Spinal Disorders: Fundamentals of Diagnosis and Treatment Part 63. Spinal disorders are among the most common medical conditions with significant impact on health related quality of life, use of health care resources and socio-economic costs. Spinal surgery is still one of the fastest growing areas in clinical medicine. | Postoperative Rehabilitation Chapter 22 611 Table 5. Cont. Task Goal Getting To instruct the patient about dressed getting dressed with minimal loading of the spine Sitting To inform the patient about the optimal sitting posture and duration. If necessary a supportive pillow is recommended Driving To instruct a patient on how to get in and out of a car. The position of the seat should be discussed as well as the importance of short breaks when driving over a longer period of time Taking a To evaluate self-care at home shower or bath patient s daily routine. To ensure good compliance and motivation it is of great importance that the exercises are simple and of short duration. Finally the home exercise program must be customized in conjunction with the surgeon based on the surgical procedure the associated contraindications and the current functional status of the patient Tables 6 7 . 612 Section Degenerative Disorders Table 6. Home exercise program after lumbar surgery Exercise Activation of m. transversus abdominis Goal To increase the ability of selective transverse abdominis activation Coordination of m. transversus abdominis while moving the lower extremity Stabilization of the trunk muscles and strengthening of the lower extremity muscles Stretching ofthe gluteal muscles After soft tissue healing stretching and strengthening exercises can be intensified To increase independency between active lumbar spine stabilization and movement of the extremity Exercise with regard to activities of daily living sit to stand and body awareness To increase flexibility of the gluteal muscles and gentle mobilization ofthe lower lumbar spine into flexion However the therapist may provide patients with educational information regarding back care basic body mechanics and practical tips for self-care. This can be in the form of group education brochures and accurate internet web sites. Approximately 3 months after surgery biological healing is complete and exercises can be .
