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ΑΝΩΤΑΤΟ ΤΕΧΝΟΛΟΓΙΚΟ<br />

ΕΚΠΑΙ∆ΕΥΤΙΚΟ Ι∆ΡΥΜΑ ΘΕΣΣΑΛΟΝΙΚΗΣ<br />

ΣΧΟΛΗ Σ.Ε.Υ.Π<br />

ΤΜΗΜΑ ΦΥΣΙΚΟΘΕΡΑΠΕΙΑΣ<br />

ΘΕΜΑ:<br />

«ΡΗΞΗ ΚΑΙ ΑΠΟΚΑΤΑΣΤΑΣΗ ΠΡΟΣΘΙΟΥ ΧΙΑΣΤΟΥ<br />

ΣΕ ΑΘΛΗΤΕΣ»<br />

ΚΑΘΗΓΗΤHΣ: κ. Κ. ΒΑΡΣΑΜΙ∆ΗΣ<br />

ΦΟΙΤΗΤΗΣ: ΑΛΜΑΝΙ∆ΗΣ ΘΕΟΧΑΡΗΣ<br />

ΘΕΣΣΑΛΟΝΙΚΗ 2007

ΑΝΩΤΑΤΟ ΤΕΧΝΟΛΟΓΙΚΟ ΕΚΠΑΙ∆ΕΥΤΙΚΟ<br />

Ι∆ΡΥΜΑ ΘΕΣΣΑΛΟΝΙΚΗΣ<br />

ΘΕΜΑ:<br />

« ΡΗΞΗ ΚΑΙ ΑΠΟΚΑΤΑΣΤΑΣΗ ΠΡΟΣΘΙΟΥ ΧΙΑΣΤΟΥ ΣΕ<br />

ΑΘΛΗΤΕΣ »<br />

ΚΑΘΗΓΗΤΗΣ: κ. Κ. ΒΑΡΣΑΜΙ∆ΗΣ<br />

ΦΟΙΤΗΤΗΣ: ΑΛΜΑΝΙ∆ΗΣ ΘΕΟΧΑΡΗΣ<br />

ΘΕΣΣΑΛΟΝΙΚΗ 2007

ΚΑΚΩΣΕΙΣ ΓΟΝΑΤΟΣ ( ΓΕΝΙΚΑ )<br />

Το γόνα<strong>τ</strong>ο α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί <strong>ε</strong><strong>π</strong>ιφ<strong>αν</strong><strong>ε</strong>ική άρθρω<strong>σ</strong>η και <strong>υ</strong>φί<strong>σ</strong><strong>τ</strong>α<strong>τ</strong>αι κακώ<strong>σ</strong><strong>ε</strong>ις<br />

<strong>σ</strong><strong>υ</strong>χνό<strong>τ</strong><strong>ε</strong>ρα α<strong>π</strong>ό <strong>τ</strong>ις άλλ<strong>ε</strong>ς αρθρώ<strong>σ</strong><strong>ε</strong>ις, ιδίως <strong>σ</strong><strong>τ</strong>ο<strong>υ</strong>ς <strong>ε</strong>φήβο<strong>υ</strong>ς<br />

αθλη<strong>τ</strong>ές και αθλή<strong>τ</strong>ρι<strong>ε</strong>ς, <strong>σ</strong><strong>τ</strong>ο<strong>υ</strong>ς ο<strong>π</strong>οίο<strong>υ</strong>ς λόγω <strong>τ</strong>ης <strong>αν</strong>ά<strong>π</strong><strong>τ</strong><strong>υ</strong>ξης, ο α-<br />

νώριµος ακόµη <strong>σ</strong>κ<strong>ε</strong>λ<strong>ε</strong><strong>τ</strong>ός <strong>αν</strong><strong>τ</strong>αγωνίζ<strong>ε</strong><strong>τ</strong>αι ένα ι<strong>σ</strong>χ<strong>υ</strong>ρό<strong>τ</strong><strong>ε</strong>ρο µ<strong>υ</strong>ϊκό <strong>σ</strong>ύ<strong>σ</strong><strong>τ</strong>ηµα.<br />

Κακώ<strong>σ</strong><strong>ε</strong>ις <strong>υ</strong>φί<strong>σ</strong><strong>τ</strong><strong>αν</strong><strong>τ</strong>αι <strong>αν</strong>α<strong>τ</strong>οµικά <strong>σ</strong><strong>τ</strong>οιχ<strong>ε</strong>ία, ό<strong>π</strong>ως οι ορογόνοι<br />

θύλακοι, ο αρθρικός θύλακος, οι αρθρικοί χόνδροι, <strong>τ</strong>α ο<strong>σ</strong><strong>τ</strong>ά, οι <strong>σ</strong><strong>υ</strong>ζ<strong>ε</strong><strong>υ</strong>κ<strong>τ</strong>ικοί<br />

χόνδροι, οι µηνί<strong>σ</strong>κοι, οι <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µοι και οι µύ<strong>ε</strong>ς <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος.<br />

'<br />

Η <strong>σ</strong><strong>υ</strong>ν<strong>ε</strong>χώς α<strong>υ</strong>ξ<strong>αν</strong>όµ<strong>ε</strong>νη <strong>σ</strong><strong>υ</strong>µµ<strong>ε</strong><strong>τ</strong>οχή <strong>σ</strong><strong>ε</strong> αθλήµα<strong>τ</strong>α, ό<strong>π</strong>ως οι χιονοδροµί<strong>ε</strong>ς,<br />

η <strong>ε</strong>νόργ<strong>αν</strong>η γ<strong>υ</strong>µνα<strong>σ</strong><strong>τ</strong>ική, <strong>τ</strong>ο <strong>π</strong>οδό<strong>σ</strong>φαιρο, <strong>τ</strong>ο rugby, η<br />

καλαθο<strong>σ</strong>φαίρι<strong>σ</strong>η, η χ<strong>ε</strong>ιρο<strong>σ</strong>φαίρι<strong>σ</strong>η και η <strong>αν</strong><strong>τ</strong>ι<strong>σ</strong>φαίρι<strong>σ</strong>η, οδηγ<strong>ε</strong>ί <strong>σ</strong><strong>ε</strong><br />

αύξη<strong>σ</strong>η <strong>τ</strong>ων κακώ<strong>σ</strong><strong>ε</strong>ων <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος. Κα<strong>τ</strong>ά <strong>τ</strong>ο<strong>υ</strong>ς Lauterburg &<br />

segantini ( 1994 ), κακώ<strong>σ</strong><strong>ε</strong>ις <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος <strong>π</strong>αρα<strong>τ</strong>ηρούν<strong>τ</strong>αι<br />

<strong>σ</strong><strong>υ</strong>χνό<strong>τ</strong><strong>ε</strong>ρα <strong>σ</strong><strong>τ</strong>ις χιονοδροµί<strong>ε</strong>ς ( 30% ) και ακολο<strong>υ</strong>θούν η <strong>ε</strong>νόργ<strong>αν</strong>η<br />

γ<strong>υ</strong>µνα<strong>σ</strong><strong>τ</strong>ική ( 28%), <strong>τ</strong>ο <strong>π</strong>οδό<strong>σ</strong>φαιρο ( 25% } και <strong>τ</strong>α οµαδικά<br />

αθλήµα<strong>τ</strong>α <strong>τ</strong>ων κλ<strong>ε</strong>ι<strong>σ</strong><strong>τ</strong>ών γ<strong>υ</strong>µνα<strong>σ</strong><strong>τ</strong>ηρίων (12%)<br />

.

Η διάγνω<strong>σ</strong>η <strong>τ</strong>ίθ<strong>ε</strong><strong>τ</strong>αι κ<strong>υ</strong>ρίως µ<strong>ε</strong> <strong>τ</strong>ην κλινική <strong>ε</strong>ξέ<strong>τ</strong>α<strong>σ</strong>η, <strong>ε</strong>νώ<br />

<strong>σ</strong><strong>υ</strong>µβάλλο<strong>υ</strong>ν οι α<strong>π</strong>λές ακ<strong>τ</strong>ινογραφί<strong>ε</strong>ς, η αξονική και<br />

µαγνη<strong>τ</strong>ική <strong>τ</strong>οµογραφία. Ιδιαί<strong>τ</strong><strong>ε</strong>ρα <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ική θέ<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>η<br />

διάγνω<strong>σ</strong>η και <strong>σ</strong><strong>τ</strong>ην <strong>αν</strong><strong>τ</strong>ιµ<strong>ε</strong><strong>τ</strong>ώ<strong>π</strong>ι<strong>σ</strong>η <strong>τ</strong>ων κακώ<strong>σ</strong><strong>ε</strong>ων<br />

κα<strong>τ</strong>έχ<strong>ε</strong>ι<br />

η αρθρο<strong>σ</strong>κό<strong>π</strong>η<strong>σ</strong>η, µ<strong>ε</strong> <strong>τ</strong>ην ο<strong>π</strong>οία<br />

<strong>ε</strong><strong>π</strong>ιβ<strong>ε</strong>βαιώνον<strong>τ</strong>αι ή α<strong>π</strong>οκλ<strong>ε</strong>ίον<strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>οιχ<strong>ε</strong>ία, <strong>π</strong>ο<strong>υ</strong> έχο<strong>υ</strong>ν<br />

δια<strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ωθ<strong>ε</strong>ί α<strong>π</strong>ό <strong>τ</strong>ην κλινική <strong>ε</strong>ξέ<strong>τ</strong>α<strong>σ</strong>η και καθορίζ<strong>ε</strong><strong>τ</strong>αι<br />

ακριβέ<strong>σ</strong><strong>τ</strong><strong>ε</strong>ρα η θ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong><strong>υ</strong><strong>τ</strong>ική αγωγή, <strong>π</strong>ο<strong>υ</strong><br />

<strong>π</strong>ρόκ<strong>ε</strong>ι<strong>τ</strong>αι να ακολο<strong>υ</strong>θηθ<strong>ε</strong>ί.<br />

Οι κακώ<strong>σ</strong><strong>ε</strong>ις <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος οφ<strong>ε</strong>ίλον<strong>τ</strong>αι <strong>σ</strong><strong>ε</strong><br />

<strong>υ</strong><strong>π</strong><strong>ε</strong>ρχρη<strong>σ</strong>ία ή <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ικά αί<strong>τ</strong>ια. Για <strong>τ</strong>ην <strong>π</strong>ρόκλη<strong>σ</strong>η <strong>τ</strong>ων κακώ<strong>σ</strong><strong>ε</strong>ων α<strong>π</strong>ό<br />

<strong>υ</strong><strong>π</strong><strong>ε</strong>ρχρη<strong>σ</strong>ία <strong>σ</strong>ηµα<strong>σ</strong>ία έχο<strong>υ</strong>ν η <strong>π</strong>ρο<strong>π</strong>ονη<strong>τ</strong>ική <strong>τ</strong><strong>ε</strong>χνική, η έν<strong>τ</strong>α<strong>σ</strong>η και η<br />

διάρκ<strong>ε</strong>ια <strong>τ</strong>ης <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>ης, ορι<strong>σ</strong>µένα <strong>ε</strong>ξαρ<strong>τ</strong>ήµα<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong> <strong>ε</strong>ξο<strong>π</strong>λι<strong>σ</strong>µού <strong>τ</strong>ο<strong>υ</strong><br />

αθλη<strong>τ</strong>ή, <strong>τ</strong>ο δά<strong>π</strong><strong>ε</strong>δο <strong>τ</strong>ο<strong>υ</strong> αγωνι<strong>σ</strong><strong>τ</strong>ικού χώρο<strong>υ</strong> και <strong>τ</strong>ο ι<strong>σ</strong><strong>τ</strong>ορικό<br />

<strong>π</strong>ροηγούµ<strong>ε</strong>νων κακώ<strong>σ</strong><strong>ε</strong>ων. Σ<strong>τ</strong>ις <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ικές κακώ<strong>σ</strong><strong>ε</strong>ις <strong>ε</strong>νδιαφέρ<strong>ε</strong>ι<br />

κ<strong>υ</strong>ρίως ο µηχ<strong>αν</strong>ι<strong>σ</strong>µός <strong>π</strong>ρόκλη<strong>σ</strong>ης και <strong>σ</strong><strong>υ</strong>γκ<strong>ε</strong>κριµένα η <strong>τ</strong>αχύ<strong>τ</strong>η<strong>τ</strong>α, <strong>τ</strong>ο<br />

µέγ<strong>ε</strong>θος και η κα<strong>τ</strong><strong>ε</strong>ύθ<strong>υ</strong>ν<strong>σ</strong>η <strong>τ</strong>ης δύναµης, <strong>τ</strong>ο δά<strong>π</strong><strong>ε</strong>δο <strong>τ</strong>ο<strong>υ</strong> αγωνι<strong>σ</strong><strong>τ</strong>ικού<br />

χώρο<strong>υ</strong>, ο <strong>ε</strong>ξο<strong>π</strong>λι<strong>σ</strong>µός <strong>τ</strong>ο<strong>υ</strong> αθλη<strong>τ</strong>ή και <strong>τ</strong>ο ι<strong>σ</strong><strong>τ</strong>ορικό <strong>π</strong>ροηγούµ<strong>ε</strong>νων<br />

κακώ<strong>σ</strong><strong>ε</strong>ων.

1. ΑΝΑΤΟΜΙΚΑ ΣΤΟΙΧΕΙΑ ΤΗΣ ΑΡΘΡΩΣΗΣ ΤΟΥ ΓΟΝΑΤΟΣ<br />

Η άρθρω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος <strong>ε</strong>ίναι η <strong>π</strong>ιο µ<strong>ε</strong>γάλη α<strong>π</strong>ό <strong>τ</strong>ις αρθρώ<strong>σ</strong><strong>ε</strong>ις<br />

<strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong>ώµα<strong>τ</strong>ος. Είναι <strong>σ</strong>ύνθ<strong>ε</strong><strong>τ</strong>η άρθρω<strong>σ</strong>η <strong>π</strong>ο<strong>υ</strong> α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί<strong>τ</strong>αι α<strong>π</strong>ό δύο<br />

<strong>ε</strong><strong>π</strong>ιµέρο<strong>υ</strong>ς αρθρώ<strong>σ</strong><strong>ε</strong>ις: Α: <strong>τ</strong>ην <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδοµηριαία και Β: <strong>τ</strong>ην κνη-<br />

µοµηριαία άρθρω<strong>σ</strong>η, <strong>π</strong>ο<strong>υ</strong> <strong>π</strong><strong>ε</strong>ριβάλλον<strong>τ</strong>αι α<strong>π</strong>ό ένα κοινό αρθρικό<br />

θύλακα. Η κ<strong>ε</strong>φαλή <strong>τ</strong>ης <strong>π</strong><strong>ε</strong>ρόνης δ<strong>ε</strong> <strong>σ</strong><strong>υ</strong>µµ<strong>ε</strong><strong>τ</strong>έχ<strong>ε</strong>ι <strong>σ</strong><strong>τ</strong>ην άρθρω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong><br />

γόνα<strong>τ</strong>ος.

ΣΤΟΙΧΕΙΑ ΟΣΤΕΟΛΟΓΙΑΣ<br />

Α. ΕΠΙΓΟΝΑΤΙ∆ΟΜΗΡΙΑΙΑ ΑΡΘΡΩΣΗ<br />

{Patellofemoral joit )<br />

Η <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδοµηριαία άρθρω<strong>σ</strong>η έχ<strong>ε</strong>ι ως αρθρικές <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ι<strong>ε</strong>ς:<br />

1. <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ια <strong>τ</strong>ης <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδας.<br />

Η µηριαία <strong>τ</strong>ροχιλία κα<strong>τ</strong>αλαµβάν<strong>ε</strong>ι <strong>τ</strong>ην <strong>π</strong>ρό<strong>σ</strong>θια <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ια <strong>τ</strong>ο<strong>υ</strong><br />

κά<strong>τ</strong>ω άκρο<strong>υ</strong> <strong>τ</strong>ο<strong>υ</strong> µηριαίο<strong>υ</strong> και <strong>ε</strong>µφ<strong>αν</strong>ίζ<strong>ε</strong>ι <strong>σ</strong><strong>τ</strong>ο µέ<strong>σ</strong>ο <strong>τ</strong>ης µια<br />

κάθ<strong>ε</strong><strong>τ</strong>η αύλακα, <strong>π</strong>ο<strong>υ</strong> ονοµάζ<strong>ε</strong><strong>τ</strong>αι α<strong>υ</strong>χένας και διαχωρίζ<strong>ε</strong>ι <strong>τ</strong>α<br />

δύο <strong>π</strong>λάγια ο-γκώµα<strong>τ</strong>α.<br />

2. Η <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδα α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί <strong>τ</strong>ο µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρο Την µηριαία <strong>τ</strong>ροχιλία,<br />

Την αρθρική α<strong>π</strong>ό <strong>τ</strong>α <strong>σ</strong>η<strong>σ</strong>αµο<strong>ε</strong>ιδή ο<strong>σ</strong><strong>τ</strong>ά και δια<strong>π</strong>λά<strong>σ</strong><strong>σ</strong><strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ο<br />

<strong>ε</strong><strong>σ</strong>ω<strong>τ</strong><strong>ε</strong>ρικό <strong>τ</strong>ο<strong>υ</strong> κα<strong>τ</strong>αφ<strong>υ</strong><strong>τ</strong>ικού <strong>τ</strong>ένον<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong>. Η<br />

<strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδα <strong>ε</strong>ίναι α<strong>π</strong>ο<strong>π</strong>λα<strong>τ</strong><strong>υ</strong><strong>σ</strong>µένη α<strong>π</strong>ό µ<strong>π</strong>ρος <strong>π</strong>ρος <strong>τ</strong>α <strong>π</strong>ί<strong>σ</strong>ω,<br />

έχ<strong>ε</strong>ι <strong>σ</strong>χήµα <strong>τ</strong>ρίγωνο, µ<strong>ε</strong> <strong>τ</strong>η βά<strong>σ</strong>η <strong>π</strong>ρος <strong>τ</strong>α άνω, <strong>τ</strong>ην κορ<strong>υ</strong>φή<br />

<strong>π</strong>ρος <strong>τ</strong>α κά<strong>τ</strong>ω και <strong>ε</strong>µφ<strong>αν</strong>ίζ<strong>ε</strong>ι δύο <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ι<strong>ε</strong>ς, <strong>τ</strong>ην <strong>π</strong>ρό<strong>σ</strong>θια και<br />

<strong>τ</strong>ην ο<strong>π</strong>ί<strong>σ</strong>θια.<br />

Η <strong>π</strong>ρό<strong>σ</strong>θια <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ια <strong>ε</strong>ίναι <strong>υ</strong><strong>π</strong>όκ<strong>υ</strong>ρ<strong>τ</strong>η και έχ<strong>ε</strong>ι <strong>π</strong>ολλές<br />

αύλακ<strong>ε</strong>ς <strong>π</strong>ο<strong>υ</strong> <strong>υ</strong><strong>π</strong>οδέχον<strong>τ</strong>αι <strong>τ</strong>ις δ<strong>ε</strong><strong>σ</strong>µίδ<strong>ε</strong>ς <strong>τ</strong>ο<strong>υ</strong> κα<strong>τ</strong>αφ<strong>υ</strong><strong>τ</strong>ικού<br />

<strong>τ</strong>ένον<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong>. Η ο<strong>π</strong>ί<strong>σ</strong>θια <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ια <strong>ε</strong>µφ<strong>αν</strong>ίζ<strong>ε</strong>ι<br />

ωο<strong>ε</strong>ιδή αρθρική <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ια, <strong>π</strong>ο<strong>υ</strong> <strong>υ</strong><strong>π</strong>οδιαιρ<strong>ε</strong>ί<strong>τ</strong>αι α<strong>π</strong>ό µια <strong>σ</strong>χ<strong>ε</strong>δόν<br />

κάθ<strong>ε</strong><strong>τ</strong>η ακρολοφία, <strong>π</strong>ο<strong>υ</strong> <strong>αν</strong><strong>τ</strong>ι<strong>σ</strong><strong>τ</strong>οιχ<strong>ε</strong>ί <strong>σ</strong><strong>τ</strong>ον α<strong>υ</strong>χένα <strong>τ</strong>ης <strong>τ</strong>ροχιλίας,<br />

<strong>σ</strong><strong>ε</strong> δύο <strong>ε</strong>λαφρά <strong>υ</strong><strong>π</strong>όκοιλ<strong>ε</strong>ς αρθρικές <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ι<strong>ε</strong>ς <strong>π</strong>ο<strong>υ</strong><br />

<strong>αν</strong><strong>τ</strong>ι<strong>σ</strong><strong>τ</strong>οιχούν <strong>σ</strong><strong>τ</strong>α <strong>π</strong>λάγια ογκώµα<strong>τ</strong>α <strong>τ</strong>ης <strong>τ</strong>ροχιλίας.<br />

Η βά<strong>σ</strong>η <strong>τ</strong>ης <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδας χρη<strong>σ</strong>ιµ<strong>ε</strong>ύ<strong>ε</strong>ι για <strong>τ</strong>ην κα<strong>τ</strong>άφ<strong>υ</strong><strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong>ένον<strong>τ</strong>α<br />

<strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong>, <strong>ε</strong>νώ η κορ<strong>υ</strong>φή <strong>τ</strong>ης για <strong>τ</strong>ην έκφ<strong>υ</strong><strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>ε</strong><strong>τ</strong><strong>τ</strong>ιγονα<strong>τ</strong>ιδικού<br />

<strong>τ</strong>ένον<strong>τ</strong>α. Κα<strong>τ</strong>ά <strong>τ</strong>ην έκ<strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, η αρθρική <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ια<br />

<strong>τ</strong>ης <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδας έρχ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>ε</strong> άµ<strong>ε</strong><strong>σ</strong>η <strong>ε</strong><strong>π</strong>αφή µ<strong>ε</strong> <strong>τ</strong>η µηριαία

<strong>τ</strong>ροχιλία, <strong>ε</strong>νώ κα<strong>τ</strong>ά <strong>τ</strong>ην κάµψη, η <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδα α<strong>π</strong>οµακρύν<strong>ε</strong><strong>τ</strong>αι <strong>π</strong>ρος<br />

<strong>τ</strong>ην κνήµη.<br />

Ε<strong>π</strong>ιγονα<strong>τ</strong>ίδα α<strong>π</strong>ό <strong>ε</strong>µ<strong>π</strong>ρός (δ<strong>ε</strong>ξ.80%) ,Ε<strong>π</strong>ιγονα<strong>τ</strong>ίδα α<strong>π</strong>ό <strong>π</strong>ί<strong>σ</strong>ω<br />

(δ<strong>ε</strong>ξ.80%)<br />

Β. ΚΝΗΜΟΜΗΡΙΑΙΑ ΑΡΘΡΟΣΗ<br />

(Tibiofemoral joint)<br />

Η κνηµοµηριαία άρθρω<strong>σ</strong>η έχ<strong>ε</strong>ι ως αρθρικές <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ι<strong>ε</strong>ς:<br />

1. Την αρθρική <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ια <strong>τ</strong>ων µηριαίων κονδύλων,<br />

2. Τις κνηµιαί<strong>ε</strong>ς γλήν<strong>ε</strong>ς,<br />

3. Το<strong>υ</strong>ς µ<strong>ε</strong><strong>τ</strong>αξύ <strong>τ</strong>ο<strong>υ</strong>ς, έ<strong>σ</strong>ω και έξω µηνί<strong>σ</strong>κο.<br />

Μηριαίοι κόνδ<strong>υ</strong>λοι (Femoral condyles)<br />

Ο έ<strong>σ</strong>ω µηριαίος κόνδ<strong>υ</strong>λος ( Medial Femoral Condyle ) <strong>ε</strong>ίναι <strong>σ</strong><strong>τ</strong><strong>ε</strong>νό<strong>τ</strong><strong>ε</strong>ρος<br />

και <strong>ε</strong><strong>π</strong>ιµηκέ<strong>σ</strong><strong>τ</strong><strong>ε</strong>ρος α<strong>π</strong>ό <strong>τ</strong>ον έξω, <strong>ε</strong>νώ ο έξω µηριαίος κόνδ<strong>υ</strong>λος<br />

(Lateral Femoral Condyle ) <strong>ε</strong>ίναι <strong>ε</strong><strong>υ</strong>ρύ<strong>τ</strong><strong>ε</strong>ρος και <strong>π</strong>ροέχ<strong>ε</strong>ι <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρο<br />

<strong>π</strong>ρος <strong>τ</strong>α µ<strong>π</strong>ρος. Οι µηριαίοι κόνδ<strong>υ</strong>λοι <strong>σ</strong><strong>υ</strong>γκλίνο<strong>υ</strong>ν <strong>π</strong>ρος<br />

<strong>τ</strong>α µ<strong>π</strong>ρος και <strong>σ</strong><strong>υ</strong>ν<strong>ε</strong>νώνον<strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>η µηριαία <strong>τ</strong>ροχιλία, <strong>ε</strong>νώ <strong>π</strong>ρος <strong>τ</strong>α <strong>π</strong>ί<strong>σ</strong>ω<br />

διαχωρίζον<strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>η µ<strong>ε</strong><strong>σ</strong>οκονδΰλιο <strong>ε</strong>ν<strong>τ</strong>οµή ή <strong>τ</strong>ο µ<strong>ε</strong><strong>σ</strong>οκονδύλιο

βόθρο <strong>π</strong>ο<strong>υ</strong> χωρίζ<strong>ε</strong><strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ο <strong>σ</strong>ώµα <strong>τ</strong>ο<strong>υ</strong> µηριαίο<strong>υ</strong> µ<strong>ε</strong> <strong>τ</strong>η µ<strong>ε</strong><strong>σ</strong>οκονδύλιο<br />

γραµµή, η ο<strong>π</strong>οία α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί <strong>τ</strong>η βά<strong>σ</strong>η <strong>τ</strong>ης ιγν<strong>υ</strong>ακής <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ιας.<br />

Μηριαίο ο<strong>σ</strong><strong>τ</strong>ούν, <strong>π</strong><strong>ε</strong>ριφ<strong>ε</strong>ρικό άκρο, α<strong>τ</strong><strong>τ</strong>ό έξω (δ<strong>ε</strong>ξ.80%)<br />

Μηριαίο ο<strong>σ</strong><strong>τ</strong>οΰν, <strong>π</strong><strong>ε</strong>ριφ<strong>ε</strong>ρικό άκρο, α<strong>π</strong>ό κά<strong>τ</strong>ω (δ<strong>ε</strong>ξ.50%)<br />

Κνηµιαίοι κόνδ<strong>υ</strong>λοι { Tibia Condyles )<br />

Ο έ<strong>σ</strong>ω και ο έξω κνηµιαίος κόνδ<strong>υ</strong>λος (Medial & Lateral Condye)<br />

<strong>ε</strong>µφ<strong>αν</strong>ίζο<strong>υ</strong>ν µια άνω <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ια <strong>π</strong>ο<strong>υ</strong> φέρ<strong>ε</strong>ι <strong>τ</strong>ην κνηµιαία γλήνη και<br />

µια <strong>π</strong><strong>ε</strong>ριφέρ<strong>ε</strong>ια. Οι κνηµιαί<strong>ε</strong>ς γλήν<strong>ε</strong>ς <strong>ε</strong>ίναι <strong>υ</strong><strong>π</strong>όκοιλ<strong>ε</strong>ς και<br />

<strong>σ</strong><strong>υ</strong>ν<strong>τ</strong>ά<strong>σ</strong><strong>σ</strong>ον<strong>τ</strong>αι µ<strong>ε</strong> <strong>τ</strong>ο<strong>υ</strong>ς µηριαίο<strong>υ</strong>ς κονδύλο<strong>υ</strong>ς. Η γλήνη <strong>τ</strong>ο<strong>υ</strong> έ<strong>σ</strong>ω<br />

κονδύλο<strong>υ</strong> <strong>ε</strong>ίναι ωο<strong>ε</strong>ιδής, βαθύ<strong>τ</strong><strong>ε</strong>ρη και <strong>ε</strong><strong>π</strong>ιµηκέ<strong>σ</strong><strong>τ</strong><strong>ε</strong>ρη α<strong>π</strong>ό <strong>τ</strong>ην έξω,<br />

<strong>ε</strong>νώ <strong>τ</strong>ο<strong>υ</strong> ςξω <strong>ε</strong>ίναι <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρο <strong>σ</strong><strong>τ</strong>ρογγ<strong>υ</strong>λή και <strong>σ</strong>χ<strong>ε</strong>δόν <strong>ε</strong><strong>π</strong>ί<strong>π</strong><strong>ε</strong>δη.

Μ<strong>ε</strong><strong>τ</strong>αξύ <strong>τ</strong>ων δύο κνηµιαίων γληνών και <strong>π</strong>ί<strong>σ</strong>ω α<strong>π</strong>ό <strong>τ</strong>η µ<strong>ε</strong><strong>σ</strong>ό<strong>τ</strong>η<strong>τ</strong>ά<br />

<strong>τ</strong>ο<strong>υ</strong>ς, βρί<strong>σ</strong>κ<strong>ε</strong><strong>τ</strong>αι <strong>τ</strong>ο µ<strong>ε</strong><strong>σ</strong>ογλήνιο ή µ<strong>ε</strong><strong>σ</strong>οκονδύλιο έ<strong>π</strong>αρµα . Μ<strong>π</strong>ρο<strong>σ</strong><strong>τ</strong>ά<br />

και <strong>π</strong>ί<strong>σ</strong>ω α<strong>π</strong>ό <strong>τ</strong>ο µ<strong>ε</strong><strong>σ</strong>ογλήνιο έ<strong>π</strong>αρµα βρί<strong>σ</strong>κον<strong>τ</strong>αι δύο άχονδρ<strong>ε</strong>ς και<br />

<strong>αν</strong>ώµαλ<strong>ε</strong>ς <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ι<strong>ε</strong>ς, ο <strong>π</strong>ρό<strong>σ</strong>θιος και ο ο<strong>π</strong>ί<strong>σ</strong>θιος<br />

µ<strong>ε</strong><strong>σ</strong>ογλήνιος βόθρος<br />

Σ<strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο µ<strong>ε</strong><strong>σ</strong>ογλήνιο βόθρο <strong>π</strong>ρο<strong>σ</strong>φύον<strong>τ</strong>αι οι δύο µηνί<strong>σ</strong>κοι<br />

και ο <strong>π</strong>ρό<strong>σ</strong>θιος χια<strong>σ</strong><strong>τ</strong>ός, <strong>ε</strong>νώ <strong>σ</strong><strong>τ</strong>ον ο<strong>π</strong>ί<strong>σ</strong>θιο <strong>π</strong>ρο<strong>σ</strong>φύ<strong>ε</strong><strong>τ</strong>αι ο ο<strong>π</strong>ί<strong>σ</strong>θιος<br />

χια<strong>σ</strong><strong>τ</strong>ός.<br />

Κνήµη α<strong>π</strong>ό <strong>ε</strong>µ<strong>π</strong>ρός (δ<strong>ε</strong>ξ.35%), Κνήµη α<strong>π</strong>ό έξω (δ<strong>ε</strong>ξ.35%) και<br />

Κνήµη α<strong>π</strong>ό <strong>π</strong>ί<strong>σ</strong>ω (δ<strong>ε</strong>ξ.35%)

Κνήµη και <strong>π</strong><strong>ε</strong>ρόνη α<strong>π</strong>ό <strong>π</strong>άνω (δ<strong>ε</strong>ξ.70%)<br />

∆ιάρθριοι µηνί<strong>σ</strong>κοι ( Interarticular menisci )<br />

Οι διάρθριοι µηνί<strong>σ</strong>κοι, ο έ<strong>σ</strong>ω και ο έξω, α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λούν<strong>τ</strong>αι α<strong>π</strong>ό<br />

<strong>π</strong><strong>υ</strong>κνό κολλαγόνο, <strong>σ</strong><strong>υ</strong>νδ<strong>ε</strong><strong>τ</strong>ικό ι<strong>σ</strong><strong>τ</strong>ό και χονδρικά κύ<strong>τ</strong><strong>τ</strong>αρα. Οι δύο<br />

µηνο<strong>ε</strong>ιδής δί<strong>σ</strong>κοι <strong>π</strong>αραµβάλλον<strong>τ</strong>αι µ<strong>ε</strong><strong>τ</strong>αξύ <strong>τ</strong>ων κονδύλων <strong>τ</strong>ο<strong>υ</strong><br />

µηριαίο<strong>υ</strong> και <strong>τ</strong>ων κνηµιαίων γλήνων και κα<strong>τ</strong>αλαµβάνο<strong>υ</strong>ν <strong>π</strong><strong>ε</strong>ρί<strong>π</strong>ο<strong>υ</strong><br />

<strong>τ</strong>α δύο έξω <strong>τ</strong>ρι<strong>τ</strong>ηµόρια <strong>τ</strong>ης <strong>σ</strong>ύ<strong>σ</strong><strong>τ</strong>οιχης κνηµιαίας γλήνης. Μ<strong>ε</strong> <strong>τ</strong>ο<strong>υ</strong>ς<br />

µηνί<strong>σ</strong>κο<strong>υ</strong>ς η κνηµοµηριαία διάρθρω<strong>σ</strong>η διαιρ<strong>ε</strong>ί<strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ην άνω ή<br />

µηνι<strong>σ</strong>κοµηριαία και <strong>τ</strong>ην κά<strong>τ</strong>ω ή µηνι<strong>σ</strong>κοκνηµιαία διάρθρω<strong>σ</strong>η.<br />

Κάθ<strong>ε</strong> µηνί<strong>σ</strong>κος <strong>ε</strong>µφ<strong>αν</strong>ίζ<strong>ε</strong>ι δύο χ<strong>ε</strong>ίλη, <strong>τ</strong>ο έξω και <strong>τ</strong>ο έ<strong>σ</strong>ω, δύο<br />

<strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ι<strong>ε</strong>ς, <strong>τ</strong>ην άνω και <strong>τ</strong>ην κά<strong>τ</strong>ω, δύο άκρα, <strong>π</strong>ο<strong>υ</strong> ονοµάζον<strong>τ</strong>αι<br />

κέρα<strong>τ</strong>α, <strong>τ</strong>ο <strong>π</strong>ρό<strong>σ</strong>θιο και <strong>τ</strong>ο ο<strong>π</strong>ί<strong>σ</strong>θιο και λ<strong>ε</strong><strong>π</strong><strong>τ</strong>ύν<strong>ε</strong><strong>τ</strong>αι βαθµιαία α<strong>π</strong>ό <strong>τ</strong>ην<br />

<strong>π</strong><strong>ε</strong>ριφέρ<strong>ε</strong>ια <strong>π</strong>ρος <strong>τ</strong>ο κέν<strong>τ</strong>ρο. Το <strong>π</strong>ρό<strong>σ</strong>θιο κέρας <strong>τ</strong>ο<strong>υ</strong> έ<strong>σ</strong>ω µηνί<strong>σ</strong>κο<strong>υ</strong><br />

και <strong>τ</strong>ο <strong>π</strong>ρό<strong>σ</strong>θιο <strong>υ</strong><strong>π</strong>όκ<strong>υ</strong>ρ<strong>τ</strong>ο χ<strong>ε</strong>ίλος <strong>τ</strong>ο<strong>υ</strong> έξω µηνί<strong>σ</strong>κο<strong>υ</strong>, <strong>σ</strong><strong>υ</strong>νδέον<strong>τ</strong>αι<br />

µ<strong>ε</strong><strong>τ</strong>αξύ <strong>τ</strong>ο<strong>υ</strong>ς µ<strong>ε</strong> <strong>τ</strong>ον <strong>ε</strong>γκάρ<strong>σ</strong>ιο <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µο ( Transverse Ligament ).<br />

Ο έ<strong>σ</strong>ω µηνί<strong>σ</strong>κος ( Medial meniscus ), έχ<strong>ε</strong>ι ηµικ<strong>υ</strong>κλικό <strong>σ</strong>χήµα, µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρο<br />

µήκος α<strong>π</strong>ό <strong>τ</strong>ον έξω και <strong>π</strong>ρο<strong>σ</strong>φύ<strong>ε</strong><strong>τ</strong>αι µ<strong>ε</strong> <strong>τ</strong>ο <strong>π</strong>ρό<strong>σ</strong>θιο κέρας<br />

<strong>σ</strong><strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο µ<strong>ε</strong><strong>σ</strong>ογλήνιο βόθρο, µ<strong>π</strong>ρο<strong>σ</strong><strong>τ</strong>ά α<strong>π</strong>ό <strong>τ</strong>ην έκφ<strong>υ</strong><strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong><br />

<strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού, <strong>ε</strong>νώ µ<strong>ε</strong> <strong>τ</strong>ο ο<strong>π</strong>ί<strong>σ</strong>θιο κέρας <strong>π</strong>ρο<strong>σ</strong>φύ<strong>ε</strong><strong>τ</strong>αι <strong>π</strong>ί<strong>σ</strong>ω α<strong>π</strong>ό<br />

<strong>τ</strong>ην <strong>π</strong>ρό<strong>σ</strong>φ<strong>υ</strong><strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> έξω µηνί<strong>σ</strong>κο<strong>υ</strong> και µ<strong>π</strong>ρο<strong>σ</strong><strong>τ</strong>ά α<strong>π</strong>ό <strong>τ</strong>ην έκφ<strong>υ</strong><strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong><br />

ο<strong>π</strong>ί<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού.

Η <strong>π</strong><strong>ε</strong>ριφέρ<strong>ε</strong>ια <strong>τ</strong>ο<strong>υ</strong> έ<strong>σ</strong>ω µηνί<strong>σ</strong>κο<strong>υ</strong>, <strong>σ</strong><strong>υ</strong>νά<strong>π</strong><strong>τ</strong><strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong><strong>ε</strong>νά µ<strong>ε</strong> <strong>τ</strong>ο έ<strong>σ</strong>ω<br />

θ<strong>υ</strong>λακο<strong>σ</strong><strong>υ</strong>νδ<strong>ε</strong><strong>σ</strong>µικό <strong>σ</strong>ύ<strong>σ</strong><strong>τ</strong>ηµα ( αρθρικό θύλακο και έ<strong>σ</strong>ω <strong>π</strong>λάγιο<br />

<strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µο <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος ). Είναι <strong>ε</strong><strong>π</strong>οµένως λιγό<strong>τ</strong><strong>ε</strong>ρο <strong>ε</strong><strong>υ</strong>κίνη<strong>τ</strong>α α<strong>π</strong>ό<br />

<strong>τ</strong>ον έξω, γ<strong>ε</strong>γονός <strong>π</strong>ο<strong>υ</strong> µαζί µ<strong>ε</strong> <strong>τ</strong>ο ηµικ<strong>υ</strong>κλικό <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong>χήµα, <strong>ε</strong>ρµην<strong>ε</strong>ύ<strong>ε</strong>ι<br />

<strong>τ</strong>η µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρη <strong>σ</strong><strong>υ</strong>χνό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ων ρήξ<strong>ε</strong>ων <strong>τ</strong>ο<strong>υ</strong> έ<strong>σ</strong>ω µηνί<strong>σ</strong>κο<strong>υ</strong>, ως <strong>π</strong>ρος<br />

<strong>τ</strong>ον έξω (5:1 ).<br />

Ο έξω µηνί<strong>σ</strong>κος ( Lateral meniscue ), έχ<strong>ε</strong>ι <strong>σ</strong>χ<strong>ε</strong>δόν κ<strong>υ</strong>κλικό <strong>σ</strong>χή-<br />

µα, <strong>ε</strong>ίναι µικρό<strong>τ</strong><strong>ε</strong>ρος α<strong>π</strong>ό <strong>τ</strong>ον έ<strong>σ</strong>ω και <strong>π</strong>ρο<strong>σ</strong>φύ<strong>ε</strong><strong>τ</strong>αι µ<strong>ε</strong> <strong>τ</strong>ο <strong>π</strong>ρό<strong>σ</strong>θιο<br />

κέρας <strong>τ</strong>ο<strong>υ</strong> µ<strong>π</strong>ρο<strong>σ</strong><strong>τ</strong>ά α<strong>π</strong>ό <strong>τ</strong>ο µ<strong>ε</strong><strong>σ</strong>ογλήνιο έ<strong>π</strong>αρµα, <strong>π</strong>ί<strong>σ</strong>ω και έξω α<strong>π</strong>ό<br />

<strong>τ</strong>ην έκφ<strong>υ</strong><strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> ο<strong>π</strong>ί<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού, <strong>ε</strong>νώ µ<strong>ε</strong> <strong>τ</strong>ο ο<strong>π</strong>ί<strong>σ</strong>θιο κέρας <strong>π</strong>ρο<strong>σ</strong>φύ<strong>ε</strong><strong>τ</strong>αι<br />

<strong>σ</strong><strong>τ</strong>ην ο<strong>π</strong>ί<strong>σ</strong>θια <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ια <strong>τ</strong>ο<strong>υ</strong> µ<strong>ε</strong><strong>σ</strong>ογλήνιο<strong>υ</strong> <strong>ε</strong><strong>π</strong>άρµα<strong>τ</strong>ος.<br />

Η ο<strong>π</strong>ί<strong>σ</strong>θια µοίρα <strong>τ</strong>ο<strong>υ</strong> έξω χ<strong>ε</strong>ίλο<strong>υ</strong>ς <strong>π</strong>ο<strong>υ</strong> έρχ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>ε</strong> <strong>σ</strong>χέ<strong>σ</strong>η µ<strong>ε</strong> <strong>τ</strong>ον<br />

<strong>τ</strong>ένον<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong> ιγν<strong>υ</strong>ακού µ<strong>υ</strong>ός, µ<strong>ε</strong> <strong>τ</strong>ον ο<strong>π</strong>οίο χωρίζ<strong>ε</strong><strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ον έξω<br />

<strong>π</strong>λάγιο <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µο. Το ο<strong>π</strong>ί<strong>σ</strong>θιο κέρας <strong>τ</strong>ο<strong>υ</strong> <strong>ε</strong>νι<strong>σ</strong>χύ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>ε</strong> <strong>π</strong>ολλές <strong>π</strong><strong>ε</strong>ρι<strong>π</strong><strong>τ</strong>ώ<strong>σ</strong><strong>ε</strong>ις<br />

α<strong>π</strong>ό <strong>τ</strong>ον ο<strong>π</strong>ί<strong>σ</strong>θιο µηνι<strong>σ</strong>κοµηριαίο ή <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µο <strong>τ</strong>ο<strong>υ</strong> Wrisberg,<br />

<strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο µηνι<strong>σ</strong>κοµηριαίο ή <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µο <strong>τ</strong>ο<strong>υ</strong> Humphry και <strong>τ</strong>ην<br />

<strong>π</strong><strong>ε</strong>ρι<strong>τ</strong>ονία <strong>π</strong>ο<strong>υ</strong> καλύ<strong>π</strong><strong>τ</strong><strong>ε</strong>ι <strong>τ</strong>ον ιγν<strong>υ</strong>ακό µ<strong>υ</strong> και <strong>τ</strong>ο <strong>τ</strong>οξο<strong>ε</strong>ιδές <strong>σ</strong>ύµ<strong>π</strong>λ<strong>ε</strong>γµα,<br />

<strong>σ</strong><strong>τ</strong>ην ο<strong>π</strong>ί<strong>σ</strong>θια-έξω γωνία <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος.<br />

Η <strong>π</strong><strong>ε</strong>ριφέρ<strong>ε</strong>ια <strong>τ</strong>ο<strong>υ</strong> έξω µηνί<strong>σ</strong>κο<strong>υ</strong>, δ<strong>ε</strong>ν έρχ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>ε</strong> <strong>ε</strong><strong>π</strong>αφή µ<strong>ε</strong> <strong>τ</strong>ον<br />

έξω <strong>π</strong>λάγιο <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µο <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος. Είναι <strong>ε</strong><strong>π</strong>οµένως <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρο<br />

<strong>ε</strong><strong>υ</strong>κίνη<strong>τ</strong>ος α<strong>π</strong>ό <strong>τ</strong>ον έ<strong>σ</strong>ω, γ<strong>ε</strong>γονός <strong>π</strong>ο<strong>υ</strong> µαζί µ<strong>ε</strong> <strong>τ</strong>ο <strong>σ</strong>χ<strong>ε</strong>δόν κ<strong>υ</strong>κλικό<br />

<strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong>χήµα, <strong>ε</strong>ρµην<strong>ε</strong>ύ<strong>ε</strong>ι <strong>τ</strong>η µικρό<strong>τ</strong><strong>ε</strong>ρη <strong>σ</strong><strong>υ</strong>χνό<strong>τ</strong>η<strong>τ</strong>α ρήξ<strong>ε</strong>ων, ως<br />

<strong>π</strong>ρος <strong>τ</strong>ον έ<strong>σ</strong>ω µηνί<strong>σ</strong>κο.

