Notesale: Turn your study into money

Document Preview

Extracts from the notes are below, to see the PDF you'll receive please use the links above

---

WORK PLAN
PART I
...
Generalities - definition, classification, epidemiological data
II
...
Criteria to support the diagnosis:
a)
...
Paraclinical investigations - ex
...
Evolution and prognosis
V
...
prophylactic treatment
2
...
drug treatment
4
...

1
...
hydro-thermotherapy treatment
3
...
massage treatment:
 Physiological effects of massage
 Anatomical description of the region
 Massage technique
 Joint mobilization (kinesitherapy)
 Medical gymnastics
5
...
balneological treatment (mineral waters, mud)
BIBLIOGRAPHY
Recommendations: 14 font, 2 cm margins, 20 pages
...


I
...

In complex post-traumatic injuries, nerve involvement is almost the rule
...

Isolated peripheral nerve palsies are due to local causes
...
Neuritis, whatever its cause, achieves a partial or total
interruption of the nerve influx in the peripheral nerve, causing motor,
sensory or sensorimotor disturbances in the corresponding territory
...

Peripheral paralysis includes paralysis of roots, plexuses, nerve trunks and
peripheral branches
...
ETIOPATHOGENY – causes, mechanisms, pathological anatomy

Etiology
...

Direct trauma, with immediate impact , through wounds on the course of
the nerve, fractures of the pelvis and femur, buttock contusions (by falling on
the buttock), fractures of the calf bones, coxo-femoral dislocations, proximal
tibio-fibular dislocations or dislocation reduction maneuvers, or late by
embedding the nerve in a vicious callus or in a scar tissue
...
Prolonged
compression in the "leg over leg" or cross-legged position - for the external
popliteal sciatic nerve
...

Iatrogenic factors: applications of forceps, surgical interventions on the
pelvis or the inguinal canal, compressions in operative positions that require
abduction or maximum flexion of the thighs, compression by a tourniquet or
the arms of the gynecological table, incorrectly applied intrafemoral
injections, traction on the lower limbs in newborns
...
either of an
infectious factor, especially viral
...

 Destruction of the axon, but keeping intact the connective tissue of
the nerve
...
Only a transient
conduction block occurs
...
CRITERIA TO SUPPORT THE DIAGNOSIS
...

The thorough clinical examination ("neuromuscular" testing) must establish
which nerve (or nerves) have been damaged - respectively determine which
muscles and movements are affected
...

 Vegetative and trophic disorders whose intensity and appearance
vary greatly from one nerve to another
...

External popliteal sciatic nerve palsy, (common peroneal nerve)
Terminal branch of the sciatic nerve, from the popliteal space, the extenso
popliteal sciatic nerve surrounds the neck of the fibula, enters the anteroexternal box of the calf, ensuring the motor innervation for the anterior
gambier muscles, the peroneal muscles, the extensors of the fingers and the
pedios
...

Injury to the external popliteal sciatic nerve causes a paralysis of the anteroexternal box of the calf with the abolition of the movements of dorsiflexion
of the leg and of the proximal phalanges of the fingers, of abduction and
elevation of the lateral edge of the leg
...
As a result of this deficiency, walking becomes difficult,
stepped - the patient is forced to raise the knee and flex the leg a lot and when
he leans, the foot hits the ground first with the tip
...
Atrophies affect the antero-external lobe of the calf
...

Internal popliteal sciatic nerve palsy, (tibial nerve)
The second terminal branch of the great sciatic nerve, the internal popliteal
sciatic nerve, continues its course on the posterior side of the calf, engaging
under the twin and thin plantar muscles, after which it passes under the arch
of the soleus, taking the name of the posterior tibial nerve
...

It innervates the motor, in the calf, the muscles of the posterior regions:
triceps sural (muscles: soleus, external and internal twin), posterior calf,
common flexor of the fingers and proper flexor of the big toe, thin plantar; to
the flexor brevis, abductor and adductor hallucis, flexor digitorum brevis,
interosseous and lumbrical muscles, flexor brevis and adductor pollicis
...
It contains an
important number of vegetative fibers
...
The
adduction and raising of the inner edge of the leg are diminished, however,
possible through the action of the anterior tibial muscle innervated by the
external popliteal sciatic
...
The distribution of paralysis and amyotrophies give the leg a
characteristic "leg valgus" (dorsal flexion and abduction of the leg) with
"hammer toes" (hyperextension of the first phalanx and flexion of the other
two)
...

