The Effect of a Specific Physical Rehabilitation Program on Some

Transcription

1 The Effect of a Specific Physical Rehabilitation Program on Some Retired Athletes injured with Osteoarthritis of the knee Joint 1-Prof. Dr. / Mohammed kadry Bakry *Professor of Sports Injury and Physical Rehabilitation, Department of Sport Health Sciences, Faculty of Physical Education for Boys, Helwan University. 2-Ass.Dr/ Nader Mohammad Tawfik *Lecturer of Sports Injury and Physical Rehabilitation at Faculty of Physical Education for Boys, Helwan University. 3-Researcher/ Islam Youssef Ismail *Physical Rehabilitation Specialist in Sports medicine Unit at Fayoum Stadium. 1

2 Abstract The research aims to design a physical rehabilitation program to see its impact on: 1- The muscles' strength that controlling the knee joint and its range of motion (ROM) of some retired athletes of the research sample. The researchers have used the experimental method because it suits this study. This method was applied through the experimental design (before/ after) on an experimental group and a control group. They were chosen intentionally from the men who are retired athletes that injured with the osteoarthritis of the knee joint and visits the sports medicine unit at Fayoum Sports Stadium. This choose was according to the diagnosis of the specialist doctor, where the number of the total sample was (20) injured, aged between (40-50) years old. The sample was divided into two groups. Each group consists of (10) injured ones, and the researchers group took into consideration the researcher homogeneity among the sample's individual in terms of height, weight, and age. And the research was applied on the experimental group. The most important results was as follows:- 1- There were statistically significant differences in developing the muscular strength to muscles that controlling the knee joint. It was in favor of the after measurement. 2- There were statistically significant differences in restoring range of motion to the knee joint. It was in favor of the after measurement. 2

3 1. Introduction and Research Problem Technological progress has negative effects which caused by lacking of movement and effort. The modern machines are doing most of the works, so the strong muscles became weak muscles and the joints were marred by obstacles and roughness, many accidents and sports injuries, as well as the wrong positioning during the daily life. The injury returns to the lack of fitness, thus the individual will be subject to a lot of injuries in general and the knee joint in particular. (3:17) The therapeutic rehabilitation exercises are considered one of the physical rehabilitation components that are used in the treatment of injuries as well as in the rehabilitation of the individual and prevent a recurrence of the injury. And the therapeutic exercises have an important role in maintaining health and fitness of the individual in the convalescence period and prevent what can be caused by long bedridden that cause the damage to the vital systems of the body such as (circulatory system, respiratory System, nervous system, musculoskeletal system). (1:65( Mohammed kadry Bakry (2000) mentioned that "the treatment with a standard movement one of the natural and basic means in the integrated treatment and the treatment process and the kinetic rehabilitation depends on various kinds of physical exercises. (7: 43) The knee joint consists of the tibiofemoral joint from the lower end of the femur and the upper wide end of the tibia. Also the joint consists of two cartilages; one of them is internal which resembles the letter (C) and the other external almost like the circuit (Meniscal), pairs of ligaments arranged like a letter (X), one of them in the front and the other in the 3

4 back. (Cruciates), Two correlative ligaments one of them in the front and the other in the back and Fibrous capsule (Capsule), and Synovial Membrane. (10:67) The main reason for the Osteoarthritis of the knee returns to the advancing age and the weakness of muscles and ligaments of the retired athletes, overweight and there are other reasons such as fractures inside the joint, inflammations, rheumatism diseases and other diseases in the late stage of the disease. Here the patient needs to alter the knee (knee dressing with metal pieces). (10:32) Also, some research indicates that most of the people who are subject to Osteoarthritis of the knee joint are the retired athletes due to the burden on the knee joint while exercising the sport, the obvious weakness of muscles and ligaments and lack of secretion of the gelatinous substance after stopping exercise, where the researches has been conducted on nearly 700 retired athletes from Sweden who shared in championships of the Olympic Games. And the follow-up showed that 85% of those retired athletes were suffered from Osteoarthritis of the knee and inflammation in the joints. (11) And Some previous studies, whether Arabic or foreign, have proved that the effective role of rehabilitative exercises and its effect on the knee joint and these studies is the study of Samir Karam Hussein (1995), and Mohammed Abdel Basset (2002). (5) (6) Thus, the researchers being exposed to how to treat that problem suffered by many retired athletes gives a scientific description in how to treat them by knowing the extent effect of rehabilitation exercises and its related effects on the body, and through the work of researchers in 4

5 the field of rehabilitation and sports injuries. And through viewing previous studies and scientific research, the researchers noted that a few studies have addressed Osteoarthritis of the knee joint for retired athletes, which is one of the main reasons leading to the increase of the knee joint pain. From here the researcher gets interested in setting a physical rehabilitation program by practicing rehabilitation exercise to get rid of knee joint pain. 2. Research Objectives This research aims to identify the muscles' strength that controlling the knee joint and its range of motion (ROM) of some retired athletes of the research sample. 3. Research Procedures Research approach The researchers have used the experimental method because it suits the nature of the research by using the experimental design (before/ after) measurements on two groups; a control group and an experimental group. Research Sample The sample of the research has been chosen intentionally according to the diagnosis of the specialized doctor, from the men injured with Osteoarthritis of the knee of some retired athletes who are visitors to the Sports medicine Unit at Fayoum Stadium. The total number of the sample is (20) injured aged between (40-50) years old. The sample has divided into two groups, each group consists of (10) injured. The researchers took into consideration the homogeneity 5