Η αιµά<strong>τ</strong>ω<strong>σ</strong>η <strong>τ</strong>ων µηνί<strong>σ</strong>κων γίν<strong>ε</strong><strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>η µέ<strong>σ</strong>η αρθρική και <strong>τ</strong>ις<br />

κά<strong>τ</strong>ω αρθρικές αρ<strong>τ</strong>ηρί<strong>ε</strong>ς <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, <strong>π</strong>ο<strong>υ</strong> <strong>σ</strong>χηµα<strong>τ</strong>ίζο<strong>υ</strong>ν αρ<strong>τ</strong>ηριακά<br />

<strong>τ</strong>όξα µόνο <strong>σ</strong><strong>τ</strong>ο έξω χ<strong>ε</strong>ίλος <strong>τ</strong>ο<strong>υ</strong> µηνί<strong>σ</strong>κο<strong>υ</strong>, <strong>ε</strong>νώ <strong>αν</strong><strong>τ</strong>ίθ<strong>ε</strong><strong>τ</strong>α <strong>τ</strong>ο <strong>υ</strong><strong>π</strong>όλοι<strong>π</strong>ο<br />

<strong>τ</strong>µήµα <strong>τ</strong>ο<strong>υ</strong> <strong>ε</strong>ίναι <strong>αν</strong>άγγ<strong>ε</strong>ιο και δια<strong>τ</strong>ρέφ<strong>ε</strong><strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ο αρθρικό <strong>υ</strong>γρό. Λόγω<br />

<strong>τ</strong>ης ιδιαι<strong>τ</strong><strong>ε</strong>ρό<strong>τ</strong>η<strong>τ</strong>ας <strong>τ</strong>ης αιµά<strong>τ</strong>ω<strong>σ</strong>ης, η <strong>ε</strong><strong>π</strong>ούλω<strong>σ</strong>η µ<strong>ε</strong> <strong>σ</strong><strong>υ</strong>ν<strong>τ</strong>ηρη<strong>τ</strong>ική<br />

αγωγή <strong>ε</strong>ίναι δ<strong>υ</strong>να<strong>τ</strong>ή µόνο <strong>σ</strong><strong>ε</strong> µικρής έκ<strong>τ</strong>α<strong>σ</strong>ης ρήξ<strong>ε</strong>ις, <strong>π</strong>ο<strong>υ</strong><br />

<strong>ε</strong>ν<strong>τ</strong>ο<strong>π</strong>ίζον<strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ην <strong>π</strong><strong>ε</strong>ριφ<strong>ε</strong>ρική µοίρα <strong>τ</strong>ο<strong>υ</strong> µηνί<strong>σ</strong>κο<strong>υ</strong>.<br />

∆ιάρθρω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, µηνί<strong>σ</strong>κοι µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό <strong>ε</strong>γκάρ<strong>σ</strong>ια δια<strong>τ</strong>οµή<br />

<strong>τ</strong>ο<strong>υ</strong> αρθρικού θ<strong>υ</strong>λάκο<strong>υ</strong> <strong>τ</strong>ων χια<strong>σ</strong><strong>τ</strong>ών και <strong>τ</strong>ων <strong>π</strong>λαγίων <strong>σ</strong><strong>υ</strong>νδ. α<strong>π</strong>ό<br />

<strong>π</strong>άνω (δ<strong>ε</strong>ξ.65%) ΚΑΙ ∆ιάρθρω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, αρ<strong>τ</strong>ηριακή<br />

αιµά<strong>τ</strong>ω<strong>σ</strong>η <strong>τ</strong>ων µηνί<strong>σ</strong>κων µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό <strong>ε</strong>γκάρ<strong>σ</strong>ια δια<strong>τ</strong>οµή <strong>τ</strong>ο<strong>υ</strong><br />

αρθρικού θ<strong>υ</strong>λάκο<strong>υ</strong>, <strong>τ</strong>ων χια<strong>σ</strong><strong>τ</strong>ών και <strong>τ</strong>ων <strong>π</strong>λάγιων <strong>σ</strong><strong>υ</strong>νδ. α<strong>π</strong>ό<br />

<strong>π</strong>άνω (δ<strong>ε</strong>ξ.65%)<br />

Οι µηνί<strong>σ</strong>κοι <strong>π</strong><strong>ε</strong>ριορίζο<strong>υ</strong>ν <strong>τ</strong>η δ<strong>υ</strong><strong>σ</strong>αρµονία µ<strong>ε</strong><strong>τ</strong>αξύ <strong>τ</strong>ων αρθρικών<br />

<strong>ε</strong><strong>π</strong>ιφ<strong>αν</strong><strong>ε</strong>ιών <strong>τ</strong>ο<strong>υ</strong> µηριαίο<strong>υ</strong> και <strong>τ</strong>ης κνήµης, α<strong>υ</strong>ξάνον<strong>τ</strong>ας <strong>τ</strong>ο βάθος <strong>τ</strong>ων<br />

κνηµιαίων γληνών, δι<strong>ε</strong><strong>υ</strong>κολύνο<strong>υ</strong>ν <strong>τ</strong>ις <strong>σ</strong><strong>τ</strong>ροφικλές κινή<strong>σ</strong><strong>ε</strong>ις <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος,<br />

<strong>ε</strong>νώ <strong>π</strong>αράλληλα κα<strong>τ</strong><strong>αν</strong>έµο<strong>υ</strong>ν οµοιόµορφα και αµβλύνο<strong>υ</strong>ν <strong>τ</strong>ο<strong>υ</strong>ς<br />

κραδα<strong>σ</strong>µούς <strong>π</strong>ο<strong>υ</strong> <strong>π</strong>ροκαλούν<strong>τ</strong>αι κα<strong>τ</strong>ά <strong>τ</strong>η φόρ<strong>τ</strong>ι<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong>κέλο<strong>υ</strong>ς. Η<br />

άµβλ<strong>υ</strong>ν<strong>σ</strong>η <strong>τ</strong>ων κραδα<strong>σ</strong>µών γίν<strong>ε</strong><strong>τ</strong>αι <strong>π</strong>ρος όλ<strong>ε</strong>ς <strong>τ</strong>ις κα<strong>τ</strong><strong>ε</strong><strong>υ</strong>θύν<strong>σ</strong><strong>ε</strong>ις (κάθ<strong>ε</strong><strong>τ</strong>α,<br />

οβ<strong>ε</strong>λιαία και <strong>ε</strong>γκάρ<strong>σ</strong>ια).<br />

Κα<strong>τ</strong>ά <strong>τ</strong>ην κάµψη και έκ<strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος οι µηνί<strong>σ</strong>κοι ακολο<strong>υ</strong>θούν<br />

<strong>τ</strong>ην κίνη<strong>σ</strong>η <strong>τ</strong>ων κνηµιαίων κονδύλων, <strong>ε</strong>νώ κα<strong>τ</strong>ά <strong>τ</strong>ις <strong>σ</strong><strong>τ</strong>ροφές ακολο<strong>υ</strong>θούν<br />

<strong>τ</strong>ην κίνη<strong>σ</strong>η <strong>τ</strong>ων µηριαίων κονδύλων,

Η <strong>π</strong>ρό<strong>σ</strong>θια και ο<strong>π</strong>ί<strong>σ</strong>θια µοίρα <strong>τ</strong>ο<strong>υ</strong> έ<strong>σ</strong>ω µηνί<strong>σ</strong>κο<strong>υ</strong> ακολο<strong>υ</strong>θούν <strong>τ</strong>ην<br />

κίνη<strong>σ</strong>η <strong>τ</strong>ης κνήµης, η µέ<strong>σ</strong>η όµως µοίρα ακολο<strong>υ</strong>θ<strong>ε</strong>ί <strong>τ</strong>ον έ<strong>σ</strong>ω µηριαίο<br />

κόνδ<strong>υ</strong>λο. Υ<strong>π</strong>άρχ<strong>ε</strong>ι <strong>ε</strong><strong>π</strong>οµένως <strong>π</strong>ιθ<strong>αν</strong>ό<strong>τ</strong>η<strong>τ</strong>α να <strong>υ</strong><strong>π</strong>ο<strong>σ</strong><strong>τ</strong><strong>ε</strong>ί κάκω<strong>σ</strong>η κα<strong>τ</strong>ά<br />

<strong>τ</strong>ις <strong>σ</strong><strong>τ</strong>ροφικές κινή<strong>σ</strong><strong>ε</strong>ις.<br />

Ο έξω µηνί<strong>σ</strong>κος, ακολο<strong>υ</strong>θ<strong>ε</strong>ί και α<strong>υ</strong><strong>τ</strong>ός <strong>τ</strong>ον έξω µηριαίο κόνδ<strong>υ</strong>λο<br />

κα<strong>τ</strong>ά <strong>τ</strong>ις <strong>σ</strong><strong>τ</strong>ροφές <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος. Λόγω όµως <strong>τ</strong>ης <strong>σ</strong><strong>υ</strong>νάφ<strong>ε</strong>ιας <strong>τ</strong>ο<strong>υ</strong> µ<strong>ε</strong><br />

<strong>τ</strong>ο<strong>υ</strong>ς <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>ς <strong>τ</strong>ο<strong>υ</strong> \Λ/risberg και <strong>τ</strong>ο<strong>υ</strong> Humphry, µ<strong>ε</strong>ιώνον<strong>τ</strong>αι οι <strong>π</strong>ιθ<strong>αν</strong>ό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς<br />

κάκω<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong>. Ε<strong>π</strong>ι<strong>π</strong>λέον κα<strong>τ</strong>ά <strong>τ</strong>ην έ<strong>σ</strong>ω <strong>σ</strong><strong>τ</strong>ροφή <strong>τ</strong>ης κνή-<br />

µης, µ<strong>ε</strong> <strong>τ</strong>ο γόνα<strong>τ</strong>ο <strong>σ</strong><strong>ε</strong> κάµψη, ο ιγν<strong>υ</strong>ακός µ<strong>υ</strong>ς έλκ<strong>ε</strong>ι <strong>τ</strong>ην ο<strong>π</strong>ί<strong>σ</strong>θια µοί<br />

ρα <strong>τ</strong>ο<strong>υ</strong> έξω µηνί<strong>σ</strong>κο<strong>υ</strong> <strong>π</strong>ρος <strong>τ</strong>α <strong>π</strong>ί<strong>σ</strong>ω, α<strong>π</strong>ο<strong>τ</strong>ρέ<strong>π</strong>ον<strong>τ</strong>ας <strong>τ</strong>ην <strong>π</strong>αγίδ<strong>ε</strong><strong>υ</strong><strong>σ</strong>η<br />

<strong>τ</strong>ο<strong>υ</strong> µ<strong>ε</strong><strong>τ</strong>αξύ µηριαίο<strong>υ</strong> και κνηµιαίο<strong>υ</strong> κονδύλο<strong>υ</strong>.<br />

Αρθρικός θύλακας ( Joint capsule )<br />

Ο αρθρικός θύλακας α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί<strong>τ</strong>αι, α<strong>π</strong>ό έξω <strong>π</strong>ρος <strong>τ</strong>α έ<strong>σ</strong>ω, α<strong>π</strong>ό<br />

<strong>τ</strong>ον ινώδη θύλακα και α<strong>π</strong>ό <strong>τ</strong>ον αρθρικό <strong>υ</strong>µένα.<br />

Ο ινώδης θύλακας <strong>ε</strong>ίναι κοινός για <strong>τ</strong>ην <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδο-µηριαία και<br />

<strong>τ</strong>ην κνηµοµηριαία άρθρω<strong>σ</strong>η και έχ<strong>ε</strong>ι <strong>σ</strong>χήµα <strong>π</strong><strong>ε</strong>ριχ<strong>ε</strong>ιρί-δος.<br />

Ο ινώδης θύλακας <strong>π</strong>ρο<strong>σ</strong>φύ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ο µηριαίο ο<strong>σ</strong><strong>τ</strong>ό και <strong>σ</strong><strong>τ</strong>ην κνή-<br />

µη, <strong>σ</strong><strong>ε</strong> διαφορ<strong>ε</strong><strong>τ</strong>ική α<strong>π</strong>ό<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η α<strong>π</strong>ό <strong>τ</strong>ις αρθρικές <strong>τ</strong>ο<strong>υ</strong>ς <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ι<strong>ε</strong>ς.<br />

Σ<strong>τ</strong>ην <strong>π</strong>ρό<strong>σ</strong>θια <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ια <strong>τ</strong>ο<strong>υ</strong> µηριαίο<strong>υ</strong>, ο ινώδης θύλακας <strong>π</strong>ρο<strong>σ</strong>φύ<strong>ε</strong><strong>τ</strong>αι<br />

1CM ως 2cm <strong>π</strong>άνω α<strong>π</strong>ό <strong>τ</strong>η µηριαία <strong>τ</strong>ροχιλία, όµως η<br />

γραµµή <strong>αν</strong>άκαµψης <strong>τ</strong>ο<strong>υ</strong> θύλακα βρί<strong>σ</strong>κ<strong>ε</strong><strong>τ</strong>αι <strong>π</strong>ολύ ψηλό<strong>τ</strong><strong>ε</strong>ρα, <strong>σ</strong>χηµα<strong>τ</strong>ίζον<strong>τ</strong>ας<br />

<strong>τ</strong>ον <strong>υ</strong><strong>π</strong><strong>ε</strong>ρ<strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδικό ορογόνο θύλακα. Σ<strong>τ</strong>ην ο<strong>π</strong>ί<strong>σ</strong>θια <strong>ε</strong>-<br />

<strong>π</strong>ιφάν<strong>ε</strong>ια <strong>τ</strong>ο<strong>υ</strong> µηριαίο<strong>υ</strong> ο ινώδης θύλακας <strong>π</strong>ρο<strong>σ</strong>φύ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>α χ<strong>ε</strong>ίλη<br />

<strong>τ</strong>ο<strong>υ</strong> αρθρικού χόνδρο<strong>υ</strong> <strong>τ</strong>ων µηριαίων κονδύλων και <strong>σ</strong><strong>τ</strong>ο ο<strong>π</strong>ί<strong>σ</strong>θιο<br />

χ<strong>ε</strong>ίλος <strong>τ</strong>ης µ<strong>ε</strong><strong>σ</strong>οκονδ<strong>υ</strong>λίο<strong>υ</strong> <strong>ε</strong>ν<strong>τ</strong>οµής.<br />

Σ<strong>τ</strong>ην <strong>π</strong>ρό<strong>σ</strong>θια <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ια <strong>τ</strong>ης κνήµης, ο ινώδης θύλακας <strong>π</strong>ρο<strong>σ</strong>φύ<strong>ε</strong><strong>τ</strong>αι<br />

<strong>σ</strong><strong>τ</strong>ο χ<strong>ε</strong>ίλος <strong>τ</strong>ο<strong>υ</strong> µ<strong>ε</strong><strong>σ</strong>ογλήνιο<strong>υ</strong> βόθρο<strong>υ</strong> και <strong>σ</strong><strong>τ</strong>α <strong>π</strong>λάγια κα<strong>τ</strong>ά

*<br />

µήκος <strong>τ</strong>ο<strong>υ</strong> <strong>υ</strong><strong>π</strong>ογλήνιο<strong>υ</strong> χ<strong>ε</strong>ίλο<strong>υ</strong>ς, <strong>σ</strong><strong>ε</strong> α<strong>π</strong>ό<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η 4mm έως 5mm α<strong>π</strong>ό<br />

<strong>τ</strong>ον αρθρικό χόνδρο. Σ<strong>τ</strong>ην ο<strong>π</strong>ί<strong>σ</strong>θια <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ια <strong>τ</strong>ης κνήµης, ο ινώδης<br />

θύλακας <strong>π</strong>ρο<strong>σ</strong>φύ<strong>ε</strong><strong>τ</strong>αι κα<strong>τ</strong>ά µήκος <strong>τ</strong>ων χ<strong>ε</strong>ιλέων <strong>τ</strong>ο<strong>υ</strong> αρθρικού χόνδρο<strong>υ</strong><br />

και <strong>σ</strong><strong>υ</strong>µφύ<strong>ε</strong><strong>τ</strong>αι µ<strong>ε</strong> <strong>τ</strong>ο<strong>υ</strong>ς χια<strong>σ</strong><strong>τ</strong>ούς <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>ς.<br />

Σ<strong>τ</strong>ην <strong>π</strong>ρό<strong>σ</strong>θια <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ια <strong>τ</strong>ο<strong>υ</strong> ινώδο<strong>υ</strong>ς θ<strong>υ</strong>λάκο<strong>υ</strong> <strong>υ</strong><strong>π</strong>άρχ<strong>ε</strong>ι <strong>ε</strong><strong>υ</strong>ρύ<br />

άνοιγµα, <strong>τ</strong>α χ<strong>ε</strong>ίλη <strong>τ</strong>ο<strong>υ</strong> ο<strong>π</strong>οίο<strong>υ</strong> <strong>π</strong>ρο<strong>σ</strong>φύον<strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ην <strong>π</strong><strong>ε</strong>ριφέρ<strong>ε</strong>ια <strong>τ</strong>ης<br />

<strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδας, <strong>ε</strong>ξω<strong>τ</strong><strong>ε</strong>ρικά <strong>τ</strong>ο<strong>υ</strong> αρθρικού χόνδρο<strong>υ</strong>.<br />

Ο αρθρικός <strong>υ</strong>µένας ( Synovial mebrane ) έχ<strong>ε</strong>ι <strong>τ</strong>η µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρη <strong>ε</strong>-<br />

<strong>π</strong>ιφάν<strong>ε</strong>ια α<strong>π</strong>ό <strong>τ</strong>ο<strong>υ</strong>ς αρθρικούς <strong>υ</strong>µέν<strong>ε</strong>ς <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong>ώµα<strong>τ</strong>ος και διακό<strong>π</strong><strong>τ</strong><strong>ε</strong><strong>τ</strong>αι,<br />

ό<strong>π</strong>ως και ο αρθρικός θύλακος, <strong>σ</strong><strong>τ</strong>ην <strong>π</strong><strong>ε</strong>ριφέρ<strong>ε</strong>ια <strong>τ</strong>ης <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδας.<br />

Πάνω α<strong>π</strong>ό <strong>τ</strong>ην <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδα ο αρθρικός <strong>υ</strong>µένας <strong>ε</strong>µφ<strong>αν</strong>ίζ<strong>ε</strong>ι <strong>π</strong>ρο<strong>ε</strong>κβολή,<br />

<strong>τ</strong>ο <strong>υ</strong><strong>π</strong><strong>ε</strong>ρ<strong>τ</strong>ροχίλιο κόλ<strong>π</strong>ωµα, <strong>π</strong>ο<strong>υ</strong> βρί<strong>σ</strong>κ<strong>ε</strong><strong>τ</strong>αι κά<strong>τ</strong>ω α<strong>π</strong>ό <strong>τ</strong>ον<br />

<strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο και <strong>ε</strong><strong>π</strong>ικοινων<strong>ε</strong>ί µ<strong>ε</strong> <strong>τ</strong>ον <strong>υ</strong><strong>π</strong><strong>ε</strong>ρ<strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδικό ορογόνο<br />

θύλακα ( Suprapatellar bursa).<br />

Κά<strong>τ</strong>ω α<strong>π</strong>ό <strong>τ</strong>ην <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδα ο αρθρικός <strong>υ</strong>µένας χωρίζ<strong>ε</strong><strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ον<br />

<strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδικό <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µο µ<strong>ε</strong> <strong>τ</strong>ο λι<strong>π</strong>ώδ<strong>ε</strong>ς <strong>σ</strong>ώµα <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, <strong>ε</strong>νώ<br />

<strong>σ</strong><strong>τ</strong>α <strong>π</strong>λάγια <strong>τ</strong>ης άρθρω<strong>σ</strong>ης, διακό<strong>π</strong><strong>τ</strong><strong>ε</strong><strong>τ</strong>αι λόγω <strong>τ</strong>ης <strong>π</strong>ρό<strong>σ</strong>φ<strong>υ</strong><strong>σ</strong>ης <strong>τ</strong>ων<br />

µηνί<strong>σ</strong>κων, οι ο<strong>π</strong>οίοι <strong>ε</strong><strong>π</strong>οµένως δ<strong>ε</strong>ν καλύ<strong>π</strong><strong>τ</strong>ον<strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ον αρθρικό<br />

<strong>υ</strong>µένα. Σ<strong>τ</strong>ην ο<strong>π</strong>οί<strong>σ</strong>θια <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ια ο αρθρικός <strong>υ</strong>µένας <strong>π</strong><strong>ε</strong>ριβάλλ<strong>ε</strong>ι <strong>τ</strong>ον<br />

<strong>π</strong>ρό<strong>σ</strong>θιο και <strong>τ</strong>ον ο<strong>π</strong>ί<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό, α<strong>π</strong>ό µ<strong>π</strong>ρο<strong>σ</strong><strong>τ</strong>ά και α<strong>π</strong>ό <strong>τ</strong>α <strong>π</strong>λάγια,<br />

οι ο<strong>π</strong>οίοι µ<strong>ε</strong> <strong>τ</strong>ην κάλ<strong>υ</strong>ψη α<strong>υ</strong><strong>τ</strong>ή καθί<strong>σ</strong><strong>τ</strong><strong>αν</strong><strong>τ</strong>αι <strong>ε</strong>ξω<strong>υ</strong>µ<strong>ε</strong>νικά <strong>αν</strong>α<strong>τ</strong>οµικά<br />

<strong>σ</strong><strong>τ</strong>οιχ<strong>ε</strong>ία.

∆ιάρθρω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, <strong>π</strong>λήρω<strong>σ</strong>η <strong>τ</strong>ης αρθρικής κοιλό<strong>τ</strong>η<strong>τ</strong>ας<br />

µ<strong>ε</strong> <strong>υ</strong>γρό. Α<strong>π</strong>ό έξω (δ<strong>ε</strong>ξ.65%)<br />

∆ιάρθρω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, <strong>π</strong>λήρω<strong>σ</strong>η <strong>τ</strong>ης αρθρικής<br />

κοιλό<strong>τ</strong>η<strong>τ</strong>αςµ<strong>ε</strong> <strong>υ</strong>γρό α<strong>π</strong>ό <strong>π</strong>ί<strong>σ</strong>ω (δ<strong>ε</strong>ξ. 65

1.2 ΣΤΟΙΧΕΙΑ ΜΥΟΛΟΠΑΣ<br />

Λίγοι µόνο µύ<strong>ε</strong>ς <strong>ε</strong>ν<strong>ε</strong>ργούν <strong>σ</strong><strong>τ</strong>ην διάρθρω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος. Οι <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ροι<br />

δρο<strong>υ</strong>ν και <strong>σ</strong><strong>τ</strong>ο ι<strong>σ</strong>χίο ή <strong>σ</strong><strong>τ</strong>ην <strong>π</strong>οδοκνηµική.<br />

Μύ<strong>ε</strong>ς <strong>τ</strong>ο<strong>υ</strong> µηρού και <strong>τ</strong>ο<strong>υ</strong> ι<strong>σ</strong>χίο<strong>υ</strong> , µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό µ<strong>ε</strong>ρική αφαίρ<strong>ε</strong><strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> µ<strong>ε</strong>γάλο<strong>υ</strong><br />

και <strong>τ</strong>ο<strong>υ</strong> µέ<strong>σ</strong>ο<strong>υ</strong> γλο<strong>υ</strong><strong>τ</strong>ιαίο<strong>υ</strong> , α<strong>π</strong>ό <strong>π</strong>ί<strong>σ</strong>ω (δ<strong>ε</strong>ξ. )

Μύ<strong>ε</strong>ς <strong>τ</strong>ο<strong>υ</strong> µηρού και <strong>τ</strong>ο<strong>υ</strong> ι<strong>σ</strong>χίο<strong>υ</strong> µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό αφαίρ<strong>ε</strong><strong>σ</strong>η <strong>τ</strong>ης <strong>π</strong>λα<strong>τ</strong><strong>ε</strong>ίας<br />

<strong>π</strong><strong>ε</strong>ρι<strong>τ</strong>ονίας µέχρι <strong>τ</strong>η λαγονοκνηµιαία <strong>τ</strong>αινία, α<strong>π</strong>ό <strong>ε</strong>µ<strong>π</strong>ρός (δ<strong>ε</strong>ξ)

Μύ<strong>ε</strong>ς <strong>σ</strong><strong>τ</strong>ην <strong>π</strong><strong>ε</strong>ριοχή <strong>τ</strong>ης διάρθρω<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, µ<strong>ε</strong><strong>τ</strong>ά <strong>τ</strong>ην<br />

αφαίρ<strong>ε</strong><strong>σ</strong>η <strong>τ</strong>ων <strong>τ</strong><strong>τ</strong><strong>ε</strong>ρι<strong>τ</strong>ονιών και µ<strong>ε</strong>γάλο<strong>υ</strong> µέρο<strong>υ</strong>ς <strong>τ</strong>ων ι<strong>σ</strong>χιοκνηµιαίων<br />

µ<strong>υ</strong>ών, α<strong>π</strong>ό <strong>π</strong>ί<strong>σ</strong>ω (δ<strong>ε</strong>ξ

Μύ<strong>ε</strong>ς <strong>τ</strong>ης κνήµης, µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό µ<strong>ε</strong>ρική αφαίρ<strong>ε</strong><strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γα<strong>σ</strong><strong>τ</strong>ρο-<br />

κνήµιο<strong>υ</strong> µ., α<strong>π</strong>ό <strong>π</strong>ί<strong>σ</strong>ω. (δ<strong>ε</strong>ξ.)<br />

Κα<strong>τ</strong>ά <strong>τ</strong>ον <strong>ε</strong>γκάρ<strong>σ</strong>ιο άξονα <strong>π</strong>ο<strong>υ</strong> διέρχ<strong>ε</strong><strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ο<strong>υ</strong>ς µηριαίο<strong>υ</strong>ς κονδύλο<strong>υ</strong>ς<br />

γίν<strong>ε</strong><strong>τ</strong>αι κάµψη και έκ<strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ης κνήµη

Οι µύ<strong>ε</strong>ς <strong>π</strong>ο<strong>υ</strong> <strong>ε</strong>ν<strong>ε</strong>ργούν <strong>σ</strong><strong>τ</strong>ην άρθρω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος διακρίνον<strong>τ</strong>αι <strong>σ</strong><strong>ε</strong><br />

καµ<strong>π</strong><strong>τ</strong>ήρ<strong>ε</strong>ς, <strong>ε</strong>κ<strong>τ</strong><strong>ε</strong>ίνον<strong>τ</strong><strong>ε</strong>ς, έ<strong>σ</strong>ω <strong>σ</strong><strong>τ</strong>ροφ<strong>ε</strong>ίς και έξω <strong>σ</strong><strong>τ</strong>ροφ<strong>ε</strong>ίς.<br />

- Καµ<strong>π</strong><strong>τ</strong>ήρ<strong>ε</strong>ς: Ηµιϋµ<strong>ε</strong>νώδης ( κόκκινο ), Ηµι<strong>τ</strong><strong>ε</strong>νον<strong>τ</strong>ώδης ( µ<strong>π</strong>λ<strong>ε</strong> ),<br />

∆ικέφαλος µηριαίος ( κί<strong>τ</strong>ρινο ), Ι<strong>σ</strong>χνός ( <strong>π</strong>ορ<strong>τ</strong>οκαλί), Ρα<strong>π</strong><strong>τ</strong>ικός<br />

(<strong>π</strong>ρά<strong>σ</strong>ινο), Ιγν<strong>υ</strong>άκός ( καφέ), Γα<strong>σ</strong><strong>τ</strong>ροκνήµιος ( µωβ ).<br />

- Εκ<strong>τ</strong><strong>ε</strong>ίνον<strong>τ</strong><strong>ε</strong>ς: Τ<strong>ε</strong><strong>τ</strong>ρακέφαλος µηριαίος, <strong>τ</strong><strong>ε</strong>ίνων <strong>τ</strong>ην <strong>π</strong>λα<strong>τ</strong><strong>ε</strong>ία <strong>π</strong><strong>ε</strong>ρι<strong>τ</strong>ονία<br />

( λαγονοκνηµιαία <strong>τ</strong>αινία ). Ο <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλος µηριαίος <strong>ε</strong><br />

ν<strong>ε</strong>ργ<strong>ε</strong>ί καλύ<strong>τ</strong><strong>ε</strong>ρα ό<strong>τ</strong><strong>αν</strong> ο µηρός βρί<strong>σ</strong>κ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>ε</strong> έκ<strong>τ</strong>α<strong>σ</strong>η κα<strong>τ</strong>ά <strong>τ</strong>ην<br />

άρθρω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> ι<strong>σ</strong>χίο<strong>υ</strong>, για<strong>τ</strong>ί <strong>τ</strong>ό<strong>τ</strong><strong>ε</strong> ο ορθός µηριαίος ( κόκκινο )<br />

<strong>σ</strong><strong>υ</strong>ν<strong>ε</strong>ργ<strong>ε</strong>ί µ<strong>ε</strong> <strong>τ</strong>ο<strong>υ</strong>ς <strong>π</strong>λα<strong>τ</strong>ύς µ<strong>υ</strong>ς ( µ<strong>π</strong>λ<strong>ε</strong>).<br />

- Έ<strong>σ</strong>ω <strong>σ</strong><strong>τ</strong>ροφ<strong>ε</strong>ίς: Ηµιϋµ<strong>ε</strong>νώδης ( κόκκινο ), ηµι<strong>τ</strong><strong>ε</strong>νον<strong>τ</strong>ώδης (<br />

µ<strong>π</strong>λ<strong>ε</strong> ), ι<strong>σ</strong>χνός ( κί<strong>τ</strong>ρινο ), ρα<strong>π</strong><strong>τ</strong>ικός ( <strong>π</strong>ορ<strong>τ</strong>οκαλί), ιγν<strong>υ</strong>ακός (<br />

<strong>π</strong>ρά<strong>σ</strong>ινο).<br />

- Έξω <strong>σ</strong><strong>τ</strong>ροφ<strong>ε</strong>ίς: ∆ικέφαλος µηριαίος ( κόκκινο ). Υ<strong>π</strong>οβοηθ<strong>ε</strong>ί<strong>τ</strong>αι<br />

<strong>ε</strong>λάχι<strong>σ</strong><strong>τ</strong>α α<strong>π</strong>ό <strong>τ</strong>ην λαγονοκνηµιαία <strong>τ</strong>αινί

ΣΤΟΙΧΕΙΑ ΣΥΝ∆ΕΣΜΟΛΟΓΙΑΣ<br />

Ε<strong>π</strong>ιγονα<strong>τ</strong>ιδικός Σύνδ<strong>ε</strong><strong>σ</strong>µος (Patellar liament)Ο <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδικός<br />

<strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος ή <strong>τ</strong>ένον<strong>τ</strong>ας α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί <strong>τ</strong>η <strong>σ</strong><strong>υ</strong>νέχ<strong>ε</strong>ια <strong>τ</strong>ο<strong>υ</strong> κα<strong>τ</strong>αφ<strong>υ</strong><strong>τ</strong>ικού<br />

<strong>τ</strong>ένον<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong> και <strong>ε</strong>ίναι µια ι<strong>σ</strong>χ<strong>υ</strong>ρή και <strong>π</strong>λα<strong>τ</strong><strong>ε</strong>ιά<br />

<strong>τ</strong><strong>ε</strong>νον<strong>τ</strong>ώδης <strong>τ</strong>αινία, µήκο<strong>υ</strong>ς 5αη ως 6αη, <strong>π</strong>ο<strong>υ</strong> <strong>ε</strong>κφύ<strong>ε</strong><strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ην<br />

κορ<strong>υ</strong>φή και <strong>τ</strong>α <strong>π</strong>λάγια χ<strong>ε</strong>ίλη <strong>τ</strong>ης <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδας και κα<strong>τ</strong>αφύ<strong>ε</strong>-<strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ην<br />

κά<strong>τ</strong>ω µήρα <strong>τ</strong>ο<strong>υ</strong> κνηµιαίο<strong>υ</strong> κ<strong>υ</strong>ρ<strong>τ</strong>ώµα<strong>τ</strong>ος. Η ο<strong>π</strong>ί<strong>σ</strong>θια <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ια <strong>τ</strong>ο<strong>υ</strong><br />

<strong>τ</strong>ένον<strong>τ</strong>α χωρίζ<strong>ε</strong><strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ην κνήµη µ<strong>ε</strong> <strong>τ</strong>ον <strong>υ</strong><strong>π</strong>ο<strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδικό ορογόνο<br />

θύλακο, <strong>ε</strong>νώ <strong>π</strong>ρος <strong>τ</strong>α <strong>π</strong>άνω χωρίζ<strong>ε</strong><strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ον αρθρικό <strong>υ</strong>µένα, µ<strong>ε</strong><br />

<strong>τ</strong>ο λι<strong>π</strong>ώδ<strong>ε</strong>ς <strong>σ</strong>ώµα <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος.<br />

Το λι<strong>π</strong>ώδ<strong>ε</strong>ς <strong>σ</strong>ώµα <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος ( Infrapatellar pad ) α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί<strong>τ</strong>αι<br />

α<strong>π</strong>ό δοµικό λί<strong>π</strong>ος και καλύ<strong>π</strong><strong>τ</strong><strong>ε</strong>ι <strong>τ</strong>ο χώρο κά<strong>τ</strong>ω α<strong>π</strong>ό <strong>τ</strong>ην <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδα,<br />

µ<strong>ε</strong><strong>τ</strong>αξύ <strong>τ</strong>ο<strong>υ</strong> <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδικού <strong>τ</strong>ένον<strong>τ</strong>α και <strong>τ</strong>ων ο<strong>σ</strong><strong>τ</strong>ών <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος,<br />

<strong>ε</strong>νώ χωρίζ<strong>ε</strong><strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ην αρθρική κοιλό<strong>τ</strong>η<strong>τ</strong>α, µ<strong>ε</strong> <strong>τ</strong>ον αρθρικό <strong>υ</strong>µένα.<br />

Το λι<strong>π</strong>ώδ<strong>ε</strong>ς <strong>σ</strong>ώµα <strong>π</strong>ιέζ<strong>ε</strong><strong>τ</strong>αι κα<strong>τ</strong>ά <strong>τ</strong>ην έκ<strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος α<strong>π</strong>ό <strong>τ</strong>ον<br />

<strong>τ</strong>ένον<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong><strong>υ</strong><strong>σ</strong><strong>π</strong>ώµ<strong>ε</strong>νο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong>, α<strong>π</strong>ωθ<strong>ε</strong>ί<strong>τ</strong>αι <strong>π</strong>ρος <strong>τ</strong>α <strong>π</strong>λάγια<br />

και <strong>σ</strong>χηµα<strong>τ</strong>ίζ<strong>ε</strong>ι δύο ογκώµα<strong>τ</strong>α, <strong>ε</strong>νώ <strong>αν</strong><strong>τ</strong>ίθ<strong>ε</strong><strong>τ</strong>α κα<strong>τ</strong>ά <strong>τ</strong>ην κάµψη<br />

<strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος και <strong>υ</strong><strong>π</strong>ό <strong>τ</strong>ην <strong>ε</strong><strong>π</strong>ίδρα<strong>σ</strong>η <strong>τ</strong>ης α<strong>τ</strong>µο<strong>σ</strong>φαιρικής <strong>π</strong>ί<strong>ε</strong><strong>σ</strong>ης,<strong>υ</strong><br />

<strong>π</strong>οχωρ<strong>ε</strong>ί <strong>σ</strong>χηµα<strong>τ</strong>ίζον<strong>τ</strong>ας δύο <strong>ε</strong>ν<strong>τ</strong><strong>υ</strong><strong>π</strong>ώµα<strong>τ</strong>α <strong>σ</strong><strong>τ</strong>α <strong>π</strong>λάγια <strong>τ</strong>ο<strong>υ</strong> <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδικού<br />

<strong>τ</strong>ένον<strong>τ</strong>α.

Καθ<strong>ε</strong>κ<strong>τ</strong>ικοί <strong>τ</strong>ης <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδας ( Patellar rentinacular ligament )<br />

Ο έ<strong>σ</strong>ω και ο έξω <strong>π</strong>λάγιος καθ<strong>ε</strong>κ<strong>τ</strong>ικός <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος <strong>τ</strong>ης <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδας<br />

α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λούν <strong>π</strong>ρο<strong>ε</strong>κβολές <strong>τ</strong>ο<strong>υ</strong> κα<strong>τ</strong>αφ<strong>υ</strong><strong>τ</strong>ικού <strong>τ</strong>ένον<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong>,<br />

κα<strong>τ</strong>αφύον<strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>α <strong>π</strong>λάγια <strong>τ</strong>ο<strong>υ</strong> κνηµιαίο<strong>υ</strong> κ<strong>υ</strong>ρ<strong>τ</strong>ώµα<strong>τ</strong>ος και<br />

χρη<strong>σ</strong>ιµ<strong>ε</strong>ύο<strong>υ</strong>ν για <strong>τ</strong>η <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρο<strong>π</strong>οίη<strong>σ</strong>η <strong>τ</strong>ης <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδας α<strong>π</strong>ό <strong>τ</strong>α <strong>π</strong>λάγια.<br />

Έ<strong>σ</strong>ω <strong>π</strong>λάγιος <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος ( Μedial collateral ligament)<br />

Ο έ<strong>σ</strong>ω <strong>π</strong>λάγιος <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος <strong>ε</strong>κφύ<strong>ε</strong><strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ο έ<strong>σ</strong>ω <strong>υ</strong><strong>π</strong><strong>ε</strong>ρκονδύλιο<br />

κύρ<strong>τ</strong>ωµα, κά<strong>τ</strong>ω α<strong>π</strong>ό <strong>τ</strong>ο φύµα <strong>τ</strong>ο<strong>υ</strong> µ<strong>ε</strong>γάλο<strong>υ</strong> <strong>π</strong>ρο<strong>σ</strong>αγωγού, φέρ<strong>ε</strong><strong>τ</strong>αι<br />

<strong>π</strong>ρος <strong>τ</strong>α κά<strong>τ</strong>ω και κα<strong>τ</strong>αφύ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ην έ<strong>σ</strong>ω <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ια <strong>τ</strong>ης κνήνης, 7αη<br />

έως 8οΓΠ <strong>π</strong><strong>ε</strong>ριφ<strong>ε</strong>ρικά <strong>τ</strong>ο<strong>υ</strong> έ<strong>σ</strong>ω µ<strong>ε</strong><strong>σ</strong>άρθριο<strong>υ</strong> δια<strong>σ</strong><strong>τ</strong>ήµα<strong>τ</strong>ος, <strong>σ</strong><strong>υ</strong>να<strong>π</strong><strong>τ</strong>ό-<br />

µ<strong>ε</strong>νος <strong>σ</strong><strong>τ</strong><strong>ε</strong>νά µ<strong>ε</strong> <strong>τ</strong>ον αρθρικό θύλακα και <strong>τ</strong>ον έ<strong>σ</strong>ω µηνί<strong>σ</strong>κο.<br />

Ο έ<strong>σ</strong>ω <strong>π</strong>λάγιος <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί <strong>τ</strong>ο <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικό<strong>τ</strong><strong>ε</strong>ρο <strong>σ</strong><strong>τ</strong>ηρικ<strong>τ</strong>ικό<br />

<strong>σ</strong><strong>τ</strong>οιχ<strong>ε</strong>ίο <strong>σ</strong><strong>τ</strong>ην έ<strong>σ</strong>ω <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ια <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, <strong>σ</strong><strong>τ</strong>ην <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρό<strong>τ</strong>η<strong>τ</strong>α<br />

<strong>τ</strong>ης ο<strong>π</strong>οίας <strong>σ</strong><strong>υ</strong>µβάλλο<strong>υ</strong>ν ο έ<strong>σ</strong>ω <strong>π</strong>λα<strong>τ</strong>ύς, ο ηµι<strong>υ</strong>µ<strong>ε</strong>νώδης και οι κα<strong>τ</strong>αφ<strong>υ</strong><strong>τ</strong>ικοί<br />

<strong>τ</strong>ένον<strong>τ</strong><strong>ε</strong>ς <strong>τ</strong>ο<strong>υ</strong> ρα<strong>π</strong><strong>τ</strong>ικού, <strong>τ</strong>ο<strong>υ</strong> ι<strong>σ</strong>χνού και <strong>τ</strong>ο<strong>υ</strong> ηµι<strong>τ</strong><strong>ε</strong>νον<strong>τ</strong>ώδο<strong>υ</strong>ς,<br />

<strong>π</strong>ο<strong>υ</strong> <strong>σ</strong>χηµα<strong>τ</strong>ίζο<strong>υ</strong>ν <strong>τ</strong>ο χήν<strong>ε</strong>ιο <strong>π</strong>όδα. Ο έ<strong>σ</strong>ω <strong>π</strong>λάγιος <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος<br />

µαζί µ<strong>ε</strong> <strong>τ</strong>ον αρθρικό θύλακα, α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λούν <strong>τ</strong>ο έ<strong>σ</strong>ω θ<strong>υ</strong>λακο<strong>σ</strong><strong>υ</strong>νδ<strong>ε</strong><strong>σ</strong>µικό<br />

<strong>σ</strong>ύ<strong>σ</strong><strong>τ</strong>ηµα.

