S-4-01-04
REHABILITATION OF RHEUMATOID PATIENTS - MUSCLE EXERCISE, BRACING AND REDUCTION OF FLEXION CONTRACTURE AROUND THE KNEE.
T. Koshino, T. Saito, N. Sakai, M. Mizui and H. Saito (Yokohama City University, Yokohama, Japan)
Purpose: Rehabilitation for severe disabilities of rheumatoid patients is investigated.
Methods and results: 1) Quadriceps weakness was noted to be the most remarkable, and straight leg raising exercise was more effective in strengthening the quadriceps for arthritic knee than the other methods requiring knee flexion-extension. 2) The knee brace with lateral uprights was found to enhance stability of the rheumatoid joint with improvement of walking ability, ended in increase of ADL and QOL. 3) Another important problem was severe flexion contracture which frequently brought about disabilities of walking. Traction for a week and then walking-exercise with a long leg cast in the maximum ex- tended position for another week were given serially to the patients with knee flexion contracture more than 60°. The improvements were remarkable and total knee replacements were performed thereafter. 4) During rehabilitation managements, several complications were experienced especially in rheumatoid patients. The most important and the most frequent one was fracture, because of fragility of rheumatoid bones due to osteoporosis, medication of steroid, severe contraeture of the surrounding joints. The majority of them were of stress or spontaneous fracture.
Conclusion These four important treatments should be done for rheumatoid with great caution to avoid fracture.
S-4-02-01
CHANGES IN LOW BACK MUSCLE CONDITION AND PSYCHOLOGICAL COMPLAINTS AFTER THE ROESSINGH BACK SCHOOL PROGRAM.
D. Wever-2, M.M.R. Hutten-1, H.J. Hermens-1, M.G.B.G. Blokhorst-2, G. Zilvold-2
(1-Roessingh Research and Development, Enschede, The Netherlands; 2-Roessingh Rehabilitation Center, Enschede, The Netherlands)
The objective of this study was to investigate whether low back muscle condition, psychological complaints and pain experiences change during the Roessingh Back School program.
62 patients with chronic low back pain participated in this study. Low back muscle condition was assessed by means of lumbar dynamometry measurements using the Isostation B200. Torque, velocity and range of motion parameters were measured. Psychological complaints and pain experiences were assessed using the Symptom Checklist (SCL-90) and the Multidimensional Pain questionnaire (MPI- DV).
When mean parameter values are used, results show a significant increase in low back muscle condition, a significant decrease in some psychological complaints and pain intensity. When individual scores were used, an increase in low back muscle condition was found in about 50% of the patients, a decrease in psychological complaints in about 10-20% of the patients and a decrease in pain intensity and interference of pain in 21% and 28% of the patients. From this it can be concluded that, during the RRP, low back muscle condition increases in a lot of low back pain patients. Psychological complaints and pain experiences changed in less patients.
