Table 1. The 12-week rehabilitation protocol following extensor hallucis longus tendon reconstruction

Week Program Hallux range of motion (ROM) / Weight bearing (WB)
1 Wound healing and electrical muscle stimulation (EMS) No ROM and no WB; a posterior splint was worn
2 Wound healing and EMS No ROM and no WB; a posterior splint was worn
3−4 Passive at-home stretching of the hallux: 3 times daily, 10 minutes, with EMS. No active ROM and partial WB; a posterior splint was worn
5−6 Passive at-home stretching of the hallux with increased power: 3 times daily, 10 minutes, with EMS. No active ROM and partial WB; a posterior splint was worn
6 Active stretching of the hallux: 3 times daily, 10 minutes, with EMS.Static cycling: 3 times weekly, 15 minutes. Start active ROM, remove the posterior splint, and start full WB on the boot walker everyday
8 Static cycling: 3 times weekly, 30 minutes.Gait cycle and toe crunch exercises were performed to improve stiffness and walking. More active ROM, full WB on the boot walker for outdoor activity
10 Static cycling: 3 times weekly, 30 minutes.Gait cycle and toe crunch exercises were performed to improve stiffness and walking.Lower extremities strengthening routine. Allow more active ROM, full WB on the boot walker at work
12 Static cycling: 4 times weekly, 30 minutes.Gait cycle and toe crunch exercises were performed to improve stiffness and walking.Lower extremities strengthening routine. Remove boot walker and start full WB with comfortable shoes