Rehabilitation

REHABILITATION FOR CHIROPRACTIC PATIENTS:

At Boston Spine Clinics, many of our patients are introduced to in-house rehab that features weight lifting. The key here is the protocol used.

Years ago it became clear that while manipulation of the spine is a highly effective therapeusis for helping patients recover from both chronic pain syndromes and ballistic accidents, sometimes manipulation as well as the use of basic therapies such as electrical stimulation and intersegmental traction wasn't enough to complete the recovery process for certain patients.

Enter Rehabilitation Methods: After becoming certified in Rehab Methods I discovered several protocols for patient treatment. The one I settled on is called "ZINOVIEFF," also known as "Phase 1 Rehab." I liked it because it is simple and the weights go DOWN as the patient progresses through each set. Here's an example:

The patient has a neck injury. After determining that s/he is "De-conditioned," it is decided that Rehab is indicated. We start the patient out on a standard cervical weight lifting machine at 10 pounds. The patient is to flex forward with the 10 lbs. of resistance for three seconds to maximum ROM (range of motion). Then, the patient brings his/her neck back to starting position by taking 6 full seconds to to so. This is the so-called "eccentric" aspect of the workout. It is when the muscles are still contracted but lengthening simultaneously as the aparatus is returned to starting position. This is the better aspect of the workout. The flexion forward is called the "concentric" flexion. The patient repeats this 10 times and then rests. The patient next does a second set of 10 repetitions (reps) at 75% of the original weight. In this case, 7.5 lbs. There is minute rest period and the patient finishes up with a final set at 50% of the original weight, in this case 5 lbs. When this is all completed, we have the patient repeat the entire process in cervical extension followed by right and left lateral cervical bending. All together, the patient will have completed 120 reps for the cervical spine that day in a supervised, injury free protocol. I have never had to use a different protocol in my offices. The same ZINOVIEFF system is used for lumbar flexion and extension. It has helped thousands of patients complete their treatment with us successfully in conjuction with chiropractic manipulation of the spine and other therapies.

Note the following recent article: Murphy B, Taylor HH, Marshall P, "The Effect of Spinal Manipulation on the Efficacy of a Rehabilitation Protocol for Patients with Chronic Neck Pain: A Pilot Study," JMPT Vol. 33, #3, March-April 2010.   Upshot: Chiropractic care combined with exercise and exercise alone are both effective at reducing functional disability and pain in chronic non-specific neck pain patients. *2009 ACC-RAC Award Winning Paper.

Dr. Haberstroh is a Boston Chiropractor and a Somerville Chiropractor.