∆ιάρθρω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, διά<strong>τ</strong>αξη <strong>τ</strong>ων ινών <strong>τ</strong>ο<strong>υ</strong> έ<strong>σ</strong>ω <strong>π</strong>λαγίο<strong>υ</strong><br />

<strong>σ</strong><strong>υ</strong>νδ. <strong>σ</strong><strong>ε</strong> θέ<strong>σ</strong>η έκ<strong>τ</strong>α<strong>σ</strong>ης α<strong>π</strong>ό έ<strong>σ</strong>ω. (δ<strong>ε</strong>ξ 60%)<br />

∆ιάρθρω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, διά<strong>τ</strong>αξη <strong>τ</strong>ων ινών <strong>τ</strong>ο<strong>υ</strong> έ<strong>σ</strong>ω <strong>π</strong>λαγίο<strong>υ</strong><br />

<strong>σ</strong><strong>υ</strong>νδ. <strong>σ</strong><strong>ε</strong> θέ<strong>σ</strong>η κάµψης, α<strong>π</strong>ό έ<strong>σ</strong>ω (δ<strong>ε</strong>ξ. 60%)

Έξω <strong>π</strong>λάγιος <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος (Lateral collateral ligament}.<br />

Ο έξω <strong>π</strong>λάγιος <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος έχ<strong>ε</strong>ι <strong>σ</strong>χοινο<strong>ε</strong>ιδή µορφή και <strong>ε</strong>ίναι βραχύ<strong>τ</strong><strong>ε</strong>ρος<br />

α<strong>π</strong>ό <strong>τ</strong>ον έ<strong>σ</strong>ω. Εκφύ<strong>ε</strong><strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ο έ<strong>σ</strong>ω <strong>υ</strong><strong>π</strong><strong>ε</strong>ρκονδύλιο κύρ<strong>τ</strong>ω-<br />

µα και κα<strong>τ</strong>αφύ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ην έξω <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ια <strong>τ</strong>ης κ<strong>ε</strong>φαλής <strong>τ</strong>ης <strong>π</strong><strong>ε</strong>ρόνης. Ο<br />

έξω <strong>π</strong>λάγιος <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος, ο ο<strong>π</strong>οίος δ<strong>ε</strong>ν <strong>σ</strong><strong>υ</strong>νά<strong>π</strong><strong>τ</strong><strong>ε</strong><strong>τ</strong>αι µ<strong>ε</strong> <strong>τ</strong>ον αρθρικό<br />

θύλακα και <strong>τ</strong>ον έξω µηνί<strong>σ</strong>κο, α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί µ<strong>ε</strong> <strong>τ</strong>ον αρθρικό θύλακα, <strong>τ</strong>ο<br />

έξω θ<strong>υ</strong>λακο<strong>σ</strong><strong>υ</strong>νδ<strong>ε</strong><strong>σ</strong>µικό <strong>σ</strong>ύ<strong>σ</strong><strong>τ</strong>ηµα.<br />

Λοξός ιγν<strong>υ</strong>ακός Σύνδ<strong>ε</strong><strong>σ</strong>µος ( Oblique popiteal<br />

ligament)<br />

Ο λοξός ιγν<strong>υ</strong>ακός <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος ή <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος <strong>τ</strong>ο<strong>υ</strong> \Λ/ίη5ΐονν <strong>ε</strong>ίναι µια<br />

λ<strong>ε</strong><strong>π</strong><strong>τ</strong>ή και <strong>π</strong>λα<strong>τ</strong><strong>ε</strong>ιά ινώδης <strong>τ</strong><strong>ε</strong>νόν<strong>τ</strong>ια δ<strong>ε</strong><strong>σ</strong>µίδα <strong>τ</strong>ο<strong>υ</strong> κα<strong>τ</strong>αφ<strong>υ</strong><strong>τ</strong>ικού <strong>τ</strong>ένον<strong>τ</strong>α<br />

<strong>τ</strong>ο<strong>υ</strong> ηµι<strong>υ</strong>µ<strong>ε</strong>νώδο<strong>υ</strong>ς µ<strong>υ</strong>ός ( λοξή δ<strong>ε</strong><strong>σ</strong>µίδα ), φέρ<strong>ε</strong><strong>τ</strong>αι λοξά <strong>π</strong>ρος<br />

<strong>τ</strong>α άνω και έξω <strong>τ</strong>ο<strong>υ</strong> µηριαίο<strong>υ</strong> κονδύλο<strong>υ</strong> <strong>ε</strong><strong>π</strong><strong>ε</strong>κ<strong>τ</strong><strong>ε</strong>ινόµ<strong>ε</strong>νος µέχρι <strong>τ</strong>ην<br />

έξω κ<strong>ε</strong>φαλή <strong>τ</strong>ο<strong>υ</strong> γα<strong>σ</strong><strong>τ</strong>ροκνηµίο<strong>υ</strong> µ<strong>υ</strong>ός.<br />

Τοξο<strong>ε</strong>ιδής ιγν<strong>υ</strong>ακός Σύνδ<strong>ε</strong><strong>σ</strong>µος ( ARCUET POPLITEAL LIGAMENT ).<br />

Ο <strong>τ</strong>οξο<strong>ε</strong>ιδής ιγν<strong>υ</strong>ακός <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος <strong>ε</strong>κφύ<strong>ε</strong><strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ην κορ<strong>υ</strong>φή <strong>τ</strong>ης<br />

κ<strong>ε</strong>φαλής <strong>τ</strong>ης <strong>π</strong><strong>ε</strong>ρόνης, φέρ<strong>ε</strong><strong>τ</strong>αι <strong>π</strong>ρος <strong>τ</strong>α άνω και α<strong>π</strong>ο<strong>σ</strong>χίζ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>ε</strong><br />

δύο δ<strong>ε</strong><strong>σ</strong>µίδ<strong>ε</strong>ς, <strong>τ</strong>ην έξω και <strong>τ</strong>ην έ<strong>σ</strong>ω. Η έξω δ<strong>ε</strong><strong>σ</strong>µίδα, <strong>π</strong>ο<strong>υ</strong> ονοµάζ<strong>ε</strong><strong>τ</strong>αι<br />

και βραχύς έξω <strong>π</strong>λάγιος <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος, <strong>σ</strong><strong>υ</strong>νά<strong>π</strong><strong>τ</strong><strong>ε</strong><strong>τ</strong>αι µ<strong>ε</strong> <strong>τ</strong>ον ινώδη<br />

θύλακα, <strong>ε</strong>νώ η έ<strong>σ</strong>ω κα<strong>τ</strong>αφύ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ον έξω κόνδ<strong>υ</strong>λο <strong>τ</strong>ης κνήµης <strong>ε</strong>ρχόµ<strong>ε</strong>νη<br />

<strong>σ</strong><strong>ε</strong> <strong>σ</strong><strong>τ</strong><strong>ε</strong>νή <strong>σ</strong>χέ<strong>σ</strong>η µ<strong>ε</strong> <strong>τ</strong>ον ιγν<strong>υ</strong>ακό µ<strong>υ</strong>.

ΧΙΑΣΤΟΙ ΣΥΝ∆ΕΣΜΟ ( Cruciate ligaments)<br />

Oι χια<strong>σ</strong><strong>τ</strong>οί <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µοι, <strong>π</strong>ρό<strong>σ</strong>θιος και ο<strong>π</strong>ί<strong>σ</strong>θιος, <strong>ε</strong>ίναι ι<strong>σ</strong>χ<strong>υ</strong>ρό<strong><strong>τ</strong>α<strong>τ</strong>ο</strong>ι<br />

και <strong>σ</strong>χηµα<strong>τ</strong>ίζο<strong>υ</strong>ν ένα οβ<strong>ε</strong>λιαίο διάφραγµα <strong>σ</strong><strong>τ</strong>ο <strong>ε</strong><strong>σ</strong>ω<strong>τ</strong><strong>ε</strong>ρικό <strong>τ</strong>ης άρθρω<strong>σ</strong>ης<br />

<strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος. Οι δύο χια<strong>σ</strong><strong>τ</strong>οί <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µοι ονοµά<strong>σ</strong><strong>τ</strong>ηκ<strong>αν</strong> έ<strong>τ</strong><strong>σ</strong>ι<br />

για<strong>τ</strong>ί δια<strong>σ</strong><strong>τ</strong>α<strong>υ</strong>ρώνον<strong>τ</strong>αι µ<strong>ε</strong><strong>τ</strong>αξύ <strong>τ</strong>ο<strong>υ</strong>ς <strong>αν</strong>άµ<strong>ε</strong><strong>σ</strong>α <strong>σ</strong><strong>τ</strong>η µηριαία και κνη-<br />

µιαία <strong>π</strong>ρό<strong>σ</strong>φ<strong>υ</strong><strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong>ς.<br />

Ο <strong>π</strong>ρό<strong>σ</strong>θιος χια<strong>σ</strong><strong>τ</strong>ός <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος (Anterior cruciate ligament<br />

ACL ), έχ<strong>ε</strong>ι <strong>σ</strong>χοινο<strong>ε</strong>ιδή µορφή, <strong>ε</strong>κφύ<strong>ε</strong><strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο µ<strong>ε</strong><strong>σ</strong>ογλήνιο<br />

βόθρο, <strong>π</strong>ί<strong>σ</strong>ω α<strong>π</strong>ό <strong>τ</strong>ο <strong>π</strong>ρό<strong>σ</strong>θιο άκρο <strong>τ</strong>ο<strong>υ</strong> έ<strong>σ</strong>ω µηνί<strong>σ</strong>κο<strong>υ</strong> και<br />

φ<strong>ε</strong>ρόµ<strong>ε</strong>νος <strong>π</strong>ρος <strong>τ</strong>α άνω, έξω και <strong>π</strong>ί<strong>σ</strong>ω, χιάζ<strong>ε</strong><strong>τ</strong>αι µ<strong>ε</strong> <strong>τ</strong>ον ο<strong>π</strong>ί<strong>σ</strong>θιο και<br />

κα<strong>τ</strong>αφύ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ην ο<strong>π</strong>ί<strong>σ</strong>θια µοίρα <strong>τ</strong>ης µ<strong>ε</strong><strong>σ</strong>οκονδ<strong>υ</strong>λίο<strong>υ</strong> <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ιας <strong>τ</strong>ο<strong>υ</strong><br />

έξω µηριαίο<strong>υ</strong> κονδύλο<strong>υ</strong>. Η κνηµιαία <strong>π</strong>ρό<strong>σ</strong>φ<strong>υ</strong><strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong> <strong>ε</strong>ίναι<br />

<strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρό<strong>τ</strong><strong>ε</strong>ρη α<strong>π</strong>ό <strong>τ</strong>η µηριαία, <strong>ε</strong><strong>π</strong><strong>ε</strong>ιδή η <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ια <strong>π</strong>ρό<strong>σ</strong>φ<strong>υ</strong><strong>σ</strong>ης<br />

<strong>σ</strong><strong>τ</strong>ην κνήµη <strong>ε</strong>ίναι <strong>ε</strong><strong>υ</strong>ρύ<strong>τ</strong><strong>ε</strong>ρη α<strong>π</strong>ό <strong>τ</strong>ην <strong>αν</strong><strong>τ</strong>ί<strong>σ</strong><strong>τ</strong>οιχη <strong>τ</strong>ο<strong>υ</strong> έξω µηριαίο<strong>υ</strong><br />

κονδύλο<strong>υ</strong>. Ο <strong>π</strong>ρό<strong>σ</strong>θιος χια<strong>σ</strong><strong>τ</strong>ός α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί<strong>τ</strong>αι α<strong>π</strong>ό δύο µοίρ<strong>ε</strong>ς, µια<br />

<strong>π</strong>ρό<strong>σ</strong>θια-έ<strong>σ</strong>ω, λ<strong>ε</strong><strong>π</strong><strong>τ</strong>ό<strong>τ</strong><strong>ε</strong>ρη και µια ο<strong>π</strong>ί<strong>σ</strong>θια-έξω, <strong>π</strong>ιο ογκώδης και <strong>τ</strong>ο<br />

µέ<strong>σ</strong>ο µήκος <strong>τ</strong>ο<strong>υ</strong> <strong>ε</strong>ίναι 3,8 <strong>ε</strong>κ. Ο <strong>π</strong>ρό<strong>σ</strong>θιος χια<strong>σ</strong><strong>τ</strong>ός έχ<strong>ε</strong>ι <strong>π</strong><strong>ε</strong>ρί<strong>π</strong>ο<strong>υ</strong> <strong>τ</strong>ην<br />

ίδια ι<strong>σ</strong>χύ µ<strong>ε</strong> <strong>τ</strong>ον έ<strong>σ</strong>ω <strong>π</strong>λάγιο <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µο και <strong>τ</strong>η µι<strong>σ</strong>ή, <strong>σ</strong><strong>υ</strong>γκρι<strong>τ</strong>ικά µ<strong>ε</strong><br />

<strong>τ</strong>ον ο<strong>π</strong>ί<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό.<br />

Οι Marshall και Monagem, καθώς και άλλοι <strong>υ</strong><strong>π</strong>ο<strong>σ</strong><strong>τ</strong>ηρίζο<strong>υ</strong>ν ό<strong>τ</strong>ι<br />

<strong>π</strong>έρα α<strong>π</strong>ό <strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο-έ<strong>σ</strong>ω <strong>π</strong>λάγιο <strong>τ</strong>µήµα <strong>τ</strong>ο<strong>υ</strong>, οι <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρ<strong>ε</strong>ς<br />

α<strong>π</strong>ό <strong>τ</strong>ις ίν<strong>ε</strong>ς <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>π</strong>αραµένο<strong>υ</strong>ν χαλαρές κα<strong>τ</strong>ά <strong>τ</strong>ην<br />

κάµψη. Ω<strong>σ</strong><strong>τ</strong>ό<strong>σ</strong>ο, <strong>σ</strong><strong>τ</strong>ην έκ<strong>τ</strong>α<strong>σ</strong>η όλ<strong>ε</strong>ς οι ίν<strong>ε</strong>ς βρί<strong>σ</strong>κον<strong>τ</strong>αι κά<strong>τ</strong>ω α<strong>π</strong>ό<br />

<strong>τ</strong>ά<strong>σ</strong>η.<br />

Κάθ<strong>ε</strong> ξ<strong>ε</strong>χωρι<strong>σ</strong><strong>τ</strong>ό µικροδ<strong>ε</strong>µά<strong>τ</strong>ιο µ<strong>π</strong>ορ<strong>ε</strong>ί να κιν<strong>ε</strong>ί<strong>τ</strong>αι µ<strong>ε</strong> <strong>ε</strong>λικο<strong>ε</strong>ιδή<br />

<strong>π</strong>ορ<strong>ε</strong>ία γύρω α<strong>π</strong>ό <strong>τ</strong>ον διαµήκη άξονα <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>, <strong>ε</strong>ί<strong>τ</strong><strong>ε</strong> να κιν<strong>ε</strong>ί<strong>τ</strong>αι<br />

<strong>π</strong>αράλληλα µ<strong>ε</strong> α<strong>υ</strong><strong>τ</strong>όν α<strong>π</strong>ό <strong>τ</strong>ην µηριαία µέχρι <strong>τ</strong>ην κνηµιαία <strong>π</strong>ρό<strong>σ</strong>φ<strong>υ</strong><strong>σ</strong>η<br />

<strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>

Ο ο<strong>π</strong>ί<strong>σ</strong>θιος χια<strong>σ</strong><strong>τ</strong>ός <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος (Posterior cruciate ligament,<br />

PCL ), <strong>ε</strong>ίναι βραχύ<strong>τ</strong><strong>ε</strong>ρος , αλλά ι<strong>σ</strong>χ<strong>υ</strong>ρό<strong>τ</strong><strong>ε</strong>ρος α<strong>π</strong>ό <strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο.<br />

Εκφ΄θ<strong>ε</strong><strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ον ο<strong>π</strong>ί<strong>σ</strong>θιο µ<strong>ε</strong><strong>σ</strong>ογλήνιο βόθρο και φ<strong>ε</strong>ρόµ<strong>ε</strong>νος <strong>π</strong>ρος <strong>τ</strong>α<br />

άνω ,έ<strong>σ</strong>ω και <strong>π</strong>ρό<strong>σ</strong>ω, χιάζ<strong>ε</strong><strong>τ</strong>αι µ<strong>ε</strong> <strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο και κα<strong>τ</strong>αφύ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ην<br />

<strong>π</strong>ρό<strong>σ</strong>θια µοίρα <strong>τ</strong>ο<strong>υ</strong> µ<strong>ε</strong><strong>σ</strong>οκονδ<strong>υ</strong>λίο<strong>υ</strong> <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ιας <strong>τ</strong>ο<strong>υ</strong> έ<strong>σ</strong>ω µηριαίο<strong>υ</strong><br />

κονδύλο<strong>υ</strong>. Ο ο<strong>π</strong>ί<strong>σ</strong>θιος χια<strong>σ</strong><strong>τ</strong>ός α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί<strong>τ</strong>αι α<strong>π</strong>ό δύο µοίρ<strong>ε</strong>ς, µια<br />

<strong>π</strong>ρό<strong>σ</strong>θια ογκωδέ<strong>σ</strong><strong>τ</strong><strong>ε</strong>ρη και µια ο<strong>π</strong>ί<strong>σ</strong>θια, λ<strong>ε</strong><strong>π</strong><strong>τ</strong>ό<strong>τ</strong><strong>ε</strong>ρη. Η ι<strong>σ</strong>χύς <strong>τ</strong>ο<strong>υ</strong><br />

ο<strong>π</strong>ί<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>ε</strong>ίναι δι<strong>π</strong>λά<strong>σ</strong>ια <strong>ε</strong>κ<strong>ε</strong>ίνης <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong>.<br />

Ο <strong>π</strong>ρό<strong>σ</strong>θιοςς και ο ο<strong>π</strong>ί<strong>σ</strong>θιος χια<strong>σ</strong><strong>τ</strong>ός, <strong>π</strong><strong>ε</strong>ριβάλλον<strong>τ</strong>αι α<strong>π</strong>ό µ<strong>π</strong>ρο<strong>σ</strong><strong>τ</strong>ά και<br />

α<strong>π</strong>ό <strong>τ</strong>α <strong>π</strong>λάγια , α<strong>π</strong>ό <strong>τ</strong>ον αρθρικό <strong>υ</strong>µένα. Είναι <strong>ε</strong><strong>π</strong>οµένως <strong>ε</strong>νδοαρθρικά<br />

αλλά <strong>ε</strong>ξω<strong>υ</strong>µ<strong>ε</strong>νικά <strong>αν</strong>α<strong>τ</strong>οµικά <strong>σ</strong><strong>τ</strong>οιχ<strong>ε</strong>ία.<br />

2.α.ΒΙΟΜΗΧΑΝΙΚΗ ΚΑΤΑΣΚΕΥΗ ΤΗΣ ΑΡΘΡΩΣΗΣ ΤΟΥ ΓΟΝΑΤΟΣ<br />

Η άρθρω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος <strong>π</strong>αρο<strong>υ</strong><strong>σ</strong>ιάζ<strong>ε</strong>ι µ<strong>ε</strong>γάλη <strong>ε</strong>λ<strong>ε</strong><strong>υ</strong>θ<strong>ε</strong>ρία <strong>σ</strong><strong>τ</strong>ις κινή<strong>σ</strong><strong>ε</strong>ις<br />

και <strong>ε</strong>ίναι λιγό<strong>τ</strong><strong>ε</strong>ρο <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρή α<strong>π</strong>ό άλλ<strong>ε</strong>ς αρθρώ<strong>σ</strong><strong>ε</strong>ις (<strong>π</strong>.χ. αγκώνας ).<br />

Εκ<strong>τ</strong>ώς α<strong>π</strong>ό <strong>τ</strong>ην κάµψη και έκ<strong>τ</strong>α<strong>σ</strong>η, <strong>ε</strong><strong>π</strong>ι<strong>τ</strong>ρέ<strong>π</strong><strong>ε</strong>ι και <strong>σ</strong><strong>τ</strong>ροφές. Μ<strong>ε</strong> <strong>τ</strong>ην<br />

<strong>σ</strong><strong>υ</strong>µµ<strong>ε</strong><strong>τ</strong>οχή <strong>σ</strong><strong>τ</strong>ην αθλη<strong>τ</strong>ική δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ο γόνα<strong>τ</strong>ο φορ<strong>τ</strong>ίζ<strong>ε</strong><strong>τ</strong>αι µ<strong>ε</strong><br />

δ<strong>υ</strong>νάµ<strong>ε</strong>ις , <strong>π</strong>ο<strong>υ</strong> <strong>π</strong>ολλές φορές ι<strong>σ</strong>οδ<strong>υ</strong>ναµούν µ<strong>ε</strong> 6-8 φορές <strong>τ</strong>ο

βάρος <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong>ώµα<strong>τ</strong>ος. Οι δ<strong>υ</strong>νάµ<strong>ε</strong>ις <strong>π</strong>ο<strong>υ</strong> <strong>π</strong>αράγον<strong>τ</strong>αι και <strong>π</strong>ροκαλούν <strong>τ</strong>ην<br />

κάµψη και <strong>τ</strong>ην έκ<strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, <strong>π</strong>ροέρχον<strong>τ</strong>αι κ<strong>υ</strong>ρίως α<strong>π</strong>ό <strong>τ</strong>η<br />

µ<strong>υ</strong>ϊκή <strong>σ</strong><strong>υ</strong><strong>σ</strong><strong>τ</strong>ολή. Έ<strong>τ</strong><strong>σ</strong>ι για να µην <strong>π</strong>ροκληθ<strong>ε</strong>ί κά<strong>π</strong>οιος <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µός,<br />

α<strong>υ</strong><strong>τ</strong>ές οι δ<strong>υ</strong>νάµ<strong>ε</strong>ις <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να <strong>ε</strong>ξι<strong>σ</strong>ορρο<strong>π</strong>ηθούν α<strong>π</strong>ό <strong>τ</strong>ο<strong>υ</strong>ς µ<strong>υ</strong>ς και <strong>τ</strong>ο<strong>υ</strong>ς<br />

<strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>ς. Σ<strong>ε</strong> <strong>π</strong><strong>ε</strong>ρί<strong>π</strong><strong>τ</strong>ω<strong>σ</strong>η <strong>π</strong>ο<strong>υ</strong> οι µ<strong>υ</strong>ς γύρω α<strong>π</strong>ό <strong>τ</strong>ο γόνα<strong>τ</strong>ο, δ<strong>ε</strong>ν<br />

<strong>ε</strong>ίναι <strong>τ</strong>ό<strong>σ</strong>ο δ<strong>υ</strong>να<strong>τ</strong>οί ώ<strong>σ</strong><strong>τ</strong><strong>ε</strong> να α<strong>π</strong>ορροφή<strong>σ</strong>ο<strong>υ</strong>ν και να δια<strong>σ</strong>κορ<strong>π</strong>ί<strong>σ</strong>ο<strong>υ</strong>ν <strong>τ</strong>ην<br />

<strong>π</strong>αραγόµ<strong>ε</strong>νη <strong>υ</strong>ψηλή κινη<strong>τ</strong>ική <strong>ε</strong>νέργ<strong>ε</strong>ια, α<strong>υ</strong><strong>τ</strong>ή µ<strong>ε</strong><strong>τ</strong>αβιβάζ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ο<strong>υ</strong>ς<br />

<strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>ς και <strong>τ</strong><strong>ε</strong>λικά <strong>σ</strong><strong>τ</strong>α ο<strong>σ</strong><strong>τ</strong>ά, <strong>π</strong>ροκαλών<strong>τ</strong>ας <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µούς.<br />

Κά<strong>τ</strong>ω άκρο : Ο<strong>σ</strong><strong>τ</strong>ά , Σύνδ<strong>ε</strong><strong>σ</strong>µοι, Αρθρώ<strong>σ</strong><strong>ε</strong>ις

2.β. ΒΙΟΜΗΧΑΝΙΚΗ ΤΟΥ ΠΡΟΣΘΙΟΥ ΧΙΑΣΤΟΥ<br />

Η βιοµηχ<strong>αν</strong>ική λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργικό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>π</strong><strong>ε</strong>ριγράφηκ<strong>ε</strong><br />

καλύ<strong>τ</strong><strong>ε</strong>ρα α<strong>π</strong>ό <strong>τ</strong>ο<strong>υ</strong>ς Bulter, Mayes και GROUD.. Α<strong>υ</strong><strong>τ</strong>οί βρήκ<strong>αν</strong><br />

ό<strong>τ</strong>ι ο <strong>π</strong>ρό<strong>σ</strong>θιος χια<strong>σ</strong><strong>τ</strong>ός <strong>ε</strong>ίναι ο βα<strong>σ</strong>ικός <strong>π</strong><strong>ε</strong>ριορι<strong>σ</strong><strong>τ</strong>ικός <strong>π</strong>αράγον<strong>τ</strong>ας<br />

α<strong>π</strong>έν<strong>αν</strong><strong>τ</strong>ι <strong>σ</strong><strong>τ</strong>ην <strong>π</strong>ρό<strong>σ</strong>θια µ<strong>ε</strong><strong>τ</strong>α<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>η <strong>τ</strong>ης κνήµης <strong>π</strong>άνω <strong>σ</strong><strong>τ</strong>ο µηρό<br />

α<strong>π</strong>ό δ<strong>υ</strong>νάµ<strong>ε</strong>ις µ<strong>ε</strong> φορά <strong>π</strong>ρος <strong>τ</strong>α <strong>ε</strong>µ<strong>π</strong>ρός. Ο <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος <strong>π</strong>αρέχ<strong>ε</strong>ι <strong>τ</strong>ο<br />

85% και <strong>τ</strong>ο 87% <strong>τ</strong>ο<strong>υ</strong> ολικού <strong>π</strong><strong>ε</strong>ριορι<strong>σ</strong>µού <strong>σ</strong><strong>τ</strong>ις 90° και 30° κάµψης<br />

<strong>αν</strong><strong>τ</strong>ί<strong>σ</strong><strong>τ</strong>οιχα. Σηµ<strong>αν</strong><strong>τ</strong>ικός <strong>ε</strong>ίναι και ο ρόλος <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού και<br />

<strong>σ</strong><strong>τ</strong>ον <strong>π</strong><strong>ε</strong>ριορι<strong>σ</strong>µό <strong>τ</strong>ης έ<strong>σ</strong>ω <strong>σ</strong><strong>τ</strong>ροφής <strong>τ</strong>ης κνήµης, ό<strong>π</strong>ως φαίν<strong>ε</strong><strong>τ</strong>αι α<strong>π</strong>ό<br />

<strong>τ</strong>α µ<strong>ε</strong><strong>τ</strong>ρικά test <strong>π</strong>ο<strong>υ</strong> έκ<strong>αν</strong><strong>ε</strong> ο Lipke <strong>π</strong>άνω <strong>σ</strong><strong>ε</strong> γόνα<strong>τ</strong>α <strong>π</strong><strong>τ</strong>ωµά<strong>τ</strong>ων, <strong>σ</strong><strong>τ</strong>α<br />

ο<strong>π</strong>οία <strong>ε</strong>ίχ<strong>ε</strong> κο<strong>π</strong><strong>ε</strong>ί ο <strong>π</strong>ρό<strong>σ</strong>θιος χια<strong>σ</strong><strong>τ</strong>ός.<br />

Εικόνα 23: ∆ιάρθρω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, <strong>σ</strong><strong>ε</strong> θέ<strong>σ</strong>η κάµψης 90° ,αφο<strong>υ</strong> αφαιρέθηκ<strong>αν</strong><br />

ο αρθρικός θύλακας και οι <strong>π</strong>λάγιοι <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µοι, α<strong>τ</strong><strong>τ</strong>ό <strong>ε</strong>µ<strong>π</strong>ρός(δ<strong>ε</strong>ξ.<br />

65%)<br />

Λόγω <strong>τ</strong>ης λοξής φοράς <strong>τ</strong>ων χια<strong>σ</strong><strong>τ</strong>ών <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µων, <strong>σ</strong><strong>ε</strong> κάθ<strong>ε</strong> θέ<strong>σ</strong>η<br />

δια<strong>τ</strong><strong>ε</strong>ίν<strong>ε</strong><strong>τ</strong>αι κά<strong>π</strong>οιος χια<strong>σ</strong><strong>τ</strong>ός <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος ή <strong>τ</strong>µήµα <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>. Η<br />

κύρια <strong>ε</strong>νέργ<strong>ε</strong>ια <strong>τ</strong>ο<strong>υ</strong>ς φαίν<strong>ε</strong><strong>τ</strong>αι µόλις γίνον<strong>τ</strong>αι<br />

<strong>αν</strong><strong>ε</strong>ν<strong>ε</strong>ργ<strong>ε</strong>ίς οι <strong>π</strong>λάγιοι

<strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µοι. Ε<strong>π</strong>οµένως οι χια<strong>σ</strong><strong>τ</strong>οί δια<strong>τ</strong>ηρούν <strong>τ</strong>η <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ης<br />

άρθρω<strong>σ</strong>ης ό<strong>τ</strong><strong>αν</strong> χαλαρώνο<strong>υ</strong>ν οι <strong>π</strong>λάγιοι.<br />

Ο Fukubayashi και άλλοι έδ<strong>ε</strong>ιξ<strong>αν</strong> ό<strong>τ</strong>ι <strong>υ</strong><strong>π</strong>άρχ<strong>ε</strong>ι µ<strong>ε</strong>γάλη διάφορο<strong>π</strong>οίη<strong>σ</strong>η<br />

<strong>σ</strong><strong>τ</strong>ην έξω <strong>σ</strong><strong>τ</strong>ροφή <strong>τ</strong>ης κνήµης κα<strong>τ</strong>ά <strong>τ</strong>ις 30° <strong>τ</strong><strong>ε</strong>λικής έκ<strong>τ</strong>α<strong>σ</strong>ης<br />

<strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος (χωρίς φόρ<strong>τ</strong>ι<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>οδιού ) ή <strong>τ</strong>ης <strong>π</strong>αράλληλης έξω<br />

<strong>σ</strong><strong>τ</strong>ροφής <strong>τ</strong>ης κνήµης και έ<strong>σ</strong>ω <strong>σ</strong><strong>τ</strong>ροφής <strong>τ</strong>ο<strong>υ</strong> µηρού ( µ<strong>ε</strong> φόρ<strong>τ</strong>ι<strong>σ</strong>η ) <strong>σ</strong><strong>ε</strong><br />

γόνα<strong>τ</strong>α µ<strong>ε</strong> <strong>π</strong>ροβληµα<strong>τ</strong>ικούς χια<strong>σ</strong><strong>τ</strong>ούς. Σ<strong>υ</strong>µ<strong>π</strong><strong>ε</strong>ρα<strong>σ</strong>µα<strong>τ</strong>ικά έχο<strong>υ</strong>ν κα<strong>τ</strong>αλήξ<strong>ε</strong>ι<br />

ό<strong>τ</strong>ι και οι χια<strong>σ</strong><strong>τ</strong>οί µαζί µ<strong>ε</strong> <strong>τ</strong>ο<strong>υ</strong>ς <strong>υ</strong><strong>π</strong>όλοι<strong>π</strong>ο<strong>υ</strong>ς ζωικούς <strong>π</strong>αράγον<strong>τ</strong><strong>ε</strong>ς,<br />

α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λούν ένα <strong>π</strong>ρω<strong>τ</strong>αρχικό µηχ<strong>αν</strong>ι<strong>σ</strong>µό <strong>σ</strong><strong>τ</strong>ην <strong>π</strong>αραγωγή<br />

<strong>τ</strong>ης <strong>σ</strong><strong>τ</strong>ροφής κα<strong>τ</strong>ά <strong>τ</strong>ην κάµψη ή <strong>τ</strong>ην έκ<strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος.<br />

Κά<strong>τ</strong>ω άκρο : Ο<strong>σ</strong><strong>τ</strong>ά, Σύνδ<strong>ε</strong><strong>σ</strong>µοι, Αρθρώ<strong>σ</strong><strong>ε</strong>ις

Ο Kapandij <strong>π</strong><strong>ε</strong>ριγράφ<strong>ε</strong>ι <strong>τ</strong>ο µηχ<strong>αν</strong>ικό ρόλο <strong>τ</strong>ων χια<strong>σ</strong><strong>τ</strong>ών και δια<strong>τ</strong><strong>υ</strong><strong>π</strong>ών<strong>ε</strong>ι<br />

<strong>τ</strong>ην ά<strong>π</strong>οψη <strong>τ</strong>ο<strong>υ</strong> ό<strong>τ</strong>ι κα<strong>τ</strong>ά <strong>τ</strong>ην κάµψη <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος ο <strong>π</strong>ρό<strong>σ</strong>θιος<br />

χια<strong>σ</strong><strong>τ</strong>ός <strong>π</strong>ροκαλ<strong>ε</strong>ί <strong>τ</strong>ην <strong>π</strong>ρό<strong>σ</strong>θια κίνη<strong>σ</strong>η γλι<strong>σ</strong><strong>τ</strong>ρήµα<strong>τ</strong>ος <strong>τ</strong>ο<strong>υ</strong> µηριαίο<strong>υ</strong>,<br />

καθώς οι κόνδ<strong>υ</strong>λοί <strong>τ</strong>ο<strong>υ</strong> ρολλάρο<strong>υ</strong>ν <strong>π</strong>ρος <strong>τ</strong>α <strong>π</strong>ί<strong>σ</strong>ω.<br />

Α<strong>υ</strong><strong>τ</strong>ό <strong>π</strong><strong>ε</strong><strong>τ</strong><strong>υ</strong>χαίν<strong>ε</strong><strong>τ</strong>αι µέ<strong>σ</strong>α α<strong>π</strong>ό <strong>τ</strong>η <strong>σ</strong><strong>υ</strong>νδ<strong>ε</strong><strong>σ</strong>µική <strong>τ</strong>ά<strong>σ</strong>η <strong>π</strong>ο<strong>υ</strong> <strong>π</strong>αράγ<strong>ε</strong><strong>τ</strong>αι,<br />

καθώς η µηριαία <strong>π</strong>ρό<strong>σ</strong>φ<strong>υ</strong><strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong> <strong>τ</strong><strong>ε</strong>ίν<strong>ε</strong>ι να κινηθ<strong>ε</strong>ί<br />

µακρύ<strong>τ</strong><strong>ε</strong>ρα α<strong>π</strong>ό <strong>τ</strong>ην κνηµιαία. Έ<strong>τ</strong><strong>σ</strong>ι, <strong>ε</strong><strong>π</strong><strong>ε</strong>ιδή ο <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος δ<strong>ε</strong>ν µ<strong>π</strong>ορ<strong>ε</strong>ί<br />

να µ<strong>ε</strong><strong>τ</strong>αβάλλ<strong>ε</strong>ι <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικά <strong>τ</strong>ο µήκος <strong>τ</strong>ο<strong>υ</strong>, η <strong>τ</strong><strong>ε</strong>λική κίνη<strong>σ</strong>η <strong>π</strong>ο<strong>υ</strong><br />

<strong>π</strong>ροκαλ<strong>ε</strong>ί<strong>τ</strong>αι <strong>ε</strong>ίναι α<strong>υ</strong><strong>τ</strong>ή <strong>τ</strong>ης <strong>π</strong>ρό<strong>σ</strong>θιας µ<strong>ε</strong><strong>τ</strong>α<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong> µηριαίο<strong>υ</strong>.<br />

3. ΡΗΞΗ ΠΡΟΣΘΙΟΥ ΧΙΑΣΤΟΥ ΣΥΝ∆ΕΣΜΟΥ<br />

3.1 ΓΕΝΙΚΑ<br />

Ο <strong>π</strong>ρό<strong>σ</strong>θιος χια<strong>σ</strong><strong>τ</strong>ός <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος έχ<strong>ε</strong>ι <strong>σ</strong>χοινο<strong>ε</strong>ιδή µορφή, <strong>ε</strong>κφύ<strong>ε</strong><strong>τ</strong>αι<br />

α<strong>π</strong>ό <strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο µ<strong>ε</strong><strong>σ</strong>ογλήνιο βόθρο, <strong>π</strong>ί<strong>σ</strong>ω α<strong>π</strong>ό <strong>τ</strong>ο <strong>π</strong>ρό<strong>σ</strong>θιο άκρο<br />

<strong>τ</strong>ο<strong>υ</strong> έ<strong>σ</strong>ω µηνί<strong>σ</strong>κο<strong>υ</strong>, φέρ<strong>ε</strong><strong>τ</strong>αι <strong>π</strong>ρος <strong>τ</strong>α άνω, έξω και <strong>π</strong>ί<strong>σ</strong>ω, χιαζ<strong>ε</strong><strong>τ</strong>αι µ<strong>ε</strong><br />

<strong>τ</strong>ον ο<strong>π</strong>ί<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό.και κα<strong>τ</strong>αφύ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ην ο<strong>π</strong>ί<strong>σ</strong>θια µοίρα <strong>τ</strong>ης µ<strong>ε</strong><strong>σ</strong>οκονδ<strong>υ</strong>λίο<strong>υ</strong><br />

<strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ιας <strong>τ</strong>ο<strong>υ</strong> έξω µηριαίο<strong>υ</strong> κονδύλο<strong>υ</strong>.<br />

Ο <strong>π</strong>ρό<strong>σ</strong>θιος, ό<strong>π</strong>ως και ο ο<strong>π</strong>ί<strong>σ</strong>θιος χια<strong>σ</strong><strong>τ</strong>ός, <strong>π</strong><strong>ε</strong>ριβάλλ<strong>ε</strong><strong>τ</strong>αι α<strong>π</strong>ό<br />

<strong>τ</strong>ον αρθρικό <strong>υ</strong>µένα, <strong>ε</strong>ίναι <strong>ε</strong><strong>π</strong>οµένως <strong>ε</strong>νδοαρθρικό, αλλά <strong>ε</strong>ξω<strong>υ</strong>µ<strong>ε</strong>νικό<br />

<strong>αν</strong>α<strong>τ</strong>οµικό <strong>σ</strong><strong>τ</strong>οιχ<strong>ε</strong>ίο ( Κahle et al 1984 ).<br />

Ο <strong>π</strong>ρό<strong>σ</strong>θιος χια<strong>σ</strong><strong>τ</strong>ός α<strong>π</strong>ορροφά <strong>τ</strong>ο 86% <strong>τ</strong>ης δύναµης, <strong>π</strong>ο<strong>υ</strong> <strong>π</strong>ροκαλ<strong>ε</strong>ί<br />

<strong>τ</strong>ην <strong>π</strong>ρος <strong>τ</strong>α <strong>π</strong>ρό<strong>σ</strong>ω ολί<strong>σ</strong>θη<strong>σ</strong>η <strong>τ</strong>ων κνηµιαίων κονδύλων, ως<br />

<strong>π</strong>ρος <strong>τ</strong>ο<strong>υ</strong>ς κονδύλο<strong>υ</strong>ς <strong>τ</strong>ο<strong>υ</strong> µηριαίο<strong>υ</strong>, <strong>ε</strong>νώ κα<strong>τ</strong>ά δ<strong>ε</strong>ύ<strong>τ</strong><strong>ε</strong>ρο λόγο <strong>αν</strong><strong>τ</strong>ί<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η<br />

<strong>π</strong>ροβάλλο<strong>υ</strong>ν <strong>τ</strong>ο ο<strong>π</strong>ί<strong>σ</strong>θιο κέρας <strong>τ</strong>ο<strong>υ</strong> έ<strong>σ</strong>ω µηνί<strong>σ</strong>κο<strong>υ</strong>, ο έ<strong>σ</strong>ω<br />

<strong>π</strong>λάγιος <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος, η έ<strong>σ</strong>ω ο<strong>π</strong>ί<strong>σ</strong>θια <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ια <strong>τ</strong>ο<strong>υ</strong> αρθρικού θ<strong>υ</strong>λάκο<strong>υ</strong><br />

και η κ<strong>υ</strong>ρ<strong>τ</strong>ή αρθρική <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ια <strong>τ</strong>ων µηριαίων κονδύλων ( Renstrom<br />

1995)

Οι ρήξ<strong>ε</strong>ις <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>π</strong>αρα<strong>τ</strong>ηρούν<strong>τ</strong>αι µ<strong>ε</strong> <strong>σ</strong><strong>υ</strong>ν<strong>ε</strong>χώς α<strong>υ</strong>ξ<strong>αν</strong>όµ<strong>ε</strong>νη<br />

<strong>σ</strong><strong>υ</strong>χνό<strong>τ</strong>η<strong>τ</strong>α, λόγω <strong>τ</strong>ης µ<strong>ε</strong>γάλης <strong>σ</strong><strong>υ</strong>µµ<strong>ε</strong><strong>τ</strong>οχής <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ληθ<strong>υ</strong><strong>σ</strong>µού<br />

<strong>σ</strong><strong>ε</strong> αθλήµα<strong>τ</strong>α, ό<strong>π</strong>ως <strong>τ</strong>ο <strong>π</strong>οδό<strong>σ</strong>φαιρο, η καλαθο<strong>σ</strong>φαίρι<strong>σ</strong>η, <strong>τ</strong>ο<br />

Γ<strong>υ</strong>9&γ, η <strong>αν</strong><strong>τ</strong>ι<strong>σ</strong>φαίρι<strong>σ</strong>η και οι χιονοδροµί<strong>ε</strong>ς. Ιδιαί<strong>τ</strong><strong>ε</strong>ρα <strong>σ</strong><strong>τ</strong>ις χιονοδρο-<br />

µί<strong>ε</strong>ς οι κακώ<strong>σ</strong><strong>ε</strong>ις <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong> καλύ<strong>π</strong><strong>τ</strong>ο<strong>υ</strong>ν <strong>τ</strong>ο<br />

25% ως 30% όλων <strong>τ</strong>ων κακώ<strong>σ</strong><strong>ε</strong>ων <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος (Paletta & Warren<br />

1994).

Η ρήξη <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>π</strong><strong>ε</strong>ριγράφηκ<strong>ε</strong> <strong>σ</strong><strong>τ</strong>ην Αγγλόφωνη<br />

βιβλιογραφία α<strong>π</strong>ό <strong>τ</strong>ον J.Stark, <strong>τ</strong>ο 1850, <strong>ε</strong>νώ η <strong>π</strong>ρώ<strong>τ</strong>η <strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ική<br />

<strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong> <strong>αν</strong>ακοινώθηκ<strong>ε</strong> α<strong>π</strong>ό <strong>τ</strong>ον Ε. W. Hey Groves <strong>τ</strong>ο 1917<br />

(Snοοκ1988).<br />

Μηχ<strong>αν</strong>ι<strong>σ</strong>µοί:<br />

Οι ρήξ<strong>ε</strong>ις <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>σ</strong><strong>υ</strong>νοδ<strong>ε</strong>ύο<strong>υ</strong>ν <strong>σ</strong><strong>υ</strong>νήθως <strong>τ</strong>ις ρήξ<strong>ε</strong>ις<br />

<strong>τ</strong>ων <strong>π</strong>λαγίων <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µων και οφ<strong>ε</strong>ίλον<strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ο<strong>υ</strong>ς <strong>ε</strong>ξής µηχ<strong>αν</strong>ι<strong>σ</strong>µούς<br />

:<br />

1. Έξω <strong>σ</strong><strong>τ</strong>ροφή <strong>τ</strong>ης κνήµης και βλαι<strong>σ</strong>ο<strong>π</strong>οίη<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος,<br />

<strong>π</strong>ο<strong>υ</strong> βρί<strong>σ</strong>κ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>ε</strong> <strong>ε</strong>λαφρά κάµψη.<br />

2. Έ<strong>σ</strong>ω <strong>σ</strong><strong>τ</strong>ροφή <strong>τ</strong>ης κνήµης και ραιβο<strong>π</strong>οίη<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος,<br />

<strong>π</strong>ο<strong>υ</strong> βρί<strong>σ</strong>κ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>ε</strong> <strong>ε</strong>λαφρά κάµψη.<br />

3. Βίαιη <strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong>, <strong>ε</strong>νώ <strong>τ</strong>ο γόνα<strong>τ</strong>ο βρί<strong>σ</strong>κ<strong>ε</strong><br />

<strong>τ</strong>αι <strong>σ</strong><strong>ε</strong> <strong>ε</strong>λαφρά κάµψη.<br />

4. Υ<strong>π</strong><strong>ε</strong>ρέκ<strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος και έ<strong>σ</strong>ω <strong>σ</strong><strong>τ</strong>ροφή <strong>τ</strong>ης κνήµης.<br />

Ο <strong>π</strong>ρό<strong>σ</strong>θιος χια<strong>σ</strong><strong>τ</strong>ός <strong>υ</strong>φί<strong>σ</strong><strong>τ</strong>α<strong>τ</strong>αι ρήξη <strong>σ</strong><strong>υ</strong>νήθως <strong>σ</strong><strong>τ</strong>η µ<strong>ε</strong><strong>σ</strong>ό<strong>τ</strong>η<strong>τ</strong>ά <strong>τ</strong>ο<strong>υ</strong><br />

(70%), <strong>ε</strong>νώ <strong>σ</strong><strong>π</strong><strong>αν</strong>ιό<strong>τ</strong><strong>ε</strong>ρα <strong>π</strong>αρα<strong>τ</strong>ηρ<strong>ε</strong>ί<strong>τ</strong>αι α<strong>π</strong>ό<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η <strong>τ</strong>ης µηριαίας και<br />

<strong>τ</strong>ης κνηµιαίας <strong>π</strong>ρό<strong>σ</strong>φ<strong>υ</strong><strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong>. Κα<strong>τ</strong>ά <strong>τ</strong>ο<strong>υ</strong>ς Higgins & Steadman<br />

(1987), η <strong>π</strong>λ<strong>ε</strong>ιονό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ων ρήξ<strong>ε</strong>ων <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>σ</strong><strong>τ</strong>ο<strong>υ</strong>ς<br />

χιονοδρόµο<strong>υ</strong>ς, <strong>ε</strong>ν<strong>τ</strong>ο<strong>π</strong>ίζ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>η µηριαία <strong>π</strong>ρό<strong>σ</strong>φ<strong>υ</strong><strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>.

