ABSTRACT
Tendinopathies show a high prevalence within the general population and sport. Despite recent progress in understanding and treating soft tissue injuries, this pathology remains a therapeutic challenge. Rehabilitation in eccentric mode has shown promising results but the mechanisms by which eccentric contractions aid in healing are still difficult to determine. Based on a review of the literature and our own clinical experience, we recommend some rehabilitation protocols and consider the various hypotheses presented in the literature.
Subject(s)
Exercise Therapy/methods , Tendinopathy/rehabilitation , HumansABSTRACT
This article presents a synthesis of different aspects which concern the doctors in the new physiotherapy nomenclature. With reference to the new rules for prescription, these must obligatorily indicate the maximum number of sessions (9 for existing pathologies, 30 for F and E), the diagnosis, the location of the lesions. We explain precisely the different categories of pathological conditions defined by this nomenclature, and the rules concerning them. There are the "existing" pathologies for which 18 sessions will be reimbursed at the optimal rate, from thereon the reimbursement decreases. For the pathological conditions as in List F ("functional" pathologies), the physiotherapist must send a notification to the consulting doctor, he must therefore have in his possession the elements which show that the patient has in effect a pathological condition as in List F. These pathological conditions have been divided into two categories; the acute pathologies (60 sessions reimbursed per year--calendar year); the chronic pathologies (60 sessions per year--civil calendar) during 3 years. For the pathological conditions as in List E, an agreement by the consulting doctor is necessary on the basis of a medical and physiotherapy report. For this category of patient, there are no limitations to the number of sessions. The perinatal physiotherapy is limited to 9 sessions around the time of birth. We also explain the rules concerning the written report of physiotherapy, obligatory once per year for the F and E pathologies, and the possibility for the doctor to prescribe a consultation examination. Also, we inform you of the different possibilities to obtain a second session of daily physiotherapy.
Subject(s)
Family Practice , Physical Therapy Modalities , Terminology as Topic , HumansABSTRACT
Chronic obstructive pulmonary disease (COPD) imposes a major strain on the respiratory muscle pump, and it is conventionally thought that the inspiratory muscles of the neck adapt to this chronic overload by developing hypertrophy. Yet previous anthropometric studies have shown atrophy of the sternomastoid muscles. To solve this discrepancy, we have measured the cross-sectional area of these muscles by computed tomography. Ten stable patients with severe airflow obstruction (FEV1 = 0.76 +/- 0.12 L) and hyperinflation (FRC = 210 +/- 29% of predicted) and 10 control subjects matched for age, sex, and height were studied. The sternomastoid cross-sectional area in the patients averaged (mean +/- SD) 4.29 +/- 1.48 cm2, and that in the control subjects was 3.96 +/- 0.82 cm2. This small difference could be entirely accounted for by hyperinflation, and it was not statistically significant. Sternomastoid muscle torque in patients was also similar to that in the control subjects. In patients with severe COPD, therefore, the sternomastoid muscles are essentially normal. As a corollary, their frequent prominence on clinical examination is only apparent.
