TREATMENT BY MEDICINE SCOLIOSIS PHYSICAL AND REHABILITATION BY MASTER LUYEYE NZEKAMA SCHOLASTIQUE C. R. H. P / DR CONGO

PLAN INTRODUCTION

MATERIAL ET METHODS

RESULTS

DISCUSSION

CONCLUSION

RECOMMANDATIONS

PROBLEMATIC In developed countries, the management

of scoliosis is multidisciplinary (1). It involves the general practitioner, orthopedic surgeon, radiologist and physiotherapists (physical medicine). Indeed, it is now recognized that the intervention of physical medicine

(Physiotherapy) allows patients with scoliosis improve the flexibility of the spine, postural correction, self-magnification, chest expansion, the spinal muscle toning muscles, stretching the muscles of the hips and periarticular proprioception (1).

In the Democratic Republic of Congo (DRC) centers and hospitals dealing with special physical care of patients with scoliosis do not exist. During different periods of our training course in physical medicine, our attention was usually by printing the growing incidence of scoliosis in hospital in Kinshasa.

But she was also particularity attracted by the gravity distortions encountered and the lack of taking early physical load. The delay is due to the ignorance or negligence of parents of children with scoliosis.

Prevention of scoliosis is not an act of anticipation Congolese community. In order to prevent this disability, community, parents, teachers and health professionals do not take into account the risk factors for scoliosis including how to sleep, sit in school, wearing heavy bags on one side.

GENERAL OBJECTIVES

This study aims to assess in scoliosis, the impact of physical medicine on linear growth, pain, muscle strength of the

spine and relaxing the spine.

SPECIFIC OBJECTIVES

To achieve this overall objective, the following specific objectives were: - to

determine the change in the physical size after treatment, confirming the flexibility of the spine, toning the spinal muscles after physical therapy and decrease soreness and spine in one physical therapy.

MATERIALS AND

METHODS

NATURE AND TIME OF STUDY

The present interventional study (test) was carried out from August to October 2005.

The intervention consisted of applying the principles of physical medicine in the treatment of scoliosis in morphologically, joint and muscle.

POPULATION STUDY

Were eligible, patients with scoliosis. For financial reasons, an arbitrary non-random sample of 15 patients with complete medical records were included in this study.

Children suffering from scoliosis aged 11 to 20 years were included in this study.

THE EXERCISES USED BY THERAPIST

Exercises supervision for the physical treatment of scoliosis, based on the method of recovery (11) and the method of maintenance (12), had several repeated 10 times by KLAPP (13) years, five times as Schroth (14 ) and three times as VON Niederhoffer (15).

These exercises were performed by patients during intermittent sessions (Monday, Wednesday and Friday). Each session lasted 30 minutes. Thus, the number of 36 sessions (three sessions per week during the study period).

STATISTICAL ANALYSIS After verification, validation and

evaluation of data with completeness and consistency tests, the data were entered and analyzed on a personal computer with the EPI-INFO Version 6.04 software. The data were presented as frequencies, tables and figures.

STATISTICS DESCRIPTIVE

The qualitative variables were presented as a proportion(percentage). Quantitative variables (continuous) have summers summarized as means ± standard deviations (SD) with values of variation (CV%: reproducibility of size between assessments).

The Chi-square test of Pearson with calculating p trend (gradient) was used to compare proportions between assessments over time.

Analysis of variance (ANOVA) was used to compare means between the different assessments over time. The test - Student's t was used to compare means between two groups. The value of p <0.05 was considered statistical significance (p> 0.01: highly significant).

RESULTS

Figure 1. Polygone de fréquences relatives de la population

étudiée.

Figure 2. Evolution de la taille avec le temps et le traitement des scolioses

par la médecine physique.

Figure 3. Diminution importante du nombre des patients avec

douleur au cours du traitement physique.

Figure 4. Réduction importante du nombre des patients avec gibbosité

au cours du traitement physique.

Figure 5. Evolution de la souplesse du rachis au cours

du traitement.

Figure 6. Nombre des patients avec absence de contraction musculaire ( )

et présence de forte contraction musculaire ( ) au cours du traitement physique.

DISCUSSION

Despite the small number of children with scoliosis evaluated in this study, as reported elsewhere (21), the early implementation of the single physical medicine, has demonstrated a significant impact on growth in stature, pain, strength, the flexibility of the spine and the amplification of the rib cage.

But in developed countries, the management of scoliosis is rather multidisciplinary: general medicine, orthopedic surgery, radiology and physiotherapy.

CONCLUSION

The data collected in this study demonstrate the significant impact of physical medicine on severe and less severe scoliosis.

For pain, the hump, the ability of muscle contraction but vertebral bone deformities could not be assessed due to time constraints. Certain periods seem conducive to the emergence and worsening of the deformity cases before age 11 who worry less.

RECOMMENDATIONS

At the end of this study, the following recommendations are made: educate the community, parents and other health professionals instead of physical medicine in the multidisciplinary management of scoliosis; first resorting to physical therapy suitable for less serious and serious before referring scoliosis surgery scoliosis;

Establish rehabilitation centers equipped and directed by physical medicine; Encourage applied research on scoliosis among both teachers and students in physical medicine and rehabilitation; To early detection by parents and health care professionals in consultation with children.

THANK YOU FOR YOUR ATTENTION

GOD BLESS YOU