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"Medicina Sportiva" No.14 - 2008 The 15-th Sports Medicine Balkan Congress
CHRONIC DISEASE AND PHYSICAL ACTIVITY


CONTROL OF THE COMPENSATORY MECHANISMS BY PHYSIOTHERAPY AFTER SURGICAL STABILIZED PROXIMAL TIBIA FRACTURE

Tasheva Rumiana1, Aliakova Zoya2, Penev Plamen2, Borisov Stoil2
1National Sports Academy «Vassil Levsky» - Sofia,
2Military Medical Academy – Sofia, Bulgaria

An improved method of treatment of the proximal tibia fracture is a surgical stabilization. The early phase has to lead on adequate recovery of the patients by physiotherapy. 
THE PURPOSE OF THIS STUDY is to present the developed physiotherapy program on the control of the compensatory mechanisms and muscle reactivation during the early phase after surgical stabilized proximal tibia fracture in soccer player.
Material and method.  A male 42 years old patient was observed after proximal dextral lateral tibia fracture (type b1 regarding AO classification) during soccer play. The surgical  stabilization was made in Austria in June 2008. The brace was used for the relative immobilization after the surgery for 30 days.  The physiotherapy was directed to restore of the knee range motion, muscle reactivation and weight bearing by controlling the compensatory mechanisms. The unloaded exercises were performed with changing of the initial position in passive and active insufficiency. 
RESULTS. The early post surgical results (10 days after surgery) show the knee range of motion for flexion 20º and extension -15º which progressed to flexion 115º and extension -5º after 3 weeks. The circumference data manifests to reduce the knee effusion but in being the muscle thigh hypotrophy. The weight bearing was improved with one crutch at doing the daily activities.
CONCLUSION. The precise physiotherapy leads to correct of the compensatory mechanisms and to progress the opportunely recovery of the patient after surgical stabilized proximal tibia fracture in soccer player.
Key words: compensatory mechanisms, physiotherapy, proximal tibia fracture.





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