6 among the sample's individual in terms of height, weight, and age. And the research was applied on the experimental group. Measuring instruments used in the research: 1. Measure the degree of pain: Use the degree of pain scale (VAS- Visual analog scale). 2. Measure the muscular strength by Dynamometer device. 3. Measure the range of motion by Goniometer device. 4. The Proposed rehabilitation Program The research has been applied on the men injured with Osteoarthritis of the knee of some retired athletes who are visitors to the Sports medicine Unit at Fayoum Stadium. They aged between (40-50) years old. The researcher has applied for the proposed rehabilitation program in the Sports medicine Unit at Fayoum Stadium. Also, choose the sports medicine hospital at Nasr city to conduct the before and after measurements of the research sample. The researcher has applied the program on the experimental group under consideration and they are (10) injured with Osteoarthritis of the knee of some retired athletes. The program application took (9) weeks of (3) rehabilitation sessions/ week. The program was divided into three rehabilitation stages, where each stage of the three stages divided into (9) rehabilitation sessions. The total number of the program rehabilitation sessions are (27) session. The session is started by using the snow and then the rehabilitation exercises depending on each stage. 6

7 5. Results and discussion Table No. (1) The arithmetic mean, standard deviation and skewness coefficient of the age and some anthropometric variables (NO. =20) Variables A S SK Age Length Weight As shown in Table No.1: The Skewness coefficient is confined between (±3) of the age and some anthropometric variables to the whole sample which indicates moderation of the data. Table No. (2) The significant difference between the two groups in the descriptive variables (No. =20) Variables Experimental Control A S A S T Significance Age Length Weight Significance <0.05 Table (2) shows that There are no statistically significant differences between the two groups in the descriptive variables under consideration, which shows the equality between them. 7

8 Table No. (3) The difference between two groups (Experimental and control) in the before measurement (No. = 20) Statement Variables Experimental Control T Significance A S A S Extension 60/ Right Extension 60/ Left Flexion 60/ Right Muscular strength Flexion 60/ left Extension 180/ Right Extension 180/ Left Flexion 180/ Right Flexion 180/ Left Range of Motion Right Leg ( ROM) Left Leg Significance <0.05 Table (3) shows that: There are no statistically significant differences between the two groups in all the study, which shows the equality between them. Table No. (4) The difference between two groups (Experimental / control) in the after measurement (No. = 20) Statement Muscular strength Variables Experimental Control A S A S T Significance Extension 60/ Right * Extension 60/ Left * Flexion 60/ Right * Flexion 60/ left * Extension 180/ Right * Extension 180/ Left * Flexion 180/ Right *

9 Range of Motion ( ROM) Flexion 180/ Left * Right Leg * Left Leg * Significance <0.05 Table (4) shows that: There are statistically significant differences between the two groups in the after measurement of all variables in favor of the experimental group. Table No. (5) The difference between before/after measurements of the Experimental group (No. = 10) Statement Muscular strength Range of Motion ( ROM) Variables Experimental Control A S A S T Significance Extension 60/ Right * Extension 60/ Left * Flexion 60/ Right * Flexion 60/ left * Extension 180/ Right * Extension 180/ Left * Flexion 180/ Right * Flexion 180/ Left * Right Leg * Left Leg * Significance <0.05 Table (5) shows that: There is statistical significant differences between the two measurements of the experimental group in favor of the after measurement of all the study variables. 9

10 Statement Table No. (6) The difference between two measurements (before/ after) of the control group (No. = 10) Experimental Control Variables T Significance A S A S Extension 60/ Right * Extension 60/ Left * Muscular strength Flexion 60/ Right Flexion 60/ left Extension 180/ Right * Extension 180/ Left * Flexion 180/ Right * Flexion 180/ Left Range of Motion Right Leg * ( ROM) Left Leg * Significance <0.05 Table (6) shows that: There is statistical significant differences between the two measurements in favor of the after measurement of all the study variables except for the measurement of (right and left flexion 60/S- left flexion 180/S, there is no difference between the two measurements of the control group Table No. (7) The improvement percentage for each group (No. = 10) Statement Variables Experimental % Control % Extension 60/ Right Extension 60/ Left Flexion 60/ Right Muscular strength Flexion 60/ left Extension 180/ Right Extension 180/ Left Flexion 180/ Right

11 Flexion 180/ Left Range of Motion Right Leg ( ROM) Left Leg Significance <0.05 Table (7) shows that: There are varying in the sample responses for both groups on the study variables, where the highest rates were the experimental group in comparison with the control group. Figure (1) The improvement rate of the experimental and control group in the range of motion (ROM) Right Leg Left Leg Control Experimental The improvement rate of the range of motion Figure (2) Experimental Control 11

