Table 1 Model of physical therapy program in symptomatic lumbar SPL, proposed by Ferrari and colleagues (from: Ferrari S, Vanti C, Costa F, Fornari M. Can physical therapy centred on cognitive and behavioural principles improve pain self-efficacy in symptomatic lumbar isthmic spondylolisthesis? A case series. J Bodyw Mov Ther. 2016;20 [3]:554–64). Reproduced by kind permission of … . (editor)
From: Lumbar spondylolisthesis: STATE of the art on assessment and conservative treatment
| Education | Ergonomics |
Supervised Exercises | Home exercises | |
|---|---|---|---|---|
| Session #1 | Spondylolisthesis: origin and transmission of lumbar pain | The sitting posture: at home, at work, driving car, with or without lumbar supports |
Awareness of sitting and standing positions Lumbar muscles contraction and relaxation |
Exercises in lying position: bring one or both knees to the chest Supine bridge exercise slowly |
| Session #2 | Modulation of pain: descending pathways, role of drugs and exercise | The standing posture: at home, at work, etc. |
Isometric activation of local stabilizers in supine, quadrupedal, sitting and standing positions Maintaining muscle contraction for 10 s and breathing normally Dynamic tasks, from the easiest to the most difficult, maintaining muscle stabilization and five seconds of static contraction between movements. |
Active exercises in standing position Dynamic simple upper and lower limb movements |
| Session #3 | Active and passive coping strategies: different effects | Load carrying, with or without lumbar support |
Start of the progressive supervised physical and functional graded activity Start of functional recovery of balance and coordination |
Start of Swiss ball exercises Start of aerobic activity (i.e., walking, cycling, swimming) |
| Session #4 | Previous lessons review, to mark the right procedure: pain ➔ awareness ➔ active coping ➔ physical activity | Practical simulation of posture and load management | Starting of functional recovery of strength, endurance, and range of motion |
Progression of exercises in lying, standing, sitting position Progression of aerobic activity |
|
Sessions from #5 to #10 | Prognosis of lumbar Spondylolisthesis | Repetition and reinforcement of concepts | Progression of functional recovery of strength, endurance, range of motion, balance and coordination |
High-loading exercises Nordic walking, dance or Pilates procedures |