Μηχ<strong>αν</strong>ι<strong>σ</strong>µοί ρήξης <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>. Ε<strong>π</strong>άνω α:<br />

Έξω <strong>σ</strong><strong>τ</strong>ροφή <strong>τ</strong>ης κνήµης και βλαι<strong>σ</strong>ο<strong>π</strong>οίη<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, <strong>π</strong>ο<strong>υ</strong> βρί<strong>σ</strong>κ<strong>ε</strong><strong>τ</strong>αι<br />

<strong>σ</strong><strong>ε</strong> <strong>ε</strong>λαφρά κάµψη. Ε<strong>π</strong>άνω β : Έ<strong>σ</strong>ω <strong>σ</strong><strong>τ</strong>ροφή <strong>τ</strong>ης κνήµης και ραιβο<strong>π</strong>οίη<strong>σ</strong>η<br />

<strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, <strong>π</strong>ο<strong>υ</strong> βρί<strong>σ</strong>κ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>ε</strong> <strong>ε</strong>λαφρά κάµψη. Κά<strong>τ</strong>ω: Υ<strong>π</strong><strong>ε</strong>ρέκ<strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong><br />

γόνα<strong>τ</strong>ος και έ<strong>σ</strong>ω <strong>σ</strong><strong>τ</strong>ροφή <strong>τ</strong>ης κνήµης.<br />

3.2 ∆ΙΑΓΝΩΣΗ<br />

Τα <strong>σ</strong><strong>υ</strong>µ<strong>π</strong><strong>τ</strong>ώµα<strong>τ</strong>α <strong>σ</strong><strong>υ</strong>νί<strong>σ</strong><strong>τ</strong><strong>αν</strong><strong>τ</strong>αι <strong>σ</strong><strong>ε</strong> οίδηµα <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, <strong>ε</strong><strong>π</strong>ώδ<strong>υ</strong>νη<br />

κινη<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ης άρθρω<strong>σ</strong>ης και δ<strong>υ</strong><strong>σ</strong>χέρ<strong>ε</strong>ια βάδι<strong>σ</strong>ης. Σ<strong>τ</strong>η διάγνω<strong>σ</strong>η<br />

<strong>σ</strong><strong>υ</strong>µβάλλο<strong>υ</strong>ν η γνώ<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> µηχ<strong>αν</strong>ι<strong>σ</strong>µού κάκω<strong>σ</strong>ης, <strong>τ</strong>ο αίµαρθρο, <strong>π</strong>ο<strong>υ</strong><br />

α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί <strong>σ</strong><strong>υ</strong>χνά <strong>τ</strong>ο µόνο κλινικό <strong>σ</strong>ηµ<strong>ε</strong>ίο και οι λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργικές δοκιµα<strong>σ</strong>ί<strong>ε</strong>ς,<br />

µ<strong>ε</strong> <strong>τ</strong>ις ο<strong>π</strong>οί<strong>ε</strong>ς <strong>ε</strong>λέγχ<strong>ε</strong><strong>τ</strong>αι η ακ<strong>ε</strong>ραιό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού.

Αν<strong>ε</strong>ξάρ<strong>τ</strong>η<strong>τ</strong>α α<strong>π</strong>ό <strong>τ</strong>ο µηχ<strong>αν</strong>ι<strong>σ</strong>µό <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µού, ο αθλη<strong>τ</strong>ής <strong>τ</strong>ις <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρ<strong>ε</strong>ς<br />

φορές (85%) δ<strong>ε</strong>ν <strong>ε</strong>ίναι ικ<strong>αν</strong>ός να <strong>σ</strong><strong>υ</strong>ν<strong>ε</strong>χί<strong>σ</strong><strong>ε</strong>ι να αγωνίζ<strong>ε</strong><strong>τ</strong>αι<br />

και θα <strong>υ</strong><strong>π</strong>ο<strong>σ</strong><strong>τ</strong><strong>ε</strong>ί άµ<strong>ε</strong><strong>σ</strong>ο <strong>π</strong>ρήξιµο <strong>σ</strong><strong>τ</strong>ο γόνα<strong>τ</strong>ο, <strong>π</strong>όνο <strong>π</strong>ο<strong>υ</strong> κ<strong>τ</strong><strong>υ</strong><strong>π</strong>ά<strong>ε</strong>ι<br />

<strong>σ</strong><strong>τ</strong>ο <strong>π</strong>ί<strong>σ</strong>ω µέρος <strong>τ</strong>ο<strong>υ</strong> γονά<strong>τ</strong>ο<strong>υ</strong> και διαφορ<strong>ε</strong><strong>τ</strong>ικά <strong>ε</strong><strong>π</strong>ί<strong>π</strong><strong>ε</strong>δα α<strong>σ</strong><strong>τ</strong>άθ<strong>ε</strong>ιας.<br />

Η διόγκω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος γίν<strong>ε</strong><strong>τ</strong>αι <strong>ε</strong>ν<strong>τ</strong>ονό<strong>τ</strong><strong>ε</strong>ρη µέ<strong>σ</strong>α <strong>σ</strong><strong>τ</strong>ις <strong>ε</strong><strong>π</strong>όµ<strong>ε</strong>ν<strong>ε</strong>ς 24<br />

ώρ<strong>ε</strong>ς και <strong>π</strong>αράλληλα <strong>π</strong>αρα<strong>τ</strong>ηρ<strong>ε</strong>ί<strong>τ</strong>αι « ψ<strong>ε</strong><strong>υ</strong>δοκλ<strong>ε</strong>ίδωµα » <strong>τ</strong>ης άρθρω<strong>σ</strong>ης.<br />

Ο De Havven Noyes και άλλοι <strong>ε</strong>ξ<strong>ε</strong><strong>τ</strong>άζον<strong>τ</strong>ας αρθρο<strong>σ</strong>κο<strong>π</strong>ικά αθλη<strong>τ</strong>ές<br />

µ<strong>ε</strong> αίµαρθρο α<strong>π</strong>ό οξύ <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µό γόνα<strong>τ</strong>ος, βρήκ<strong>αν</strong> µ<strong>ε</strong>ρική ή<br />

ολική ρήξη <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>σ</strong><strong>τ</strong>ο 72% <strong>τ</strong>ων <strong>π</strong><strong>ε</strong>ρι<strong>π</strong><strong>τ</strong>ώ<strong>σ</strong><strong>ε</strong>ων, <strong>σ</strong><strong>τ</strong>α 2/3<br />

<strong>τ</strong>ων ο<strong>π</strong>οίων <strong>π</strong>αρα<strong>τ</strong>ηρήθηκ<strong>αν</strong> <strong>π</strong>αράλληλ<strong>ε</strong>ς µηνι<strong>σ</strong>κικές βλάβ<strong>ε</strong>ς. Ο De<br />

Havven βρήκ<strong>ε</strong> <strong>ε</strong><strong>π</strong>ί<strong>σ</strong>ης µ<strong>ε</strong>µονωµέν<strong>ε</strong>ς µηνι<strong>σ</strong>κικές βλάβ<strong>ε</strong>ς <strong>σ</strong><strong>τ</strong>ο 15%,<br />

ο<strong>σ</strong><strong>τ</strong><strong>ε</strong>οχονδρικά κα<strong>τ</strong>άγµα<strong>τ</strong>α <strong>σ</strong><strong>τ</strong>ο 6%, ρήξ<strong>ε</strong>ις <strong>τ</strong>ο<strong>υ</strong> ο<strong>π</strong>ί<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού<br />

<strong>σ</strong><strong>τ</strong>ο 3% και µη <strong>π</strong>αρα<strong>τ</strong>ηρή<strong>σ</strong>ιµ<strong>ε</strong>ς βλάβ<strong>ε</strong>ς <strong>σ</strong><strong>τ</strong>ο 4% <strong>τ</strong>ων <strong>π</strong><strong>ε</strong>ρι<strong>π</strong><strong>τ</strong>ώ<strong>σ</strong><strong>ε</strong>ων.<br />

Εξω µηνι<strong>σ</strong>κος<br />

Ο<strong>π</strong>ι<strong>σ</strong>θιος χια<strong>σ</strong><strong>τ</strong>ος<br />

ΑρΟρική<br />

ΑΡΘ. ΘΎΛΑΚΑΣ<br />

'Ε<strong>σ</strong>ω µηνί<strong>σ</strong>κος<br />

Μηχ<strong>αν</strong>ι<strong>σ</strong>µός κάκω<strong>σ</strong>ης <strong>τ</strong>ων χια<strong>σ</strong><strong>τ</strong>ών <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µων. Α. Προ<strong>σ</strong>φύ<strong>σ</strong><strong>ε</strong>ις <strong>τ</strong>ων<br />

χια<strong>σ</strong><strong>τ</strong>ών <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µων <strong>σ</strong><strong>ε</strong> <strong>σ</strong>χέ<strong>σ</strong>η µ<strong>ε</strong> <strong>τ</strong>ην αρθρική κοιλό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος.<br />

Β. Μ<strong>ε</strong>ρική ρήξη <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>. Γ. Ολική

ρήξη <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>. ∆. Ρήξη µ<strong>ε</strong> α<strong>π</strong>ο<strong>σ</strong><strong>π</strong>α<strong>σ</strong><strong>τ</strong>ικό κά<strong>τ</strong>αγµα<br />

<strong>τ</strong>ο<strong>υ</strong> ο<strong>π</strong>ί<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>.<br />

Οι λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργικές διαδικα<strong>σ</strong>ί<strong>ε</strong>ς <strong>π</strong><strong>ε</strong>ριλαµβάνο<strong>υ</strong>ν <strong>σ</strong><strong>υ</strong>νήθως <strong>τ</strong>ην <strong>π</strong>ρό<strong>σ</strong>θια<br />

<strong>σ</strong><strong>υ</strong>ρ<strong>τ</strong>αρο<strong>ε</strong>ιδή µ<strong>ε</strong> <strong>τ</strong>ο γόνα<strong>τ</strong>ο <strong>σ</strong><strong>ε</strong> κάµψη 90° (Direkt anterior<br />

drawer/Palmer), <strong>τ</strong>ην <strong>π</strong>ρό<strong>σ</strong>θια <strong>σ</strong><strong>υ</strong>ρ<strong>τ</strong>αρο<strong>ε</strong>ιδή µ<strong>ε</strong> <strong>τ</strong>ο γόνα<strong>τ</strong>ο <strong>σ</strong><strong>ε</strong> κάµψη 20°<br />

(Lachman test) και <strong>τ</strong>η δοκιµα<strong>σ</strong>ία <strong>σ</strong><strong>τ</strong>ροφικής µ<strong>ε</strong><strong>τ</strong>α<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>ης ή Pivot<br />

shift<br />

Πρό<strong>σ</strong>θια <strong>σ</strong><strong>υ</strong>ρ<strong>τ</strong>αρο<strong>ε</strong>ιδής δοκιµα<strong>σ</strong>ία <strong>σ</strong><strong>ε</strong> κάµψη 90'<br />

(Direkt anterior drawer in 90 of flexion/Palmer test)<br />

Η <strong>π</strong>ρό<strong>σ</strong>θια <strong>σ</strong><strong>υ</strong>ρ<strong>τ</strong>αρο<strong>ε</strong>ιδής δοκιµα<strong>σ</strong>ία <strong>π</strong><strong>ε</strong>ριγράφηκ<strong>ε</strong> για <strong>π</strong>ρώ<strong>τ</strong>η<br />

φορά α<strong>π</strong>ό <strong>τ</strong>ον Segont <strong>τ</strong>ο 1879 και α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί <strong>τ</strong>ην <strong>π</strong>αλαιό<strong>τ</strong><strong>ε</strong>ρη δοκι-<br />

µα<strong>σ</strong>ία <strong>σ</strong><strong>τ</strong>ην <strong>ε</strong>ξέ<strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ων <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µων <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος και <strong>σ</strong><strong>υ</strong>γκ<strong>ε</strong>κριµένα<br />

για <strong>τ</strong>ον έλ<strong>ε</strong>γχο ρήξ<strong>ε</strong>ων <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού και δ<strong>ε</strong><strong>υ</strong><strong>τ</strong><strong>ε</strong>ρ<strong>ε</strong><strong>υ</strong>όν<strong>τ</strong>ως<br />

<strong>τ</strong>ο<strong>υ</strong> έ<strong>σ</strong>ω µηνί<strong>σ</strong>κο<strong>υ</strong>, <strong>τ</strong>ο<strong>υ</strong> έ<strong>σ</strong>ω <strong>π</strong>λαγίο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong> και <strong>τ</strong>ων <strong>π</strong>ρο<strong>σ</strong>θίων-έξω<br />

<strong>σ</strong><strong>τ</strong>οιχ<strong>ε</strong>ίων <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, ό<strong>π</strong>ως η λαγονοκνηµιαία <strong>τ</strong>αινία και<br />

<strong>τ</strong>ο <strong>π</strong>ρό<strong>σ</strong>θιο και µέ<strong>σ</strong>ο <strong>τ</strong>ρι<strong>τ</strong>ηµοριο <strong>τ</strong>ο<strong>υ</strong> αρθρικού θ<strong>υ</strong>λάκο<strong>υ</strong>. O Finochietto<br />

(1935) και ο Palmer(1938) <strong>ε</strong><strong>π</strong>έφ<strong>ε</strong>ρ<strong>αν</strong> ορι<strong>σ</strong>µέν<strong>ε</strong>ς <strong>τ</strong>ρο<strong>π</strong>ο<strong>π</strong>οιή<strong>σ</strong><strong>ε</strong>ις<br />

<strong>σ</strong><strong>τ</strong>ην <strong>ε</strong>κ<strong>τ</strong>έλ<strong>ε</strong><strong>σ</strong>η <strong>τ</strong>ης δοκιµα<strong>σ</strong>ίας α<strong>υ</strong><strong>τ</strong>ής.<br />

Η δοκιµα<strong>σ</strong>ία γίν<strong>ε</strong><strong>τ</strong>αι µ<strong>ε</strong> <strong>τ</strong>ον α<strong>σ</strong>θ<strong>ε</strong>νή <strong>σ</strong><strong>ε</strong> ύ<strong>π</strong><strong>τ</strong>ια θέ<strong>σ</strong>η, <strong>τ</strong>ο ι<strong>σ</strong>χίο <strong>σ</strong><strong>ε</strong><br />

κάµψη 45° και <strong>τ</strong>ο γόνα<strong>τ</strong>ο <strong>σ</strong><strong>ε</strong> κάµψη 90°. Ο <strong>ε</strong>ξ<strong>ε</strong><strong>τ</strong>α<strong>σ</strong><strong>τ</strong>ής ακινη<strong>τ</strong>ο<strong>π</strong>οι<strong>ε</strong>ί<br />

<strong>τ</strong>ο <strong>σ</strong>κέλος καθήµ<strong>ε</strong>νος <strong>ε</strong><strong>π</strong>άνω <strong>σ</strong><strong>τ</strong>ο <strong>π</strong>όδι <strong>τ</strong>ο<strong>υ</strong> α<strong>σ</strong>θ<strong>ε</strong>νούς και <strong>τ</strong>ο<strong>π</strong>οθ<strong>ε</strong><strong>τ</strong><strong>ε</strong>ί<br />

<strong>τ</strong>α χέρια <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ί<strong>σ</strong>ω α<strong>π</strong>ό <strong>τ</strong>ο άνω άκρο <strong>τ</strong>ης κνήµης, <strong>ε</strong>νώ <strong>τ</strong>α δάκ<strong>τ</strong><strong>υ</strong>λα<br />

<strong>τ</strong>ο<strong>υ</strong> ψηλαφούν <strong>τ</strong>ην κα<strong>τ</strong>άφ<strong>υ</strong><strong>σ</strong>η <strong>τ</strong>ων ο<strong>π</strong>ί<strong>σ</strong>θιων µηριαίων, ώ<strong>σ</strong><strong>τ</strong><strong>ε</strong> να <strong>ε</strong>-<br />

λέγχ<strong>ε</strong><strong>τ</strong>αι η χάλα<strong>σ</strong>ή <strong>τ</strong>ο<strong>υ</strong>ς. Σ<strong>τ</strong>η <strong>σ</strong><strong>υ</strong>νέχ<strong>ε</strong>ια α<strong>σ</strong>κ<strong>ε</strong>ί έλξη <strong>σ</strong><strong>τ</strong>ο άνω άκρο <strong>τ</strong>ης<br />

κνήµης και αξιολογ<strong>ε</strong>ί <strong>τ</strong>ην <strong>π</strong>ρος <strong>τ</strong>α <strong>π</strong>ρό<strong>σ</strong>ω κίνη<strong>σ</strong>η <strong>τ</strong>ων κονδύλων<br />

<strong>τ</strong>ηςκνήµης.

Η έλξη <strong>τ</strong>ο<strong>υ</strong> άνω άκρο<strong>υ</strong> <strong>τ</strong>ης κνήµης, µ<strong>π</strong>ορ<strong>ε</strong>ί να α<strong>υ</strong>ξηθ<strong>ε</strong>ί µ<strong>ε</strong> <strong>τ</strong>α<strong>υ</strong><strong>τ</strong>όχρονη<br />

<strong>π</strong>ί<strong>ε</strong><strong>σ</strong>η <strong>τ</strong>ων µηριαίων κονδύλων α<strong>π</strong>ό <strong>τ</strong>ο<strong>υ</strong>ς <strong>αν</strong><strong>τ</strong>ίχ<strong>ε</strong>ιρ<strong>ε</strong>ς <strong>τ</strong>ο<strong>υ</strong> <strong>ε</strong>ξ<strong>ε</strong><strong>τ</strong>α<strong>σ</strong><strong>τ</strong>ή,<br />

<strong>π</strong>ο<strong>υ</strong> <strong>τ</strong>ο<strong>π</strong>οθ<strong>ε</strong><strong>τ</strong>ούν<strong>τ</strong>αι <strong>π</strong>αράλληλα <strong>π</strong>ρος <strong>τ</strong>ον <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδικό <strong>τ</strong>ένον<strong>τ</strong>α,<br />

ώ<strong>σ</strong><strong>τ</strong><strong>ε</strong> να <strong>π</strong><strong>ε</strong>ριορίζον<strong>τ</strong>αι οι <strong>σ</strong><strong>τ</strong>ροφικές κινή<strong>σ</strong><strong>ε</strong>ις κα<strong>τ</strong>ά <strong>τ</strong>ην <strong>π</strong>ρος<br />

<strong>τ</strong>α <strong>π</strong>ρό<strong>σ</strong>ω κίνη<strong>σ</strong>η <strong>τ</strong>ης κνήµης. Η δοκιµα<strong>σ</strong>ία γίν<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>υ</strong>γκρι<strong>τ</strong>ικά µ<strong>ε</strong> <strong>τ</strong>ο<br />

άλλο γόνα<strong>τ</strong>ο, ώ<strong>σ</strong><strong>τ</strong><strong>ε</strong> να α<strong>π</strong>οφ<strong>ε</strong>ύγ<strong>ε</strong><strong>τ</strong>αι η <strong>ε</strong>ξαγωγή λ<strong>αν</strong>θα<strong>σ</strong>µένων <strong>σ</strong><strong>υ</strong>-<br />

µ<strong>π</strong><strong>ε</strong>ρα<strong>σ</strong>µά<strong>τ</strong>ων <strong>σ</strong><strong>ε</strong> <strong>π</strong><strong>ε</strong>ρι<strong>π</strong><strong>τ</strong>ώ<strong>σ</strong><strong>ε</strong>ις <strong>υ</strong><strong>π</strong><strong>ε</strong>ρ<strong>ε</strong>λα<strong>σ</strong><strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>ας <strong>τ</strong>ων αρθρώ<strong>σ</strong><strong>ε</strong>ων.<br />

Η <strong>ε</strong>ξέ<strong>τ</strong>α<strong>σ</strong>η µ<strong>π</strong>ορ<strong>ε</strong>ί να γίν<strong>ε</strong>ι και µ<strong>ε</strong> <strong>τ</strong>ον α<strong>σ</strong>θ<strong>ε</strong>νή καθήµ<strong>ε</strong>νο <strong>σ</strong><strong>τ</strong>ην<br />

άκρη <strong>τ</strong>ης <strong>ε</strong>ξ<strong>ε</strong><strong>τ</strong>α<strong>σ</strong><strong>τ</strong>ικής κλίνης, µ<strong>ε</strong> <strong>τ</strong>ο γόνα<strong>τ</strong>ο <strong>σ</strong><strong>ε</strong> κάµψη 90° (Hughstone<br />

et al. 1976).<br />

Η <strong>π</strong>ρό<strong>σ</strong>θια ολί<strong>σ</strong>θη<strong>σ</strong>η <strong>τ</strong>ων κνηµιαίων κονδύλων αξιολογ<strong>ε</strong>ί<strong>τ</strong>αι ως<br />

<strong>ε</strong>ξής:<br />

* ολί<strong>σ</strong>θη<strong>σ</strong>η µ<strong>ε</strong><strong>τ</strong>αξύ 3mm και 5mm <strong>αν</strong><strong>τ</strong>ι<strong>σ</strong><strong>τ</strong>οιχ<strong>ε</strong>ί κλινικά <strong>σ</strong><strong>ε</strong> <strong>ε</strong><strong>π</strong>ιµή<br />

κ<strong>υ</strong>ν<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού (ρήξη 1 ο<strong>υ</strong> βαθµού)<br />

* α<strong>π</strong>ό 5mmως 10mm α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί θ<strong>ε</strong><strong>τ</strong>ικό <strong>σ</strong>ηµ<strong>ε</strong>ίο µ<strong>ε</strong>ρικής ρήξης<br />

<strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong> (ρήξη 2 ο<strong>υ</strong> βαθµού) και<br />

* ολί<strong>σ</strong>θη<strong>σ</strong>η άνω <strong>τ</strong>ων ΙΟmm <strong>υ</strong><strong>π</strong>οδηλών<strong>ε</strong>ι <strong>ε</strong>κ<strong>τ</strong><strong>ε</strong><strong>τ</strong>αµένη ή <strong>π</strong>λήρη<br />

ρήξη <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού (ρήξη 3 ο<strong>υ</strong> βαθµού).<br />

Α<strong>π</strong>ό <strong>π</strong>ολλούς <strong>σ</strong><strong>υ</strong>γγραφ<strong>ε</strong>ίς <strong>αν</strong>αφέρ<strong>ε</strong><strong>τ</strong>αι, ό<strong>τ</strong>ι <strong>τ</strong>ο <strong>π</strong>ρό<strong>σ</strong>θιο <strong>σ</strong><strong>υ</strong>ρ<strong>τ</strong>αρο<strong>ε</strong>ιδές<br />

<strong>σ</strong>ηµ<strong>ε</strong>ίο δ<strong>ε</strong>ν α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί αξιό<strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ο <strong>σ</strong><strong>τ</strong>οιχ<strong>ε</strong>ίο <strong>σ</strong><strong>τ</strong>η διάγνω<strong>σ</strong>η βλαβών<br />

<strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>, <strong>ε</strong><strong>π</strong><strong>ε</strong>ιδή <strong>ε</strong>ίναι δ<strong>υ</strong>να<strong>τ</strong>ό να<br />

<strong>π</strong>αραχθ<strong>ε</strong>ί και έ<strong>π</strong><strong>ε</strong>ι<strong>τ</strong>α α<strong>π</strong>ό ρήξη µόνο <strong>τ</strong>ο<strong>υ</strong> ο<strong>π</strong>ί<strong>σ</strong>θιο<strong>υ</strong> λοξού <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong><br />

ή <strong>τ</strong>ο<strong>υ</strong> έ<strong>σ</strong>ω µηνί<strong>σ</strong>κο<strong>υ</strong> (Larso 1982, Toral et al. 1990). Το γ<strong>ε</strong>γονός<br />

α<strong>υ</strong><strong>τ</strong>ό <strong>ε</strong>ρµην<strong>ε</strong>ύ<strong>ε</strong>ι <strong>τ</strong>ο ψ<strong>ε</strong><strong>υ</strong>δώς θ<strong>ε</strong><strong>τ</strong>ικό ή αρνη<strong>τ</strong>ικό <strong>π</strong>ρό<strong>σ</strong>θιο <strong>σ</strong><strong>υ</strong>ρ<strong>τ</strong>αρο<strong>ε</strong>ιδές<br />

<strong>σ</strong>ηµ<strong>ε</strong>ίο, <strong>π</strong>ο<strong>υ</strong> δια<strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ών<strong>ε</strong><strong>τ</strong>αι κα<strong>τ</strong>ά <strong>τ</strong>ην <strong>ε</strong>ξέ<strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος<br />

(Muller et al. 1988).

Πρό<strong>σ</strong>θια <strong>σ</strong><strong>υ</strong>ρ<strong>τ</strong>αρο<strong>ε</strong>ιδής δοκιµα<strong>σ</strong>ία µ<strong>ε</strong> <strong>τ</strong>ο γόνα<strong>τ</strong>ο <strong>σ</strong><strong>ε</strong> κάµψη<br />

90°.<br />

Πρό<strong>σ</strong>θια <strong>σ</strong><strong>υ</strong>ρ<strong>τ</strong>αρο<strong>ε</strong>ιδής δοκιµα<strong>σ</strong>ία, µ<strong>ε</strong> <strong>τ</strong>ο γόνα<strong>τ</strong>ο <strong>σ</strong><strong>ε</strong> κάµψη<br />

20°.<br />

Πρό<strong>σ</strong>θια <strong>σ</strong><strong>υ</strong>ρ<strong>τ</strong>αρο<strong>ε</strong>ιδής δοκιµα<strong>σ</strong>ία <strong>σ</strong><strong>ε</strong> κάµψη 20°<br />

Direct anterior drawer in 20 of flexin or Lachman-trillat test)<br />

Η δοκιµα<strong>σ</strong>ία α<strong>υ</strong><strong>τ</strong>ή γνω<strong>σ</strong><strong>τ</strong>ή ως «Lachman test», <strong>π</strong><strong>ε</strong>ριγράφηκ<strong>ε</strong> αρχικά<br />

α<strong>π</strong>ό <strong>τ</strong>ον Albert trillat <strong>τ</strong>ο 1972 και α<strong>π</strong>ό <strong>τ</strong>ον John Lachman <strong>τ</strong>ο<br />

1976 και χρη<strong>σ</strong>ιµο<strong>π</strong>οι<strong>ε</strong>ί<strong>τ</strong>αι για <strong>τ</strong>η διάγνω<strong>σ</strong>η ρήξ<strong>ε</strong>ων <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong><br />

χια<strong>σ</strong><strong>τ</strong>ού.<br />

Η δοκιµα<strong>σ</strong>ία γίν<strong>ε</strong><strong>τ</strong>αι µ<strong>ε</strong> <strong>τ</strong>ον α<strong>σ</strong>θ<strong>ε</strong>νή <strong>σ</strong><strong>ε</strong> ύ<strong>π</strong><strong>τ</strong>ια θέ<strong>σ</strong>η και <strong>τ</strong>ον <strong>ε</strong>ξ<strong>ε</strong><strong>τ</strong>α<strong>σ</strong><strong>τ</strong>ή<br />

<strong>σ</strong><strong>τ</strong>ην <strong>π</strong>λ<strong>ε</strong><strong>υ</strong>ρά <strong>τ</strong>ο<strong>υ</strong> <strong>ε</strong>ξ<strong>ε</strong><strong>τ</strong>αζοµένο<strong>υ</strong> γόνα<strong>τ</strong>ος. Μ<strong>ε</strong> <strong>τ</strong>ο γόνα<strong>τ</strong>ο <strong>σ</strong><strong>ε</strong><br />

κάµψη 15° ως 20°, ο µηρός ακινη<strong>τ</strong>ο<strong>π</strong>οι<strong>ε</strong>ί<strong>τ</strong>αι µ<strong>ε</strong> <strong>τ</strong>ο ένα χέρι, <strong>ε</strong>νώ µ<strong>ε</strong><br />

<strong>τ</strong>ο άλλο <strong>π</strong>ο<strong>υ</strong> <strong>τ</strong>ο<strong>π</strong>οθ<strong>ε</strong><strong>τ</strong><strong>ε</strong>ί<strong>τ</strong>αι <strong>π</strong>ί<strong>σ</strong>ω α<strong>π</strong>ό <strong>τ</strong>ο άνω άκρο <strong>τ</strong>ης κνήµης, α-<br />

<strong>σ</strong>κ<strong>ε</strong>ί<strong>τ</strong>αι ι<strong>σ</strong>χ<strong>υ</strong>ρή έλξη <strong>π</strong>ρος <strong>τ</strong>α άνω (<strong>π</strong>ρό<strong>σ</strong>ω}. Ο <strong>αν</strong><strong>τ</strong>ίχ<strong>ε</strong>ιρας <strong>τ</strong>ο<strong>υ</strong> χ<strong>ε</strong>ριού,<br />

<strong>π</strong>ο<strong>υ</strong> α<strong>σ</strong>κ<strong>ε</strong>ί <strong>τ</strong>ην έλξη <strong>σ</strong><strong>τ</strong>ην κνήµη, ψηλαφά <strong>τ</strong>ο µ<strong>ε</strong><strong>σ</strong>άρθριο διά-

<strong>σ</strong><strong>τ</strong>ηµα, ώ<strong>σ</strong><strong>τ</strong><strong>ε</strong> να γίν<strong>ε</strong><strong>τ</strong>α, <strong>αν</strong><strong>τ</strong>,λη<strong>π</strong><strong>τ</strong>ή ο<strong>π</strong>οιοδη<strong>π</strong>ο<strong>τ</strong><strong>ε</strong> ολί<strong>σ</strong>θη<strong>σ</strong>η <strong>τ</strong>ων κν η -<br />

µιαίων κονδύλων <strong>π</strong>ρος <strong>τ</strong>α <strong>π</strong>ρό<strong>σ</strong>ω.<br />

Εκ<strong>τ</strong>έλ<strong>ε</strong><strong>σ</strong>η <strong>τ</strong>ης <strong>π</strong>ρό<strong>σ</strong>θιας <strong>σ</strong><strong>υ</strong>ρ<strong>τ</strong>αρο<strong>ε</strong>ιδούς δοκιµα<strong>σ</strong>ίας, µ<strong>ε</strong> <strong>τ</strong>ο γόνα<strong>τ</strong>ο <strong>σ</strong><strong>ε</strong><br />

κάµψη 20°, α<strong>π</strong>ό <strong>τ</strong>ον Lonh Lancham (αρι<strong>σ</strong><strong>τ</strong><strong>ε</strong>ρά) και <strong>τ</strong>ον Albert trillat (δ<strong>ε</strong>ξιά.)<br />

Σ<strong>τ</strong>η διάρκ<strong>ε</strong>ια <strong>τ</strong>ης δοκιµα<strong>σ</strong>ίας Lachman γίν<strong>ε</strong><strong>τ</strong>αι ο<strong>π</strong><strong>τ</strong>ικός έλ<strong>ε</strong>γχος <strong>τ</strong>ης<br />

<strong>ε</strong>λαφρά κ<strong>υ</strong>ρ<strong>τ</strong>ής <strong>π</strong>ρος <strong>τ</strong>α <strong>ε</strong>µ<strong>π</strong>ρός γραµµής, <strong>π</strong>ο<strong>υ</strong> <strong>ε</strong>νών<strong>ε</strong>ι <strong>τ</strong>ον κά<strong>τ</strong>ω<br />

<strong>π</strong>όλο <strong>τ</strong>ης <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδας, <strong>τ</strong>ον <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδικό <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µο και <strong>τ</strong>ο άνω<br />

άκρο <strong>τ</strong>ης κνήµης. Η <strong>π</strong>ρό<strong>σ</strong>θια ολί<strong>σ</strong>θη<strong>σ</strong>η <strong>τ</strong>ης κνήµης, λόγω ρήξης<br />

<strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού, <strong>π</strong>ροκαλ<strong>ε</strong>ί διά<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η <strong>τ</strong>ης γραµµής α<strong>υ</strong><strong>τ</strong>ής (<br />

Torg et all. 1976).

Πρό<strong>σ</strong>θια <strong>σ</strong><strong>υ</strong>ρ<strong>τ</strong>αρο<strong>ε</strong>ιδής δοκιµα<strong>σ</strong>ία, µ<strong>ε</strong> <strong>τ</strong>ο γόνα<strong>τ</strong>ο <strong>σ</strong><strong>ε</strong> κάµψη<br />

20° (Direct anterior in 20 of flexion/Lachman-Trillat test), µ<strong>ε</strong> <strong>τ</strong>ον<br />

α<strong>σ</strong>θ<strong>ε</strong>νή <strong>σ</strong><strong>ε</strong> ύ<strong>π</strong><strong>τ</strong>ια θέ<strong>σ</strong>η (<strong>ε</strong><strong>π</strong>άνω) και<br />

<strong>π</strong>ρηνή (κά<strong>τ</strong>ω).<br />

Η δοκιµα<strong>σ</strong>ία Lachman <strong>ε</strong>ίναι δ<strong>υ</strong>να<strong>τ</strong>ό να <strong>ε</strong>κ<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong><strong>σ</strong><strong>τ</strong><strong>ε</strong>ί και µ<strong>ε</strong> <strong>τ</strong>ον α-<br />

<strong>σ</strong>θ<strong>ε</strong>νή <strong>σ</strong><strong>ε</strong> <strong>π</strong>ρηνή θέ<strong>σ</strong>η και <strong>τ</strong>ο γόνα<strong>τ</strong>ο <strong>σ</strong><strong>ε</strong> κάµψη 20°. Σ<strong>τ</strong>ην <strong>π</strong><strong>ε</strong>ρί<strong>π</strong><strong>τ</strong>ω<strong>σ</strong>η<br />

α<strong>υ</strong><strong>τ</strong>ή ο <strong>ε</strong>ξ<strong>ε</strong><strong>τ</strong>α<strong>σ</strong><strong>τ</strong>ής <strong>σ</strong><strong>υ</strong>γκρα<strong>τ</strong><strong>ε</strong>ί <strong>τ</strong>ην κνήµη <strong>τ</strong>ο<strong>υ</strong> α<strong>σ</strong>θ<strong>ε</strong>νούς <strong>σ</strong><strong>τ</strong>η µα<strong>σ</strong>χάλη<br />

<strong>τ</strong>ο<strong>υ</strong> και <strong>τ</strong>ο<strong>π</strong>οθ<strong>ε</strong><strong>τ</strong><strong>ε</strong>ί <strong>τ</strong>ον <strong>αν</strong><strong>τ</strong>ίχ<strong>ε</strong>ιρα <strong>τ</strong>ο<strong>υ</strong> άλλο<strong>υ</strong> χ<strong>ε</strong>ριού <strong>σ</strong><strong>τ</strong>ο έξω<br />

µ<strong>ε</strong><strong>σ</strong>άρθριο διά<strong>σ</strong><strong>τ</strong>ηµα, <strong>ε</strong>νώ µ<strong>ε</strong> <strong>τ</strong>ο δ<strong>ε</strong>ίκ<strong>τ</strong>η ψηλαφά <strong>τ</strong>ο <strong>π</strong>ρό<strong>σ</strong>θιο µ<strong>ε</strong><strong>σ</strong>άρθριο<br />

διά<strong>σ</strong><strong>τ</strong>ηµα. Ο <strong>ε</strong>ξ<strong>ε</strong><strong>τ</strong>α<strong>σ</strong><strong>τ</strong>ής <strong>π</strong>ιέζ<strong>ε</strong>ι <strong>σ</strong><strong>τ</strong>η <strong>σ</strong><strong>υ</strong>νέχ<strong>ε</strong>ια <strong>τ</strong>ο άνω άκρο <strong>τ</strong>ης<br />

κνήµης <strong>π</strong>ρος <strong>τ</strong>α <strong>ε</strong>µ<strong>π</strong>ρός, <strong>υ</strong><strong>π</strong>οβοηθούµ<strong>ε</strong>νος α<strong>π</strong>ό <strong>τ</strong>η βαρύ<strong>τ</strong>η<strong>τ</strong>α. Η κίνη<strong>σ</strong>η<br />

<strong>τ</strong>ης κνήµης γίν<strong>ε</strong><strong>τ</strong>αι αι<strong>σ</strong>θη<strong>τ</strong>ή α<strong>π</strong>ό <strong>τ</strong>ον <strong>αν</strong><strong>τ</strong>ίχ<strong>ε</strong>ιρα, <strong>π</strong>ο<strong>υ</strong> ψηλαφά<br />

<strong>τ</strong>ο έξω µ<strong>ε</strong><strong>σ</strong>άρθριο διά<strong>σ</strong><strong>τ</strong>ηµα.<br />

Κα<strong>τ</strong>ά <strong>τ</strong>ην <strong>ε</strong>κ<strong>τ</strong>έλ<strong>ε</strong><strong>σ</strong>η <strong>τ</strong>ων <strong>σ</strong><strong>υ</strong>ρ<strong>τ</strong>αρο<strong>ε</strong>ιδών δοκιµα<strong>σ</strong>ιών, µ<strong>ε</strong> <strong>τ</strong>ο γόνα<strong>τ</strong>ο<br />

<strong>σ</strong><strong>ε</strong> κάµψη 90° ή 20°, η έλξη, <strong>π</strong>ο<strong>υ</strong> α<strong>σ</strong>κ<strong>ε</strong>ί<strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ον <strong>ε</strong>ξ<strong>ε</strong><strong>τ</strong>α<strong>σ</strong><strong>τ</strong>ή (Τ), <strong>ε</strong>-

ξι<strong>σ</strong>ορρο<strong>π</strong><strong>ε</strong>ί<strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ην <strong>τ</strong>ριβή µ<strong>ε</strong><strong>τ</strong>αξύ <strong>τ</strong>ων αρθρικών <strong>ε</strong><strong>π</strong>ιφ<strong>αν</strong><strong>ε</strong>ιών<br />

(Ρ), <strong>τ</strong>ην <strong>αν</strong><strong>τ</strong>ί<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ων ο<strong>π</strong>ί<strong>σ</strong>θιων µηριαίων ( Ο ) και <strong>τ</strong>ο βάρος<br />

<strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong>κέλο<strong>υ</strong>ς (νν).<br />

Η δοκιµα<strong>σ</strong>ία Lachman θ<strong>ε</strong>ωρ<strong>ε</strong>ί<strong>τ</strong>αι <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρο αξιό<strong>π</strong>ι<strong>σ</strong><strong>τ</strong>η α<strong>π</strong>ό<br />

<strong>τ</strong>ην <strong>π</strong>ρό<strong>σ</strong>θια <strong>σ</strong><strong>υ</strong>ρ<strong>τ</strong>αρο<strong>ε</strong>ιδή µ<strong>ε</strong> <strong>τ</strong>ο γόνα<strong>τ</strong>ο <strong>σ</strong><strong>ε</strong> κάµψη 90°, για <strong>τ</strong>η<br />

διάγνω<strong>σ</strong>η ρήξ<strong>ε</strong>ων <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού, για <strong>τ</strong>ο<strong>υ</strong>ς <strong>ε</strong>ξής λόγο<strong>υ</strong>ς (<br />

Τοrg et al. 1990):<br />

• Σ<strong>τ</strong>ις <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρ<strong>ε</strong>ς <strong>π</strong><strong>ε</strong>ρι<strong>π</strong><strong>τ</strong>ώ<strong>σ</strong><strong>ε</strong>ις οξ<strong>ε</strong>ίας ρήξης <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong><br />

χια<strong>σ</strong><strong>τ</strong>ού, <strong>π</strong>ροκαλ<strong>ε</strong>ί<strong>τ</strong>αι αίµαρθρο, <strong>τ</strong>ο ο<strong>π</strong>οίο <strong>ε</strong>µ<strong>π</strong>οδίζ<strong>ε</strong>ι <strong>τ</strong>ην κάµψη <strong>τ</strong>ο<strong>υ</strong><br />

γόνα<strong>τ</strong>ος <strong>σ</strong><strong>τ</strong>ις 90°, για <strong>τ</strong>ην <strong>ε</strong>κ<strong>τ</strong>έλ<strong>ε</strong><strong>σ</strong>η <strong>τ</strong>ης <strong>π</strong>ρό<strong>σ</strong>θιας <strong>σ</strong><strong>υ</strong>ρ<strong>τ</strong>αρο<strong>ε</strong>ιδούς<br />

δοκιµα<strong>σ</strong>ίας.<br />

• Ό<strong>τ</strong><strong>αν</strong> <strong>τ</strong>ο γόνα<strong>τ</strong>ο βρί<strong>σ</strong>κ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>ε</strong> κάµψη 90° και <strong>ε</strong>φ' ό<strong>σ</strong>ον ο ο<strong>π</strong>ί<br />

<strong>σ</strong>θιος λοξός <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος και ο έ<strong>σ</strong>ω µηνί<strong>σ</strong>κος <strong>ε</strong>ίναι ακέραιοι, ο έ<strong>σ</strong>ω<br />

µηνί<strong>σ</strong>κος <strong>π</strong>ο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>νδέ<strong>ε</strong><strong>τ</strong>αι µ<strong>ε</strong> <strong>τ</strong>ον έ<strong>σ</strong>ω κνηµιαίο κόνδ<strong>υ</strong>λο, δρα ως<br />

<strong>σ</strong>φήνα και <strong>π</strong>αρ<strong>ε</strong>µ<strong>π</strong>οδίζ<strong>ε</strong>ι <strong>τ</strong>ην <strong>π</strong>ρό<strong>σ</strong>θια ολί<strong>σ</strong>θη<strong>σ</strong>η <strong>τ</strong>ης έ<strong>σ</strong>ω κνηµιαίας<br />

γλήνης.<br />

Η <strong>π</strong>ρό<strong>σ</strong>θια ολί<strong>σ</strong>θη<strong>σ</strong>η <strong>ε</strong>µ<strong>π</strong>οδίζ<strong>ε</strong><strong>τ</strong>αι <strong>ε</strong><strong>π</strong>ι<strong>π</strong>λέον, α<strong>π</strong>ό <strong>τ</strong>ην α<strong>υ</strong>ξηµένη<br />

<strong>αν</strong><strong>τ</strong>ί<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>π</strong>ο<strong>υ</strong> <strong>π</strong>ροβάλλ<strong>ε</strong>ι <strong>σ</strong><strong>τ</strong>ην κίνη<strong>σ</strong>η <strong>τ</strong>ων κνηµιαίων γληνών, η<br />

έν<strong>τ</strong>ονα κ<strong>υ</strong>ρ<strong>τ</strong>ή ο<strong>π</strong>ί<strong>σ</strong>θια αρθρική <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ια <strong>τ</strong>ων µηριαίων κονδύλων.<br />

Σ<strong>υ</strong>γχρόνως ο ο<strong>π</strong>ί<strong>σ</strong>θιος λοξός <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος <strong>υ</strong>φί<strong>σ</strong><strong>τ</strong>α<strong>τ</strong>αι διά<strong>τ</strong>α<strong>σ</strong>η και<br />

<strong>ε</strong>µ<strong>π</strong>οδίζ<strong>ε</strong>ι <strong>τ</strong>ην ολί<strong>σ</strong>θη<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> έ<strong>σ</strong>ω µηριαίο<strong>υ</strong> κονδύλο<strong>υ</strong>, <strong>ε</strong><strong>π</strong>ί <strong>τ</strong>ο<strong>υ</strong> έ<strong>σ</strong>ω<br />

µηνί<strong>σ</strong>κο<strong>υ</strong>, δρών<strong>τ</strong>ας <strong>σ</strong><strong>υ</strong>ναγωνι<strong>σ</strong><strong>τ</strong>ικά µ<strong>ε</strong> <strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό. Ιδιαί<strong>τ</strong><strong>ε</strong>ρη<br />

<strong>σ</strong>ηµα<strong>σ</strong>ία έχ<strong>ε</strong>ι η <strong>αν</strong><strong>τ</strong>ί<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ων ο<strong>π</strong>ί<strong>σ</strong>θιων µηριαίων, η ο<strong>π</strong>οία <strong>σ</strong><strong>ε</strong><br />

αθλη<strong>τ</strong>ές µ<strong>ε</strong> έν<strong>τ</strong>ονη µ<strong>υ</strong>ϊκή <strong>αν</strong>ά<strong>π</strong><strong>τ</strong><strong>υ</strong>ξη, <strong>υ</strong><strong>π</strong><strong>ε</strong>ρνικά <strong>σ</strong><strong>υ</strong>χνά <strong>τ</strong>ην έλξη, <strong>π</strong>ο<strong>υ</strong><br />

α<strong>σ</strong>κ<strong>ε</strong>ί<strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ον <strong>ε</strong>ξ<strong>ε</strong><strong>τ</strong>α<strong>σ</strong><strong>τ</strong>ή.<br />

• Ό<strong>τ</strong><strong>αν</strong> <strong>τ</strong>ο γόνα<strong>τ</strong>ο βρί<strong>σ</strong>κ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>ε</strong> έκ<strong>τ</strong>α<strong>σ</strong>η ή <strong>σ</strong><strong>ε</strong> <strong>ε</strong>λαφρά κάµψη ως<br />

20°, η <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ια <strong>τ</strong>ων µηριαίων κονδύλων, <strong>π</strong>ο<strong>υ</strong> έρχ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>ε</strong> <strong>ε</strong><strong>π</strong>αφή<br />

µ<strong>ε</strong> <strong>τ</strong>ις κνηµιαί<strong>ε</strong>ς γλήν<strong>ε</strong>ς, <strong>ε</strong>ίναι <strong>ε</strong>λαφρά κ<strong>υ</strong>ρ<strong>τ</strong>ή. Σ<strong>τ</strong>ην <strong>π</strong><strong>ε</strong>ρί<strong>π</strong><strong>τ</strong>ω<strong>σ</strong>η α<strong>υ</strong><strong>τ</strong>ή<br />

