Cerebral palsy of the child in rehabilitation environment: epidemiologic and clinical profile and therapeutic modalities

INTRODUCTION

Cerebral palsy (CP) is a group of permanent disorders of the development of movement and posture causing activity limitation.

AIM

To evaluate the epidemiological, clinical, and radiological profile of children with CP and to study the therapeutic modalities in daily clinical practice.

METHOD

This was a retrospective, descriptive study, carried out in a physical medicine and rehabilitation department, including all the patients referred with the diagnosis of cerebral palsy between January 2000 and December 2016. We used pre-established records to collect data. The missing data were collected from the files of the pediatric department. To classify cerebral palsy, we used a motor impairment classification, topographic classification according to the affected limb and the GMFCS - ER.

RESULTS

Fifty patients were included with a gender ratio of 1.23. The mean age of patients was 7.8 years old. The risk factors for CP were mainly represented by perinatal asphyxia (55%) and prematurity (37%). The spastic form was predominant (74%). Quadriplegia was the most severe clinical form (61%). Neuro-orthopedic deformations were found in 78% of cases. Half of the children had GMFCS score between 1 and 2. Brain MRI lesions were dominated by anoxic-ischemic sequelae (34%). Physical therapy was prescribed for all patients. The most prescribed devices were the dynamic ankle foot orthosis (60%). Baclofen was prescribed in 5% of cases and botulinum toxin injection was performed in 30% of children.

CONCLUSION

The cerebral palsy defines the clinical and functional disorders caused by non-progressive developmental damage to the brain of the infant which requires a multidisciplinary management.

AB1004 CONTRIBUTION OF DRY REHABILITATION VERSUS BALNEOTHERAPY IN THE CONTROL OF PAIN TRIGGERS IN GONARTHROSIS

Background

Gonarthrosis is a very common condition and a real public health problem [1]. One of the pillars of its management is pain management. In addition to drug treatment, rehabilitation is part of the therapeutic arsenal.

Objectives

The main objective of our work was to compare the contribution of balneotherapy versus dry rehabilitation in the control of pain triggers.

Methods

We carried out a prospective, comparative study carried out over a period of 15 months, (September 2016- December 2017), in 120 patients recruited from the outpatient department of the Physical Medicine and Functional Rehabilitation Department of HMPIT in whom the diagnosis of knee osteoarthritis (KOA) was made according to the criteria of the ACR [2].

The patients were randomly divided into 2 groups of 60 patients each. The first group, called G1, received a standard rehabilitation program. The second group, called G2, received water gymnastics. Two evaluations were made, the first (T1) before the beginning of the rehabilitation and the second (T2) at the end of the eight weeks of treatment.

Results

The mean age of our patients was 57.2 ± 12.5 years in G1 vs 54.3 ± 7.1 years in G2 (p = 0.012). The sex ratio was 0.2 in G1 versus 0.37 in G2 (p = 0.011). The duration of KOA was 63.4 ± 4.5 months in G1 vs 56.2±7.5 months in G2 (p=0.172).

Pain was triggered by standing in 92% of cases in G1 versus 98% in G2 with a mean delay of 17.2 min for G1 and 20.1 min for G2. There was no statistically significant difference between the two groups (p=0.452). After rehabilitation, 22% of the patients in G1 and 43% in G2 noted an improvement in pain with a statistically significant difference between the 2 groups (p=0.001).

Prolonged sitting in 62% of cases in G1 versus 38% in G2 with a mean delay of 6.2 min for G1 and 52.3 min for G2 awakened pain. There was a statistically significant difference between the two groups (p=0.02). After rehabilitation, 23% of the patients in G1 and 30% in G2 noted an improvement in pain with a statistically significant difference between the 2 groups (p=0.001).

Pain was awakened by squatting in 93% of cases in G1 versus 97% of G2. There was no statistically significant difference between the 2 groups (p=0.554). After rehabilitation, 13% of the patients in G1 and 30% in G2 had noted a complete disappearance of pain with a statistically significant difference between the 2 groups (p=0.001).

All patients in G1 and 92% of patients in G2 reported pain when climbing/descending stairs. There was no statistically significant difference between the 2 groups. An improvement in symptomatology was noted in both groups with disappearance of pain in 18% of G1 and 27% of G2.

