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Aquales funktionstraining als alternatives behandlungsregime in der rehabilitation von patienten mit retropatellaren kniegelenkschaden (Aquatic functional training as an alternative treatment in the rehabilitation of patients with diseases of the retropatellar joint) [German]
Dalichau S, Scheele K
Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin 1999 Oct;9(5):172-178
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: Assessment of the effectiveness of an aquatic functional training in the rehabilitation of diseases of the retropatellar joint. SUBJECTS: In the frame of a controlled comparative study for evaluation of three kinds of physical treatment the functional adaptations of 45 patients aged from 37 to 52 years were investigated. DESIGN: 11 female and 28 male patients were randomized into three treatment groups. Six male patients formed the control group. The treatment groups carried out an ambulant rehabilitation programme with physical applications four times weekly each time 120 Minutes over a period of 8 weeks. The standard group got the physical applications only. The programme of the land group was supplemented by a muscle training on machines for 60 minutes per therapy unit. The water group carried out additionally an aquatic functional training each time twice 30 minutes. The four groups were tested at the beginning (T1), at the end (T2) and three months after T2 (T3). Stretch ability and strength of the thigh muscles, the reaction forces of the ground while walking and the functional status of the retropatellar joint by means of a clinical score was investigated by the examiner. RESULTS: In T1 was a homogenous level in all groups. While the results of the control group remained virtually unchanged over the period of investigation the standard and the land group got a significant improvement in T2 in all of the parameters investigated and returned in T3 to the level at the beginning. However, in the water group as well the stretch ability and the strength of the thigh muscles as the symmetry of the reaction forces while walking and the functional status of the joint increased in T2 over the level of the other treatment groups. In T3 the status was stabilized and led to decreased trouble in the retropatellar joint. CONCLUSIONS: The accomodatic resistance and the physical properties of the medium water induced strengthening of the muscles in a gentle way and an improved function of the arthron. The aquatic functional training does not represent only an alternative kind of treatment, but seems to be the most promising method in the rehabilitation of the diseases of the retropatellar joint. Further investigations have to evaluate long-term effects.

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