η <strong>τ</strong>ριβή ( Ρ) µ<strong>ε</strong><strong>τ</strong>αξύ <strong>τ</strong>ων αρθρικών <strong>ε</strong><strong>π</strong>ιφ<strong>αν</strong><strong>ε</strong>ιών <strong>ε</strong>ίναι αµ<strong>ε</strong>λη<strong>τ</strong>έα, <strong>ε</strong>ξα-

λ<strong>ε</strong>ίφ<strong>ε</strong><strong>τ</strong>αι η <strong>αν</strong><strong>τ</strong>αγωνι<strong>σ</strong><strong>τ</strong>ική δρά<strong>σ</strong>η <strong>τ</strong>ων ο<strong>π</strong>ί<strong>σ</strong>θιων µηριαίων ( Ο ) και η<br />

µόνη δύναµη <strong>π</strong>ο<strong>υ</strong> <strong>αν</strong><strong>τ</strong>ι<strong>σ</strong><strong>τ</strong>ρα<strong>τ</strong><strong>ε</strong>ύ<strong>ε</strong><strong>τ</strong>αι <strong>τ</strong>ην έλξη <strong>π</strong>ο<strong>υ</strong> α<strong>σ</strong>κ<strong>ε</strong>ί<strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ον<br />

<strong>ε</strong>ξ<strong>ε</strong><strong>τ</strong>α<strong>σ</strong><strong>τ</strong>ή (Τ), <strong>ε</strong>ίναι <strong>τ</strong>ο βάρος <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong>κέλο<strong>υ</strong>ς <strong>τ</strong>ο<strong>υ</strong> αθλη<strong>τ</strong>ή (\Λ/).<br />

Η µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρη αξιο<strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ία <strong>τ</strong>ης δοκιµα<strong>σ</strong>ίας Lachman <strong>σ</strong><strong>ε</strong> <strong>σ</strong>χέ<strong>σ</strong>η µ<strong>ε</strong><br />

<strong>τ</strong>ην <strong>π</strong>ρό<strong>σ</strong>θια <strong>σ</strong><strong>υ</strong>ρ<strong>τ</strong>αρο<strong>ε</strong>ιδή µ<strong>ε</strong> <strong>τ</strong>ο γόνα<strong>τ</strong>ο <strong>σ</strong><strong>ε</strong> κάµψη 90°, για <strong>τ</strong>η διάγνω<strong>σ</strong>η<br />

<strong>τ</strong>ων ρήξ<strong>ε</strong>ων <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ο<strong>υ</strong>, <strong>αν</strong>αγνωρίζ<strong>ε</strong><strong>τ</strong>αι και α<strong>π</strong>ό<br />

<strong>τ</strong>ον Larson 1982.<br />

Η δοκιµα<strong>σ</strong>ία Lachman αξιολογ<strong>ε</strong>ί<strong>τ</strong>αι βά<strong>σ</strong><strong>ε</strong>ι κλινικών <strong>π</strong>αρα<strong>τ</strong>ηρή<strong>σ</strong><strong>ε</strong>ων,<br />

µ<strong>ε</strong><strong>τ</strong>ρή<strong>σ</strong><strong>ε</strong>ων µ<strong>ε</strong> <strong>τ</strong>η <strong>σ</strong><strong>υ</strong><strong>σ</strong>κ<strong>ε</strong><strong>υ</strong>ή ΚΤ-2000 (ΚΤ-2000) και<br />

αρθρο<strong>σ</strong>κο<strong>π</strong>ηκών ή <strong>ε</strong>γχ<strong>ε</strong>ιρη<strong>τ</strong>ικών <strong>ε</strong><strong>υ</strong>ρηµά<strong>τ</strong>ων, ως <strong>ε</strong>ξής (Queale et<br />

al.1994):<br />

Lanchman 1+: Ελάχι<strong>σ</strong><strong>τ</strong>η <strong>π</strong>ρό<strong>σ</strong>θια <strong>π</strong>αρ<strong>ε</strong>κ<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>η <strong>τ</strong>ης κνήµης, <strong>αν</strong><strong>τ</strong>ιλη<strong>π</strong><strong>τ</strong>ή<br />

α<strong>π</strong>ό <strong>τ</strong>ον <strong>ε</strong>ξ<strong>ε</strong><strong>τ</strong>α<strong>σ</strong><strong>τ</strong>ή. Αν<strong>τ</strong>ι<strong>σ</strong><strong>τ</strong>οιχ<strong>ε</strong>ία ΚΤ-2000 :1mm ως 6mm<br />

Lanchman 2+: Ορα<strong>τ</strong>ή <strong>π</strong>ρό<strong>σ</strong>θια <strong>π</strong>αρ<strong>ε</strong>κ<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>η <strong>τ</strong>ης κνήµης. Αν<strong>τ</strong>ι<strong>σ</strong><strong>τ</strong>οιχ<strong>ε</strong>ία<br />

ΚΤ-2000 : 2mm ως 9mm<br />

Lanchman 3+: Πρό<strong>σ</strong>θια <strong>π</strong>αρ<strong>ε</strong>κ<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>η <strong>τ</strong>ης κνήµης, <strong>υ</strong><strong>π</strong>ό <strong>τ</strong>ην <strong>ε</strong><strong>π</strong>ίδρα<strong>σ</strong>η<br />

<strong>τ</strong>ο<strong>υ</strong> βάρο<strong>υ</strong>ς <strong>τ</strong>ο<strong>υ</strong> µηρού, µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό <strong>τ</strong>ο<strong>π</strong>οθέ<strong>τ</strong>η<strong>σ</strong>η <strong>υ</strong><strong>π</strong>ο<strong>σ</strong><strong>τ</strong>ηρίγ-<br />

µα<strong>τ</strong>ος <strong>σ</strong><strong>τ</strong>ο κά<strong>τ</strong>ω <strong>τ</strong>ρι<strong>τ</strong>ηµόριο <strong>τ</strong>ης κνήµης. Αν<strong>τ</strong>ι<strong>σ</strong><strong>τ</strong>οιχ<strong>ε</strong>ία ΚΤ-2000 :<br />

6MMως 16mm<br />

Lanchman 4+: Πρό<strong>σ</strong>θια <strong>π</strong>αρ<strong>ε</strong>κ<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>η <strong>τ</strong>ης κνήµης, κα<strong>τ</strong>ά <strong>τ</strong>η <strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η<br />

<strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong> (<strong>ε</strong>ν<strong>ε</strong>ργη<strong>τ</strong>ική δοκιµα<strong>σ</strong>ία), η ο<strong>π</strong>οία α<strong>π</strong><strong>ε</strong>ικονίζ<strong>ε</strong><strong>τ</strong>αι<br />

και ακ<strong>τ</strong>ινολογικά. Αν<strong>τ</strong>ι<strong>σ</strong><strong>τ</strong>οιχ<strong>ε</strong>ία ΚΤ-2000 : ΙΟmm ως 20mm.<br />

Η κλινική <strong>αν</strong><strong>τ</strong>ι<strong>σ</strong><strong>τ</strong>οιχ<strong>ε</strong>ία <strong>τ</strong>ης κλίµακας Lanchman έχ<strong>ε</strong>ι ως <strong>ε</strong>ξής :<br />

Lanchman 1+: Ε<strong>π</strong>ιµήκ<strong>υ</strong>ν<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ο<strong>υ</strong>.<br />

Lanchman 2+: Μ<strong>ε</strong>ρική ρήξη <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ο<strong>υ</strong>.<br />

Lanchman 3+ & 4+: Πλήρης ρήξη <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ο<strong>υ</strong>, µ<strong>ε</strong> <strong>π</strong>ρό<strong>σ</strong>θ<strong>ε</strong>ια<br />

α<strong>σ</strong><strong>τ</strong>άθ<strong>ε</strong>ια <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος. Παράγον<strong>τ</strong><strong>ε</strong>ς, ό<strong>π</strong>ως η <strong>σ</strong><strong>υ</strong>γγ<strong>ε</strong>νής <strong>υ</strong><strong>π</strong><strong>ε</strong>ρ<strong>ε</strong>λα<strong>σ</strong><strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>α<br />

<strong>τ</strong>ων αρθρώ<strong>σ</strong><strong>ε</strong>ων, η <strong>αν</strong><strong>ε</strong><strong>π</strong>άρκ<strong>ε</strong>ια <strong>τ</strong>ων <strong>π</strong>λαγίων <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µων<br />

και οι µηνι<strong>σ</strong>κικές βλάβ<strong>ε</strong>ς, <strong>ε</strong><strong>π</strong>ιβαρύνο<strong>υ</strong>ν <strong>τ</strong>ην κλινική <strong>ε</strong>ικόνα

Οι <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρές ακ<strong>τ</strong>ινογραφί<strong>ε</strong>ς <strong>ε</strong>νός <strong>π</strong>ρό<strong>σ</strong>φα<strong>τ</strong>α <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µένο<strong>υ</strong> γονά<strong>τ</strong>ο<strong>υ</strong>,<br />

θα δ<strong>ε</strong>ίξο<strong>υ</strong>ν κα<strong>τ</strong>ά βά<strong>σ</strong>η µόνο <strong>τ</strong>ο αίµαρθρο. Α<strong>υ</strong><strong>τ</strong>ό γίν<strong>ε</strong><strong>τ</strong>αι για<strong>τ</strong>ί η<br />

µ<strong>ε</strong>γάλη <strong>π</strong>λ<strong>ε</strong>ιονό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ων ρήξ<strong>ε</strong>ων <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>π</strong>αρα<strong>τ</strong>ηρούν<strong>τ</strong>αι<br />

<strong>σ</strong><strong>τ</strong>η µ<strong>ε</strong><strong>σ</strong>ό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong> και όχι <strong>σ</strong><strong>τ</strong>ις ο<strong>σ</strong><strong>τ</strong>ικές <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρο<strong>σ</strong>φύ<strong>σ</strong><strong>ε</strong>ις. Οι<br />

Κennedy και Flower <strong>αν</strong>αφέρο<strong>υ</strong>ν ό<strong>τ</strong>ι <strong>τ</strong>ο 72% 50 αρρώ<strong>σ</strong><strong>τ</strong>ων µ<strong>ε</strong> ρήξ<strong>ε</strong>ις<br />

<strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>ε</strong>ίχ<strong>αν</strong> <strong>π</strong>άθ<strong>ε</strong>ι ρήξη <strong>σ</strong><strong>τ</strong>η µ<strong>ε</strong><strong>σ</strong>ό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong>, ό<strong>π</strong>ως έδ<strong>ε</strong>ιξ<strong>αν</strong><br />

οι αρθρω<strong>τ</strong>οµές <strong>π</strong>ο<strong>υ</strong> έγιν<strong>αν</strong>. Οι Νoyes,De Lucas και Τorrible,<br />

κα<strong>τ</strong>έληξ<strong>αν</strong> µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό <strong>π</strong>ρω<strong>τ</strong>ό<strong>τ</strong><strong>υ</strong><strong>π</strong><strong>ε</strong>ς µ<strong>ε</strong>λέ<strong>τ</strong><strong>ε</strong>ς <strong>σ</strong><strong>τ</strong>ο ό<strong>τ</strong>ι οι µ<strong>ε</strong>γάλ<strong>ε</strong>ς<br />

<strong>τ</strong>αχύ<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς φόρ<strong>τ</strong>ι<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong> <strong>π</strong>ο<strong>υ</strong> <strong>σ</strong>χ<strong>ε</strong><strong>τ</strong>ίζον<strong>υ</strong>αι µ<strong>ε</strong> <strong>τ</strong>ο<strong>υ</strong>ς<br />

αθλη<strong>τ</strong>ικούς <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µούς <strong>π</strong>ροκαλούν ρήξ<strong>ε</strong>ις <strong>σ</strong><strong>τ</strong>η µ<strong>ε</strong><strong>σ</strong>ό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong><br />

<strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>. Ε<strong>π</strong>ί<strong>σ</strong>ης βρήκ<strong>αν</strong> ό<strong>τ</strong>ι οι µικρό<strong>τ</strong><strong>ε</strong>ρ<strong>ε</strong>ς <strong>τ</strong>αχύ<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς φόρ<strong>τ</strong>ι<strong>σ</strong>ης (<br />

µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ροι χρόνοι δρά<strong>σ</strong>ης <strong>τ</strong>ων δ<strong>υ</strong>νάµ<strong>ε</strong>ων <strong>π</strong>άνω <strong>σ</strong><strong>τ</strong>ο <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µο )<br />

<strong>ε</strong><strong>π</strong>ιφέρο<strong>υ</strong>ν α<strong>π</strong>οκόλλη<strong>σ</strong>η <strong>τ</strong>ης κνηµιαίας και <strong>σ</strong><strong>ε</strong> µικρό<strong>τ</strong><strong>ε</strong>ρη έκ<strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ης<br />

µηριαίας <strong>π</strong>ρό<strong>σ</strong>φ<strong>υ</strong><strong>σ</strong>ης.<br />

Το ά<strong>τ</strong>οµο µ<strong>ε</strong> ένα οξύ, 3 ο<strong>υ</strong> βαθµού <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µό <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong><br />

χια<strong>σ</strong><strong>τ</strong>ού, θα <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να <strong>ε</strong>ξ<strong>ε</strong><strong>τ</strong>α<strong>σ</strong><strong>τ</strong><strong>ε</strong>ί για να καθορι<strong>σ</strong><strong>τ</strong><strong>ε</strong>ί <strong>τ</strong>ο <strong>αν</strong> <strong>υ</strong><strong>π</strong>άρχ<strong>ε</strong>ι<br />

<strong>π</strong>αράλληλα <strong>π</strong>ρο<strong>σ</strong>θιο<strong>π</strong>λαγια <strong>σ</strong><strong>τ</strong>ροφική α<strong>σ</strong><strong>τ</strong>άθ<strong>ε</strong>ια. Α<strong>υ</strong><strong>τ</strong>ό <strong>ε</strong>ίναι <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικό<br />

για<strong>τ</strong>ί οi McDevit και muur, οι Marchall και Οlsen έχο<strong>υ</strong>ν δ<strong>ε</strong>ίξ<strong>ε</strong>ι <strong>π</strong>άνω <strong>σ</strong><strong>ε</strong><br />

<strong>σ</strong>κύλο<strong>υ</strong>ς και άλλοι <strong>σ</strong><strong>ε</strong> <strong>αν</strong>θρώ<strong>π</strong>ο<strong>υ</strong>ς ό<strong>τ</strong>ι ο <strong>π</strong>ροβληµα<strong>τ</strong>ικός <strong>π</strong>ρό<strong>σ</strong>θιος<br />

χια<strong>σ</strong><strong>τ</strong>ός και η <strong>π</strong>ρο<strong>σ</strong>θιο<strong>π</strong>λαγια <strong>σ</strong><strong>τ</strong>ροφική α<strong>σ</strong><strong>τ</strong>άθ<strong>ε</strong>ια <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος<br />

<strong>σ</strong>χ<strong>ε</strong><strong>τ</strong>ίζον<strong>τ</strong>αι µ<strong>ε</strong> <strong>τ</strong>ην <strong>αν</strong>ά<strong>π</strong><strong>τ</strong><strong>υ</strong>ξη <strong>ε</strong>κφ<strong>υ</strong>λι<strong>σ</strong><strong>τ</strong>ικής αρθρί<strong>τ</strong>ιδας.<br />

Υ<strong>π</strong>άρχο<strong>υ</strong>ν <strong>π</strong>ολλά διαγνω<strong>σ</strong><strong>τ</strong>ικά test για <strong>τ</strong>ον καθορι<strong>σ</strong>µό <strong>τ</strong>ο<strong>υ</strong> <strong>ε</strong><strong>π</strong>ι<strong>π</strong>έδο<strong>υ</strong><br />

<strong>τ</strong>ης <strong>π</strong>ρο<strong>σ</strong>θιο<strong>π</strong>λάγιας <strong>σ</strong><strong>τ</strong>ροφικής α<strong>σ</strong><strong>τ</strong>άθ<strong>ε</strong>ιας. Α<strong>υ</strong><strong>τ</strong>ά <strong>π</strong><strong>ε</strong>ριλαµβάνο<strong>υ</strong>ν: (α) <strong>τ</strong>ο<br />

ίθδί <strong>σ</strong><strong>τ</strong>ροφικής µ<strong>ε</strong><strong>τ</strong>α<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>ης ( Ρivot Shift test), (β) <strong>τ</strong>ο GERK TEST, (γ) <strong>τ</strong>ο<br />

<strong>σ</strong><strong>υ</strong>ρ<strong>τ</strong>αρω<strong>τ</strong>ό κάµψης-<strong>σ</strong><strong>τ</strong>ροφής, (δ) Lossee test. Το Ρivot SHIFT TEST<br />

<strong>π</strong>ο<strong>υ</strong> <strong>ε</strong>ίναι και <strong>τ</strong>ο α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong><strong>σ</strong>µα<strong>τ</strong>ικό<strong>τ</strong><strong>ε</strong>ρο <strong>π</strong>ραγµα<strong>τ</strong>ο<strong>π</strong>οι<strong>ε</strong>ί<strong>τ</strong>αι µ<strong>ε</strong> <strong>τ</strong>ον<br />

<strong>π</strong>αρακά<strong>τ</strong>ω <strong>τ</strong>ρό<strong>π</strong>ο:

Ο α<strong>σ</strong>θ<strong>ε</strong>νής ξα<strong>π</strong>λών<strong>ε</strong>ι ύ<strong>π</strong><strong>τ</strong>ια <strong>σ</strong><strong>τ</strong>ο κρ<strong>ε</strong>βά<strong>τ</strong>ι. Η κνήµη <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µένο<strong>υ</strong><br />

κρα<strong>τ</strong>ιέ<strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ο ύψος <strong>τ</strong>ο<strong>υ</strong> κνηµιαίο<strong>υ</strong> κ<strong>υ</strong>ρ<strong>τ</strong>ώµα<strong>τ</strong>ος α<strong>π</strong>ό <strong>τ</strong>ο δ<strong>ε</strong>ξί<br />

ή αρι<strong>σ</strong><strong>τ</strong><strong>ε</strong>ρό χέρι <strong>τ</strong>ο<strong>υ</strong> <strong>ε</strong>ξ<strong>ε</strong><strong>τ</strong>α<strong>σ</strong><strong>τ</strong>ή µ<strong>ε</strong> <strong>τ</strong>ο γόνα<strong>τ</strong>ο <strong>σ</strong><strong>ε</strong> <strong>τ</strong>έλ<strong>ε</strong>ια έκ<strong>τ</strong>α<strong>σ</strong>η ( <strong>τ</strong>ο<br />

δ<strong>ε</strong>ξί χέρι θα <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να κρα<strong>τ</strong>ά<strong>ε</strong>ι <strong>τ</strong>ην κνήµη για να <strong>ε</strong>ξ<strong>ε</strong><strong>τ</strong>α<strong>σ</strong><strong>τ</strong><strong>ε</strong>ί <strong>τ</strong>ο αρι<strong>σ</strong><strong>τ</strong><strong>ε</strong>ρό<br />

γόνα<strong>τ</strong>ο και <strong>τ</strong>ο αρι<strong>σ</strong><strong>τ</strong><strong>ε</strong>ρό χέρι για <strong>τ</strong>ο δ<strong>ε</strong>ξί). Το <strong>αν</strong><strong>τ</strong>ίθ<strong>ε</strong><strong>τ</strong>ο χέρι<br />

<strong>π</strong>ιάν<strong>ε</strong>ι <strong>τ</strong>ο <strong>σ</strong>ύ<strong>σ</strong><strong>τ</strong>οιχο α<strong>σ</strong><strong>τ</strong>ράγαλο και <strong>ε</strong>φαρµόζ<strong>ε</strong>ι <strong>τ</strong>η µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρη δ<strong>υ</strong>να<strong>τ</strong>ή<br />

έ<strong>σ</strong>ω <strong>σ</strong><strong>τ</strong>ροφή. Μ<strong>ε</strong><strong>τ</strong>ά <strong>τ</strong>ο γόνα<strong>τ</strong>ο κάµ<strong>π</strong><strong>τ</strong><strong>ε</strong><strong>τ</strong>αι και <strong>τ</strong>ο χέρι <strong>π</strong>ο<strong>υ</strong> βρί<strong>σ</strong>κ<strong>ε</strong><strong>τ</strong>αι<br />

κον<strong>τ</strong>ά <strong>σ</strong><strong>τ</strong>ο γόνα<strong>τ</strong>ο <strong>ε</strong>φαρµόζ<strong>ε</strong>ι µια δύναµη <strong>π</strong>ο<strong>υ</strong> <strong>υ</strong><strong>π</strong>οβάλλ<strong>ε</strong>ι <strong>τ</strong>ο γόνα<strong>τ</strong>ο<br />

<strong>σ</strong><strong>ε</strong> βλαι<strong>σ</strong>ό<strong>τ</strong>η<strong>τ</strong>α. Κα<strong>τ</strong>ά <strong>τ</strong>η διάρκ<strong>ε</strong>ια <strong>τ</strong>ο<strong>υ</strong> χ<strong>ε</strong>ιρι<strong>σ</strong>µού ο <strong>ε</strong>ξ<strong>ε</strong><strong>τ</strong>α<strong>σ</strong><strong>τ</strong>ής<br />

θα αι<strong>σ</strong>θ<strong>αν</strong>θ<strong>ε</strong>ί και ο α<strong>σ</strong>θ<strong>ε</strong>νής θα κα<strong>τ</strong>αλάβ<strong>ε</strong>ι µια α<strong>π</strong>ό<strong>τ</strong>οµη µ<strong>ε</strong><strong>τ</strong>α<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>η<br />

<strong>τ</strong>ης κνήµης <strong>π</strong>άνω <strong>σ</strong><strong>τ</strong>ο µηριαίο <strong>αν</strong> <strong>τ</strong>ο test <strong>ε</strong>ίναι θ<strong>ε</strong><strong>τ</strong>ικό. Η <strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ό<strong>τ</strong>η<strong>τ</strong>α<br />

α<strong>υ</strong><strong>τ</strong>ού <strong>τ</strong>ο<strong>υ</strong> test <strong>σ</strong><strong>τ</strong>ον καθορι<strong>σ</strong>µό <strong>τ</strong>ο<strong>υ</strong> <strong>ε</strong><strong>π</strong>ι<strong>π</strong>έδο<strong>υ</strong> <strong>τ</strong>ης <strong>π</strong>ρο<strong>σ</strong>θιο<strong>π</strong>λάγιας<br />

<strong>σ</strong><strong>τ</strong>ροφικής α<strong>σ</strong><strong>τ</strong>άθ<strong>ε</strong>ιας ή <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ροβλήµα<strong>τ</strong>ος <strong>σ</strong><strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό έ-<br />

χ<strong>ε</strong>ι <strong>ε</strong><strong>π</strong>ιβ<strong>ε</strong>βαιωθ<strong>ε</strong>ί α<strong>π</strong>ό <strong>τ</strong>ο<strong>υ</strong>ς Felto και Μarchall. Α<strong>υ</strong><strong>τ</strong>οί βρήκ<strong>αν</strong> ό<strong>τ</strong>ι η<br />

α<strong>π</strong>οκο<strong>π</strong>ή <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>π</strong>αρήγαγ<strong>ε</strong> ένα θ<strong>ε</strong><strong>τ</strong>ικό Ρivot Shift<br />

<strong>σ</strong>ηµ<strong>ε</strong>ίο <strong>σ</strong><strong>ε</strong> 33 α<strong>π</strong>ό <strong>τ</strong>α 37 <strong>π</strong><strong>τ</strong>ωµα<strong>τ</strong>ικά γόνα<strong>τ</strong>α. Ω<strong>σ</strong><strong>τ</strong>ό<strong>σ</strong>ο <strong>π</strong>αρα<strong>τ</strong>ήρη<strong>σ</strong><strong>αν</strong><br />

ό<strong>τ</strong>ι και η <strong>π</strong>ολύ µ<strong>ε</strong>γάλη αλλά φ<strong>υ</strong><strong>σ</strong>ιολογική χαλαρό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ων µαλακών<br />

ι<strong>σ</strong><strong>τ</strong>ών µ<strong>π</strong>ορ<strong>ε</strong>ί να <strong>π</strong>ροκαλέ<strong>σ</strong><strong>ε</strong>ι ένα λάθος θ<strong>ε</strong><strong>τ</strong>ικό <strong>σ</strong>ηµ<strong>ε</strong>ίο.<br />

Το <strong>τ</strong><strong>ε</strong><strong>σ</strong><strong>τ</strong> <strong>σ</strong><strong>τ</strong>ροφικής µ<strong>ε</strong><strong>τ</strong>α<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>ης (PIVOT SHIFT TEST)

Σ<strong>ε</strong> µ<strong>ε</strong>µονωµέν<strong>ε</strong>ς ρήξ<strong>ε</strong>ις <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού, η <strong>π</strong>ρό<strong>σ</strong>θια <strong>σ</strong><strong>υ</strong>ρ<strong>τ</strong>αρο<strong>ε</strong>ιδής<br />

δοκιµα<strong>σ</strong>ία <strong>ε</strong>ίναι θ<strong>ε</strong><strong>τ</strong>ική <strong>σ</strong><strong>τ</strong>ο 54% <strong>τ</strong>ων <strong>π</strong><strong>ε</strong>ρι<strong>π</strong><strong>τ</strong>ώ<strong>σ</strong><strong>ε</strong>ων κα<strong>τ</strong>ά<br />

<strong>τ</strong>ην αρχική <strong>ε</strong>ξέ<strong>τ</strong>α<strong>σ</strong>η και <strong>σ</strong><strong>τ</strong>ο 81% κα<strong>τ</strong>ά <strong>τ</strong>ην <strong>ε</strong>ξέ<strong>τ</strong>α<strong>σ</strong>η <strong>υ</strong><strong>π</strong>ογ<strong>ε</strong>ν<strong>ε</strong><strong>τ</strong>ική<br />

νάρκω<strong>σ</strong>η, <strong>ε</strong>νώ <strong>τ</strong>α <strong>αν</strong><strong>τ</strong>ί<strong>σ</strong><strong>τ</strong>οιχα <strong>π</strong>ο<strong>σ</strong>ο<strong>σ</strong><strong>τ</strong>ά για <strong>τ</strong>η δοκιµα<strong>σ</strong>ία Lanchman<br />

<strong>ε</strong>ίναι 98% και 100% και για <strong>τ</strong>η δοκιµα<strong>σ</strong>ία Ρΐvot Shift <strong>ε</strong>ίναι 97% και<br />

100% (Donaldos et al. 1985).<br />

Η διάγνω<strong>σ</strong>η <strong>υ</strong><strong>π</strong>οβοηθ<strong>ε</strong>ί<strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ις α<strong>π</strong>λές ακ<strong>τ</strong>ινογραφί<strong>ε</strong>ς µ<strong>ε</strong> <strong>τ</strong>ις<br />

ο<strong>π</strong>οί<strong>ε</strong>ς <strong>ε</strong>λέγχ<strong>ε</strong><strong>τ</strong>αι η ύ<strong>π</strong>αρξη α<strong>π</strong>ο<strong>σ</strong><strong>π</strong>α<strong>σ</strong><strong>τ</strong>ικού κα<strong>τ</strong>άγµα<strong>τ</strong>ος <strong>τ</strong>ης έξω<br />

κνηµιαίας γλήνης <strong>π</strong>ο<strong>υ</strong> χαρακ<strong>τ</strong>ηρίζ<strong>ε</strong><strong>τ</strong>αι α<strong>π</strong>ό α<strong>π</strong>ό<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> µηνι<strong>σ</strong>κοκνηµιαίο<strong>υ</strong><br />

<strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong> µ<strong>ε</strong>ζί µ<strong>ε</strong> ο<strong>σ</strong><strong>τ</strong>ικό <strong>τ</strong><strong>ε</strong>µάχιο και <strong>ε</strong>ίναι γνω<strong>σ</strong><strong>τ</strong>ό<br />

ως « κά<strong>τ</strong>αγµα Segond ». Προκαλ<strong>ε</strong>ί<strong>τ</strong>αι κα<strong>τ</strong>ά <strong>τ</strong>ην κάµψη <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος<br />

και <strong>τ</strong>ην έ<strong>σ</strong>ω <strong>σ</strong><strong>τ</strong>ροφή <strong>τ</strong>ης κνήµης και <strong>π</strong>αρα<strong>τ</strong>ηρ<strong>ε</strong>ί<strong>τ</strong>αι <strong>σ</strong><strong>ε</strong> ρήξ<strong>ε</strong>ις <strong>τ</strong>ο<strong>υ</strong><br />

<strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού (Ηess et al. 1994).<br />

Ιδιαί<strong>τ</strong><strong>ε</strong>ρη <strong>σ</strong><strong>υ</strong>µβολή <strong>σ</strong><strong>τ</strong>η διάγνω<strong>σ</strong>η ρήξ<strong>ε</strong>ων <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού<br />

και <strong>τ</strong>ων <strong>σ</strong><strong>υ</strong>νοδών ο<strong>σ</strong><strong>τ</strong>ικών κακώ<strong>σ</strong><strong>ε</strong>ων έχ<strong>ε</strong>ι η µαγνη<strong>τ</strong>ική <strong>τ</strong>οµογραφία,<br />

<strong>τ</strong>ο <strong>π</strong>ο<strong>σ</strong>ο<strong>σ</strong><strong>τ</strong>ό ακριβ<strong>ε</strong>ίας <strong>τ</strong>ης ο<strong>π</strong>οίας κ<strong>υ</strong>µαίν<strong>ε</strong><strong>τ</strong>αι µ<strong>ε</strong><strong>τ</strong>αξύ 90% και<br />

100%.<br />

Η διάγνω<strong>σ</strong>η <strong>τ</strong><strong>ε</strong>κµηριών<strong>ε</strong><strong>τ</strong>αι µ<strong>ε</strong> <strong>τ</strong>ην αρθρο<strong>σ</strong>κό<strong>π</strong>η<strong>σ</strong>η, µ<strong>ε</strong> <strong>τ</strong>ην ο<strong>π</strong>οία<br />

<strong>ε</strong>ίναι δ<strong>υ</strong>να<strong>τ</strong>ή η <strong>π</strong>αράλληλη διάγνω<strong>σ</strong>η και α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ης <strong>σ</strong><strong>υ</strong>νδ<strong>ε</strong><strong>σ</strong>µικής<br />

βλάβης.

3.3 ΑΝΤΙΜΕΤΩΠΙΣΗ ΡΗΞΗΣ ΤΟΥ ΠΡΟΣΘΙΟΥ ΧΙΑΣΤΟΥ<br />

Έχ<strong>ε</strong>ι γίν<strong>ε</strong>ι α<strong>π</strong>οδ<strong>ε</strong>κ<strong>τ</strong>ό α<strong>π</strong>ό όλο<strong>υ</strong>ς ό<strong>τ</strong>ι ο ρόλος και η <strong>σ</strong>ηµα<strong>σ</strong>ία <strong>τ</strong>ων<br />

χια<strong>σ</strong><strong>τ</strong>ών <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µων <strong>ε</strong>ίναι ιδιαί<strong>τ</strong><strong>ε</strong>ρα <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικός, <strong>τ</strong>ό<strong>σ</strong>ο για <strong>τ</strong>ην οµαλή<br />

λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργία <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος ό<strong>σ</strong>ο και για <strong>τ</strong>η <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong>. Μ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό<br />

<strong>π</strong><strong>ε</strong>ιραµα<strong>τ</strong>ικές µ<strong>ε</strong>λέ<strong>τ</strong><strong>ε</strong>ς <strong>π</strong>ο<strong>υ</strong> έγιν<strong>αν</strong> <strong>σ</strong><strong>τ</strong>ην Ορθο<strong>π</strong>αιδική κλινική <strong>τ</strong>ο<strong>υ</strong><br />

Α.Π.Θ. (Πο<strong>υ</strong>ρνάρας 1980), α<strong>π</strong>οδ<strong>ε</strong>ίχ<strong>τ</strong>ηκ<strong>ε</strong> ό<strong>τ</strong>ι ο ρόλος <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong><br />

χια<strong>σ</strong><strong>τ</strong>ού <strong>ε</strong>ίναι <strong>π</strong>ιο <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικός α<strong>π</strong>ό α<strong>υ</strong><strong>τ</strong>όν <strong>τ</strong>ο<strong>υ</strong> ο<strong>π</strong>ί<strong>σ</strong>θιο<strong>υ</strong>, χωρίς φ<strong>υ</strong><strong>σ</strong>ικά<br />

να <strong>υ</strong><strong>π</strong>ο<strong>τ</strong>ιµά<strong>τ</strong>αι ο ρόλος <strong>τ</strong>ο<strong>υ</strong> δ<strong>ε</strong>ύ<strong>τ</strong><strong>ε</strong>ρο<strong>υ</strong>. Α<strong>π</strong>ό ό<strong>σ</strong>ο<strong>υ</strong>ς έχο<strong>υ</strong>ν α<strong><strong>σ</strong>χολη</strong>θ<strong>ε</strong>ί<br />

ιδιαί<strong>τ</strong><strong>ε</strong>ρα µ<strong>ε</strong> <strong>τ</strong>ο θέµα θ<strong>ε</strong>ωρ<strong>ε</strong>ί<strong>τ</strong>αι ό<strong>τ</strong>ι η ρήξη <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού,<br />

<strong>ε</strong>άν αφ<strong>ε</strong>θ<strong>ε</strong>ί ως έχ<strong>ε</strong>ι, α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί <strong>τ</strong>ην αρχή <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong>έλο<strong>υ</strong>ς <strong>τ</strong>ο<strong>υ</strong> γόνα-

<strong>τ</strong>ος. Γ<strong>ε</strong>γονός <strong>π</strong>ο<strong>υ</strong> <strong>σ</strong>ηµαίν<strong>ε</strong>ι ό<strong>τ</strong>ι µ<strong>ε</strong> <strong>τ</strong>η ρήξη αρχίζ<strong>ε</strong>ι µια <strong>σ</strong><strong>ε</strong>ιρά γ<strong>ε</strong>γονό<strong>τ</strong>ων,<br />

<strong>π</strong>ο<strong>υ</strong> <strong>π</strong><strong>ε</strong>ριλαµβάν<strong>ε</strong>ι κα<strong>τ</strong>ά <strong>σ</strong><strong>ε</strong>ιρά <strong>τ</strong>η <strong>σ</strong><strong>τ</strong>ροφική α<strong>σ</strong><strong>τ</strong>άθ<strong>ε</strong>ια, <strong>τ</strong>η ρήξη<br />

<strong>τ</strong>ο<strong>υ</strong> έ<strong>σ</strong>ω και έξω µηνί<strong>σ</strong>κο<strong>υ</strong> ως α<strong>π</strong>ο<strong>τ</strong>έλ<strong>ε</strong><strong>σ</strong>µα <strong>τ</strong>ης <strong>σ</strong><strong>τ</strong>ροφικής α<strong>σ</strong><strong>τ</strong>άθ<strong>ε</strong>ιας<br />

και <strong>τ</strong>έλος <strong>τ</strong>ις ο<strong>σ</strong><strong>τ</strong><strong>ε</strong>οαρθρι<strong>τ</strong>ικές αλλοιώ<strong>σ</strong><strong>ε</strong>ις και <strong>τ</strong>ην ολική κα<strong>τ</strong>α<strong>σ</strong><strong>τ</strong>ροφή<br />

<strong>τ</strong>ης άρθρω<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος.<br />

Σ<strong>τ</strong>όχοι <strong>τ</strong>ης θ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong><strong>υ</strong><strong>τ</strong>ικής αγωγής <strong>ε</strong>ίναι η α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ης<br />

<strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρό<strong>τ</strong>η<strong>τ</strong>ας <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, <strong>π</strong>ο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>νδέ<strong>ε</strong><strong>τ</strong>αι άµ<strong>ε</strong><strong>σ</strong>α µ<strong>ε</strong> <strong>τ</strong>ην <strong>π</strong>ρο<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ία<br />

<strong>τ</strong>ων µηνί<strong>σ</strong>κων και <strong>τ</strong>ων αρθρικών χόνδρων και η <strong>τ</strong>αχύ<strong>τ</strong><strong>ε</strong>ρη, κα<strong>τ</strong>ά<br />

<strong>τ</strong>ο δ<strong>υ</strong>να<strong>τ</strong>όν, <strong>ε</strong><strong>π</strong>άνοδος <strong>σ</strong><strong>ε</strong> αθλη<strong>τ</strong>ική δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong>α. Ό<strong>τ</strong><strong>αν</strong> <strong>τ</strong>ο γόνα<strong>τ</strong>ο<br />

<strong>ε</strong>µφ<strong>αν</strong>ίζ<strong>ε</strong>ι α<strong>σ</strong><strong>τ</strong>άθ<strong>ε</strong>ια, οι µηνί<strong>σ</strong>κοι και ιδιαί<strong>τ</strong><strong>ε</strong>ρα ο έ<strong>σ</strong>ω, <strong>υ</strong>φί<strong>σ</strong><strong>τ</strong><strong>αν</strong><strong>τ</strong>αι <strong>τ</strong>η<br />

δρά<strong>σ</strong>η δ<strong>υ</strong>νάµ<strong>ε</strong>ων, <strong>π</strong>ο<strong>υ</strong> µ<strong>π</strong>ορούν να <strong>π</strong>ροκαλέ<strong>σ</strong>ο<strong>υ</strong>ν διαφόρο<strong>υ</strong> βαθ-<br />

µού ρήξ<strong>ε</strong>ις.<br />

Μ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό µηνι<strong>σ</strong><strong>ε</strong>κ<strong>τ</strong>οµή <strong>π</strong><strong>ε</strong>ριορίζ<strong>ε</strong><strong>τ</strong>αι η δ<strong>υ</strong>να<strong>τ</strong>ό<strong>τ</strong>η<strong>τ</strong>α α<strong>π</strong>ό<strong>σ</strong>β<strong>ε</strong><strong>σ</strong>ης<br />

<strong>τ</strong>ων κραδα<strong>σ</strong>µών και <strong>ε</strong><strong>π</strong>ηρ<strong>ε</strong>άζ<strong>ε</strong><strong>τ</strong>αι η κινη<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, µ<strong>ε</strong><br />

α<strong>π</strong>ο<strong>τ</strong>έλ<strong>ε</strong><strong>σ</strong>µα <strong>τ</strong>η δ<strong>υ</strong><strong>σ</strong>λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργία <strong>τ</strong>ης άρθρω<strong>σ</strong>ης κα<strong>τ</strong>ά <strong>τ</strong>ην <strong>ε</strong>µφάνι<strong>σ</strong>η<br />

ο<strong>σ</strong><strong>τ</strong><strong>ε</strong>οαρθρί<strong>τ</strong>ιδας.<br />

Μ<strong>ε</strong> <strong>τ</strong>ην α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ης <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρό<strong>τ</strong>η<strong>τ</strong>ας <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, διαφ<strong>υ</strong>λά<strong>σ</strong><strong>σ</strong><strong>ε</strong><strong>τ</strong>αι<br />

η ακ<strong>ε</strong>ραιό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ων µηνί<strong>σ</strong>κων και <strong>τ</strong>ων αρθρικών χόνδρων

και <strong>π</strong>ρολαµβάν<strong>ε</strong><strong>τ</strong>αι ή καθ<strong>υ</strong><strong>σ</strong><strong>τ</strong><strong>ε</strong>ρ<strong>ε</strong>ί η <strong>ε</strong>µφάνι<strong>σ</strong>η ο<strong>σ</strong><strong>τ</strong><strong>ε</strong>οαρθρικών αλλοιώ<strong>σ</strong><strong>ε</strong>ων.<br />

Αθλήµα<strong>τ</strong>α, ό<strong>π</strong>ως <strong>τ</strong>ο <strong>π</strong>οδό<strong>σ</strong>φαιρο, η χ<strong>ε</strong>ιρο<strong>σ</strong>φαίρι<strong>σ</strong>η, η καλαθο<strong>σ</strong>φαίρι<strong>σ</strong>η,<br />

η <strong>π</strong><strong>ε</strong><strong>τ</strong>ο<strong>σ</strong>φαίρι<strong>σ</strong>η, η <strong>αν</strong><strong>τ</strong>ι<strong>σ</strong>φαίρι<strong>σ</strong>η, η <strong>ε</strong>νόργ<strong>αν</strong>η γ<strong>υ</strong>µνα<strong>σ</strong><strong>τ</strong>ική, <strong>τ</strong>ο<br />

hokey και οι χιονοδροµί<strong>ε</strong>ς, χαρακ<strong>τ</strong>ηρίζον<strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>αχύ<strong>τ</strong>α<strong>τ</strong><strong>ε</strong>ς διαδοχικές<br />

<strong>ε</strong><strong>π</strong>ι<strong>τ</strong>αχύν<strong>σ</strong><strong>ε</strong>ις, <strong>ε</strong><strong>π</strong>ιβραδύν<strong>σ</strong><strong>ε</strong>ις, <strong>σ</strong><strong>τ</strong>ροφές <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος και άλµα<strong>τ</strong>α, <strong>π</strong>ο<strong>υ</strong><br />

<strong>ε</strong><strong>π</strong>ιβαρύνο<strong>υ</strong>ν ιδιαί<strong>τ</strong><strong>ε</strong>ρα <strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό ( κeene et al. 1993,<br />

shelbourne & gonson 1993, paletta& awarren 1994).<br />

Παράγον<strong>τ</strong><strong>ε</strong>ς <strong>π</strong>ο<strong>υ</strong> <strong>ε</strong><strong>π</strong>ηρ<strong>ε</strong>άζο<strong>υ</strong>ν <strong>τ</strong>ην <strong>ε</strong><strong>π</strong>ιλογή <strong>τ</strong>ης <strong>σ</strong><strong>υ</strong>ν<strong>τ</strong>ηρη<strong>τ</strong>ικής ή <strong>τ</strong>ης<br />

<strong>ε</strong>γχ<strong>ε</strong>ιρη<strong>τ</strong>ικής αγωγής, <strong>ε</strong>ίναι οι λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργικές α<strong>π</strong>αι<strong>τ</strong>ή<strong>σ</strong><strong>ε</strong>ις <strong>τ</strong>ο<strong>υ</strong> αθλη<strong>τ</strong>ή, η<br />

ηλικία, <strong>τ</strong>ο <strong>ε</strong><strong>π</strong>ί<strong>π</strong><strong>ε</strong>δο <strong>τ</strong>ων αθλη<strong>τ</strong>ικών <strong>ε</strong>να<strong>σ</strong>χολή<strong>σ</strong><strong>ε</strong>ων, οι καθηµ<strong>ε</strong>ρινές<br />

δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς και <strong>τ</strong>ο <strong>ε</strong><strong>π</strong>άγγ<strong>ε</strong>λµα <strong>τ</strong>ο<strong>υ</strong>. Η ηλικία α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικό<br />

<strong>π</strong>αράγον<strong>τ</strong>α, <strong>ε</strong><strong>π</strong><strong>ε</strong>ιδή <strong>σ</strong><strong>ε</strong> ν<strong>ε</strong>αρά ά<strong>τ</strong>οµα <strong>τ</strong>ρο<strong>π</strong>ο<strong>π</strong>οιούν<strong>τ</strong>αι δ<strong>υ</strong><strong>σ</strong>κολό<strong>τ</strong><strong>ε</strong>ρα οι<br />

αθλη<strong>τ</strong>ικές δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς, <strong>ε</strong><strong>π</strong>οµένως <strong>τ</strong>ο α<strong>π</strong>ο<strong>τ</strong>έλ<strong>ε</strong><strong>σ</strong>µα <strong>τ</strong>ης <strong>σ</strong><strong>υ</strong>ν<strong>τ</strong>ηρη<strong>τ</strong>ικής<br />

θ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong>ίας δ<strong>ε</strong>ν <strong>ε</strong>ίναι <strong>π</strong>άν<strong>τ</strong>ο<strong>τ</strong><strong>ε</strong> ικ<strong>αν</strong>ο<strong>π</strong>οιη<strong>τ</strong>ικό.<br />

