Evaluation of Physiotherapy in the Treatment of Legg-Calvé-Perthes Disease

Brech, Guilherme Carlos; Guarnieiro, Roberto

doi:10.1590/s1807-59322006000600006

Cited by 35 publications

(25 citation statements)

References 27 publications

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“…The results of OSI of SCD participants during two leg stance at stability level 6 had revealed significant improvement in the postural control with p < 0.05. This finding agrees with the results of Brech et al [21] who had studied the effect of physiotherapy program on 17 patients who have LeggCalve-Perthes disease with hip AVN. Whereas in this study, the number of the treatment sessions is decreased from 24 sessions to 12 sessions along a period that extend for 6 weeks with utilizing a moderate exercise intensity on a bigger number of participants.…”

Section: Postural Controlsupporting

confidence: 93%

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The Effect of Physiotherapy Program on Hip Pain and Postural Control in Adolescents with Sickle Cell Disease

A¹,

Heba²

2019

J Med - Clin Res & Rev

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Background: Sickle cell disease (SCD) is one of the most known genetic diseases in Saudi Arabia. With a common complication found to be the avascular necrosis (AVN) of the femoral head by 27% in eastern province. This avascular necrosis causes distraction of the hip joint; pain; and other complications.Objectives: the aim of this study was to measure the effect of physiotherapy program on pain intensity and postural stability in sickle cell disease adolescents with hip avascular necrosis.Methods: 21 participants who are aged between 10 to 18 years old and known to have Sickle cell disease with hip avascular necrosis were recruited. Measurements were taken at baseline and at the end of the treatment program. Wong-Baker FACES pain rating scale was use to evaluate the pain intensity. Biodex Balance System was used to evaluate the Overall stability index. Manual goniometer was use to evaluate the range of motion. Manual muscle testing was used to evaluate the muscle power. The statistical outcome differences within the group analysis was measured using paired t-test. Wilcoxon signed rank test was used to measure the differences within the group analysis for non-parametric variables.Results: All participants showed significant statistical differences in pain intensity; Overall stability index at level 6; range of motion; and muscle power. However; overall stability index at level 12 post-test result was better than the pre-test result; but it did not give a significant statistical difference. Conclusion:Physiotherapy program proved to be an effective method to improve the pain intensity and postural stability in sickle cell disease patients with hip avascular necrosis. Furthermore; improvement of range of motion and muscle power will improve or limit the related complications.

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Section: Postural Controlsupporting

confidence: 93%

“…Performed as 2 sessions per week for 6 weeks. Each session extended up to one and half hour as modified from the literature [21]. The exercises were done to the affected side only during the physiotherapy sessions that include stretching, isometric and concentric exercises.…”

Section: Interventionmentioning

confidence: 99%

The Effect of Physiotherapy Program on Hip Pain and Postural Control in Adolescents with Sickle Cell Disease

A¹,

Heba²

2019

J Med - Clin Res & Rev

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“…The main aim of therapy for LCPD is to improve mobility and the joint's congruence and relieve the hip joint pain [23,24]. Especially the hip joint mobility, the abduction and the inner rotation of the leg as well as the mobility of the lumbar spine could be improved by physiotherapy.…”

Section: Therapymentioning

confidence: 99%

Legg-Calvé-Perthes Disease and Its Physiotherapy - “If the Hip Melts Away”

AH¹

2018

ORP

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ClassificationsThe disease progresses into 4 chronological stages ( Figure 1):• Condensation stage (Ø 7 months)• Fragmentation stage (Ø 8.5 months)• Reossification stage (Ø 18 months)• End stage [15] Krieg AH, et al., J Orthop Res Physiother 2018, 3: 037 Abstract Legg-Calvé-Perthes disease (or Perthes disease) is a disorder of the hip, which is caused by a vascular disorder ischemia of the femoral head and passes through four stages. It affects mostly infants and children of caucasian population. The cause of the ischemia is not yet known and therefore cannot be prevented norreversed. Limping, restriction of the movement and pain can lead to the diagnosis. X-rays as well as Magnetic Resonance Imaging (MRI) confirms it. The classification of Herring (A-C) is helpful to make a clinical prognosis and further treatment. The main aim of therapy is to improve joint the mobility and the joint's congruence ("containment"), build up muscle strength and reduce pain. Physiotherapy is an undisputed method, lasts over years involving an extensive movement therapy of the affected hip, the torso and the non-affected limb. Short-term drug-related analgesia, botulinum injection into the adductors and a weight relief can accompany therapy. An indication for operative treatment is given by subluxation within stadium B or B/C of Herring. Containment (hip centering/ joint's congruence) can be achieved by femoral varization osteotomy or pelvic osteotomy. Only one quarter of all patients is treated with surgery and physiotherapy remains the most relevant therapy on Perthes disease.

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“…Physiotherapie mit Muskeldehnungs-und Detonisierungstechniken sollten verordnet werden, sobald Bewegungseinschränkungen manifest werden. Die Eltern sollen idealerweise auch angeleitet werden, die Übungen täglich zu Hause mit ihrem Kind durchzuführen [30].…”

Section: Definitionunclassified

Morbus Perthes

2014

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Morbus Perthes today still poses a challenge for the orthopaedic surgeon because of the unclear aetiology as well as the controversial discussion about the role and kind of multiple treatment principles. The prognosis depends upon clinical (e.g. age at onset, reduction of range of motion, gender) and radiological (extent of necrosis, containment) parameters. Of these, only the reduced range of motion and a loss of containment can be adressed therapeutically, be it in a conservative and/or operative concept. Pelvic osteotomies have the advantage of a high potential of correction without the biomechanic disadvantages which are associated with intertrochanteric varus osteotomies. Nowadays, the use of orthoses is considered to be obsolete. Non-containment is targeted mainly on the symptomatic treatment and the correction of residual deformities. Based on the outcome after the final stage there is a risk of premature osteoarthritis with the need of early total hip replacement.

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Evaluation of Physiotherapy in the Treatment of Legg-Calvé-Perthes Disease

Cited by 35 publications

References 27 publications

The Effect of Physiotherapy Program on Hip Pain and Postural Control in Adolescents with Sickle Cell Disease

The Effect of Physiotherapy Program on Hip Pain and Postural Control in Adolescents with Sickle Cell Disease

Legg-Calvé-Perthes Disease and Its Physiotherapy - “If the Hip Melts Away”

Morbus Perthes

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