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    Kyphoplasty Physical Therapy Post Op Protocol

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    Moin Rashid
    The document outlines a post-operative physical therapy protocol for kyphoplasty in 3 phases, focusing initially on pain and wound management, progressing to dynamic lumbar stabilization exercises and functional activities, and finally advancing lifting, flexibility, and trunk control exercises while avoiding movements that put high stress on the spine. Precautions are given at each phase to prevent twisting or bending of the lumbar spine as healing progresses.

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    © All Rights Reserved
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    Kyphoplasty Physical Therapy Post Op Protocol

    Uploaded by

    Moin Rashid
    351 views3 pages
    The document outlines a post-operative physical therapy protocol for kyphoplasty in 3 phases, focusing initially on pain and wound management, progressing to dynamic lumbar stabilization exercises and functional activities, and finally advancing lifting, flexibility, and trunk control exercises while avoiding movements that put high stress on the spine. Precautions are given at each phase to prevent twisting or bending of the lumbar spine as healing progresses.

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    KYPHOPLASTY-PHYSICAL-THERAPY-POST-OP-PROTOCOL

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    The document outlines a post-operative physical therapy protocol for kyphoplasty in 3 phases, focusing initially on pain and wound management, progressing to dynamic lumbar stabilization exercises and functional activities, and finally advancing lifting, flexibility, and trunk control exercises while avoiding movements that put high stress on the spine. Precautions are given at each phase to prevent twisting or bending of the lumbar spine as healing progresses.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    351 views3 pages

    Kyphoplasty Physical Therapy Post Op Protocol

    Uploaded by

    Moin Rashid
    The document outlines a post-operative physical therapy protocol for kyphoplasty in 3 phases, focusing initially on pain and wound management, progressing to dynamic lumbar stabilization exercises and functional activities, and finally advancing lifting, flexibility, and trunk control exercises while avoiding movements that put high stress on the spine. Precautions are given at each phase to prevent twisting or bending of the lumbar spine as healing progresses.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    KYPHOPLASTY PHYSICAL THERAPY POST OP PROTOCOL

    PHASE 1 – 0-2 WEEKS (IMMEDIATE POST SURGICAL)


    OBJECTIVES: Decrease pain and inflammation and encourage wound healing. Educate on bed mobility,
    body mechanics and posture. Increase aerobic tolerance (independent with issued HEP and 15 min.
    exercise tolerance/time).
    PRECAUTIONS: Prevent excessive initial mobility or stress on spine. Avoid lifting, bending and twisting
    of the spine.

    BRACING: JEWETT BRACE DERMABOND CLOSURE:


    USUALLY NO BRACE UNLESS > 2 LEVELS AND/OR
    PATIENT OSTEOPOROTIC SURGICAL SITE OR INCISION -OK TO GET WET – DO
    NOT SUBMERGE
    CRITERIA FOR PROGRESSION TO NEXT PHASE:
    -PAIN MANAGED (MEDS/ACTIVITY MODIFICATION) DO NOT APPLY LOTION/BALMS/OINTMENTS/OILS
    -ABLE TO PERFORM ADL’S FOR SELF CARE AND TO INCISION
    HYGIENE
    -TOLERANCE OF 15-30 MIN. OF CARDIO EXERCISE
    AND 15 MIN. OF STRENGTH/STRETCH EXERCISE

    -INDEPENDENT WITH PRESCRIBED HEP

    PHYSICAL THERAPY: EXERCISES:

    EDUCATION: INITIAL POST OP HOME EXERCISE PROGRAM


    BED MOBILITY: USE LOG ROLL AND TRANSFER -ANKLE PUMPS
    AVOIDING TWISTING/BENDING -GLUT SETS
    -ABDOMINAL ISOMETRICS
    BODY MECHANICS: NO LIFTING > 5 LBS. REINFORCE -SHORT ARC QUAD SETS
    SITTING (GET UP EVERY 30 MIN.), STANDING AND -DOWEL BENCH PRESS
    ADL MODIFICATIONS – NEUTRAL SPINE. -DIAPHRAGMATIC BREATHING

    DRIVING: ALLOWED WHEN OFF NARCOTIC PAIN CARDIO: INCREASE TOLERANCE TO WALKING
    MEDICATION AND/OR OUT OF BRACE (2-4 WEEKS) -UP TO ½ MILE TOTAL DAILY (15 – 30 MIN. CARDIO).

    NOTIFY DOCTOR IF INCISION DRAINING OR SIGNS OF INFECTION


    PHASE 2 – 2 TO 4 WEEKS (START OF OUTPATIENT PT)
    OBJECTIVES: Reestablish neuromuscular recruitment of multifidus with dynamic lumbar stability
    exercise. Normalize gait and any extremity flexibility deficits. Return to functional ADL’s and improve
    position tolerance for return to work.
    PRECAUTIONS: AVOID TWISTING, AND BENDING OF THE LUMBAR SPINE. AVOID LUMBAR LOADING.