An adjustment on the parameters by which the 2 groups differed was made without impact on the results obtained.

Conclusion

Rehabilitation has an important role in the control of pain triggers by ensuring, in addition to analgesic means, good muscle balance, joint gain and good proprioception. Balneotherapy has proven to be more effective.

References

[1]Johnson VL, Hunter DJ. The epidemiology of osteoarthritis. Best Pract Res Clin Rheumatol. 2014;28(1):5-15.

[2]Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum. 1986;29(8):1039-49.

Disclosure of Interests

None declared

AB1499 PAIN MANAGEMENT IN KNEE OSTEOARTHRITIS: BALNEOTHERAPY VERSUS CLASSIC REHABILITATION

Background

Knee osteoarthritis presents a heavy financial burden due to disability and supported care. Gonalgia is the main symptom leading patients to consult. For some clinicians, this is a warning signal that correlates with the extent of joint degradation [1]. The management of pain in knee osteoarthritis is multidisciplinary comprising pharmacological and non-pharmacological means including classical rehabilitation and aquatic gymnastics.

The objective of our work was to study the contribution of aquatic gymnastics compared to conventional rehabilitation in the management of pain in patients with knee osteoarthritis.

Objectives

The objective of our work was to study the contribution of aquatic gymnastics compared to conventional rehabilitation in the management of pain in patients with knee osteoarthritis.

Methods

Prospective, evaluative and comparative study about 120 patients with knee osteoarthritis carried out over 15 months (September 2016- December 2017) in the Department of Physical Medicine and Functional Rehabilitation.

The patients were divided into two groups of 60. The first group (G1) benefited from a classic rehabilitation program, the second group (G2) benefited from aquatic gymnastics.

The 2 programs were carried out at the rate of three sessions per week for two months. The study was based on the assessment of pain by the following scales: VAS pain and the Western Ontario and McMaster Universities’ Osteoarthritis Index (WOMAC) questionnaire for the lower limbs (pain section).

Results

The mean age of our patients was 57.2 ± 12.5 years in G1 vs 54.3 ± 7.1 years in G2 (p = 0.012). The sex ratio was 0.2 in G1 versus 0.37 in G2 (p = 0.011). The duration of knee osteoarthritis was 63.4 ± 4.5 months in G1 vs 56.2±7.5 months in G2 (p=0.172).

The pain was mechanical in 89 % of cases. Positional nocturnal pain was noted in 72% of cases. Hydarthrosis was associated in 46% of cases. A daily intake of palliative I analgesics was noted in 56 % of patients.

The mean pain VAS at rest of 33.4±18 in G1 vs 27.3±23.2 in G2 (p=0.13). On exertion, it was 72.3±19 in G1 vs 83.3±20 in G2 (p = 0.72).

After the rehabilitation treatment, an improvement in the two groups was objectified, which was significantly more marked in G2:

Resting VAS improved by 57 % for G1 and by 84% for G2 (p = 0.015). Exercise VAS improved 20% in G1 and 43% in G2 (p <0.001).

The mean WOMAC pain score was 14.3 in G1 and 10.3 in G2 (p = 0.006).

There was an improvement in the WOMAC pain score of 24% in G1 and 58% in G2 (p <0.001).

Conclusion

Functional rehabilitation in the water or in the dry has a marked effect on pain in gonarthrosis patients. The aquatic environment can also bring many benefits on pain by lightening the weight of the body and the analgesic effect of the heat.

References

[1]Trouvin A-P, Perrot S. Douleur dans l’arthrose : comprendre les mécanismes pour améliorer la prise en charge. Revue du Rhumatisme. 2018 Jun;85(4):324–30.

Disclosure of Interests

None declared

AB1500 ASSESSMENT OF CLINICAL PARAMETERS AFTER CLASSIC REHABILITATION VERSUS BALNEOTHERAPY IN GONARTHROSIS

Background

Knee osteoarthritis (KOA) is the most common pathology of the lower limb. It is multifactorial and constitutes a real public health problem. Nowadays, in addition to the rehabilitation that is part of the multidisciplinary management of this affection, water gymnastics is increasingly finding its place [1].

Objectives

The main objective of our work was to compare the contribution of aquatic gymnastics compared to classical rehabilitation in patients with knee osteoarthritis through a clinical evaluation.

