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Tematica Licenta si disertatie (4 noiembrie 2014 } Propus de: conf univ dr, Zoltan Pasztai Anul Universitar 2014/2015 (CA2Controtul bazinului si reluarea mersului dupa AVC a sechelarului hemiplegic; 2} . Reeducarea locomotiei dupa sechelaritate T11-12 , chiar a mersului (-prineipii- mijloace Ttehnici in cazuistica paraplegica) 3. Rolul kinetoterapeutului in abordarea afectiunile MS : periatrita scapulo-humerala, epicondilita cot ;

nivelul functional al hemiplegicului, dupa caz , folosiind in timpul liber : a) banda de alergare ,b) mers pe jos , c) pedalaj la bicicleta stationara. 8, Impactul leziuni cerebrale traumatice si participarea la activitayi de petrecere a timpului liber. 9. Contributii la studiul reabilitarii pacientilor dupa leziune de menise - prin protocol program de tip Felix Coordonator stiintifie : Conf univ dr Pasztai Zoltan ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION General Considerations: Progression should be based on careful monitoring ofthe patient's functional status Early emphasis on achieving full hyperextension equal to the opposite side Passive and active range of motion as tolerated. CPM willbe used 4-6 hours per day until patient reaches 120 degrees of flexion. Full weight bearing as soon as tolerated with no limp (unless otherwise indicated) Regular manual treatment should be conducted to the patella and all incisions Controlled exercises can be performed without the use of the brace ( post-op brace issued on ingividual basis) Exercises should focus on proper patella tracking and recruitment of the VMO_ Early recruitment of the VMO using home electrical stimulation unit if necessary No resisted leg extension machines (isotonic or isokinetic) at any point in the rehtab process Patient should be well aware that healing and tissue maturation continue to take place for 1 year alter surgery Patients are given a functional assessmentlsport test at 3 and 6 months and 1 year post-op ‘Max protection phase M.D. visit day 1 post-op to change dressing and review home program M.D. vist at 8 - 10 days for suture removal and check-up Icing and elevation as much as able to minimize edema and promote healing Use of a CPM at home for 4 -6 hours a day Gait training to promote best quality of gait with the least amount of assistance Passive and active range of motion exercises Balancelproprioception exercises in a protected environment \Welleg stationary eycling, upper body conditioning, care conditioning Soft tissue treatments to posterior musculature, quads, and infrapatellar pouch Extensive patellar mobilizations, superior, inferior glides and patellar tipping ‘~*Passive range of motion should be 0 degrees or hyperextension to 90 degrees flexion, minimal pain and edema, unassisted good quality gait before moving onto Phase I, Moderate protection phase M.O. visit at weeks (post op brace may be discontinued as soon appropriate muscular control is, achieved) Patient stil needs to be somewhat restful with low impact on knee, must elevate and ice daily Walking for exercise limited to 15:20 minutes per day ifno swelling or limping Continue with range of motion, galt training, soft tissue treatments and balance exercises Incorporate functional exercises! eccentrics (Le. squats, bridging, intense core training and 2 inch step downs) Leg weight machines PRE's (Le. leg press, hamstring curls, calf raises, abduction/adduction) + Aerobic exercises as tolerated (.e. bilateral stationary cycling, UBE, Eliptical) * Pool workouts including deep water running, waist high fast walking in all directions “Range of motion should be equal extension bilaterally to 120 degrees flexion, normal gait without assist single leg balance abilty, no significant edema before moving to Phase Il, CPM can be discontinued if ROM (goals reached. Return to function/strengthening phase Continue any necessary sof tissue mobilization required ‘© Emphasize self stretching of both lower extremities ‘+ Increase the intensity of functional exercises (i.e. progress cycling, ok for road cycling, increase resistance in exercises, up to 1 hour walking for exercise, add stair climber or versa cimber, increase challenge of proprioceptive training and eccentric exercises ie. 4-6 inch step downs) All exercises stil in a controlled environment ‘+ Greater emphasis on single leg strength exercises such as leg press and single leg squats, “*Patients should have full hyperextension and 80- 90 % of fll flexion, able to do 4 inch single leg step down, and bike with minimal resistance for 20-30 minutes before moving to Phase IV Progressive Activity phase ‘Ad lateral training exercises ((. lateral lunges, lateral step-ups, step overs) Begin to incorporate sport-specif training (.e. volleyball Bumping, easy hiking, functional training ‘exercises in ALL planes of motion) No culting or pivoting ‘+ Focus on good quality eccentric strength and continue to increase challenge and complexity of proprioceptive exercises: ‘All activities should be pain free without swelling, descending stairs should be smooth and pain free, single leg squatting for 30 seconds should be of good quality and pain free before moving to Phase V. ‘Training for Sport phase ‘© MD. visit at 3 months and functional test Incorporate bilateral, low level jumping exercises. Watch for compensatory patterns with take-offs or landings + Progress to running if able to demonstrate good mechanics and appropriate strength at 12 weeks + Add appropriate agilty training with progressive complexity and challenge stil cautious with cutting ‘and pivoting + Patients should be weaned into a home program with exercises specific to their particular activity/sport, aggressive road cycling is encouraged ‘© Fitfor functional knee brace if requested by M.D. **Single leg squat test for 1 minute must be at least 80% of uninvolved leg, moderate resistance biking for 30 minutes should be easily tolerated, patient should be confident with all ADLs and independent in an “appropriate gym and outdoor training program before moving to Phase IV. Pt should be well educated on

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