Πολλοί αθλη<strong>τ</strong>ές µ<strong>ε</strong> χαλαρό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού, <strong>π</strong>ο<strong>υ</strong> <strong>αν</strong><strong>τ</strong>ι-<br />

µ<strong>ε</strong><strong>τ</strong>ω<strong>π</strong>ί<strong>σ</strong><strong>τ</strong>ηκ<strong>ε</strong> <strong>σ</strong><strong>υ</strong>ν<strong>τ</strong>ηρη<strong>τ</strong>ικά, µ<strong>π</strong>ορούν να <strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ρέψο<strong>υ</strong>ν <strong>σ</strong><strong>ε</strong> αθλη<strong>τ</strong>ική<br />

δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong>α χαµηλό<strong>τ</strong><strong>ε</strong>ρης όµως έν<strong>τ</strong>α<strong>σ</strong>ης και <strong>π</strong>ρο<strong>σ</strong>αρµόζον<strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ην<br />

α<strong>σ</strong><strong>τ</strong>άθ<strong>ε</strong>ια <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, <strong>τ</strong>ρο<strong>π</strong>ο<strong>π</strong>οιών<strong>τ</strong>ας ορι<strong>σ</strong>µέν<strong>ε</strong>ς κινή<strong>σ</strong><strong>ε</strong>ις. Αν<strong>τ</strong>ίθ<strong>ε</strong><strong>τ</strong>α <strong>σ</strong><strong>ε</strong><br />

αθλη<strong>τ</strong>ές <strong>υ</strong>ψηλών <strong>ε</strong><strong>π</strong>ιδό<strong>σ</strong><strong>ε</strong>ων, η χ<strong>ε</strong>ιρο<strong>υ</strong>ργική <strong>αν</strong><strong>τ</strong>ιµ<strong>ε</strong><strong>τ</strong>ώ<strong>π</strong>ι<strong>σ</strong>η α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί <strong>τ</strong>η<br />

θ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong>ία <strong>ε</strong>κλογής.<br />

Α<strong>π</strong>ό <strong>π</strong>ολλούς <strong>σ</strong><strong>υ</strong>γγραφ<strong>ε</strong>ίς αµφι<strong>σ</strong>βη<strong>τ</strong><strong>ε</strong>ί<strong>τ</strong>αι <strong>π</strong>λέον ο « χρ<strong>υ</strong><strong>σ</strong>ός κ<strong>αν</strong>όνας »<br />

<strong>τ</strong>ο<strong>υ</strong> Ρpalmer (1938), <strong>π</strong>ο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>νι<strong>σ</strong><strong>τ</strong>ά άµ<strong>ε</strong><strong>σ</strong>η χ<strong>ε</strong>ιρο<strong>υ</strong>ργική <strong>ε</strong><strong>π</strong>έµβα<strong>σ</strong>η <strong>ε</strong>ν<strong>τ</strong>ός<br />

<strong>τ</strong>ων δύο <strong>π</strong>ρώ<strong>τ</strong>ων <strong>ε</strong>βδοµάδων α<strong>π</strong>ό <strong>τ</strong>ην κάκω<strong>σ</strong>η, <strong>ε</strong><strong>π</strong><strong>ε</strong>ιδή η <strong>ε</strong><strong>π</strong><strong>ε</strong>ίγο<strong>υ</strong><strong>σ</strong>α<br />

χ<strong>ε</strong>ιρο<strong>υ</strong>ργική <strong>ε</strong><strong>π</strong>έµβα<strong>σ</strong>η <strong>σ</strong><strong>υ</strong>νδέ<strong>ε</strong><strong>τ</strong>αι µ<strong>ε</strong> α<strong>υ</strong>ξηµένη <strong>σ</strong><strong>υ</strong>χνό<strong>τ</strong>η<strong>τ</strong>α <strong>αν</strong>ά<strong>π</strong><strong>τ</strong><strong>υ</strong>ξης<br />

µ<strong>ε</strong><strong>τ</strong><strong>ε</strong>γχ<strong>ε</strong>ιρη<strong>τ</strong>ικών <strong>σ</strong><strong>υ</strong>µφύ<strong>σ</strong><strong>ε</strong>ων <strong>σ</strong><strong>τ</strong>ην άρθρω<strong>σ</strong>η ( Strum et al. 1990,<br />

Shelbourne et al. 1991, Ηarmer et al. 1992, \Λ/asilewksi et al. 1993,<br />

paletta&warren 1994, Wasilewski & Koth & 1994)

Οι <strong>σ</strong><strong>υ</strong>γγραφ<strong>ε</strong>ίς <strong>π</strong>ρο<strong>τ</strong><strong>ε</strong>ίνο<strong>υ</strong>ν <strong>π</strong>αροχέ<strong>τ</strong><strong>ε</strong><strong>υ</strong><strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> αιµάρθρο<strong>υ</strong> και καθ<strong>υ</strong><strong>σ</strong><strong>τ</strong>έρη<strong>σ</strong>η<br />

<strong>τ</strong>ης <strong>ε</strong><strong>π</strong>έµβα<strong>σ</strong>ης για 3 έως 6 <strong>ε</strong>βδοµάδ<strong>ε</strong>ς, <strong>σ</strong><strong>τ</strong>ο διά<strong>σ</strong><strong>τ</strong>ηµα<br />

<strong>τ</strong>ων ο<strong>π</strong>οίων <strong>ε</strong>φαρµόζ<strong>ε</strong><strong>τ</strong>αι <strong>π</strong>ρόγραµµα φ<strong>υ</strong><strong>σ</strong>ιοθ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong>ίας, <strong>π</strong>ο<strong>υ</strong> <strong>π</strong><strong>ε</strong>ριλαµβάν<strong>ε</strong>ι<br />

<strong>τ</strong>η χρή<strong>σ</strong>η ψ<strong>υ</strong>χρών <strong>ε</strong><strong>π</strong>ιθ<strong>ε</strong>µά<strong>τ</strong>ων, <strong>τ</strong>ην <strong>π</strong>αράλληλη ά<strong>σ</strong>κη<strong>σ</strong>η<br />

<strong>π</strong>ί<strong>ε</strong><strong>σ</strong>ης <strong>σ</strong><strong>τ</strong>ην άρθρω<strong>σ</strong>η µ<strong>ε</strong> <strong>τ</strong>η <strong>σ</strong><strong>υ</strong><strong>σ</strong>κ<strong>ε</strong><strong>υ</strong>ή Cryocuff / Aircast, <strong>π</strong>αθη<strong>τ</strong>ική<br />

κινη<strong>σ</strong>ιοθ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong>ία και <strong>τ</strong>ην <strong>ε</strong>κ<strong>τ</strong>έλ<strong>ε</strong><strong>σ</strong>η ι<strong>σ</strong>οµ<strong>ε</strong><strong>τ</strong>ρικών α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ων <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong>.<br />

Η φ<strong>υ</strong><strong>σ</strong>ιοθ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong>ία έχ<strong>ε</strong>ι ως <strong>σ</strong><strong>τ</strong>όχο <strong>τ</strong>ην <strong>ε</strong><strong>π</strong>ί<strong>τ</strong><strong>ε</strong><strong>υ</strong>ξη <strong>π</strong>ρο<strong>ε</strong>γχ<strong>ε</strong>ιρη<strong>τ</strong>ικής<br />

κινη<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>ας <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος 0° ως 90°, <strong>τ</strong>ην α<strong>π</strong>οφ<strong>υ</strong>γή α<strong>τ</strong>ροφίας <strong>τ</strong>ο<strong>υ</strong><br />

<strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong> και <strong>τ</strong>ην <strong>σ</strong>χ<strong>ε</strong>δόν <strong>π</strong>λήρη <strong>υ</strong><strong>π</strong>οχώρη<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> αιµάρθρο<strong>υ</strong>,<br />

<strong>π</strong>ο<strong>υ</strong> θ<strong>ε</strong>ωρ<strong>ε</strong>ί<strong>τ</strong>αι <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικός <strong>π</strong>αράγον<strong>τ</strong>ας µ<strong>ε</strong><strong>τ</strong><strong>ε</strong>γχ<strong>ε</strong>ιρη<strong>τ</strong>ικής δ<strong>υ</strong><strong>σ</strong>καµψίας<br />

<strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, <strong>σ</strong><strong>τ</strong>ην ο<strong>π</strong>οία ού<strong>τ</strong>ως ή άλλως <strong>σ</strong><strong>υ</strong>µβάλλ<strong>ε</strong>ι η χ<strong>ε</strong>ιρο<strong>υ</strong>ργική<br />

<strong>ε</strong><strong>π</strong>έµβα<strong>σ</strong>η.<br />

Η <strong>ε</strong>γχ<strong>ε</strong>ιρη<strong>τ</strong>ική <strong>αν</strong><strong>τ</strong>ιµ<strong>ε</strong><strong>τ</strong>ώ<strong>π</strong>ι<strong>σ</strong>η <strong>σ</strong><strong>υ</strong>νί<strong>σ</strong><strong>τ</strong>α<strong>τ</strong>αι <strong>σ</strong><strong>ε</strong> καθήλω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong><br />

χια<strong>σ</strong><strong>τ</strong>ού µ<strong>ε</strong> <strong>σ</strong>ύρµα, βίδ<strong>ε</strong>ς ή µη α<strong>π</strong>ορροφή<strong>σ</strong>ιµο ράµµα, <strong>σ</strong><strong>τ</strong>ις<br />

<strong>π</strong><strong>ε</strong>ρι<strong>π</strong><strong>τ</strong>ώ<strong>σ</strong><strong>ε</strong>ις α<strong>π</strong>ό<strong>σ</strong><strong>π</strong>α<strong>σ</strong>ης <strong>τ</strong>ης µηριαίας ή <strong>τ</strong>ης κνηµιαίας <strong>π</strong>ρό<strong>σ</strong>φ<strong>υ</strong><strong>σ</strong>ης<br />

<strong>τ</strong>ο<strong>υ</strong>.<br />

Σ<strong>ε</strong> ρήξη <strong>τ</strong>ης µ<strong>ε</strong><strong>σ</strong>ό<strong>τ</strong>η<strong>τ</strong>ας <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού, <strong>ε</strong><strong>π</strong><strong>ε</strong>ιδή η <strong>τ</strong><strong>ε</strong>λικο<strong>τ</strong><strong>ε</strong>λική<br />

<strong>σ</strong><strong>υ</strong>ρραφή <strong>σ</strong><strong>υ</strong>νήθως α<strong>π</strong>ο<strong>τ</strong><strong>υ</strong>γχάν<strong>ε</strong>ι, έχ<strong>ε</strong>ι <strong>ε</strong><strong>π</strong>ικρα<strong>τ</strong>ή<strong>σ</strong><strong>ε</strong>ι η <strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ική<br />

<strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>, µ<strong>ε</strong> χρη<strong>σ</strong>ιµο<strong>π</strong>οίη<strong>σ</strong>η α<strong>υ</strong><strong>τ</strong>οµο<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µά<strong>τ</strong>ων <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδικού<br />

<strong>τ</strong>ένον<strong>τ</strong>α, λαγονοκνηµιαίας <strong>τ</strong>αινίας, <strong>τ</strong>ένον<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong> ηµι<strong>τ</strong><strong>ε</strong>νον<strong>τ</strong>ώδο<strong>υ</strong>ς<br />

και <strong>τ</strong>ο<strong>υ</strong> ι<strong>σ</strong>χνού ή <strong>σ</strong><strong>υ</strong>νθ<strong>ε</strong><strong>τ</strong>ικών µο<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µά<strong>τ</strong>ων ( Shelbourne &<br />

Rowdon 1994).<br />

Μ<strong>ε</strong><strong>τ</strong><strong>ε</strong>γχ<strong>ε</strong>ιρη<strong>τ</strong>ικά <strong>τ</strong>ο<strong>π</strong>οθ<strong>ε</strong><strong>τ</strong><strong>ε</strong>ί<strong>τ</strong>αι ΜΚΠ γύψινος νάρθηκας για 2 βδο-<br />

µάδ<strong>ε</strong>ς <strong>π</strong><strong>ε</strong>ρί<strong>π</strong>ο<strong>υ</strong> και <strong>σ</strong><strong>τ</strong>η <strong>σ</strong><strong>υ</strong>νέχ<strong>ε</strong>ια λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργικός νάρθηκας ή <strong>τ</strong>ο<strong>π</strong>οθ<strong>ε</strong><strong>τ</strong><strong>ε</strong>ί<strong>τ</strong>αι<br />

<strong>ε</strong>ξ' αρχής λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργικός νάρθηκας, <strong>ε</strong>φ' ό<strong>σ</strong>ον <strong>π</strong>ρόκ<strong>ε</strong>ι<strong>τ</strong>αι να <strong>ε</strong>-<br />

φαρµο<strong>σ</strong><strong>τ</strong><strong>ε</strong>ί <strong>π</strong>ρόγραµµα <strong>ε</strong>ν<strong>τ</strong>α<strong>τ</strong>ικής φ<strong>υ</strong><strong>σ</strong>ιοθ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong>ίας α<strong>π</strong>ό <strong>τ</strong>ην <strong>π</strong>ρώ<strong>τ</strong>η<br />

µ<strong>ε</strong><strong>τ</strong>αγχ<strong>ε</strong>ιρη<strong>τ</strong>ική ηµέρα.

Μ<strong>ε</strong> <strong>τ</strong>η φ<strong>υ</strong><strong>σ</strong>ιοθ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong>ία <strong>ε</strong><strong>π</strong>ιδιώκ<strong>ε</strong><strong>τ</strong>αι η <strong>υ</strong><strong>π</strong>οχώρη<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> µ<strong>ε</strong><strong>τ</strong><strong>ε</strong>γχ<strong>ε</strong>ιρη<strong>τ</strong>ικού<br />

αιµάρθρο<strong>υ</strong>, η <strong>τ</strong>αχύ<strong>τ</strong><strong>ε</strong>ρη α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ης <strong>ε</strong>ν<strong>ε</strong>ργη<strong>τ</strong>ικής και<br />

<strong>π</strong>αθη<strong>τ</strong>ικής κινη<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>ας <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, η <strong>ε</strong>νί<strong>σ</strong>χ<strong>υ</strong><strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong><br />

και <strong>τ</strong>ων ο<strong>π</strong>ί<strong>σ</strong>θιων µηριαίων και η <strong>π</strong>ρώιµη φόρ<strong>τ</strong>ι<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong>κέλο<strong>υ</strong>ς.<br />

Ο χρόνος έναρξης <strong>τ</strong>ης φ<strong>υ</strong><strong>σ</strong>ιοθ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong>ίας <strong>ε</strong>ξαρ<strong>τ</strong>ά<strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>η<br />

<strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong> µο<strong>σ</strong>χ<strong>ε</strong>ύµα<strong>τ</strong>ος.<br />

4. ΧΕΙΡΟΥΡΓΙΚΗ ΑΠΟΚΑΤΑΣΤΑΣΗ ΤΩΝ ΣΥΝ∆ΕΣΜΙΚΩΝ<br />

ΒΛΑΒΩΝ<br />

ΓΕΝΙΚΑ<br />

Οι <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µοι <strong>π</strong>ο<strong>υ</strong> <strong>π</strong><strong>ε</strong>ριβάλλο<strong>υ</strong>ν <strong>τ</strong>ην <strong>αν</strong>α<strong>τ</strong>οµικά α<strong>σ</strong><strong>τ</strong>αθή άρθρω<strong>σ</strong>η<br />

<strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, <strong>ε</strong>ίναι ιδιαί<strong>τ</strong><strong>ε</strong>ρα <strong>ε</strong><strong>υ</strong><strong>π</strong>ρό<strong>σ</strong>βλη<strong>τ</strong>οι <strong>σ</strong><strong>ε</strong> οξ<strong>ε</strong>ίς ή χρόνιο<strong>υ</strong>ς<br />

<strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µούς. Οξ<strong>ε</strong>ί<strong>ε</strong>ς ρήξ<strong>ε</strong>ις ή χρόνι<strong>ε</strong>ς <strong>αν</strong><strong>ε</strong><strong>π</strong>άρκ<strong>ε</strong>ι<strong>ε</strong>ς <strong>τ</strong>ων χια<strong>σ</strong><strong>τ</strong>ών,<br />

<strong>π</strong>λάγιων, θ<strong>υ</strong>λακικών ή λοξών <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µων µ<strong>π</strong>ορούν να θέ<strong>σ</strong>ο<strong>υ</strong>ν <strong>σ</strong><strong>ε</strong><br />

<strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικό κίνδ<strong>υ</strong>νο <strong>τ</strong>ις λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργικές ικ<strong>αν</strong>ό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς <strong>τ</strong>ο<strong>υ</strong> α<strong>τ</strong>όµο<strong>υ</strong> <strong>σ</strong><strong>τ</strong>ην <strong>ε</strong>ργα<strong>σ</strong>ία<br />

<strong>τ</strong>ο<strong>υ</strong> ή κα<strong>τ</strong>ά <strong>τ</strong>η διάρκ<strong>ε</strong>ια δηµιο<strong>υ</strong>ργικών ή ψ<strong>υ</strong>χαγωγικών δρα<strong>σ</strong><strong>τ</strong>ηριο<strong>τ</strong>ή<strong>τ</strong>ων.<br />

Σοβαρές ρήξ<strong>ε</strong>ις ή <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µοί <strong>τ</strong>ων <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µων<br />

µ<strong>π</strong>ορούν να <strong>π</strong>ροκαλέ<strong>σ</strong>ο<strong>υ</strong>ν µ<strong>ε</strong>γάλη α<strong>σ</strong><strong>τ</strong>άθ<strong>ε</strong>ια <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, αρθρική<br />

διάβρω<strong>σ</strong>η, <strong>π</strong>όνο και <strong>π</strong><strong>ε</strong>ριορι<strong>σ</strong>µό <strong>τ</strong>ης κίνη<strong>σ</strong>ης. Ό<strong>π</strong>ως <strong>σ</strong>ηµ<strong>ε</strong>ιώθηκ<strong>ε</strong><br />

και <strong>π</strong>ροηγο<strong>υ</strong>µένως, ο <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος <strong>π</strong>ο<strong>υ</strong> <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ίζ<strong>ε</strong><strong>τ</strong>αι<br />

<strong>σ</strong><strong>υ</strong>χνό<strong>τ</strong><strong>ε</strong>ρα <strong>ε</strong>ίναι ο <strong>π</strong>ρό<strong>σ</strong>θιος χια<strong>σ</strong><strong>τ</strong>ός <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος.

Η χ<strong>ε</strong>ιρο<strong>υ</strong>ργική <strong>ε</strong><strong>π</strong>έµβα<strong>σ</strong>η <strong>ε</strong>νδ<strong>ε</strong>ίκν<strong>υ</strong><strong>τ</strong>αι, ό<strong>τ</strong><strong>αν</strong> η α<strong>σ</strong><strong>τ</strong>άθ<strong>ε</strong>ια <strong>τ</strong>ης άρθρω<strong>σ</strong>ης<br />

<strong>π</strong>ροκαλ<strong>ε</strong>ί <strong>αν</strong>ικ<strong>αν</strong>ό<strong>τ</strong>η<strong>τ</strong>α και λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργικούς <strong>π</strong><strong>ε</strong>ριορι<strong>σ</strong>µούς ή<br />

µ<strong>π</strong>ορ<strong>ε</strong>ί, <strong>τ</strong><strong>ε</strong>λικά, να οδηγή<strong>σ</strong><strong>ε</strong>ι <strong>σ</strong><strong>ε</strong> <strong>ε</strong>κφύλι<strong>σ</strong>η <strong>τ</strong>ων αρθρικών <strong>ε</strong><strong>π</strong>ιφ<strong>αν</strong><strong>ε</strong>ιών.<br />

Οι οξ<strong>ε</strong>ί<strong>ε</strong>ς <strong>σ</strong><strong>υ</strong>νδ<strong>ε</strong><strong>σ</strong>µικές βλάβ<strong>ε</strong>ς, µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό µ<strong>ε</strong>γάλο<strong>υ</strong>ς <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µούς<br />

<strong>τ</strong>ης άρθρω<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, α<strong>π</strong>οκαθί<strong>σ</strong><strong>τ</strong>α<strong>τ</strong>αι χ<strong>ε</strong>ιρο<strong>υ</strong>ργικά,<br />

αφού <strong>υ</strong><strong>π</strong>οχωρή<strong>σ</strong>ο<strong>υ</strong>ν <strong>τ</strong>α οξ<strong>ε</strong>ία <strong>σ</strong><strong>υ</strong>µ<strong>π</strong><strong>τ</strong>ώµα<strong>τ</strong>α <strong>τ</strong>ης άρθρω<strong>σ</strong>ης και<br />

µ<strong>π</strong>ορ<strong>ε</strong>ί να γίν<strong>ε</strong>ι µια ακριβής διάγνω<strong>σ</strong>η. Τα χρόνια <strong>ε</strong>λλ<strong>ε</strong>ίµµα<strong>τ</strong>α <strong>αν</strong><strong>τ</strong>ι-<br />

µ<strong>ε</strong><strong>τ</strong>ω<strong>π</strong>ίζον<strong>τ</strong>αι χ<strong>ε</strong>ιρο<strong>υ</strong>ργικά, <strong>αν</strong> η <strong>σ</strong><strong>υ</strong>ν<strong>τ</strong>ηρη<strong>τ</strong>ική (µη χ<strong>ε</strong>ιρο<strong>υ</strong>ργική) <strong>π</strong>αρέµβα<strong>σ</strong><strong>ε</strong>ι<br />

α<strong>π</strong>ο<strong>τ</strong>ύχ<strong>ε</strong>ι.<br />

Η <strong>σ</strong><strong>υ</strong>νδ<strong>ε</strong><strong>σ</strong>µική χ<strong>ε</strong>ιρο<strong>υ</strong>ργική <strong>ε</strong><strong>π</strong>έµβα<strong>σ</strong>η, <strong>ε</strong>ί<strong>τ</strong><strong>ε</strong> <strong>ε</strong>ίναι αρθρο<strong>σ</strong>κό<strong>π</strong>η<strong>σ</strong>η<br />

<strong>ε</strong>ί<strong>τ</strong><strong>ε</strong> <strong>αν</strong>οικ<strong>τ</strong>ή διαδικα<strong>σ</strong>ία, <strong>π</strong><strong>ε</strong>ριλαµβάν<strong>ε</strong>ι µια άµ<strong>ε</strong><strong>σ</strong>η α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η<br />

<strong>τ</strong>ο<strong>υ</strong> ριγµένο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>, µια <strong>ε</strong>νδαρθρική ή <strong>ε</strong>ξωαρθρική <strong>αν</strong>ακα<strong>τ</strong>α<strong>σ</strong>κ<strong>ε</strong><strong>υ</strong>ή<br />

<strong>τ</strong>ων αρθρικών δοµών ή ένα <strong>σ</strong><strong>υ</strong>νδ<strong>υ</strong>α<strong>σ</strong>µό <strong>τ</strong>ων διαδικα<strong>σ</strong>ιών για<br />

<strong>τ</strong>ην α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ης <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρό<strong>τ</strong>η<strong>τ</strong>ας <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος. Σ<strong>τ</strong>ις <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρ<strong>ε</strong>ς<br />

<strong>π</strong><strong>ε</strong>ρι<strong>π</strong><strong>τ</strong>ώ<strong>σ</strong><strong>ε</strong>ις, η άµ<strong>ε</strong><strong>σ</strong>η α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η, µ<strong>ε</strong> <strong>τ</strong>ην έννοια <strong>τ</strong>ης<br />

<strong>σ</strong><strong>υ</strong>ρραφής <strong>τ</strong>ο<strong>υ</strong> ριγµένο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>, <strong>π</strong>αρέχ<strong>ε</strong>ι <strong>τ</strong>ο λιγό<strong>τ</strong><strong>ε</strong>ρο <strong>ε</strong><strong>υ</strong><strong>π</strong>ρό<strong>σ</strong>δ<strong>ε</strong>κ<strong>τ</strong>ο<br />

α<strong>π</strong>ο<strong>τ</strong>έλ<strong>ε</strong><strong>σ</strong>µα. Οι άµ<strong>ε</strong><strong>σ</strong><strong>ε</strong>ς α<strong>π</strong>οκα<strong>τ</strong>α<strong>σ</strong><strong>τ</strong>ά<strong>σ</strong><strong>ε</strong>ις <strong>σ</strong><strong>υ</strong>χνά δ<strong>ε</strong>ν <strong>ε</strong>ίναι <strong>ε</strong>-<br />

<strong>π</strong>ι<strong>τ</strong><strong>υ</strong>χ<strong>ε</strong>ίς, για<strong>τ</strong>ί οι <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µοι <strong>π</strong>αρο<strong>υ</strong><strong>σ</strong>ιάζο<strong>υ</strong>ν µια <strong>π</strong>ολύ αδύναµη αγγ<strong>ε</strong>ίω<strong>σ</strong>η,<br />

α<strong>π</strong>αι<strong>τ</strong>ών<strong>τ</strong>ας µ<strong>ε</strong>γάλ<strong>ε</strong>ς <strong>π</strong><strong>ε</strong>ριόδο<strong>υ</strong>ς ακινη<strong>τ</strong>ο<strong>π</strong>οίη<strong>σ</strong>ης και <strong>π</strong><strong>ε</strong>ριορι<strong>σ</strong>µού<br />

<strong>τ</strong>ης φόρ<strong>τ</strong>ι<strong>σ</strong>ης, έ<strong>τ</strong><strong>σ</strong>ι ώ<strong>σ</strong><strong>τ</strong><strong>ε</strong> να µην δια<strong>τ</strong>αραχθ<strong>ε</strong>ί ο <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος<br />

καθώς <strong>ε</strong><strong>π</strong>ο<strong>υ</strong>λών<strong>ε</strong><strong>τ</strong>αι.

µ<strong>ε</strong><strong>τ</strong>ω<strong>π</strong>ίζον<strong>τ</strong>αι χ<strong>ε</strong>ιρο<strong>υ</strong>ργικά, <strong>αν</strong> η <strong>σ</strong><strong>υ</strong>ν<strong>τ</strong>ηρη<strong>τ</strong>ική (µη χ<strong>ε</strong>ιρο<strong>υ</strong>ργική) <strong>π</strong>αρέµβα<strong>σ</strong><strong>ε</strong>ι<br />

α<strong>π</strong>ο<strong>τ</strong>ύχ<strong>ε</strong>ι.<br />

Η <strong>σ</strong><strong>υ</strong>νδ<strong>ε</strong><strong>σ</strong>µική χ<strong>ε</strong>ιρο<strong>υ</strong>ργική <strong>ε</strong><strong>π</strong>έµβα<strong>σ</strong>η, <strong>ε</strong>ί<strong>τ</strong><strong>ε</strong> <strong>ε</strong>ίναι αρθρο<strong>σ</strong>κό<strong>π</strong>η<strong>σ</strong>η<br />

<strong>ε</strong>ί<strong>τ</strong><strong>ε</strong> <strong>αν</strong>οικ<strong>τ</strong>ή διαδικα<strong>σ</strong>ία, <strong>π</strong><strong>ε</strong>ριλαµβάν<strong>ε</strong>ι µια άµ<strong>ε</strong><strong>σ</strong>η α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η<br />

<strong>τ</strong>ο<strong>υ</strong> ριγµένο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>, µια <strong>ε</strong>νδαρθρική ή <strong>ε</strong>ξωαρθρική <strong>αν</strong>ακα<strong>τ</strong>α<strong>σ</strong>κ<strong>ε</strong><strong>υ</strong>ή<br />

<strong>τ</strong>ων αρθρικών δοµών ή ένα <strong>σ</strong><strong>υ</strong>νδ<strong>υ</strong>α<strong>σ</strong>µό <strong>τ</strong>ων διαδικα<strong>σ</strong>ιών για<br />

<strong>τ</strong>ην α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ης <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρό<strong>τ</strong>η<strong>τ</strong>ας <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος. Σ<strong>τ</strong>ις <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρ<strong>ε</strong>ς<br />

<strong>π</strong><strong>ε</strong>ρι<strong>π</strong><strong>τ</strong>ώ<strong>σ</strong><strong>ε</strong>ις, η άµ<strong>ε</strong><strong>σ</strong>η α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η, µ<strong>ε</strong> <strong>τ</strong>ην έννοια <strong>τ</strong>ης<br />

<strong>σ</strong><strong>υ</strong>ρραφής <strong>τ</strong>ο<strong>υ</strong> ριγµένο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>, <strong>π</strong>αρέχ<strong>ε</strong>ι <strong>τ</strong>ο λιγό<strong>τ</strong><strong>ε</strong>ρο <strong>ε</strong><strong>υ</strong><strong>π</strong>ρό<strong>σ</strong>δ<strong>ε</strong>κ<strong>τ</strong>ο<br />

α<strong>π</strong>ο<strong>τ</strong>έλ<strong>ε</strong><strong>σ</strong>µα. Οι άµ<strong>ε</strong><strong>σ</strong><strong>ε</strong>ς α<strong>π</strong>οκα<strong>τ</strong>α<strong>σ</strong><strong>τ</strong>ά<strong>σ</strong><strong>ε</strong>ις <strong>σ</strong><strong>υ</strong>χνά δ<strong>ε</strong>ν <strong>ε</strong>ίναι <strong>ε</strong>-<br />

<strong>π</strong>ι<strong>τ</strong><strong>υ</strong>χ<strong>ε</strong>ίς, για<strong>τ</strong>ί οι <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µοι <strong>π</strong>αρο<strong>υ</strong><strong>σ</strong>ιάζο<strong>υ</strong>ν µια <strong>π</strong>ολύ αδύναµη αγγ<strong>ε</strong>ίω<strong>σ</strong>η,<br />

α<strong>π</strong>αι<strong>τ</strong>ών<strong>τ</strong>ας µ<strong>ε</strong>γάλ<strong>ε</strong>ς <strong>π</strong><strong>ε</strong>ριόδο<strong>υ</strong>ς ακινη<strong>τ</strong>ο<strong>π</strong>οίη<strong>σ</strong>ης και <strong>π</strong><strong>ε</strong>ριορι<strong>σ</strong>µού<br />

<strong>τ</strong>ης φόρ<strong>τ</strong>ι<strong>σ</strong>ης, έ<strong>τ</strong><strong>σ</strong>ι ώ<strong>σ</strong><strong>τ</strong><strong>ε</strong> να µην δια<strong>τ</strong>αραχθ<strong>ε</strong>ί ο <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος<br />

καθώς <strong>ε</strong><strong>π</strong>ο<strong>υ</strong>λών<strong>ε</strong><strong>τ</strong>αι.<br />

Οι <strong>ε</strong>ξωαρθρικές διαδικα<strong>σ</strong>ί<strong>ε</strong>ς α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης, οι ο<strong>π</strong>οί<strong>ε</strong>ς <strong>π</strong><strong>ε</strong>ριλαµβάνο<strong>υ</strong>ν<br />

<strong>τ</strong>η µ<strong>ε</strong><strong>τ</strong>άθ<strong>ε</strong><strong>σ</strong>η δ<strong>υ</strong>ναµικών µ<strong>υ</strong>ο<strong>τ</strong><strong>ε</strong>νόν<strong>τ</strong>ιων <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρο<strong>π</strong>οιών ή<br />

<strong>ε</strong><strong>σ</strong>ω<strong>τ</strong><strong>ε</strong>ρικών δοµών γύρω α<strong>π</strong>ό <strong>τ</strong>ο γόνα<strong>τ</strong>ο, ό<strong>π</strong>ως <strong>τ</strong>ο<strong>υ</strong> ηµι<strong>τ</strong><strong>ε</strong>νον<strong>τ</strong>ώδο<strong>υ</strong>ς<br />

µ<strong>υ</strong>ός, <strong>τ</strong>ο<strong>υ</strong> αρθρικού θ<strong>υ</strong>λάκο<strong>υ</strong> ή <strong>τ</strong>ης λαγονοκνηµιαίας <strong>τ</strong>αινίας,<br />

έχο<strong>υ</strong>ν <strong>σ</strong>χ<strong>ε</strong>δια<strong>σ</strong><strong>τ</strong><strong>ε</strong>ί, για να <strong>π</strong>αρέχο<strong>υ</strong>ν <strong>ε</strong>ξω<strong>τ</strong><strong>ε</strong>ρική <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρό<strong>τ</strong>η<strong>τ</strong>α <strong>σ</strong><strong>τ</strong>ην<br />

άρθρω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος. Χρη<strong>σ</strong>ιµο<strong>π</strong>οιήθηκ<strong>αν</strong> <strong>π</strong>ολύ <strong>σ</strong><strong>υ</strong>χνά <strong>σ</strong><strong>τ</strong>ο <strong>π</strong>αρ<strong>ε</strong>λθόν,<br />

αλλά όχι <strong>τ</strong>ό<strong>σ</strong>ο <strong>σ</strong><strong>υ</strong>χνά <strong>σ</strong>ήµ<strong>ε</strong>ρα, για<strong>τ</strong>ί δ<strong>ε</strong>ν α<strong>π</strong>οκαθι<strong>σ</strong><strong>τ</strong>ούν <strong>τ</strong>η<br />

φ<strong>υ</strong><strong>σ</strong>ιολογική αρθροκινηµα<strong>τ</strong>ική <strong>τ</strong>ο<strong>υ</strong> γονά<strong>τ</strong>ο<strong>υ</strong>. Μ<strong>ε</strong> <strong>τ</strong>ην <strong>π</strong>άροδο <strong>τ</strong>ο<strong>υ</strong><br />

χρόνο<strong>υ</strong>, οι µ<strong>ε</strong><strong>τ</strong>α<strong>τ</strong>ιθέµ<strong>ε</strong>ν<strong>ε</strong>ς δοµές <strong>σ</strong><strong>υ</strong>χνά <strong>υ</strong><strong>π</strong><strong>ε</strong>ρδια<strong>τ</strong><strong>ε</strong>ίνον<strong>τ</strong>αι, µ<strong>ε</strong> α<strong>π</strong>ο<strong>τ</strong>έλ<strong>ε</strong><strong>σ</strong>µα<br />

<strong>τ</strong>ην <strong>ε</strong><strong>π</strong><strong>αν</strong><strong>ε</strong>µφάνι<strong>σ</strong>η <strong>τ</strong>ης α<strong>σ</strong><strong>τ</strong>άθ<strong>ε</strong>ιας <strong>τ</strong>ο<strong>υ</strong> γονά<strong>τ</strong>ο<strong>υ</strong>. Σήµ<strong>ε</strong>ρα, οι<br />

<strong>ε</strong>ξωαρθρικές διαδικα<strong>σ</strong>ί<strong>ε</strong>ς χρη<strong>σ</strong>ιµο<strong>π</strong>οιούν<strong>τ</strong>αι κ<strong>υ</strong>ρίως ως <strong>σ</strong><strong>υ</strong>µ<strong>π</strong>ληρω-<br />

µα<strong>τ</strong>ικό βοηθη<strong>τ</strong>ικό <strong>τ</strong>µήµα µιας <strong>ε</strong>νδοαρθρικής διαδικα<strong>σ</strong>ίας α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης,<br />

<strong>σ</strong><strong>ε</strong> δύ<strong>σ</strong>κολ<strong>ε</strong>ς <strong>π</strong><strong>ε</strong>ρι<strong>π</strong><strong>τ</strong>ώ<strong>σ</strong><strong>ε</strong>ις ή <strong>σ</strong><strong>ε</strong> <strong>ε</strong>φήβο<strong>υ</strong>ς <strong>π</strong>ο<strong>υ</strong> δ<strong>ε</strong>ν <strong>π</strong>αρο<strong>υ</strong><strong>σ</strong>ιάζο<strong>υ</strong>ν<br />

ο<strong>σ</strong><strong>τ</strong>ική ωρίµ<strong>αν</strong><strong>σ</strong>η και οι <strong>ε</strong><strong>π</strong>ιφύ<strong>σ</strong><strong>ε</strong>ις <strong>τ</strong>ο<strong>υ</strong>ς <strong>ε</strong>ίναι ακόµη <strong>αν</strong>οιχ<strong>τ</strong>ές.

Η <strong>π</strong>ιο <strong>ε</strong><strong>π</strong>ι<strong>τ</strong><strong>υ</strong>χής χ<strong>ε</strong>ιρο<strong>υ</strong>ργική <strong>ε</strong><strong>π</strong>έµβα<strong>σ</strong>η για <strong>τ</strong>ο<strong>υ</strong>ς <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µούς<br />

<strong>τ</strong>ων <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µων <strong>ε</strong>ίναι η <strong>ε</strong>ξωαρθρική α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η, η ο<strong>π</strong>οία χρη<strong>σ</strong>ιµο<strong>π</strong>οι<strong>ε</strong>ί<strong>τ</strong>αι<br />

<strong>σ</strong><strong>υ</strong>χνό<strong>τ</strong><strong>ε</strong>ρα για βλάβ<strong>ε</strong>ς <strong>σ</strong><strong>τ</strong>ο<strong>υ</strong>ς <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong>ς και ο<strong>π</strong>ί<strong>σ</strong>θιο<strong>υ</strong>ς<br />

χια<strong>σ</strong><strong>τ</strong>ούς <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>ς. Η διαδικα<strong>σ</strong>ία <strong>π</strong><strong>ε</strong>ριλαµβάν<strong>ε</strong>ι <strong>τ</strong>η χρή<strong>σ</strong>η <strong>ε</strong>νός<br />

α<strong>υ</strong><strong>τ</strong>ο<strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ικού µο<strong>σ</strong>χ<strong>ε</strong>ύµα<strong>τ</strong>ος (ι<strong>σ</strong><strong>τ</strong>ός <strong>τ</strong>ο<strong>υ</strong> ίδιο<strong>υ</strong> <strong>τ</strong>ο<strong>υ</strong> α<strong>σ</strong>θ<strong>ε</strong>νούς ), <strong>ε</strong>νός<br />

<strong>ε</strong><strong>τ</strong><strong>ε</strong>ροµο<strong>σ</strong>χ<strong>ε</strong>ύµα<strong>τ</strong>ος (ι<strong>σ</strong><strong>τ</strong>ός δωρη<strong>τ</strong>ή) ή <strong>ε</strong>νός <strong>σ</strong><strong>υ</strong>νθ<strong>ε</strong><strong>τ</strong>ικού µο<strong>σ</strong>χ<strong>ε</strong>ύµα<strong>τ</strong>ος<br />

ό<strong>π</strong>ως <strong>τ</strong>ο GORE-TEX. Ο <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδικός <strong>τ</strong>ένον<strong>τ</strong>ας έχ<strong>ε</strong>ι α<strong>π</strong>οδ<strong>ε</strong>ιχθ<strong>ε</strong>ί ό<strong>τ</strong>ι<br />

έχ<strong>ε</strong>ι <strong>τ</strong>ην ίδια <strong>ε</strong>λα<strong>σ</strong><strong>τ</strong>ική δύναµη µ<strong>ε</strong> <strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό και α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί<br />

<strong>τ</strong>ο µό<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µα <strong>π</strong>ο<strong>υ</strong> <strong>ε</strong><strong>π</strong>ιλέγ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>υ</strong>χνό<strong>τ</strong><strong>ε</strong>ρα για µη <strong>ε</strong>νδοαρθρική α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η.<br />

Πλα<strong>σ</strong><strong>τ</strong>ική <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>, µ<strong>ε</strong> χρη<strong>σ</strong>ιµο<strong>π</strong>οίη<strong>σ</strong>η<br />

λωρίδας α<strong>π</strong>ό <strong>τ</strong>ον <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδικό <strong>τ</strong>ένον<strong>τ</strong>α, ο<strong>σ</strong><strong>τ</strong>ικού <strong>τ</strong>µήµα<strong>τ</strong>ος α<strong>π</strong>ό <strong>τ</strong>ην<br />

<strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδα και λωρίδας α<strong>π</strong>ό <strong>τ</strong>ον κα<strong>τ</strong>αφ<strong>υ</strong><strong>τ</strong>ικό <strong>τ</strong>ένον<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong>

Άλλα <strong>υ</strong><strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>τ</strong>α µο<strong>σ</strong>χ<strong>ε</strong>ύµα<strong>τ</strong>ος, <strong>τ</strong>α ο<strong>π</strong>οία δ<strong>ε</strong>ν <strong>ε</strong>ίναι<br />

<strong>τ</strong>ό<strong>σ</strong>ο ι<strong>σ</strong>χ<strong>υ</strong>ρά ό<strong>σ</strong>ο ο <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδικός <strong>τ</strong>ένον<strong>τ</strong>ας, <strong>ε</strong>ίναι ένα <strong>τ</strong>µήµα <strong>τ</strong>ης<br />

λαγονο-κνηµιαίας <strong>τ</strong>αινίας ή <strong>τ</strong>ων <strong>τ</strong><strong>ε</strong>νόν<strong>τ</strong>ων <strong>τ</strong>ο<strong>υ</strong> ηµι<strong>τ</strong><strong>ε</strong>νον<strong>τ</strong>ώδο<strong>υ</strong>ς και<br />

<strong>τ</strong>ο<strong>υ</strong> ι<strong>σ</strong>χνού <strong>π</strong>ρο<strong>σ</strong>αγωγού. Ε<strong>τ</strong><strong>ε</strong>ροµό<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µα ή <strong>σ</strong><strong>υ</strong>νθ<strong>ε</strong><strong>τ</strong>ικό µό<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µα<br />

χρη<strong>σ</strong>ιµο<strong>π</strong>οι<strong>ε</strong>ί<strong>τ</strong>αι, ό<strong>τ</strong><strong>αν</strong> έχ<strong>ε</strong>ι α<strong>π</strong>ο<strong>τ</strong>ύχ<strong>ε</strong>ι <strong>π</strong>ροηγούµ<strong>ε</strong>νη α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η µ<strong>ε</strong><br />

α<strong>υ</strong><strong>τ</strong>ο<strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ικό µό<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µα. Οι <strong>τ</strong><strong>ε</strong>λ<strong>ε</strong><strong>υ</strong><strong>τ</strong>αί<strong>ε</strong>ς <strong>ε</strong>ξ<strong>ε</strong>λίξ<strong>ε</strong>ις <strong>σ</strong><strong>τ</strong>ην <strong>τ</strong>ο<strong>π</strong>οθέ<strong>τ</strong>η<strong>σ</strong>η και<br />

<strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρο<strong>π</strong>οίη<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> µο<strong>σ</strong>χ<strong>ε</strong>ύµα<strong>τ</strong>ος και η β<strong>ε</strong>λ<strong>τ</strong>ίω<strong>σ</strong>η και η <strong>αν</strong>ά<strong>π</strong><strong>τ</strong><strong>υ</strong>ξη <strong>τ</strong>ων<br />

αρθρο<strong>σ</strong>κο<strong>π</strong>ικών <strong>τ</strong><strong>ε</strong>χνικών έχο<strong>υ</strong>ν µ<strong>ε</strong>ιώ<strong>σ</strong><strong>ε</strong>ι <strong>τ</strong>ην <strong>αν</strong>άγκη για µ<strong>ε</strong>γάλ<strong>ε</strong>ς<br />

<strong>π</strong><strong>ε</strong>ριόδο<strong>υ</strong>ς ακινη<strong>τ</strong>ο<strong>π</strong>οίη<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong> χ<strong>ε</strong>ιρο<strong>υ</strong>ργηµένο<strong>υ</strong> γονά<strong>τ</strong>ο<strong>υ</strong> και<br />

<strong>π</strong>ρο<strong>σ</strong><strong>τ</strong>α<strong>τ</strong><strong>ε</strong><strong>υ</strong><strong>τ</strong>ικής φόρ<strong>τ</strong>ι<strong>σ</strong>ης κα<strong>τ</strong>ά <strong>τ</strong>η βάδι<strong>σ</strong>η, καθώς <strong>τ</strong>ο µό<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µα <strong>ε</strong>-<br />

<strong>π</strong>ο<strong>υ</strong>λών<strong>ε</strong><strong>τ</strong>αι.<br />

Οι <strong>σ</strong><strong>τ</strong>όχοι <strong>τ</strong>ης χ<strong>ε</strong>ιρο<strong>υ</strong>ργικής <strong>ε</strong><strong>π</strong>έµβα<strong>σ</strong>ης και <strong>τ</strong>ης µ<strong>ε</strong><strong>τ</strong><strong>ε</strong>γχ<strong>ε</strong>ιρη<strong>τ</strong>ικής<br />

α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης <strong>ε</strong>ίναι : (1) η α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ης <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρό<strong>τ</strong>η<strong>τ</strong>ας και<br />

<strong>τ</strong>ης κίνη<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, (2) η <strong>αν</strong>ώδ<strong>υ</strong>νη και <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρή φόρ<strong>τ</strong>ι<strong>σ</strong>η, (3) η<br />

ικ<strong>αν</strong>ο<strong>π</strong>οιη<strong>τ</strong>ική µ<strong>ε</strong><strong>τ</strong><strong>ε</strong>γχ<strong>ε</strong>ιρη<strong>τ</strong>ική δύναµη και <strong>αν</strong><strong>τ</strong>οχή και (4) η ικ<strong>αν</strong>ό<strong>τ</strong>η<strong>τ</strong>α<br />

<strong>τ</strong>ο<strong>υ</strong> α<strong>σ</strong>θ<strong>ε</strong>νούς να <strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ρέψ<strong>ε</strong>ι <strong>σ</strong><strong>τ</strong>ις <strong>π</strong>ρο <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µού <strong>τ</strong>ο<strong>υ</strong><br />

λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργικές δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς.

