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• W2002284600 abstract "Disablement models provide a useful framework for the rehabilitation of individuals who present with a variety of knee ligament injuries. One such disablement scheme was proposed by Nagi in which disablement is classified by pathology, impairment, functional limitations, or disability.21 Impairments following knee ligament injury include pain, swelling, loss of motion, weakness, joint laxity, and loss of proprioception. Functional limitations include limitations in performing basic activities of daily living and sports, such as difficulty with walking and climbing stairs and the inability to run, jump, and pivot. Disability may include the inability to participate in work, school, sports, or recreational activities. Hypothetically, impairment of the knee associated with a knee ligament injury relates to an individual's loss of function and disability. As a result, rehabilitation for a patient with a knee ligament injury focuses on the treatment of the resulting impairments (i.e., reducing pain and swelling, restoring range of motion, strength, and endurance and enhancing proprioception, and dynamic stability) with the goal of restoring function and minimizing disability. To facilitate rehabilitation, clinical pathways for evaluation and treatment of the knee have been developed to improve clinical decision making.15 Once a patient's impairments and functional limitations have been identified, the clinical pathway can be used to select the most appropriate form of treatment. For example, examination of a patient following a knee ligament injury may reveal a knee extensor lag that causes the patient to walk with a flexed knee during the midstance phase of gait. Further examination may reveal that the knee extensor lag is caused by quadriceps weakness or limited superior glide of the patella. Accordingly, the most efficient treatment for this patient would include quadriceps strengthening exercises or mobilization to increase superior glide of the patella. Elimination of these impairments would be expected to improve the patient's gait pattern. Note that these clinical pathways are not based on the underlying pathologic condition but are based on the identification and treatment of the patient's impairments and functional limitations. Pathology is important when applying these pathways, and therapists must consider the underlying pathology and modify the clinical pathway accordingly. For example, injury to the knee may result in limited flexion and hamstring weakness. According to the clinical pathway for the knee, the most effective intervention for these impairments include active knee flexion and resistive hamstring exercises. When the underlying pathology involves injury and reconstruction of the posterior cruciate ligament (PCL), however, active flexion and resistive hamstring exercises immediately after surgery would be contraindicated to avoid placing undue stress on the PCL graft. This article describes the modifications made in the treatment of knee ligament injuries based on the underlying pathologic condition. Topics covered include a review of the pertinent biomechanics of the knee, general guidelines for rehabilitation of knee ligament injuries, and a discussion of the modifications that are made in the rehabilitation program based on the specific knee ligaments involved." @default.
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• W2002284600 date "2000-07-01" @default.
• W2002284600 modified "2023-10-16" @default.
• W2002284600 title "REHABILITATION OF THE MULTIPLE-LIGAMENT–INJURED KNEE" @default.
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• W2002284600 doi "https://doi.org/10.1016/s0278-5919(05)70223-4" @default.
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