Proposal for rehabilitation after conservative treatment and in the presence of complications in Colles’ fracture – selected aspects

Aneta Bac, Dorota Czechowska, Andrzej Szczygieł

Aneta Bac, Dorota Czechowska, Andrzej Szczygieł – Proposal for rehabilitation after conservative treatment and in the presence of complications in Colles’ fracture – selected aspects. Fizjoterapia Polska 2009; 9(2); 181-190

Abstract
Colles’ fracture is one of the most common types of forearm fractures, affecting mainty women around the age of 60, most often those suffering from osteoporosis. On the basis of literature data and the authors’ own experiences, the article presents protocols of physiotherapeutic management ofpatients with fractures ofthe distal epiphysis ofthe radius and management of complications associated with these fractures. The therapeutic procedure consists of three basie stages. The first two are the repositioning and immobilization of the fracture, sometimes preceded by surgical intervention. The third stage consists in intensive physiotherapy aiming to speed up the bone healing process, restore as much wrist mobility as possible, restore limb strength and function, and prevent or cope with possible complications. Physiotherapists dealing with a Colles fracture employ a yariety of exercises using specialist equipment and modern manual therapy techniques, such as the „hold-relax techniques, Brian Mulligan’s MWM, and, in later stages, active exercises aga-inst resistance. The goal of the therapy is to achieve fuli range of motion in the joint, inerease muscle strength and improve pro-prioception. Working with the patient, the therapist can utilize appropriate equipment, functional exercises related to actMties ofda-ily living, and physical agents. As with any musculoskeletal injury, fractures of the distal epiphysis of the radius may be accompa-nied by various complications. These can be divided into early (loss of reposition, median nerve neuropathy etc.) and late complications. The latter group includes incorrect union of fractured bone, carpal tunnel syndrome, wrist instability etc. Early and appropriate physiotherapy may prevent many secondary complications and speed up fuli functional recovery of the patient.
Key words:
Colles fracture, exercises, mobilisations with movement, secondary complications
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Factors influencing the incidence of shoulder pain in post-stroke patients

Teresa Pop, Agnieszka Dziedzic, Katarzyna Łach-Pop

Teresa Pop, Agnieszka Dziedzic, Katarzyna Łach-Pop – Factors influencing the incidence of shoulder pain in post-stroke patients. Fizjoterapia Polska 2010; 10(2); 103-112

Abstract
Pain and functional impairment of the paretic shoulder are a frequent complication in post-stroke patients. The pain is mostly localised to the glenohumeral joint, but sometimes radiates to the upper arm and, infrequently, to the forearm. The paper aims at assessing the incidence of shoulder joint pain in post-stroke patients, and at investigating the predisposing factors. Material and method. The study group consisted of 81 stroke survivors (41 females and 40 males) hospitalized due to stroke in the Stroke Unit of the Neurology Ward and in the Rehabilitation Ward.The study used a questionnaire to obtain characteristics of the study group, a VAS scale to assess pain intensity, as well as the Ashworth scale and Barthel index. Shoulder joint pain occurred in 58% of the participants. Mean pain intensity was 5 according to the VAS scale. Muscle tone in the upper extremity in the study group averaged at 2 in the Ashworth scale. Among those suffering from shoulder pain, 53% experienced it in the morning.
Key words:
stroke, complications, shoulder, pain
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