初級 頸椎術後リハビリテーション

Pain level ≤3/10 at rest with verbal report of tolerable incisional discomfort,Cervical ROM limited to neutral rotation (0-45°), flexion/extension within pain-free ranges,Neurological status stable with no worsening radicular symptoms into bilateral upper extremities,Patient demonstrates independent bed mobility with log-roll technique protecting cervical spine,Soft tissue tolerance allows gentle palpation of cervical paraspinals without exacerbation,Cardiovascular tolerance for 10-15 minutes of seated activity without orthostatic symptoms

→ 次の段階へ： Early Mobility Phase (Weeks 2-3)

Incisional healing progressing without signs of infection or dehiscence,Active cervical flexion improved to 30°, extension to 20° without provocation of radicular symptoms,Patient demonstrates proper chin-tuck posture in sitting with cervical support for 15 minutes,Deep cervical flexor activation visible during supine craniocervical flexion with pressure biofeedback,Tolerates prone lying with pillow under forehead for 5 minutes without increased neck pain,Grip strength ≥70% of contralateral side or baseline, no worsening upper extremity paresthesia

→ 次の段階へ： Early Mobility Phase (Weeks 3-4)

Cervical flexion ROM 40°, extension 30°, rotation 60° bilaterally without reproduction of radicular pain,Patient independently performs cervical retraction (chin-tuck) 10 repetitions with proper technique,Scapular setting demonstrated in sitting with shoulders in neutral, no compensatory cervical elevation,Tolerates 20 minutes of gentle cervical ROM exercises without post-exercise soreness increase,Upper trapezius and levator scapulae tension ≤3/5 on modified Ashworth scale,Able to maintain neutral cervical posture during functional activities for 30-minute periods

→ 次の段階へ： Intermediate Phase (Weeks 4-5)

Cervical rotation improved to 70° bilaterally, lateral flexion 35° each side within tolerance,Craniocervical flexion test achieves 22-24 mmHg pressure (level 3-4) with proper activation pattern,Patient demonstrates coordinated scapulothoracic movement during shoulder flexion to 90°,No reproduction of facet joint pain with gentle posterior-anterior glides on cervical spinous processes,Tolerates isometric cervical muscle contractions held for 5 seconds without increase in symptoms,Able to perform activities of daily living requiring cervical rotation (checking blind spots) safely

→ 次の段階へ： Intermediate Phase (Weeks 5-6)

Full pain-free cervical ROM in all planes except combined movements requiring surgical clearance,Cervical extensor endurance test holds neutral position for 60 seconds without tremor or substitution,Patient demonstrates isolated deep cervical flexor activation without superficial flexor substitution,Shoulder abduction to 90° without scapular winging or elevation of cervical spine,Tolerance for 30 minutes of therapeutic exercise without post-treatment symptom exacerbation,Postural awareness improves with ability to correct forward head position independently

→ 次の段階へ： Advanced Strengthening (Weeks 6-7)

Neck Disability Index score improved by ≥10 points from baseline,Cervical proprioception testing demonstrates accurate reproduction of neutral head position with eyes closed,Patient tolerates resistance training with Theraband at yellow-green level for cervical stabilization,Deep cervical flexor endurance test achieves >30 seconds hold at optimal pressure,No reproduction of discogenic pain with loaded cervical flexion/extension activities,Tolerates 45-minute therapy sessions with intermittent rest breaks

→ 次の段階へ： Advanced Strengthening (Weeks 7-8)

Cervical muscle strength ≥4/5 on manual muscle testing for flexors, extensors, and lateral flexors,Patient demonstrates proper cervical spine protection during lifting tasks ( <5 lbs),Scapular stability allows unilateral arm activities without compensatory cervical movement,Endurance testing for cervical extensors achieves 90+ seconds without fatigue,Tolerates functional simulation of work-related tasks requiring sustained cervical postures,Visual analog scale during activities ≤2/10, returning to baseline within 24 hours post-exercise

→ 次の段階へ： Return to Function (Weeks 8-9)

Cervical ROM within 10% of preoperative baseline or functional requirements,Patient completes cervical stabilization exercises with external perturbation training,Return to light duty work activities with proper ergonomic setup and periodic breaks,Proprioceptive training achieves 80% accuracy in head repositioning tasks,Grip strength returns to 90%+ of contralateral side or baseline,Tolerance for community outings and driving with cervical support as needed

→ 次の段階へ： Return to Function (Week 9)

Neck Disability Index score <20% disability (mild disability category),Patient demonstrates independent home exercise program with proper cervical spine mechanics,Full return to sedentary work with ergonomic modifications or clearance from surgeon for higher demand,Cervical endurance meets functional demands for 8+ hours of daily activity,No neurological complications including no new or worsening radiculopathy symptoms,Patient reports satisfaction ≥8/10 with functional outcomes and pain management

→ 次の段階へ： Discharge to maintenance program