Sensitive, causative, hypo objective pain or anesthesia may be encountered
in the open skin area
...


5

Lesions of the internal popliteal sciatic nerve are rare, but it can sometimes be
affected in the tarsal tunnel creating a tunnel syndrome (analogous to carpal
tunnel syndrome - but much rarer) - tarsal tunnel syndrome
...
The motor deficit is moderate and is limited to a paresis of
the finger flexors
...
The symptoms worsen after exertion and during the
night, they are relieved by rest
...
The cause of tarsal
tunnel syndrome remains mostly unknown, sometimes old foot traumas are
found
...
radiological, laboratory tests
It must aim at two objectives:
 Demonstration of the nature of the nerve injury
...
The stepped measurement of
nerve conduction velocity can locate, in the case of a selective slowing
(conduction block), the lesional level, a particularly important fact, especially
in the diagnosis of canal syndromes
...
The appearance of polyphasic and accelerated motor unit potentials
are witnesses of the reinnervation process
...

With the help of paraclinical investigations, it must be guided by a correct
clinical examination and electrical examination for a topographical diagnosis
first
...
will
be oriented on a case-by-case basis
...
,
functional radiographs, radioculography, CT or MRI), Doppler examination
of the cervical vessels are sometimes necessary for the etiological diagnosis
...
EVOLUTION AND PROGNOSIS
...

After only a few days, the sensitivity at the periphery of the denervated area
begins to recover, based on its takeover by the nerves in the neighboring
territory
...

The regeneration speed is variable, depending on the nerve
...

The acquisition of voluntary movement is better from this point of view in the
hand than in the leg, and faster in the child than in the old
...
TREATMENT
...
Prophylactic treatment
...
in wrong positions, the correct knowledge
of the anatomical structures, in performing the surgical act, gentle maneuvers
in reducing dislocations
...


2
...

In the recovery of peripheral nerve paralysis, bed rest is very important
...

The dietary treatment consists of a hyposodium diet when the patient is
administered NSAIDs
...


3
...

Etiopathogenic treatment : in peripheral nerve palsies of compressive
cause, the treatment must remove the compressive factor through surgical
intervention, reduction of a dislocation, radiotherapy or cytostatic medication
...

Associated with the above prescriptions, the nerve regeneration process will
be stimulated by the administration of group B vitamins regardless of the
location of the injury or the nature of the cause
...

Recuperative treatment - of particular importance in the treatment of
peripheral
nerve
disorders
is
physiobalneotherapy
including
hydrothermotherapy, electrotherapy, physical therapy (passive and active) and
balneotherapy and massage
...


1
...

Heat and especially short-term heat increase sensitivity and long-term heat
decreases sensitivity
...

The thermal factor (heat) is of particular importance due to the effects it has
on the body, such as:
 Increased skin hyperemia through the phenomenon of
vasodilatation;
 Decontracting and muscle relaxing effect;
 The decrease in the viscosity of the articular fluid, thus making it
easier to perform movements through an increase in mobility;
 Antialgesic effect;
 Increased blood flow to the muscles
...
Motor syndrome - follow:
1
...

2
...

3
...

9

4
...
Recovery of mobility and strength of segments not affected by paralysis:
 Active exercises, isometric exercises
...
The sensitive syndrome
 Occupational therapy
...
Vasculo-nutritional syndrome - will be performed:
 anti-slope posts,
 Passive, active mobilisations, of muscles left intact or partially
paralyzed
...
;
 The massage performed on the superficial and deep planes
...


2
...

Hydrotherapy - is the application for prophylactic and curative purposes of a
varied number of procedures that are based on water at different temperatures
and under various states of aggregation, as well as some closely related
techniques
...
Application technique - this bath is performed in a
tub larger than the usual ones with water at a temperature of 32 0 C
...
The patient sits in the bathroom in such a way that
there is enough space behind him for the technician's manipulations
...

The technician sits to the left and a little behind the patient, takes a special
vessel with a capacity of 1
...

10

After that, perform quick frictions with water on the back and the sides of the
chest in a vertical direction from top to bottom and vice versa
...

The halbbad can be completed with an energetic casting performed from 11
...
The duration
of the bath is 3-5 minutes
...
The action is exciting,
toning, sedative and antithermic
...
It is a warm bath that is associated with
movements in all the patient's joints
...

