Physiotherapists in Newcastle Upon Tyne treat many different conditions including the issues profiled below.

Continuous Passive Motion after Knee Replacement

Total knee replacement is an increasingly common treatment for knee osteoarthritis and large numbers of elderly people undergo this operation every year. Physiotherapy management and treatment of these patients post-operatively is therefore becoming increasingly important if the best functional outcome is to be achieved. Early rehabilitation focuses on improving strength in the quadriceps muscle, restoring range of motion of knee flexion and facilitating gait and activities of daily living. The restoration of knee ranges of movement is one of the key elements on which success is judged and much physiotherapy time is dedicated to this part of the treatment.

A continuous passive motion machine is commonly used to improve knee flexion range of movement, as regular passive movement of a joint has been shown to result in better healing as compared to resting. Research work has shown a minor short term effect of using this treatment technique and it is often reserved for difficult cases such as after manipulation under anaesthetic for a stiff joint. Patients can remain on the machine for long periods but it is important not to forget active practice of the ranges of motion to improve muscle function. Overall continuous passive motion has not been shown to play a significant role in standard knee replacements.

Fatigue and Tiredness - The Management of the Condition

Drug therapies given for arthritic condition, known as disease modifying anti rheumatoid drugs and the new biological treatments, have been shown to reduce the fatigue reported by patients, perhaps partly at least by reducing inflammation and pain levels which have some effects on fatigue levels. While fatigue can be improved by these drugs and by antidepressants, it can occur in the absence of depression or inflammation. Exercise therapy in groups has shown some trends towards improvement of fatigue, although the effects of exercise therapy on chronic fatigue syndrome are not clear.

Group therapy may be included in self management programmes which combine this with education and psychological interventions. Both these therapies have shown some effects in particular circumstances. Acupuncture however has shown no effect in chronic fatigue syndrome. Evidence for non-drug treatments is limited by the number of good quality research trials available, most of which are not set up to examine the fatigue nor the potential treatments for it. A good definition of fatigue does not yet exist nor is there any possibility of logically grading the degrees of tiredness from slight to exhaustion, limiting meaningful work on the condition. Pain management programmes, which often have a physiotherapist and a clinical psychologist, presently address these patients.