Spinal loads during post-operative physiotherapeutic exercises

PLoS One. 2014 Jul 7;9(7):e102005. doi: 10.1371/journal.pone.0102005. eCollection 2014.

Abstract

After spinal surgery, physiotherapeutic exercises are performed to achieve a rapid return to normal life. One important aim of treatment is to regain muscle strength, but it is known that muscle forces increase the spinal loads to potentially hazardous levels. It has not yet been clarified which exercises cause high spinal forces and thus endanger the surgical outcome. The loads on vertebral body replacements were measured in 5 patients during eleven physiotherapeutic exercises, performed in the supine, prone, or lateral position or on all fours (kneeling on the hands and knees). Low resultant forces on the vertebral body replacement were measured for the following exercises: lifting one straight leg in the supine position, abduction of the leg in the lateral position, outstretching one leg in the all-fours position, and hollowing the back in the all-fours position. From the biomechanical point of view, these exercises can be performed shortly after surgery. Implant forces similar or even greater than those for walking were measured during: lifting both legs, lifting the pelvis in the supine position, outstretching one arm with or without simultaneously outstretching the contralateral leg in the all-fours position, and arching the back in the all-fours position. These exercises should not be performed shortly after spine surgery.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomechanical Phenomena
  • Exercise / physiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Period
  • Posture
  • Spine / physiopathology*
  • Stress, Mechanical*

Grant support

This study was funded by the Deutsche Forschungsgemeinschaft (project: Ro 581/18-1) and the Deutsche Arthrose-Hilfe e.V., Frankfurt. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.