Exercise training should be initiated when the patient learns how to relieve his or her symptoms. Functional activities are the motor activities we most advocate. The patient should be able to perform independent activities of daily living at this stage. Evaluating the patient’s performance and improving the patient’s posture and stability will be effective with the following methods.
1. Weight-bearing exercises.
Modified bridging exercises: Modified bridging exercises require stabilization of the extensor and flexor muscles of the trunk as well as the strength of the quadriceps and gluteus maximus. The gluteus maximus and abdominal muscles work together to control the tilt of the pelvis, and the lumbar extensors stabilize the spine but antagonize the pull of the gluteus maximus.
Patient Position: The patient is placed supine in a flexed hip and knee position, allowing the patient to lift and lower the pelvis with attention to maintaining a normal spinal position. Maintain the bridge in an isometric motion.
Changing arm movements: The strength of the hand support can be changed.
Advanced movements: lift one leg. Extend the knee to allow the leg to be lifted, adding weight at the ankle when the patient can tolerate greater resistance, as well as matching the arm movements. Abduct and adduct the thigh while maintaining the same pelvic position. Legs can also be placed over the yoga ball to increase the difficulty
Push-ups: Doing push-ups strengthens the triceps and scapular band musculature in preparation for exercises that require pushing.
It is necessary to train this movement in the role of controlling the neutral position of the spine.
Patient position: standing or prone facing the wall, supporting the wall or floor with the hands. Remind the patient to maintain a neutral spine position.
This movement can be done on the wall when the patient is not strong enough, and in the prone position, the knee can be used as a support point before the foot.
In order to train the patient’s stabilizing function on the unstable surface, a yoga ball can be placed under the patient’s thighs and knees, with hands propped on the ground to maintain a stable spinal position, and then do push-ups with both hands.
Advanced: Only the lower limbs are supported by the yoga ball, and most of the strength is concentrated in the arms.
2.Traditional stability exercises
Squat and touch: in standing position, make the patient touch the ground downward while squatting, the spine is flexed at this time, so that the patient maintains the neutral position of the spine with the strength of the spinal extensors. The patient is then made to stand and do an overhead motion, which causes the spine to extend to maintain the neutral position of the spine with the force of the flexor muscles.
Progression: The patient is made to do the above with hand weight and still maintain a neutral spine.
Turning and leaning forward and backward: allows the patient to practice weight transfer when leaning forward and backward, as well as lateral movements, while maintaining a neutral spine.
A jump rope as an aid can help you to maintain a neutral spine position while turning and also improve body rotation. Jump rope around the table leg or column, two of each hold the ends of the rope, turn the upper body while pulling the rope back and forth. In the process of practice to pay attention to keep your head stable, while experiencing the transfer of gravity. This exercise can help you increase the range of body movement.