Acute effects of early Core exercises program post lumbar arthrodesis. Biofeedback, supervised, autonomously: which is the better methods? Exploratory study.

To evaluate and compare the acute effects of three rehabilitations methods on balance and spine alignment of patients underwent LIF.

Twentyseven patients (58.67±8.49 yy; 13 Female) were recruited, signed an informed consent and randomly divided into three groups who did the same core exercises of perception and activation for the same time but using different tools. Before starting, all participants were trained by the same physiotherapist to do the exercises correctly. BF, used autonomously a visual biofeedback provided by a monitor connected to an inertial sensor, worn on the sternum, and a stabilometric platform (Riablo, Euleria Health, Rovereto, Italy). SV and AE used a checkered mirror. SV did the exercises with the corrections of the physiotherapist while AE did it independently. No significant differences between groups at baseline. The interventions were done the second day after LIF and lasted 10 minutes. Before (T0) and after the intervention (T1), an assessment was made. Balance and Spine alignment were evaluated with Spine 3D (Sensormedica, Guidonia, Italy), a non-invasive, three-dimensional optoelectronic detection system that uses Light Detection and Ranging technology combined with a stabilometric platform. In T0, participants were asked to assume the most correct posture possible; in T1, they were asked to do it again using the sensorimotor information learned during the intervention. 

At T1 compared to T0: SV, Spine alignment improve but Balance gets worse; AE, all outcomes worsen; BF, all outcomes improve. A comparison between the groups was also made and  significance was set for p ≤ 0.05. About Balance, significance in favor of BF is highlighted for Delta X, Delta Y and Ellipse area; no significant differences between SV and AE.  No significant difference regarding Spine alignment.

According to the literature SV results shows that, in acute, after a supervised session of perception and activation core exercises, Spine alignment improve and Balance gets worse. BF results suggest that the use of the stabilometric platform prevent the Balance worsening. Conversely AE is not useful.

Immediately post LIF, a session of core perception and activation exercises, supported by a visual biofeedback, could reduce the postural sequelae made by the surgery.