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Nel mondo industrializzato le malattie degenerative della colonna lombare e cervicale rappresentano praticamente la causa più comune di disabilità permanente e di assenza dal lavoro. Rilevanza sociale presentano inoltre le malattie infiammatorie acute e croniche, settiche e asettiche delle articolazioni, così come le artropatie da microtrauma ripetuto. Sono inoltre di interesse riabilitatorio alcune più rare condizioni morbose, quali le osteonecrosi, le osteocondriti, le condromatosi e le malattie articolari su base neuropatica. In aggiunta, la riabilitazione ortopedica si occupa del recupero funzionale di disabilità legate a malformazioni e dimorfismi congeniti, così come delle alterazioni muscolo-scheletriche conseguenti a gravi ustioni. Non da ultimo è necessario sottolineare la profonda diversità dei rispettivi percorsi riabilitativi propri dei pazienti pediatrici, adulti e anziani, legata al ruolo giocato dall'invecchiamento del sistema osteoarticolare.
La base scientifica della riabilitazione ortopedica risiede nell'approfondita conoscenza dell'anatomia del segmento osteoarticolare interessato e dell'alterazione biomeccanica che ha prodotto la disabilità, così come della biologia del processo di guarigione dell'osso e dei tessuti molli a esso collegati quali muscoli, nervi e legamenti. Tuttavia la complessità di alcune strutture e il continuo progresso delle conoscenze fanno sì che la riabilitazione ortopedica assuma ulteriori connotati super-specialistici, come per esempio nel caso di quella dei pazienti politraumatizzati in cui sia presente una frattura del bacino, o di quelli con fratture ossee secondarie all'osteoporosi. Recentemente stanno assumendo un ruolo sempre più importante e autonomo la riabilitazione dopo ricostruzione artroscopica e quella dopo posizionamento di protesi.
In generale, la riabilitazione ortopedica si fonda essenzialmente sull'impiego della cinesiterapia e sulla terapia fisica. Il movimento rappresenta lo scopo finale della cinesiterapia. L'assenza o la riduzione di movimento comportano infatti alterazioni qualitative e quantitative del tessuto muscolare e del tessuto connettivo delle strutture articolari e periarticolari. L'immobilità è conseguente a traumi, apparecchi gessati, stati algici articolari o muscolari. Il dolore osteo-artro-muscolare dà luogo a una scorretta esecuzione dei movimenti e all'instaurazione di meccanismi adattativi di compenso. Tutto questo si traduce frequentemente nell'esecuzione abituale di movimenti anomali che alterano la fisiologica dinamica dell'apparato locomotore e che diventano a loro volta causa di malattia, concorrendo a mantenere o a peggiorare l'iniziale condizione patologica.
La mancanza di movimento o/e la sua scorretta esecuzione sono inoltre causa di una graduale perdita degli schemi motori o dell'instaurarsi di schemi errati. Il ripristino o la prevenzione della perdita del normale tono-trofismo e della coordinazione muscolare sono tra gli obiettivi fondamentali della cinesiterapia. La mobilità delle articolazioni, l'estensibilità dei tessuti molli e il loro trofismo sono infatti mantenuti dal fisiologico movimento delle parti del corpo. Un corretto intervento cinesiterapico è in grado di opporsi ai processi di ipotrofia e di degenerazione tessutale e alle produzioni abnormi di tessuto connettivo, mantenendo o recuperando la funzione delle strutture interessate direttamente o indirettamente dal processo patologico. La locuzione 'terapia fisica' definisce l'insieme delle metodologie terapeutiche che utilizzano agenti fisici quali l'aria, l'acqua, la luce, l'elettricità, il calore, le onde sonore ed elettromagnetiche.

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Responsabile
dott. Claudio Crisci
 
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Recapiti
081.715.55.19
 
Canale di Clinic Center

Clinic Center S.p.A. - Viale Maria Bakunin, 171 - Parco San Paolo - 80126 Napoli
P.IVA 00767770639
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