","Progressive resistance exercises with 1-5 lb.","Balance exercises.","Hamstring curls.","Stationary cycling with increasing resistance as tolerated."],"applies_when":["Weeks 12-16"],"dosage_and_progression":["Progress weight-bearing by 25% per week until full weight-bearing is achieved.","Once fully weight-bearing, wean from crutches.","Discontinue the T-Scope brace."]},"pl":{"goals":["Prawidłowa mechanika chodu, poprawa siły kończyny dolnej, pełny zakres ruchu i kontrola nerwowo-mięśniowa."],"exercises":["Zwiększać program wzmacniania.","Rozpocząć wzmacnianie w zamkniętym łańcuchu: wspięcia na palce, mini-przysiady i PNF z oporem.","Progresywne ćwiczenia oporowe z obciążeniem 1–5 lb.","Ćwiczenia równowagi.","Uginanie kolan.","Rower stacjonarny ze zwiększaniem oporu według tolerancji."],"applies_when":["tygodnie 12–16"],"dosage_and_progression":["Zwiększać obciążanie o 25% tygodniowo do uzyskania pełnego obciążania.","Po uzyskaniu pełnego obciążania odstawić kule.","Odstawić ortezę T-Scope."]},"original":{"goals":["Proper gait mechanics, improved lower-extremity strength, full range of motion and neuromuscular control."],"exercises":["Progress the strengthening program.","Begin closed-chain strengthening with toe raises, mini squats and PNF with resistance.","Progressive resistance exercises with 1-5 lb.","Balance exercises.","Hamstring curls.","Stationary cycling with increasing resistance as tolerated."],"applies_when":["Weeks 12-16"],"dosage_and_progression":["Progress weight-bearing by 25% per week until full weight-bearing is achieved.","Once fully weight-bearing, wean from crutches.","Discontinue the T-Scope brace."]}},"additional_notes_de":"Ziele: korrekte Gangmechanik, bessere Kraft der unteren Extremität, voller Bewegungsumfang und neuromuskuläre Kontrolle.","additional_notes_en":"Goals: proper gait mechanics, improved lower-extremity strength, full range of motion and neuromuscular control.","additional_notes_pl":"Cele: prawidłowa mechanika chodu, poprawa siły kończyny dolnej, pełny zakres ruchu i kontrola nerwowo-mięśniowa.","minimum_patient_share":null,"therapeutic_content_de":"Kräftigungsprogramm steigern; Kräftigung in geschlossener Kette beginnen: Zehenstände, Mini-Kniebeugen und PNF gegen Widerstand; progressive Widerstandsübungen mit 1–5 lb; Gleichgewichtsübungen; Beinbeugerübungen; Ergometer mit zunehmendem Widerstand nach Verträglichkeit.","therapeutic_content_en":"Progress the strengthening program; begin closed-chain strengthening with toe raises, mini squats and PNF with resistance; progressive resistance exercises with 1-5 lb; balance exercises; hamstring curls; stationary cycling with increasing resistance as tolerated.","therapeutic_content_pl":"Zwiększać program wzmacniania; rozpocząć wzmacnianie w zamkniętym łańcuchu: wspięcia na palce, mini-przysiady i PNF z oporem; progresywne ćwiczenia oporowe z obciążeniem 1–5 lb; ćwiczenia równowagi; uginanie kolan; rower stacjonarny ze zwiększaniem oporu według tolerancji.","minimum_requirements_de":"Belastung wöchentlich um 25 % bis zur Vollbelastung steigern; nach Erreichen der Vollbelastung Gehstützen abtrainieren; T-Scope-Orthese absetzen.","minimum_requirements_en":"Progress weight-bearing by 25% per week until full weight-bearing is achieved; once fully weight-bearing, wean from crutches; discontinue the T-Scope brace.","minimum_requirements_pl":"Zwiększać obciążanie o 25% tygodniowo do uzyskania pełnego obciążania; po uzyskaniu pełnego obciążania odstawić kule; odstawić ortezę T-Scope.","additional_notes_original":"Goals: proper gait mechanics, improved lower-extremity strength, full range of motion and neuromuscular control.","therapeutic_content_original":"Progress the strengthening program; begin closed-chain strengthening with toe raises, mini squats and PNF with resistance; progressive resistance exercises with 1-5 lb; balance exercises; hamstring curls; stationary cycling with increasing resistance as tolerated.","minimum_requirements_original":"Progress weight-bearing by 25% per week until full weight-bearing is achieved; once fully weight-bearing, wean from crutches; discontinue the T-Scope brace.","structured_content_v2":"$undefined"},{"id":"ec1d2b2b-7d1f-559e-b456-4a00111eac29","name_de":"Phase 5: Monate 4–6","name_en":"Phase 5: Months 4-6","name_pl":"Faza 5: miesiące 4–6","source_page":2,"module_number":5,"name_original":"Phase 5: Months 4-6","service_codes":[],"structured_content":{"de":{"goals":["Voller schmerzfreier Bewegungsumfang, keine Reizung des Patellofemoralgelenks, Wiederherstellung von Kraft und Propriozeption sowie Kraftentwicklung."],"exercises":["Kräftigung steigern.","Bisherige Beweglichkeits- und Kräftigungsübungen fortsetzen und steigern.","Funktionelle Geh-Jogging-Lauf-Progression.","Vorwärts- und Rückwärtslauf mit 1/2, 3/4 und voller Geschwindigkeit steigern.","Kräftigung der unteren Extremität mit Kniebeugen und einbeinigen Übungen einschließlich erhöhtem Split Squat und TRX steigern.","Dynamisches Gleichgewicht steigern.","Aerobe Kondition auf Crosstrainer, beim Schwimmen und Radfahren steigern."],"applies_when":["Monate 4–6"],"restrictions":["Keine Einschränkungen des Bewegungsumfangs oder der Belastung."],"progression_criteria":["Isometrische Kraft von Gluteus medius und maximus >80 % der Gegenseite.","Kein Valguskollaps.","Bei einbeinigen Ausdaueraufgaben keine femorale Adduktion oder Innenrotation, kein Beckensinken und keine übermäßige Rumpfneigung."]},"en":{"goals":["Full pain-free range of motion, no evidence of patellofemoral joint irritation, restoration of strength and proprioception, and power progression."],"exercises":["Progress strengthening.","Continue and progress previous flexibility and strengthening activities.","Functional walk-jog-run progression.","Forward and backward running progression at 1/2, 3/4 and full speed.","Progress lower-extremity strengthening with squats and single-leg exercises including elevated split squats and TRX.","Progress dynamic balance.","Increase aerobic conditioning with the elliptical, swimming and cycling."],"applies_when":["Months 4-6"],"restrictions":["No range-of-motion or weight-bearing restrictions."],"progression_criteria":["Gluteus medius and maximus isometric strength >80% of the contralateral limb.","No valgus collapse.","No femoral adduction or internal rotation, pelvic drop, or excessive trunk lean during single-leg endurance tasks."]},"pl":{"goals":["Pełny bezbolesny zakres ruchu, brak podrażnienia stawu rzepkowo-udowego, odtworzenie siły i propriocepcji oraz zwiększanie mocy."],"exercises":["Zwiększać wzmacnianie.","Kontynuować i zwiększać wcześniejsze ćwiczenia elastyczności i wzmacniania.","Funkcjonalna progresja marsz–trucht–bieg.","Progresja biegu do przodu i tyłu z prędkością 1/2, 3/4 i pełną.","Zwiększać wzmacnianie kończyny dolnej przez przysiady i ćwiczenia jednonóż, w tym przysiad wykroczny z nogą uniesioną oraz TRX.","Zwiększać równowagę dynamiczną.","Zwiększać kondycję tlenową na orbitreku, w pływaniu i na rowerze."],"applies_when":["miesiące 4–6"],"restrictions":["Brak ograniczeń zakresu ruchu lub obciążania."],"progression_criteria":["Izometryczna siła mięśnia pośladkowego średniego i wielkiego >80% kończyny przeciwnej.","Bez zapadania kolana do koślawości.","Podczas jednonóż wykonywanych zadań wytrzymałościowych bez przywiedzenia i rotacji wewnętrznej kości udowej, opadania miednicy ani nadmiernego pochylenia tułowia."]},"original":{"goals":["Full pain-free range of motion, no evidence of patellofemoral joint irritation, restoration of strength and proprioception, and power progression."],"exercises":["Progress strengthening.","Continue and progress previous flexibility and strengthening activities.","Functional walk-jog-run progression.","Forward and backward running progression at 1/2, 3/4 and full speed.","Progress lower-extremity strengthening with squats and single-leg exercises including elevated split squats and TRX.","Progress dynamic balance.","Increase aerobic conditioning with the elliptical, swimming and cycling."],"applies_when":["Months 4-6"],"restrictions":["No range-of-motion or weight-bearing restrictions."],"progression_criteria":["Gluteus medius and maximus isometric strength >80% of the contralateral limb.","No valgus collapse.","No femoral adduction or internal rotation, pelvic drop, or excessive trunk lean during single-leg endurance tasks."]}},"additional_notes_de":"Ziele: voller schmerzfreier Bewegungsumfang, keine Reizung des Patellofemoralgelenks, Wiederherstellung von Kraft und Propriozeption sowie Kraftentwicklung. Progressionskriterien: isometrische Kraft von Gluteus medius und maximus >80 % der Gegenseite; kein Valguskollaps; bei einbeinigen Ausdaueraufgaben keine femorale Adduktion oder Innenrotation, kein Beckensinken und keine übermäßige Rumpfneigung.","additional_notes_en":"Goals: full pain-free range of motion, no evidence of patellofemoral joint irritation, restoration of strength and proprioception, and power progression. Criteria for progression: gluteus medius and maximus isometric strength >80% of the contralateral limb; no valgus collapse; no femoral adduction or internal rotation, pelvic drop, or excessive trunk lean during single-leg endurance tasks.","additional_notes_pl":"Cele: pełny bezbolesny zakres ruchu, brak podrażnienia stawu rzepkowo-udowego, odtworzenie siły i propriocepcji oraz zwiększanie mocy. Kryteria progresji: izometryczna siła mięśnia pośladkowego średniego i wielkiego >80% kończyny przeciwnej; bez zapadania kolana do koślawości; podczas jednonóż wykonywanych zadań wytrzymałościowych bez przywiedzenia i rotacji wewnętrznej kości udowej, opadania miednicy ani nadmiernego pochylenia tułowia.","minimum_patient_share":null,"therapeutic_content_de":"Kräftigung steigern; bisherige Beweglichkeits- und Kräftigungsübungen fortsetzen und steigern; funktionelle Geh-Jogging-Lauf-Progression; Vorwärts- und Rückwärtslauf mit 1/2, 3/4 und voller Geschwindigkeit steigern; Kräftigung der unteren Extremität mit Kniebeugen und einbeinigen Übungen einschließlich erhöhtem Split Squat und TRX steigern; dynamisches Gleichgewicht steigern; aerobe Kondition auf Crosstrainer, beim Schwimmen und Radfahren steigern.","therapeutic_content_en":"Progress strengthening; continue and progress previous flexibility and strengthening activities; functional walk-jog-run progression; forward and backward running progression at 1/2, 3/4 and full speed; progress lower-extremity strengthening with squats and single-leg exercises including elevated split squats and TRX; progress dynamic balance; increase aerobic conditioning with the elliptical, swimming and cycling.","therapeutic_content_pl":"Zwiększać wzmacnianie; kontynuować i zwiększać wcześniejsze ćwiczenia elastyczności i wzmacniania; funkcjonalna progresja marsz–trucht–bieg; progresja biegu do przodu i tyłu z prędkością 1/2, 3/4 i pełną; zwiększać wzmacnianie kończyny dolnej przez przysiady i ćwiczenia jednonóż, w tym przysiad wykroczny z nogą uniesioną oraz TRX; zwiększać równowagę dynamiczną; zwiększać kondycję tlenową na orbitreku, w pływaniu i na rowerze.","minimum_requirements_de":"Keine Einschränkungen des Bewegungsumfangs oder der Belastung.","minimum_requirements_en":"No range-of-motion or weight-bearing restrictions.","minimum_requirements_pl":"Brak ograniczeń zakresu ruchu lub obciążania.","additional_notes_original":"Goals: full pain-free range of motion, no evidence of patellofemoral joint irritation, restoration of strength and proprioception, and power progression. Criteria for progression: gluteus medius and maximus isometric strength >80% of the contralateral limb; no valgus collapse; no femoral adduction or internal rotation, pelvic drop, or excessive trunk lean during single-leg endurance tasks.","therapeutic_content_original":"Progress strengthening; continue and progress previous flexibility and strengthening activities; functional walk-jog-run progression; forward and backward running progression at 1/2, 3/4 and full speed; progress lower-extremity strengthening with squats and single-leg exercises including elevated split squats and TRX; progress dynamic balance; increase aerobic conditioning with the elliptical, swimming and cycling.","minimum_requirements_original":"No range-of-motion or weight-bearing restrictions.","structured_content_v2":"$undefined"},{"id":"e4a499d9-9b9b-5c50-b4a2-5fda0a1a2c46","name_de":"Phase 6: ab Monat 6","name_en":"Phase 6: Months 6+","name_pl":"Faza 6: od 6. miesiąca","source_page":2,"module_number":6,"name_original":"Phase 6: Months 6+","service_codes":[],"structured_content":{"de":{"goals":["Abschluss der angemessenen funktionellen Progression, Erhalt der Kraft und Patientenschulung."],"exercises":["Funktionelle Progression einschließlich Richtungswechseln, Crossover und Carioca","plyometrische Übungen entsprechend den Patientenzielen, einschließlich Medizinballarbeit und Schlittenübungen","Agilitätsübungen mit Seitwärtsschritten, Koordinationsleiter, Hütchen, Z- und W-Cuts sowie multiplanaren sportartspezifischen Übungen."],"applies_when":["ab Monat 6"],"progression_criteria":["Freigabe durch den Operateur","Kraftindex der ischiokruralen Muskulatur >90 % gegenüber der Gegenseite","Quadrizepskraftindex >90 % gegenüber der Gegenseite","Differenz der anterioren Reichweite im Y-Balance-Test <4 cm","keine Schmerzen oder Instabilität."],"physiotherapist_actions":["Die Quelle nennt für diese Phase keine gesonderten Einschränkungen."]},"en":{"goals":["completion of appropriate functional progression, strength maintenance and patient education."],"exercises":["Functional progression including cutting, crossover and carioca","plyometric exercises appropriate to patient goals, including medicine-ball work and sled drills","agility drills with shuffles, ladder footwork, cone drills, Z-cuts, W-cuts and multiplanar sport-specific drills."],"applies_when":["Months 6+"],"progression_criteria":["surgeon clearance","hamstring strength index >90% compared with the contralateral limb","quadriceps strength index >90% compared with the contralateral limb","Y-Balance anterior-reach difference <4 cm","no pain or instability."],"physiotherapist_actions":["The source states no separate restrictions for this phase."]},"pl":{"goals":["ukończenie odpowiedniej progresji funkcjonalnej, utrzymanie siły i edukacja pacjenta."],"exercises":["Progresja funkcjonalna obejmująca między innymi zmiany kierunku, crossover i carioca","ćwiczenia plyometryczne zgodne z celami pacjenta, w tym piłka lekarska i ćwiczenia z saniami","ćwiczenia zwinności: kroki odstawno-dostawne, praca nóg na drabince, ćwiczenia z pachołkami, cięcia Z i W oraz wielopłaszczyznowe ćwiczenia specyficzne dla sportu."],"applies_when":["od 6. miesiąca"],"progression_criteria":["zgoda chirurga","wskaźnik siły mięśni kulszowo-goleniowych >90% względem kończyny przeciwnej","wskaźnik siły mięśnia czworogłowego >90% względem kończyny przeciwnej","różnica przedniego zasięgu w teście Y-Balance <4 cm","brak bólu lub niestabilności."],"physiotherapist_actions":["Źródło nie podaje odrębnych ograniczeń dla tej fazy."]},"original":{"goals":["completion of appropriate functional progression, strength maintenance and patient education."],"exercises":["Functional progression including cutting, crossover and carioca","plyometric exercises appropriate to patient goals, including medicine-ball work and sled drills","agility drills with shuffles, ladder footwork, cone drills, Z-cuts, W-cuts and multiplanar sport-specific drills."],"applies_when":["Months 6+"],"progression_criteria":["surgeon clearance","hamstring strength index >90% compared with the contralateral limb","quadriceps strength index >90% compared with the contralateral limb","Y-Balance anterior-reach difference <4 cm","no pain or instability."],"physiotherapist_actions":["The source states no separate restrictions for this phase."]}},"additional_notes_de":"Ziele: Abschluss der angemessenen funktionellen Progression, Erhalt der Kraft und Patientenschulung. Entlassungskriterien: Freigabe durch den Operateur; Kraftindex der ischiokruralen Muskulatur >90 % gegenüber der Gegenseite; Quadrizepskraftindex >90 % gegenüber der Gegenseite; Differenz der anterioren Reichweite im Y-Balance-Test <4 cm; keine Schmerzen oder Instabilität.","additional_notes_en":"Goals: completion of appropriate functional progression, strength maintenance and patient education. Discharge criteria: surgeon clearance; hamstring strength index >90% compared with the contralateral limb; quadriceps strength index >90% compared with the contralateral limb; Y-Balance anterior-reach difference <4 cm; no pain or instability.","additional_notes_pl":"Cele: ukończenie odpowiedniej progresji funkcjonalnej, utrzymanie siły i edukacja pacjenta. Kryteria wypisu: zgoda chirurga; wskaźnik siły mięśni kulszowo-goleniowych >90% względem kończyny przeciwnej; wskaźnik siły mięśnia czworogłowego >90% względem kończyny przeciwnej; różnica przedniego zasięgu w teście Y-Balance <4 cm; brak bólu lub niestabilności.","minimum_patient_share":null,"therapeutic_content_de":"Funktionelle Progression einschließlich Richtungswechseln, Crossover und Carioca; plyometrische Übungen entsprechend den Patientenzielen, einschließlich Medizinballarbeit und Schlittenübungen; Agilitätsübungen mit Seitwärtsschritten, Koordinationsleiter, Hütchen, Z- und W-Cuts sowie multiplanaren sportartspezifischen Übungen.","therapeutic_content_en":"Functional progression including cutting, crossover and carioca; plyometric exercises appropriate to patient goals, including medicine-ball work and sled drills; agility drills with shuffles, ladder footwork, cone drills, Z-cuts, W-cuts and multiplanar sport-specific drills.","therapeutic_content_pl":"Progresja funkcjonalna obejmująca między innymi zmiany kierunku, crossover i carioca; ćwiczenia plyometryczne zgodne z celami pacjenta, w tym piłka lekarska i ćwiczenia z saniami; ćwiczenia zwinności: kroki odstawno-dostawne, praca nóg na drabince, ćwiczenia z pachołkami, cięcia Z i W oraz wielopłaszczyznowe ćwiczenia specyficzne dla sportu.","minimum_requirements_de":"Die Quelle nennt für diese Phase keine gesonderten Einschränkungen.","minimum_requirements_en":"The source states no separate restrictions for this phase.","minimum_requirements_pl":"Źródło nie podaje odrębnych ograniczeń dla tej fazy.","additional_notes_original":"Goals: completion of appropriate functional progression, strength maintenance and patient education. Discharge criteria: surgeon clearance; hamstring strength index >90% compared with the contralateral limb; quadriceps strength index >90% compared with the contralateral limb; Y-Balance anterior-reach difference <4 cm; no pain or instability.","therapeutic_content_original":"Functional progression including cutting, crossover and carioca; plyometric exercises appropriate to patient goals, including medicine-ball work and sled drills; agility drills with shuffles, ladder footwork, cone drills, Z-cuts, W-cuts and multiplanar sport-specific drills.","minimum_requirements_original":"The source states no separate restrictions for this phase.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["lower_leg","knee","lower_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"d08c089b-4bcb-54d9-a3bc-45e0aaef0c8a","slug":"us-jared-lee-15-anterior-shoulder-stabilization","title_pl":"Protokół rehabilitacji po przedniej stabilizacji barku","title_de":"Rehabilitationsprotokoll nach anteriorer Schulterstabilisierung","title_en":"Anterior Shoulder Stabilization Rehabilitation Protocol","title_original":"Anterior Shoulder Stabilization Rehabilitation","summary_pl":"Czterofazowy protokół po przedniej stabilizacji barku, od ochrony naprawy do stopniowego powrotu do pracy i sportu.","summary_de":"Vierphasiges Protokoll nach anteriorer Schulterstabilisierung – vom Schutz der Rekonstruktion bis zur schrittweisen Rückkehr zu Arbeit und Sport.","summary_en":"Four-phase rehabilitation protocol after anterior shoulder stabilization, from repair protection to gradual return to work and sport.