Early return to work following an aggressive rehabilitation program initiated one day after spine surgery.
In a program designed and conducted in a private rehabilitation center, 38 postoperative cervical or lumbar spine patients were treated with an aggressive rehabilitation regimen. The regimen included an aquatic component, stabilization and flexibility exercises, resistance and aerobic exercises, progressively difficult walks, educational sessions, and limited palliative modalities. Readiness for discharge was evaluated on the basis of clinical observations and submaximal cardiovascular testing, and a computer analysis comparing range of motion, strength, and functional capacity with normative data. No complications developed during the recovery of any patients. After an average of 3.3 days following discharge from the rehab program, 89% returned to their former occupations without restrictions. At follow-up, all patients had been working continuously at their occupation for over 25 months post-discharge. The authors conclude that, based on this retrospective analysis, this is a safe means of potentially reducing hospital time, minimizing postoperative morbidity, and restoring patients to their former occupations. These findings can only be viewed as preliminary, however, and further study in a prospective, controlled clinical trial is needed to draw definitive conclusions regarding the effectiveness of this aggressiveness rehabilitation program in the general population of postoperative spine patients.
Scandia Centrum of Rehab Medicine, 2205 Fontaine Avenue, 22903, Charlottesville, Virginia.
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Sjolinder
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