Phase I Fusion: 6-10 Weeks Post-Surgery

• Instruction in proper icing techniques to control inflammation
• Anti-inflammatory modalities on a limited basis
• Dural stretching / gentle AROM, avoid rotation
• Floor stabilization exercises as tolerated
• Low intensity cardiovascular exercise ( 5-15 min / 50-60%max HR)
• Posture and body mechanics instruction with ADL’s
• Return to light ADL’s

Phase II Fusion: 11-15 Weeks Post-Surgery

• No isometric tests
• No rotational MedX or forced 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

MedX cervical rehabilitation

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

MedX lumbar rehabilitation

• Limit lumbar 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 weight resistance is at 20-30% BW for females & males
• Resistance exercise limited to 40 repetitions at moderate fatigue level.
• Progress to max weights at 40%BW for females, 50%BW for males

Phase III Fusion: 6 Months 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 limited AROM at most 0-108 (normal is 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/ 20-30inch-lbs for men
• Resistance exercise limited to 40 repetitions at a moderate fatigue level; pain limited
• Progress resistance up to max 60 women/ 90 men; additional resistance by doctor order only

MedX lumbar rehabilitation

• Progress slowly to 12-60 at most (normal 0-72)
• Progress weights to max 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 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