4.2 ΤΕΧΝΙΚΕΣ ΣΤΙΣ ΟΠΟΙΕΣ ΧΡΗΣΙΜΟΠΟΙΟΥΝΤΑΙ ΙΣΤΟΙ<br />

ΠΟΥ ΠΡΟΕΡΧΟΝΤΑΙ ΑΠΟ ΤΟ Ι∆ΙΟ ΑΤΟΜΑ<br />

Η <strong>τ</strong><strong>ε</strong>χνική <strong>π</strong>ο<strong>υ</strong> χρη<strong>σ</strong>ιµο<strong>π</strong>οι<strong>ε</strong>ί<strong>τ</strong>αι <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρο α<strong>π</strong>ό κάθ<strong>ε</strong> άλλη, <strong>ε</strong>ίναι<br />

α<strong>υ</strong><strong>τ</strong>ή κα<strong>τ</strong>ά <strong>τ</strong>ην ο<strong>π</strong>οία γίν<strong>ε</strong><strong>τ</strong>αι <strong>ε</strong>νδαρθρική <strong>υ</strong><strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong><br />

<strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ο<strong>υ</strong> µ<strong>ε</strong> κοµµά<strong>τ</strong>ι <strong>τ</strong>ο<strong>υ</strong> <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδικού <strong>τ</strong>ένον<strong>τ</strong>α, <strong>π</strong>ο<strong>υ</strong><br />

<strong>π</strong>αίρν<strong>ε</strong><strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ο µέ<strong>σ</strong>ο <strong>τ</strong>ρί<strong>τ</strong>ο <strong>τ</strong>ο<strong>υ</strong> µαζί µ<strong>ε</strong> µικρού <strong>π</strong>άχο<strong>υ</strong>ς ο<strong>σ</strong><strong>τ</strong>ικές<br />

<strong>π</strong>λάκ<strong>ε</strong>ς <strong>σ</strong><strong>τ</strong>ις 2 άκρ<strong>ε</strong>ς <strong>τ</strong>ο<strong>υ</strong>, <strong>π</strong>ο<strong>υ</strong> <strong>π</strong>ροέρχον<strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ην <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδική<br />

και <strong>τ</strong>ην κνηµιαία <strong>π</strong>ρό<strong>σ</strong>φ<strong>υ</strong><strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong>.<br />

Μό<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µα αϊ<strong>τ</strong>ό <strong>τ</strong>ον <strong>ε</strong><strong>π</strong>ίγονα<strong>τ</strong>ιδικό <strong>τ</strong>ένον<strong>τ</strong>α <strong>π</strong>ριν <strong>ε</strong><strong>τ</strong>οιµα<strong>σ</strong><strong>τ</strong><strong>ε</strong>ί για να<br />

<strong>τ</strong>ο<strong>π</strong>οθ<strong>ε</strong><strong>τ</strong>ηθ<strong>ε</strong>ί <strong>σ</strong><strong>τ</strong>ο <strong>τ</strong>ούν<strong>ε</strong>λ.<br />

Μ<strong>ε</strong><strong>τ</strong>ά <strong>τ</strong>ην α<strong>π</strong>ό<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> µο<strong>σ</strong>χ<strong>ε</strong>ύµα<strong>τ</strong>ος, γίνον<strong>τ</strong>αι <strong>τ</strong>α κα<strong>τ</strong>άλληλη<br />

<strong>τ</strong>ούν<strong>ε</strong>λ <strong>σ</strong><strong>τ</strong>ο µηριαίο και <strong>τ</strong>ην κνήµη <strong>σ</strong><strong>τ</strong>α <strong>σ</strong>ηµ<strong>ε</strong>ία <strong>π</strong>ρό<strong>σ</strong>φ<strong>υ</strong><strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong><br />

<strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ο<strong>υ</strong>, α<strong>π</strong>ό <strong>τ</strong>α ο<strong>π</strong>οία θα <strong>π</strong><strong>ε</strong>ρα<strong>σ</strong><strong>τ</strong><strong>ε</strong>ί <strong>τ</strong>ο µό<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µα για να<br />

<strong>π</strong>άρ<strong>ε</strong>ι έ<strong>τ</strong><strong>σ</strong>ι <strong>τ</strong>η θέ<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> µέ<strong>σ</strong>α <strong>σ</strong><strong>τ</strong>ο γόνα<strong>τ</strong>ο. Οι δύο άκρ<strong>ε</strong>ς <strong>τ</strong>ο<strong>υ</strong> µο<strong>σ</strong>χ<strong>ε</strong>ύµα<strong>τ</strong>ος<br />

<strong>π</strong>αραµένο<strong>υ</strong>ν µέ<strong>σ</strong>α <strong>σ</strong><strong>τ</strong>ο <strong>τ</strong>ούν<strong>ε</strong>λ για να µ<strong>π</strong>ορέ<strong>σ</strong>ο<strong>υ</strong>ν να <strong>ε</strong>ν<strong>σ</strong>ωµα<strong>τ</strong>ωθούν<br />

οι ο<strong>σ</strong><strong>τ</strong>ικές <strong>π</strong>λάκ<strong>ε</strong>ς µ<strong>ε</strong> <strong>τ</strong>ο <strong>τ</strong>οίχωµα <strong>τ</strong>ο<strong>υ</strong>ς. Σ<strong>τ</strong>ο <strong>τ</strong>έλος, <strong>τ</strong>ο<br />

µό<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µα <strong>τ</strong><strong>ε</strong>ν<strong>τ</strong>ών<strong>ε</strong><strong>τ</strong>αι και <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρο<strong>π</strong>οι<strong>ε</strong>ί<strong>τ</strong>αι <strong>σ</strong><strong>ε</strong> α<strong>υ</strong><strong>τ</strong>ή <strong>τ</strong>η θέ<strong>σ</strong>η µ<strong>ε</strong> <strong>τ</strong>η<br />

χρή<strong>σ</strong>η <strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ικών <strong>τ</strong>α<strong>π</strong>ών <strong>π</strong>ο<strong>υ</strong> µ<strong>π</strong>αίνο<strong>υ</strong>ν <strong>σ</strong><strong>τ</strong>α <strong>ε</strong>ξω<strong>τ</strong><strong>ε</strong>ρικά <strong>σ</strong><strong>τ</strong>όµια <strong>τ</strong>ων<br />

<strong>τ</strong>ούν<strong>ε</strong>λ.<br />

Αφού <strong>τ</strong>ο κοµµά<strong>τ</strong>ι <strong>τ</strong>ο<strong>υ</strong> <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδικού <strong>τ</strong>ένον<strong>τ</strong>α <strong>τ</strong>ο<strong>π</strong>οθ<strong>ε</strong><strong>τ</strong>ηθ<strong>ε</strong>ί <strong>σ</strong><strong>τ</strong>ον<br />

<strong>αν</strong>α<strong>τ</strong>οµικό <strong>π</strong><strong>ε</strong>ριβαλλον<strong>τ</strong>ικό χώρο <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ο<strong>υ</strong>, ξ<strong>ε</strong>κινά<strong>ε</strong>ι µια<br />

διαδικα<strong>σ</strong>ία <strong>σ</strong><strong>τ</strong>αδιακής µ<strong>ε</strong><strong>τ</strong>α<strong>τ</strong>ρο<strong>π</strong>ής <strong>τ</strong>ης ι<strong>σ</strong><strong>τ</strong>ολογικής δοµής <strong>τ</strong>ο<strong>υ</strong>, η

ο<strong>π</strong>οία γίν<strong>ε</strong><strong>τ</strong>αι <strong>π</strong>αρόµοια µ' α<strong>υ</strong><strong>τ</strong>ή <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ραγµα<strong>τ</strong>ικού<br />

<strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια-<strong>σ</strong><strong>τ</strong>ού. Πριν <strong>τ</strong>ην <strong>ε</strong><strong>π</strong><strong>αν</strong>αγγ<strong>ε</strong>ίω<strong>σ</strong>ή <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ο<strong>υ</strong><br />

ολοκλκηρών<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ις 6 βδοµάδ<strong>ε</strong>ς, <strong>τ</strong>ο µό<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µα δια<strong>τ</strong>ρέφ<strong>ε</strong><strong>τ</strong>αι<br />

διαχ<strong>υ</strong><strong>τ</strong>ικά µέ<strong>σ</strong>α α<strong>π</strong>ό <strong>τ</strong>ο αρθρικό <strong>υ</strong>γρό. Πι<strong>σ</strong><strong>τ</strong><strong>ε</strong>ύ<strong>ε</strong><strong>τ</strong>αι ό<strong>τ</strong>ι η<br />

µηδ<strong>ε</strong>νική αιµα<strong>τ</strong>ική <strong>π</strong>αροχή <strong>σ</strong><strong>τ</strong>ο µό<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µα κα<strong>τ</strong>ά <strong>τ</strong>ις <strong>π</strong>ρώ<strong>τ</strong><strong>ε</strong>ς 6<br />

<strong>ε</strong>βδοµάδ<strong>ε</strong>ς δ<strong>ε</strong>ν α<strong>π</strong>ο<strong>τ</strong>ρέ<strong>π</strong><strong>ε</strong>ι <strong>τ</strong>ο<strong>υ</strong>ς ινοβλά<strong>σ</strong><strong>τ</strong><strong>ε</strong>ς γ<strong>ε</strong>ι<strong>τ</strong>ονικών<br />

<strong>π</strong><strong>ε</strong>ριοχών α<strong>π</strong>ό <strong>τ</strong>ο να µ<strong>ε</strong><strong>τ</strong>ακινηθούν µέ<strong>σ</strong>α <strong>σ</strong><strong>τ</strong>ον ι<strong>σ</strong><strong>τ</strong>ό <strong>τ</strong>ο<strong>υ</strong> και να<br />

<strong>π</strong>ολλα<strong>π</strong>λα<strong>σ</strong>ια<strong>σ</strong><strong>τ</strong>ούν µαζικά, έ<strong>τ</strong><strong>σ</strong>ι ώ<strong>σ</strong><strong>τ</strong><strong>ε</strong> να <strong>π</strong>ροχωρή<strong>σ</strong><strong>ε</strong>ι η<br />

διαδικα<strong>σ</strong>ία <strong>τ</strong>ης « <strong>σ</strong><strong>υ</strong>νδ<strong>ε</strong><strong>σ</strong>µο<strong>π</strong>οίη<strong>σ</strong>ης » <strong>τ</strong>ο<strong>υ</strong> µο<strong>σ</strong>χ<strong>ε</strong>ύµα<strong>τ</strong>ος. Τα<br />

νέα α<strong>υ</strong><strong>τ</strong>ά κύ<strong>τ</strong><strong>τ</strong>αρα έχο<strong>υ</strong>ν διαφορ<strong>ε</strong><strong>τ</strong>ικά χαρακ<strong>τ</strong>ηρι<strong>σ</strong><strong>τ</strong>ικά α<strong>π</strong>ό<br />

<strong>τ</strong>ο<strong>υ</strong>ς <strong>τ</strong><strong>υ</strong><strong>π</strong>ικούς <strong>τ</strong><strong>ε</strong>-νόν<strong>τ</strong>ιο<strong>υ</strong>ς ινοβλά<strong>σ</strong><strong>τ</strong><strong>ε</strong>ς και µοιάζο<strong>υ</strong>ν<br />

<strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρο µ<strong>ε</strong> κ<strong>υ</strong><strong>τ</strong><strong>τ</strong>αρικές µορφές <strong>π</strong>ο<strong>υ</strong> <strong>π</strong><strong>ε</strong>ρα<strong>τ</strong>ηρούν<strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ο<br />

<strong>ε</strong><strong>σ</strong>ω<strong>τ</strong><strong>ε</strong>ρικό <strong>τ</strong>ων <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µων. Μ<strong>ε</strong><strong>τ</strong>ά <strong>τ</strong>ην <strong>ε</strong>γκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong>ς, <strong>τ</strong>α<br />

κύ<strong>τ</strong><strong>τ</strong>αρα α<strong>υ</strong><strong>τ</strong>ά αρχίζο<strong>υ</strong>ν <strong>τ</strong>ην <strong>π</strong>αραγωγή κολλαγόνο<strong>υ</strong> <strong>τ</strong>ύ<strong>π</strong>ο<strong>υ</strong> III (<br />

<strong>σ</strong><strong>υ</strong>νδ<strong>ε</strong><strong>σ</strong>µικό κολλαγόνο ), <strong>τ</strong>ο ο<strong>π</strong>οίο δ<strong>ε</strong> βρί<strong>σ</strong>κ<strong>ε</strong><strong>τ</strong>αι <strong>τ</strong><strong>ε</strong>λικά <strong>σ</strong><strong>τ</strong>ον<br />

<strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδικό <strong>τ</strong>ένον<strong>τ</strong>α. Έ<strong>τ</strong><strong>σ</strong>ι, µέ<strong>σ</strong>α <strong>σ</strong><strong>ε</strong> διά<strong>σ</strong><strong>τ</strong>ηµα 30 <strong>ε</strong>-<br />

βδοµάδων α<strong>π</strong>ό <strong>τ</strong>ην <strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ική, η <strong>π</strong><strong>ε</strong>ρι<strong>ε</strong>κ<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong><br />

µο<strong>σ</strong>χ<strong>ε</strong>ύµα<strong>τ</strong>ος <strong>σ</strong><strong>ε</strong> <strong>σ</strong><strong>υ</strong>νδ<strong>ε</strong><strong>σ</strong>µικό κολλαγόνο, γίν<strong>ε</strong><strong>τ</strong>αι η ίδια ό<strong>π</strong>ως<br />

και <strong>σ</strong><strong>ε</strong> ένα κ<strong>αν</strong>ονικό <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό, <strong>ε</strong>νώ <strong>σ</strong><strong>τ</strong>ο ίδιο χρονικό<br />

<strong>σ</strong>ηµ<strong>ε</strong>ίο, <strong>τ</strong>ό<strong>σ</strong>ο η µικρο<strong>σ</strong>κο<strong>π</strong>ική, ό<strong>σ</strong>ο και η βιοµηχ<strong>αν</strong>ική<br />

κα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> µο<strong>σ</strong>χ<strong>ε</strong>ύµα<strong>τ</strong>ος, µοιάζ<strong>ε</strong>ι <strong>π</strong>άρα <strong>π</strong>ολύ, µ' α<strong>υ</strong><strong>τ</strong>ή<br />

<strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού.<br />

Η <strong>τ</strong><strong>ε</strong>χνική α<strong>υ</strong><strong>τ</strong>ή χρη<strong>σ</strong>ιµο<strong>π</strong>οιήθηκ<strong>ε</strong> <strong>τ</strong>ό<strong>σ</strong>ο <strong>σ</strong><strong>ε</strong> οξ<strong>ε</strong>ί<strong>ε</strong>ς ό<strong>σ</strong>ο και <strong>σ</strong><strong>ε</strong><br />

χρόνι<strong>ε</strong>ς κα<strong>τ</strong>α<strong>σ</strong><strong>τ</strong>ά<strong>σ</strong><strong>ε</strong>ις <strong>π</strong>άρα <strong>π</strong>ολύ <strong>σ</strong><strong>τ</strong>η δ<strong>ε</strong>κα<strong>ε</strong><strong>τ</strong>ία <strong>τ</strong>ο<strong>υ</strong> 1980 και α<strong>π</strong>ό <strong>τ</strong>α<br />

µέ<strong>σ</strong>α <strong>τ</strong>ης άρχι<strong>σ</strong><strong>ε</strong> να γίνα<strong>τ</strong>αι και αρθρο<strong>σ</strong>κο<strong>π</strong>ικά. Η αρθρο<strong>σ</strong>κο<strong>π</strong>ική<br />

<strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ική, <strong>σ</strong><strong>ε</strong> <strong>αν</strong><strong>τ</strong>ίθ<strong>ε</strong><strong>σ</strong>η µ<strong>ε</strong> <strong>τ</strong>ις <strong>π</strong>αραδο<strong>σ</strong>ιακές <strong>σ</strong><strong>υ</strong>νδ<strong>ε</strong><strong>σ</strong>µο<strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ικές<br />

<strong>π</strong>ο<strong>υ</strong> <strong>π</strong>ροϋ<strong>π</strong>οθέ<strong>τ</strong>ο<strong>υ</strong>ν µ<strong>ε</strong>γάλ<strong>ε</strong>ς δια<strong>τ</strong>οµές, <strong>π</strong><strong>ε</strong>ριόρι<strong>σ</strong><strong>ε</strong> δρα<strong>σ</strong><strong>τ</strong>ικά <strong>τ</strong>ην<br />

βραχ<strong>υ</strong><strong>π</strong>ρόθ<strong>ε</strong><strong>σ</strong>µη και µακρ<strong>υ</strong><strong>π</strong>ρόθ<strong>ε</strong><strong>σ</strong>µη νο<strong>σ</strong>ηρό<strong>τ</strong>η<strong>τ</strong>α ( <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδο-<br />

µηριαίος <strong>π</strong>όνος, <strong>π</strong>όνος α<strong>π</strong>ό <strong>τ</strong>ις <strong>τ</strong>οµές ) και <strong>ε</strong><strong>π</strong>έ<strong>τ</strong>ρ<strong>ε</strong>ψ<strong>ε</strong> <strong>τ</strong>η µ<strong>ε</strong>ίω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong><br />

χρόνο<strong>υ</strong> <strong>π</strong>αραµονής <strong>σ</strong><strong>τ</strong>ο νο<strong>σ</strong>οκοµ<strong>ε</strong>ίο, <strong>τ</strong>αχύ<strong>τ</strong><strong>ε</strong>ρη <strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ροφή <strong>τ</strong>ης λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργικό<strong>τ</strong>η<strong>τ</strong>ας<br />

<strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος και καλύ<strong>τ</strong><strong>ε</strong>ρο αι<strong>σ</strong>θη<strong>τ</strong>ικό α<strong>π</strong>ο<strong>τ</strong>έλ<strong>ε</strong><strong>σ</strong>µα.

Αλλ<strong>ε</strong>ς <strong>τ</strong><strong>ε</strong>χνικές <strong>π</strong>ο<strong>υ</strong> χρη<strong>σ</strong>ιµο<strong>π</strong>οιούν ι<strong>σ</strong><strong>τ</strong>ούς α<strong>π</strong>ό <strong>τ</strong>ο ίδιο <strong>τ</strong>ο ά<strong>τ</strong>οµο<br />

<strong>ε</strong>ίναι διάφορ<strong>ε</strong>ς <strong>ε</strong>ξωαρθρικές ή µ<strong>ε</strong>ικ<strong>τ</strong>ές, κα<strong>τ</strong>ά <strong>τ</strong>ις ο<strong>π</strong>οί<strong>ε</strong>ς γίν<strong>ε</strong><strong>τ</strong>αι <strong>ε</strong>ν<strong>ε</strong>ργη<strong>τ</strong>ική<br />

µ<strong>ε</strong><strong>τ</strong>αφορά µο<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µά<strong>τ</strong>ων. Οι <strong>τ</strong><strong>ε</strong>χνικές α<strong>υ</strong><strong>τ</strong>ές έχο<strong>υ</strong>ν δ<strong>ε</strong>χθ<strong>ε</strong>ί <strong>τ</strong>η<br />

µικρό<strong>τ</strong><strong>ε</strong>ρη <strong>π</strong>ρο<strong>σ</strong>οχή α<strong>π</strong>ό όλ<strong>ε</strong>ς <strong>τ</strong>ις <strong>σ</strong><strong>υ</strong>νδ<strong>ε</strong><strong>σ</strong>µο<strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ικές <strong>π</strong>ο<strong>υ</strong> <strong>ε</strong>ίναι<br />

διαθέ<strong>σ</strong>ιµ<strong>ε</strong>ς.<br />

Χρη<strong>σ</strong>ιµο<strong>π</strong>οιούν<strong>τ</strong>αι κα<strong>τ</strong>ά βά<strong>σ</strong>η <strong>σ</strong><strong>ε</strong> χρόνι<strong>ε</strong>ς κα<strong>τ</strong>α<strong>σ</strong><strong>τ</strong>ά<strong>σ</strong><strong>ε</strong>ις <strong>π</strong><strong>ε</strong>ριορι<strong>σ</strong>µένης<br />

<strong>π</strong>ρο<strong>σ</strong>θιο<strong>π</strong>λάγιας <strong>σ</strong><strong>τ</strong>ροφικής <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρό<strong>τ</strong>η<strong>τ</strong>ας α<strong>π</strong>ό <strong>π</strong>ρόβληµα<br />

<strong>σ</strong><strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό, <strong>σ</strong><strong>τ</strong>ις ο<strong>π</strong>οί<strong>ε</strong>ς έχ<strong>ε</strong>ι <strong>αν</strong>α<strong>π</strong><strong>τ</strong><strong>υ</strong>χθ<strong>ε</strong>ί χαλαρό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ων<br />

δ<strong>ε</strong><strong>υ</strong><strong>τ</strong><strong>ε</strong>ρ<strong>ε</strong><strong>υ</strong>όν<strong>τ</strong>ων θ<strong>υ</strong>λακο<strong>σ</strong><strong>υ</strong>νδ<strong>ε</strong><strong>σ</strong>µικών <strong>π</strong><strong>ε</strong>ριορι<strong>σ</strong><strong>τ</strong>ικών <strong>π</strong>αραγόν<strong>τ</strong>ων.<br />

Οι <strong>τ</strong><strong>υ</strong><strong>π</strong>ικό<strong>τ</strong><strong>ε</strong>ρ<strong>ε</strong>ς α<strong>π</strong>ό α<strong>υ</strong><strong>τ</strong>ές <strong>ε</strong>ίναι η <strong>π</strong>αράλληλη <strong>τ</strong><strong>ε</strong>νον<strong>τ</strong>οµ<strong>ε</strong><strong>τ</strong>άθ<strong>ε</strong><strong>σ</strong>η <strong>τ</strong>ων<br />

<strong>τ</strong><strong>ε</strong>νόν<strong>τ</strong>ων <strong>τ</strong>ο<strong>υ</strong> χήν<strong>ε</strong>ιο<strong>υ</strong> <strong>π</strong>όδα <strong>ε</strong><strong>σ</strong>ω<strong>τ</strong><strong>ε</strong>ρικά και <strong>τ</strong>ης µακράς κ<strong>ε</strong>φαλής <strong>τ</strong>ο<strong>υ</strong><br />

· δικέφαλο<strong>υ</strong> µηριαίο<strong>υ</strong> <strong>ε</strong>ξω<strong>τ</strong><strong>ε</strong>ρικά <strong>π</strong>άνω <strong>σ</strong><strong>τ</strong>ην κνήµη και κά<strong>τ</strong>ω α<strong>π</strong>ό<br />

<strong>τ</strong>ον έξω <strong>π</strong>λάγιο <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µο, η µ<strong>ε</strong>ρική <strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ική µ<strong>ε</strong> <strong>σ</strong><strong>υ</strong>νδ<strong>υ</strong>α<strong>σ</strong>µένη<br />

χρή<strong>σ</strong>η<br />

<strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong>ένον<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong> ηµι<strong>τ</strong><strong>ε</strong>νον<strong>τ</strong>ώδη και <strong>τ</strong>ης λαγονοκνηµιαίας <strong>τ</strong>αινίας και<br />

η <strong>τ</strong><strong>ε</strong>χνική Ι<strong>π</strong><strong>ε</strong>δΙΙ ( <strong>ε</strong>ν<strong>ε</strong>ργη<strong>τ</strong>ική µ<strong>ε</strong><strong>τ</strong>αφορά <strong>τ</strong>ης λαγονοκνηµιαίας <strong>τ</strong>αινίας<br />

<strong>σ</strong><strong>τ</strong>ο κνηµιαίο <strong>π</strong>λα<strong>τ</strong>ώ ). Σ<strong>ε</strong> γ<strong>ε</strong>νικές γραµµές, α<strong>υ</strong><strong>τ</strong>ή η κα<strong>τ</strong>ηγορία <strong>π</strong>αρο<strong>υ</strong><strong>σ</strong>ιάζ<strong>ε</strong>ι<br />

<strong>π</strong>ολλά <strong>π</strong>ροβλήµα<strong>τ</strong>α <strong>τ</strong><strong>ε</strong>χνικής φύ<strong>σ</strong>ης ( µ<strong>ε</strong>γάλος χρόνος<br />

χ<strong>ε</strong>ιρο<strong>υ</strong>ργ<strong>ε</strong>ίο<strong>υ</strong>, <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρ<strong>ε</strong>ς <strong>ε</strong><strong>π</strong>ι<strong>π</strong>λοκές α<strong>π</strong>ό <strong>τ</strong>ις κοινές <strong>ε</strong>νδαρθρικές<br />

), <strong>ε</strong>νώ δ<strong>ε</strong>ν µ<strong>π</strong>ορούν να καλύψο<strong>υ</strong>ν <strong>τ</strong>ις α<strong>π</strong>αι<strong>τ</strong>ή<strong>σ</strong><strong>ε</strong>ις λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργικής <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρό<strong>τ</strong>η<strong>τ</strong>ας<br />

<strong>π</strong>ο<strong>υ</strong> έχ<strong>ε</strong>ι <strong>τ</strong>ο γόνα<strong>τ</strong>ο <strong>ε</strong>νός αθλη<strong>τ</strong>ή <strong>υ</strong>ψηλής κλά<strong>σ</strong>ης, γι' α<strong>υ</strong><strong>τ</strong>ό<br />

<strong>σ</strong><strong>τ</strong>αδιακά <strong>π</strong>αραµ<strong>ε</strong>ρίζον<strong>τ</strong>αι.<br />

Ενδαρθρική α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong><br />

Ενδ<strong>ε</strong>ίξ<strong>ε</strong>ις για χ<strong>ε</strong>ιρο<strong>υ</strong>ργ<strong>ε</strong>ίο<br />

(α) Σοβαρή οξ<strong>ε</strong>ία ρήξη ή χρόνια <strong>αν</strong><strong>ε</strong><strong>π</strong>άρκ<strong>ε</strong>ια <strong>τ</strong><strong>π</strong><strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού<br />

<strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong> η ο<strong>π</strong>οία οδηγ<strong>ε</strong>ί <strong>σ</strong><strong>ε</strong> µη φ<strong>υ</strong><strong>σ</strong>ιολογική <strong>π</strong>ρό<strong>σ</strong>θια µ<strong>ε</strong><strong>τ</strong>α<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>η<br />

<strong>τ</strong>ης κνήµης <strong>σ</strong><strong>τ</strong>ο µηριαίο και α<strong>σ</strong><strong>τ</strong>άθ<strong>ε</strong>ια ή <strong>π</strong><strong>ε</strong>ραµόρφω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γονά-

<strong>τ</strong>ο<strong>υ</strong>. Η <strong>ε</strong>ξέ<strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ης µ<strong>ε</strong><strong>τ</strong>α<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>ης άξονα - µοχλού ( ρivot-shift.) <strong>ε</strong>ίναι<br />

<strong>ε</strong><strong>π</strong>ί<strong>σ</strong>ης µη φ<strong>υ</strong><strong>σ</strong>ιολογική. Ένα έλλ<strong>ε</strong>ιµα <strong>σ</strong><strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό<br />

<strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µο <strong>σ</strong><strong>υ</strong>χνά <strong>σ</strong><strong>υ</strong>νδιάζ<strong>ε</strong><strong>τ</strong>αι µ<strong>ε</strong> βλάβη και άλλων δοµών <strong>τ</strong>ο<strong>υ</strong> γονά<strong>τ</strong>ο<strong>υ</strong>,<br />

ό<strong>π</strong>ως <strong>τ</strong>ο<strong>υ</strong> έ<strong>σ</strong>ω <strong>π</strong>λαγίο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong> <strong>π</strong>ο<strong>υ</strong> οδηγ<strong>ε</strong>ί <strong>σ</strong><strong>ε</strong> <strong>σ</strong><strong>τ</strong>ροφική<br />

α<strong>σ</strong><strong>τ</strong>άθ<strong>ε</strong>ια <strong>τ</strong>ης άρθρω<strong>σ</strong>ης.<br />

(β) Μ<strong>ε</strong>ρική ρήξη <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong> η ο<strong>π</strong>οία έχ<strong>ε</strong>ι ως α<strong>π</strong>ο<strong>τ</strong>έλ<strong>ε</strong><strong>σ</strong>µα <strong>τ</strong>ον<br />

<strong>π</strong><strong>ε</strong>ριορι<strong>σ</strong>µό <strong>τ</strong>ων λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργικών δρα<strong>σ</strong><strong>τ</strong>ηριο<strong>τ</strong>ή<strong>τ</strong>ων <strong>σ</strong><strong>ε</strong> <strong>ε</strong>ν<strong>ε</strong>ργά ά<strong>τ</strong>οµα,<br />

(γ) Α<strong>π</strong>ο<strong>τ</strong><strong>υ</strong>χηµένη <strong>σ</strong><strong>υ</strong>ν<strong>τ</strong>ηρη<strong>τ</strong>ική ( µη χ<strong>ε</strong>ιρο<strong>υ</strong>ργική ) <strong>αν</strong><strong>τ</strong>ιµ<strong>ε</strong><strong>τ</strong>ώ<strong>π</strong>ι<strong>σ</strong>η <strong>τ</strong>ης<br />

ρήξης <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>.<br />

4 ∆ιαδικα<strong>σ</strong>ί<strong>ε</strong>ς<br />

(α) Γ<strong>ε</strong>νικά <strong>σ</strong><strong>τ</strong>οιχ<strong>ε</strong>ία<br />

Υ<strong>π</strong>άρχ<strong>ε</strong>ι µια µ<strong>ε</strong>γάλη <strong>π</strong>οικιλία χ<strong>ε</strong>ιρο<strong>υ</strong>ργικών διαδικα<strong>σ</strong>ιών για <strong>τ</strong>ην<br />

<strong>αν</strong><strong>τ</strong>ιµ<strong>ε</strong><strong>τ</strong>ώ<strong>π</strong>ι<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>ε</strong>λλ<strong>ε</strong>ίµµα<strong>τ</strong>ος <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong><br />

<strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος και <strong>ε</strong>ιδικό<strong>τ</strong><strong>ε</strong>ρα, η <strong>ε</strong>νδοαρθρική ή <strong>ε</strong>ξωαρθρική α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η<br />

ή η άµ<strong>ε</strong><strong>σ</strong>η α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> ριγµένο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>. Ο<br />

<strong>τ</strong>ύ<strong>π</strong>ος <strong>τ</strong>ης διαδικα<strong>σ</strong>ίας <strong>π</strong>ο<strong>υ</strong> θα <strong>ε</strong><strong>π</strong>ιλ<strong>ε</strong>γ<strong>ε</strong>ί <strong>ε</strong>ξαρ<strong>τ</strong>ά<strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>η <strong>σ</strong>οβαρό<strong>τ</strong>η<strong>τ</strong>α<br />

και <strong>τ</strong>ον <strong>ε</strong>ν<strong>τ</strong>ο<strong>π</strong>ι<strong>σ</strong>µό <strong>τ</strong>ης ρήξης, ό<strong>π</strong>ως <strong>ε</strong><strong>π</strong>ί<strong>σ</strong>ης και α<strong>π</strong>ό <strong>τ</strong>ην ηλικία<br />

<strong>τ</strong>ο<strong>υ</strong> α<strong>σ</strong>θ<strong>ε</strong>νούς και α<strong>π</strong>ό <strong>τ</strong>ο <strong>ε</strong><strong>π</strong>ί<strong>π</strong><strong>ε</strong>δο <strong>τ</strong>ης δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong>ας <strong>σ</strong><strong>τ</strong>ο ο<strong>π</strong>οίο ο<br />

α<strong>σ</strong>θ<strong>ε</strong>νής <strong>ε</strong><strong>π</strong>ιθ<strong>υ</strong>µ<strong>ε</strong>ί να <strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ρέψ<strong>ε</strong>ι.<br />

Ό<strong>π</strong>ως <strong>αν</strong>αφέρθηκ<strong>ε</strong> <strong>π</strong>ροηγο<strong>υ</strong>µένως, η <strong>π</strong>ιο <strong>σ</strong><strong>υ</strong>χνή και <strong>ε</strong><strong>π</strong>ι<strong>τ</strong><strong>υ</strong>χηµένη<br />

διαδικα<strong>σ</strong>ία <strong>σ</strong>ήµ<strong>ε</strong>ρα <strong>ε</strong>ίναι η <strong>ε</strong>νδαρθρική, µ<strong>ε</strong> <strong>τ</strong>η χρη<strong>σ</strong>ιµο<strong>π</strong>οίη<strong>σ</strong>η α<strong>υ</strong><strong>τ</strong>ο<strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ικού<br />

µο<strong>σ</strong>χ<strong>ε</strong>ύµα<strong>τ</strong>ος α<strong>π</strong>ό <strong>τ</strong>ον <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδικό <strong>τ</strong>ένον<strong>τ</strong>α, <strong>τ</strong>ο ο<strong>π</strong>οίο<br />

<strong>αν</strong><strong>τ</strong>ικαθι<strong>σ</strong><strong>τ</strong>ά <strong>τ</strong>ον ριγµένο <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µο.<br />

(β) Η <strong>ε</strong>νδαρθρική α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>π</strong><strong>ε</strong>ριλαµβάν<strong>ε</strong>ι µια αρθρο<strong>τ</strong>οµή ή<br />

<strong>ε</strong>κ<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί<strong>τ</strong>αι µ<strong>ε</strong> <strong>τ</strong>η βοήθ<strong>ε</strong>ια αρθρο<strong>σ</strong>κό<strong>π</strong>η<strong>σ</strong>ης. Αν χρη<strong>σ</strong>ιµο<strong>π</strong>οιηθ<strong>ε</strong>ί αρ-

θρο<strong>τ</strong>οµή, <strong>π</strong>ραγµα<strong>τ</strong>ο<strong>π</strong>οι<strong>ε</strong>ί<strong>τ</strong>αι µια έ<strong>σ</strong>ω ή έξω <strong>τ</strong>οµή <strong>π</strong>αρά <strong>τ</strong>ης <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδας.<br />

Η µέθοδος <strong>ε</strong><strong>π</strong>ι<strong>τ</strong>ρέ<strong>π</strong><strong>ε</strong>ι <strong>τ</strong>ην α<strong>π</strong>οκάλ<strong>υ</strong>ψη <strong>τ</strong>ης άρθρω<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong> γονά<strong>τ</strong>ο<strong>υ</strong><br />

και <strong>τ</strong>ων <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µένων ι<strong>σ</strong><strong>τ</strong>ών, αλλά <strong>π</strong><strong>ε</strong>ριλαµβάν<strong>ε</strong>ι <strong>τ</strong>οµή <strong>τ</strong>ο<strong>υ</strong><br />

αρθρικού θ<strong>υ</strong>λάκο<strong>υ</strong> και <strong>ε</strong>ξάρθρηµα ή ηµι<strong>ε</strong>ξάρθρηµα <strong>τ</strong>ης <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδας,<br />

θέ<strong>τ</strong>ον<strong>τ</strong>ας έ<strong>τ</strong><strong>σ</strong>ι <strong>σ</strong><strong>ε</strong> κίνδ<strong>υ</strong>νο <strong>τ</strong>ον <strong>ε</strong>κ<strong>τ</strong>α<strong>τ</strong>ικό µηχ<strong>αν</strong>ι<strong>σ</strong>µό και α<strong>υ</strong>ξάνον<strong>τ</strong>ας<br />

<strong>τ</strong>ον <strong>π</strong>όνο <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong> µ<strong>ε</strong><strong>τ</strong><strong>ε</strong>γχ<strong>ε</strong>ιρη<strong>τ</strong>ικά. Η α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η<br />

<strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong> µ<strong>ε</strong> <strong>τ</strong>η βοήθ<strong>ε</strong>ια αρθρο<strong>σ</strong>κό<strong>π</strong>η<strong>σ</strong>ης<br />

α<strong>π</strong>αι<strong>τ</strong><strong>ε</strong>ί <strong>τ</strong>ρ<strong>ε</strong>ις µικρές <strong>τ</strong>οµές για <strong>π</strong>ύλ<strong>ε</strong>ς, ό<strong>π</strong>ως <strong>ε</strong><strong>π</strong>ί<strong>σ</strong>ης και µια <strong>τ</strong>οµή<br />

<strong>σ</strong><strong>τ</strong>ην <strong>π</strong><strong>ε</strong>ριοχή α<strong>π</strong>ό <strong>τ</strong>ην ο<strong>π</strong>οία θα ληφθ<strong>ε</strong>ί <strong>τ</strong>ο µό<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µα, <strong>αν</strong> χρη<strong>σ</strong>ιµο<strong>π</strong>οιηθ<strong>ε</strong>ί<br />

α<strong>υ</strong><strong>τ</strong>ο<strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ικό µό<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µα. Η <strong>ε</strong>νδο<strong>σ</strong>κο<strong>π</strong>ική διαδικα<strong>σ</strong>ία <strong>ε</strong><strong>π</strong>ιβαρύν<strong>ε</strong>ι<br />

λιγό<strong>τ</strong><strong>ε</strong>ρο <strong>τ</strong>ις δοµές <strong>τ</strong>ο<strong>υ</strong> γονά<strong>τ</strong>ο<strong>υ</strong> και <strong>ε</strong><strong>π</strong>ι<strong>τ</strong>ρέ<strong>π</strong><strong>ε</strong>ι <strong>π</strong>ιο έν<strong>τ</strong>ονη<br />

και γρήγορη µ<strong>ε</strong><strong>τ</strong><strong>ε</strong>γχ<strong>ε</strong>ιρη<strong>τ</strong>ική α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η α<strong>π</strong>ό ό,<strong>τ</strong>ι η <strong>αν</strong>οιχ<strong>τ</strong>ή διαδικα<strong>σ</strong>ία.<br />

(γ) Σ<strong>ε</strong> µια <strong>ε</strong>νδαρθρική α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού<br />

<strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong> µ<strong>ε</strong> µό<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µα α<strong>π</strong>ό <strong>τ</strong>ον <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδικό <strong>τ</strong>ένον<strong>τ</strong>α, ο<br />

ριγµένος <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος α<strong>π</strong>οµακρύν<strong>ε</strong><strong>τ</strong>αι και <strong>αν</strong>οίγον<strong>τ</strong>αι ο<strong>σ</strong><strong>τ</strong>ικές<br />

αύλακ<strong>ε</strong>ς <strong>σ</strong><strong>τ</strong>ην κνήµη και <strong>τ</strong>ο µηριαίο ο<strong>σ</strong><strong>τ</strong>ό. Η µ<strong>ε</strong><strong>σ</strong>οκονδύλιος <strong>ε</strong>ν<strong>τ</strong>οµή<br />

µ<strong>π</strong>ορ<strong>ε</strong>ί να δι<strong>ε</strong><strong>υ</strong>ρ<strong>υ</strong>νθ<strong>ε</strong>ί (<strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ική), <strong>αν</strong> <strong>π</strong>αρο<strong>υ</strong><strong>σ</strong>ιάζ<strong>ε</strong>ι µη φ<strong>υ</strong><strong>σ</strong>ιολογική<br />

<strong>σ</strong><strong>τ</strong>ένω<strong>σ</strong>η. Σ<strong>τ</strong>η <strong>σ</strong><strong>υ</strong>νέχ<strong>ε</strong>ια <strong>τ</strong>ο κ<strong>ε</strong>ν<strong>τ</strong>ρικό ένα <strong>τ</strong>ρί<strong>τ</strong>ο <strong>τ</strong>ο<strong>υ</strong> <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδικού<br />

<strong>τ</strong>ένον<strong>τ</strong>α, µ<strong>ε</strong> ο<strong>σ</strong><strong>τ</strong>ική <strong>σ</strong>φήνα και <strong>σ</strong><strong>τ</strong>α δύο <strong>τ</strong>ο<strong>υ</strong> άκρα, α<strong>π</strong>οµακρύν<strong>ε</strong><strong>τ</strong>αι<br />

και <strong>τ</strong>ο<strong>π</strong>οθ<strong>ε</strong><strong>τ</strong><strong>ε</strong>ί<strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ις <strong>π</strong>ρο<strong>ε</strong><strong>τ</strong>οιµα<strong>σ</strong>µέν<strong>ε</strong>ς ο<strong>σ</strong><strong>τ</strong>ικές αύλακ<strong>ε</strong>ς <strong>τ</strong>ης κνήµης<br />

και <strong>τ</strong>ο<strong>υ</strong> µηριαίο<strong>υ</strong>. Η <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρο<strong>π</strong>οίη<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> µο<strong>σ</strong>χ<strong>ε</strong>ύµα<strong>τ</strong>ος<br />

<strong>ε</strong><strong>π</strong>ι<strong>τ</strong><strong>υ</strong>γχάν<strong>ε</strong><strong>τ</strong>αι µ<strong>ε</strong> ράµµα<strong>τ</strong>α και <strong>ε</strong>νι<strong>σ</strong>χύ<strong>ε</strong><strong>τ</strong>αι µ<strong>ε</strong> βίδ<strong>ε</strong>ς χωρίς κ<strong>ε</strong>φάλι ή<br />

ήλο<strong>υ</strong>ς <strong>σ</strong><strong>ε</strong> <strong>σ</strong>χήµα αγκύλης. Οι <strong>π</strong><strong>ε</strong>ριοχές α<strong>π</strong>ό <strong>τ</strong>ις ο<strong>π</strong>οί<strong>ε</strong>ς λήφθηκ<strong>ε</strong> <strong>τ</strong>ο<br />

ο<strong>σ</strong><strong>τ</strong>ικό µό<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µα, <strong>σ</strong><strong>τ</strong>η <strong>σ</strong><strong>υ</strong>νέχ<strong>ε</strong>ια γ<strong>ε</strong>µίζον<strong>τ</strong>αι µ<strong>ε</strong> <strong>σ</strong><strong>π</strong>ογγώδ<strong>ε</strong>ς ο<strong>σ</strong><strong>τ</strong>ό α<strong>π</strong>ό<br />

<strong>τ</strong>ις ο<strong>σ</strong><strong>τ</strong>ικές αύλακ<strong>ε</strong>ς <strong>τ</strong>ης κνήµης και <strong>τ</strong>ο<strong>υ</strong> µηριαίο<strong>υ</strong>.<br />

(δ) Το µό<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µα <strong>τ</strong>ο<strong>π</strong>οθ<strong>ε</strong><strong>τ</strong><strong>ε</strong>ί<strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ην ίδια θέ<strong>σ</strong>η ό<strong>π</strong>ο<strong>υ</strong> βρι<strong>σ</strong>κό<strong>τ</strong><strong>αν</strong> ο<br />

ρηγµένος <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος. Η ι<strong>σ</strong>οµ<strong>ε</strong><strong>τ</strong>ρική <strong>τ</strong>ο<strong>π</strong>οθέ<strong>τ</strong>η<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> µο<strong>σ</strong>χ<strong>ε</strong>ύµα<strong>τ</strong>ος<br />

α<strong>π</strong>οδ<strong>ε</strong>ίχθηκ<strong>ε</strong> ό<strong>τ</strong>ι <strong>ε</strong><strong>π</strong>ι<strong>τ</strong>ρέ<strong>π</strong><strong>ε</strong>ι να <strong>ε</strong>φαρµο<strong>σ</strong><strong>τ</strong>ούν <strong>σ</strong>χ<strong>ε</strong><strong>τ</strong>ικά ί<strong>σ</strong><strong>ε</strong>ς <strong>τ</strong>ά<strong>σ</strong><strong>ε</strong>ις <strong>σ</strong><strong>τ</strong>ο

