Lucrare in Engleza

8/20/2019 Lucrare in Engleza

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THE IMPORTANCE OF PHYSICAL THERAPY IN RECOVERY OF

ARTHRITIC JOINTS

Stan Mariana

Ivan GabrielaAsist. Univ. r! "#itres$" An$a

E$%l%&i$al Universit' %( )"$*arest



Keywords: Arthrosis, joints, Kinetic treatment, Recovery, Chronic rheumatism degenerative.

Unprecedented developments in the technical field,have led to profoundtransformations in the lives of the population.Both freely practiced, eercise and physical

wor! were reduced due to the increasing degree of comfort and civili"ation.But reducing the

physical effort has led to the emergence of sedentary, which nowadays has #ecome a disease

of the human civili"ation. $his paper aims to provide, on the one hand, issues of artro"ice

diseases, on the other hand put in the foreground elements of anatomy applied in functional

recovery of hip joint arthrosis Briefly in the paper have #een included as #ac!ground

information in advance of the presentation theme successive phases of treatment through

medical gymnastics. %uring the recovery process, as the social&medical comple, physical

therapy is a therapeutic means. $he importance of stemming from her etended herself so

long as the disease evolves. 'n the case ofarthrosis physical therapy may #e etended for a

long duration of time. $he treatment of the locomotor system re(uires the colla#oration of ateam of specialists in the fields of : surgery,orthopedics, physiotherapy, physical therapy,

!inetoteraphy, technicians in the field of orthotics and prosthesis, as well as other medical and

paramedical staff, each purpose for which specialist the specific o#jectives of.

Arthritis are chronic arthropathies, painful sometimes shear characteri"ed #y

altering the articular cartilage and hypertrophic lesions of epifi"iar #one eosto"e. Arthritis are

encountered fre(uently in people over )* years after this age their fre(uency increasing as the

passage of the years. $oday ,when average life span has increased significantly compared to

previous years in many countries including in our country approimately +* years the

proportion that is elderly is particularly high. 't is natural that society to handle this part of the

population including healthcare. $hats why doctors around the world deal with this type of

ailments common at this age. 't is triggered when certain protein constituents modify while others increase the

num#er or si"e of. 't is in fact an attempt #y the #ody to repair the cartilage cells proliferation

#ut the result of this #alance #etween the action of destruction and that regeneration is a

cartilage which ma!e it disappear surface smoothness of connection of #ones and that allow

them to slip.

$his process is accompanied #y a mass production of en"ymes that typically sits in

cartilage cells.$he action of these en"ymes cause local swelling which increases tissue

damage. 'n soon, small erosions occur on the surface of cartilage that now seems to #e full of

small craters. -o the neigh#or #one will #e damaged with crac!s and cysts. At the same time

in an attempt to develop the contact surface of #ones and thus get greater sta#ility, #one grows

#ut this os is no longer one normal #ut is louder and more li!ely the micro&fractures that occur especially when the joints supports an unusually high weight. %ue to the inflammatory

process each element of the joint undergoes hypertrophy : tendons, muscles, ligaments and

joint capsule.

$he progress of this disease varies from patient to patient. $his condition

can develop up to the total destruction of the joint, or to stop at a time.$here are patients with

deformed fingers #ut felt no pain, while others may invo!e pain while a o#vious deformity of

the joints. Arthrosis are common especially in people over )* years. 'n the case of joint pains

which shows a young or young * years, there is another process typically pathology,

inflammatory or mechanical congenital, degenerative, not one.

Chronic rheumatism, degenerative joint typically affect less one, at least during the onset of

the disease. /ost often #e seen in the following joints: hip 0coofemoral osteoarthritis or

osteoarthritis12 !nee 0!nee osteoarthritis or osteoarthritis12 3and 4oints or spine



'n advanced osteoarthritis, affected joints may #e deformed and increased in volume

due to growths, sometimes eu#erant #one etremities. Apart from osteoarthritis pain longer

accompany the delimitation joint range of motion,for eample in osteoarthritis sufferer

mem#er not fle as #efore, ends harder to #raid sits difficult position legs.

Arthrosis evolution is chronic, lasting for long periods of time. 'n the a#sence of

ade(uate treatment, degenerative lesions is increasing from year to year, with no other alternative 0once produced no lesions regress1.

