General Guidelines for Managing Chronic Spinal Problems: Return to Function Phase

By Carolyn Kisner PT, MS and Lynn Allen Colby PT, MS on November 20th 2008

Patients who have been treated through the acute and subacute phases of healing with appropriately graded exercises should have minimal impairments that prevent or restrict daily activities. Individuals who must do heavy material handling (e.g., a manual laborer, firefighter, caregiver of small children or patients) or who participate in high-demand sports activities may require additional rehabilitative training to return safely to these high-demand activities and to avoid further injury. Impairments in strength, endurance, neuromuscular control, and skill are related to the functional goals of the individual. At this stage, conditioning and spinal control during high-intensity and repetitive activities are emphasized. Any underlying impairments that interfere with the desired outcomes must be remediated.

Management Guidelines—Chronic Spinal Problems/Return to Function Phase
Impairments and Functional Limitations

Pain: only when excessive stress is placed on vulnerable tissues in repetitive or sustained nature for prolonged periods
Poor neuromuscular control and endurance in high-intensity or destabilized situations
Flexibility and strength imbalances
Generalized deconditioning
Inability to perform high-intensity physical demands for extended periods of time

Buy the Book that holds this excerpt: Therapeutic Exercise: Foundations and Techniques (Therapeutic Exercise: Foundations & Techniques)

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Filed Under: Physical Therapy, cheng
Tags: activities, deconditioning, impairments, pain, remediated, stress

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