An evaluation of the rehabilitation for patients recovering from knee joint trauma surgically treated by internal osteosynthesis

Paweł Ryngier, Edward Saulicz, Rafał Gnat, Tomasz Wolny

Paweł Ryngier, Edward Saulicz, Rafał Gnat, Tomasz Wolny – An evaluation of the rehabilitation for patients recovering from knee joint trauma surgically treated by internal osteosynthesis. Fizjoterapia Polska 2001; 1(4); 369-375

Abstract
Background. When the knee joint is immobilized, the sliding of joint surfaces is quickly reduced, primarily as a result of the periartricular contraction of the soft tissues (especially the articular capsule). This kind of mechanical imbalance between gliding and rolling is additionally strengthened by the disturbance of muscle equilibrium, both between different muscle groups (the femoral quadriceps and the ischio-crural muscles) and within the thigh muscle itself (between the vastus medialis and the rectus femoris). In the latter case, this status may also lead to the physiological route of knee-cap slide. In view of the complex arthromechanics of the knee joint and the proper distribution of muscle strength for its functioning, the purpose of our research was to study the impact of selected techniques of manual therapy and some of the motion patterns of the PNF method on improving the activity of the knee joint patients with injuries in the vicinity of this joint surgically treated by internal osteosynthesis. Material and methods. The study involved two groups of 17 people who were treated surgically for injuries to the vicinity of the knee joint. After a period of immobility the active mobility of this joint was assessed in all patients, along with the strength of the muscles functionally connected with the knee joint and subjective pain complaints. The studied patients from both groups underwent routine rehabilitation. Selected traction and mobilization techniques for the knee joint were additionally introduced for the patients from the main group, with exercises based on the notion of post-isometric relaxation and some motion patterns taken from PNF models. Results. The statistical analysis of the quantitative data we acquired pointed to a larger range of improvement in the mobility of the knee joint, associated with a somewhat larger simultaneous increase in the strength of the evaluated muscle groups among the patients from the main group.

Key words:
Immobilization, kinesitherapy, manual therapy

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Changes of values of selected spirometric parameters in course of complex rehabilitation treatment in patients with scolioses of I° and II°

Rafał Gnat, Edward Saulicz, Marek Zięba, Paweł Ryngier

Rafał Gnat, Edward Saulicz, Marek Zięba, Paweł Ryngier – Changes of values of selected spirometric parameters in course of complex rehabilitation treatment in patients with scolioses of I° and II°. Fizjoterapia Polska 2003; 3(1); 21-29

Abstract
Both the values of the spirometric parameters in people with low-degree scoliosis and their changes in course of the rehabilitation treatment aiming to correct the body posture are subjects rarely mentioned in literature. Just sparse articles give evidence for the presence of respiratory disturbances even in early stages of the development of scoliosis. The hypothesis claiming that normalisation of the values of selected spirometric parameters, decreased earlier, during attempts of correction of the body posture could be obtained was brought forward for needs of the presented report. 60 children with scolioses of Ist and IInd degree and without any coexisting health problems participated. The evaluation of the values of selected spirometric parameters was performed twice: at the beginning of the treatment (initial test) and after its termination (final test). The time of therapeutic influence averaged 28,77 days (SD = 9,47) and daily load with corrective exercises about 3 hours with supplementary procedures. During the period of time between initial and final tests most of the assessed spirometric parameters showed significant improvement increasing their values and bringing them closer to standards (FVC EX, FVC IN, FEV1, PEF, PIF, VC, IC). The ERV parameter didn’t show any important alterations. The volumes TV and MV as well as Tiffeneau coefficient maintained their previous rise tendencies.According to the stated hypothesis the corrective rehabilitation treatment improved values of selected spirometric parameters, which were decreased in course of low-degree scoliosis. Basing on the results some practical clues concerning corrective treatment of this postural fault may also be formulated.

Key words:
Scoliosis, rehabilitation treatment, Spirometry, spirometric parameters

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