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
| Â | 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 âž” awareness âž” active coping âž” 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 |