Application technique - the kineto bath is carried out in a larger tub that is
filled 3/4 with water at a temperature of 36-38 0 C
...
he is left alone to get used to the environment
...
after that, the patient is left to rest for a
while, after which he is invited to repeat the movements shown by the
technician on his own
...
after which the patient is wiped and
left to rest
...
Mobilization in water is
less painful due to the muscle relaxation that occurs under the influence of
warm water and loss of body weight according to Archimedes' law
...

Massage bath
...

The duration varies depending on the region on which the massage is
performed
...


11

Foot baths
...

The patient sitting on a chair puts his feet in the water in such a way that the
water rises to 1 palm width below the knees
...

Mode of action - those of short duration 1-2 min
...
Those lasting longer than 5-10
min
...

Warm foot baths are prescribed with water at 35 0 -40 0 C and last 10-20
minutes
...

Alternating foot baths are practiced with the help of 2 vessels: one with
warm water at 38 0 -42 0 C, the other with cold water at 18 0 -20 0 C
...
The maneuver is
repeated 3-5 times, necessarily ending with cold water
...
Alternating baths are actually doing vascular gymnastics
Ascending foot baths Use the foot bath in which water is placed at 35 0 C
...
reach the water temperature of 40 0 -44 0 C and
stay here for 15-30 minutes
...

Baths with chamomile flowers or mint
...
Mode of
action : sedative effect on the nervous system
...
Baths with bubbles of different gases are
practiced in ordinary tubs that have adapted a connection system to gas tubes
and another connection to the bubble generator placed at the bottom of the
tubs
...
They
resemble natural carbonated baths
...


12

The chemical effect - through gas resorption through the skin and active
hyperemia
...

The bath with oxygen and air bubbles
...

Through the fine integumentary massage produced by breaking the
bubbles, it excites the peripheral nerve endings and has a calming role in the
activity of the central nervous system
...
Due to the shape and pressure of the water column, they
have the strongest mechanical action
...

The Scottish shower - is practiced with the help of two mobile and
horizontal rubber tubes equipped with metal ends to narrow the water column
...

The patient is placed in front of the shower at a distance of 2-4m in relation to
the pressure of the water column, which is 1
...
It is applied to
the prescribed area, first the column of warm water for 10-15 seconds, then
the column of cold water for 5-10 seconds, alternatively 2-4 times
...

Massage shower
...
It is more
frequently applied partially, rarely generally
...

The massage shower produces an important hyperemia with a significant
resorptive and toning effect through the combined action of the massage and
the thermal factor
...
It consists in applying a high-pressure roll shower
under water 3-6 atmospheres with different bath water temperatures
...

The shower with a temperature of 1-2 0 C higher than the water in the tub is
introduced into the water by segment under the control of one of the
assistant's hands up to 5-10 cm from the area to be applied
...

The intense action of the underwater shower is due to the different
temperature of the bath plus the shower as well as the strong massage of the
water column that strongly compresses the tissues
...

Paraffin wraps
...

Application technique: melt a quantity of white paraffin in a vessel in such
a way that a few unheated pieces remain, in order to avoid overheating
...
5-1cm thick layer of paraffin is created
...

The duration is 30 min
...
On non-hairy areas, paraffin removal is very easy due to the sweat
produced by the paraffin
...
The patient
inserts the foot, takes it out and waits for the paraffin to harden on the skin
...
When the temperature becomes bearable,
the extremity is left in the paraffin for a longer time
...
The
skin heats up to 38-40 0 C, causing abundant local sweating
...
After
wrapping, a cold procedure is applied
...
TREATMENT BY ELECTROTHERAPY
...

Simple galvanizing
...

It is applied to different regions: transverse application - the electrodes are
placed on either side of the region to be treated; longitudinal application when the electrodes are placed at a distance from each other
...

The intensity of the current - which is closely related to the sensitivity and
tolerance of the skin, the evolution of the condition, the size of the electrodes
and the duration of the application
...

Duration - is approximately 30 minutes
...
In general, 8-10 sessions are used in acute
conditions and 12-20 sessions in chronic conditions
...

Galvanic baths
...
In this
modality, both the action of the direct current and the thermal effect of the
water are combined, acting as a mediator between the electrode and the skin
...
Can be applied: partial or 4-cell, general or Stenger bathrooms
...
The water in the tubs varies
between 36-38 0 C
4-cells are 2 for the upper limbs and 2 for the lower limbs
...

The duration of a session - is between 10-30 min
...
The number of sessions - is 10-15
sessions
...
Current direction - it is directed from a control panel in
multiple ways: downward, upward, transverse or even diagonally
...
Duration 15-30 min
...