12 In light of the outcome of the statistical results, figures, and in accordance to the objectives and hypotheses of the research. The researcher interprets and discusses the results to verify the achievement of the objectives and the hypothesis of the research. Discuss Results 1. Discuss the muscular strength variable for both legs As Shown in Table (3) and Table (4) that there are statistically significant differences between the after and before measurement in the muscle strength variable of the legs between the research sample of the two groups; experimental and control group, in favor of the experimental group. The measurement resulted in an improvement rate in the table (7) and figure (2) indicated that there is a rate of improvement of the after measurement which related to the muscle strength variable of the experimental group. This improvement rate of the strength of extension related to the right leg at angle 90 degree/s was (1.50%). Where the improvement rate of the control group of the right leg extension strength at angle 60 degree/s was (0.31%). While the improvement rate of the extension strength related to the left leg of the experimental group at angle 60 degree/s was (0.96%).The improvement rate of the control group to extension strength of the left leg at angle 60 degree/s was (0.38%).The flexion strength related to the right leg of the experimental group at angle 60 degree/s with improvement rate (3.5%). The improvement rate of the control group of flexion strength related to the right leg at angle 60 degree/s was (0.48%). The flexion strength related to the left leg of the experimental 12

13 group at angle 60 degree/s with improvement rate (2.8%). And the improvement rate of the control group related to the left leg at angle 60 degree/s was (0.32%). The extension strength related to the right leg of the experimental group at angle 180 degree/s with an improvement rate (2.1%). While the improvement rate of the control group of the extension strength related to the right leg at angle 180 degree/s was (0.38%). The extension strength related to the left leg of the experimental group at angle 180 degree/s with improvement rate (2.2%). The improvement rate of the control group of the extension strength related to the left leg at angle 180 degree/s was (0.42%). The flexion strength related to the right leg of the experimental group at angle 180 degree/s was (3.2%). The improvement rate of the control group of flexion strength related to the right leg at angle 180 degree/s was (1.30%). The flexion strength of the left leg related to the experimental group at angle 180 degree/s with an improvement rate (3.7%). And the improvement rate of the control group of flexion strength related to the left leg at angle 180 degree/s was (0.81%). From the previous results, it is obvious the correctness of first hypotheses which stated that; there are a statistically significant difference in developing the muscular strength to the muscles controlling the knee joint in favor of the after measurement of the experimental group. 2. Discuss the range of motion variable As shown in table (5) and table (6) that there are statistically significant differences between the measurement of before and after measurement in range of motion variable between the research 13

14 sample of the two groups; experimental and control group in favor of the experimental group. This improvement rates resulted in table (7) and (Figure 1) which indicated that the improvement rate of the after measurement in range of motion variable of the experimental group related to the right leg was (36.7%) where the improvement rate of the control group in range of motion related to the right leg (10.6%). While the improvement rate of the experimental group related to the left leg (36.7%) and the improvement rate of the control group in range of motion of the left leg was (9.6%) From the previous results, the second hypothesis is clear which stated that there are statistically significant differences to restore range of motion of the knee joint in favor of the after measurement of the experimental group. 6. Conclusions 1-The specific physical rehabilitation program that was implemented has a positive effect to restore and improve the muscle strength controlling the knee joint. 2- The Program have a positive effect to restore and improve range of motion in the knee joint of the retired athletes as a sample research. 7. Recommendations 1- In the light of the above results, the researchers recommended the application of the proposed program for retired athletes aged from (40-50) years old. 14

15 2- To conduct further researches that include another age categories from the retired athletes. References First: Arabic References: 1- Abu Ela Abdul-Fattah (1998): Sports Training and Physiological Bases, Dar al-fikr al' Arabi, Cairo. 2-Ahmed Khaled (1990): Physiotherapy Why, Al-Ahram Center for Translation and Publication, Ed.2, Cairo. 3- Al-Mofti Ibrahim Hassan (1998): Modern Sports Training, Dar alfikr al' Arabi, Cairo. 4- Soheir Salem Hafez (1986): The Starting Foot Injuries and its Relation with the High Starting Competitions, Faculty of Physical Education for Girls, Alexandria University. 5- Samir Karam Hussein Awad (1995): The effect of a proposed rehabilitation Program on people Injured with Patellar Osteoarthritis for the volleyball youth player, Master Thesis, Faculty of Physical Education for Girls, Cairo. 6-Mohammed Abdel-Basset (2002): Artificial Knee Joint with a Moving joint. 7- Mohammed kadry Bakry (2000): Sports Rehabilitation, Sports injuries and First Aid, Cairo. 8- Mohammed kadry Bakry, Seham El-Sayed El Ghamry (2013): Sports Injuries and Physical Rehabilitation, Dar El Manar Publishing 15

16 House, Cairo. Second: Foreign references 9-Champ (1995): Sports medicine book, Williams and Wilkins. 10- J.Lrrgan & Jame (1996): The Knee ligamentous and meniscal injuries New, Churchill living stone. Third: World Wide Network References

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