Rehabilitation programmes include individual medical gymnastics with a physical therapist and procedures adapted to the situation and needs of the patient: therapeutic ultrasound, electroanalgaesic procedures, electrostimulation, continuous passive stretching, shock wave therapy, K – taping / kinesio taping, cryotherapy, hypobaric therapy and magnet therapy.
Hypobaric therapy or vacuum therapy (Green Sack) is a therapeutic method in which intermittent pulse changes of the pressure lower than the mean value of the atmospheric pressure have an effect on blood and lymph circulation, improve capillary function in conditions with reduced or poor circulation, such as Mb. Raynaud and diabetic micro and macro-angiopathy. It is used for pain syndromes like tendinopathy, overuse injuries, and “frozen shoulder after injury or surgery, and in conditioning training of athletes and speed recovery after exercise (lactate elimination, simulation of high altitude training).
SHOCKWAVE THERAPY (Swiss Dolorclast, extracorporeal shockwave therapy, ESWT) is a non-invasive therapeutic method based on acoustic impulses whose energy is transmitted and focused to a depth of 4-7 cm. Microtrauma caused by shockwaves leads to reduced sensitivity to pain receptors and increases local circulation (neovascularization), which speeds up the healing process in the treated tendon, muscle and bone tissue. The method has so far been approved by the United States Food and Drug Administration (FDA) for treatment of plantar fasciitis and tennis elbow and has shown good results in treating chronic pain conditions such as sutendinopathy in the shoulder area, the patellar ligaments (called “jumper’s knee”) and Achilles tendons, pseudoarthrosis stress fractures, calcifications and diabetic ulcers.
LASER THERAPY. The source of laser light is a stimulated emission of electrons that uses monochrome, polarized, coherent low energy light. Laser therapy has a bio-stimulating effect, i.e. it stimulates natural healing processes by acting favourably on wound healing and scar firmness, having an anti-inflammatory and analgesic effect.
ULTRASOUND THERAPY is a method in which the crystal vibrates in an ultrasonic head and creates waves of high frequency and the tissue converts that mechanical energy of waves into heat. The effect of ultrasound is partly thermal and partly mechanical (micro-massaging and cavitation). The ultrasound increases the pain tolerance level and reduces the perception of pain, reduces inflammation in tissues and has a positive effect on healing of tissue in the early stages.
ELECTROTHERAPY. This is a therapeutic method involving direct application of electricity for designated purpose. INTERFERENCE CURRENTS are applied most frequently in the treatment of various pain syndromes improving local blood supply. TENS (transcutaneous electrical nerve stimulation) is based on electroanalgaesia interrupting pain transmission at higher levels of the nervous system by peripheral stimulation of nerve fibres. It is used for acute and chronic pain conditions, e.g. in neurology, posttraumatic conditions, surgery, rehabilitation.
ELECTROSTIMULATING THERAPY uses electrical impulses to elicit muscle contraction in cases of inactivate muscular atrophy and peripheral and central palsy. Besides classical electrical stimulation in the rehabilitation of athletes, we use Compex devices to increase muscular strength and endurance as well as for faster active muscle recovery after training.
MAGNETOTHERAPY uses the effect of electromagnetic fields on cell metabolism for injuries of musculoskeletal system in inflammatory and degenerative rheumatic diseases and for central and peripheral nervous system diseases.
K-taping / Kinesiotaping is a therapeutic method of using tapes to achieve relief of a painful body part both during exercise and at home. The method is not invasive and does not involve drugs. It is used for muscle injuries to normalize tone, reduce pain and improve the elasticity of muscles, ligaments relief, to relieve pain, and to stimulate lymph flow.
CONTINUOUS PASSIVE EXERCISE with dynamic splint (Kinetek) is used in the early stages of rehabilitation after injury or shoulder, elbow, knee, or hip surgery.
INDIVIDUAL MEDICAL GYMNASTICS, individually guided and customized, it is the most important component of rehabilitation carried out by professional therapists. Individual medical gymnastics includes several types of exercises:
Range of motion exercises – which can be active or passive.
Strengthening exercises are conducted through two types of muscle contractions: static or isometric contraction and dynamic contraction (concentric and eccentric).
Eccentric exercises are a special type of exercises in which the muscle lengthens during contraction. These exercises have proven to be particularly effective in tendinopathies of Achilles tendon, jumper’s knee, as well as for tennis and golf elbow conditions.
Proprioception and balance exercises are used in the final stages of rehabilitation before returning to everyday sport activities and to help prevent repeated injuries. In their individual work our therapists use a number of specific techniques and concepts, such as PNF (proprioceptive neuromuscular facilitation), Mulligan, Kaltenborg, Alexander technique, McKenzie, Bobath, KMT, Yumeiho … in order to achieve more efficient rehabilitation.
Aida Filipčić, MD, specialist in physical medicine and rehabilitation