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Exercise Rehabilitation Following a Spinal Fusion

February 10, 2022

The human spine plays an integral part in allowing the body to move freely and bend with flexibility, while also acting as the body’s central support structure (Oxland, 2015). Patients that present with symptomatic instability, structural deformities, or elevated pain, may be treated with an interbody spinal fusion (Enders & Coughlin et al, 2020). Common spinal deformities including scoliosis, kyphosis, and lordosis, which are commonly caused by degeneration, are typical precursors for spinal fusion surgery.


Spinal fusion surgery is a neurosurgical or orthopaedical surgical technique where a bone graft is added to a segment of the spine. Bone grafts are commonly taken from the patients’ hip, harvested from cadaver bone, or a manufactured synthetic bone substitute (Ullrich, 2013). This sets up a biological response in the body that causes the bone graft to grow between the two vertebral elements to create a bone fusion (Ullrich, 2013). Two vertebral segments are fused together to stop the motion at one segment. Cervical and Lumbar spinal fusions have provided a greater than 90% likelihood of relieving radicular symptoms and stabilisation, or improving myelopathy (Levin & Hale et al, 2007). Following spinal fusion surgery, stiffness and soreness are likely to occur, thus exercise rehabilitation has long been a common feature in the postoperative management of patients undergoing this procedure (Madera & Brady et al, 2017).

 

Rehabilitation following a Spinal Fusion:


Postoperatively, physical therapy and rehabilitation modalities are frequently used to improve patients’ activity levels, range of motion, and core strength (Madera & Brady et al, 2017). Immediately following surgery, short distance walks are recommended in conjunction with static lower limb musculature stretching, in line with specialist recommendations (Miller, 2016). Strengthening exercises have long been the cornerstone of physical therapy. Evidence states that motor control and strengthening exercises play a vital part in postoperative rehabilitation as neutral spine exercises are recommended to increase core strength and improve disability index scores (Madera & Brady et al, 2017). As trunk muscle function and health related fitness in patients with chronic back pain are often extensively impaired, comprehensive training programmes are required. Effectiveness of exercise interventions are partly adherence dependent, thus supervised rehabilitation assist in goal setting, as well as monitoring progression and motivation (Tarnanen & Neva, 2012)

When looking at the current literature, multiple studies support a multidisciplinary approach, using evidence-based guidelines, to deliver the best outcomes for individuals following spinal fusion surgery (Madera & Brady et al, 2017.)



James McNally

Workers Compensation Specialist ‑ Team Leader East (AEP, ESSAM)

Exercise Rehabilitation Services

     




References

Oxland, T. (2015). Fundamental biomechanics of the spine – What we have learned in the past 25 years and future direction. Journal of Biomechanics, 49(6), 817-832.

Enders, J., Coughlin, D., Mroz, T., Vira, S. (2020). Surface Technologies in Spinal Fusion. Neurological Clinics in North America, 31(1), 57-64.

Ullrich, P. (2013). Lumbar Spinal Fusion Surgery. Spine Health.

Levin, D., Hale, J., Bendo, J. (2007). Adjacent segment degeneration following spinal fusion for degenerative disease. Health and Medicine, 65(1).

Madera, M., Brady, J., Deily, S., McGinty, T., Moroz, L., Singh, D., Tipton, G., Truumees, E. (2017). The role of physical therapy and rehabilitation after lumbar fusion surgery for degenerative disease: a systematic review. Journal of Neurosurgery, 26(6), 694-704.

Miller, R. (2016). Guide to Physical Therapy After Spinal Fusion. Spine Health.

Tarnanen, S., Neva, M., Dekker, J., Hakkinen, K., Vihtonen, K., Pekkanen, L., Hakkinen, A. (2012). Randomised controlled trial of postoperative exercise rehabilitation program after lumbar spine fusion: study protocol. BMC Musculoskeletal Disorders, 13(1), 123.