Methods

This is a prospective, comparative and evaluative study carried out in a department of Physical Medicine and Functional Rehabilitation over a period of 15 months between September 2016 and December 2017, including 60 patients with KOA.

The patients were randomly divided into 2 groups of 60 patients each one. The first(G1) benefited from a classic rehabilitation program. The second(G2) benefited from water gymnastics. Two clinical evaluations were carried out: T1 before the start of rehabilitation and T2 at the end of the eight weeks of treatment.

Results

The mean age of our patients was 57.2 ± 12.5 years in G1 vs 54.3 ± 7.1 years in G2 (p = 0.012). The sex ratio was 0.2 in G1 versus 0.37 in G2 (p = 0.011). The duration of knee osteoarthritis was 63.4 ± 4.5 months in G1 vs 56.2±7.5 months in G2 (p=0.172).

55 patients presented with a misalignment of the lower limbs with a varus knee in 33% of cases (G1 25% and G2 42%). 5 patients in G1 and 7 patients in G2 had a valgus knee. In G1, one patient had recurvatum and two patient had knee flexum with no statistically significant difference between the two groups.

After classic rehabilitation, Zohlen’s sign had disappeared in 6 patients for the right knee and 3 patients for the left knee. However, after water gymnastics, this sign had disappeared in 12 patients for the right knee and in 16 patients for the left knee.

A functional mobility sector (>90◦) was found in all patients with an average of 120◦ in G1 and 126◦ in G2. After rehabilitation, an improvement of 2% in G1 and 5% in G2 was noted with a statistically significant difference between the two groups (p<0.001).

Thirty-sex percent of G1 patients had quadriceps amyotrophy versus 32 % of G2, which disappeared in 5 patients after classic rehabilitation and in 6 patients after hydrotherapy.

48 patients of G1 and 56 patients of G2 presented with quadriceps retraction which disappeared in 21 subjects of G1 after classic rehabilitation and in 45 subjects of G2 after hydrotherapy.

A retraction of the hamstrings was noted in 13 and 18 patients respectively in G1 and G2 with a total improvement in the 2 groups.

Conclusion

Dry rehabilitation has its place in the management of knee osteoarthritis, but rehabilitation in water has better results. The aquatic environment makes it possible, by reducing the weight of the body, to reduce the stresses exerted on the knee joints, allowing better joint mobility with the added effect of heat on the reduction of pain and muscle relaxation.

References

[1]Erika Ferreira Nascimento, Paulo Henrique Altran Veiga, Rogério Azevedo Antunes Pereira, Antônio Nery de Araújo Neto. Analysis of quality of life and function in the elderly with overweight gonarthrosis submitted to aquatic physical therapy. Geriatrics gerontology and aging. 2012;6(1).

Disclosure of Interests

None declared

AB1497 THE EFFECT OF AQUATIC REHABILITATION ON QUALITY OF LIFE IN PATIENTS WITH KNEE OSTEOARTHRITIS

Background

In addition to its multiple functional, social and economic consequences, knee osteoarthritis is responsible for a significant deterioration in the quality of life (QOL)[1]. Studies examining the impact of osteoarthritis on quality of life have been made possible through the development of validated measurement questionnaires. The SF-12 score with its aspects (physical, mental and social) is a valid and reliable instrument for the assessment of QOL.

Objectives

The main aim of our study was to make a comparison between the contribution of aquatic rehabilitation and classic rehabilitation in patients with knee osteoarthritis using the SF-12 score.

Methods

We carried out a prospective, comparative study carried out over a period of 15 months, (September 2016- December 2017), in 120 patients recruited from the outpatient department of the Physical Medicine and Functional Rehabilitation Department of HMPIT in whom the diagnosis of knee osteoarthritis was made according to the criteria of the ACR.

The patients were randomly divided into 2 groups of 60 patients each. The first group called G1 received a classic rehabilitation program. The second group called G2 benefited from aquatic gymnastics. The study was based on the SF-12 quality of life assessment. Two evaluations were made, the first (T1) before the start of rehabilitation and the second (T2) at the end of the eight weeks of care.

Results

The mean age of our patients was 57.2 ± 12.5 years in G1 vs 54.3 ± 7.1 years in G2 (p = 0.012). The sex ratio was 0.2 in G1 versus 0.37 in G2 (p = 0.011). The duration of knee osteoarthritis was 63.4 ± 4.5 months in G1 vs 56.2±7.5 months in G2 (p=0.172).

