ThemFis_Vol_4_Issue_7_JulSeptember2007_3-16

Chronic Tendinopathy of the Achilles and Patellar Tendon. Part II: Treatment and Rehabilitation.

Vasileios Korakakis

The treatment of the tendinopathy is based mostly on antiflammatory means, which many times are inappropriate or ineffective. The classic physiotherapy approaches and physical means seem to have a limited effectiveness. The new data about eccentric loading training programmes redirect the rehabilitation strategies and seem to be especially effective, although they require a great deal of commitment in behalf of the patient, are considered to be rather strenuous and the underlying mechanism is still undefined.

ThemFis_Vol_4_Issue_7_JulSeptember2007_17-24

Influence of Exercise on Functional Ability of Elderly People with Knee Osteoarthritis.

Eleni Lamprou, Georgia Petta

17 eldrley people with knee osteoarthritis (63-80 years) were allocated in an intervention (N=10) and a control group (n=7). Their functional ability was assessed with the Timed Up and Go Test and with the timing of walking a distance of 5m. The exercise programme included strenghtening and balance exercises performed 3 times a week. There was a statistically significant reduction of the time taken to perform the TUG test and the 5m walk before and after the exercise regime in the intervention group, whereas in the control group a trend for the increase of the time taken for the TUG test was noted. The strengthening and exercise programme seems to improve the functional ability of elderly people with knee osteoarthritis and its application for the reduction of falls is indicated.

ThemFis_Vol_4_Issue_7_JulSeptember2007_25-45

The Maturation of Gait and the Control of Balance according to the Ontogenetic Model.

Eirini Liapi, A. Georgiadou, N. Ifantis

Walking like normal adults do, presupposes intervening developmental stages. Through these stages the gait pattern matures and balance control is achieved. Assaiante & Amblard suggest an ontogenetic model of balance control in children and adults. In their model the researchers hypothesize that the two main modes of balance control (ascending and descending temporal organization) operate alternately and are associated with either of two modes of body joint linkage (?en bloc? and articulated) during four successive periods in the course of ontogenesis. It is worth noting that the proposed ontogenetic model can be related to a neurobiological perspective. In motor development, two maturational gradients (cephalocaudal or caudocephalic) operate alternatively during the life span. The sensory contribution to balance control and movement is not included in this review, and the way they process result from a schematic model of development.

ThemFis_Vol_4_Issue_7_JulSeptember2007_46-58

Therapeutic heat in the treatment of long-term restrictions in joint range of motion. Part I: Efficiency of Thermal Modalities.

Minas Kessekidis

The long-term restriction in the range of motion of a joint represents a common, yet a very challenging problem for the physical therapist in orthopaedic rehabilitation. Such a restriction in the range of motion of a joint is mainly attributed to an adaptive shortening of the periarticular tissues secondary to injury, immobilization or degeneration of the joint. The aim of the therapeutic program is the progressive increase in the extensibility of the shortened soft tissues and, finally, the restoration of full range of motion in the affected joint. In order to accomplish that, the therapeutic intervention is primarily based on a stretching program comprised of low-load, prolonged stretches, which has been proven very effective for the elongation of connective tissues. In addition, a series of laboratory studies have shown that passive increase in tissue temperature more than 3 to 4_C results in improvement of their elastic properties and an increase in their extensibility. The above evidence led to the conclusion that the combination of "heat and stretch" represents the optimum intervention for the treatment of joint contractures. This technique requires that the tight soft tissues are placed in a stretching position during or immediately after the implementation of therapeutic heating. However, despite the extensive clinical use of the technique and the empirically proven effectiveness, its foundation solely on laboratory studies in animal models allows questions to be raised. Recently, several studies were performed in human subjects, in order to assess the efficacy of thermal modalities to induce the required increases in tissue temperature, as well as, to establish whether the "heat and stretch" technique yields superior clinical results than the performance of stretching exercises only, with regard to the flexibility of different soft tissues. The aim of the present study is to review and discuss the recent research evidence concerning this therapeutic intervention.