International Journal of Physical Medicine & Rehabilitation
Open Access

Aggressive Rehabilitation

An aggressive rehabilitation protocol is defined as early use of passive or active range of motion exercise, increased dosage of a rehabilitation protocol, an accelerated or intensive rehabilitation protocol, or combined pre-operative rehabilitation [1,5-7].

Increasingly, such aggressive rehabilitation is being used to maximize restored function after cell-transplantation or other innovative surgeries that are surfacing throughout the world, including those discussed in previous articles. Often videos are produced to document improvement, and given the impressive nature of the physical activities that could be done after but not before surgery, it is assumed that the new-found abilities prove the intervention’s efficacy.

However, this assumption may not be valid; in fact, in some cases, perhaps little of the restored function is due to the surgery but rather to the rehabilitation aggressively pursued after the intervention but not before. If post-surgical functional recovery depends upon slowly regenerating neurons reaching an anatomically distant target site, it will take a relatively long time for improvements to appear. If during that period, the patient is enthusiastically working out, the true cause of any ensuing improvement is questionable. As such, some surgical interventions now require patients to aggressively rehabilitate before, as well as after, surgery.

Furthermore, if patients believe with heart-and-soul conviction that the surgery will help him, it will shift their consciousness from the prior “you-will-never-walk-again” attitude that is often imprinted on the patient’s consciousness by our medical authorities to a self-fulfilling belief of what may be truly possible through hard work. Their will propels them to new functional levels, perhaps only a small amount of which is actually due to the surgery.