Initially, the mean of SF12-P in G1 patients was 31.2 ± 6.5 compared to 35.4±6.2 in G2 patients. In our patients, the SF12-P score was less than 50 in 100% of cases in G1 and in 98% of cases in G2. There was a statistically significant difference between the 2 groups (p = 0.04).

After classical rehabilitation, the SF12-P had increased on average by 2.3 against 6.1 after aquatic gymnastics with a statistically significant difference between the 2 groups (p = 0.012).

Initially, the mean of SF12-M in G1 patients was 32.5 ± 10.2 and 35.3 ± 8.9 in G2 patients. In our patients, the SF12-M score was less than 50 in 94% of cases in G1 and in 98% of cases in G2. There was no statistically significant difference between the 2 groups (p = 0.652).

After classical rehabilitation, the SF12-M increased on average by 6.9 and 12.1 after aquatic gymnastics with a statistically significant difference between the 2 groups (p = 0.005).

Conclusion

The effectiveness of functional rehabilitation, whether aquatic or dry, has been well demonstrated by the study of quality of life, with better results for balneotherapy. The physical properties of water and heat have a positive short-term impact on quality of life by acting on several parameters, including pain, contractures and anxiety. Further studies evaluating this long-term effectiveness will be required.

References

[1]Gabriel SE, Crowson CS, Campion ME, O’Fallon WM. Indirect and non-medical costs among people with rheumatoid arthritis and osteoarthritis compared with nonarthritic controls. J Rheumatol. 1997;24(1):43–8.

Disclosure of Interests

None declared

AB1002 CLASSIC VERSUS AQUATIC REHABILITATION IN GONARTHROSIS: WOMAC SCORE

Background

Gonarthrosis is the most frequent and common condition of the lower limb, responsible for gonalgia, stiffness, leading sometimes to major functional impotence. The WOMAC with its three domains (pain, stiffness and function) is a valid index for the evaluation of lower limb osteoarthritis [1].

The management of gonarthrosis is multidisciplinary with rehabilitation as the mainstay.

Currently, aquatic gymnastics is more and more prescribed in the management of this pathology.

Objectives

The objective of our work was to compare the contribution of aquatic rehabilitation to classical one in patients with gonarthrosis through the WOMAC score.

Methods

This is a prospective, comparative study conducted over a period of 15 months, between September 2016 and December 2017, including 120 patients recruited at the Physical Medicine and Functional Rehabilitation Department of The HMPIT, in whom the diagnosis of gonarthrosis was made according to the ACR criteria.

The patients were randomly divided into 2 groups of 60 patients each. The first group, called G1, received a conventional rehabilitation program. The second group, called G2, received aquatic rehabilitation.

Two evaluations were made, the first (T1) before the beginning of the rehabilitation and the second (T2) at the end of the eight weeks of treatment.

Results

The average age of the general population was 54.85 ± 9.5 years [40- 81 years].

The average age of G1 was 59.07 ± 10.2 years versus 50.63 ± 6.4 years for G2.

Among the 120 patients, 28 were male (23%) and 92 were female(77%) There were 6 males and 54 females in group 1 versus 22 males and 38 females in group 2.

Initially, the average WOMAC pain was 15.1 ± 3.9 in G1 and 12.3 ± 1.22 in G2.

There was a statistically significant difference between the 2 groups (p=0.01). After rehabilitation, there was an improvement in the WOMAC pain score of 17% in G1 and 50% in G2 with a statistically significant difference between the 2 groups (p<0.001).

The average WOMAC score for stiffness was initially 5.1 ± 2 in G1 and 3.2 ± 2 in G2 with no statistically significant difference between the 2 groups (p=0.076).

After rehabilitation, an improvement of this score was noted in both groups, it was 19% in G1 and 50% in G2 with a statistically significant difference between the 2 groups (p<0.001).

The average initial WOMAC function score was 42.32 ±15.7 in G1 and 33 ± 11 in G2 with a statistically significant difference between the 2 groups (p=0.002).

After conventional rehabilitation, this score had improved by 10% and after hydrotherapy, the improvement was 46% with a statistically significant difference between the 2 groups (p<0.001).

