Rehabilitation after surgery repair of flexor tendon injuries of the hand with Kleinert early passive mobilization protocol.

INTRODUCTION: Rehabilitation after surgery repair of flexor tendon injuries of the hand remains challenging and requires experienced professionals and interdisciplinary approaches. AIM: The aim of this study was to evaluate rehabilitation results after surgery repair of flexor tendon injuries in the hand with the early passive mobilization--Kleinert protocol. MATERIALS AND METHODS: In this retrospective case-series study rehabilitation results of flexor tendon injuries in the hand with the early passive mobilization--Kleinert protocol were evaluated in 35 patients, treated in the Orthopaedic Clinic University Clinical Centre of Kosovo between December 2007 and November 2008. Patients had unilateral injuries on right hand without associated injuries. Patients were divided in three groups: patient with injury of FPL (n = 15), patient with injury of FDP and FDS dig. I-V (n = 10) and patient with injury of FDP and FDS dig.II (n = 10). Patients were included in a rehabilitation program using the Kleinert-early passive mobilization protocol. Functional evaluation was made using the mean improvement on MCP, PIP and DIP joints motion, mean functional are of motion (FAM) and total active motion (TAM) scoring system of The American Society of Surgery of Hand. The functional outcomes were analyzed by Paired t-test, and One way Analysis of Variance, while the mean TAM score were compared using the Wilcoxon Matched-Pairs Signed-Ranks test with significance set at p < 0.05. RESULTS: About 67% of patients with FPL injuries achieved excellent range TAM score, and about 22% of patients with FDS&FDP injuries achieved excellent and 74% good range of total active motion. CONCLUSIONS: With earlier performed primary surgical tendon repair followed by Kleinert-early passive mobilization protocol may achieves satisfactory functional results for any flexor tendon injuries in zones I-IV of the hand.

Postural disharmony in relation to the back pain and physiotherapeutic rehabilitation.

INTRODUCTION: Postural attitude is putting the body at attention as an important factor in the prevention of spinal deformities axis and thus the back pains due to changes in articulacio sacroiliaca (ASI), lumbal syndrome (SL), cervical syndrome (SC) and others. PURPOSE: The purpose of this research is to determine the level of impact of spinal muscular misbalance that affects daily life activities, physiotherapeutic protocol according to Dr. MC Gill's, and senso-motoric exercises to reduce the pain that backpack. In this material were included 43 patients, 13 males and 30 females aged 18 to 50 years old who were inculded in the second and third degree after completing a survey of ODI's-the index of disability (Oswestry Disability Index). RESULTS: The results obtained show that after the protocol of physiotherapeutic Dr. MC Gill's, and senzoro-motor exercise significantly decrease pain in the back which confirmed the results of the questionnaire according to ODI, where it is seen that out of 30 patients with complaints of second-degree or 69.8%, and 13 patients or 30.2% that have been complaints of third degree with significant disorders of activity of daily life before rehabilitation treatment. The results obtained after three-month rehabilitation treatment according ODIT's questionnaire (Oswestry Disability Index) show that 31 patients have complaints of first instance or 72.1%, then 9 patients have complaints or 20.9% of second level and 3 patients or 7.0% remained in the third degree of apparent disorder of daily life activity. CONCLUSION: From this we can highlight the misbalance of muscles of the body is one of the leading causes of back pain.