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"cfb136b8-da12-5d2d-811c-78af11392fd8","condition_slug":"anterior-shoulder-stabilization","condition_name_pl":"Stan po przedniej stabilizacji barku","condition_name_de":"Zustand nach anteriorer Schulterstabilisierung","condition_name_en":"Status Post Anterior Shoulder Stabilization","condition_name_original":"Status Post Anterior Shoulder Stabilization","icd_codes":[],"category_key":"shoulder","category_pl":"Bark","category_de":"Schulter","category_en":"Shoulder","body_regions_pl":["Bark"],"body_regions_de":["Schulter"],"body_regions_en":["Shoulder"],"search_terms_pl":["przednia stabilizacja barku","niestabilność przednia barku","rehabilitacja po stabilizacji barku"],"search_terms_de":["anteriore Schulterstabilisierung","vordere Schulterinstabilität","Rehabilitation Schulterstabilisierung"],"search_terms_en":["anterior shoulder stabilization","anterior shoulder instability rehabilitation"],"source_document_id":"dd8d0a16-a20a-5eba-b5e9-62f7566f41dc","source_title":"Anterior Shoulder Stabilization Rehabilitation","issuer":"Jared Lee, MD","source_country_code":"US","jurisdiction_code":"US-CO","authority_level":"clinic","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_requires_review","official_url":"https://jaredleemd.com/wp-content/uploads/2025/06/Anterior-Shoulder-Stabilization-Rehabilitation-Protocol.pdf","source_sha256":"3b48749fcba573c7f60e9a963281df398c6f125619bd96fde40c8e3c8cb8127b","authorization_required":true,"license_note":"All Rights Reserved. Authorization is required before final public release. Current development and staging remain allowed by the owner's decision.","modules":[{"id":"1b17b763-bb5f-507a-a4dc-c2bc5a6f9421","name_de":"Phase I: Wochen 0–2","name_en":"Phase I: Weeks 0-2","name_pl":"Faza I: tygodnie 0–2","source_page":1,"module_number":1,"name_original":"Phase 1: Weeks 0-2","service_codes":[],"structured_content":{"de":{"goals":["Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, die operierten Strukturen schützen und Schultersteife vermeiden."],"exercises":["Passiver Bewegungsumfang: Flexion 0–60°, Abduktion 0–60° und Außenrotation bis neutral","uneingeschränkter Bewegungsumfang von Ellenbogen, Handgelenk und Hand bei angelegtem Arm","Wall Slides","Pendelübungen","Skapularetraktion in der Armschlinge","Dehnung und Bewegungsübungen der Halswirbelsäule"],"applies_when":["Wochen 0–2"],"restrictions":["Einfache Armschlinge durchgehend außer bei Physiotherapie, Ankleiden und Körperpflege","keine Lasten über 5 lb heben","keine Kräftigung."],"physiotherapist_actions":["physikalische Maßnahmen nach Bedarf."]},"en":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness."],"exercises":["Passive range of motion 0-60° flexion, 0-60° abduction and external rotation to neutral","unrestricted elbow, wrist and hand range of motion with the arm at the side","wall slides","pendulums","scapular retraction in the sling","cervical stretching and range of motion"],"applies_when":["Weeks 0-2"],"restrictions":["Wear a simple sling at all times except during physical therapy, dressing and hygiene","no lifting greater than 5 lb","no strengthening."],"physiotherapist_actions":["modalities as needed."]},"pl":{"goals":["zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona operowanych struktur oraz zapobieganie sztywności barku."],"exercises":["Bierny zakres ruchu: zgięcie 0–60°, odwodzenie 0–60° i rotacja zewnętrzna do pozycji neutralnej","nieograniczony zakres ruchu łokcia, nadgarstka i ręki przy ramieniu ułożonym wzdłuż tułowia","ślizgi po ścianie","ćwiczenia wahadłowe","retrakcja łopatki w temblaku","rozciąganie i zakres ruchu odcinka szyjnego"],"applies_when":["tygodnie 0–2"],"restrictions":["Prosty temblak przez cały czas z wyjątkiem fizjoterapii, ubierania się i higieny","nie podnosić ciężaru większego niż 5 lb","bez wzmacniania."],"physiotherapist_actions":["fizykoterapia według potrzeb."]},"original":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness."],"exercises":["Passive range of motion 0-60° flexion, 0-60° abduction and external rotation to neutral","unrestricted elbow, wrist and hand range of motion with the arm at the side","wall slides","pendulums","scapular retraction in the sling","cervical stretching and range of motion"],"applies_when":["Weeks 0-2"],"restrictions":["Wear a simple sling at all times except during physical therapy, dressing and hygiene","no lifting greater than 5 lb","no strengthening."],"physiotherapist_actions":["modalities as needed."]}},"additional_notes_de":"Ziele: Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, die operierten Strukturen schützen und Schultersteife vermeiden.","additional_notes_en":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and avoid shoulder stiffness.","additional_notes_pl":"Cele: zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona operowanych struktur oraz zapobieganie sztywności barku.","minimum_patient_share":null,"therapeutic_content_de":"Passiver Bewegungsumfang: Flexion 0–60°, Abduktion 0–60° und Außenrotation bis neutral; uneingeschränkter Bewegungsumfang von Ellenbogen, Handgelenk und Hand bei angelegtem Arm; Wall Slides; Pendelübungen; Skapularetraktion in der Armschlinge; Dehnung und Bewegungsübungen der Halswirbelsäule; physikalische Maßnahmen nach Bedarf.","therapeutic_content_en":"Passive range of motion 0-60° flexion, 0-60° abduction and external rotation to neutral; unrestricted elbow, wrist and hand range of motion with the arm at the side; wall slides; pendulums; scapular retraction in the sling; cervical stretching and range of motion; modalities as needed.","therapeutic_content_pl":"Bierny zakres ruchu: zgięcie 0–60°, odwodzenie 0–60° i rotacja zewnętrzna do pozycji neutralnej; nieograniczony zakres ruchu łokcia, nadgarstka i ręki przy ramieniu ułożonym wzdłuż tułowia; ślizgi po ścianie; ćwiczenia wahadłowe; retrakcja łopatki w temblaku; rozciąganie i zakres ruchu odcinka szyjnego; fizykoterapia według potrzeb.","minimum_requirements_de":"Einfache Armschlinge durchgehend außer bei Physiotherapie, Ankleiden und Körperpflege; keine Lasten über 5 lb heben; keine Kräftigung.","minimum_requirements_en":"Wear a simple sling at all times except during physical therapy, dressing and hygiene; no lifting greater than 5 lb; no strengthening.","minimum_requirements_pl":"Prosty temblak przez cały czas z wyjątkiem fizjoterapii, ubierania się i higieny; nie podnosić ciężaru większego niż 5 lb; bez wzmacniania.","additional_notes_original":"Goals: Reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair, and avoid shoulder stiffness","therapeutic_content_original":"Passive range of motion 0-60° flexion, 0-60° abduction and external rotation to neutral; unrestricted elbow, wrist and hand range of motion with the arm at the side; wall slides; pendulums; scapular retraction in the sling; cervical stretching and range of motion; modalities as needed.","minimum_requirements_original":"Wear a simple sling at all times except during physical therapy, dressing and hygiene; no lifting greater than 5 lb; no strengthening.","structured_content_v2":"$undefined"},{"id":"cca9c467-047e-5175-952d-94107f9222d7","name_de":"Phase II: Wochen 2–6","name_en":"Phase II: Weeks 2-6","name_pl":"Faza II: tygodnie 2–6","source_page":1,"module_number":2,"name_original":"Phase 2: Weeks 2-6","service_codes":[],"structured_content":{"de":{"goals":["Bewegungsumfang steigern, Schmerzen und Muskelatrophie begrenzen, die operierten Strukturen schützen und mit der neuromuskulären Kontrolle beginnen."],"exercises":["Passiver Bewegungsumfang: Flexion 0–60°, Abduktion 0–60° und Außenrotation 0–30°","uneingeschränkter Bewegungsumfang von Ellenbogen, Handgelenk und Hand bei angelegtem Arm","Wall Slides","Pendelübungen","Skapularetraktion in der Armschlinge","Dehnung und Bewegungsübungen der Halswirbelsäule","bisherige Übungen fortsetzen","Skapulakräftigung beginnen"],"applies_when":["Wochen 2–6"],"restrictions":["Einfache Armschlinge durchgehend außer bei Physiotherapie, Ankleiden und Körperpflege","keine Lasten über 5 lb heben."],"physiotherapist_actions":["physikalische Maßnahmen nach Bedarf."]},"en":{"goals":["progress range of motion, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control."],"exercises":["Passive range of motion 0-60° flexion, 0-60° abduction and external rotation 0-30°","unrestricted elbow, wrist and hand range of motion with the arm at the side","wall slides","pendulums","scapular retraction in the sling","cervical stretching and range of motion","continue previous exercises","initiate scapular strengthening"],"applies_when":["Weeks 2-6"],"restrictions":["Wear a simple sling at all times except during physical therapy, dressing and hygiene","no lifting greater than 5 lb."],"physiotherapist_actions":["modalities as needed."]},"pl":{"goals":["zwiększanie zakresu ruchu, ograniczenie bólu i zaniku mięśni, ochrona operowanych struktur oraz rozpoczęcie kontroli nerwowo-mięśniowej."],"exercises":["Bierny zakres ruchu: zgięcie 0–60°, odwodzenie 0–60° i rotacja zewnętrzna 0–30°","nieograniczony zakres ruchu łokcia, nadgarstka i ręki przy ramieniu ułożonym wzdłuż tułowia","ślizgi po ścianie","ćwiczenia wahadłowe","retrakcja łopatki w temblaku","rozciąganie i zakres ruchu odcinka szyjnego","kontynuować wcześniejsze ćwiczenia","rozpocząć wzmacnianie łopatki"],"applies_when":["tygodnie 2–6"],"restrictions":["Prosty temblak przez cały czas z wyjątkiem fizjoterapii, ubierania się i higieny","nie podnosić ciężaru większego niż 5 lb."],"physiotherapist_actions":["fizykoterapia według potrzeb."]},"original":{"goals":["progress range of motion, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control."],"exercises":["Passive range of motion 0-60° flexion, 0-60° abduction and external rotation 0-30°","unrestricted elbow, wrist and hand range of motion with the arm at the side","wall slides","pendulums","scapular retraction in the sling","cervical stretching and range of motion","continue previous exercises","initiate scapular strengthening"],"applies_when":["Weeks 2-6"],"restrictions":["Wear a simple sling at all times except during physical therapy, dressing and hygiene","no lifting greater than 5 lb."],"physiotherapist_actions":["modalities as needed."]}},"additional_notes_de":"Ziele: Bewegungsumfang steigern, Schmerzen und Muskelatrophie begrenzen, die operierten Strukturen schützen und mit der neuromuskulären Kontrolle beginnen.","additional_notes_en":"Goals: progress range of motion, minimize pain, retard muscle atrophy, protect the repair and begin neuromuscular control.","additional_notes_pl":"Cele: zwiększanie zakresu ruchu, ograniczenie bólu i zaniku mięśni, ochrona operowanych struktur oraz rozpoczęcie kontroli nerwowo-mięśniowej.","minimum_patient_share":null,"therapeutic_content_de":"Passiver Bewegungsumfang: Flexion 0–60°, Abduktion 0–60° und Außenrotation 0–30°; uneingeschränkter Bewegungsumfang von Ellenbogen, Handgelenk und Hand bei angelegtem Arm; Wall Slides; Pendelübungen; Skapularetraktion in der Armschlinge; Dehnung und Bewegungsübungen der Halswirbelsäule; bisherige Übungen fortsetzen; Skapulakräftigung beginnen; physikalische Maßnahmen nach Bedarf.","therapeutic_content_en":"Passive range of motion 0-60° flexion, 0-60° abduction and external rotation 0-30°; unrestricted elbow, wrist and hand range of motion with the arm at the side; wall slides; pendulums; scapular retraction in the sling; cervical stretching and range of motion; continue previous exercises; initiate scapular strengthening; modalities as needed.","therapeutic_content_pl":"Bierny zakres ruchu: zgięcie 0–60°, odwodzenie 0–60° i rotacja zewnętrzna 0–30°; nieograniczony zakres ruchu łokcia, nadgarstka i ręki przy ramieniu ułożonym wzdłuż tułowia; ślizgi po ścianie; ćwiczenia wahadłowe; retrakcja łopatki w temblaku; rozciąganie i zakres ruchu odcinka szyjnego; kontynuować wcześniejsze ćwiczenia; rozpocząć wzmacnianie łopatki; fizykoterapia według potrzeb.","minimum_requirements_de":"Einfache Armschlinge durchgehend außer bei Physiotherapie, Ankleiden und Körperpflege; keine Lasten über 5 lb heben.","minimum_requirements_en":"Wear a simple sling at all times except during physical therapy, dressing and hygiene; no lifting greater than 5 lb.","minimum_requirements_pl":"Prosty temblak przez cały czas z wyjątkiem fizjoterapii, ubierania się i higieny; nie podnosić ciężaru większego niż 5 lb.","additional_notes_original":"Goals: Progress range of motion, minimize pain, retard muscle atrophy, protect the repair, and begin neuromuscular control","therapeutic_content_original":"Passive range of motion 0-60° flexion, 0-60° abduction and external rotation 0-30°; unrestricted elbow, wrist and hand range of motion with the arm at the side; wall slides; pendulums; scapular retraction in the sling; cervical stretching and range of motion; continue previous exercises; initiate scapular strengthening; modalities as needed.","minimum_requirements_original":"Wear a simple sling at all times except during physical therapy, dressing and hygiene; no lifting greater than 5 lb.","structured_content_v2":"$undefined"},{"id":"698658df-546f-57ed-b7c5-fde76355e403","name_de":"Phase III: Wochen 6–12","name_en":"Phase III: Weeks 6-12","name_pl":"Faza III: tygodnie 6–12","source_page":1,"module_number":3,"name_original":"Phase 3: Weeks 6-12","service_codes":[],"structured_content":{"de":{"goals":["voller Bewegungsumfang, minimale Schmerzen, Beginn der Muskelaktivierung und Kräftigung sowie Schutz der operierten Strukturen."],"exercises":["Schrittweise den vollständigen passiven Bewegungsumfang in allen Ebenen erreichen","danach aktive Bewegungen beginnen und bis zum vollen aktiven Bewegungsumfang gegen die Schwerkraft steigern","Kraft des M. pectoralis minor steigern","Skapularetraktoren kräftigen","vorsichtige isotonische Übungen und rhythmische Stabilisation der Rotatorenmanschette in offener und geschlossener Kette beginnen.","Wochen 8–10: das bisherige Kräftigungsprogramm steigern."],"applies_when":["Wochen 6–12"],"restrictions":["Einfache Armschlinge schrittweise ablegen","keine aggressive Mobilisation oder Dehnung","keine Lasten über 10 lb heben","die vordere Kapsel nicht durch aggressive Überkopfkräftigung belasten."],"physiotherapist_actions":["Dehnung der hinteren Kapsel beginnen: Cross-Body-Stretch, Innenrotation in Seitenlage sowie posteriore und inferiore Mobilisation des Glenohumeralgelenks"]},"en":{"goals":["full range of motion, minimal pain, begin muscular activation and strengthening and protect the repair."],"exercises":["Progress to full passive range of motion in all planes","once full passive range is achieved, begin active range of motion and progress to full active range in gravity-resisted positions","enhance pectoralis minor strength","strengthen scapular retractors","begin gentle isotonic and rhythmic stabilization techniques for the rotator cuff in open and closed chains.","Weeks 8-10: progress the previous strengthening program."],"applies_when":["Weeks 6-12"],"restrictions":["Wean from the simple sling","no aggressive range of motion or stretching","no lifting greater than 10 lb","do not stress the anterior capsule with aggressive overhead strengthening."],"physiotherapist_actions":["begin posterior capsular stretching with cross-arm stretch, side-lying internal rotation stretch and posterior/inferior glenohumeral joint mobilization"]},"pl":{"goals":["pełny zakres ruchu, minimalny ból, rozpoczęcie aktywacji mięśniowej i wzmacniania oraz ochrona operowanych struktur."],"exercises":["Stopniowo uzyskać pełny bierny zakres ruchu we wszystkich płaszczyznach","po jego osiągnięciu rozpocząć czynny zakres ruchu i zwiększać go do pełnego w pozycjach przeciw grawitacji","zwiększać siłę mięśnia piersiowego mniejszego","wzmacnianie retraktorów łopatki","rozpocząć delikatne techniki izotoniczne i stabilizację rytmiczną stożka rotatorów w łańcuchu otwartym i zamkniętym.","Tygodnie 8–10: rozwijać wcześniejszy program wzmacniania."],"applies_when":["tygodnie 6–12"],"restrictions":["Stopniowo odstawić prosty temblak","bez agresywnego zwiększania zakresu ruchu ani rozciągania","nie podnosić ciężaru większego niż 10 lb","nie obciążać przedniej torebki agresywnym wzmacnianiem nad głową."],"physiotherapist_actions":["rozpocząć rozciąganie tylnej torebki: rozciąganie ramienia w poprzek tułowia, rotacja wewnętrzna w leżeniu bokiem oraz mobilizacja tylna i dolna stawu ramiennego"]},"original":{"goals":["full range of motion, minimal pain, begin muscular activation and strengthening and protect the repair."],"exercises":["Progress to full passive range of motion in all planes","once full passive range is achieved, begin active range of motion and progress to full active range in gravity-resisted positions","enhance pectoralis minor strength","strengthen scapular retractors","begin gentle isotonic and rhythmic stabilization techniques for the rotator cuff in open and closed chains.","Weeks 8-10: progress the previous strengthening program."],"applies_when":["Weeks 6-12"],"restrictions":["Wean from the simple sling","no aggressive range of motion or stretching","no lifting greater than 10 lb","do not stress the anterior capsule with aggressive overhead strengthening."],"physiotherapist_actions":["begin posterior capsular stretching with cross-arm stretch, side-lying internal rotation stretch and posterior/inferior glenohumeral joint mobilization"]}},"additional_notes_de":"Ziele: voller Bewegungsumfang, minimale Schmerzen, Beginn der Muskelaktivierung und Kräftigung sowie Schutz der operierten Strukturen.","additional_notes_en":"Goals: full range of motion, minimal pain, begin muscular activation and strengthening and protect the repair.","additional_notes_pl":"Cele: pełny zakres ruchu, minimalny ból, rozpoczęcie aktywacji mięśniowej i wzmacniania oraz ochrona operowanych struktur.","minimum_patient_share":null,"therapeutic_content_de":"Schrittweise den vollständigen passiven Bewegungsumfang in allen Ebenen erreichen; danach aktive Bewegungen beginnen und bis zum vollen aktiven Bewegungsumfang gegen die Schwerkraft steigern; Dehnung der hinteren Kapsel beginnen: Cross-Body-Stretch, Innenrotation in Seitenlage sowie posteriore und inferiore Mobilisation des Glenohumeralgelenks; Kraft des M. pectoralis minor steigern; Skapularetraktoren kräftigen; vorsichtige isotonische Übungen und rhythmische Stabilisation der Rotatorenmanschette in offener und geschlossener Kette beginnen. Wochen 8–10: das bisherige Kräftigungsprogramm steigern.","therapeutic_content_en":"Progress to full passive range of motion in all planes; once full passive range is achieved, begin active range of motion and progress to full active range in gravity-resisted positions; begin posterior capsular stretching with cross-arm stretch, side-lying internal rotation stretch and posterior/inferior glenohumeral joint mobilization; enhance pectoralis minor strength; strengthen scapular retractors; begin gentle isotonic and rhythmic stabilization techniques for the rotator cuff in open and closed chains. Weeks 8-10: progress the previous strengthening program.","therapeutic_content_pl":"Stopniowo uzyskać pełny bierny zakres ruchu we wszystkich płaszczyznach; po jego osiągnięciu rozpocząć czynny zakres ruchu i zwiększać go do pełnego w pozycjach przeciw grawitacji; rozpocząć rozciąganie tylnej torebki: rozciąganie ramienia w poprzek tułowia, rotacja wewnętrzna w leżeniu bokiem oraz mobilizacja tylna i dolna stawu ramiennego; zwiększać siłę mięśnia piersiowego mniejszego; wzmacnianie retraktorów łopatki; rozpocząć delikatne techniki izotoniczne i stabilizację rytmiczną stożka rotatorów w łańcuchu otwartym i zamkniętym. Tygodnie 8–10: rozwijać wcześniejszy program wzmacniania.","minimum_requirements_de":"Einfache Armschlinge schrittweise ablegen; keine aggressive Mobilisation oder Dehnung; keine Lasten über 10 lb heben; die vordere Kapsel nicht durch aggressive Überkopfkräftigung belasten.","minimum_requirements_en":"Wean from the simple sling; no aggressive range of motion or stretching; no lifting greater than 10 lb; do not stress the anterior capsule with aggressive overhead strengthening.","minimum_requirements_pl":"Stopniowo odstawić prosty temblak; bez agresywnego zwiększania zakresu ruchu ani rozciągania; nie podnosić ciężaru większego niż 10 lb; nie obciążać przedniej torebki agresywnym wzmacnianiem nad głową.","additional_notes_original":"Goals: Full range of motion, minimal pain, begin muscular activation and strengthening, protect the repair","therapeutic_content_original":"Progress to full passive range of motion in all planes; once full passive range is achieved, begin active range of motion and progress to full active range in gravity-resisted positions; begin posterior capsular stretching with cross-arm stretch, side-lying internal rotation stretch and posterior/inferior glenohumeral joint mobilization; enhance pectoralis minor strength; strengthen scapular retractors; begin gentle isotonic and rhythmic stabilization techniques for the rotator cuff in open and closed chains. Weeks 8-10: progress the previous strengthening program.","minimum_requirements_original":"Wean from the simple sling; no aggressive range of motion or stretching; no lifting greater than 10 lb; do not stress the anterior capsule with aggressive overhead strengthening.","structured_content_v2":"$undefined"},{"id":"57744685-a5f5-5e5a-9af1-24ea0e308473","name_de":"Phase IV: Wochen 12–20","name_en":"Phase IV: Weeks 12-20","name_pl":"Faza IV: tygodnie 12–20","source_page":2,"module_number":4,"name_original":"Phase 4: Weeks 12-20","service_codes":[],"structured_content":{"de":{"goals":["funktionelle Aktivitäten sowie fortgeschrittene sportliche und Freizeitaktivitäten nach Vorgabe des Operateurs steigern."],"exercises":["Alle Kräftigungsübungen fortsetzen","vollen Bewegungsumfang erhalten","Außenrotation kräftigen","periskapuläre T- und Y-Übungen","progressive Ballstabilisation an der Wand und Ballprellen an der Wand","allgemeines Krafttraining der oberen Extremität mit geringer Last und vielen Wiederholungen beginnen, dabei Bankdrücken mit weitem Griff, Military Press und Latziehen hinter den Kopf vermeiden.","Woche 16: bei entsprechender Indikation ein Intervall-Sportprogramm beginnen."],"applies_when":["Wochen 12–20"],"restrictions":["Keine schwere Kräftigung oder Gewichtheben bis 4 Monate","keine Wurf- oder Überkopfbewegungen bis 4 Monate"],"progression_criteria":["Freigabe durch den Operateur","Kraftdefizit <10 %","Limb-Symmetry-Index ≥90 %","45/50 Punkte in biomechanischen Funktionstests, sofern durchgeführt","keine Schmerzen und keine berichtete Instabilität."],"dosage_and_progression":["schrittweise Rückkehr zu anstrengender Arbeit, Freizeit- und Sportaktivitäten."]