Conclusion

These results were aligned with the literature and confirmed the effectiveness of functional treatment whether aquatic or classic with better outcome for aquatic rehabilitation. The best would be to combine the different methods according to the needs of the patient and their functional capacities in order to ensure a better adherence.

References

[1]Guermazi M, Poiraudeau S, Yahia M, Mezganni M, Fermanian J, Elleuch MH, et al. Translation, adaptation and validation of the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) for an Arab population. Osteoarthr Car- tilage. 2004;12(6):459-68.

Disclosure of Interests

None declared

AB1003 EFFECTIVENESS OF CLASSIC VERSUS AQUATIC REHABILITATION IN GONARTHROSIS: LEQUESNE SCORE

Background

Gonarthrosis is a benign knee condition, but it can become disabling if poorly managed. The evaluation of the functional impact of gonarthrosis is based on Lequesne’s algofunctional index [1], thus judging the effectiveness or failure of the proposed treatment.

Water gymnastics is increasingly prescribed in the management of this pathology.

Objectives

The main aim of our work was to compare the efficacy of aquatic gymnastics with conventional rehabilitation in patients with gonarthrosis using Lequesne’s algofunctional index.

Methods

This is a prospective, comparative study conducted over a period of 15 months, between September 2016 december 2017, including 120 patients recruited at the outpatient clinic of the Physical Medicine and Functional Rehabilitation Department of The HMPIT, in whom the diagnosis of gonarthrosis was made according to the ACR criteria.

The patients were randomly divided into 2 groups of 60 patients each. The first group, called G1, received a conventional rehabilitation program. The second group, called G2, received water gymnastics.

Two evaluations were made, the first (T1) before the beginning of the rehabilitation and the second (T2) at the end of the eight weeks of treatment.

Results

The mean age of the general population was 54.85 ± 9.501 years [40- 81 years]. The mean age of G1 was 59.07 ± 10.275 years versus 50.63 ± 6.425 years for G2.

Thus, there was a female predominance with a sex ratio M/F of 0.11 in G1 and 0.57 in G2.

Lequesne’s algofunctional index was initially 11.46 ± 3.2 in G1 patients and 8.7 ± 1 in G2 patients with a statistically significant difference between the 2 groups (p<0.001). The discomfort according to the Lequesne algofunctional index was very important and unbearable in 69% of the cases in G1 against 41% of the cases in G2. The Lequesne index was ≥ 10 in 46 patients in G1 (i.e. 77%) versus 32 patients in G2 (i.e. 53%). After conventional rehabilitation, there was a 10% improvement in this index compared with a 28% improvement after water gymnastics with a statistically significant difference between the 2 groups (p<0.001).

Conclusion

The effectiveness of functional treatment whether aquatic or classic was well demonstrated by Lequesne’s algofunctional index, with better result for aquatic rehabilitation. The best would be to combine the two according to the initial functional capacities of the patient to ensure his adherence to the rehabilitation program.

References

[1]Guermazi M, Mezganni M, Yahia M, Poiraudeau S, Fermanian J, Elleuch MH, et al. Translation and construct validity of the Lequesne index for Arab speaking North African patients with osteoarthritis of the knee. Ann Readapt Med Phys. 2004;47(5):195-203.

Disclosure of Interests

None declared

WITHDRAWN: Neuropathic Pain in Patients with Knee Osteoarthritis: Relation with Comorbidities and Functional Status

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Functional repercussion of polyarthrosis of the elderly in tunisia

INTRODUCTION

Osteoarthritis (OA) is the most common degenerative joint disease in the elderly. The often multifocal location at this age can be a source of pain, limitation of everyday activities, thus affecting their quality of life.

AIM

To evaluate functional status of aged people with generalized OA in Tunisia, and to detect the main factors associated with a poor function in order to optimize their medical care.

METHODS

A cross-sectional, descriptive study done between January and March 2017. Fifty patients were included, aged 65 years and over followed for generalized osteoarthritis. The functional repercussions of polyarthrosis was assessed by functional independence measure (FIM), the Lequesne Algofunctional Index, the Womac index for hip and knee OA, and the Oswestry questionnaire for low back pain.

