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Table 1 Staged rehabilitation programme for the staged group

From: Efficacy of lumbar kinetic chain training for staged rehabilitation after percutaneous endoscopic lumbar discectomy

Timing Purpose Treatment points Notes Basic exercises Selective actions
1–3 days To control postoperative pain and prevent complications Rest in bed, turn over axially with medication. Limb active movement training, lower extremity passive joint mobility training or active joint mobility training. Assess lower extremity sensation and motor function. Use analgesics when necessary. Patients who did show a worsened condition after the operation entered the lower-level rehabilitation. Passive straight-leg raising exercises Bridge support
(Single bridge)
4 days-2 weeks To control waist movement and carry out physical rehabilitation. Active training for the lower extremities in bed, straight leg raising training and isometric contraction training for lumbar extensors. A waist girdle or lumbosacral brace was used to stand by the bed for 10 min 2–3 times a day. Avoid violent straight leg raising. Apply analgesics when necessary. The patients who can complete this level of training can enter the lower level of rehabilitation. Bridge support
(Single bridge/Double bridge)
Horizontal arch movement and supine curly hug exercise
2–3 weeks To appropriately increase the range of lumbar motion. A hard waist or lumbosacral brace was used for indoor walking, and the walking distance was gradually increased. Equipment was selected mainly to enhance the strength of lower extremity muscles, and the intensity of the exercises was moderate. The patients without complications were discharged. Analgesics were not used. Bridge support
Supine arch motion
Supine curly hug exercise
Prone upper-limb-support stretching exercise
4–6 weeks To gradually strengthen the lower back muscles and abdominal muscles. To gradually transition to daily activities. With protection of the waist, gradually resume walking in the community, participate in daily life activities and non-physical work, and increase the walking distance. Selective training to increase lower extremity muscle endurance. Replace the soft waist support. Avoid weight-bearing on the waist and straight-leg bending activities, learn to sit correctly and maintain lordosis. Bridge support
Supine arch motion
Supine curly hug exercise
Prone upper limb support and stretching exercise
forward bending
Supine leg lift
6–12 weeks To complete daily activities independently and allow patients to perform general work Gradually participate in general work with waist protection.
Gradually perform strength training for the core muscle groups of the spine.
Avoid physical labour and weight-bearing and follow the rehabilitation training plan. Supine arch motion
Supine curly hug exercise
Prone upper limb support and stretching exercises
Sit forward and bend your legs
Modified Yanfei exercise in the supine position pelvic alternate pronation exercise
12–24 weeks To allow patients to independently complete daily activities and participate in normal work Remove waist circumference for functional exercise of lower back gluteal muscles and participate in general work. Perform strengthening training for the core muscles of the spine. Avoid strenuous exercise and high-intensity weight-bearing. Prone upper-limb-support and stretching exercises
Supine leg lift
Modified Yanfei exercise performance
Lateral pelvic strengthening exercise
Crawling training