There are a number of key components that go into any rehabilitation plan. Decreasing pain, inflammation, and muscle spasm are all important in the beginning stages. We want the patient to be able to see a decrease in pain before we can truly get into exercises and rehab work. This can be accomplished through electrical stim, cold-laser, stretching, massage, Graston and icing. Once they are out of the acute phase they can begin the strengthening aspect. This is key in increasing the healing time and preventing further injury to the area. Depending on the area being treated, a rehab protocol can be put into place to develop the muscle strength needed to support the surrounding ligaments and joints. This will often include body-weight exercises, range of motion exercises, resistance band work, and light weighted exercises. Rehab is often started slowly as to not aggravate a condition, and as the patient progresses, so can the difficulty.
This study was designed to test the changes in low back pain following rehabilitation. 17 patients were assessed and included in the study as having low back pain. Muscle activity was measured prior to the active rehab program as well as after the program. Patients were also given a questionnaire to fill out regarding their pain. The results showed that following an active rehab program, pain scales decreased and increase in the height of the low back musculature.
Changes in muscle activity and stature recovery after active rehabilitation for chronic low back pain.
Lewis S1, Holmes P2, Woby S3, Hindle J4, Fowler N2.
Patients with low back pain often demonstrate elevated paraspinal muscle activity compared to asymptomatic controls. This hyperactivity has been associated with a delayed rate of stature recovery following spinal loading tasks. The aim of this study was to investigate the changes in muscle activity and stature recovery in patients with chronic low back pain following an active rehabilitation programme. The body height recovery over a 40-min unloading period was assessed via stadiometry and surface electromyograms were recorded from the paraspinal muscles during standing. The measurements were repeated after patients had attended the rehabilitation programme and again at a six-month follow-up. Analysis was based on 17 patients who completed the post-treatment analysis and 12 of these who also participated in the follow-up. By the end of the six months, patients recovered significantly more height during the unloading session than at their initial visit (ES = 1.18; P < 0.01). Greater stature recovery immediately following the programme was associated with decreased pain (r = -0.55; P = 0.01). The increased height gain after six months suggests that delayed rates of recovery are not primarily caused by disc degeneration. Muscle activity did not decrease after treatment, perhaps reflecting a period of adaptation or altered patterns of motor control. PubMed