RESULTS

The mean age of patients was 71.94 ± 0.8 years with a sex ratio of 0.42.The functional status of patients with polyarthrosis were altered to varying degrees. The most impaired dimensions of FIM were self-care, transfers and locomotion. Activities of daily living of the Lequesne index was the most impaired section with an average of 5.28. The three dimensions of the Womac index were affected, particularly the pain section with an average of 49.18/100. The Oswestry index was altered with an average of 18.89 / 40. Factors associated with poor functional status were: Female gender (p<0,05), age of development (p<0,05), spinal arthrosis (p<0,05) and history of falls(p<0,05).

CONCLUSION

Polyarthrosis is accompanied by functional impairment in the elderly. Factors associated with functional impairment should be considered in the Patient Management Program.

Evaluation after two years of functionnal restoration for chronic low back pain : Tunisian experience

INTRODUCTION

functional restoration of the spine is a proven method in the short-term management of chronic low back pain. The aim of our study  was to evaluate the effect of a functional restoration program at two years of evolution.

METHODS

retrospective study of patients enrolled in a functional restoration program during 2014 and summoned after two years,  in 2016. Patients have had the same clinical and functional evaluation before the program, at five weeks and  at two years.

RESULTS

Thirty patients were enrolled in the study. The average age was 45 years. Eighty % of the patients were overweight. Significant improvement for all clinical and functional parameters at five weeks was noted. This gain was maintained significantly for some parameters at two years.

CONCLUSION

The results of the functional rehabilitation of the spine are satisfactory at two years of evolution.

Ground surface nature can influence visual information contribution in postural control

BACKGROUND

In sport, the nature of ground surface is likely to influence the contribution of visual information on postural control. Boxing and wrestling are respectively practiced on firm and soft ground surfaces. The aim was to compare the postural control of boxers with that of wrestlers on stable (firm) and unstable (soft and dynamic) ground surfaces, with and without deprivation of vision.

METHODS

Fifteen male international boxers and 15 male international wrestlers presenting the same anthropometrics characteristics and the same number of years of sports practice were recruited. Spatiotemporal parameters of displacement of the center of feet pressure (COP) were measured on a force platform in static (firm and foam surfaces with eyes open and eyes closed) and dynamic conditions (medio/lateral and antero-posterior directions with eyes open and eyes closed).

RESULTS

The results mainly showed a significant vision × group interaction in the antero-posterior direction for the dynamic postural condition (P<0.017). This indicated that the contribution of visual information was greater for the boxers than for the wrestlers in challenging condition (P=0.030).

CONCLUSIONS

Further studies are needed to confirm whether the nature of ground surface influences the contribution of visual information, which can be, in turn, affected by the specificity of motor skills.

[Isokinetic profile of knee muscles in Tunisian competitive footballers]

BACKGROUND

During football several joints are greatly demanded, especially the knees.The interest of the isokinetic is to detect an imbalance between agonist and antagonist muscles of the muscle leg and between dominant and non dominant leg, in order to prevent injuries and to improve the physical fitness of young soccer players.

AIM

evaluate the isokinetic profile of flexor and extensor muscles of the knee of competitive footballers Methods : Prospective study conducted in the department of Physical and Rehabilitation Medicine of the Military Tunis Hospital, including 15 competitive footballers and evaluated during the month of August 2012. All patients underwent an isokinetic assessment of agonist and antagonist muscles of the knees in concentric mode 3 speed 60 ° / 120 ° and 180 ° (with analysis of figures and curves), using a Biodex dynamometer. The selected parameters were the time of maximum force (MFM) of the knee flexors and extensors, and the agonists / antagonists ratio (IJ / Q). The data were analyzed by SPSS software.

RESULTS

15 competitive footballers were included. The average age is 23.20 years ± 3.99 years, ranging from 18 to 28 years. The average size is 167.13 cm ± 3.6 cm with a range of 163 and 172 cm. The average weight is 60.87 kg ± 5.97 with a range of 50 to 70 kg. The isokinetic evaluation showed a statistically significant superiority of the flexor muscles of the right knee compared with those of the left knee at the speed 60 / s (p = 0.046) and 120 / s (p = 0.031), whereas this difference has not been found for the extensors muscles. The values of the ratio of quadriceps to hamstring increases with the speed of movement performed, the maximum moment / weight moving in the opposite direction.

CONCLUSION

The isokinetic evaluation allows an objective assessment of the flexor and extensor muscles of the knee footballers, in order to correct imbalance and preserve the sporting future of the young footballers.