Phase I Non-Fusion: 2-4 Weeks Post-Surgery

• Instruction in proper icing techniques to control inflammation
• Anti-inflammatory modalities on a limited basis
• Dural stretching / gentle AROM exercise
• McKenzie extension exercise progression
• Floor stabilization exercises including abdominal isometrics, bridging, glut squeezes, lower abdominal exercises, etc.
• Low intensity cardiovascular exercise ( 5-15 min / 50-60%max HR)
• Posture and body mechanics instruction with ADL’s
• Return to light ADL’s
• Limit flexion exercises and activities

Phase II Non-Fusion: 4-8 Weeks Post-Surgery

• No isometric tests
• No rotational MedX or rotational exercise
• Progression of spinal mobility exercises to include the Swiss ball
• Increased cardiovascular activity (20-30 min / 65-70% max HR)
• Progression of HEP / Circuit to mild-moderate intensity level

MedX cervical EXT rehabilitation

• Limit cervical flexion AROM to 18-90; normal measure is 0-126 degrees
• Starting cervical extension weight resistance of 90-120 inch pounds for females, 120-140 inch pounds for males
• Resistance exercise limited to 40 repetitions at a moderate fatigue level; pain limited
• Progress to max weights at 140 (women) and 180 (men) or by doctor order

MedX lumbar EXT rehabilitation

• Limit lumbar flexion AROM to 12-42 (extension-flexion); normal measure is 0-72 *Ensure patient is moving slowly and pausing to avoid using momentum in shorter arc of motion.
• Starting lumbar resistance is 20-30% BW for females & males
• Resistance exercise limited to 40 repetitions at a moderate fatigue level; pain limited
• Progress to max weights of 40%BW for females, 50% BW for males

Phase III Non-Fusion: 8-12 Weeks Post-Surgery

• Isometric testing per physician
• Rotary MedX added at week 9 per physician
• Increased cardiovascular activity (20-30 min / 65-85% max HR)
• Progression of HEP / Circuit to moderate-max intensity
• Functional and Return to Work conditioning

MedX cervical EXT rehabilitation

• Progress slowly to full cervical flexion AROM (0-126)
• Starting cervical extension weight resistance of 120-140 inch pounds for females, 140-160 for males if not involved with Phase II.
• Resistance exercise limited to 40 repetitions at a moderate-max fatigue; pain limited
• Progress resistance up to 190 inch-lbs for women/ 240 for men; additional resistance by doctor order only

MedX cervical ROT rehabilitation

• Cervical Rotation AROM initially limited to 24-24; not to exceed 54-54
• Cervical Rotation starting resistance 10-20 inch-lbs women/ 20-30 inch-lbs for men
• Resistance exercise limited to 40 repetitions at a moderate fatigue level; pain limited
• Progress resistance up to 60 women/ 90 men; additional resistance by doctor order only

MedX lumbar rehabilitation

• Progress slowly to full flexion AROM (0-72); limit flexion to 48 if weights are heavy
• Progress weights to 60%BW for women; 80%BW for men; additional resistance by doctor order only
• Resistance exercise limited to 40 repetitions at a moderate-max fatigue; pain limited

MedX rotary torso rehabilitation

• Rotary torso initial ROM limited to 36-36; not to exceed 42-42
• Initial resistance at warm up weights of 20 for women / 30 for men
• Progress resistance up to max 30%BW for women / 40%BW for men additional resistance by doctor order
• Resistance exercise limited to 40 repetitions at a moderate fatigue level; pain limited