3: Rehabilitation principles for treating chronic musculoskeletal injuries

Abstract

Evaluation of patients for rehabilitation after musculoskeletal injury involves identifying, grading and assessing the injury and its impact on the patient's normal activities. Management is guided by a multidisciplinary team, comprising the patient, doctor and physical therapist, with other health professionals recruited as required. Parallel interventions involving the various team members are specified in a customised management plan. The key component of the plan is active mobilisation utilising strengthening, flexibility and endurance exercise programs. Passive physical treatments (heat, ice, and manual therapy), as well as drug therapy and psychological interventions, are used as adjunctive therapy. Biomechanical devices or techniques (eg, orthotic devices) may also be helpful. Coexisting conditions such as depression and drug dependence are treated at the same time as the injury. Effective team communication, simulated environmental testing and, for those employed, contact with the employer facilitate a staged return to normal living, sports and occupational activities.

Comparison of Four Physiotherapy Regimens in the Treatment of Long-Term Mechanical Low Back Pain

“…Exercise has been found to improve self-confidence and self-esteem 58,59) , but the observation is contrary in this study. There was 27.4% attrition in this study and this would have affected the outcome of this study with respect to its external validity.…”

Mud Therapy Combined with Core Exercise for Chronic Nonspecific Low Back Pain: A Pilot, Single‐Blind, Randomized Controlled Trial

“…e therapeutic application of topical heat is used for the relief of musculoskeletal pain syndromes [11,12], and thermotherapy using mud can be also recommended to treat patients with chronic LBP [13], neck pain [14][15][16], or osteoarthritic pain [17]. An appropriate level of pain control by thermotherapy may be required before exercises for pain control in nonspecific LBP.…”

Homochirality as a Consequence of Thermodynamic Equilibrium?

“…Trauma rehabilitation extends beyond acute injury or wound management, to reintegration of the patient into the home and community. The cognitive and neuropsychological sequelae of trauma are also well recognized2, 6, 7.…”