},"en":{"goals":["progress functional activities and advanced sport and recreational activity per surgeon."],"exercises":["Continue all strengthening exercises","maintain full range of motion","external rotation strengthening","periscapular T's and Y's","progressive ball stabilization on the wall and wall-ball dribbles","begin generalized upper-extremity weightlifting with low weight and high repetitions, avoiding wide-grip bench press, military press and lat pull behind the head.","Week 16: initiate an interval sports program if appropriate."],"applies_when":["Weeks 12-20"],"restrictions":["No heavy strengthening or weightlifting until 4 months","no throwing or overhead movements until 4 months"],"progression_criteria":["surgeon clearance","<10% strength deficit","limb similarity index ≥90%","45/50 on biomechanical functional tests, if performed","no pain or complaints of instability."],"dosage_and_progression":["gradual return to strenuous work, recreational activities and sports."]},"pl":{"goals":["rozwijanie aktywności funkcjonalnych oraz zaawansowanej aktywności sportowej i rekreacyjnej zgodnie z decyzją chirurga."],"exercises":["Kontynuować wszystkie ćwiczenia wzmacniające","utrzymywać pełny zakres ruchu","wzmacnianie rotacji zewnętrznej","ćwiczenia T i Y mięśni okoł łopatkowych","stopniowana stabilizacja piłki na ścianie i kozłowanie piłki o ścianę","rozpocząć ogólny trening siłowy kończyny górnej z małym obciążeniem i dużą liczbą powtórzeń, unikając wyciskania leżąc szerokim chwytem, wyciskania żołnierskiego i ściągania drążka za głowę.","Tydzień 16: rozpocząć interwałowy program sportowy, jeżeli wskazany."],"applies_when":["tygodnie 12–20"],"restrictions":["Bez ciężkiego wzmacniania ani treningu siłowego do 4 miesięcy","bez rzucania ani ruchów nad głową do 4 miesięcy"],"progression_criteria":["zgoda chirurga","deficyt siły <10%","wskaźnik podobieństwa kończyn ≥90%","wynik 45/50 w biomechanicznych testach funkcjonalnych, jeżeli wykonano","brak bólu i zgłaszanej niestabilności."],"dosage_and_progression":["stopniowy powrót do ciężkiej pracy, rekreacji i sportu."]},"original":{"goals":["progress functional activities and advanced sport and recreational activity per surgeon."],"exercises":["Continue all strengthening exercises","maintain full range of motion","external rotation strengthening","periscapular T's and Y's","progressive ball stabilization on the wall and wall-ball dribbles","begin generalized upper-extremity weightlifting with low weight and high repetitions, avoiding wide-grip bench press, military press and lat pull behind the head.","Week 16: initiate an interval sports program if appropriate."],"applies_when":["Weeks 12-20"],"restrictions":["No heavy strengthening or weightlifting until 4 months","no throwing or overhead movements until 4 months"],"progression_criteria":["surgeon clearance","<10% strength deficit","limb similarity index ≥90%","45/50 on biomechanical functional tests, if performed","no pain or complaints of instability."],"dosage_and_progression":["gradual return to strenuous work, recreational activities and sports."]}},"additional_notes_de":"Ziele: funktionelle Aktivitäten sowie fortgeschrittene sportliche und Freizeitaktivitäten nach Vorgabe des Operateurs steigern. Entlassungskriterien: Freigabe durch den Operateur; Kraftdefizit <10 %; Limb-Symmetry-Index ≥90 %; 45/50 Punkte in biomechanischen Funktionstests, sofern durchgeführt; keine Schmerzen und keine berichtete Instabilität.","additional_notes_en":"Goals: progress functional activities and advanced sport and recreational activity per surgeon. Discharge criteria: surgeon clearance; <10% strength deficit; limb similarity index ≥90%; 45/50 on biomechanical functional tests, if performed; no pain or complaints of instability.","additional_notes_pl":"Cele: rozwijanie aktywności funkcjonalnych oraz zaawansowanej aktywności sportowej i rekreacyjnej zgodnie z decyzją chirurga. Kryteria wypisu: zgoda chirurga; deficyt siły <10%; wskaźnik podobieństwa kończyn ≥90%; wynik 45/50 w biomechanicznych testach funkcjonalnych, jeżeli wykonano; brak bólu i zgłaszanej niestabilności.","minimum_patient_share":null,"therapeutic_content_de":"Alle Kräftigungsübungen fortsetzen; vollen Bewegungsumfang erhalten; Außenrotation kräftigen; periskapuläre T- und Y-Übungen; progressive Ballstabilisation an der Wand und Ballprellen an der Wand; allgemeines Krafttraining der oberen Extremität mit geringer Last und vielen Wiederholungen beginnen, dabei Bankdrücken mit weitem Griff, Military Press und Latziehen hinter den Kopf vermeiden. Woche 16: bei entsprechender Indikation ein Intervall-Sportprogramm beginnen.","therapeutic_content_en":"Continue all strengthening exercises; maintain full range of motion; external rotation strengthening; periscapular T's and Y's; progressive ball stabilization on the wall and wall-ball dribbles; begin generalized upper-extremity weightlifting with low weight and high repetitions, avoiding wide-grip bench press, military press and lat pull behind the head. Week 16: initiate an interval sports program if appropriate.","therapeutic_content_pl":"Kontynuować wszystkie ćwiczenia wzmacniające; utrzymywać pełny zakres ruchu; wzmacnianie rotacji zewnętrznej; ćwiczenia T i Y mięśni okoł łopatkowych; stopniowana stabilizacja piłki na ścianie i kozłowanie piłki o ścianę; rozpocząć ogólny trening siłowy kończyny górnej z małym obciążeniem i dużą liczbą powtórzeń, unikając wyciskania leżąc szerokim chwytem, wyciskania żołnierskiego i ściągania drążka za głowę. Tydzień 16: rozpocząć interwałowy program sportowy, jeżeli wskazany.","minimum_requirements_de":"Keine schwere Kräftigung oder Gewichtheben bis 4 Monate; keine Wurf- oder Überkopfbewegungen bis 4 Monate; schrittweise Rückkehr zu anstrengender Arbeit, Freizeit- und Sportaktivitäten.","minimum_requirements_en":"No heavy strengthening or weightlifting until 4 months; no throwing or overhead movements until 4 months; gradual return to strenuous work, recreational activities and sports.","minimum_requirements_pl":"Bez ciężkiego wzmacniania ani treningu siłowego do 4 miesięcy; bez rzucania ani ruchów nad głową do 4 miesięcy; stopniowy powrót do ciężkiej pracy, rekreacji i sportu.","additional_notes_original":"Goals: Progression of functional activities, advanced sport, and recreational activity per surgeon. Criteria for Discharge: Surgeon clearance; <10% strength deficit; Limb similarity index of 90% or greater; 45/50 on biomechanical functional tests (if performed); NO pain or complaints of instability","therapeutic_content_original":"Continue all strengthening exercises; maintain full range of motion; external rotation strengthening; periscapular T's and Y's; progressive ball stabilization on the wall and wall-ball dribbles; begin generalized upper-extremity weightlifting with low weight and high repetitions, avoiding wide-grip bench press, military press and lat pull behind the head. Week 16: initiate an interval sports program if appropriate.","minimum_requirements_original":"No heavy strengthening or weightlifting until 4 months; no throwing or overhead movements until 4 months; gradual return to strenuous work, recreational activities and sports.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["shoulder","upper_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"17a3f2bd-c0e4-5f1f-b928-2c7d1500a7cb","slug":"us-jared-lee-19-trochlea-oats","title_pl":"Protokół rehabilitacji po przeszczepie allograftu kostno-chrzęstnego bloczka kości udowej","title_de":"Rehabilitationsprotokoll nach osteochondraler Allografttransplantation der Trochlea femoris","title_en":"Trochlear Osteochondral Allograft Transplantation Rehabilitation Protocol","title_original":"Trochlea OATs Rehabilitation","summary_pl":"Pięcioetapowy protokół po transplantacji allograftu kostno-chrzęstnego bloczka kości udowej, z zachowaniem numeracji źródła.","summary_de":"Fünfstufiges Protokoll nach osteochondraler Allografttransplantation der Trochlea femoris unter Beibehaltung der Quellennummerierung.","summary_en":"Five-stage rehabilitation protocol after trochlear osteochondral allograft transplantation, preserving the source phase numbering.","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":[],"physician_clearance_required":false,"condition_id":"366bafad-136e-59c0-b1d0-16d8259a2900","condition_slug":"trochlea-oats","condition_name_pl":"Stan po przeszczepie allograftu kostno-chrzęstnego bloczka kości udowej","condition_name_de":"Zustand nach osteochondraler Allografttransplantation der Trochlea femoris","condition_name_en":"Status Post Trochlear Osteochondral Allograft Transplantation","condition_name_original":"Status Post Trochlear Osteochondral Allograft Transplantation","icd_codes":[],"category_key":"knee","category_pl":"Kolano","category_de":"Knie","category_en":"Knee","body_regions_pl":["Kolano","Bloczek kości udowej"],"body_regions_de":["Knie","Trochlea femoris"],"body_regions_en":["Knee","Femoral Trochlea"],"search_terms_pl":["przeszczep kostno-chrzęstny bloczka","OATS bloczka kości udowej","allograft chrząstki kolana"],"search_terms_de":["osteochondrale Allografttransplantation Trochlea","OATS Trochlea femoris","Knorpeltransplantation Knie"],"search_terms_en":["trochlea OATS","trochlear osteochondral allograft transplantation","knee cartilage allograft rehabilitation"],"source_document_id":"8dd2e5d6-401b-5f91-9510-60c0289429bd","source_title":"Trochlea OATs Rehabilitation","issuer":"Jared Lee, MD","source_country_code":"US","jurisdiction_code":"US-CO","authority_level":"clinic","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"version_date_requires_review","official_url":"https://jaredleemd.com/wp-content/uploads/2025/06/Trochlea-OATs-Rehabilitation-Protocol.pdf","source_sha256":"621d4b4886c1bc0d16e02857f361c0bfb8320aff1c9b034d79e016e8316efed2","authorization_required":true,"license_note":"All Rights Reserved. Authorization is required before final public release. Current development and staging remain allowed by the owner's decision.","modules":[{"id":"b91ebd3e-7ad6-5a19-a83d-d223a6769085","name_de":"Phase I: Wochen 0–6","name_en":"Phase I: Weeks 0-6","name_pl":"Faza I: tygodnie 0–6","source_page":1,"module_number":1,"name_original":"Phase 1: Weeks 0-6","service_codes":[],"structured_content":{"de":{"goals":["Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, das Transplantat schützen und den Bewegungsumfang wiederherstellen."],"exercises":["Passiver, aktiver und aktiv-assistierter Bewegungsumfang außerhalb der Orthese 0–90° für 6 Wochen","vollständige Kniestreckung bis zum 14. postoperativen Tag erreichen","Schmerzmanagement","Quadrizepsanspannung und Anheben des gestreckten Beins","Kräftigung der Hüftabduktion und -adduktion","Dehnung der ischiokruralen Muskulatur und Wade","Fußpumpen und vollständiger Bewegungsumfang des Sprunggelenks"],"applies_when":["Wochen 0–6"],"restrictions":["Belastung 6 Wochen nur mit bei 0–30° verriegelter Orthese","keine superior-inferiore oder medial-laterale Patellamobilisation"],"dosage_and_progression":["isometrische Quadrizepskräftigung sofort beginnen."],"physiotherapist_actions":["Unterarmgehstützen nach Bedarf","Bewegungsumfang 0–90°","Patellamobilisation ausschließlich lateral nach medial","physikalische Maßnahmen nach Bedarf."]},"en":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and restore range of motion."],"exercises":["Passive, active and active-assisted range of motion out of the brace 0-90° for 6 weeks","full knee extension must be achieved by postoperative day 14","pain management","quadriceps sets and straight-leg raises","hip abduction and adduction strengthening","hamstring and calf stretching","ankle pumps and full ankle range of motion"],"applies_when":["Weeks 0-6"],"restrictions":["Weight-bearing is allowed only with the brace locked at 0-30° for 6 weeks","no superior-inferior or medial-lateral patellar mobilization"],"dosage_and_progression":["begin isometric quadriceps strengthening immediately."],"physiotherapist_actions":["crutches as needed","range of motion 0-90°","patellar mobilization lateral-to-medial only","modalities as needed."]},"pl":{"goals":["zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona przeszczepu oraz odtworzenie zakresu ruchu."],"exercises":["Bierny, czynny i czynny wspomagany zakres ruchu poza ortezą 0–90° przez 6 tygodni","pełny wyprost kolana należy uzyskać do 14. dnia po zabiegu","napinanie mięśnia czworogłowego i unoszenie wyprostowanej kończyny","wzmacnianie odwodzenia i przywodzenia biodra","rozciąganie mięśni kulszowo-goleniowych i łydki","pompki stopy i pełny zakres ruchu stawu skokowego"],"applies_when":["tygodnie 0–6"],"restrictions":["Obciążanie dozwolone wyłącznie z ortezą zablokowaną w zakresie 0–30° przez 6 tygodni","bez mobilizacji rzepki w kierunku górno-dolnym ani przyśrodkowo-bocznym"],"dosage_and_progression":["natychmiast rozpocząć izometryczne wzmacnianie mięśnia czworogłowego."],"physiotherapist_actions":["kule według potrzeb","zakres ruchu 0–90°","kontrola bólu","mobilizacja rzepki wyłącznie w kierunku boczno-przyśrodkowym","fizykoterapia według potrzeb."]},"original":{"goals":["reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and restore range of motion."],"exercises":["Passive, active and active-assisted range of motion out of the brace 0-90° for 6 weeks","full knee extension must be achieved by postoperative day 14","pain management","quadriceps sets and straight-leg raises","hip abduction and adduction strengthening","hamstring and calf stretching","ankle pumps and full ankle range of motion"],"applies_when":["Weeks 0-6"],"restrictions":["Weight-bearing is allowed only with the brace locked at 0-30° for 6 weeks","no superior-inferior or medial-lateral patellar mobilization"],"dosage_and_progression":["begin isometric quadriceps strengthening immediately."],"physiotherapist_actions":["crutches as needed","range of motion 0-90°","patellar mobilization lateral-to-medial only","modalities as needed."]}},"additional_notes_de":"Ziele: Schwellung und Ödem reduzieren, Schmerzen und Muskelatrophie begrenzen, das Transplantat schützen und den Bewegungsumfang wiederherstellen.","additional_notes_en":"Goals: reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair and restore range of motion.","additional_notes_pl":"Cele: zmniejszenie obrzęku, ograniczenie bólu i zaniku mięśni, ochrona przeszczepu oraz odtworzenie zakresu ruchu.","minimum_patient_share":null,"therapeutic_content_de":"Passiver, aktiver und aktiv-assistierter Bewegungsumfang außerhalb der Orthese 0–90° für 6 Wochen; vollständige Kniestreckung bis zum 14. postoperativen Tag erreichen; Schmerzmanagement; Patellamobilisation ausschließlich lateral nach medial; Quadrizepsanspannung und Anheben des gestreckten Beins; Kräftigung der Hüftabduktion und -adduktion; Dehnung der ischiokruralen Muskulatur und Wade; Fußpumpen und vollständiger Bewegungsumfang des Sprunggelenks; physikalische Maßnahmen nach Bedarf.","therapeutic_content_en":"Passive, active and active-assisted range of motion out of the brace 0-90° for 6 weeks; full knee extension must be achieved by postoperative day 14; pain management; patellar mobilization lateral-to-medial only; quadriceps sets and straight-leg raises; hip abduction and adduction strengthening; hamstring and calf stretching; ankle pumps and full ankle range of motion; modalities as needed.","therapeutic_content_pl":"Bierny, czynny i czynny wspomagany zakres ruchu poza ortezą 0–90° przez 6 tygodni; pełny wyprost kolana należy uzyskać do 14. dnia po zabiegu; kontrola bólu; mobilizacja rzepki wyłącznie w kierunku boczno-przyśrodkowym; napinanie mięśnia czworogłowego i unoszenie wyprostowanej kończyny; wzmacnianie odwodzenia i przywodzenia biodra; rozciąganie mięśni kulszowo-goleniowych i łydki; pompki stopy i pełny zakres ruchu stawu skokowego; fizykoterapia według potrzeb.","minimum_requirements_de":"Belastung 6 Wochen nur mit bei 0–30° verriegelter Orthese; Unterarmgehstützen nach Bedarf; Bewegungsumfang 0–90°; keine superior-inferiore oder medial-laterale Patellamobilisation; isometrische Quadrizepskräftigung sofort beginnen.","minimum_requirements_en":"Weight-bearing is allowed only with the brace locked at 0-30° for 6 weeks; crutches as needed; range of motion 0-90°; no superior-inferior or medial-lateral patellar mobilization; begin isometric quadriceps strengthening immediately.","minimum_requirements_pl":"Obciążanie dozwolone wyłącznie z ortezą zablokowaną w zakresie 0–30° przez 6 tygodni; kule według potrzeb; zakres ruchu 0–90°; bez mobilizacji rzepki w kierunku górno-dolnym ani przyśrodkowo-bocznym; natychmiast rozpocząć izometryczne wzmacnianie mięśnia czworogłowego.","additional_notes_original":"Goals: Reduce swelling and edema, minimize pain, retard muscle atrophy, protect the surgical repair, range of motion restoration","therapeutic_content_original":"Passive, active and active-assisted range of motion out of the brace 0-90° for 6 weeks; full knee extension must be achieved by postoperative day 14; pain management; patellar mobilization lateral-to-medial only; quadriceps sets and straight-leg raises; hip abduction and adduction strengthening; hamstring and calf stretching; ankle pumps and full ankle range of motion; modalities as needed.","minimum_requirements_original":"Weight-bearing is allowed only with the brace locked at 0-30° for 6 weeks; crutches as needed; range of motion 0-90°; no superior-inferior or medial-lateral patellar mobilization; begin isometric quadriceps strengthening immediately.","structured_content_v2":"$undefined"},{"id":"0d931e24-1cc6-53a2-b6fc-22dad9221dd2","name_de":"Phase II: Wochen 6–12","name_en":"Phase II: Weeks 6-12","name_pl":"Faza II: tygodnie 6–12","source_page":1,"module_number":2,"name_original":"Phase 2: Weeks 6-12","service_codes":[],"structured_content":{"de":{"goals":["voller Bewegungsumfang, minimale Schmerzen, Steigerung der Widerstandsübungen, Wiederherstellung eines normalen Gangbilds und Schutz der Transplantatfixation."],"exercises":["Bewegungsumfang wöchentlich um 10–15° steigern, bis der volle Bewegungsumfang von mindestens 0–120° erreicht ist","bisherige Übungen fortsetzen","Radfahren ohne Widerstand beginnen","vorsichtige Übungen mit dem eigenen Körpergewicht","Kräftigung der Glutealmuskulatur mit Clamshells, Reverse Clamshells, Hüftabduktion in Seitenlage und Hüftextension in Bauchlage","Wassertherapie mit Schwerpunkt Gangnormalisierung"],"applies_when":["Wochen 6–12"],"restrictions":["keine aggressive Kräftigung bis Woche 12."],"dosage_and_progression":["Belastung mit vollständig entriegelter Orthese beginnen","Belastung nach Verträglichkeit und Gehhilfen bei Bedarf schrittweise absetzen","Bewegungsumfang steigern"],"physiotherapist_actions":["Weichteilmobilisation","Patellamobilisation in allen Ebenen","physikalische Maßnahmen nach Bedarf."]