初級頸椎腱修復リハビリテーション

Cervical collar/wearing protocol as prescribed by surgeon,Neck pain less than 3/10 at rest,No neurological symptoms (numbness, tingling, weakness in arms),Incision healing progressing without signs of infection,Able to tolerate short sitting periods without increased symptoms,Deep cervical flexor activation with chin tucks tolerated

→ 次の段階へ： Week 2-3

Pain less than 4/10 with gentle cervical rotation (less than 30 degrees),Cervical flexion/extension within pain-free range,Tolerance of isometric cervical muscle contractions (2-3 seconds hold),No provocation of radicular symptoms with upper extremity movements,Able to perform chin tucks in neutral without increased neck pain,Scapular positioning exercises tolerated

→ 次の段階へ： Week 4-5

Cervical flexion 30-40 degrees, extension 20-30 degrees,Cervical rotation 45-60 degrees each direction,Lateral flexion 20-30 degrees each side,No reproduction of neural symptoms with cervical movements,Tolerance of prone lying with cervical extension (if indicated),Isometric cervical flexion, extension, and lateral flexion at 50% effort

→ 次の段階へ： Week 4-5

Full pain-free cervical ROM in all planes (flexion, extension, rotation, lateral flexion),Cervical muscular endurance test (craniocervical flexion) holding 10 seconds,Upper extremity strength 4/5 in shoulder abductors,No reproduction of neck or arm pain with resisted movements,Tolerates 10 repetitions of cervical stabilization exercises,Postural awareness improved - reduced forward head position

→ 次の段階へ： Week 6-7

Cervical flexor endurance greater than 20 seconds in modified curl-up,Cervical extensor endurance greater than 20 seconds in prone extension,Lateral flexion strength equal bilaterally (manual muscle testing 4+/5),Tolerates light resistance training (1-2 kg) for upper extremities,No symptom provocation with activities above shoulder height,Functional tolerance for computer work 20-30 minutes

→ 次の段階へ： Week 6-7

Cervical rotation strength 4+/5 bilaterally,Deep cervical flexor coordination with respiratory control,Tolerates progressive resistance (2-4 kg) for cervical musculature,Scapular stabilization exercises (rows, prone Y-T-W) without compensation,Return to light recreational activities permitted,Neck Disability Index improvement of at least 10%

→ 次の段階へ： Week 8-9

Cervical muscle strength 5/5 in all directions,Proprioceptive exercises (cervical position sense) within 10% accuracy,Tolerates full work duties as tolerated,Endurance training 20-30 minutes cardiovascular,No restrictions with lifting up to 5 kg,Patient-reported outcome measures improved by 20%

→ 次の段階へ： Week 8-9

Full cervical ROM equal to pre-injury status,Return to unrestricted work activities,Tolerance of overhead activities without symptoms,Sports-specific training initiated if applicable,Neck Pain and Disability Scale score less than 20%,Patient satisfaction greater than 8/10

→ 次の段階へ： Week 9-10

Functional capacity evaluation passed for job demands,Cervical isokinetic testing within 15% of pre-injury,No restrictions for contact sports (if cleared by surgeon),Independent with home exercise program,Sleep quality return to pre-injury baseline,Psychological readiness for full return

→ 次の段階へ： Week 10

Full return to pre-injury activity level,Maintenance of cervical strength and endurance,No recurrence of symptoms with activity progression,Understanding of warning signs requiring medical attention,Discharge criteria met with individualized home program,Follow-up appointment scheduled

→ 次の段階へ： Discharge