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    Rehabilitasi Post Op Spine Surgery: Kobal Sangaji Dokter Spesialis Rehabilitasi Medik RS Awalbros Pekanbaru

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    kurnia
    The document discusses post-operative rehabilitation after spine surgery. It covers anatomy and functions of the back, rehabilitation principles like modifying activities and correcting biomechanical abnormalities, and the importance of functional stability and core stability exercises. It reviews research on the benefits of post-op rehabilitation and education programs. The rehabilitation process involves pain control, one-on-one training, recovery exercises, and education on proper back mechanics and gradual return to activity.

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    Rehabilitasi Post Op Spine Surgery: Kobal Sangaji Dokter Spesialis Rehabilitasi Medik RS Awalbros Pekanbaru

    Uploaded by

    kurnia
    42 views27 pages
    The document discusses post-operative rehabilitation after spine surgery. It covers anatomy and functions of the back, rehabilitation principles like modifying activities and correcting biomechanical abnormalities, and the importance of functional stability and core stability exercises. It reviews research on the benefits of post-op rehabilitation and education programs. The rehabilitation process involves pain control, one-on-one training, recovery exercises, and education on proper back mechanics and gradual return to activity.

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    Materi dr. Kobal.pptx

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    The document discusses post-operative rehabilitation after spine surgery. It covers anatomy and functions of the back, rehabilitation principles like modifying activities and correcting biomechanical abnormalities, and the importance of functional stability and core stability exercises. It reviews research on the benefits of post-op rehabilitation and education programs. The rehabilitation process involves pain control, one-on-one training, recovery exercises, and education on proper back mechanics and gradual return to activity.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    42 views27 pages

    Rehabilitasi Post Op Spine Surgery: Kobal Sangaji Dokter Spesialis Rehabilitasi Medik RS Awalbros Pekanbaru

    Uploaded by

    kurnia
    The document discusses post-operative rehabilitation after spine surgery. It covers anatomy and functions of the back, rehabilitation principles like modifying activities and correcting biomechanical abnormalities, and the importance of functional stability and core stability exercises. It reviews research on the benefits of post-op rehabilitation and education programs. The rehabilitation process involves pain control, one-on-one training, recovery exercises, and education on proper back mechanics and gradual return to activity.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 27

    Rehabilitasi post op

    spine surgery
    Kobal Sangaji
    Dokter Spesialis Rehabilitasi Medik
    RS Awalbros Pekanbaru
    Back / Lumbal

     Anatomy view : tempat tegaknya tubuh


     Fungsi lumbal
     Disabilitas 85% setiap orang menderita nyeri tulang belakang
     Kinesiology
    Rehabilitation Principle

    • Assess any Abnormality and treat to correct the Abnormality


    • MODIFY ACTIVITIES
    • CORRECT BIOMECHANICAL ABNORMALITIES
    • POSTURAL ASSESSMENT OF FUNCTIONAL POSITIONS
    • LIFTING MECHANICS
    • CORE STABILITY : LOCAL THEN GLOBAL
    • ASSESS / STRETCH TIGHTNESS
    • EDUCATION
    • HOME EXERCISE REGIME
    FUNCTIONAL STABILITY

    NEED TO UTILISE BOTH MUSCLE FORCES AND PASSIVE STRUCTURES TO


    DYNAMICALLY STABILISE THE SPINE FUNCTIONALLY

    ANY DEFICITS ASSESSED NEED TO BE ADDRESSED IN A REHABILITATION .PLAN


    Spine Surgery and Post-Op Rehabilitation
     Increasing rates for many procedures, particular
    complex surgery in older patients
     Outcomes are variable
     Failure rates are reported between 10% - 40%
     Utilization and content of post-operative
    rehabilitation are inconsistent.
     Evidence-base for post-operative rehabilitation
    strategies is sparse
    THE RESEARCH
    Alexsiev et al. Function After
    Spinal Treatment, Exercise, and
    Rehabilitation (FASTER): A Factorial Randomized Trial to
    Determine Whether the Functional Outcome of Spinal
    Surgery Can Be Improved. Spine 2011: 997-1003

     388 patients undergoing surgery for lateral nerve


    root compression or disc prolapse.
     Factorial Randomized Trial
     Factor 1: either 6 weeks of rehabilitation or usual care by
    surgeon
     Factor 2: Either an Educational Booklet (“Your Back
    Operation”) or usual advice by surgeon
    Alexsiev et al. Function After
    Spinal Treatment, Exercise, and
    Rehabilitation (FASTER): A Factorial Randomized Trial to
    Determine Whether the Functional Outcome of Spinal
    Surgery Can Be Improved. Spine 2011: 997-1003

    Rehabilitation Intervention:
    - Began 6-8 weeks after surgery
    - 12 standardized 1-hour classes run by a PT (twice weekly)
    - General aerobic fitness, stretching, stability,
    strengthening, ergonomic advice, motivation

    Education Intervention:
    - Given a copy of booklet at hospital discharge
    Key themes derived from literature used to develop booklet

    Eur Spine J. 2007 Mar; 16(3): 339–346.


