初級 頸椎骨折後リハビリテーション

Pain level at or below 3/10 at rest with static cervical spine positioning,No neurological deficits (radiculopathy, sensory changes) in cervical nerve root distribution,Cervical spine maintained in neutral alignment with prescribed orthotic device if indicated,Paraspinal muscle spasm reduced by at least 30% on palpation,Intervertebral foraminal patency maintained without compression signs,Cardiovascular tolerance to supine positioning exercises for 5 minutes without symptom exacerbation

→ 次の段階へ： Early Mobilization Phase

Pain level at or below 2/10 with gentle cervical spine active assisted range of motion,Cervical flexor endurance test hold time greater than 10 seconds in supine,Tolerance to cervical retraction (deep neck flexor activation) without increased symptoms,Facet joint mobility assessment reveals no hypermobility or painful translation,Active cervical rotation improved to 30 degrees bilaterally without dizziness,Ability to perform scapular stabilization exercises without compensatory cervical motion

→ 次の段階へ： Intermediate Mobilization Phase

Cervical active range of motion improved to 50% of normal in flexion, extension, and rotation,Deep cervical flexor (longus capitis, longus colli) contraction palpable on manual palpation,No provocation of symptoms with cervical facet joint loading in neutral and rotated positions,Tolerance to prone lying exercises for 10 minutes without positional intolerance,Cervical proprioception: ability to maintain neutral head position with eyes closed for 30 seconds,Isometric cervical muscle testing (flexors, extensors, lateral flexors) rated 3/5 without pain escalation

→ 次の段階へ： Strengthening Phase

Cervical range of motion achieved to 70% of normal in all planes,Neck Disability Index score improved by at least 10 points from baseline,Cervical flexor endurance test improved to greater than 30 seconds hold,Scapular upward rotation and posterior tilt during arm elevation without excessive cervical substitution,Tolerance to light resistance cervical strengthening (2-3 lbs) without post-exercise symptom increase,Intervertebral disc height maintained on functional movement patterns without pain provocation

→ 次の段階へ： Advanced Strengthening Phase

Cervical range of motion restored to 85% of normal in all planes,Cervical muscular strength 4/5 on manual muscle testing for flexors, extensors, and lateral flexors,No recurrence of neurological symptoms with sustained cervical positions or movement,Functional capacity to maintain neutral cervical posture during 30 minutes of sitting,Cervical proprioception testing: accurate head repositioning within 5 degrees of target,Multifidus and erector spinae activation observable on ultrasound or palpation during loading tasks

→ 次の段階へ： Functional Integration Phase

Neck Disability Index score below 20 points (mild disability),Pain-free completion of cervical movement patterns during activities of daily living,Cervical endurance sufficient for 20 repetitions of resisted cervical exercises,Tolerance to functional positions (driving, computer work) for 45-minute sessions without flare-up,Cervical nerve root function normal on neurological screening (motor, sensory, reflex),Facet joint stress testing negative for painful articular dysfunction

→ 次の段階へ： Return to Activity Phase

Full cervical range of motion restored (within 10 degrees of normal),Cervical muscular endurance: flexor endurance test greater than 45 seconds,Return to light work duties without cervical symptom exacerbation,No夜间疼痛 (night pain) or morning stiffness greater than 15 minutes,Proprioceptive accuracy within normal limits on cervical repositioning accuracy test,Vertebral body consolidation evidenced by imaging if performed (clinical clearance)

→ 次の段階へ： Final Conditioning Phase

Neck Disability Index score below 10 points (minimal disability),Complete return to pre-injury activity level without restrictions,Cervical muscle strength 5/5 on manual muscle testing,No compensatory movement patterns in scapulothoracic or cervicothoracic junctions,Patient education completed on spine hygiene, ergonomic principles, and maintenance exercises,Visual Analog Scale score 0-1/10 with full activity participation