Randomized controlled trial of postoperative exercise rehabilitation program after lumbar spine fusion: study protocol

Abstract Background Lumbar spine fusion (LSF) effectively decreases pain and disability in specific spinal disorders; however, the disability rate following surgery remains high. This, combined with the fact that in Western countries the number of LSF surgeries is increasing rapidly it is important to develop rehabilitation interventions that improve outcomes. Methods/design In the present RCT-study we aim to assess the effectiveness of a combined back-specific and aerobic exercise intervention for patients after LSF surgery. One hundred patients will be randomly allocated to a 12-month exercise intervention arm or a usual care arm. The exercise intervention will start three months after surgery and consist of six individual guidance sessions with a physiotherapist and a home-based exercise program. The primary outcome measures are low back pain, lower extremity pain, disability and quality of life. Secondary outcomes are back function and kinesiophobia. Exercise adherence will also be evaluated. The outcome measurements will be assessed at baseline (3 months postoperatively), at the end of the exercise intervention period (15 months postoperatively), and after a 1-year follow-up. Discussion The present RCT will evaluate the effectiveness of a long-term rehabilitation program after LSF. To our knowledge this will be the first study to evaluate a combination of strength training, control of the neutral lumbar spine position and aerobic training principles in rehabilitation after LSF. Trial registration ClinicalTrials.gov Identifier NCT00834015peerReviewe

Sheet metal prototyping with industrial robots - technical properties and application fields

Since recent times prototyping methods for sheet metal products have mostly been related to rapid tooling, where traditional hard dies are replaced with softer and more inexpensive short lifetime dies. There have been only a few direct sheet metal prototyping methods, and their use has been limited. On the other hand, the sheet metal industry is growing and metals are replacing plastics in many applications due to stricter recycling regulations and rapid metals development. New formable high strength steels are very attractive to industry, because they enable lighter components with the Same mechanical properties. Many industrial sectors take advantage of the new material development, and there is clear need for sophisticated forming methods. As customized products become more and more popular, and new models are created, more prototypes and one-part series are needed in a rapid time schedule and with costs as low as possible. A relatively new approach for sheet metal prototyping is lncremental Sheet Forming (ISF), a sheet metal prototyping method suitable for large variety of products without major tool changes. There is a commercially available forming machine, specially designed for ISF. Also milling machines can be used with certain limitations: the spindles are not designed to handle the forces that appear in ISF and the machines may break down in forming. This paper describes two incremental forming methods which use flexible and cost-efficient industrial robots: forming by pressing and by hammering. Using industrial robots brings cost efficiency and flexibility to the forming. The investment costs for robots are relatively low, which makes these processes well suitable for wide range of applications in a variety of business areas