January 17, 2025
Hi all, Daniel from AB here! Today I want to share with you all how exercise can benefit your relationships. Exercise is often celebrated for its physical and mental health benefits, but its positive impact on relationships is equally significant. Engaging in regular physical activity can enhance your connections with others, fostering stronger, healthier relationships. Here's how: Shared Activities Exercising together, like jogging or hiking, creates shared experiences and strengthens bonds. Improved Mood Exercise reduces stress and boosts mood, leading to more positive interactions with others. Increased Confidence Feeling good about yourself can improve how you relate to others, enhancing social interactions. Social Interaction Joining fitness groups introduces you to new people, expanding your social network. Better Communication Exercise improves cognitive function, helping you communicate more effectively. Quality Time Physical activities provide a chance to spend quality time with loved ones. Encouragement Working out with others offers mutual motivation and support, strengthening relationships. Exercise offers more than just physical and mental health benefits; it can also significantly enhance your relationships. By engaging in physical activities with others, you can build stronger bonds, improve communication, and create lasting memories. So, lace up your sneakers, grab a friend or loved one, and start reaping the relational benefits of exercise today! Daniel Dewberry Workers Compensation Specialist ‑ Team Leader East (AEP, ESSAM) Exercise Rehabilitation Services ‑ WA
January 10, 2025
With a new year upon us every individual will be looking to achieve a new list of goals they would like to achieve for both their physical and mental wellbeing. It is important when setting goals for the new year to break it down into steps so that these can be achieved and keep you motivated along the way. Here are a few steps to help. Specificity A goal must be clear and precise. Ambiguity leads to confusion, whereas specificity provides direction. Instead of saying, “I want to get fit,” try “I will jog for 30 minutes, five days a week.” This leaves no room for misinterpretation and gives you a concrete path to follow. Measurable: Track Your Progress Goals need to include criteria for measuring success. By tracking your progress, you can stay motivated and recognize when adjustments are needed. Pro Tip: Use tools like journals, apps, or spreadsheets to monitor milestones. Celebrate small wins to keep the momentum alive. Achievable: Stay Realistic Ambition is admirable, but setting goals too far out of reach can lead to frustration and a lack of motivation. Ensure your objectives are challenging yet feasible given your current resources and timeframe. For instance, if you’re a beginner runner, completing a marathon in three months might be overly ambitious, but aiming for a 5K race is more realistic. Pro Tip: Reflect on your past achievements to gauge what’s attainable. Stretch yourself but avoid setting yourself up for failure. Relevant: Align with Your Values Your goals should resonate with your larger life purpose and priorities. Fitness goals should reflect what you want to achieve—not what others expect of you. When your goals are personally meaningful, they’re more likely to inspire consistent action. For example, a person training for a marathon has a different motivation than someone aiming to reduce back pain through core exercises. Both goals are valid, but their relevance depends entirely on the individual’s priorities and circumstances. Time-bound: Set a Deadline A goal without a deadline is just a wish. Adding a timeframe creates urgency and helps you stay on track. Instead of “I’ll lose 5Kg,” say, “I’ll lose 5Kg by a certain date or I will lose 0.5Kg per week for 10 weeks” Pro Tip: Break larger goals into smaller, time-bound tasks. This makes big ambitions feel more manageable and achievable. By using the SMART goal structure, the goals you set coming into 2025 are far more likely to be achieved by keeping you on track and helping you recognise the small wins along the way. These small wins build confidence, discipline and motivation towards the larger goals which will help keep the momentum moving in the right direction. Adrian McKenna​​​​ Exercise Physiologist Exercise Rehabilitation Services ‑ WA
December 19, 2024
T ime spent in natural outdoor environments has been found to increase cognitive function. Staying active during the holidays can be both fun and beneficial for your health. With all the festive activities, food, and time off, it’s easy to slip into a more sedentary routine, but there are plenty of ways to stay moving while enjoying the season. Here are some ideas to stay active this holiday period. Holiday walks: Take advantage of the holiday lights and decorations around your neighbourhood or a local park. Evening strolls to view holiday displays can be a fun way to stay active. Summer in Australia is a great time to get outdoors as the days are longer. Family sports and games: If you have a backyard or nearby park, gather your friends and family for a game of football, soccer, or basketball. The possibilities are endless. Holiday morning walk or run: Start the day with a refreshing walk or run before the big feast. It’s an excellent way to clear your mind, get some fresh air, and set a positive tone for the day ahead. It can help boost your mood, reduce stress, and improve your metabolism. Holiday advent active calendar: Create your own "active advent calendar" to keep you motivated throughout December. Each day, set a small fitness challenge that fits with your schedule and surroundings. This is a fun way to build consistency while staying active during the festive season. Beach activities: Australia's coastline is perfect for surfing, whether you're a beginner or an expert. December is an ideal time to hit the beach as the weather heats up. Volleyball and cricket are amongst the most popular beach games. References: - Biddle, G.J. et al. (2022) ‘A Christmas themed physical activity intervention to increase participation in physical activity during Advent: Pilot randomised controlled trial’, BMJ [Preprint]. doi:10.1136/bmj-2022-072807. - Boere, K. et al. (2023) ‘Exercising is good for the brain but exercising outside is potentially better’, Scientific Reports, 13(1). doi:10.1038/s41598-022-26093-2. Shafiq Adie Exercise Scientist Corporate Health Services
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