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Patients recovering from
cervical spine injuries or those receiving treatment for acute or chronic
cervical dysfunction require a well rounded treatment program. At St.
Mary's Spine Center in San Francisco,we may include education (neck
school), manualtherapy, physical agent modalities, ergonomic assessment,
stretching, and stabilization training. At some point in treatment, every
patient needs an exercise program that includes aerobic conditioning. The
benefits of aerobic conditioning are well documented:
* Decreased occurrence of neck and back pain * Decrease in intensity and duration of orthopedic spine injury * Reduced incapacity and dependence * Lower stress levels and reduced anxiety
At St. Mary's, we believe in using our professional relationship to convince every patient who can safely exercise to do so, as part of their regular treatment program. Unfortunately, not all patients can exercise comfortably on all given modalities. In our center we use a variety of exercise equipment (a treadmill for walking or running; supine or upright stationary bicycle; stair and ladder climbing simulators; cross country sled simulators; upper body ergometers; and weight tralning). We may try numerous combinations of these modalities to meet a patient's individual training needs. In a significant number of cases, patients can exercise only while fully supported in a supine position or in cervical traction. For these patients, use of portable cervical traction units such as the Lossing Neck traction unit has led to good results. One advantage of the Lossing unit is that patients can learn to set themselves up in the unit before, after and/or during some forms of exercise. The patient's condition should be relatively nonirn'table and pain should not be severe; and as a general rule, the exercise should not be executed with the shoulder flexed or abducted more than 90 degrees. Supine exercises may include cycling on a bicycle ergometer, lower extremity exercise and gentle upper body exercises. Beginning asymptomatic exercise in this fashion promotes the "exercise ethic" in our patients by providing a successful exercise experience with the added benefit of encouraging independence from therapists. This article is excerpted from "Supplemental Therapeutics for the Cervical Spine," presented at the American Physical Therapy Association 1991 National Conference in Boston, Mass. |
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