The action: it is based on the thermomechanical effect of water, on the effect
of the continuous spout and on the chemical effect when ionization is used
...

Ionogalvanization
...

The general principle of ionization: it is based on the electrolytic dissociation
of various medicinal substances and the transport of anions (-) and cations (+)
to electrodes of the opposite sign to their electric charges
...
From here it migrates through the intact skin
through the openings of the sweat and sebaceous glands towards the opposite
pole, arriving inside the body where they are taken up by the lymphatic
network and the superficial blood circulation, contributing to the general
circulation
...

The difference between ionization and simple electroplating consists only in
soaking the hydrophilic layer in medicinal solution instead of water
...
The analgesic effect of the
direct current is added to the pharmaco-dynamic effect of the medicinal
solution
...

The effect of penetration to the deep skin layer has a reflex action visceral
boxes at the level of dermatomes
...

Good effects can be obtained with very small amounts of medicinal
substances avoiding the gastrointestinal tract
...


16

Applications are made on well-defined painful points, with general small
round or even point-shaped lead electrodes and transverse applications at the
joint level with polar electrodes of different sizes
...
The positive electrode is placed 2-3 cm
...

We start with the fixed diphasing, always ensuring that the intensity does not
reach the painful threshold (the minimum value of intensity that produces a
muscle contraction) and we gradually increase the intensity due to the
installation of the accommodation phenomenon
...
if we exceed this
duration, the analgesic efficacy decreases
...
at each new procedure
during the same meeting
...

The pace of the sessions - is determined by the stage of the condition, if the
intensity of the pain is high we apply it 2 times a day, if it is less 1 procedure
a day
...
For
dynamo-gen purposes we can use more than 10 sessions
...
It
acts as a vasoconstrictor and tones the arterial walls at the frequency of 50 Hz
...
Improving arterial circulation by inhibiting the
sympathetic
...

Short period - it has an exciting and tonic effect, it acts like a more intense
deep massage, it has a vasoconstrictive action, which shows the resorptive
role with fast action on hematomas and post-traumatic edemas or from
peripheral stasis
...
It is
used at frequencies of 100 Hz
...

Low-frequency pulsed currents are used in therapy for:
1
...

It is based on the excitation action of electrical impulses on excitable
substrates: muscles and nerve fibers
...

Striated, normally innervated skeletal muscle - responds to impulses with
relatively short duration and relatively fast frequency around 30Hz
...
1-5 millisec
...

This tetanizing or maximal contraction action is maintained as long as the
current passes through the muscle
...
and the
pause between pulses of 19 millisec
...

2
...
Using selective
excitations with such impulses can lead to obtaining muscle contraction
capacities
...

 Currents with triangular pulses - with linear or exponential growth
fronts
...
It is not a
recovery method in itself, but prepares the initiation of recuperative
physiotherapy
...

Short waves
These waves have electrolytic and electrochemical action and do not produce
polarization phenomena
...

They have deep caloric effects without causing skin damage
...

These high frequency currents can be applied either in: inductor field either in
the capacitor field
1
...

2
...

The action on the peripheral nervous system-increases excitability, increases
the driving speed, decreases the rheobase and shortens the chronaxis
...

The effects are: hyperemic effect, analgesic action, muscle relaxant and
antispasmodic effect
metabolic activation effect
Short waves produce immediate endothermy with a residual (long-lasting)
effect of approximately 48-72h
...

Ultrasounds have a frequency of 800-1000 KHz
...

The emitting head moves on the skin through the gel or other ointment,
without pressing too hard, in a circular or linear direction depending on the
region to be treated, and at a very low speed
...

It is very important that the transmitter keeps a perfect contact with the entire
surface of the skin and is kept in a vertical position with it
...

Discontinuous field - when we have a rhythmic interruption with a certain
frequency of ultrasound from the continuous field and when we have to take
into account the shape and duration of the pulse, the duration of the pause and
the interleaving frequency of the respective radiations
...
Slow
linear or circular movements will be performed at a distance of approximately
3 cm from the skin, making sure that the emitting surface is parallel to the
skin
...

Action on striated and smooth muscles
In hypertonic muscles - it produces a decrease in muscle tone, and in atrophic
muscles - it achieves toning
...

The following physiological effects are obtained: analgesic, muscle relaxant,
hyperemic,
tonic, neuro-muscular; excited by the nervous system
...


