Balneophysiotherapeutic Recovery Methods in Ankylosis of the Ankle

This comprehensive document presents an in-depth guide to the balneophysiotherapeutic management of ankle ankylosis, a condition marked by reduced joint mobility due to trauma, chronic inflammation, or autoimmune disorders. The condition, if left untreated, severely limits locomotion and leads to long-term disability, making early and structured intervention essential.

The theoretical foundation begins with classification and etiopathogenesis, dividing causes into non-traumatic (rheumatoid arthritis, scleroderma, degenerative joint disease) and traumatic origins such as fractures and Volkmann’s ischemic contracture. Each is broken down by genetic, hormonal, and environmental influences, followed by clinical insights into disease progression and diagnostic techniques, including radiologic and laboratory evaluations.

Treatment is outlined in a structured format:

• Prophylactic measures emphasize early correction, proper ergonomics, and targeted patient education.

• Curative approaches integrate dietetic control, psychological stabilization, orthopedic correction, and surgical options when necessary.

The focus then shifts to balneophysiotherapeutic recovery methods, which are central to regaining functional mobility:

• Hydrotherapy using temperature-varied mineral water baths improves circulation and joint lubrication.

• Thermotherapy and electrotherapy are applied to reduce inflammation, stimulate neuromuscular activity, and prepare tissues for mobilization.

• A dedicated section on massage therapy explains both the physiological rationale and anatomical techniques for treating the ankle and associated muscular structures.

• The plan continues with physical therapy protocols, emphasizing CFM (circulatory, flexibility, and muscular) exercises to gradually restore range of motion.

• A concluding note on spa therapy highlights mineral-rich environments beneficial for long-term maintenance.

Ideal for students in physical therapy, rehabilitation medicine, and occupational therapy, this resource supports evidence-based learning and is used widely in advanced coursework focused on musculoskeletal recovery.

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Contents Table

1. General

2. Definition of Diseases

3. Etiopathogeny
   3.1. Non-traumatic causes
   3.1.1. Rheumatoid polyarthritis or chronic evolving polyarthritis
   a) Hereditary factor
   b) Other predisposing factors
   3.1.2. Scleroderma
   a) The genetic factor
   b) Other determining factors
   3.1.3. Arthritic disease or degenerative rheumatism
   a) The hereditary factor
   b) Other predisposing factors
   c) Endocrine factors
   3.1.4.
   a) Affecting the juxta-articular bone
   b) Damage to new tissues
   c) Stenosing tenosynovitis of the calf
   3.2. Traumatic causes
   b) Volkmann retraction

4. Symptomatology
   4.1. Ankylosis of the ankle caused by non-traumatic causes
   4.1.1. Due to rheumatoid
   a) Disease history
   b) Anamnesis
   c) Objective examination
   4.1.2. Due to scleroderma
   4.1.3. Due to arthrosis
   4.2. Ankylosis due to post-traumatic causes

5. Criteria for Supporting the Diagnosis
   5.1. Traumatic causes
   5.1.1.
   a) Clinical criteria
   b) Radiological criteria
   5.1.2. Sclerodermic ankylosis
   a) Clinical criteria
   b) Radiological criteria
   c) Laboratory indicators
   5.1.3. Ankylosis due to arthrosis
   a) Clinical criteria
   b) Radiological criteria
   5.2. Posttraumatic causes
   5.2.1. Due to fracture or dislocation
   5.2.2. Volkmann’s retraction

6. Evolution and Forecast

7. The Treatment
   7.1. Prophylactic treatment
   7.2. Curative treatment
   7.2.1. Gyno-dietetic treatment
   7.2.2. Mental state correction
   7.4. Orthopedic treatment
   7.5. Surgical treatment
   7.6. Balneophysiotherapeutic recuperative treatment
   7.6.1. Hydrotherapy
   7.6.2. Thermotherapy
   7.6.3. Electrotherapy

8. Massage Technique in Ankylosis of the Ankle
   8.1. Physiological effects of massage
   8.2. Anatomical description of the region
   8.3. Massage technique for leg, ankle, foot
   8.4. Physical therapy
   8.5. CFM exercises

9. Clean the Bath (final procedural recommendations)