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


REHABILITATION ASPECTS CONCERNING TRAUMATIC LESIONS OF EXTERNAL POPLITEAL SCIATIC NERVE

Scarlet Rodica , Brailescu Consuela, Murgu Andreea, Nica Adriana
UMF ,,Carol Davila” Bucharesti, National Institute of Rehabilitation, Physical Medicine and Balneology Bucharest, Romania


Introduction.  It is very unusual the total lesion of the sciatic nerve (traumatic or not); the most frequent and the most dysfunctional for the patient is the lesion of one of its two components – the external popliteal nerve. This paper evaluates the functional deficits after a traumatic lesion of EPS and the necessity of an early and individualized rehabilitation therapy for a good recovery.
Material and method.  We designed a retrospective study on a 96 patients who suffered traumatic lesions of EPS nerve and we evaluated them at the beginning and at the end of the rehabilitation programme in our clinic.     The recovery program was complex and strictly individualized depending upon the clinico-functional status of every patient; it consists in  kinetotherapy, low frequency and exponential electrostimulations, analgetic electrotherapy, lasertherapy, ultrasound.
Results. The evaluation of the patient consists of : pain intensity score (on visual analogue scale), neuro-muscular appreciation (muscular balance, neurologic evaluation and EMG), gait examination and functional implications (FIM scale).  Statistical analysis showed traumatic EPS lesions affecting mostly men (70%of cases), socio-professional active (62% under 45years), especially after road accidents (43%) or work-related trauma (37%); the neurological examination and EMG showed the predominance of neurapraxia and partial axonotmesis (70%), with better prognosis after early initialized rehabilitation.
The study shows pain relief (a decrease of 4 VAS points at 85%cases), sensitive and vasculo-trophic  improvement at 85% , a better muscular strength in EPS territory for 60% of patients, and of great importance – improvement of the functional capacity for ambulation (25% of those with specific gait abnormalities), but also for familial and socio-professional reintegration.
Conclusions. After traumatic lesions of external popliteal sciatic nerve, the complex therapeutic rehabilitation methods (including neurotrophic drugs, electrostimulations, analgetic electrotherapy, massage, splinting, kinetotherapy) during hospitalization and continuously daily training after the
initial program has a major role for clinical and functional improvement of the patient , better quality of life and socio-professional reintegration.
Key-words: external popliteal sciatic nerve; clinical and functional evaluation; rehabilitation program.





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