4
...
We say that the massage is a "treatment" because it acts on the body
from the outside, the Subject being massaged does not expend energy and is
not required to actively participate in its performance
...
Premises:
 Sedative action - on articular muscular neuralgic pains (calming)
...

 The action of removing stasis interstitial fluids - with acceleration
resorption processes in the massed region
...

 It also improves the functional properties of the muscles (excitability,
conductivity, contractility) and motor nerves, increasing the motor
impulse and muscle contraction capacity
...
General:
 Stimulation of functions of the circulatory system - improves venous
circulation, increases the amount of hemoglobin in the blood,
increasing the number of leukocytes and red blood cells
...

 Increase in basal metabolism
Other effects of the massage are :
 Favorable effects on: general conditions of the patient, improvement of
sleep, removal of muscle fatigue
...

 The reflex mechanism - in the skin there are numerous nerve endings
(called exteroceptors) in muscles, ligaments and tendons,
proprioceptors at the level of which stimuli of different intensities are
born that start towards the central nervous system
...

GLUTCH REGION
...

The muscles of the gluteal region form a characteristic human muscular relief
in the posterior part of the pelvis
...
These muscles do: thigh extension, abduction and lateral
rotation and medial rotation of the thigh
...
Superficial gluteal muscles:
 The gluteus maximus muscle
...
Deep gluteal muscles:
 The gluteus medius muscle;
 Gluteus minor muscle;
3
...

The thigh consists of: the femur bone considered the longest bone of the body
...

Innervation of the thigh is provided by the femoral nerve, the sciatic nerve
and the popliteal nerve
...
Anterior muscles (extensors) :
 Quadriceps femoris muscle;
 Tailor's muscle;
 The tensor muscle of the fascia lata
...
Medial muscles (adductors):
 gracilis muscle ;
 Pectineus muscle ;
 Long adductor muscle;
 Adductor brevis;
 Adductor large muscle
...
Posterior muscles (flexors):
 Biceps femoris muscle;
 Semitendinosus muscle;
 The semimembranous muscle;
CALB REGION
The shin consists of the tibia and the fibula
...
Through their action, they perform the movements of:
dorsal and plantar flexion of the foot, extension and flexion of the fingers,
pronation of the foot and plantar abduction
...
Anterior calf muscles:
 The anterior tibial muscle ;
 Extensor digitorum longus muscle;
 Long extensor hallucis muscle;
 The peroneal muscles, which have the role of pronation;

2
...
Superficial plane muscles:
 The triceps sural muscle;
 Twin muscles - there are 2: one medial and one lateral;
 The soleus muscle;
 Thin plantar muscle;
23

b)
...
Lateral muscles of the calf
 Peroneus longus muscle;
 Peroneus brevis muscle
...

It is the joint between the femoral condyles, the patella and the tibial
condyles
...
the incongruity
between the articular faces is completed by two menisci in the shape of the
letter " C"
...

 Lateral meniscus
...
The movements are flexion-extension
and, to a very limited extent, rotation and lateral inclination
...

The skeleton of the actual leg is made up of three segments:
 Tarsus - consists of 7 bones, arranged in 2 rows;
 Metatarsus - consists of 5 bones
 Phalanges - there are 14 of them, 3 for each finger, except for the big
toe, which has only 2 phalanges
...
Through their
action, they participate in the extension of the fingers,
1
...
The plantar muscles of the leg: they are divided into 3 groups:
a)
...
Lateral plantar muscles ( muscles of the little finger ): correspond to the
hypothena eminence:
 The abductor muscle of the little finger
 The flexor muscle of the little finger
 The opposite muscle of the little finger
c)
...
The two earthworms
lateral , and the two medial lumbricals
...

 The Deep Plan:
 Interosseous muscles of the leg
The tendon muscles of the leg - there are 7 of which 3 plantar interossei
and 4 dorsal interossei
...

 Plantar interosseous muscles;
...

To perform the massage, use:
 talcum powder,
 Different ointments (containing medicines),
 oils,
 Soap
...
Avoid massaging
moles
...

COXO-FEMURAL JOINT MASSAGE
Is made of:
The head of the femur - which articulates with the acetabular cavity of the
coxal bone
...

Specific smoothing is done with the ulnar part of the hands and friction on the
gluteal fold and around the coxo-femoral joint
...

BUTT MASSAGE
...

Smoothing- is performed in a circular and combed form
...

Gels - on the entire surface of the region with fingers or fist
...

The pinching and all forms of tapping and vibrations are performed
...

