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Complex rehabilitation after replacement of anterior cruciate ligament of knee joint and return to preoperative acitivites
BOOROVÁ, Pavla
As the topic of my bachelor thesis I chose "Comprehensive rehabilitation after replacement of the anterior cruciate ligament of the knee joint and return to preoperative activities". I chose this topic because the rupture of LCA is very common especially with athletes with whom I would like to work in the future. Another reason was the fact that I have a personal experience with the LCA rupture and I would like to get more into this issue. The anatomy, biomechanics and kinesiology of the knee joint is described in the theoretical part. I consider the chapter in which I deal with the mechanism of LCA injury interesting. I believe that this information could be beneficial not only for athletes. An important chapter the treatment of LCA injury is the one, where I describe both operative and conservative treatment and a chapter dedicated to physiotherapy after LCA sculpture, where I describe the various stages of rehabilitation and the techniques and procedures used. For the practical part I chose the method of qualitative research. The research group contained a total of four patients after LCA rupture. Two of them were treated operatively, and two conservatively. The therapy with surgically treated patients took place between 5th -10th postoperative week, and monitoring conservatively treated patients lasted 4 weeks. All patients were athletic people aged 32 to 52 years. Initial and final kinesiological examinations and appropriate therapy were performed within research. The aim of this work was to determine an appropriate rehabilitation plan that was optimal for patients after LCA surgery and to map alternative methods of treatment for LCA injury. The results of the research show that in the surgically solved patients regular exercise primarily resulted in an increase in joint extent, muscle strength and stability in the knee joint. In the conservatively solved patients we managed to ensure a better stability of the knee joint above all, which was most affected in both patients. This work can be used as a study material for physiotherapists in their clinical practice or for physiotherapy students interested in this issue.
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Casuistry of physiotherapy care of a patient after ACL reconstruction
Szabóová, Veronika ; Neuwirthová, Svatava (advisor) ; Hamouzová, Dita (referee)
Title: Casuistry of physiotherapy care of a patient after ACL reconstruction Objectives: Summary of theoretical knowledge related to the issue of convalescence after anterior cruciate ligament reconstruciton using autograft from patellar ligament in terms of physiotherapy and processing of a physiotherapy care casuistry of a patient with complete anterior cruciate ligament tear treated by this surgical technique, proposing a therapy based on the initial examination, monitoring the process of the therapy and evaluating its results. Summary: The thesis is divided in two parts, the theoretical part and the special part. Theoretical part contains review of a literature discussing anatomy, kinesiology and biomechanics of a knee joint. Furthermore, it describes importance of ligamentous apparatus focused on the anterior cruciate ligament and consequence of its dysfunction for stability of a knee joint. Conclusion of this part is devoted to damages of an anterior cruciate ligament, description of the surgical technique using autograft from the patellar ligament and eventually to subsequent physiotherapy care. The special part is more extensive and forms the case study of a patient after anterior cruciate ligament reconstruction. It contains methodology of the casuistry, input kinesiology analysis,...
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Physiotherapy for patients with LCA rupture during surgical and conservative therapy
PÍCHA, Radek
The bachelor thesis deals with the issue of an anterior cruciate ligament (ligamnetum cruciatum anterius ? LCA) trauma. The anterior cruciate ligament is an important stabilizer of the knee joint. During the LCA lesion serious biomechanical changes occur. The LCA trauma most frequently happens due to forced hyperextension or rotation of the knee joint. Nowadays this injury is quite frequent, in the sports medicine it occurs in the incidence of 1 / 1750 inhabitants. The therapy of the injured LCA has been very efficient recently mainly due to modern approaches both in the medicine and the following rehabilitation. The thesis contains the analysis of the anatomy and biomechanics of the knee joint, the next part describes LCA trauma mechanisms, methods of its examination and possibilities of the successive therapy. One part of the thesis is focused on the comparison of the conservative and the surgical therapy, there are described the circumstances under which it is decided which one of these therapies will be chosen. It is necessary to mention that the most important criterions for the proper therapy choice are the individual needs of the patient. The basic aim of the thesis is the comparison of the efficiency of therapeutic procedures for particular patients and the assembly of the short-term and the long-term treatment plans. The practical part of the thesis is processed by the qualitative research method. Three probands after the surgical therapy and two probands after the conservative therapy were examined. The observation and the therapy for surgically treated patients were carried out between the second and the sixth post-operative week, the examination for conservatively treated patients was carried out for six weeks. Patients were predominantly athletes in the age of 18 ? 24 years. They passed the initial and the final kineziologic examinations and the rehabilitation therapy; the treatment efficiency was rated by the Lysholm score. The initial Lysholm score for surgically treated patients varied between 32 and 34 points and after the therapy it increased to 48 ? 75 points. For conservatively treated patients the initial score varied between 73 and 76 points and the final score was 76 ? 81 points. There is one more important detail in the thesis ? the anthropometry results. The quadriceps femoris perimeter increase was around 1,5cm and the triceps surae perimeter increase was around 1cm. The final examination showed that the majority of the patients is missing minimally 1cm in the quadriceps femoris perimeter compared to the healthy leg. The similar indicator has been found also for the muscular strength testing. The examination was focused mainly on the knee joint extensors and flexors testing. All patients proved the increase of the muscular strength; surgically treated patients reached muscular strength maximally 4+. The short-time rehabilitation plan is initially based on the edema and pain elimination. Subsequent rehabilitation step is the training of the walking with the help of French canes and the knee joint motion range recovery and its stabilization. The aim of the long-term rehabilitation plan is the gradual return to social and sport activities. The basic factor of the long-term rehabilitation plan is good muscular training. In the conclusion it is important to mention that it is not possible to state which therapy (surgical or conservative) is more suitable or efficient, during the decision making process it is necessary to consider individual needs of a particular patient. The thesis may be utilized in the clinical practice of physiotherapists for the improvement of the care of the patient who is diagnosed with rpt. LCA.
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