Arthritic patients typically have the following characteristics sociological: aniety,

neurotic, limitation of daily activities or wor! , limitation of joy and personal satisfaction.

Arthrosis diagnosis is made through la#oratory namely #y radiological

eamination that epress the corresponding modifications lesions. As a result of the thinning

of the cartilage, joint space is reduced. %ensification #one #eneath the cartilage eroded #y

emphasi"ing translatess opacity to 5&rays and the presence of osteophytes, which appear as

horns, help shape clinical radiological picture. 6ther la#oratory tests, such as those that reveal

an inflammatory process, acute or chronic 07-3, electrophoresis1 are normal. $he lac! of a

#iological syndrome of inflammation contri#utes to the differentiation in terms of la#oratory

investigations of arthrosis and arthritis. Arthrosis causes remain un!nown, #ut it deduce that would result from the

occurrence of fractures. -ome reaserchers have judged athroses wrongly, calling them

processes of aging or wear , though neither one nor the other. $he process of senescense is

another pathological component. 8ven though arthrosis are more fre(uent in the elderly, the

fact that they are not present at all the people who have reached a certain age is an argument

against the theory that consider arthrosis li!e a simple result of aging process.

Among the factors that play a role in arthrosis are: mechanical factors 0static disorders,

microtraumas1, endocrine factors 0 menopause, acromegaly1 , meta#olic factors 0high

cholesterol and uric acid in the #lood1.

'n o#ese patients the fre(uency of arthrosis is higher than those of normal weight , as a

result of some mechanisms: re(uiring ecessive joint support, the eistence of meta#olic

disorders, circulator" disorders.

Arthrossis classification, ethiologic criterion: arthrosis primitive 0 no o#vious cause1

and athrosis secodary 0 due to a particular cause, most often a constitutional anomaly1.

By palpation we followed the discovery of small su#cutaneous nodules, hard, whitish,

sometimes ulcerated. -ymmetric palpation allowed me algesia terrain appreciation and

registered maimum joint swelling or periarticular. 9ain evaluation we performed with a

discussion he had with patients after palpation of the patella cartilage faces pressure on its top

edge and ' appreciated it on a visual analogue scale from *&*. -ensitivity assessment we

made using an o#ject with internal ti#ial plateau wal!ed in the popliteal space ' as!ed the

patient if she or something. $he various treatments are applied with the intention of suppressing the

inflammatory process of rheumatoid and hoping to relieve symptoms and prevent joint

damage etension. Among the forms of treatment include: drug treatment, physical therapy2

03ydrotherapy, 8lectrotherapy1 surgery.

Kinesiology Reha#ilitation 9rogram includes:

9osture & complete program for fighting joint stiffness. 't starts from the position of

maimum permissi#le amplitude with stiffness and long&acting eternal forces while

attempting to increase the amplitude of movement angles. Can #e used to help some

proprioceptive neuromuscular facilitation techni(ues such as alternating contraction isometric

& isotonic, rhythmic sta#ili"ation. 'n osteoarthritis & avoiding fleums, for deviations in the

frontal plane 0varus, valgus1 is immaterial direct posture, posture correction is only valid for wal!ing foot with shoe inserts. 4oint mo#ili"ation& to maintain or increase the range of



movement.;ou can use all the techni(ues !nown: posture, passive motion, active,etc.

Restoring sta#ility #oth analytical muscle toning eercises and closed !inetic chain eercises2

Restoration of muscle control dynamic wal!ing 0coordination, #alance, a#ility1 so as to avoid

limping ./uscle tone: in osteoarthritis muscle tone that will follow !nee wal!ing & mainly

(uadriceps and hamstrings will pursue recovery etensor force for the last * <. Restoring

sta#ility #oth analytical muscle toning eercises and closed !inetic chain eercises, eercise #i!e ergonomic indicated individuali"ation for each patient provided the wor!ing parameters.

/uscle contractions can #e isotonic and isometric. Kinetic treatment follows: control and pain

relief, maintaining = increasing joint mo#ility, maintain = increase muscle tone, fighting

deformations gait reha#ilitation.



CA-8 -$U%'8-

CA-8 >R.