},"en":{"goals":["full range of motion, minimal pain, increase resistance exercises, restore a normal gait pattern and protect graft fixation."],"exercises":["Increase range of motion by 10-15° per week until full motion is achieved, at least 0-120°","continue previous exercises","begin cycling without resistance","gentle body-weight exercises","gluteal strengthening with clamshells, reverse clamshells, side-lying hip abduction and prone hip extension","aquatic therapy emphasizing gait normalization"],"applies_when":["Weeks 6-12"],"restrictions":["no aggressive strengthening until week 12."],"progression_criteria":["weight-bearing as tolerated and wean crutches if needed"],"dosage_and_progression":["Begin weight-bearing with the brace completely unlocked","begin increasing range of motion"],"physiotherapist_actions":["soft-tissue mobilization","patellar mobilization in all planes","modalities as needed."]},"pl":{"goals":["pełny zakres ruchu, minimalny ból, zwiększanie ćwiczeń oporowych, odtworzenie prawidłowego wzorca chodu i ochrona mocowania przeszczepu."],"exercises":["Zwiększać zakres ruchu o 10–15° tygodniowo do uzyskania pełnego zakresu, co najmniej 0–120°","kontynuować wcześniejsze ćwiczenia","rozpocząć jazdę na rowerze bez oporu","delikatne ćwiczenia z masą własnego ciała","wzmacnianie mięśni pośladkowych: clamshell, reverse clamshell, odwodzenie biodra w leżeniu bokiem i wyprost biodra w leżeniu przodem","terapia w wodzie z naciskiem na normalizację chodu"],"applies_when":["tygodnie 6–12"],"restrictions":["bez agresywnego wzmacniania do 12. tygodnia."],"dosage_and_progression":["Rozpocząć obciążanie z całkowicie odblokowaną ortezą","obciążanie według tolerancji i stopniowe odstawianie kul w razie potrzeby","zwiększać zakres ruchu"],"physiotherapist_actions":["mobilizacja tkanek miękkich","mobilizacja rzepki we wszystkich płaszczyznach","fizykoterapia według potrzeb."]},"original":{"goals":["full range of motion, minimal pain, increase resistance exercises, restore a normal gait pattern and protect graft fixation."],"exercises":["Increase range of motion by 10-15° per week until full motion is achieved, at least 0-120°","continue previous exercises","begin cycling without resistance","gentle body-weight exercises","gluteal strengthening with clamshells, reverse clamshells, side-lying hip abduction and prone hip extension","aquatic therapy emphasizing gait normalization"],"applies_when":["Weeks 6-12"],"restrictions":["no aggressive strengthening until week 12."],"progression_criteria":["weight-bearing as tolerated and wean crutches if needed"],"dosage_and_progression":["Begin weight-bearing with the brace completely unlocked","begin increasing range of motion"],"physiotherapist_actions":["soft-tissue mobilization","patellar mobilization in all planes","modalities as needed."]}},"additional_notes_de":"Ziele: voller Bewegungsumfang, minimale Schmerzen, Steigerung der Widerstandsübungen, Wiederherstellung eines normalen Gangbilds und Schutz der Transplantatfixation.","additional_notes_en":"Goals: full range of motion, minimal pain, increase resistance exercises, restore a normal gait pattern and protect graft fixation.","additional_notes_pl":"Cele: pełny zakres ruchu, minimalny ból, zwiększanie ćwiczeń oporowych, odtworzenie prawidłowego wzorca chodu i ochrona mocowania przeszczepu.","minimum_patient_share":null,"therapeutic_content_de":"Bewegungsumfang wöchentlich um 10–15° steigern, bis der volle Bewegungsumfang von mindestens 0–120° erreicht ist; Weichteilmobilisation; Patellamobilisation in allen Ebenen; bisherige Übungen fortsetzen; Radfahren ohne Widerstand beginnen; vorsichtige Übungen mit dem eigenen Körpergewicht; Kräftigung der Glutealmuskulatur mit Clamshells, Reverse Clamshells, Hüftabduktion in Seitenlage und Hüftextension in Bauchlage; Wassertherapie mit Schwerpunkt Gangnormalisierung; physikalische Maßnahmen nach Bedarf.","therapeutic_content_en":"Increase range of motion by 10-15° per week until full motion is achieved, at least 0-120°; soft-tissue mobilization; patellar mobilization in all planes; continue previous exercises; begin cycling without resistance; gentle body-weight exercises; gluteal strengthening with clamshells, reverse clamshells, side-lying hip abduction and prone hip extension; aquatic therapy emphasizing gait normalization; modalities as needed.","therapeutic_content_pl":"Zwiększać zakres ruchu o 10–15° tygodniowo do uzyskania pełnego zakresu, co najmniej 0–120°; mobilizacja tkanek miękkich; mobilizacja rzepki we wszystkich płaszczyznach; kontynuować wcześniejsze ćwiczenia; rozpocząć jazdę na rowerze bez oporu; delikatne ćwiczenia z masą własnego ciała; wzmacnianie mięśni pośladkowych: clamshell, reverse clamshell, odwodzenie biodra w leżeniu bokiem i wyprost biodra w leżeniu przodem; terapia w wodzie z naciskiem na normalizację chodu; fizykoterapia według potrzeb.","minimum_requirements_de":"Belastung mit vollständig entriegelter Orthese beginnen; Belastung nach Verträglichkeit und Gehhilfen bei Bedarf schrittweise absetzen; Bewegungsumfang steigern; keine aggressive Kräftigung bis Woche 12.","minimum_requirements_en":"Begin weight-bearing with the brace completely unlocked; weight-bearing as tolerated and wean crutches if needed; begin increasing range of motion; no aggressive strengthening until week 12.","minimum_requirements_pl":"Rozpocząć obciążanie z całkowicie odblokowaną ortezą; obciążanie według tolerancji i stopniowe odstawianie kul w razie potrzeby; zwiększać zakres ruchu; bez agresywnego wzmacniania do 12. tygodnia.","additional_notes_original":"Goals: Full range of motion, minimal pain, increase resistance exercises, restore normal gait pattern, protect graft fixation","therapeutic_content_original":"Increase range of motion by 10-15° per week until full motion is achieved, at least 0-120°; soft-tissue mobilization; patellar mobilization in all planes; continue previous exercises; begin cycling without resistance; gentle body-weight exercises; gluteal strengthening with clamshells, reverse clamshells, side-lying hip abduction and prone hip extension; aquatic therapy emphasizing gait normalization; modalities as needed.","minimum_requirements_original":"Begin weight-bearing with the brace completely unlocked; weight-bearing as tolerated and wean crutches if needed; begin increasing range of motion; no aggressive strengthening until week 12.","structured_content_v2":"$undefined"},{"id":"30bb34e9-c9e9-5098-8933-72602ac9231c","name_de":"Phase III: Wochen 12–16","name_en":"Phase III: Weeks 12-16","name_pl":"Faza III: tygodnie 12–16","source_page":1,"module_number":3,"name_original":"Phase 3: Weeks 12-16","service_codes":[],"structured_content":{"de":{"goals":["korrekte Gangmechanik, bessere Kraft der unteren Extremität, voller Bewegungsumfang und neuromuskuläre Kontrolle."],"exercises":["Kräftigungsprogramm steigern","Kräftigung in geschlossener Kette beginnen: Zehenstände, Mini-Kniebeugen und PNF mit Widerstand","progressive Widerstandsübungen mit 1–5 lb","Gleichgewichtsübungen","Hamstring-Curls","Fahrradergometer mit zunehmendem Widerstand nach Verträglichkeit."],"applies_when":["Wochen 12–16"],"dosage_and_progression":["Orthese schrittweise absetzen","Kräftigungsprogression steigern."],"physiotherapist_actions":["uneingeschränkte Belastung","uneingeschränkter Bewegungsumfang"]},"en":{"goals":["proper gait mechanics, improve lower-extremity strength, full range of motion and neuromuscular control."],"exercises":["Progress the strengthening program","begin closed-chain strengthening with toe raises, mini-squats and resisted PNF","progressive resistance exercises with 1-5 lb","balance exercises","hamstring curls","stationary cycling with increasing resistance as tolerated."],"applies_when":["Weeks 12-16"],"dosage_and_progression":["Begin to wean from the brace","increase strengthening progression."],"physiotherapist_actions":["unrestricted weight-bearing","unrestricted range of motion"]},"pl":{"goals":["prawidłowa mechanika chodu, poprawa siły kończyny dolnej, pełny zakres ruchu i kontrola nerwowo-mięśniowa."],"exercises":["Rozwijać program wzmacniania","rozpocząć wzmacnianie w łańcuchu zamkniętym: wspięcia na palce, miniprzysiady i wzorce PNF z oporem","progresywne ćwiczenia oporowe 1–5 lb","ćwiczenia równoważne","uginanie podudzi","rower stacjonarny ze zwiększaniem oporu w granicach tolerancji."],"applies_when":["tygodnie 12–16"],"dosage_and_progression":["Rozpocząć odstawianie ortezy","zwiększać progresję wzmacniania."],"physiotherapist_actions":["obciążanie bez ograniczeń","zakres ruchu bez ograniczeń"]},"original":{"goals":["proper gait mechanics, improve lower-extremity strength, full range of motion and neuromuscular control."],"exercises":["Progress the strengthening program","begin closed-chain strengthening with toe raises, mini-squats and resisted PNF","progressive resistance exercises with 1-5 lb","balance exercises","hamstring curls","stationary cycling with increasing resistance as tolerated."],"applies_when":["Weeks 12-16"],"dosage_and_progression":["Begin to wean from the brace","increase strengthening progression."],"physiotherapist_actions":["unrestricted weight-bearing","unrestricted range of motion"]}},"additional_notes_de":"Ziele: korrekte Gangmechanik, bessere Kraft der unteren Extremität, voller Bewegungsumfang und neuromuskuläre Kontrolle.","additional_notes_en":"Goals: proper gait mechanics, improve lower-extremity strength, full range of motion and neuromuscular control.","additional_notes_pl":"Cele: prawidłowa mechanika chodu, poprawa siły kończyny dolnej, pełny zakres ruchu i kontrola nerwowo-mięśniowa.","minimum_patient_share":null,"therapeutic_content_de":"Kräftigungsprogramm steigern; Kräftigung in geschlossener Kette beginnen: Zehenstände, Mini-Kniebeugen und PNF mit Widerstand; progressive Widerstandsübungen mit 1–5 lb; Gleichgewichtsübungen; Hamstring-Curls; Fahrradergometer mit zunehmendem Widerstand nach Verträglichkeit.","therapeutic_content_en":"Progress the strengthening program; begin closed-chain strengthening with toe raises, mini-squats and resisted PNF; progressive resistance exercises with 1-5 lb; balance exercises; hamstring curls; stationary cycling with increasing resistance as tolerated.","therapeutic_content_pl":"Rozwijać program wzmacniania; rozpocząć wzmacnianie w łańcuchu zamkniętym: wspięcia na palce, miniprzysiady i wzorce PNF z oporem; progresywne ćwiczenia oporowe 1–5 lb; ćwiczenia równoważne; uginanie podudzi; rower stacjonarny ze zwiększaniem oporu w granicach tolerancji.","minimum_requirements_de":"Orthese schrittweise absetzen; uneingeschränkte Belastung; uneingeschränkter Bewegungsumfang; Kräftigungsprogression steigern.","minimum_requirements_en":"Begin to wean from the brace; unrestricted weight-bearing; unrestricted range of motion; increase strengthening progression.","minimum_requirements_pl":"Rozpocząć odstawianie ortezy; obciążanie bez ograniczeń; zakres ruchu bez ograniczeń; zwiększać progresję wzmacniania.","additional_notes_original":"Goals: Proper gait mechanics, improve lower extremity strength, full range of motion, neuromuscular control","therapeutic_content_original":"Progress the strengthening program; begin closed-chain strengthening with toe raises, mini-squats and resisted PNF; progressive resistance exercises with 1-5 lb; balance exercises; hamstring curls; stationary cycling with increasing resistance as tolerated.","minimum_requirements_original":"Begin to wean from the brace; unrestricted weight-bearing; unrestricted range of motion; increase strengthening progression.","structured_content_v2":"$undefined"},{"id":"4b41dbdf-c095-5ace-8264-58fa7ac98f89","name_de":"Phase 5: Monate 4–6","name_en":"Phase 5: Months 4-6","name_pl":"Faza 5: miesiące 4–6","source_page":2,"module_number":4,"name_original":"Phase 5: Months 4-6","service_codes":[],"structured_content":{"de":{"goals":["voller schmerzfreier Bewegungsumfang, keine Zeichen einer patellofemoralen Reizung, Wiederherstellung von Kraft und Propriozeption sowie Leistungssteigerung.","Die Quelle wechselt von Phase III direkt zur Bezeichnung „Phase 5“."],"exercises":["Bisherige Beweglichkeits- und Kräftigungsübungen fortsetzen und steigern","funktionelle Progression von Gehen über Joggen zum Laufen","Laufprogression vorwärts und rückwärts mit ½, ¾ und voller Geschwindigkeit","Kräftigung der unteren Extremität mit Kniebeugen und einbeinigen Übungen wie erhöhtem Split Squat und TRX steigern","dynamisches Gleichgewicht verbessern","aerobe Kondition mit Crosstrainer, Schwimmen und Radfahren steigern."],"applies_when":["Monate 4–6"],"restrictions":["keine Einschränkungen von Bewegungsumfang oder Belastung"],"progression_criteria":["kein Valguskollaps","keine femorale Adduktion oder Innenrotation, kein Beckensinken und keine übermäßige Rumpfneigung bei einbeinigen Ausdaueraufgaben."],"dosage_and_progression":["Kräftigung steigern"],"physiotherapist_actions":["isometrische Kraft von M. gluteus medius und maximus >80 % der Gegenseite."]},"en":{"goals":["full pain-free range of motion, no evidence of patellofemoral joint irritation, restoration of strength and proprioception and progression of power.","The source proceeds directly from Phase III to the label 'Phase 5'."],"exercises":["Continue and progress previous flexibility and strengthening activities","functional walk-jog-run progression","forward and backward running progression at ½, ¾ and full speed","progress lower-extremity strengthening with squats and single-leg exercises including elevated split squats and TRX","progress dynamic balance","increase aerobic conditioning with elliptical, swimming and cycling."],"applies_when":["Months 4-6"],"restrictions":["no range-of-motion or weight-bearing restrictions"],"progression_criteria":["no valgus collapse","no femoral adduction or internal rotation, pelvic drop or excessive trunk lean during single-leg endurance tasks."],"dosage_and_progression":["Progress strengthening"],"physiotherapist_actions":["gluteus medius and maximus isometric strength >80% of the contralateral limb."]},"pl":{"goals":["pełny bezbolesny zakres ruchu, brak cech podrażnienia stawu rzepkowo-udowego, odtworzenie siły i propriocepcji oraz rozwijanie mocy.","Źródło przechodzi z fazy III bezpośrednio do oznaczenia „Phase 5”."],"exercises":["Kontynuować i rozwijać wcześniejsze ćwiczenia elastyczności i wzmacniania","funkcjonalna progresja marsz–trucht–bieg","progresja biegu w przód i w tył z prędkością ½, ¾ i pełną","rozwijać wzmacnianie kończyny dolnej: przysiady i ćwiczenia jednonóż, w tym split squat z nogą uniesioną i TRX","rozwijać równowagę dynamiczną","zwiększać kondycję tlenową na orbitreku, w pływaniu i na rowerze."],"applies_when":["miesiące 4–6"],"restrictions":["bez ograniczeń zakresu ruchu i obciążania"],"progression_criteria":["bez zapadania koślawości","bez przywiedzenia i rotacji wewnętrznej kości udowej, opadania miednicy ani nadmiernego pochylenia tułowia podczas zadań wytrzymałościowych jednonóż."],"dosage_and_progression":["Zwiększać wzmacnianie"],"physiotherapist_actions":["izometryczna siła mięśnia pośladkowego średniego i wielkiego >80% kończyny przeciwnej."]},"original":{"goals":["full pain-free range of motion, no evidence of patellofemoral joint irritation, restoration of strength and proprioception and progression of power.","The source proceeds directly from Phase III to the label 'Phase 5'."],"exercises":["Continue and progress previous flexibility and strengthening activities","functional walk-jog-run progression","forward and backward running progression at ½, ¾ and full speed","progress lower-extremity strengthening with squats and single-leg exercises including elevated split squats and TRX","progress dynamic balance","increase aerobic conditioning with elliptical, swimming and cycling."],"applies_when":["Months 4-6"],"restrictions":["no range-of-motion or weight-bearing restrictions"],"progression_criteria":["no valgus collapse","no femoral adduction or internal rotation, pelvic drop or excessive trunk lean during single-leg endurance tasks."],"dosage_and_progression":["Progress strengthening"],"physiotherapist_actions":["gluteus medius and maximus isometric strength >80% of the contralateral limb."]}},"additional_notes_de":"Ziele: voller schmerzfreier Bewegungsumfang, keine Zeichen einer patellofemoralen Reizung, Wiederherstellung von Kraft und Propriozeption sowie Leistungssteigerung. Die Quelle wechselt von Phase III direkt zur Bezeichnung „Phase 5“.","additional_notes_en":"Goals: full pain-free range of motion, no evidence of patellofemoral joint irritation, restoration of strength and proprioception and progression of power. The source proceeds directly from Phase III to the label 'Phase 5'.","additional_notes_pl":"Cele: pełny bezbolesny zakres ruchu, brak cech podrażnienia stawu rzepkowo-udowego, odtworzenie siły i propriocepcji oraz rozwijanie mocy. Źródło przechodzi z fazy III bezpośrednio do oznaczenia „Phase 5”.","minimum_patient_share":null,"therapeutic_content_de":"Bisherige Beweglichkeits- und Kräftigungsübungen fortsetzen und steigern; funktionelle Progression von Gehen über Joggen zum Laufen; Laufprogression vorwärts und rückwärts mit ½, ¾ und voller Geschwindigkeit; Kräftigung der unteren Extremität mit Kniebeugen und einbeinigen Übungen wie erhöhtem Split Squat und TRX steigern; dynamisches Gleichgewicht verbessern; aerobe Kondition mit Crosstrainer, Schwimmen und Radfahren steigern.","therapeutic_content_en":"Continue and progress previous flexibility and strengthening activities; functional walk-jog-run progression; forward and backward running progression at ½, ¾ and full speed; progress lower-extremity strengthening with squats and single-leg exercises including elevated split squats and TRX; progress dynamic balance; increase aerobic conditioning with elliptical, swimming and cycling.","therapeutic_content_pl":"Kontynuować i rozwijać wcześniejsze ćwiczenia elastyczności i wzmacniania; funkcjonalna progresja marsz–trucht–bieg; progresja biegu w przód i w tył z prędkością ½, ¾ i pełną; rozwijać wzmacnianie kończyny dolnej: przysiady i ćwiczenia jednonóż, w tym split squat z nogą uniesioną i TRX; rozwijać równowagę dynamiczną; zwiększać kondycję tlenową na orbitreku, w pływaniu i na rowerze.","minimum_requirements_de":"Kräftigung steigern; keine Einschränkungen von Bewegungsumfang oder Belastung; isometrische Kraft von M. gluteus medius und maximus >80 % der Gegenseite. Progressionskriterien: kein Valguskollaps; keine femorale Adduktion oder Innenrotation, kein Beckensinken und keine übermäßige Rumpfneigung bei einbeinigen Ausdaueraufgaben.","minimum_requirements_en":"Progress strengthening; no range-of-motion or weight-bearing restrictions; gluteus medius and maximus isometric strength >80% of the contralateral limb. Progression criteria: no valgus collapse; no femoral adduction or internal rotation, pelvic drop or excessive trunk lean during single-leg endurance tasks.","minimum_requirements_pl":"Zwiększać wzmacnianie; bez ograniczeń zakresu ruchu i obciążania; izometryczna siła mięśnia pośladkowego średniego i wielkiego >80% kończyny przeciwnej. Kryteria progresji: bez zapadania koślawości; bez przywiedzenia i rotacji wewnętrznej kości udowej, opadania miednicy ani nadmiernego pochylenia tułowia podczas zadań wytrzymałościowych jednonóż.","additional_notes_original":"Goals: Full pain-free range of motion, no evidence of patellofemoral joint irritation, strength and proprioception restoration, power progression","therapeutic_content_original":"Continue and progress previous flexibility and strengthening activities; functional walk-jog-run progression; forward and backward running progression at ½, ¾ and full speed; progress lower-extremity strengthening with squats and single-leg exercises including elevated split squats and TRX; progress dynamic balance; increase aerobic conditioning with elliptical, swimming and cycling.","minimum_requirements_original":"Progress strengthening; no range-of-motion or weight-bearing restrictions; gluteus medius and maximus isometric strength >80% of the contralateral limb. Progression criteria: no valgus collapse; no femoral adduction or internal rotation, pelvic drop or excessive trunk lean during single-leg endurance tasks.","structured_content_v2":"$undefined"},{"id":"77086fb9-9ab0-5083-9b33-41f958d5f196","name_de":"Phase VI: ab Monat 6","name_en":"Phase VI: Month 6 and onward","name_pl":"Faza VI: od 6. miesiąca","source_page":2,"module_number":5,"name_original":"Phase 6: Months 6+","service_codes":[],"structured_content":{"de":{"goals":["Abschluss der geeigneten funktionellen Progression, Erhalt der Kraft und Patientenschulung."],"exercises":["Funktionelle Progression einschließlich Richtungswechsel, Crossover und Carioca","den Patientenzielen entsprechende plyometrische Übungen mit Medizinball und Schlitten","Agility-Übungen mit Seitwärtsschritten, Koordinationsleiter, Hütchen, Z- und W-Cuts sowie multiplanaren sportartspezifischen Übungen."],"applies_when":["ab Monat 6"],"restrictions":["Keine zusätzlichen Einschränkungen."],"progression_criteria":["Freigabe durch den Operateur","Hamstring-Kraftindex >90 % gegenüber der Gegenseite","Quadrizeps-Kraftindex >90 %","Differenz der anterioren Reichweite im Y-Balance-Test <4 cm","keine Schmerzen oder Instabilität."]