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nari -> Re: SLR EXCERCISES FOR LUMBAR SURGERY (August 22, 2005 12:21:00 AM)
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Hi goodlooks
We developed our own protocols, waved them past the surgeons and they OKd them - mostly, except for one who believed physical therapy was of no benefit. Unfortunately, I saw these patients only in the acute setting, and they were sometimes referred to physio in the hospital; but there were so many the dept could not handle all of them.
I am now out of date with the precise protocols used now (and have been updated a lot) as I left the area over 3 years ago.
But McKenzie seemed to work well, often diminishing post-op pain (or unaltered pain from pre-op, which was common). Also TA education, although in the four or five days they were in hospital were never enough to properly train TA.
Mobilisation was encouraged within 24 hours, with independence in basic functions. I never allowed any sort of walking aid, unless the patient was elderly and/or had motor deficits.
I think mobility facilitation is the most important; many patients feel they will fall apart if they walk too much. There is very little written on post-op protocols; each hospital seems to develop their own. Sitting for more than 20-30 mins should be avoided. Breathing control is also very useful as breath holding and hyperventilation often occured. The worst ones were the young males - they had a habit of passing out once vertical.
Think of mobilising the spine (not passively), reduce fear with education, and they mostly look after themselves. Of course, check with the surgeon's op notes if they have special requests - eg rest in bed 36-48 hours post-dural nicking.
Sorry I can't help much with rehab down the line, as I am not familiar enough with ongoing rehab processes.
Nari
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