>A/8: R./A?8: +*9R6@8--'6>: 9ensioner

$6>: Bucharest

@'R-$ %'A?>6-8: left secondary

gonarthrosis

-8C6>%AR; %'A?>6-8-: )&-

disc herniation left paralytic operated in

**+, #lood pressure

R8A-6> @6R 9R8-8>$A$'6>:

inflamathory rheumatic character,significant weight gain, dyspnea on

minimal effort.

A>A/>8-'-: difficulty wal!ing only

with support, family history thereof

rheumatic diseases.

?8>8RA C'>'CA 85A/:

9A'> A--8--/8>$: after the first

eamination, assessment of visual

analogue pain scale is +.

'>-98C$'6>: genu valgum secondaryosteoarthritis and disorders of the return

movement, partial facial swelling earlier,

accompanied #y redness of the s!in

9A9A$'6> : it feels the movement of

patella,limiting fleion and etension due

to joint swelling, limitation of a#duction of

the !nee joint angle of the thigh with the

leg is * <, limiting painful internal and

eternal rotation of the leg.

-8>-'$'7'$; : diminished sensitivityto the left !nee and the right to a

significant deterioration in mo#ility

assessment & grade '' gonarthrosis of the

laity 0stiffness1 moderate #etween * and

* < A--8--/8>$ 6@ /U-C8

$6>8&found strength D & patient may

perform a movement against gravity and

resistance against small.

CA-8 >R.

>A/8: C.?

A?8: )

9R6@8--'6>: Unemployed

$6>: Bucharest

@'R-$ %'A?>6-8: severe #ilateral

gonarthrosis

-8C6>%AR;%'A?>6-8:amyotrophic lateral sclerosis, hypertension,

o#esity grade ''R8A-6> @6R 9R8-8>$A$'6>:

rheumatic pain, venous stasis,

impotence, weight gain importance: a#out

!g, minimum effort dyspnea, severe

pain and to stand upright

A>A/>8-'-: impossi#le wal!ing

without crutches

?8>8RA C'>'C 85A/:

9A'> A--8-/8>$: After the first

eamination, assessment of visualanalogue pain scale is E.

'>-98C$'6>: return movement

disorders, swelling severe #ilateral

gonarthrosis genu fleum and of the face

earlier, with redness of the s!in

9A9A$'6>: it feels the movement of

patella,limiting fleion and etension due

to joint swelling, limitation of a#duction of

the !nee joint angle of the thigh with the

leg is * <, limiting painful internal andeternal rotation of the leg.

-8>-'$'7'$;: deterioration of

sensitivity.

/6B;'$;: gonarthrossis grade ''

with moderate laity *&*< .

A--8-/8>$ 6@ /U-C8 $6>8:found strength F , patient performed

movement against gravity , #ut not

resistance.



@or a restoration close to normal, phisical therapy is esential through its tehni(ues and

methods which has a great value for #enefic results. Applying the aproprietly treatment, the

reintegration in daily activities was (uic!ly done. $he application eercises, #oth physical

therapy programs practiced in institutions 0hospitals, clinics1 and at home, must #e o#served

regarding individuali"ation methodical effort, #ut also the correct driving s!ills training 0from

easy to difficult, from the !nown the un!nown, from simple to comple1.

B'B'6?RA93;:

.Arseni C., Constantinovici A., Gi 9ano"a ?., HTraumatismele vertebro-medulare şi ale

nervilor I, 8ditura /edicalJ, BucureGti E+F2

.Baciu C., H-emiologia clinica a aparatului locomotor I, 8ditura /edicalJ, BucureGti E+)2

F.Cio#anu 7., -troiescu, ., Gi Urseanu ., HSemiologie şi diagnostic în reumatologieI,

8ditura /edicalJ, BucureGti EE2

D.%enichi, A.,Gi Antonescu,%., HGonartroza” , 8ditura /edicalJ, BucureGti E++2

).%umitru, %., “Ghid de reeducare funţionalăI, 8ditura -port $urist, BucureGti E2

. $udor L#enghe !"inetologie profilactică terapeutică şi de

recuperare! #ditura $edicală %ucureşti &'()*

+.$rosc 9., Radu %., “Genunchiul instabil durerosI, 8ditura 4unimea, 'aGi E+2

.Urseanu, '., M +eumatismul adultului t,năr I, 8ditura /ilitarJ, BucureGti E+E

Lucrare in Engleza

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