},"en":{"goals":["complete the appropriate functional progression, maintain strength and educate the patient."],"exercises":["Functional progression including cutting, crossover and carioca","plyometric exercises appropriate to patient goals including medicine-ball work and sled drills","agility drills with shuffles, ladder footwork, cone drills, Z-cuts, W-cuts and multiplanar sport-specific drills."],"applies_when":["Month 6 and onward"],"restrictions":["No additional restrictions."],"progression_criteria":["surgeon clearance","hamstring strength index >90% versus the contralateral limb","quadriceps strength index >90%","Y-Balance anterior-reach difference <4 cm","no pain or instability."]},"pl":{"goals":["ukończenie odpowiedniej progresji funkcjonalnej, utrzymanie siły i edukacja pacjenta."],"exercises":["Progresja funkcjonalna obejmująca między innymi zmiany kierunku, crossover i carioca","ćwiczenia plyometryczne odpowiednie do celów pacjenta, w tym piłka lekarska i ćwiczenia z sankami","ćwiczenia zwinnościowe: kroki odstawno-dostawne, drabinka koordynacyjna, pachołki, cięcia po torze Z i W oraz wielopłaszczyznowe ćwiczenia specyficzne dla sportu."],"applies_when":["od 6. miesiąca"],"progression_criteria":["zgoda chirurga","wskaźnik siły mięśni kulszowo-goleniowych >90% względem kończyny przeciwnej","wskaźnik siły mięśnia czworogłowego >90%","różnica przedniego zasięgu Y-Balance <4 cm","brak bólu i niestabilności."],"physiotherapist_actions":["Brak dodatkowych ograniczeń."]},"original":{"goals":["complete the appropriate functional progression, maintain strength and educate the patient."],"exercises":["Functional progression including cutting, crossover and carioca","plyometric exercises appropriate to patient goals including medicine-ball work and sled drills","agility drills with shuffles, ladder footwork, cone drills, Z-cuts, W-cuts and multiplanar sport-specific drills."],"applies_when":["Month 6 and onward"],"restrictions":["No additional restrictions."],"progression_criteria":["surgeon clearance","hamstring strength index >90% versus the contralateral limb","quadriceps strength index >90%","Y-Balance anterior-reach difference <4 cm","no pain or instability."]}},"additional_notes_de":"Ziele: Abschluss der geeigneten funktionellen Progression, Erhalt der Kraft und Patientenschulung. Entlassungskriterien: Freigabe durch den Operateur; Hamstring-Kraftindex >90 % gegenüber der Gegenseite; Quadrizeps-Kraftindex >90 %; Differenz der anterioren Reichweite im Y-Balance-Test <4 cm; keine Schmerzen oder Instabilität.","additional_notes_en":"Goals: complete the appropriate functional progression, maintain strength and educate the patient. Discharge criteria: surgeon clearance; hamstring strength index >90% versus the contralateral limb; quadriceps strength index >90%; Y-Balance anterior-reach difference <4 cm; no pain or instability.","additional_notes_pl":"Cele: ukończenie odpowiedniej progresji funkcjonalnej, utrzymanie siły i edukacja pacjenta. Kryteria wypisu: zgoda chirurga; wskaźnik siły mięśni kulszowo-goleniowych >90% względem kończyny przeciwnej; wskaźnik siły mięśnia czworogłowego >90%; różnica przedniego zasięgu Y-Balance <4 cm; brak bólu i niestabilności.","minimum_patient_share":null,"therapeutic_content_de":"Funktionelle Progression einschließlich Richtungswechsel, Crossover und Carioca; den Patientenzielen entsprechende plyometrische Übungen mit Medizinball und Schlitten; Agility-Übungen mit Seitwärtsschritten, Koordinationsleiter, Hütchen, Z- und W-Cuts sowie multiplanaren sportartspezifischen Übungen.","therapeutic_content_en":"Functional progression including cutting, crossover and carioca; plyometric exercises appropriate to patient goals including medicine-ball work and sled drills; agility drills with shuffles, ladder footwork, cone drills, Z-cuts, W-cuts and multiplanar sport-specific drills.","therapeutic_content_pl":"Progresja funkcjonalna obejmująca między innymi zmiany kierunku, crossover i carioca; ćwiczenia plyometryczne odpowiednie do celów pacjenta, w tym piłka lekarska i ćwiczenia z sankami; ćwiczenia zwinnościowe: kroki odstawno-dostawne, drabinka koordynacyjna, pachołki, cięcia po torze Z i W oraz wielopłaszczyznowe ćwiczenia specyficzne dla sportu.","minimum_requirements_de":"Keine zusätzlichen Einschränkungen.","minimum_requirements_en":"No additional restrictions.","minimum_requirements_pl":"Brak dodatkowych ograniczeń.","additional_notes_original":"Goals: Completion of appropriate functional progression, strength maintenance, patient education\n\nCriteria for discharge:\n-Surgeon clearance\n-Hamstring strength index >90% as compared to contralateral limb\n-Quadriceps strength index >90% compared to contralateral limb\n-Y-Balance anterior reach < 4cm\n-No complaints of pain or instability","therapeutic_content_original":"Functional progression including cutting, crossover and carioca; plyometric exercises appropriate to patient goals including medicine-ball work and sled drills; agility drills with shuffles, ladder footwork, cone drills, Z-cuts, W-cuts and multiplanar sport-specific drills.","minimum_requirements_original":"No additional restrictions.","structured_content_v2":"$undefined"}],"publication_disposition":"published_v2","disposition_reason":"existing_database_content_enabled_by_product_owner_2026_09_06","document_family":"rehabilitation_protocol","content_role":"core_protocol","classification_status":"verified","clinical_domain":"musculoskeletal","clinical_entity_type":"procedure_aftercare","body_region_codes":["knee","lower_extremity"],"procedure_codes":[],"icf_tags":[],"presentation_modes":["timeline","milestone_timeline"],"content_schema_version":1,"modules_v2":"$undefined","protocol_content_v2":{}},{"id":"1e5c363d-447d-538a-a17b-22366165dc10","slug":"us-south-shore-26-acl-reconstruction","title_pl":"Protokół rehabilitacji po rekonstrukcji ACL","title_de":"Rehabilitationsprotokoll nach VKB-Rekonstruktion","title_en":"ACL Reconstruction Rehabilitation Protocol","title_original":"ACL Reconstruction","summary_pl":"Protokół rehabilitacji po rekonstrukcji więzadła krzyżowego przedniego w 5 fazach (0-24+ tygodni).","summary_de":"Rehabilitationsprotokoll nach VKB-Rekonstruktion in 5 Phasen (0-24+ Wochen).","summary_en":"Rehabilitation protocol for ACL reconstruction across 5 phases (0-24+ weeks).","country_code":"US","source_language":"en","publication_year":null,"version_label":"","target_professions":["physiotherapist"],"clinical_scope":"physiotherapy","structure_type":"phases","patient_populations":[],"clinical_contexts":[],"care_pathways":["return_to_sport"],"physician_clearance_required":true,"condition_id":"d0990ed1-7e63-5a92-be5c-97efbb2c9307","condition_slug":"acl-reconstruction","condition_name_pl":"Stan po rekonstrukcji ACL","condition_name_de":"Zustand nach VKB-Rekonstruktion","condition_name_en":"Status Post ACL Reconstruction","condition_name_original":"Status Post ACL Reconstruction","icd_codes":[],"category_key":"knee","category_pl":"Kolano","category_de":"Knie","category_en":"Knee","body_regions_pl":["Kolano","Kończyna dolna"],"body_regions_de":["Knie","Untere Extremität"],"body_regions_en":["Knee","Lower extremity"],"search_terms_pl":["rekonstrukcja ACL","rekonstrukcja więzadła krzyżowego przedniego","rehabilitacja kolana"],"search_terms_de":["VKB-Rekonstruktion","Rekonstruktion des vorderen Kreuzbandes","Knierehabilitation"],"search_terms_en":["ACL reconstruction","anterior cruciate ligament reconstruction","knee rehabilitation"],"source_document_id":"e0a2ec2d-bc21-5331-9726-67e22539450e","source_title":"ACL Reconstruction","issuer":"South Shore Orthopedics","source_country_code":"US","jurisdiction_code":"US-MA","authority_level":"hospital","document_type":"local_protocol_collection","source_clinical_scope":"physiotherapy","source_target_professions":["physiotherapist"],"freshness_status":"stale_requires_clinical_update_check","official_url":"https://octanecdn.com/southshoreorthopedicscom/southshoreorthopedicscom_145981834.pdf","source_sha256":"1f591d550b6c115e530bfb0a1efd77d30f2b036e56a66c9b0068e4a0d9d3839a","authorization_required":false,"license_note":"Public source file retained locally for source verification.","modules":[{"id":"9514b014-e2dd-5ba0-8b7f-59c035c9518d","name_de":"Beginn der Physiotherapie und aktive Mitarbeit","name_en":"Starting physical therapy and active participation","name_pl":"Rozpoczęcie fizjoterapii i aktywny udział pacjenta","source_page":2,"module_number":1,"name_original":"Recovery/Time off Work; Post Operative Visits","service_codes":[],"structured_content":{"de":{"exercises":[],"dosage_and_progression":["Patient:innen führen täglich Übungen durch, um Bewegungsumfang und Kraft angemessen wiederzuerlangen; dieser Abschnitt nennt weder Übungsnamen noch Dosierungen."],"physiotherapist_actions":["Physiotherapie nach der Freigabe beim ersten postoperativen Termin beginnen, üblicherweise etwa 7–10 Tage nach der Operation."]},"en":{"exercises":[],"dosage_and_progression":["The patient performs daily exercises to ensure proper return of range of motion and strength; this section does not name or dose those exercises."],"physiotherapist_actions":["Begin physical therapy after clearance at the first postoperative visit, usually approximately 7–10 days after surgery."]},"pl":{"exercises":[],"dosage_and_progression":["Pacjent codziennie wykonuje ćwiczenia, aby zapewnić prawidłowy powrót zakresu ruchu i siły; źródło nie podaje w tej sekcji nazw ani dawki tych ćwiczeń."],"physiotherapist_actions":["Rozpocznij fizjoterapię po zgodzie udzielonej podczas pierwszej kontroli pooperacyjnej, zwykle około 7–10 dni po operacji."]},"original":{"exercises":[],"dosage_and_progression":["He or she must be an active participant during this process, performing daily exercises to ensure there is proper return of range of motion and strength."],"physiotherapist_actions":["At this time you will most likely be cleared to make an appointment to begin Physical Therapy."]}},"additional_notes_de":"Der zeitliche Verlauf der Rückkehr ist individuell.","additional_notes_en":"The recovery timetable is individual.","additional_notes_pl":"Tempo powrotu jest indywidualne.","minimum_patient_share":null,"therapeutic_content_de":"Patient:innen sollen aktiv an der Rehabilitation teilnehmen und täglich Übungen durchführen, um Bewegungsumfang und Kraft wiederzuerlangen.","therapeutic_content_en":"The patient should actively participate in rehabilitation and perform daily exercises to restore range of motion and strength.","therapeutic_content_pl":"Pacjent ma aktywnie uczestniczyć w rehabilitacji i codziennie wykonywać ćwiczenia, aby odzyskać zakres ruchu oraz siłę.","minimum_requirements_de":"Der erste postoperative Termin findet etwa 7–10 Tage nach der Operation statt; dann wird voraussichtlich die Terminvereinbarung für die Physiotherapie freigegeben.","minimum_requirements_en":"The first postoperative visit is approximately 7–10 days after surgery; the patient will most likely then be cleared to make an appointment for physical therapy.","minimum_requirements_pl":"Pierwsza kontrola pooperacyjna odbywa się około 7–10 dni po operacji; wtedy pacjent najprawdopodobniej otrzyma zgodę na umówienie fizjoterapii.","additional_notes_original":"Recovery is different in each case.","therapeutic_content_original":"He or she must be an active participant during this process, performing daily exercises to ensure there is proper return of range of motion and strength.","minimum_requirements_original":"Your first post-op visit to the doctor’s office will be approximately 7-10 days after the operation. At this time you will most likely be cleared to make an appointment to begin Physical Therapy.","structured_content_v2":"$undefined"},{"id":"89dd82de-866d-5594-b463-5685176c944c","name_de":"Eis, Krücken und Orthese nach der Operation","name_en":"Postoperative ice, crutches and brace","name_pl":"Lód, kule i orteza po operacji","source_page":3,"module_number":2,"name_original":"Ice; Crutches; Brace","service_codes":[],"structured_content":{"de":{"warnings":["Zu hohe Belastung des Knies in der frühen Phase kann übermäßige und anhaltende Schwellung, eine schlechte Gangmechanik und eine übermäßige Beanspruchung des heilenden VKB-Transplantats verursachen."],"exercises":[],"restrictions":["Das Hilfsmittel nicht absetzen, bevor ein korrektes Gangbild erreicht ist.","Sofern ärztlich nicht anders angeordnet, die Orthese in den ersten 2 Wochen beim Gehen und Schlafen in Extension verriegelt halten."],"dosage_and_progression":["Eis 3–5-mal täglich für 10–20 Minuten anwenden und stets eine Schicht zwischen Eis und Haut belassen.","Patellarsehnentransplantat: sofort WBAT mit Krücken, Ausschleichen ab Woche 2; Hamstring- oder Allograft: 4 Wochen PWB, WBAT mit Krücken in Woche 4–6, Ausschleichen ab Woche 6."],"physiotherapist_actions":["Krückengebrauch entsprechend der Transplantatart anleiten und das Gangbild korrigieren; das Hilfsmittel erst bei korrektem Gangbild absetzen.","Orthesengebrauch anleiten: in den ersten 2 Wochen beim Gehen und Schlafen üblicherweise in Extension verriegelt, im Sitzen entriegelt; die Entriegelung beim Gehen richtet sich nach der Wiederkehr des Muskeltonus."]},"en":{"warnings":["Excessive early weight bearing can create excessive and persistent swelling, poor gait mechanics and undue stress on the healing ACL graft."],"exercises":[],"restrictions":["Do not discontinue the assistive device before a proper gait pattern is achieved.","Unless the doctor instructs otherwise, keep the brace locked in extension during walking and sleeping for the first 2 weeks."],"dosage_and_progression":["Apply ice 3–5 times/day for 10–20 minutes with one layer maintained between the ice and skin.","Patellar tendon graft: immediate WBAT with crutches and begin weaning at 2 weeks; hamstring or allograft: PWB for 4 weeks, WBAT with crutches during weeks 4–6 and wean at 6 weeks."],"physiotherapist_actions":["Teach crutch use according to graft type and correct gait mechanics; discontinue the assistive device only after a proper gait pattern is achieved.","Teach brace use: generally locked in extension during walking and sleeping for the first 2 weeks and unlocked while sitting; unlocking during walking depends on recovery of muscle tone."]},"pl":{"warnings":["Zbyt duże obciążanie kolana we wczesnym okresie może powodować nadmierny i utrzymujący się obrzęk, nieprawidłową mechanikę chodu oraz nadmierne naprężenie gojącego się graftu ACL."],"exercises":[],"restrictions":["Nie odstawiaj urządzenia pomocniczego przed uzyskaniem prawidłowego wzorca chodu.","Jeżeli lekarz nie zaleci inaczej, podczas chodu i snu utrzymuj ortezę zablokowaną w wyproście przez pierwsze 2 tygodnie."],"dosage_and_progression":["Stosuj lód 3–5 razy dziennie przez 10–20 minut, zawsze z jedną warstwą między lodem a skórą.","Przeszczep z więzadła rzepki: WBAT o kulach od razu, rozpocznij odstawianie po 2 tygodniach; graft z hamstringów lub allograft: PWB przez 4 tygodnie, WBAT z kulami w tygodniach 4–6, odstawienie po 6 tygodniach."],"physiotherapist_actions":["Naucz używania kul zgodnie z rodzajem graftu i koryguj wzorzec chodu; odstawienie pomocy jest dozwolone dopiero po uzyskaniu prawidłowego chodu.","Ucz używania ortezy: zwykle zablokowana w wyproście podczas chodu i snu przez pierwsze 2 tygodnie, odblokowana w siadzie; odblokowanie podczas chodu zależy od odzyskania napięcia mięśniowego."]},"original":{"warnings":["Putting too much weight on your knee in the early phases of recovery can create excessive and persistent swelling, poor gait mechanics and may cause undue stress on the healing ACL graft."],"exercises":[],"restrictions":["In all cases proper gait pattern must be achieved in order to discontinue use of assistive device!","Generally it is recommended that you keep the brace locked in extension while walking and when sleeping for the first two weeks after the operation."],"dosage_and_progression":["Ice should be applied 3-5 times a day for 10-20 minutes at a time. Always maintain one layer between ice and the skin.","For Patella tendon grafts you will be allowed to bear as much weight as you can tolerate on your leg while using your crutches right away after surgery. You may start to wean from the use of your crutches at 2 weeks post op. For Hamstring and Allograft ACL’s you will be partial weight bearing with crutches for the first 4 weeks. You may progress to weight bearing as tolerated with crutches between weeks 4 and 6 and wean the use of your crutches at 6 weeks post op."],"physiotherapist_actions":["It is very important for you to use crutches after the surgery as instructed by your doctor or physical therapist.","Allowing the brace to be unlocked while walking is generally based on how well you recover muscle tone in your leg."]}},"additional_notes_de":"Vor dem Absetzen des Hilfsmittels muss ein korrektes Gangbild erreicht sein.","additional_notes_en":"A proper gait pattern must be achieved before discontinuing the assistive device.","additional_notes_pl":"Przed odstawieniem pomocy musi zostać osiągnięty prawidłowy wzorzec chodu.","minimum_patient_share":null,"therapeutic_content_de":"Schmerz und Schwellung mit Eis kontrollieren sowie Belastung, Krückengang und Orthesengebrauch passend zur Transplantatart und Gangqualität anleiten.","therapeutic_content_en":"Control pain and swelling with ice and guide safe loading, crutch use and brace use according to graft type and gait quality.","therapeutic_content_pl":"Kontroluj ból i obrzęk lodem oraz prowadź bezpieczne obciążanie, chód o kulach i użycie ortezy odpowiednio do rodzaju graftu i jakości chodu.","minimum_requirements_de":"Patellarsehnentransplantat: sofort WBAT mit Krücken und Ausschleichen ab Woche 2; Hamstring- oder Allograft: 4 Wochen PWB mit Krücken, WBAT in Woche 4–6 und Ausschleichen ab Woche 6.","minimum_requirements_en":"Patellar tendon graft: immediate WBAT with crutches and begin weaning at 2 weeks; hamstring or allograft: PWB with crutches for 4 weeks, WBAT during weeks 4–6 and wean at 6 weeks.","minimum_requirements_pl":"Przeszczep z więzadła rzepki: WBAT o kulach od razu i rozpoczęcie odstawiania kul po 2 tygodniach; przeszczep z hamstringów lub allograft: PWB o kulach przez 4 tygodnie, WBAT w tygodniach 4–6 i odstawienie kul po 6 tygodniach.","additional_notes_original":"In all cases proper gait pattern must be achieved in order to discontinue use of assistive device!","therapeutic_content_original":"You must use ice on your knee after the operation for management of pain and swelling. It is very important for you to use crutches after the surgery as instructed by your doctor or physical therapist.","minimum_requirements_original":"For Patella tendon grafts you will be allowed to bear as much weight as you can tolerate on your leg while using your crutches right away after surgery. For Hamstring and Allograft ACL’s you will be partial weight bearing with crutches for the first 4 weeks.","structured_content_v2":"$undefined"},{"id":"a1b0c770-4989-5ace-b258-48dbc1a5d183","name_de":"Optionale CPM-Behandlung","name_en":"Optional CPM","name_pl":"Opcjonalny CPM","source_page":4,"module_number":3,"name_original":"CPM","service_codes":[],"structured_content":{"de":{"exercises":[],"restrictions":["CPM nur nach den konkreten ärztlichen Vorgaben zu Häufigkeit und Dauer anwenden."],"dosage_and_progression":["CPM üblicherweise 1–2 Wochen bis zu 10 Stunden täglich anwenden; ROM-Ziel 0–100° in Woche 1 und 0–120° in Woche 2."],"physiotherapist_actions":["Wenn CPM verordnet wurde, erklären, dass das Gerät in Rückenlage zur passiven Beugung und Streckung des Knies verwendet wird."]