    Alexsiev et al. Function After
    Spinal Treatment, Exercise, and
    Rehabilitation (FASTER): A Factorial Randomized Trial to
    Determine Whether the Functional Outcome of Spinal
    Surgery Can Be Improved. Spine 2011: 997-1003

    Rehabilitation Intervention:
     Of those allocated to rehabilitation – 41% attended no
    classes and an additional 16% attended less than half of the
    sessions.
     No impact on outcomes except average leg pain

    Education Intervention:
    - No impact on outcomes
    - No interaction effects between treatments
    Mannion AH et al. A randomised controlled trial of post-
    operative rehabilitation after surgical decompression of
    the lumbar spine. Eur Spine J 2007:16(8):1101-17.

     159 patients with degenerative spine disease (stenosis


    or disc disease) scheduled for decompression, age > 45
     Randomized to 1 of 3 treatment groups:
    o Self management for 12 weeks (advised to be active and
    exercise)
    o PT with spine stabilization (2 sessions per week for 12 weeks)
    o PT with mixed techniques (2 sessions per week for 12 weeks)
    Mannion AH et al. A randomised controlled trial of post-
    operative rehabilitation after surgical decompression of
    the lumbar spine. Eur Spine J 2007:16(8):1101-17.

     159 patients with degenerative spine disease (stenosis


    or disc disease) scheduled for decompression, age > 45
     Randomized to 1 of 3 treatment groups:
    o Self management for 12 weeks (advised to be active and
    exercise)
    o PT with spine stabilization (2 sessions per week for 12 weeks)
    o PT with mixed techniques (2 sessions per week for 12 weeks)
    Mannion AH et al. A randomised controlled trial of post-
    operative rehabilitation after surgical decompression of
    the lumbar spine. Eur Spine J 2007:16(8):1101-17.

    Advising patients to keep active by carrying out the type of


    physical activities that they most enjoy appears to be just as
    good as administering a supervised rehabilitation program,
    and at no cost to the health-care provider.
    Initial exercise program

    1. Ankle pump
    2. Heel slides
    3. Abdominal contraction
    4. Wall squat
    5. Heel raises
    6. Straight leg raises
    Intermediate exercise program

    1. Single knee to chest stretch


    2. Hamstring stretch
    Advanced exercise program

    1. Hip flexor stretch


    2. Piriformis stretch
    Lumbal stabilization with ball

    1. Lying on the floor


    2. Sitting on the ball
    3. Standing with ball
    4. Lying on the floor
    Aerobic exercise

     Static bike for 20-30 menit


     Treadmill 20 – 30 menit
    FAQ

     Best exercise is walking that improve blood flow & bring oxygen and nutrient
    to spinal muscle
     After decompression 6 minggu tidak boleh angkat berat, cardiovascular
    exercise setealah 3-4 minggu, start physical therapy 1 bulan setelah operasi.
    6 bulan post op return to sport
     Saraf akan regenerasi 3 minggu setelah operasi
     Nyeri pada ankle bias terjadi pada kasus post op, bila berlanjut selama tiga
    bulan maka kemungkinan reassessment ulang
     Post laminectomy syndrome akan menjadi nyeri kronis dan disabilty
    Rehabilitasi dan latihan post op spine
    surgery
    1. Pain control
    2. One and one training after surgery
    3. Exercise for recovery
    4. Education program
    Pain control

    Acute Back Pain


     Local modalities for pain/spasm
     Encourage non-­‐aggravating movement and exercise Educate / encourage neutral spine
     Manual therapy techniques
     Home exercise
     Back Care advice

    SUB-­
    ‐ACUTE BACK PAIN
     Local modalities for pain/spasm/hypo mobility Restore range with manual therapy and
    exercise Core stability regime and upgrade
     Review postures/biomechanics Home exercise / Cardio fitness
    Start program rehabilitasi

     Melalui muscle fascilitation yaitu melatih kembali untuk penguatan dan


    stabilisasi pada :
    1. Otot otot daerah insisi
    2. Otot otot yang lemah sebelum dilakukan tindakan operasi
    3. Otot otot kecil yang berfungsi stabilisasi pada area tulang belakang
    4. Melatih pada otot dan sendi yang lain
    Exercise after spine surgery

     Exercise is vital to getting better after spine surgery.


     It is the key to eliminating fatigue, getting patients back to activity safely,
    and avoiding re-injury.
     Ultimately, exercise is critical both in helping the body heal from the original
    injury and in preventing (or minimizing) future episodes of back pain
    Education

     Control regularly
     Do not carry heavy thing
     Proper back mechanic
     Exercise gradually
     Return to work and activity as prescribed by doctor
    TERIMA KASIH

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