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The honored doctor of the Russian Federation, the traumatologist of the highest category,the doctor of medical sciences A.N.Shimbaretsky In the scientific research institute of traumatology and orthopedy of Nizhniy Novgorod a wide experience of application original training apparatus for a knee joint setting on a bed is saved up. ( AC. ¹1243691). The portable training apparatus is intended for strengthening of muscles of a hip and restoration of mobility in a knee joint while treatment of its damages and diseases, especially after operations on a knee. Distinctive feature of a training apparatus is shaking lodgement for a shin which is rigidly fastened to the lever-counterbalance, to each of them cargoes-disks in various combinations and positions can fasten. Shaking on bearings lodgement for a shin represents the rectangular frame, fixed coaxially to a knee joint of a patient on the femoral support reminding the functional tire. The selected inclination and lifting of a femoral support on telescopic bars over the training apparatus basis provide the set scope of movements in a knee joint at exercises. The lodgement has a movable crosspiece made of cloth which serves as a support for a shin while doing active exercises in the conditions facilitated by a counterbalance with any degree of unloading and a support for passive movements in a joint which can be made by lowering the counterbalance lever. For training the quadriceps with burdening or for creation of considerable bending draught while treatment a knee jointcontraction a shin is placed under a crosspiece made of cloth and cover with lodgment on which cargoes-disks are fixed. while preparation of a training apparatus for the right or left foot the counterbalance lever is fixed on any part of lodgement. Changing position of support for a hip and a shin, you can adjust the device to the patient’s height. Free connection of a shin with lodgement which can be operated by the lever, allows the patient to start exercise independently and to release a foot from loaded lodgement without effort. The Unique feature of a training apparatus is that the shin laid on shakinglodgementas on scales, can be completely counterbalanced with cargo on the lever. it is enough the minimum muscular efforts to deduce such a balanced system from an unstable condition and to break the balance. Alternating weak pressure of muscles of a hip, the patient can bend and unbend a joint within the established corner easily. While immediate active therapy after operation on a knee the antigravitational effect and the set amplitude make movements safe, painless and easily to fulfill. A range of movements in a joint can be increased smoothly by tightening the probe on the end of shaking lodgement which limits lodgement’s lowering. it is possible to transit from the active, as much as possible facilitated exercises to usual movements in a joint, and then, after cargo transferring on lodgement, — to exercises with shin burdening by moving Stage by stage the cargo to the basis of the lever to reduce the action of a counterbalance. you can train back group of muscles of a hip at fastening on the end of the lever the cargoes exceeding weight of a shin. At a relaxation of these muscles passive unbeding of shins with rising lodgement occurs. With the help of a training apparatus it is possible to treat aknee joint with following kinds of therapy : 1. Exercises in the conditions of local weightlessness. 2. facilitated movements due to straining of shinsflexor . 3. The facilitated movements due to straining of quadriceps. 4. Exercises in the set range of movements with overcoming of weight of a shin. 5. Passive movements with the help of the counterbalance lever. 6. The exercises strengthening quadriceps with a raising loaded lodgement 7. The exercises strengthening shins flexor with a raising of a counterbalance. 8. Inertial pendular mechanotherapyat fastening cargoes to lodgement and to a counterbalance. 9. Bending of a shin loaded lodgement in a combination to paraffin application supervised by the patient The training apparatus is also used as the tire to produce immobilization of finitenesses in raised position at various corners of bending in a knee joint after operation. For this purpose the lever keeping lodgement shins, is connected with the training apparatus basis in necessary position. The therapy on a training apparatus changing gravitational conditions for a knee joint, has particular advantages in the nearest postoperative period: - The antigravitational effect allows to make active movements which in usual conditions are impossible because of a pain, muscular weakness, danger to break the formations restored while operation. - it is possible to repeat Exercises hundreds times without essential exhaustion, overcoming only force of inertia that allows to begin active trainings even to the patient with very low physical possibilities. - plasticity of retractedfabrics increases while repeating movements, the discomfort from extension of paraarticulary formations and muscles is overcome easily. - The strengthened blood circulation, updating of synovial liquids in a working joint and a good limfo-venous drainage warn a postoperative hypostasis, normalise the synovial environment of thejoint - Formation of intraarticulate unions is prevented and the paraarticulary device of sliding is restored. - The essential atrophy of muscles does not develop. - The range of movements arises quickly. - Ease and painlessness of exercises create a favorable psycho-emotional background for training work even for patients with weak motivation and an negative attitude to participation in rehabilitation. - The requirement in analgesic decreases and necessity of the majority procedure disappears. - The training apparatus which is constantly at the disposal of the patient, who has to keep a confinement to bed, raises the level of its general muscular activity. Indications to application of a training apparatus for a knee joint: - Intraarticulate and periarticular crises; - damages of flexor- Damage and reconstruction of sheaves -osteotomy at joint deformations - dislocations of kneecap; - synovectomy; - arthrolysis, joint mobilisation; - endoprosthesis replacement; - contraction; - osteoarthrosis; - easing of the quadriceps of a various origin and others. Possibility of exercises in various modes on one universal training apparatus which is constantly at the disposal of the patient, considerably increases efficiency of the therapy. The patient can be engaged in exercises independently during the day, according to a set program at any time, without the help of the methodologist, both in the conditions of hospital, and at home. The training apparatus is portable, and simple in application, folded it takes not large space, so it is convenient to carry and storage it. The honored doctor of the Russian Federation The traumatologist of the highest category The doctor of medical sciences A.N.Shimbaretsky |
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