},"en":{"exercises":[],"restrictions":["Use CPM only according to the doctor’s specific instructions for frequency and duration."],"dosage_and_progression":["Typically use CPM for 1–2 weeks for up to 10 hours/day; target ROM of 0–100° in week 1 and 0–120° in week 2."],"physiotherapist_actions":["If CPM is prescribed, teach that the machine is used while lying supine to passively bend and straighten the knee."]},"pl":{"exercises":[],"restrictions":["Stosuj CPM wyłącznie zgodnie ze szczegółowymi zaleceniami lekarza dotyczącymi częstotliwości i czasu."],"dosage_and_progression":["Zwykle stosuj CPM przez 1–2 tygodnie, do 10 godzin dziennie; dąż do ROM 0–100° w pierwszym tygodniu i 0–120° w drugim tygodniu."],"physiotherapist_actions":["Jeżeli CPM został zlecony, poinstruuj pacjenta, że urządzenie stosuje się w leżeniu tyłem do biernego zginania i prostowania kolana."]},"original":{"exercises":[],"restrictions":["He or she will provide specific instructions regarding the frequency and duration of how long you should use the machine."],"dosage_and_progression":["The machine is typically prescribed for 1-2 weeks and is to be used for up to 10 hours a day. Your goal should be to achieve a range of motion of 0-100 degrees in the first week and 0-120 in the second week after surgery."],"physiotherapist_actions":["The CPM is a machine that will bend and straighten your knee for you while you are lying down on your back."]}},"additional_notes_de":"Häufigkeit und Anwendungsdauer werden ärztlich festgelegt.","additional_notes_en":"The doctor specifies frequency and duration.","additional_notes_pl":"Częstotliwość i czas stosowania określa lekarz.","minimum_patient_share":null,"therapeutic_content_de":"Wenn ärztlich eine CPM-Schiene verordnet wird, beugt und streckt das Gerät das Knie passiv in Rückenlage.","therapeutic_content_en":"If the doctor prescribes CPM, the machine passively bends and straightens the knee while the patient lies supine.","therapeutic_content_pl":"Jeżeli lekarz zleci CPM, urządzenie biernie zgina i prostuje kolano w leżeniu tyłem.","minimum_requirements_de":"CPM wird üblicherweise für 1–2 Wochen bis zu 10 Stunden täglich verordnet; ROM-Ziel sind 0–100° in Woche 1 und 0–120° in Woche 2.","minimum_requirements_en":"CPM is typically prescribed for 1–2 weeks for up to 10 hours/day; ROM goals are 0–100° in week 1 and 0–120° in week 2.","minimum_requirements_pl":"CPM jest zwykle zlecany przez 1–2 tygodnie do 10 godzin dziennie; cel ROM to 0–100° w pierwszym tygodniu i 0–120° w drugim.","additional_notes_original":"He or she will provide specific instructions regarding the frequency and duration of how long you should use the machine.","therapeutic_content_original":"The CPM is a machine that will bend and straighten your knee for you while you are lying down on your back.","minimum_requirements_original":"The machine is typically prescribed for 1-2 weeks and is to be used for up to 10 hours a day. Your goal should be to achieve a range of motion of 0-100 degrees in the first week and 0-120 in the second week after surgery.","structured_content_v2":"$undefined"},{"id":"02fab7bd-0736-55bb-ba88-8c4295d6d80f","name_de":"Phase 1: 0-2 Wochen","name_en":"Phase 1: 0-2 Weeks","name_pl":"Faza 1: 0-2 tygodnie","source_page":5,"module_number":4,"name_original":"Phase 1 (0-2 Weeks)","service_codes":[],"structured_content":{"de":{"goals":["Schmerz und Schwellung kontrollieren, heilendes Gewebe schützen, die Wiederherstellung des ROM mit Schwerpunkt auf voller Extension beginnen und eine gute Quadrizepsaktivierung erreichen."],"exercises":["Fersengleiten — 2 Sätze mit 20 Wiederholungen","Assistierte Kniebeugung und -streckung im Sitzen — 2 Sätze mit 20 Wiederholungen","Ferse zur passiven Extension unterlagern oder Bauchlage mit frei hängendem Unterschenkel — 5 Minuten","Waden- und Hamstringdehnung mit Gurt — 30 Sekunden halten, 3–5 Wiederholungen","Fußpumpen ohne Widerstand — mindestens 2 Sätze mit 20 Wiederholungen","Ergometer mit minimalem Widerstand — täglich 10–15 Minuten","Quadrizeps-Anspannungen — 2–3 Sätze mit 20 Wiederholungen","Gestrecktes Beinheben ohne Lag — 2–3 Sätze mit 10–20 Wiederholungen","Hüftabduktion, -adduktion und -extension gegen die Schwerkraft — 2–3 Sätze mit 10–20 Wiederholungen","Kniebeugung im Stand oder in Bauchlage, außer bei Hamstring-Transplantat — 2–3 Sätze mit 10–20 Wiederholungen","Fußpumpen mit Theraband — 2–3 Sätze mit 20–25 Wiederholungen"],"restrictions":["Nach Entnahme eines Hamstring-Transplantats keine Kniebeugung gegen Widerstand durchführen.","Die Bledsoe-Orthese beim Gehen und Schlafen in Extension verriegelt halten; ohne Belastung auf 0–90° entriegeln."],"dosage_and_progression":["ROM-Übungen 3–5-mal täglich, Kräftigungsübungen einmal täglich und Ergometer nach Möglichkeit täglich 10–15 Minuten durchführen."],"physiotherapist_actions":["Konkrete Übungen und den Übergang zwischen den Phasen anhand des individuellen Falls und einer fundierten klinischen Beurteilung auswählen."]},"en":{"goals":["Control pain and swelling, protect healing tissue, begin restoring ROM with emphasis on full extension and establish good quadriceps activation."],"exercises":["Heel slides — 2 sets of 20 repetitions","Assisted knee flexion and extension in sitting — 2 sets of 20 repetitions","Heel prop for passive extension or prone hang — 5 minutes","Belt stretch for calf and hamstring — hold 30 seconds, 3–5 repetitions","Ankle pumps without resistance — at least 2 sets of 20 repetitions","Cycle with minimal resistance — 10–15 minutes daily","Quad sets — 2–3 sets of 20 repetitions","Straight leg raise without lag — 2–3 sets of 10–20 repetitions","Hip abduction, adduction and extension against gravity — 2–3 sets of 10–20 repetitions","Standing or prone hamstring curls, except with hamstring graft — 2–3 sets of 10–20 repetitions","Theraband ankle pumps — 2–3 sets of 20–25 repetitions"],"restrictions":["Do not perform resisted knee flexion after a hamstring graft.","Keep the Bledsoe brace locked in extension during walking and sleeping; unlock it to 0–90° when non-weight-bearing."],"dosage_and_progression":["Perform ROM exercises 3–5 times/day, strengthening once/day and cycle 10–15 minutes daily if possible."],"physiotherapist_actions":["Select specific exercises and advancement between phases according to the individual case and sound clinical judgment."]},"pl":{"goals":["Kontroluj ból i obrzęk, chroń gojące się tkanki, rozpocznij odzyskiwanie ROM ze szczególnym naciskiem na pełny wyprost i uzyskaj dobrą aktywację mięśnia czworogłowego."],"exercises":["Ślizgi piętą — 2 serie po 20 powtórzeń","Wspomagane zgięcie i wyprost kolana w siadzie — 2 serie po 20 powtórzeń","Podparcie pięty do biernego wyprostu albo zwis w leżeniu przodem — 5 minut","Rozciąganie łydki i hamstringów z paskiem — utrzymanie 30 sekund, 3–5 powtórzeń","Pompowanie stawem skokowym bez oporu — co najmniej 2 serie po 20 powtórzeń","Rower przy minimalnym oporze — 10–15 minut dziennie","Napięcia mięśnia czworogłowego — 2–3 serie po 20 powtórzeń","Unoszenie wyprostowanej nogi bez lag — 2–3 serie po 10–20 powtórzeń","Odwodzenie, przywodzenie i wyprost biodra przeciw grawitacji — 2–3 serie po 10–20 powtórzeń","Zginanie kolana w staniu lub leżeniu przodem, z wyjątkiem graftu z hamstringów — 2–3 serie po 10–20 powtórzeń","Pompowanie stawem skokowym z taśmą — 2–3 serie po 20–25 powtórzeń"],"restrictions":["Nie wykonuj zginania kolana przeciw oporowi po pobraniu graftu z hamstringów.","Podczas chodu i snu utrzymuj ortezę Bledsoe zablokowaną w wyproście; bez obciążania odblokuj ją do 0–90°."],"dosage_and_progression":["Ćwiczenia ROM wykonuj 3–5 razy dziennie, wzmacnianie raz dziennie, a rower 10–15 minut dziennie, jeśli to możliwe."],"physiotherapist_actions":["Dobieraj konkretne ćwiczenia i moment przejścia między fazami do indywidualnego przypadku, wykorzystując rzetelną ocenę kliniczną."]},"original":{"goals":["Control Pain and Swelling; Protect Healing Tissue; Begin to Restore Range of Motion (ROM) Especially Full Extension; Establish Good Quadriceps Activation"],"exercises":["Heel Slides 2 Sets of 20 Repetitions","Assisted Knee Flexion/Extension in Sitting 2 Sets of 20 Repetitions","Heel Prop (passive extension) or Prone Hang 5 Minutes","Belt Stretch (Calf/Hamstring) Hold 30 Seconds 3-5 Repetitions","Ankle Pumps without resistance at least 2 Sets of 20 Repetitions","Cycle (minimal resistance) 10-15 Minutes Daily","Quad Sets 2-3 Sets of 20 Repetitions","SLR *(no Lag)* 2-3 Sets of 10-20 Repetitions","Hip Abd/Add/Extension (against gravity) 2-3 Sets of 10-20 Repetitions","Standing or Prone Hamstring Curls (unless Hamstring Graft) 2-3 Sets of 10-20 Repetitions","T-Band Ankle Pumps 2-3 Sets of 20-25 Repetitions"],"restrictions":["Standing or Prone Hamstring Curls (unless Hamstring Graft)","Bledsoe Brace locked in extension with ambulation and sleeping; Bledsoe Brace unlocked 0-90° when non-weight bearing"],"dosage_and_progression":["Use exercise bike daily if possible for 10-15 minutes. Perform Range of Motion exercises 3-5 times a day. Perform Strengthening exercises 1 time a day."],"physiotherapist_actions":["Time tables are approximate and advancement from phase to phase as well as specific exercises performed should be based on each individual patient’s case and sound clinical judgment by the rehab professional."]}},"additional_notes_de":"ROM-Übungen 3–5-mal täglich, Kräftigungsübungen einmal täglich und Ergometer nach Möglichkeit täglich 10–15 Minuten durchführen.","additional_notes_en":"Perform ROM exercises 3–5 times/day, strengthening once/day and cycle 10–15 minutes daily if possible.","additional_notes_pl":"Ćwiczenia ROM wykonuj 3–5 razy dziennie, wzmacnianie raz dziennie, a rower 10–15 minut dziennie, jeśli to możliwe.","minimum_patient_share":null,"therapeutic_content_de":"Schmerz und Schwellung kontrollieren, heilendes Gewebe schützen, die Wiederherstellung des ROM mit Schwerpunkt auf voller Extension beginnen und eine gute Quadrizepsaktivierung erreichen.","therapeutic_content_en":"Control pain and swelling, protect healing tissue, begin restoring ROM with emphasis on full extension and establish good quadriceps activation.","therapeutic_content_pl":"Kontroluj ból i obrzęk, chroń gojące się tkanki, rozpocznij odzyskiwanie ROM ze szczególnym naciskiem na pełny wyprost i uzyskaj dobrą aktywację mięśnia czworogłowego.","minimum_requirements_de":"WBAT mit Krücken beim Patellarsehnentransplantat, PWB mit Krücken beim Hamstring- oder Allograft sowie Bledsoe-Orthese beim Gehen und Schlafen in Extension verriegelt.","minimum_requirements_en":"WBAT with crutches for patellar tendon graft, PWB with crutches for hamstring or allograft and Bledsoe brace locked in extension during walking and sleeping.","minimum_requirements_pl":"WBAT o kulach dla graftu z więzadła rzepki, PWB o kulach dla graftu z hamstringów lub allograftu oraz orteza Bledsoe zablokowana w wyproście podczas chodu i snu.","additional_notes_original":"Use exercise bike daily if possible for 10-15 minutes. Perform Range of Motion exercises 3-5 times a day. Perform Strengthening exercises 1 time a day.","therapeutic_content_original":"Control Pain and Swelling; Protect Healing Tissue; Begin to Restore Range of Motion (ROM) Especially Full Extension; Establish Good Quadriceps Activation","minimum_requirements_original":"WBAT with Crutches for Patellar Tendon Graft; PWB with Crutches for Hamstring or Allograft; Bledsoe Brace locked in extension with ambulation and sleeping","structured_content_v2":"$undefined"},{"id":"34ae5cfc-b59d-5ee7-8160-0172564d4109","name_de":"Phase 2: 2-6 Wochen","name_en":"Phase 2: 2-6 Weeks","name_pl":"Faza 2: 2-6 tygodni","source_page":6,"module_number":5,"name_original":"Phase 2 (2-6 Weeks)","service_codes":[],"structured_content":{"de":{"goals":["Heilendes Gewebe weiter schützen und ROM verbessern, die Gangmechanik normalisieren und mit dem Wiederaufbau der Kraft der unteren Extremität, besonders des Quadrizeps, beginnen."],"exercises":["ROM-Übungen aus Phase 1 fortsetzen, bis normaler ROM erreicht ist","Ergometer mit erhöhtem Widerstand","Quadrizeps-Anspannungen nach Bedarf zur VMO-Aktivierung","Vier-Wege-Programm für gestrecktes Beinheben mit Knöchelgewicht nach Bedarf","Kniebeugung nur bei Patellarsehnen- oder Allograft","Kniestreckung im Stand","Mini-Kniebeuge oder Wall Slide","Beinpresse","Fersenheben","Einbeinstand"],"restrictions":["Beim Hamstring- oder Allograft 4 Wochen PWB beibehalten; dann zu WBAT übergehen und die Krücken entsprechend dem Gangbild ausschleichen.","Geschlossenkettige Übungen dürfen begonnen werden, die Belastungsbeschränkungen beim Gehen bleiben jedoch bestehen; die Bledsoe-Orthese beim Gehen auf 0–90° einstellen."],"dosage_and_progression":["Alle ROM- und Kräftigungsübungen einmal täglich in 2–3 Sätzen mit 15–20 Wiederholungen durchführen; Ergometer nach Möglichkeit täglich."],"physiotherapist_actions":["Eine korrekte Patellamobilität sicherstellen, auf ein korrektes Gangbild achten und den Erguss vor der Progression geschlossenkettiger Übungen minimieren."]},"en":{"goals":["Continue protecting healing tissue and improving ROM, normalize gait mechanics and begin restoring lower-extremity strength, especially quadriceps strength."],"exercises":["Continue ROM exercises from phase 1 until normal ROM is achieved","Cycle with increased resistance","Continue quad sets as needed for VMO activation","Continue four-way straight leg raise program with ankle weight as needed","Hamstring curls only for patellar tendon graft and allograft","Standing terminal knee extension","Mini squat or wall slide","Leg press","Heel raises","Single-leg stance"],"restrictions":["After hamstring or allograft maintain PWB for 4 weeks; then progress to WBAT and wean crutches as gait permits.","Closed-chain exercises may begin, but maintain gait weight-bearing restrictions; use the Bledsoe brace at 0–90° during walking."],"dosage_and_progression":["Perform all ROM and strengthening exercises once/day for 2–3 sets of 15–20 repetitions; cycle daily if possible."],"physiotherapist_actions":["Ensure proper patellar mobility, stress proper gait and minimize effusion before progressing closed-chain exercise."]},"pl":{"goals":["Kontynuuj ochronę gojących się tkanek i poprawę ROM, normalizuj mechanikę chodu oraz rozpocznij odzyskiwanie siły kończyny dolnej, szczególnie mięśnia czworogłowego."],"exercises":["Kontynuacja ćwiczeń ROM z fazy 1 do uzyskania prawidłowego ROM","Rower ze zwiększonym oporem","Napięcia mięśnia czworogłowego według potrzeby dla aktywacji VMO","Czterokierunkowy program unoszenia wyprostowanej nogi z obciążnikiem na kostkę według potrzeby","Zginanie kolana tylko przy grafcie z więzadła rzepki lub allograficie","Wyprost kolana w staniu","Mini-przysiad lub wall slide","Leg press","Wspięcia na palce","Stanie jednonóż"],"restrictions":["Po grafcie z hamstringów lub allograficie utrzymaj PWB przez 4 tygodnie; następnie przejdź do WBAT i odstawiaj kule odpowiednio do chodu.","Można rozpocząć ćwiczenia w zamkniętym łańcuchu, lecz podczas chodu nadal przestrzegaj ograniczeń obciążania; utrzymuj ortezę Bledsoe 0–90° podczas chodu."],"dosage_and_progression":["Wszystkie ćwiczenia ROM i wzmacniające wykonuj raz dziennie w 2–3 seriach po 15–20 powtórzeń; rower codziennie, jeśli to możliwe."],"physiotherapist_actions":["Zapewnij prawidłową ruchomość rzepki, kładź nacisk na prawidłowy wzorzec chodu i minimalizuj wysięk przed progresją ćwiczeń w zamkniętym łańcuchu."]},"original":{"goals":["Continued protection of healing tissue; Continue to improve ROM; Normalize gait mechanics; Begin to establish return of lower extremity strength especially quadriceps"],"exercises":["Continue ROM exercises from Phase 1 until normal ROM is achieved","Cycle with increased resistance","Continue Quad Sets (as needed for VMO activation)","Continue 4 way SLR program (add ankle weight as needed)","Hamstring Curls (Patellar Tendon and Allograft Only)","Standing Terminal Knee Extension","Mini Squat and/or Wall Slide","Leg Press","Heel Raises","Single Leg Stance"],"restrictions":["Hamstring and Allograft PWB for 4 wks post op. Progress to WBAT at 4 wks post op and wean crutches as appropriate.","OK to begin closed chain exercises, but maintain weight bearing restrictions with gait; Bledsoe brace 0-90° with ambulation"],"dosage_and_progression":["Perform all ROM and strengthening exercises once a day. Do 2-3 sets of 15-20 repetitions. Cycle daily if possible."],"physiotherapist_actions":["Ensure Proper Patella Mobility; Must stress proper gait; Minimize effusion before progressing closed chain exercise"]}},"additional_notes_de":"Alle ROM- und Kräftigungsübungen einmal täglich in 2–3 Sätzen mit 15–20 Wiederholungen durchführen; Ergometer nach Möglichkeit täglich.","additional_notes_en":"Perform all ROM and strengthening exercises once/day for 2–3 sets of 15–20 repetitions; cycle daily if possible.","additional_notes_pl":"Wszystkie ćwiczenia ROM i wzmacniające wykonuj raz dziennie w 2–3 seriach po 15–20 powtórzeń; rower codziennie, jeśli to możliwe.","minimum_patient_share":null,"therapeutic_content_de":"Heilendes Gewebe weiter schützen und ROM verbessern, die Gangmechanik normalisieren und mit dem Wiederaufbau der Kraft der unteren Extremität, besonders des Quadrizeps, beginnen.","therapeutic_content_en":"Continue protecting healing tissue and improving ROM, normalize gait mechanics and begin restoring lower-extremity strength, especially quadriceps strength.","therapeutic_content_pl":"Kontynuuj ochronę gojących się tkanek i poprawę ROM, normalizuj mechanikę chodu oraz rozpocznij odzyskiwanie siły kończyny dolnej, szczególnie mięśnia czworogłowego.","minimum_requirements_de":"Krücken beim Patellarsehnentransplantat ausschleichen; beim Hamstring- oder Allograft 4 Wochen PWB beibehalten, dann zu WBAT übergehen und die Krücken entsprechend dem Gangbild ausschleichen.","minimum_requirements_en":"Wean crutches after patellar tendon graft; after hamstring or allograft maintain PWB for 4 weeks, then progress to WBAT and wean crutches as gait permits.","minimum_requirements_pl":"Odstawiaj kule po grafcie z więzadła rzepki; po grafcie z hamstringów lub allograficie utrzymaj PWB przez 4 tygodnie, następnie przejdź do WBAT i odstawiaj kule stosownie do chodu.","additional_notes_original":"Perform all ROM and strengthening exercises once a day. Do 2-3 sets of 15-20 repetitions. Cycle daily if possible.","therapeutic_content_original":"Continued protection of healing tissue; Continue to improve ROM; Normalize gait mechanics; Begin to establish return of lower extremity strength especially quadriceps","minimum_requirements_original":"Hamstring and Allograft PWB for 4 wks post op. Progress to WBAT at 4 wks post op and wean crutches as appropriate.","structured_content_v2":"$undefined"},{"id":"b816908e-c7b7-5193-97ea-cd03c3da4fc7","name_de":"Phase 3: 6-12 Wochen","name_en":"Phase 3: 6-12 Weeks","name_pl":"Faza 3: 6-12 tygodni","source_page":7,"module_number":6,"name_original":"Phase 3 (6-12 Weeks)","service_codes":[],"structured_content":{"de":{"goals":["Patellofemorale Schmerzen vermeiden, ROM und Flexibilität maximieren sowie geschlossenkettige Kraft und Propriozeption aufbauen."],"exercises":["ROM-Übungen aus Phase 1 nach Bedarf fortsetzen","Dehnung aller Muskelgruppen der unteren Extremität einschließlich Hamstrings, Quadrizeps, Wade, Glutealmuskulatur, Adduktoren und Tractus iliotibialis","Ergometer mit progressivem Widerstand","Crosstrainer ab Woche 8","Schwimmen ab Woche 6–8","Progression des Vier-Wege-Beinhebens und der Kniebeugung mit Knöchelgewichten","Kraftgeräte: Beinpresse, Beinbeuger und Multi-Hip","Kniebeugen bis 90°","Beginn der einbeinigen Kräftigung","Progression von Step-ups nach vorn","Statischer Ausfallschritt nach vorn und hinten","Einbeinstand","Statisches Gleichgewicht auf BOSU, Wackelbrett oder Schaumstoff","Star Drill: Einbeinstand mit Reichbewegung"],"restrictions":["Kein Laufen, Pivotieren oder seitliche Bewegungen.","Keine Step-downs nach vorn wegen der erhöhten patellofemoralen Belastung."],"dosage_and_progression":["ROM und Dehnung einmal täglich bis zum Erreichen eines normalen ROM durchführen; Dehnungen 30 Sekunden halten und 2–3-mal wiederholen.","Cardio 3–5-mal wöchentlich für 20–30 Minuten und Kräftigung 3–5-mal wöchentlich mit 2–3 Sätzen zu 15–20 Wiederholungen durchführen."],"physiotherapist_actions":["Auf ein korrektes Gangbild, strenge Übungstechnik und minimale patellofemorale Schmerzen achten."]