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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