The massage starts on the back of the patient, being placed in the prone
position
...

Kneading - is performed in all its forms (with one hand, with two hands
and counter time) on the entire surface
...

Friction - performed along the sciatic nerve (and at the popliteal space and
gluteal fold)
...
It is performed transversely on the muscle fibers
...

It is performed with the ending smoothing with the gradual decrease of the
rhythm and intensities, obtaining a calming (sedative) effect on the patient
...

Perform the same maneuvers as on the rear side, adding stroking and sifting
(bend the leg at 45 0 )
...
Massage maneuvers are applied to these
regions, which have a major toning role by increasing local blood circulation
...

The anterior part of the knee is massaged first, the thigh, after which the
actual massaging of the knee joint seated in semiflexion is carried out
...

Friction - applied with the police on both edges of the capsular sac,
rubbing the joint all around
...
Friction can be combined
with vibration
...

Smoothing - done with 2 hands, hand after hand and comb
...

Gelling - on the entire muscle surface and on the groove of the twin
muscles
...

Tapping - all forms and vibration
...
There is no tapping
...


FOOT MASSAGE
The patient's position - on the plantar side in the ventral recumbent position
with the foot resting on the masseur's hand, the leg being slightly flexed
...

Kneading - with 3 fingers on the external side of the tendon muscles
...

Friction - on the entire surface of the plant but especially on the plantar
aponeurosis finger over toe
...


27

Dorsal side - in supine position
...

Gelling - in the same directions as for smoothing
...
Friction can be combined with vibration
...

 MOBILIZATION OF JOINTS (Kinetotherapy)
...

In the case of the pelvic girdle and the thigh, the following movements can be
performed:
 Flexion of the thigh on the pelvis (quadriceps and tailor);
 Thigh extension (gluteus major and semitendinosus);
 Adduction of the thigh (small and medium gluteus maximus and
tensor jasciator);
 Adduction (adductors and pectineus);
 External rotation (adductors and obturator);
 Internal rotation (small and middle gluteus maximus);
 Calf flexion (quadriceps femoris)
...

In the case of the knee joint, movements are performed:
 Flexion- is the movement by which the calf comes closer to the back
of the thigh
...

 Internal rotation - the toes of the foot move closer to the midline
(adduction)
...

 Lateral and medial inclination - the thigh is fixed and the calf is
brought into semiflexion from this position the oscillatory, pendular
movements are imprinted on the calf, both laterally and medially
...

 Dorsal flexion - is the movement by which the dorsal face of the leg
approaches the anterior face of the calf
...

 Adduction - is the movement by which the tip of the hallux
approaches the medio-sagittal plane of the body
...

 Circumduction- is the movement by which the tip of the hallux
describes a circle and results from the alternative execution of the
previous movements
...

 Pronation- is the movement by which the lateral edge of the foot
rises from the ground, so that the plant looks outward
...

Walking exercises can be performed on the outer edges of the legs with the
heels out and the toes in dorsal flexion
...

Other exercises indicated in peripheral nerve paralysis are the exercises
performed at:
 Rolling carpet;
 Ergometric bicycle;
 Trellis;
 Going up and down the stairs
...
OCCUPATIONAL THERAPY
...

Occupational therapy has 4 important goals:
 Improving joint mobility, muscle strength, coordination of
movements, thus restoring the dynamic stereotypes of everyday life;
 To accustom the patient to help himself, to become independent
again in the usual activities (eating, dressing, washing, walking,
29

etc
...
So, to prepare social
reinsertion
...

 To prepare the professional reinsertion, using the elements of
occupational therapy
...
It is the ultimate goal that
we are pursuing that is important
...
BALNEOLOGICAL TREATMENT (mineral waters, mud)
The treatment stations for these ailments are recommended by the specialist
doctor with the necessary prescription
...

 The coast (Eforie and Techirghiol) - salty baths and with sapropelic
mud
A wide range of balneo-physiotherapy procedures are applied in the treatment
stations
...

Re-education and re-adaptation to daily life requires the acquisition by the
neuromotor deficient of all the motor skills that daily life demands
...
Polirom, 1993-1995
...
Dr
...
Ranga, Prof
...
I
...
, Bucharest, 1969
...
Clarence Dail and Charles Thomas – Hydrothermotherapy (simple
treatments for common ailments), Life and Health Publishing House,
Bucharest, 1999
...
, Bucharest
1983
...
, 1981
Dr
...
Ionescu – Medical Gymnastics, Ed
...

Course notes

---