},"en":{"goals":["Avoid patellofemoral pain, maximize ROM and flexibility and develop closed-chain strength and proprioception."],"exercises":["Continue ROM exercises from phase 1 as needed","Stretch all lower-extremity muscle groups including hamstrings, quadriceps, calf, glutes, adductors and iliotibial band","Cycle with progressive resistance","Elliptical from week 8","Swimming from weeks 6–8","Progress four-way straight leg raises and hamstring curls with ankle weights","Gym equipment: leg press, hamstring curl and multi-hip","Squats to 90°","Begin single-leg strengthening","Forward step-up progressions","Static forward and backward lunge","Single-leg stance","Static balance on BOSU, wobble board or foam","Star drill: single-leg stance with reach"],"restrictions":["No running, pivoting or lateral movement.","Do not perform forward step-downs because of increased patellofemoral load."],"dosage_and_progression":["Perform ROM and stretching once/day until normal ROM is achieved; hold stretches for 30 seconds and perform 2–3 repetitions each.","Perform cardio 3–5 times/week for 20–30 minutes and strengthening 3–5 times/week for 2–3 sets of 15–20 repetitions."],"physiotherapist_actions":["Stress proper gait, strict exercise form and minimal patellofemoral pain."]},"pl":{"goals":["Unikaj bólu rzepkowo-udowego, maksymalizuj ROM i elastyczność oraz rozwijaj siłę w zamkniętym łańcuchu i propriocepcję."],"exercises":["Kontynuacja ćwiczeń ROM z fazy 1 według potrzeby","Rozciąganie wszystkich grup mięśniowych kończyny dolnej, w tym hamstringów, czworogłowych, łydki, pośladków, przywodzicieli i pasma biodrowo-piszczelowego","Rower z progresywnym oporem","Orbitrek od 8. tygodnia","Pływanie od 6.–8. tygodnia","Progresja czterokierunkowego unoszenia wyprostowanej nogi i zginania kolana z obciążnikami na kostkę","Sprzęt siłowy: leg press, zginanie kolana i multi-hip","Przysiady do 90°","Rozpoczęcie wzmacniania jednonóż","Progresja step-up w przód","Wykrok statyczny w przód i w tył","Stanie jednonóż","Równowaga statyczna na BOSU, desce równoważnej lub piance","Star drill: stanie jednonóż z sięganiem"],"restrictions":["Nie wykonuj biegania, pivotów ani ruchów bocznych.","Nie wykonuj step-down w przód ze względu na zwiększone obciążenie stawu rzepkowo-udowego."],"dosage_and_progression":["ROM i rozciąganie wykonuj raz dziennie do uzyskania prawidłowego ROM; rozciąganie utrzymuj 30 sekund i wykonuj po 2–3 powtórzenia.","Cardio wykonuj 3–5 razy w tygodniu przez 20–30 minut, a wzmacnianie 3–5 razy w tygodniu po 2–3 serie po 15–20 powtórzeń."],"physiotherapist_actions":["Kładź nacisk na prawidłowy chód, ścisłą kontrolę techniki ćwiczeń i minimalny ból rzepkowo-udowy."]},"original":{"goals":["Avoid patellofemoral pain; Continue to maximize return of ROM and flexibility; Establish closed chain strength and proprioception"],"exercises":["Continue ROM exercises from phase 1 if necessary","Add Lower Extremity stretching (Hamstring, Quadriceps, Calf, Glutes, Adductors, ITB, etc)","Cycle with progressive resistance","Elliptical at 8 Weeks","Swimming at 6-8 Weeks","Continue Progression of 4 way SLR and Hamstring Curls with Ankle Weights","Gym Equipment (Leg Press, Ham Curl, Multi-Hip)","Squats to 90°","Begin Single Leg strengthening","Step Up Progressions (Forward Step Ups)","Static Forward/Backward Lunge","Single Leg Stance","Static Balance on Bosu/Wobble Board/Foam/Etc","Star Drill (single leg stance with reach)"],"restrictions":["No running; No pivoting or lateral movements","Forward Step Downs are not recommended due to increased patella femoral load"],"dosage_and_progression":["Perform ROM and stretching exercises once a day until normal ROM is achieved. Hold stretches for 30 seconds and perform 2-3 repetitions of each.","Cardio exercise is recommended 3-5 times a week for 20-30 minutes. Perform strengthening exercises 3-5 times a week. Do 2-3 sets of 15-20 Reps."],"physiotherapist_actions":["Continue to stress proper gait; Strict attention must be paid to form and minimal patella femoral pain with exercises."]}},"additional_notes_de":"Cardio 3–5-mal wöchentlich für 20–30 Minuten und Kräftigung 3–5-mal wöchentlich mit 2–3 Sätzen zu 15–20 Wiederholungen durchführen.","additional_notes_en":"Perform cardio 3–5 times/week for 20–30 minutes and strengthening 3–5 times/week for 2–3 sets of 15–20 repetitions.","additional_notes_pl":"Cardio wykonuj 3–5 razy w tygodniu przez 20–30 minut, a wzmacnianie 3–5 razy w tygodniu po 2–3 serie po 15–20 powtórzeń.","minimum_patient_share":null,"therapeutic_content_de":"Patellofemorale Schmerzen vermeiden, ROM und Flexibilität maximieren sowie geschlossenkettige Kraft und Propriozeption aufbauen.","therapeutic_content_en":"Avoid patellofemoral pain, maximize ROM and flexibility and develop closed-chain strength and proprioception.","therapeutic_content_pl":"Unikaj bólu rzepkowo-udowego, maksymalizuj ROM i elastyczność oraz rozwijaj siłę w zamkniętym łańcuchu i propriocepcję.","minimum_requirements_de":"Kein Laufen, Pivotieren oder seitliche Bewegungen und das Patellofemoralgelenk nicht überlasten.","minimum_requirements_en":"No running, pivoting or lateral movement and do not overload the patellofemoral joint.","minimum_requirements_pl":"Nie wykonuj biegania, pivotów ani ruchów bocznych i nie przeciążaj stawu rzepkowo-udowego.","additional_notes_original":"Cardio exercise is recommended 3-5 times a week for 20-30 minutes. Perform strengthening exercises 3-5 times a week. Do 2-3 sets of 15-20 Reps.","therapeutic_content_original":"Avoid patellofemoral pain; Continue to maximize return of ROM and flexibility; Establish closed chain strength and proprioception","minimum_requirements_original":"Continue to stress proper gait; Must avoid patella femoral stress; No pivoting or lateral movements; No running","structured_content_v2":"$undefined"},{"id":"7abfda5c-4f45-50b6-998d-f7f172e5e874","name_de":"Phase 4: 12-16 Wochen","name_en":"Phase 4: 12-16 Weeks","name_pl":"Faza 4: 12-16 tygodni","source_page":8,"module_number":7,"name_original":"Phase 4 (12-16 Weeks)","service_codes":[],"structured_content":{"de":{"goals":["Patellofemorale Schmerzen weiter vermeiden, die einbeinige Kräftigung ausbauen und ausreichenden ROM sowie Kraft für Jogging und Plyometrie erreichen."],"exercises":["Tägliche Dehnung","Ergometer, Crosstrainer und Schwimmen","Programm für gestrecktes Beinheben und Progression an Kraftgeräten","Seitliche Step-ups und Crossover-Step-ups","Dynamischer Ausfallschritt","Seitlicher Ausfallschritt","Progressive einbeinige Kräftigung: einbeinige Kniebeuge, Split Squat und einbeiniges Kreuzheben","Dynamisches Gleichgewicht auf BOSU, Schaumstoff oder ähnlicher Unterlage","Plyometrische und Sprungprogression von Seite 10"],"restrictions":["Nur geradliniges Laufen; kein Pivotieren, keine Richtungswechsel und kein Sport.","Keine Step-downs nach vorn wegen der erhöhten patellofemoralen Belastung."],"dosage_and_progression":["Täglich dehnen, jeweils 30 Sekunden halten und 2–3 Wiederholungen durchführen; Cardio 3–5-mal wöchentlich für 20–40 Minuten.","Kräftigung und Propriozeption 3-mal wöchentlich mit 2–3 Sätzen zu 15–20 Wiederholungen durchführen; Plyometrie und Sprünge 2-mal wöchentlich."],"physiotherapist_actions":["Physiotherapeut:in oder Ärzt:in legt die ab Woche 12 beginnende Laufprogression fest."]},"en":{"goals":["Continue avoiding patellofemoral pain, progress single-leg strengthening and achieve adequate ROM and strength to begin jogging and plyometric training."],"exercises":["Daily stretching","Cycle, elliptical and swimming","Straight leg raise program and gym equipment progression","Lateral step-ups and crossover step-ups","Dynamic lunge","Lateral lunge","Progressive single-leg strengthening: single-leg squat, split squat and single-leg deadlift","Dynamic balance on BOSU, foam or similar surface","Plyometric and jumping progression from page 10"],"restrictions":["Straight-ahead running only; no pivoting, cutting or sports.","Do not perform forward step-downs because of increased patellofemoral load."],"dosage_and_progression":["Stretch daily, holding for 30 seconds and performing 2–3 repetitions each; perform cardio 3–5 times/week for 20–40 minutes.","Perform strength and proprioception 3 times/week for 2–3 sets of 15–20 repetitions; perform plyometric and jumping exercise 2 times/week."],"physiotherapist_actions":["The physical therapist or doctor outlines the return-to-running progression beginning at 12 weeks."]},"pl":{"goals":["Kontynuuj unikanie bólu rzepkowo-udowego, rozwijaj wzmacnianie jednonóż i uzyskaj ROM oraz siłę odpowiednie do rozpoczęcia joggingu i pliometrii."],"exercises":["Codzienne rozciąganie","Rower, orbitrek i pływanie","Program unoszenia wyprostowanej nogi i progresja sprzętu siłowego","Step-up w bok i crossover step-up","Wykrok dynamiczny","Wykrok boczny","Progresywne wzmacnianie jednonóż: przysiad jednonóż, split squat i martwy ciąg jednonóż","Równowaga dynamiczna na BOSU, piance lub podobnym podłożu","Progresja pliometryczna i skokowa ze strony 10"],"restrictions":["Tylko bieg w linii prostej; bez pivotów, zmian kierunku i sportu.","Nie wykonuj step-down w przód ze względu na zwiększone obciążenie stawu rzepkowo-udowego."],"dosage_and_progression":["Rozciąganie wykonuj codziennie, utrzymując 30 sekund i wykonując po 2–3 powtórzenia; cardio 3–5 razy w tygodniu przez 20–40 minut.","Wzmacnianie i propriocepcję wykonuj 3 razy w tygodniu po 2–3 serie po 15–20 powtórzeń; pliometrię i skoki 2 razy w tygodniu."],"physiotherapist_actions":["Fizjoterapeuta lub lekarz wyznacza progresję powrotu do biegania rozpoczynaną od 12. tygodnia."]},"original":{"goals":["Continue to avoid patella femoral pain; Progress with single leg strengthening; Achieve adequate ROM and strength to begin jogging and plyometric training"],"exercises":["Continue daily stretching","Continue cycle, elliptical, swimming","Continue SLR Program and Gym Equipment Progression","Continue Step-Up Progressions (lateral step-ups, cross over step-ups)","Dynamic Lunge","Lateral Lunge","Progressive Single Leg Strengthening (single leg squat, split squat, single leg dead lift)","Dynamic Balance (Bosu/Foam/Etc)","Begin Plyometric/Jumping Progression (see page 10)"],"restrictions":["Straight ahead running only; No pivoting or cutting; No sports","Forward Step Downs are not recommended due to increased patella femoral load"],"dosage_and_progression":["Perform stretching program daily. Hold stretches for 30 seconds and perform 2-3 repetitions of each. Cardio program is recommended 3-5 times a week for 20-40 minutes.","Perform strengthening/proprioception exercises 3 times a week. Do 2-3 sets of 15-20 Reps. Perform plyometric/jumping exercises 2 times a week."],"physiotherapist_actions":["Begin return to running progression at 12 weeks post op (outlined by P.T. or Doctor)"]}},"additional_notes_de":"Täglich dehnen, Cardio 3–5-mal wöchentlich für 20–40 Minuten und Kräftigung/Propriozeption 3-mal wöchentlich mit 2–3 Sätzen zu 15–20 Wiederholungen durchführen.","additional_notes_en":"Stretch daily, perform cardio 3–5 times/week for 20–40 minutes and strength/proprioception 3 times/week for 2–3 sets of 15–20 repetitions.","additional_notes_pl":"Rozciąganie wykonuj codziennie, cardio 3–5 razy w tygodniu przez 20–40 minut, a wzmacnianie i propriocepcję 3 razy w tygodniu po 2–3 serie po 15–20 powtórzeń.","minimum_patient_share":null,"therapeutic_content_de":"Progressive einbeinige Kräftigung und Propriozeption fortsetzen sowie eine geradlinige Lauf- und plyometrische Progression beginnen.","therapeutic_content_en":"Continue progressive single-leg strengthening and proprioception and begin straight-ahead running and plyometric progressions.","therapeutic_content_pl":"Kontynuuj progresywne wzmacnianie jednonóż i trening propriocepcji, rozpocznij progresję biegania w linii prostej oraz progresję pliometryczną.","minimum_requirements_de":"Nur geradliniges Laufen; kein Pivotieren, keine Richtungswechsel und kein Sport.","minimum_requirements_en":"Straight-ahead running only; no pivoting, cutting or sports.","minimum_requirements_pl":"Tylko bieg w linii prostej; bez pivotów, zmian kierunku i sportu.","additional_notes_original":"Perform stretching program daily. Hold stretches for 30 seconds and perform 2-3 repetitions of each. Cardio program is recommended 3-5 times a week for 20-40 minutes.","therapeutic_content_original":"Continue to avoid patella femoral pain; Progress with single leg strengthening; Achieve adequate ROM and strength to begin jogging and plyometric training","minimum_requirements_original":"Straight ahead running only; No pivoting or cutting; No sports","structured_content_v2":"$undefined"},{"id":"90145717-fd00-5ad4-8b8f-793d22b38f0c","name_de":"Phase 5: 16-24 Wochen und darüber hinaus","name_en":"Phase 5: 16-24 Weeks and Beyond","name_pl":"Faza 5: 16-24 tygodni i później","source_page":9,"module_number":8,"name_original":"Phase 5 (16-24 Weeks)","service_codes":[],"structured_content":{"de":{"goals":["Dynamische Kräftigung, Propriozeption, Plyometrie und Agilität fortsetzen und ausreichende Kraft für die Progression zur Sportrückkehr nach operativer Freigabe erreichen."],"exercises":["Tägliche Dehnung der unteren Extremität","Cardioprogramm fortsetzen und Intensität sowie Dauer steigern","Kräftigungsprogramm aus Phase 4 mit höherer Last und geringerem Volumen fortsetzen","Propriozeption durch schwierigere Übungen steigern","Plyometrisches und Sprungprogramm steigern","Schnelligkeits- und Agilitätsprogramm von Seite 11 beginnen"],"restrictions":["Seitliche Bewegungen nur begrenzt und kontrolliert durchführen.","Die Rückkehr zum Sport erst nach Freigabe durch den Operateur ab 6 Monaten oder später schrittweise einleiten."],"dosage_and_progression":["Täglich dehnen, jeweils 30 Sekunden halten und 2–3 Wiederholungen durchführen; Cardio 3–5-mal wöchentlich für 20–40 Minuten.","Kräftigung und Propriozeption 3-mal wöchentlich mit 2–3 Sätzen zu 15–20 Wiederholungen durchführen; Plyometrie, Sprünge und Agilität 2-mal wöchentlich."],"physiotherapist_actions":["Gemeinsam mit Operateur:in oder Physiotherapeut:in eine individuelle Progression zur Sportrückkehr entwickeln und sportartspezifische Übungen auswählen."]},"en":{"goals":["Continue dynamic strengthening, proprioception, plyometrics and agility and achieve adequate strength to begin return-to-sport progressions after surgeon clearance."],"exercises":["Daily lower-extremity stretching","Continue cardio and progress intensity and duration","Continue phase 4 strengthening with increased load and decreased volume","Advance proprioceptive training by increasing drill difficulty","Progress the plyometric and jumping program","Begin the speed and agility program from page 11"],"restrictions":["Keep lateral movement limited and controlled.","Return to sport gradually only after surgeon clearance at 6 months or later."],"dosage_and_progression":["Stretch daily, holding for 30 seconds and performing 2–3 repetitions each; perform cardio 3–5 times/week for 20–40 minutes.","Perform strength and proprioception 3 times/week for 2–3 sets of 15–20 repetitions; perform plyometric, jumping and agility exercise 2 times/week."],"physiotherapist_actions":["Work with the surgeon or physical therapist to develop an individualized return-to-sport progression and select sport-specific drills."]},"pl":{"goals":["Kontynuuj dynamiczne wzmacnianie, propriocepcję, pliometrię i zwinność oraz uzyskaj siłę potrzebną do rozpoczęcia progresji powrotu do sportu po zgodzie chirurga."],"exercises":["Codzienne rozciąganie kończyny dolnej","Kontynuacja programu cardio z progresją intensywności i czasu","Kontynuacja wzmacniania z fazy 4 ze zwiększaniem obciążenia i zmniejszaniem objętości","Progresja propriocepcji przez zwiększanie trudności ćwiczeń","Progresja programu pliometrycznego i skokowego","Rozpoczęcie programu szybkości i zwinności ze strony 11"],"restrictions":["Ruchy boczne wykonuj w ograniczonym i kontrolowanym zakresie.","Powrót do sportu wprowadzaj stopniowo wyłącznie po zgodzie chirurga, po 6 miesiącach lub później."],"dosage_and_progression":["Rozciąganie wykonuj codziennie, utrzymując 30 sekund i wykonując po 2–3 powtórzenia; cardio 3–5 razy w tygodniu przez 20–40 minut.","Wzmacnianie i propriocepcję wykonuj 3 razy w tygodniu po 2–3 serie po 15–20 powtórzeń; pliometrię, skoki i zwinność 2 razy w tygodniu."],"physiotherapist_actions":["Wspólnie z chirurgiem lub fizjoterapeutą opracuj indywidualną progresję powrotu do sportu i dobierz ćwiczenia specyficzne dla dyscypliny."]},"original":{"goals":["Continue progressive/dynamic strengthening, proprioceptive, plyometric and agility training; Achieve adequate strength to begin return to sport progressions (pending surgeon’s clearance)"],"exercises":["Continue daily lower extremity stretching","Continue cardio program and progress intensity and duration","Continue strengthening program from phase 4 (increase load and decrease volume)","Continue and advance proprioceptive training (increase difficulty of drills)","Progress plyometric/jumping program","Begin speed/agility program (see page 11)"],"restrictions":["Limited and controlled lateral movements","Gradual return to sport pending surgeon’s clearance (6 months or greater)"],"dosage_and_progression":["Perform stretching program daily. Hold stretches for 30 seconds and perform 2-3 repetitions of each. Cardio program is recommended 3-5 times a week for 20-40 minutes.","Perform strengthening/proprioception exercises 3 times a week. Do 2-3 sets of 15-20 Reps. Perform plyometric/jumping/agility exercises 2 times a week."],"physiotherapist_actions":["Work with surgeon or Physical Therapist to develop specific return to sport progression"]}},"additional_notes_de":"Täglich dehnen, Cardio 3–5-mal wöchentlich für 20–40 Minuten, Kräftigung und Propriozeption 3-mal wöchentlich mit 2–3 Sätzen zu 15–20 Wiederholungen sowie Plyometrie und Agilität 2-mal wöchentlich durchführen.","additional_notes_en":"Stretch daily, perform cardio 3–5 times/week for 20–40 minutes, strength and proprioception 3 times/week for 2–3 sets of 15–20 repetitions and plyometric/agility work 2 times/week.","additional_notes_pl":"Rozciąganie wykonuj codziennie, cardio 3–5 razy w tygodniu przez 20–40 minut, wzmacnianie i propriocepcję 3 razy w tygodniu po 2–3 serie po 15–20 powtórzeń, a pliometrię i zwinność 2 razy w tygodniu.","minimum_patient_share":null,"therapeutic_content_de":"Kraft, Cardio, Propriozeption, Plyometrie und Agilität fortsetzen und steigern sowie die schrittweise individuelle Rückkehr zum Sport vorbereiten.","therapeutic_content_en":"Continue and advance strength, cardio, proprioception, plyometrics and agility and prepare a gradual individualized return to sport.","therapeutic_content_pl":"Kontynuuj i rozwijaj siłę, cardio, propriocepcję, pliometrię i zwinność oraz przygotowuj stopniowy, indywidualny powrót do sportu.","minimum_requirements_de":"Seitliche Bewegungen bleiben begrenzt und kontrolliert und die schrittweise Rückkehr zum Sport erfordert nach mindestens 6 Monaten die Freigabe durch den Operateur.","minimum_requirements_en":"Lateral movement remains limited and controlled and gradual return to sport requires surgeon clearance at 6 months or later.","minimum_requirements_pl":"Ruchy boczne pozostają ograniczone i kontrolowane, a stopniowy powrót do sportu wymaga zgody chirurga po co najmniej 6 miesiącach.","additional_notes_original":"Perform stretching program daily. Hold stretches for 30 seconds and perform 2-3 repetitions of each. Cardio program is recommended 3-5 times a week for 20-40 minutes.","therapeutic_content_original":"Continue progressive/dynamic strengthening, proprioceptive, plyometric and agility training; Achieve adequate strength to begin return to sport progressions (pending surgeon’s clearance)","minimum_requirements_original":"Limited and controlled lateral movements; Gradual return to sport pending surgeon’s clearance (6 months or greater)","structured_content_v2":"$undefined"},{"id":"757bd994-e84b-58ac-a19a-01c63b86b7e1","name_de":"Sprung- und plyometrische Progression","name_en":"Jumping and plyometric progression","name_pl":"Progresja skokowa i pliometryczna","source_page":10,"module_number":9,"name_original":"Jumping/Plyometric Progression","service_codes":[],"structured_content":{"de":{"exercises":["Beidbeinige Sprünge vorwärts und rückwärts über eine Linie","Box Jump auf maximal 6–8 Zoll Höhe","Beidbeiniger Weitsprung","Beidbeiniger Hochsprung","Beidbeiniger Sprung mit 90°- oder 180°-Drehung","Beidbeiniger Seitwärtssprung oder seitlicher Box Jump","Depth Jump aus maximal 6–8 Zoll Höhe","Wiederholte beidbeinige Sprünge auf Distanz, Höhe, seitlich und mit Drehung","Weitsprung kombiniert mit Hochsprung","Box Jump kombiniert mit Depth Jump","Depth Jump kombiniert mit Weit- oder Hochsprung","Heiden Hop","Bounding","Einbeinige Sprünge auf Distanz, Höhe, seitlich und mit 90°- oder 180°-Drehung","Einbeiniger Box Jump auf maximal 6–8 Zoll Höhe","Einbeiniger Depth Jump aus maximal 6–8 Zoll Höhe","Wiederholte einbeinige Sprünge auf Distanz, Höhe, seitlich und mit Drehung","Einbeiniger Weitsprung kombiniert mit Hochsprung","Box Jump kombiniert mit einbeinigem Depth Jump","Einbeiniger Depth Jump kombiniert mit Weit- oder Hochsprung"],"restrictions":["Box- und Depth-Jump-Höhe maximal 6–8 Zoll."],"dosage_and_progression":["Woche 12–16: einfache beidbeinige Sprünge, maximal 60 Fußkontakte pro Training.","Woche 16–20: komplexe beidbeinige Sprünge, maximal 90 Fußkontakte pro Training; Kombinationen können in Woche 18–20 beginnen.","Woche 20–24: einbeinige Sprünge, maximal 100–120 Fußkontakte pro Training; bei Kombinationen Sprünge aneinanderreihen und schnell von Sprung zu Sprung wechseln."],"physiotherapist_actions":["Die Qualität jeder Landung in Frontal- und Sagittalebene kontrollieren; eine weiche Landung mit guter exzentrischer Kontrolle verlangen."]