Raúl Maturana in the SETLA webinar on the role of the physiotherapist in ACL injury

Fraternidad-Muprespa has participated this Saturday, October 7, in the webinar of the Spanish Society of Occupational Traumatology (SETLA), with the title “What to do in the event of a knee ACL injury? Role of the physiotherapist”, in which he intervened Raúl Maturana Mulero, physiotherapist of the Barcelona delegation with the presentation “Return to Work. The mutualists are our elite athletes” on returning to work after the anterior cruciate ligament injury.  In addition Laura Valtueña Príncipe, Supervisor in the Madrid delegation, has participated in the organization of this webinar.

The day began with the presentation of Dr. José García López, President of SETLA, thanking the attendees for their participation to give way to the moderator Joaquín Torres Belda, member of the Physiotherapy Advisory Committee on the Board of Directors of SETLA.

During the session, experts such as Dr. Santander, head of the Knee Unit at the Asepeyo Hospital in Coslada, Joaquín Rodrigo, physiotherapist at Fremap Barcelona, Rocío Alminos, physiotherapist at Mutua Universal in Seville, spoke each the different phases of the treatment.

The Anterior Cruciate Ligament (ACL) injury is one of the most common injuries in the knee, whether due to a tear or rupture of the ligament.It usually occurs in activities that put strong pressure on the knee, such as turning with the foot firmly planted, slowing down and changing direction suddenly, poor support in a jump, a blow or an impact with the knee itself.

In his presentation Raúl Maturana explained the keys to optimal recovery and return to work, analyzing the determining factors in the treatment and making a simile between elite athletes and the patients/workers we care for in the mutual.

It is important to work on all muscle parameters and integrate the muscles into functional chains in a personalized way for each patient and type of injury.

Maturana has indicated that the first thing is to assess the functional performance of the patient, for this we will have to observe different aspects such as: musculature through the biomechanics with tests such as ROM (“Range of movement”, maximum range of movement according to the physiological limits of the joints, the structures of the tendons and ligaments, and the conformation and physiological action of the muscles involved); stability with the “Y balance” Test that measures dynamic balance; and performing eccentric and polymetric exercises (exercises whose objective is the development and improvement of the power, speed and strength of the muscles).

He has highlighted the “Side Hop Test” (jump between two marks on the ground without touching them) and the “Single Leg Hop Distance” (distance achieved through a jump on one leg) as predictors of success in the evaluation of the patient's recovery, since they serve to assess and correct incorrect movement patterns, thus avoiding possible relapses.

The following has indicated the functionality of the TSK Questionnaire to know the degree of kinesiophobia (pathological fear of performing certain movements that may cause pain or that may worsen a previous injury), sharing research that shows the relationship of kinesiophobia with biodynamics and movement alterations, and how it can affect recovery and consequently RTW (return to work).

To address kinesiophobia it is necessary to work on communication, trust, involve the patient in their treatment by proposing achievable objectives, educate on the neurophysiology of pain and promote feedback in the consultation. physiotherapy.

Another of the points highlighted in his presentation is to strengthen adherence to treatment and to do so he proposes several strategies. On the one hand, analyze the influential factors, such as the characteristics of rehabilitation, the provision of services and psychological and physiological factors.On the other hand, the work groups that represent a social support mechanism that generates relationships of trust, both in person and online with mobile apps. Another strategy is “Gaming”: a through games and virtual reality, patients show higher levels in functional parameters (greater speed, strength, stability). And finally, the placebo and nocebo effect can help or hinder recovery by generating pain routes or avoiding them.

In addition, he explained the importance of assessment of the ANS (Autonomous Nervous System) to predict the exacerbation of the injury, and the need to assess and modulate it to avoid relapses and pain control. Finally, he stressed that it is necessary to close the recovery cycle through reeducation of gesture valuing synergies, gait and work gesture to prevent future injuries.

With this presentation Raúl Maturana has shown that the perspective for success in physiotherapy treatment is in a biopsychosocial model that articulates a tissue of work networks between the professionals involved, which consolidates recovery after the injury and thus obtains a discharge compatible with the patient's return to work.

The bond between the patient and the physiotherapist is an intrinsic need to achieve the recovery goal.

These are the hallmarks of the innovative project of rehabilitation and in the second phase Recover) to offer the best quality in the health treatment of our patients.

You can watch the webinar on the SETLA website by clicking on this link___HT MLTAG229___.