    IF PATIENT WEARING BRACE – GRADUALLY WEAN


    OUT OF BRACE PER DOCTOR INCISION SHOULD NO LONGER HAVE SCABBING

    CRITERIA FOR PROGRESSION TO NEXT PHASE: SCAR TISSUE MOBILIZATION VIA CUPPING –
    -PATIENT IS ABLE TO INCORPORATE GOOD BODY EDUCATE PATIENT ON SELF MOBILIZATION OF SCAR
    AND LIFTING MECHANICS
    -DYNAMIC SITTING AND STANDING TOLERANCE OF NO ADDITIONAL BALMS OR OINTMENTS IF SCABS
    15-30 MINUTES. STILL PRESENT
    -CARDIO TOLERANCE OF 30 MIN/DAY.

    PHYSICAL THERAPY: EXERCISES:

    EDUCATION: -TRAIN NEUTRAL SPINE WITH DIAPHRAGMATIC


    BACK EDUCATION PROGRAM: ANATOMY, SURGERY BREATHING – DRAWING IN ABDOMEN
    EDUCATION AND BIOMECHANICS -ADD GENTLE ARM AND LEG EXERCISES
    POSTURE EDUCATION: REINFORCE NEUTRAL SPINE -SUPINE HEEL SLIDES, SUPINE LEG LIFT,
    WITH PERFORMANCE OF FUNCTIONAL ACTIVITIES – MARCHING
    WAYS TO PROTECT SPINE WITH LOADING -ADD LUMBOPELVIC CONTROL WITH
    DRIVING: USUALLY ALLOWED BY THIS POINT WHEN MOVEMENT/INSTABILITY – BALL ETC.
    OFF PAIN MEDS AND EASE WITH IN/OUT OF CAR -CAT/CAMEL, PELVIC ROCKS, WIG-WAG
    -HIP AND KNEE FLEXIBILITY – QUADS, HAMSTRINGS
    MODALITIES: FOR SYMPTOM MODULATION AS PIRIFORMIS, GLUTS, HIP FLEXORS, CALVES
    NEEDED. (E-STIM./HEAT) -INITIATE BALANCE EXERCISES- SITTING/STANDING
    -INITIATE AQUATICS (IF AVAILABLE)
    -GAIT TRAINING
    PHASE 3 – 4 TO 8 WEEKS (ADVANCED STRENGTH PHASE)
    OBJECTIVES: Advance lifting to 15+ lbs. Progress with flexibility and strength. Address ADL and return to
    work concerns. Advance stabilization and trunk control.
    PRECAUTIONS: Advance weight as tolerated based on age and bone density concerns/functional status.
    Special consideration for osteoporosis, cancer history.

    REHAB PEARLS: EXERCISES TO AVOID WITH OSTEOPOROSIS:


    -AVOID PRELOADING SPINE IN POSTERIOR PELVIC -Dynamic abdominal ex.’s (sit-ups)
    TILT -Twisting movements (eg. golf swing)
    -FOCUS ON LOW LOAD/HIGHER REPS TO IMPROVE -Trunk flexion
    ENDURANCE RATHER THAN HIGH LOAD LOW REPS -Explosive or abrupt loading (ATV riding)
    FOR STRENGTH. -High impact loading - jumping
    -AVOID PRONE UPPER BODY EXTENSION OR PRONE
    LEG EXTENSIONS THAT ARE BALLISTIC TO AVOID
    HIGH COMPRESSION TO WEAKER SPINE

    PHYSICAL THERAPY: EXERCISES:

    ACTIVITY SPECIFIC TRAINING/BODY MECHANICS -THORACO-LUMBAR STABILITY WITH INCREASING


    ADAPTATIONS FOR SPECIFIC TASKS/JOB COMPLEXITY.
    -BRIDING ON UNSTEADY SURFACES (BALL)
    CRITERIA FOR DISCHARGE: DOUBLE LEG/SINGLE LEG, BIRD DOG, STEP
    KNEELING ARM PULLDOWNS, SHUTTLE,
    -MANUAL MUSCLE TESTS WITHIN FUNCTIONAL AIREX PAD ROWING, PUNCHOUTS, CHOPS,
    LIMITS. DIAGONAL LIFTS, ROWING ON BOSU, LUNGES
    -TRUNK AROM WITHIN FUNCTIONAL LIMITS AND SQUATTING, FLOOR TO STAND
    SYMMETRICAL SIDE TO SIDE.
    -INDEPENDENT WITH FINAL GYM PROGRAM -ADVANCED CARDIOVASCULAR TRAINING
    -OSWESTRY SCORE < 20 ELLIPTICAL, ARM BIKE

    -AVOID: SITTING ROWING, LEG PRESS DUE TO


    ANTERIOR COLUMN LOADING

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