What is the Recovery Loop?
The Recovery Loop is an open methodology for post-surgical rehabilitation. Four steps, continuous cycle:
Evaluate → Prescribe → Exercise → Re-evaluate
It is not an app. It is not software. It is a clinical framework that any doctor, physical therapist, or clinic can use for free.
You can run this process with pen and paper, or with any software you choose.
The Four Steps
1. Evaluate
Assess the patient's current state using standardized measures:
- ROM (Range of Motion) — goniometer or digital measurement
- VAS (Visual Analog Scale) — daily pain score, 0-10
- Function — sit-to-stand, walking distance, stair ability
- PROM (Patient-Reported Outcome Measures) — standardized questionnaires at defined timepoints
- Wound — photo documentation
- Effusion — swelling grade
2. Prescribe
Based on assessment findings and current rehabilitation phase, create or adjust an exercise prescription:
- Which exercises, sets, reps, hold time, frequency
- Precautions and contraindications
- Protocol templates provide starting points
3. Exercise
The patient performs prescribed exercises and logs completion:
- Self-directed at home or supervised in clinic
- Track: exercises completed, actual reps, pain during exercise, difficulty
- Daily VAS reporting
- Wound photo documentation
4. Re-evaluate
Reassess using the same measures as Step 1. Compare to previous evaluation:
- Is ROM progressing toward phase targets?
- Is pain trending down?
- Is adherence sufficient?
- Are there red flags?
Based on findings: advance, maintain, or regress phase. Then prescribe again. The loop continues.
Five-Phase Protocol (TKA Example)
| Phase | Name | Weeks | ROM Target | Advancement Criteria |
|---|---|---|---|---|
| Phase 0 | Immediate Post-Op | 0-2 | Flexion 90 | ROM >= 90, VAS <= 5, Effusion <= mild |
| Phase 1 | Acute | 2-6 | Flexion 105 | ROM >= 105, Independent ambulation |
| Phase 2 | Subacute | 6-12 | Flexion 115 | ROM >= 115, Stair ability |
| Phase 3 | Advanced | 12-24 | Flexion 125 | Functional tests passed |
| Phase 4 | Return to Function | 24-52 | Maintain | All goals met |
Phases are criteria-based, not calendar-based. Some patients advance in two weeks. Some need four.
Pain Management (Anesthesia Collaboration)
Post-operative pain control affects rehabilitation progress. The Recovery Loop includes common nerve block combo presets:
| Procedure | Pain Combo |
|---|---|
| TKR | Femoral + Adductor Canal + iPACK |
| ACLR | Adductor Canal + AFCN + iPACK |
| RCR / TSA | Supraclavicular Brachial Plexus + Serratus Anterior |
| Hip | Fascia Iliaca + LFCN |
| Intraosseous | Morphine + Ketorolac |
Each combo includes: block site, guidance method, drug, concentration, and dosage.
Who Can Use This?
Everyone. CC BY 4.0 license — free to use, modify, and commercialize. The only requirement is attribution.
| Role | How to Use |
|---|---|
| Physical Therapist | Clinical reference for rehab protocols |
| Orthopedic Surgeon | Standardize post-op rehab pathways |
| Clinic / Hospital | Adopt as departmental rehab standard |
| Researcher | Reference protocol structure in studies |
| Developer | Build compatible systems using JSON schemas |
| Medtech Company | Integrate into your products |
What's Included
| Content | Description |
|---|---|
| Recovery Loop Definition | Complete description of the four-step cycle |
| TKA 5-Phase Protocol | ROM targets, advancement criteria, exercise prescriptions |
| Pain Combo Presets | Nerve block combinations for 5 surgery types |
| SOAP Snippets | 29 clinical quick-text templates (multilingual) |
| 76 Rehab Exercises | Name + instructions + audio cues in 7 languages |
| JSON Schema | Machine-readable data format (for developers) |
What's NOT Included
- This is not an app (it is a methodology, not software)
- No patient data
- No automation or alerting
- No complete PROM questionnaire text (some instruments require separate licensing)
If you want the full automated implementation — iRehab is free.
Contribute
We welcome new protocols (shoulder, spine, ankle), new language translations, and corrections. Every contributor receives named authorship.
Links
- Recovery Loop Protocol: GitHub
- Exercise Library (76 x 7 languages): GitHub
- iRehab (free): irehab-patient.pages.dev
- WishPool: irehab-wishpool.pages.dev
Disclaimer: This content is a reference framework for clinical education and software development. It does not constitute medical advice. Clinical decisions must be made by qualified healthcare professionals based on individual patient assessment.