Spinal compression fracture

[zisuer]

Thanks for all comments, guys.

I did a lot of research on compression #, did not find any good paper about rehab program. I worry about flexion. I was taught it should be avoid. ext should be prefered, how much flexion we can go?

Hehe, after 8 weeks immobilization in ext, my client cannot tolerate back extension. When I checked his facet jts, they are irritable. I only let him do ROM within pain free range, pelvic tilt, and core stabilization. He felt much better after 1st Rx. I want to do PIVM on him, he can't tolerate it. He can not tolerate all four position. So I believe, we have to go gradually on everything. Hehe. My teacher told me the rehab need 4-6 months. So my second Rx, I just reinforce the core training and a bit limb movement. Encourage increase walking ( increase cardiac conditioning). My client likes swimming. I am thinking let him do resistance exe in water. still thinking.

I really need a systemic review on rehab for compression #. No idea what I should do on patient next.

[Quickstart]

These fractures are difficult little devils to deal with, but I've found that it is most beneficial to follow the following regimen:

- Stage I: In the initial stages the patient is going to have lots of pain, and concommitant muscle spasm. This is the area you really want to work on first. I usually work on decreasing muscle tone in the upper thoracic and lower lumbar regions (leaving the thoraco-lumbar junction alone) until about 6weeks post injury. I also strongly recommend getting your patient a thoraco-lumbar back brace to help support the spine and core muscles. Start very gentle isometric core exercises (TA/Mult) and add some gentle weight-bearing exercise. Hydro pool gentle walking to begin with, then overground.

- Stage II: At about week 6-10 more emphasis on core strengthening, gentle mobilisations of the joints around the compression fracture (but avoiding levels immediately above or below) and soft tissue work on the affected levels. Try weaning off the brace for lighter tasks.

- Stage III: 10-20 weeks. Repeat X-ray, document healing rates. If union has occurred then mobilisation of the affected area can begin, and pilates in a neutral/flexion bias position can begin. Slowly progress to gentle extension bias. Wean off brace.