},"en":{"exercises":["Double-leg hops forward and backward over a line","Box jump to a maximum height of 6–8 inches","Double-leg jump for distance","Double-leg jump for height","Double-leg jump with a 90° or 180° turn","Double-leg lateral jump or lateral box jump","Depth jump from a maximum height of 6–8 inches","Repetitive double-leg jumps for distance, height, lateral movement and turns","Jump for distance into jump for height","Box jump to depth jump","Depth jump to jump for distance or height","Heiden hop","Bounding","Single-leg jumps for distance, height, lateral movement and 90° or 180° turn","Single-leg box jump to a maximum height of 6–8 inches","Single-leg depth jump from a maximum height of 6–8 inches","Repetitive single-leg jumps for distance, height, lateral movement and turns","Single-leg jump for distance into jump for height","Box jump to single-leg depth jump","Single-leg depth jump to jump for distance or height"],"restrictions":["Limit box and depth jump height to 6–8 inches."],"dosage_and_progression":["Weeks 12–16: simple double-limb jumps, limit 60 foot contacts/workout.","Weeks 16–20: complex double-limb jumps, limit 90 foot contacts/workout; combination jumps may begin at weeks 18–20.","Weeks 20–24: single-limb jumps, limit 100–120 foot contacts/workout; string combination jumps together and move quickly from jump to jump."],"physiotherapist_actions":["Monitor every landing for good form in the frontal and sagittal planes and require a soft landing with good eccentric control."]},"pl":{"exercises":["Skoki obunóż w przód i w tył nad linią","Skok na skrzynię o wysokości maksymalnie 6–8 cali","Skok obunóż na odległość","Skok obunóż na wysokość","Skok obunóż z obrotem 90° lub 180°","Skok obunóż w bok lub boczny skok na skrzynię","Depth jump z wysokości maksymalnie 6–8 cali","Powtarzane skoki obunóż na odległość, wysokość, w bok i z obrotem","Skok na odległość połączony ze skokiem na wysokość","Skok na skrzynię połączony z depth jump","Depth jump połączony ze skokiem na odległość lub wysokość","Heiden hop","Bounding","Skoki jednonóż na odległość, wysokość, w bok i z obrotem 90° lub 180°","Skok jednonóż na skrzynię o wysokości maksymalnie 6–8 cali","Depth jump jednonóż z wysokości maksymalnie 6–8 cali","Powtarzane skoki jednonóż na odległość, wysokość, w bok i z obrotem","Skok jednonóż na odległość połączony ze skokiem na wysokość","Skok na skrzynię połączony z depth jump jednonóż","Depth jump jednonóż połączony ze skokiem na odległość lub wysokość"],"restrictions":["Wysokość skrzyni oraz depth jump nie może przekraczać 6–8 cali."],"dosage_and_progression":["Tygodnie 12–16: proste skoki obunóż, maksymalnie 60 kontaktów stóp w treningu.","Tygodnie 16–20: złożone skoki obunóż, maksymalnie 90 kontaktów stóp w treningu; kombinacje można rozpocząć w tygodniach 18–20.","Tygodnie 20–24: skoki jednonóż, maksymalnie 100–120 kontaktów stóp w treningu; w kombinacjach łącz skoki i szybko przechodź od skoku do skoku."],"physiotherapist_actions":["Kontroluj jakość każdego lądowania w płaszczyźnie czołowej i strzałkowej; wymagaj miękkiego lądowania z dobrą kontrolą ekscentryczną."]},"original":{"exercises":["Double Leg Hops (forward and backward over line)","Box Jump (6-8 inches max)","Double Leg Jump (for distance)","Double Leg Jump (for height)","Double Leg Jump (with 90° or 180° turn)","Double Leg Lateral Jump/Lateral Box Jump (side to side)","Depth Jump (6-8 inches max)","Repetitive Double Leg Jumps (distance, height, lateral, turns)","Jump for Distance into Jump for Height","Box Jump to Depth Jump","Depth Jump to Jump for Distance/Height","Heiden Hop","Bounding","Single Leg Jumps (distance, height, lateral, 90°/180° turn)","Single Leg Box Jumps (6-8 inches max)","Single Leg Depth Jumps (6-8 inches max)","Repetitive Single Leg Jumps (distance, height, lateral, 90°/180° turn)","Jump for Distance into Jump for Height","Box Jump to Depth Jump","Depth Jump to Jump for Distance/Height"],"restrictions":["Box Jump (6-8 inches max); Depth Jump (6-8 inches max)"],"dosage_and_progression":["Simple Double Limb (12-16 Weeks Post Op) Limit 60 foot contacts per workout.","Complex Double Limb (16-20 Weeks Post Op) Limit 90 foot contacts per workout. Combination Jumps begin at 18-20 weeks post op.","Single Limb (20-24 Weeks Post Op) Limit 100-120 foot contacts per workout. String jumps together. Focus on quickly moving from jump to jump."],"physiotherapist_actions":["Focus on sticking each landing with good form in frontal and sagital planes. Stress a soft landing with good eccentric control."]}},"additional_notes_de":"Jede Landung in guter Form in Frontal- und Sagittalebene stabilisieren und weich mit guter exzentrischer Kontrolle landen.","additional_notes_en":"Stick each landing with good form in the frontal and sagittal planes and land softly with good eccentric control.","additional_notes_pl":"Każde lądowanie zatrzymaj w prawidłowej pozycji w płaszczyźnie czołowej i strzałkowej, ląduj miękko z dobrą kontrolą ekscentryczną.","minimum_patient_share":null,"therapeutic_content_de":"Die Progression führt von einfachen beidbeinigen Sprüngen über komplexe und kombinierte beidbeinige Sprünge zu einbeinigen Sprüngen und Kombinationen.","therapeutic_content_en":"Progress from simple double-limb jumps through complex and combination double-limb jumps to single-limb jumps and combinations.","therapeutic_content_pl":"Progresja przechodzi od prostych skoków obunóż przez złożone i łączone skoki obunóż do skoków jednonóż i kombinacji jednonóż.","minimum_requirements_de":"Auf 60 Fußkontakte pro Training in Woche 12–16, 90 Kontakte in Woche 16–20 und 100–120 einbeinige Kontakte pro Training in Woche 20–24 begrenzen.","minimum_requirements_en":"Limit to 60 foot contacts/workout at weeks 12–16, 90 contacts at weeks 16–20 and 100–120 single-limb contacts/workout at weeks 20–24.","minimum_requirements_pl":"Limituj do 60 kontaktów stóp w treningu w tygodniach 12–16, 90 kontaktów w tygodniach 16–20 oraz 100–120 kontaktów w treningu jednonóż w tygodniach 20–24.","additional_notes_original":"Focus on sticking each landing with good form in frontal and sagital planes. Stress a soft landing with good eccentric control.","therapeutic_content_original":"Simple Double Limb (12-16 Weeks Post Op); Complex Double Limb (16-20 Weeks Post Op); Combination Jumps (begin at 18-20 weeks post op); Single Limb (20-24 Weeks Post Op); Combination Jumps (Single Leg)","minimum_requirements_original":"Limit 60 foot contacts per workout; Limit 90 foot contacts per workout; Limit 100-120 foot contacts per workout","structured_content_v2":"$undefined"},{"id":"c181d7ba-7fe4-5629-ae89-35d14386c8eb","name_de":"Schnelligkeits- und Agilitätsprogression","name_en":"Speed and agility progression","name_pl":"Progresja szybkości i zwinności","source_page":11,"module_number":10,"name_original":"Speed/Agility Progression","service_codes":[],"structured_content":{"de":{"exercises":["Vorwärts- und Rückwärtssprint","Backpedal","T Drill","Vorwärts-/Backpedal-Shuttle über 5/10/20 Yards","Box Drill mit Shuffle","10-Yard-Shuttle-Run mit schnellem Richtungswechsel","Z Drill","Box Drill mit Cuts","Sportartspezifische Übungen mit Ball, Schläger oder anderem Gerät"],"restrictions":["Sportartspezifische Trainingsübungen unter Aufsicht durchführen."],"dosage_and_progression":["Woche 1: 50–100 Yards mit ½ Geschwindigkeit sprinten, 10 Wiederholungen.","Woche 2: 50–100 Yards mit ½ Geschwindigkeit sprinten, 5 Wiederholungen; anschließend mit ¾ Geschwindigkeit, 10 Wiederholungen.","Woche 3: 100 Yards mit ½ Geschwindigkeit 2-mal, mit ¾ Geschwindigkeit 5-mal, 50–100 Yards mit voller Geschwindigkeit 5-mal und Backpedal 50 Yards mit ½ Geschwindigkeit 5-mal.","Woche 4: 100 Yards mit ½ Geschwindigkeit 1-mal, mit ¾ Geschwindigkeit 2-mal, 50 Yards mit voller Geschwindigkeit 5-mal, 100 Yards mit voller Geschwindigkeit 5-mal und Backpedal 50 Yards mit ¾ Geschwindigkeit 5-mal.","Vor Woche 5–8 jedes Training mit Sprint und Backpedal über 50 Yards beginnen: 2-mal mit ½ Geschwindigkeit und 5-mal mit voller Geschwindigkeit.","Woche 5: T Drill 3-mal mit ½ Geschwindigkeit und Vorwärts-/Backpedal-Shuttle 5/10/20 Yards 3-mal mit ½ Geschwindigkeit.","Woche 6: T Drill 3-mal mit voller Geschwindigkeit, Vorwärts-/Backpedal-Shuttle 5/10/20 Yards 3-mal mit voller Geschwindigkeit und Box Drill mit Shuffle 3-mal mit ½ Geschwindigkeit.","Woche 7: Box Drill mit Shuffle 3-mal mit voller Geschwindigkeit, 10-Yard-Shuttle-Run 3-mal mit voller Geschwindigkeit und Z Drill 6-mal mit ¾ Geschwindigkeit.","Woche 8: Box Drill mit Cuts 3-mal mit voller Geschwindigkeit, 10-Yard-Shuttle-Run 3-mal mit voller Geschwindigkeit und Z Drill 6-mal mit voller Geschwindigkeit."],"physiotherapist_actions":["Mit Patient:innen ein geeignetes Aufwärmen und Cool-down vor und nach jeder Agilitätseinheit festlegen.","Ab Woche 24 sportartspezifische Übungen entwickeln und typische Trainingsübungen der Sportart beaufsichtigen."]},"en":{"exercises":["Forward and backward sprinting","Backpedal","T drill","Forward/backpedal shuttle over 5/10/20 yards","Box drill with shuffling","10-yard shuttle run with quick direction change","Z drill","Box drill with cuts","Sport-specific drills with a ball, stick or other equipment"],"restrictions":["Perform drills used in typical sports practice under supervision."],"dosage_and_progression":["Week 1: sprint 50–100 yards at ½ speed for 10 repetitions.","Week 2: sprint 50–100 yards at ½ speed for 5 repetitions, then at ¾ speed for 10 repetitions.","Week 3: sprint 100 yards at ½ speed for 2 repetitions, at ¾ speed for 5 repetitions, sprint 50–100 yards at full speed for 5 repetitions and backpedal 50 yards at ½ speed for 5 repetitions.","Week 4: sprint 100 yards at ½ speed once, at ¾ speed twice, sprint 50 yards at full speed for 5 repetitions, sprint 100 yards at full speed for 5 repetitions and backpedal 50 yards at ¾ speed for 5 repetitions.","Before weeks 5–8 begin each workout with sprinting and backpedaling 50 yards: 2 repetitions at ½ speed and 5 repetitions at full speed.","Week 5: T drill for 3 repetitions at ½ speed and forward/backpedal shuttle 5/10/20 yards for 3 repetitions at ½ speed.","Week 6: T drill for 3 repetitions at full speed, forward/backpedal shuttle 5/10/20 yards for 3 repetitions at full speed and box drill with shuffling for 3 repetitions at ½ speed.","Week 7: box drill with shuffling for 3 repetitions at full speed, 10-yard shuttle run for 3 repetitions at full speed and Z drill for 6 repetitions at ¾ speed.","Week 8: box drill with cuts for 3 repetitions at full speed, 10-yard shuttle run for 3 repetitions at full speed and Z drill for 6 repetitions at full speed."],"physiotherapist_actions":["Establish an appropriate warm-up and cool-down with the patient before and after every agility workout.","From week 24 onward develop sport-specific drills and supervise drills used in typical sports practice."]},"pl":{"exercises":["Sprint w przód i w tył","Backpedal","T drill","Shuttle przód/backpedal na dystansach 5/10/20 jardów","Box drill z krokiem odstawno-dostawnym","Shuttle run na 10 jardów z szybką zmianą kierunku","Z drill","Box drill ze zmianami kierunku","Ćwiczenia specyficzne dla sportu z piłką, kijem lub innym sprzętem"],"restrictions":["Ćwiczenia typowe dla treningu sportowego wykonuj pod nadzorem."],"dosage_and_progression":["Tydzień 1: sprint 50–100 jardów z ½ prędkości, 10 powtórzeń.","Tydzień 2: sprint 50–100 jardów z ½ prędkości, 5 powtórzeń; następnie z ¾ prędkości, 10 powtórzeń.","Tydzień 3: sprint 100 jardów z ½ prędkości 2 razy, z ¾ prędkości 5 razy, sprint 50–100 jardów z pełną prędkością 5 razy i backpedal 50 jardów z ½ prędkości 5 razy.","Tydzień 4: sprint 100 jardów z ½ prędkości 1 raz, z ¾ prędkości 2 razy, sprint 50 jardów z pełną prędkością 5 razy, sprint 100 jardów z pełną prędkością 5 razy i backpedal 50 jardów z ¾ prędkości 5 razy.","Przed tygodniami 5–8 każdy trening rozpocznij sprintem i backpedalem na 50 jardów: 2 razy z ½ prędkości i 5 razy z pełną prędkością.","Tydzień 5: T drill 3 razy z ½ prędkości oraz shuttle przód/backpedal 5/10/20 jardów 3 razy z ½ prędkości.","Tydzień 6: T drill 3 razy z pełną prędkością, shuttle przód/backpedal 5/10/20 jardów 3 razy z pełną prędkością i box drill z krokiem odstawno-dostawnym 3 razy z ½ prędkości.","Tydzień 7: box drill z krokiem odstawno-dostawnym 3 razy z pełną prędkością, shuttle run 10 jardów 3 razy z pełną prędkością i Z drill 6 razy z ¾ prędkości.","Tydzień 8: box drill ze zmianami kierunku 3 razy z pełną prędkością, shuttle run 10 jardów 3 razy z pełną prędkością i Z drill 6 razy z pełną prędkością."],"physiotherapist_actions":["Ustal z pacjentem prawidłową rozgrzewkę i schłodzenie przed i po każdym treningu zwinności.","Od 24. tygodnia opracuj ćwiczenia specyficzne dla sportu i nadzoruj ćwiczenia typowe dla treningu tej dyscypliny."]},"original":{"exercises":["Forward/Backward Sprinting","Backpedal","T drill","Forward/backpedal shuttle 5/10/20 yard","Box drill with shuffling","10 yard shuttle run (quick direction change)","Z drill","Box drill with cuts","Sport specific drills with use of ball, stick, etc."],"restrictions":["Perform drills seen in typical sports practice with supervision."],"dosage_and_progression":["Week 1: Sprint 50-100 yards at ½ speed 10 reps.","Week 2: Sprint 50-100 yards at ½ speed 5 reps. Sprint 50-100 yards at ¾ speed 10 reps.","Week 3: Sprint 100 yards at ½ speed 2 reps. Sprint 100 yards at ¾ speed 5 reps. Sprint 50-100 yards at full speed 5 reps. Backpedal 50 yards at ½ speed 5 reps.","Week 4: Sprint 100 yards at ½ speed 1 rep. Sprint 100 yards at ¾ speed 2 reps. Sprint 50 yards at full speed 5 reps and 100 yards at full speed 5 reps. Backpedal 50 yards at ¾ speed 5 reps.","Begin each workout with sprinting and backpedaling 50 yards (2 reps at ½ speed, 5 reps at full speed).","Week 5: T drill 3 reps at ½ speed, forward/backpedal shuttle 5/10/20 yard 3 reps at ½ speed.","Week 6: T drill 3 reps full speed, forward/backpedal shuttle 5/10/20 yards 3 reps full speed, box drill with shuffling 3 reps at ½ speed.","Week 7: Box drill with shuffling 3 reps at full speed, 10 yard shuttle run (quick direction change) 3 reps at full speed, Z drill 6 reps at ¾ speed.","Week 8: Box drill with cuts 3 reps at full speed, 10 yard shuttle run (quick direction change) 3 reps at full speed, Z drill 6 reps at full speed."],"physiotherapist_actions":["Work with P.T. to establish proper warm-up and cool down before and after each workout agility session.","Work with P.T. to develop sport specific drills. Perform drills from previous weeks with use of ball, stick, etc. Perform drills seen in typical sports practice with supervision."]}},"additional_notes_de":"Ab Woche 24 sportartspezifische Übungen unter Aufsicht durchführen.","additional_notes_en":"From week 24 onward perform sport-specific drills under supervision.","additional_notes_pl":"Od 24. tygodnia ćwiczenia specyficzne dla sportu wykonuj pod nadzorem.","minimum_patient_share":null,"therapeutic_content_de":"Das Programm führt vom Vorwärts-/Rückwärtssprint in Woche 16–20 über grundlegende Richtungswechsel in Woche 20–24 zu fortgeschrittenen Übungen ab Woche 24.","therapeutic_content_en":"Progress from forward/backward sprinting at weeks 16–20 through basic change of direction at weeks 20–24 to advanced drills from week 24 onward.","therapeutic_content_pl":"Program prowadzi od sprintu w przód i w tył w tygodniach 16–20 przez podstawowe zmiany kierunku w tygodniach 20–24 do ćwiczeń zaawansowanych od 24. tygodnia.","minimum_requirements_de":"Jede Agilitätseinheit mit einem physiotherapeutisch festgelegten Aufwärmen beginnen und Cool-down beenden.","minimum_requirements_en":"Begin and end every agility workout with a warm-up and cool-down established with the physical therapist.","minimum_requirements_pl":"Każdy trening zwinności rozpoczynaj rozgrzewką i kończ schłodzeniem ustalonym z fizjoterapeutą.","additional_notes_original":"Work with P.T. to develop sport specific drills. Perform drills seen in typical sports practice with supervision.","therapeutic_content_original":"Forward/Backward Sprinting (16-20 Weeks); Basic Change of Direction (20-24 Weeks); Advanced Drills (24 Weeks and Beyond)","minimum_requirements_original":"Work with P.T. to establish proper warm-up and cool down before and after each workout agility session.","structured_content_v2":"$undefined"},{"id":"1291b24c-22e3-5162-adba-85c39142e9c8","name_de":"Eindeutige Tabellenkriterien für Phase 1–3","name_en":"Unique table criteria for phases 1–3","name_pl":"Unikalne kryteria tabeli dla faz 1–3","source_page":12,"module_number":11,"name_original":"ACL Reconstruction Protocol Summary — Phases 1-3","service_codes":[],"structured_content":{"de":{"exercises":[],"dosage_and_progression":["Phase 1: 120° Flexion anstreben; bei Meniskusrekonstruktion individuelle ROM-Vorgaben befolgen.","Phase 2: bis Woche 6 volle Flexion anstreben; bei Meniskusrekonstruktion individuelle ROM-Vorgaben befolgen.","Nach Hamstring-Transplantat die Hamstring-Kräftigung in Woche 6 beginnen."]},"en":{"exercises":[],"dosage_and_progression":["Phase 1: target 120° flexion; follow specific ROM instructions after meniscal repair.","Phase 2: target full flexion by week 6; follow specific ROM instructions after meniscal repair.","After hamstring graft begin hamstring strengthening at week 6."]},"pl":{"exercises":[],"dosage_and_progression":["Faza 1: dąż do 120° zgięcia; przy naprawie łąkotki stosuj indywidualne zalecenia ROM.","Faza 2: dąż do pełnego zgięcia do 6. tygodnia; przy naprawie łąkotki stosuj indywidualne zalecenia ROM.","Po grafcie z hamstringów rozpocznij wzmacnianie hamstringów w 6. tygodniu."]},"original":{"exercises":[],"dosage_and_progression":["Phase 1: Goal to Achieve 120° of Flexion; May Have Specific ROM Instructions if Meniscal Repair","Phase 2: Goal to Achieve Full Flexion by 6 Weeks; May Have Specific ROM Instructions if Meniscal Repair","Hamstring Strengthening Begins at Week 6 for Hamstring Graft Patients"]}},"additional_notes_de":"Nach Hamstring-Transplantat beginnt die Hamstring-Kräftigung in Woche 6.","additional_notes_en":"After hamstring graft, hamstring strengthening begins at week 6.","additional_notes_pl":"Po grafcie z hamstringów wzmacnianie hamstringów rozpoczyna się w 6. tygodniu.","minimum_patient_share":null,"therapeutic_content_de":"Die Übersichtstabelle ergänzt Phase 1–3 um ROM-Ziele und die Bedingung für den Beginn der Hamstring-Kräftigung nach Transplantatentnahme.","therapeutic_content_en":"The summary table adds ROM goals and the condition for beginning hamstring strengthening after graft harvest to phases 1–3.","therapeutic_content_pl":"Tabela podsumowująca uzupełnia fazy 1–3 o cele ROM i warunek rozpoczęcia wzmacniania hamstringów po pobraniu graftu.","minimum_requirements_de":"In Phase 1 eine Flexion von 120° und bis Woche 6 volle Flexion anstreben; bei Meniskusrekonstruktion individuelle ROM-Vorgaben befolgen.","minimum_requirements_en":"Target 120° flexion in phase 1 and full flexion by week 6; follow specific ROM instructions after meniscal repair.","minimum_requirements_pl":"Dąż do 120° zgięcia w fazie 1 i pełnego zgięcia do 6. tygodnia; przy naprawie łąkotki stosuj indywidualne zalecenia ROM.","additional_notes_original":"Hamstring Strengthening Begins at Week 6 for Hamstring Graft Patients","therapeutic_content_original":"Goal to Achieve 120° of Flexion; Goal to Achieve Full Flexion by 6 Weeks","minimum_requirements_original

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