µό<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µα, καθώς <strong>τ</strong>ο γόνα<strong>τ</strong>ο κιν<strong>ε</strong>ί<strong>τ</strong>αι µέ<strong>σ</strong>α <strong>σ</strong><strong>τ</strong>ο <strong>ε</strong>ύρος κίνη<strong>σ</strong>ης. Α<strong>υ</strong><strong>τ</strong>ό<br />

<strong>ε</strong><strong>π</strong>ι<strong>τ</strong>ρέ<strong>π</strong><strong>ε</strong>ι <strong>τ</strong>ην έναρξη <strong>τ</strong>ης κίνη<strong>σ</strong>ης <strong>σ</strong><strong>τ</strong>ην άρθρω<strong>σ</strong>η <strong>σ</strong>ύν<strong>τ</strong>οµα µ<strong>ε</strong><strong>τ</strong>ά<br />

α<strong>π</strong>ό <strong>τ</strong>η χ<strong>ε</strong>ιρο<strong>υ</strong>ργική <strong>ε</strong><strong>π</strong>έµβα<strong>σ</strong>η.<br />

(<strong>ε</strong>) Το γόνα<strong>τ</strong>ο <strong>π</strong>αροχ<strong>ε</strong><strong>τ</strong><strong>ε</strong>ύ<strong>ε</strong><strong>τ</strong>αι ( <strong>αν</strong> χρη<strong>σ</strong>ιµο<strong>π</strong>οιήθηκ<strong>ε</strong> αρθρο<strong>σ</strong>κο<strong>π</strong>ική<br />

διαδικα<strong>σ</strong>ία ) και η <strong>π</strong><strong>ε</strong>ριοχή <strong>τ</strong>ης <strong>τ</strong>οµής κλ<strong>ε</strong>ίν<strong>ε</strong><strong>τ</strong>αι. Ένα µικρό <strong>σ</strong><strong>υ</strong>µ<strong>π</strong>ι<strong>ε</strong><strong>σ</strong><strong>τ</strong>ικό<br />

<strong>υ</strong>λικό και ένα ορθο<strong>τ</strong>ικό µέ<strong>σ</strong>ο <strong>ε</strong>λέγχο<strong>υ</strong> <strong>τ</strong>ης κίνη<strong>σ</strong>ης <strong>τ</strong>ο<strong>π</strong>οθ<strong>ε</strong><strong>τ</strong>ούν<strong>τ</strong>αι<br />

αµέ<strong>σ</strong>ως <strong>σ</strong><strong>τ</strong>ο γόνα<strong>τ</strong>ο.<br />

Μ<strong>ε</strong><strong>τ</strong><strong>ε</strong>γχ<strong>ε</strong>ιρη<strong>τ</strong>ική <strong>αν</strong><strong>τ</strong>ιµ<strong>ε</strong><strong>τ</strong>ώ<strong>π</strong>ι<strong>σ</strong>η<br />

Σηµ<strong>ε</strong>ίω<strong>σ</strong>η: Πριν α<strong>π</strong>ό µία ή δύο δ<strong>ε</strong>κα<strong>ε</strong><strong>τ</strong>ί<strong>ε</strong>ς, η <strong>αν</strong><strong>τ</strong>ιµ<strong>ε</strong><strong>τ</strong>ώ<strong>π</strong>ι<strong>σ</strong>η µ<strong>ε</strong><strong>τ</strong>ά<br />

α<strong>π</strong>ό α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>π</strong><strong>ε</strong>ριλάµβ<strong>αν</strong><strong>ε</strong> µ<strong>ε</strong>γάλ<strong>ε</strong>ς<br />

<strong>π</strong><strong>ε</strong>ριόδο<strong>υ</strong>ς <strong>τ</strong>έλ<strong>ε</strong>ιας ακινη<strong>τ</strong>ο<strong>π</strong>οίη<strong>σ</strong>ης, µ<strong>ε</strong> <strong>τ</strong>ο γόνα<strong>τ</strong>ο <strong>σ</strong><strong>ε</strong> θέ<strong>σ</strong>η κάµψης,<br />

και µία <strong>ε</strong>κ<strong>τ</strong><strong>ε</strong><strong>τ</strong>αµένη <strong>π</strong><strong>ε</strong>ρίοδο ( 6 µ<strong>ε</strong> 8 <strong>ε</strong>βδοµάδ<strong>ε</strong>ς ) <strong>π</strong><strong>ε</strong>ριορι<strong>σ</strong>µένης<br />

φόρ<strong>τ</strong>ι<strong>σ</strong>ης. Η <strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ροφή <strong>σ</strong><strong>τ</strong>ην <strong>π</strong>λήρη δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong>α <strong>σ</strong><strong>υ</strong>χνά α<strong>π</strong>αι<strong>τ</strong>ού<strong>σ</strong><strong>ε</strong><br />

έν<strong>αν</strong> ολόκληρο χρόνο. Τα <strong>τ</strong><strong>ε</strong>λ<strong>ε</strong><strong>υ</strong><strong>τ</strong>αία χρόνια, µ<strong>ε</strong> <strong>τ</strong>ις <strong>ε</strong>ξ<strong>ε</strong>λίξ<strong>ε</strong>ις<br />

<strong>τ</strong>ων χ<strong>ε</strong>ιρο<strong>υ</strong>ργικών <strong>τ</strong><strong>ε</strong>χνικών και <strong>τ</strong>ην καλύ<strong>τ</strong><strong>ε</strong>ρη κα<strong>τ</strong><strong>αν</strong>όη<strong>σ</strong>η <strong>τ</strong>ης <strong>ε</strong><strong>π</strong>ούλω<strong>σ</strong>ης<br />

<strong>τ</strong>ων ι<strong>σ</strong><strong>τ</strong>ών, <strong>ε</strong>ίναι δ<strong>υ</strong>να<strong>τ</strong>ή η <strong>π</strong>ρώιµη µ<strong>ε</strong><strong>τ</strong><strong>ε</strong>γχ<strong>ε</strong>ιρη<strong>τ</strong>ική κίνη<strong>σ</strong>η και<br />

φόρ<strong>τ</strong>ι<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> άκρο<strong>υ</strong>.<br />

4.3 ΤΕΧΝΙΚΕΣ ΣΤΙΣ ΟΠΟΙΕΣ ΧΡΗΣΙΜΟΠΟΙΟΥΝΤΑΙ ΙΣΤΟΙ<br />

ΑΠΟ ΠΤΩΜΑΤΙΚΟ ∆ΟΤΗ<br />

··

Τα <strong>τ</strong><strong>ε</strong>λ<strong>ε</strong><strong>υ</strong><strong>τ</strong>αία 15 χρόνια, έχ<strong>ε</strong>ι δοθ<strong>ε</strong>ί µ<strong>ε</strong>γάλη βαρύ<strong>τ</strong>η<strong>τ</strong>α <strong>σ</strong><strong>τ</strong>η χρή<strong>σ</strong>η<br />

<strong>π</strong><strong>τ</strong>ωµα<strong>τ</strong>ικών µο<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µα<strong>τ</strong>ικών <strong>υ</strong>λικών <strong>σ</strong><strong>τ</strong>η <strong>σ</strong><strong>υ</strong>νδ<strong>ε</strong><strong>σ</strong>µο<strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ική <strong>τ</strong>ο<strong>υ</strong><br />

γονά<strong>τ</strong>ο<strong>υ</strong>, για<strong>τ</strong>ί <strong>ε</strong><strong>π</strong>ι<strong>τ</strong>ρέ<strong>π</strong><strong>ε</strong>ι <strong>τ</strong>ην α<strong>π</strong>οφύγ<strong>ε</strong>ι <strong>π</strong>ρό<strong>σ</strong>θ<strong>ε</strong><strong>τ</strong>ων δια<strong>τ</strong>οµών <strong>π</strong>ο<strong>υ</strong><br />

µ<strong>ε</strong>γαλώνο<strong>υ</strong>ν <strong>τ</strong>η νο<strong>σ</strong>ηρό<strong>τ</strong>η<strong>τ</strong>α και κα<strong>τ</strong>αλήγο<strong>υ</strong>ν <strong>σ</strong><strong>ε</strong> <strong>π</strong>αραµορφώ<strong>σ</strong><strong>ε</strong>ις<br />

και <strong>τ</strong>η δια<strong>τ</strong>ήρη<strong>σ</strong>η <strong>τ</strong>ων γ<strong>ε</strong>ι<strong>τ</strong>ονικών µ<strong>υ</strong>ο<strong>τ</strong><strong>ε</strong>νόν<strong>τ</strong>ιων ή άλλων δοµών. Ο<br />

<strong>π</strong>ρο<strong>σ</strong><strong>αν</strong>α<strong>τ</strong>ολι<strong>σ</strong>µός <strong>π</strong>ρος α<strong>υ</strong><strong>τ</strong>ό <strong>τ</strong>ο <strong>π</strong><strong>ε</strong>δίο βιολογικών <strong>υ</strong>λικών έχ<strong>ε</strong>ι<br />

<strong>π</strong>ροκύψ<strong>ε</strong>ι µ<strong>ε</strong> βά<strong>σ</strong>η <strong>τ</strong>α α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λέ<strong>σ</strong>µα<strong>τ</strong>α διαφόρων µ<strong>ε</strong>λ<strong>ε</strong><strong>τ</strong>ών, <strong>σ</strong><strong>τ</strong>ις ο<strong>π</strong>oι<strong>ε</strong>ς<br />

<strong>π</strong>ο<strong>σ</strong>ο<strong>σ</strong><strong>τ</strong>ά <strong>τ</strong>ων <strong>π</strong><strong>ε</strong>ρι<strong>π</strong><strong>τ</strong>ώ<strong>σ</strong><strong>ε</strong>ων µ<strong>ε</strong> µ<strong>ε</strong><strong>τ</strong><strong>ε</strong>γχ<strong>ε</strong>ιρη<strong>τ</strong>ικό <strong>π</strong>όνο (70%), <strong>τ</strong>α<br />

ο<strong>π</strong>οία <strong>σ</strong>χ<strong>ε</strong><strong>τ</strong>ίζον<strong>τ</strong>αι µ<strong>ε</strong> αλλαγές <strong>σ</strong><strong>τ</strong>ον αρθρικό θύλακα <strong>π</strong>ο<strong>υ</strong><br />

<strong>π</strong>αρα<strong>τ</strong>ηρήθηκ<strong>αν</strong> κα<strong>τ</strong>ά <strong>τ</strong>ο χ<strong>ε</strong>ιρο<strong>υ</strong>ργ<strong>ε</strong>ίο. Οι βα<strong>σ</strong>ικό<strong>τ</strong><strong>ε</strong>ροι <strong>π</strong>αράγον<strong>τ</strong><strong>ε</strong><strong>σ</strong><br />

<strong>π</strong>ο<strong>υ</strong> καθορίζο<strong>υ</strong>ν <strong>τ</strong>ο <strong>π</strong>ό<strong>σ</strong>ο <strong>ε</strong><strong>π</strong>ι<strong>τ</strong><strong>υ</strong>χηµένη <strong>ε</strong>ίναι η κάθ<strong>ε</strong> <strong>τ</strong>ύ<strong>π</strong>ο<strong>υ</strong><br />

<strong>π</strong>ρο<strong>σ</strong>θ<strong>ε</strong><strong>τ</strong>ική <strong>αν</strong><strong>τ</strong>ικα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού , <strong>ε</strong>ίναι η<br />

<strong>αν</strong><strong>ε</strong>κ<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ων ι<strong>σ</strong><strong>τ</strong>ών <strong>σ</strong><strong>τ</strong>ο <strong>υ</strong>λικό <strong>π</strong>ο<strong>υ</strong> χρη<strong>σ</strong>ιµο<strong>π</strong>οι<strong>ε</strong>ί<strong>τ</strong>αι και η<br />

<strong>αν</strong><strong>τ</strong>οχή <strong>σ</strong><strong>τ</strong>ην <strong>τ</strong>ά<strong>σ</strong>η. Οι µ<strong>ε</strong>λέ<strong>τ</strong><strong>ε</strong>ς <strong>σ</strong><strong>υ</strong>ν<strong>ε</strong>χίζον<strong>τ</strong>αι....

ΕΙ∆ΙΚΟ ΜΕΡΟΣ

ΑΠΟΚΑΤΑΣΤΑΣΗ<br />

Η έρ<strong>ε</strong><strong>υ</strong>να <strong>π</strong>άνω <strong>σ</strong><strong>τ</strong>η βιοµηχ<strong>αν</strong>ική <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος έχ<strong>ε</strong>ι<br />

<strong>αν</strong>αγνωρί<strong>σ</strong><strong>ε</strong>ι <strong>π</strong>ολ<strong>υ</strong>άριθµ<strong>ε</strong>ς θέ<strong>σ</strong><strong>ε</strong>ις και κα<strong>τ</strong>α<strong>σ</strong><strong>τ</strong>ά<strong>σ</strong><strong>ε</strong>ις <strong>π</strong>ο<strong>υ</strong><br />

<strong>π</strong>ροκαλούν φορ<strong>τ</strong>ίο <strong>τ</strong>ά<strong>σ</strong>ης <strong>π</strong>άνω <strong>σ</strong><strong>τ</strong>ον <strong>αν</strong>έ<strong>π</strong>αφο <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό. Η<br />

<strong>ε</strong>ξέ<strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ων θέ<strong>σ</strong><strong>ε</strong>ων <strong>π</strong>ο<strong>υ</strong> <strong>π</strong>αίρνον<strong>τ</strong>αι <strong>π</strong>αθη<strong>τ</strong>ικά, έχ<strong>ε</strong>ι α<strong>π</strong>οκαλύψ<strong>ε</strong>ι<br />

ό<strong>τ</strong>ι οι θέ<strong>σ</strong><strong>ε</strong>ις <strong>τ</strong>ης µέγι<strong>σ</strong><strong>τ</strong>ης κάµψης και έκ<strong>τ</strong>α<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος,<br />

<strong>π</strong>ροκαλούν α<strong>υ</strong>ξηµένη <strong>τ</strong>ά<strong>σ</strong>η <strong>π</strong>άνω <strong>σ</strong>' ένα <strong>αν</strong>έ<strong>π</strong>αφο <strong>π</strong>ρό<strong>σ</strong>θιο<br />

χια<strong>σ</strong><strong>τ</strong>ό, <strong>σ</strong><strong>ε</strong> <strong>σ</strong>χέ<strong>σ</strong>η µ<strong>ε</strong> <strong>τ</strong>ις θέ<strong>σ</strong><strong>ε</strong>ις διάµ<strong>ε</strong><strong>σ</strong>ο<strong>υ</strong> <strong>ε</strong>ύρο<strong>υ</strong>ς. Πα <strong>τ</strong>ο λόγο α<strong>υ</strong><strong>τ</strong>ό<br />

µ<strong>ε</strong>ρικοί <strong>σ</strong><strong>υ</strong>γγραφ<strong>ε</strong>ίς <strong>ε</strong>νθάρρ<strong>υ</strong>ν<strong>αν</strong> <strong>τ</strong>ην α<strong>π</strong>οφ<strong>υ</strong>γή α<strong>υ</strong><strong>τ</strong>ών <strong>τ</strong>ων θέ<strong>σ</strong><strong>ε</strong>ων<br />

κα<strong>τ</strong>ά <strong>τ</strong>ις <strong>π</strong>ρώιµ<strong>ε</strong>ς φά<strong>σ</strong><strong>ε</strong>ις µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό <strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ική <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού.<br />

Ο Ρaulos και άλλοι, βρήκ<strong>αν</strong> ό<strong>τ</strong>ι η <strong>τ</strong>ά<strong>σ</strong>η <strong>π</strong>άνω <strong>σ</strong><strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό<br />

α<strong>υ</strong>ξάν<strong>ε</strong><strong>τ</strong>αι δραµα<strong>τ</strong>ικά κα<strong>τ</strong>ά <strong>τ</strong>ις <strong>τ</strong><strong>ε</strong>λ<strong>ε</strong><strong>υ</strong><strong>τ</strong>αί<strong>ε</strong>ς 30° <strong>τ</strong>ης έκ<strong>τ</strong>α<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong><br />

γονά<strong>τ</strong>ο<strong>υ</strong>. Α<strong>υ</strong><strong>τ</strong>ή η αύξη<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ην <strong>τ</strong>ά<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού δ<strong>ε</strong>ν <strong>π</strong>αρα<strong>τ</strong>ηρήθηκ<strong>ε</strong><br />

κα<strong>τ</strong>ά <strong>τ</strong>ην κάµψη <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος µ<strong>ε</strong> <strong>τ</strong>ην <strong>ε</strong>φαρµογή <strong>αν</strong><strong>τ</strong>ί<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης.<br />

Παρόµοια <strong>ε</strong><strong>υ</strong>ρήµα<strong>τ</strong>α <strong>ε</strong>ίχ<strong>αν</strong> <strong>π</strong>αρο<strong>υ</strong><strong>σ</strong>ια<strong>σ</strong><strong>τ</strong><strong>ε</strong>ί <strong>π</strong>ροηγούµ<strong>ε</strong>να<br />

<strong>σ</strong><strong>τ</strong>η βιβλιογραφία <strong>τ</strong>ης βιοµηχ<strong>αν</strong>ικής και α<strong>π</strong>ό <strong>τ</strong>ό<strong>τ</strong><strong>ε</strong> έχο<strong>υ</strong>ν <strong>ε</strong><strong>π</strong>ιβ<strong>ε</strong>βαιωθ<strong>ε</strong>ί.<br />

Ο Giove et al., έβαλ<strong>αν</strong> ένα γκρο<strong>υ</strong><strong>π</strong> αρρώ<strong>σ</strong><strong>τ</strong>ων µ<strong>ε</strong> γόνα<strong>τ</strong>α, µ<strong>ε</strong><br />

<strong>π</strong>ροβληµα<strong>τ</strong>ικούς <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong>ς χια<strong>σ</strong><strong>τ</strong>ούς, <strong>σ</strong>' ένα <strong>π</strong>ρόγραµµα α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ων<br />

<strong>π</strong>ροοδ<strong>ε</strong><strong>υ</strong><strong>τ</strong>ικής <strong>αν</strong><strong>τ</strong>ί<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης (Ρ.R.Ε. Ρrograsive Resistance<br />

Exercise) για να <strong>π</strong>ροάγο<strong>υ</strong>ν <strong>τ</strong>ην µ<strong>υ</strong>ϊκή <strong>υ</strong><strong>π</strong><strong>ε</strong>ρ<strong>τ</strong>ροφία <strong>τ</strong>ο<strong>υ</strong> µηρού. Χρη<strong>σ</strong>ι-<br />

µο<strong>π</strong>οίη<strong>σ</strong><strong>αν</strong> ένα <strong>π</strong>ρόγραµµα, <strong>σ</strong><strong>τ</strong>ο ο<strong>π</strong>οίο δόθηκ<strong>ε</strong> έµφα<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ην <strong>ε</strong>νδ<strong>υ</strong>νάµω<strong>σ</strong>η<br />

<strong>τ</strong>ων ι<strong>σ</strong>χιοκνηµιαίων. Βρήκ<strong>αν</strong> ό<strong>τ</strong>ι ψηλό<strong>τ</strong><strong>ε</strong>ρα <strong>ε</strong><strong>π</strong>ί<strong>π</strong><strong>ε</strong>δα <strong>σ</strong><strong>υ</strong>µ-

µ<strong>ε</strong><strong>τ</strong>οχής <strong>σ</strong><strong>ε</strong> <strong>σ</strong><strong>π</strong>ορ, <strong>π</strong>έ<strong>τ</strong><strong>υ</strong>χ<strong>αν</strong> οι άρρω<strong>σ</strong><strong>τ</strong>οι <strong>π</strong>ο<strong>υ</strong> η δύναµη <strong>τ</strong>ων ι<strong>σ</strong>χιοκνηµιαίων<br />

<strong>τ</strong>ο<strong>υ</strong>ς ή<strong>τ</strong><strong>αν</strong> ί<strong>σ</strong>η ή και µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρη α<strong>π</strong>ό <strong>τ</strong>η δύναµη <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong><br />

<strong>τ</strong>ο<strong>υ</strong>ς. Καθώς η δύναµη <strong>τ</strong>ων ι<strong>σ</strong>χιοκνηµιαίων <strong>σ</strong><strong>τ</strong>ον κ<strong>αν</strong>ονικό<br />

<strong>π</strong>ληθ<strong>υ</strong><strong>σ</strong>µό, <strong>ε</strong>ίναι <strong>σ</strong><strong>υ</strong>νήθως <strong>τ</strong>α 2/3 α<strong>υ</strong><strong>τ</strong>ής <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong>,<br />

<strong>τ</strong>α <strong>ε</strong><strong>υ</strong>ρήµα<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong>ς <strong>π</strong>ρο<strong>τ</strong><strong>ε</strong>ίνο<strong>υ</strong>ν ό<strong>τ</strong>ι <strong>τ</strong>ο <strong>υ</strong><strong>π</strong><strong>ε</strong>ρδ<strong>υ</strong>νάµωµα <strong>τ</strong>ων ι<strong>σ</strong>χιοκνη-<br />

µιαίων θα µ<strong>π</strong>ορού<strong>σ</strong><strong>ε</strong> να βοηθή<strong>σ</strong><strong>ε</strong>ι <strong>σ</strong><strong>τ</strong>ην <strong>αν</strong><strong>τ</strong>ι<strong>σ</strong><strong>τ</strong>άθµι<strong>σ</strong>η για <strong>τ</strong>η µη ύ-<br />

<strong>π</strong>αρξη <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού. Σύν<strong>τ</strong>οµα έγιν<strong>ε</strong> κοινή <strong>π</strong>ρακ<strong>τ</strong>ική <strong>σ</strong><strong>τ</strong>ην<br />

α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µούς <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού, να δίν<strong>ε</strong><strong>τ</strong>αι<br />

έµφα<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ην <strong>ε</strong>νδ<strong>υ</strong>νάµω<strong>σ</strong>η <strong>τ</strong>ων ι<strong>σ</strong>χιοκνηµιαίων, καθώς θα <strong>ε</strong>-<br />

<strong>π</strong>ι<strong>τ</strong>ρέ<strong>π</strong><strong>ε</strong><strong>τ</strong>αι µόνο <strong>π</strong>ρο<strong>σ</strong><strong>ε</strong>κ<strong>τ</strong>ική <strong>ε</strong>νδ<strong>υ</strong>νάµω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong>. ∆ύο<br />

<strong>τ</strong>ρό<strong>π</strong>οι για να <strong>π</strong><strong>ε</strong><strong>τ</strong>ύχο<strong>υ</strong>µ<strong>ε</strong> <strong>π</strong>ρο<strong>σ</strong><strong>ε</strong>κ<strong>τ</strong>ική <strong>ε</strong>νδ<strong>υ</strong>νάµω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong>,<br />

µ<strong>ε</strong> <strong>π</strong>αράλληλη <strong>ε</strong>ξο<strong>υ</strong>δ<strong>ε</strong><strong>τ</strong>έρω<strong>σ</strong>η <strong>τ</strong>ης <strong>τ</strong>ά<strong>σ</strong>ης <strong>π</strong>άνω <strong>σ</strong><strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο<br />

χια<strong>σ</strong><strong>τ</strong>ό, <strong>ε</strong>ίναι η χρή<strong>σ</strong>η <strong>τ</strong>ων <strong>τ</strong>α<strong>υ</strong><strong>τ</strong>όχρονων ι<strong>σ</strong>οµ<strong>ε</strong><strong>τ</strong>ρικών <strong>σ</strong><strong>υ</strong><strong>σ</strong><strong>π</strong>ά<strong>σ</strong><strong>ε</strong>ων<br />

<strong>τ</strong>ων ι<strong>σ</strong>χιοκνηµιαίων µ<strong>ε</strong> <strong>τ</strong>ον <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο ή µ<strong>ε</strong> <strong>τ</strong>ο να <strong>ε</strong><strong>π</strong>ι<strong>τ</strong>ρα<strong>π</strong><strong>ε</strong>ί η έ-<br />

κ<strong>τ</strong>α<strong>σ</strong>η <strong>σ</strong><strong>ε</strong> γωνί<strong>ε</strong>ς µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρ<strong>ε</strong>ς α<strong>π</strong>ό 60° ό<strong>τ</strong><strong>αν</strong> <strong>π</strong>ραγµα<strong>τ</strong>ο<strong>π</strong>οι<strong>ε</strong>ί<strong>τ</strong>αι α-<br />

<strong>π</strong>οµονωµένη <strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong>. Η ι<strong>σ</strong>οµ<strong>ε</strong><strong>τ</strong>ρική <strong>σ</strong><strong>υ</strong> - <strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η<br />

<strong>τ</strong>ων ι<strong>σ</strong>χιοκνηµιαίων µ<strong>ε</strong> <strong>τ</strong>ον <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο, <strong>π</strong>ρο<strong>σ</strong>θέ<strong>τ</strong><strong>ε</strong>ι µια<br />

<strong>σ</strong><strong>υ</strong>ρ<strong>τ</strong>αρω<strong>τ</strong>ού <strong>τ</strong>ύ<strong>π</strong>ο<strong>υ</strong> δύναµη <strong>π</strong>άνω <strong>σ</strong><strong>τ</strong>ην κνήµη, η ο<strong>π</strong>οία <strong>π</strong>αράγ<strong>ε</strong><strong>τ</strong>αι<br />

α<strong>π</strong>ό <strong>τ</strong>ον <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο. Α<strong>υ</strong><strong>τ</strong>ή η <strong>τ</strong><strong>ε</strong>χνική <strong>π</strong>ι<strong>σ</strong><strong>τ</strong><strong>ε</strong>ύ<strong>ε</strong><strong>τ</strong>αι ό<strong>τ</strong>ι <strong>π</strong>ρο<strong>σ</strong><strong>τ</strong>α<strong>τ</strong><strong>ε</strong>ύ<strong>ε</strong>ι<br />

<strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό α<strong>π</strong>ό <strong>υ</strong><strong>π</strong><strong>ε</strong>ρβολική <strong>τ</strong>ά<strong>σ</strong>η <strong>π</strong>άνω <strong>τ</strong>ο<strong>υ</strong>, <strong>ε</strong>κ<strong>τ</strong>ός <strong>αν</strong> α<strong>υ</strong><strong>τ</strong>ή<br />

<strong>π</strong>ραγµα<strong>τ</strong>ο<strong>π</strong>οι<strong>ε</strong>ί<strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ην <strong>τ</strong>έλ<strong>ε</strong>ια έκ<strong>τ</strong>α<strong>σ</strong>η. Οι ΥΒΒΙΙΟΒ και 5353Κ!<br />

(1987) χρη<strong>σ</strong>ιµο<strong>π</strong>οίη<strong>σ</strong><strong>αν</strong> ένα δι<strong>σ</strong>διά<strong>σ</strong><strong><strong>τ</strong>α<strong>τ</strong>ο</strong> µον<strong>τ</strong>έλο και ηλ<strong>ε</strong>κ<strong>τ</strong>ροµ<strong>υ</strong>ογραφικές<br />

<strong>π</strong>ληροφορί<strong>ε</strong>ς για να καθορί<strong>σ</strong>ο<strong>υ</strong>ν <strong>τ</strong>ο κα<strong>τ</strong>ά <strong>π</strong>ό<strong>σ</strong>ο <strong>ε</strong>ίναι δ<strong>υ</strong>να<strong>τ</strong>ή<br />

η χρή<strong>σ</strong>η <strong>τ</strong>ης <strong>τ</strong><strong>ε</strong>χνικής <strong>τ</strong>ων <strong>σ</strong><strong>υ</strong> - <strong>σ</strong><strong>υ</strong><strong>σ</strong><strong>π</strong>ά<strong>σ</strong><strong>ε</strong>ων µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό <strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ική<br />

<strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού.<br />

Βρήκ<strong>αν</strong> ό<strong>τ</strong>ι κα<strong>τ</strong>ά <strong>τ</strong>ην <strong>τ</strong>α<strong>υ</strong><strong>τ</strong>όχρονη ι<strong>σ</strong>οµ<strong>ε</strong><strong>τ</strong>ρική <strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ις 5°<br />

κάµψης <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, η κνήµη δέχ<strong>ε</strong><strong>τ</strong>αι µια <strong>π</strong>ρό<strong>σ</strong>θια <strong>σ</strong><strong>υ</strong>ρ<strong>τ</strong>αρω<strong>τ</strong>ή δύναµη<br />

ί<strong>σ</strong>η µ<strong>ε</strong> <strong>τ</strong>ο 15% <strong>τ</strong>ης <strong>τ</strong>ά<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong>. Η δύναµη α<strong>υ</strong><strong>τ</strong>ή<br />

<strong>π</strong><strong>ε</strong>ριορίζ<strong>ε</strong><strong>τ</strong>αι, καθώς µ<strong>ε</strong>γαλών<strong>ε</strong>ι η γωνία κάµψης <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, γιο

να γίν<strong>ε</strong>ι ί<strong>σ</strong>η µ<strong>ε</strong> 0° <strong>σ</strong><strong>ε</strong> µια µέ<strong>σ</strong>η γωνία 7,4° κάµψης. Σ<strong>ε</strong> µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρ<strong>ε</strong>ς<br />

γωνί<strong>ε</strong>ς κάµψης, <strong>π</strong>αράγ<strong>ε</strong><strong>τ</strong>αι µια <strong>σ</strong><strong>υ</strong>ρ<strong>τ</strong>αρω<strong>τ</strong>ή δύναµη <strong>σ</strong><strong>τ</strong>ην κνήµη, µ<strong>ε</strong><br />

φορά <strong>π</strong>ρος <strong>τ</strong>α <strong>π</strong>ί<strong>σ</strong>ω, η ο<strong>π</strong>οία <strong>σ</strong><strong>τ</strong>αδιακά α<strong>υ</strong>ξάν<strong>ε</strong><strong>τ</strong>αι µ<strong>ε</strong> γωνία κάµψης.<br />

Η <strong>τ</strong>ά<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ον <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο και <strong>τ</strong>ο<strong>υ</strong>ς ι<strong>σ</strong>χιοκνηµιαίο<strong>υ</strong>ς κα<strong>τ</strong>ά <strong>τ</strong>η<br />

µέγι<strong>σ</strong><strong>τ</strong>η δ<strong>υ</strong>να<strong>τ</strong>ή <strong>σ</strong><strong>υ</strong> - <strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong>ς, φ<strong>τ</strong>άν<strong>ε</strong>ι <strong>τ</strong>α 30% µ<strong>ε</strong> 60% α<strong>υ</strong><strong>τ</strong>ής<br />

<strong>π</strong>ο<strong>υ</strong> <strong>π</strong>αρα<strong>τ</strong>ηρ<strong>ε</strong>ί<strong>τ</strong>αι κα<strong>τ</strong>ά <strong>τ</strong>ην ξ<strong>ε</strong>χωρι<strong>σ</strong><strong>τ</strong>ή µέγι<strong>σ</strong><strong>τ</strong>η ι<strong>σ</strong>οµ<strong>ε</strong><strong>τ</strong>ρική <strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η<br />

<strong>τ</strong>ο<strong>υ</strong> κάθ<strong>ε</strong> µ<strong>υ</strong> ξ<strong>ε</strong>χωρι<strong>σ</strong><strong>τ</strong>ά. Η κλινική <strong>π</strong><strong>ε</strong>ίρα, µ<strong>ε</strong> <strong>τ</strong>ην <strong>τ</strong><strong>ε</strong>χνική α<strong>υ</strong><strong>τ</strong>ή,<br />

έχ<strong>ε</strong>ι δ<strong>ε</strong>ίξ<strong>ε</strong>ι ό<strong>τ</strong>ι µ<strong>π</strong>ορ<strong>ε</strong>ί να χρη<strong>σ</strong>ιµο<strong>π</strong>οι<strong>ε</strong>ί<strong>τ</strong>αι χωρίς <strong>ε</strong><strong>π</strong>ιφύλαξη, µ<strong>ε</strong> <strong>τ</strong>ο<br />

γόνα<strong>τ</strong>ο <strong>σ</strong><strong>ε</strong> ο<strong>π</strong>οιαδή<strong>π</strong>ο<strong>τ</strong><strong>ε</strong> θέ<strong>σ</strong>η κάµψης, <strong>π</strong>έρα α<strong>π</strong>ό <strong>τ</strong>ις 7,5° και ό<strong>τ</strong>ι η<br />

µ<strong>υ</strong>ϊκή <strong>τ</strong>ά<strong>σ</strong>η <strong>π</strong>ο<strong>υ</strong> <strong>π</strong>αράγ<strong>ε</strong><strong>τ</strong>αι <strong>ε</strong>ίναι ικ<strong>αν</strong>ή να <strong>π</strong><strong>ε</strong>ριορί<strong>σ</strong><strong>ε</strong>ι <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικά <strong>τ</strong>ην<br />

<strong>τ</strong>αχύ<strong>τ</strong>η<strong>τ</strong>α <strong>π</strong><strong>τ</strong>ώ<strong>σ</strong>ης <strong>τ</strong>ης µ<strong>υ</strong>ϊκής δύναµης, <strong>ε</strong>νώ, <strong>τ</strong>έλος, <strong>π</strong>ι<strong>σ</strong><strong>τ</strong><strong>ε</strong>ύ<strong>ε</strong><strong>τ</strong>αι ό<strong>τ</strong>ι<br />

κα<strong>τ</strong>' α<strong>υ</strong><strong>τ</strong>όν <strong>τ</strong>ον <strong>τ</strong>ρό<strong>π</strong>ο µ<strong>π</strong>ορ<strong>ε</strong>ί να µ<strong>ε</strong>ιωθ<strong>ε</strong>ί ο ολικός χρόνος α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης.<br />

Σ<strong>αν</strong> δ<strong>ε</strong>ύ<strong>τ</strong><strong>ε</strong>ρη <strong>ε</strong>ναλλακ<strong>τ</strong>ική λύ<strong>σ</strong>η α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ων, <strong>τ</strong>ο<strong>π</strong>οθ<strong>ε</strong><strong>τ</strong>ών<strong>τ</strong>ας <strong>τ</strong>ο γόνα<strong>τ</strong>ο<br />

α<strong>π</strong>ό <strong>τ</strong>ις 60° κάµψης και <strong>π</strong>άνω ( και µέχρι <strong>τ</strong>ις 90° ) κα<strong>τ</strong>ά <strong>τ</strong>ην<br />

ά<strong>σ</strong>κη<strong>σ</strong>η, οι δ<strong>υ</strong>νάµ<strong>ε</strong>ις <strong>π</strong>ο<strong>υ</strong> <strong>σ</strong>χ<strong>ε</strong><strong>τ</strong>ίζον<strong>τ</strong>αι µ<strong>ε</strong> <strong>τ</strong>ις α<strong>π</strong>οµονωµέν<strong>ε</strong>ς <strong>σ</strong><strong>υ</strong><strong>σ</strong><strong>π</strong>ά<strong>σ</strong><strong>ε</strong>ις<br />

<strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong>, µ<strong>ε</strong><strong>τ</strong>αβάλλον<strong>τ</strong>αι έ<strong>τ</strong><strong>σ</strong>ι <strong>π</strong>ο<strong>υ</strong> να <strong>ε</strong>λαχι<strong>σ</strong><strong>τ</strong>ο<strong>π</strong>οι<strong>ε</strong>ί<strong>τ</strong>αι<br />

κάθ<strong>ε</strong> δύναµη <strong>π</strong>ο<strong>υ</strong> <strong>π</strong>ροωθ<strong>ε</strong>ί <strong>τ</strong>ην <strong>π</strong>ρος <strong>τ</strong>α µ<strong>π</strong>ρο<strong>σ</strong><strong>τ</strong>ά <strong>π</strong>αρ<strong>ε</strong>κ<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>η<br />

<strong>τ</strong>ης κνήµης. Το µόνο <strong>π</strong>ρόβληµα <strong>π</strong>ο<strong>υ</strong> <strong>π</strong>ροκύ<strong>π</strong><strong>τ</strong><strong>ε</strong>ι µ<strong>ε</strong> <strong>τ</strong>ον<br />

<strong>π</strong>αρα<strong>π</strong>άνω <strong>τ</strong>ρό<strong>π</strong>ο ά<strong>σ</strong>κη<strong>σ</strong>ης και <strong>τ</strong>ο ο<strong>π</strong>οίο κάν<strong>ε</strong>ι <strong>σ</strong>χ<strong>ε</strong><strong>τ</strong>ικά δύ<strong>σ</strong>κολη <strong>τ</strong>η<br />

<strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η και χρη<strong>σ</strong>ιµο<strong>π</strong>οίη<strong>σ</strong>η <strong>τ</strong>έ<strong>τ</strong>οιων α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ων, <strong>ε</strong>ίναι η <strong>π</strong>ολύ κοινή<br />

<strong>ε</strong><strong>π</strong>ι<strong>π</strong>λοκή, µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό <strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ική <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού, <strong>τ</strong>ο<strong>υ</strong> <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδοµηριαίο<strong>υ</strong><br />

<strong>π</strong>όνο<strong>υ</strong>. Α<strong>υ</strong><strong>τ</strong>ή η δια<strong>τ</strong>αραχή <strong>ε</strong><strong>π</strong>ιδ<strong>ε</strong>ινών<strong>ε</strong><strong>τ</strong>αι, κάνον<strong>τ</strong>ας<br />

α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις ι<strong>σ</strong>οµ<strong>ε</strong><strong>τ</strong>ρικές ή µ<strong>ε</strong> <strong>αν</strong><strong>τ</strong>ί<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ον <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο, <strong>σ</strong><strong>ε</strong> γωνία<br />

µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρη α<strong>π</strong>ό 30° κάµψης. Ο <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδοµηριαίος <strong>π</strong>όνος, µ<strong>π</strong>ορ<strong>ε</strong>ί<br />

να α<strong>π</strong>ο<strong>τ</strong>ρα<strong>π</strong><strong>ε</strong>ί ή και να θ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong><strong>υ</strong><strong>τ</strong><strong>ε</strong>ί µόνο µ<strong>ε</strong> <strong>ε</strong>νδ<strong>υ</strong>νάµω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong>,<br />

<strong>σ</strong><strong>τ</strong>ο <strong>ε</strong>ύρος α<strong>π</strong>ό 0° - 30°, αλλά α<strong>υ</strong><strong>τ</strong>ό <strong>ε</strong>ίναι <strong>τ</strong>ο <strong>ε</strong>ύρος κίνη<strong>σ</strong>ης<br />

<strong>π</strong>ο<strong>υ</strong> α<strong>σ</strong>κ<strong>ε</strong>ί<strong>τ</strong>αι η µέγι<strong>σ</strong><strong>τ</strong>η <strong>τ</strong>ά<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό. Έ<strong>τ</strong><strong>σ</strong>ι, κα-

<strong>τ</strong>αλήγο<strong>υ</strong>µ<strong>ε</strong> <strong>σ</strong>' α<strong>υ</strong><strong>τ</strong>ό <strong>π</strong>ο<strong>υ</strong> ο Ρaoulos έχ<strong>ε</strong>ι α<strong>π</strong>οκαλέ<strong>σ</strong><strong>ε</strong>ι <strong>σ</strong><strong>αν</strong> <strong>τ</strong>ο « <strong>π</strong>αράδοξο<br />

<strong>τ</strong>ης ά<strong>σ</strong>κη<strong>σ</strong>ης ».<br />

Γ<strong>ε</strong>νικά, η χρη<strong>σ</strong>ιµο<strong>π</strong>οίη<strong>σ</strong>η <strong>τ</strong><strong>ε</strong>χνικών ό<strong>π</strong>ως οι <strong>π</strong>αρα<strong>π</strong>άνω, <strong>ε</strong><strong>π</strong>ι<strong>τ</strong>ρέ<strong>π</strong>ο<strong>υ</strong>ν<br />

<strong>τ</strong>ο ξ<strong>ε</strong>κίνηµα α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ων <strong>π</strong>ο<strong>υ</strong> <strong>π</strong>ροάγο<strong>υ</strong>ν <strong>τ</strong>ο α<strong>σ</strong>φαλές δ<strong>υ</strong>νάµω-<br />

µα <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong>, <strong>π</strong>ολύ νωρί<strong>τ</strong><strong>ε</strong>ρα α<strong>π</strong>ό ό<strong>τ</strong>ι θα ή<strong>τ</strong><strong>αν</strong> άλλο<strong>τ</strong><strong>ε</strong> δ<strong>υ</strong>να<strong>τ</strong>ό,<br />

µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό <strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ική <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού. Τ<strong>υ</strong><strong>π</strong>ικά, οι <strong>ε</strong>ν<strong>ε</strong>ργη<strong>τ</strong>ικές<br />

α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις ρο<strong>υ</strong><strong>τ</strong>ίνας µ<strong>ε</strong> <strong>αν</strong><strong>τ</strong>ί<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η για <strong>τ</strong>ην <strong>ε</strong>νδ<strong>υ</strong>νάµω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong>,<br />

καθ<strong>υ</strong><strong>σ</strong><strong>τ</strong><strong>ε</strong>ρούν<strong>τ</strong>αι για 6 µήν<strong>ε</strong>ς <strong>π</strong><strong>ε</strong>ρί<strong>π</strong>ο<strong>υ</strong>, µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό <strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ική<br />

<strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού και µέχρι και ένα χρόνο <strong>σ</strong><strong>ε</strong> µια <strong>αν</strong>αφορά (<br />

Ηenning et al. 1985). Οι α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις <strong>π</strong>ο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>ζη<strong>τ</strong>ήθηκ<strong>αν</strong> <strong>π</strong>αρα<strong>π</strong>άνω,<br />

ξ<strong>ε</strong>κινάν<strong>ε</strong> µέ<strong>σ</strong>α <strong>σ</strong><strong>τ</strong>ις δύο <strong>π</strong>ρώ<strong>τ</strong><strong>ε</strong>ς βδοµάδ<strong>ε</strong>ς, µ<strong>ε</strong><strong>τ</strong>ά <strong>τ</strong>ο χ<strong>ε</strong>ιρο<strong>υ</strong>ργ<strong>ε</strong>ίο<br />

(Οdellito at al. 1988).<br />

O Grood et al. (1984), <strong>π</strong>αρα<strong>τ</strong>ήρη<strong>σ</strong><strong>αν</strong> <strong>τ</strong>ις δ<strong>υ</strong>νάµ<strong>ε</strong>ις <strong>π</strong>άνω <strong>σ</strong><strong>ε</strong> <strong>π</strong><strong>τ</strong>ω-<br />

µα<strong>τ</strong>ικά γόνα<strong>τ</strong>α µ<strong>ε</strong> κοµµένο <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό, κα<strong>τ</strong>ά <strong>τ</strong>ην <strong>αν</strong>α<strong>π</strong>αραγωγή<br />

<strong>τ</strong>ης ά<strong>σ</strong>κη<strong>σ</strong>ης έκ<strong>τ</strong>α<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος. ∆ια<strong>π</strong>ί<strong>σ</strong><strong>τ</strong>ω<strong>σ</strong><strong>αν</strong> α<strong>υ</strong>ξηµένη<br />

<strong>π</strong>ρό<strong>σ</strong>θια <strong>π</strong>αρ<strong>ε</strong>κ<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>η <strong>τ</strong>ης κνήµης <strong>π</strong>άνω <strong>σ</strong><strong>τ</strong>ο µηριαίο, κα<strong>τ</strong>ά <strong>τ</strong>ις <strong>τ</strong><strong>ε</strong>λ<strong>ε</strong><strong>υ</strong><strong>τ</strong>αί<strong>ε</strong>ς<br />

30° <strong>τ</strong>ης έκ<strong>τ</strong>α<strong>σ</strong>ης και δια<strong>τ</strong>ύ<strong>π</strong>ω<strong>σ</strong><strong>αν</strong> <strong>τ</strong>ην ά<strong>π</strong>οψη ό<strong>τ</strong>ι α<strong>υ</strong><strong>τ</strong>ή η<br />

<strong>π</strong>αρ<strong>ε</strong>κ<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>η θα διέ<strong>τ</strong><strong>ε</strong>ιν<strong>ε</strong> <strong>τ</strong>ο<strong>υ</strong>ς δ<strong>ε</strong><strong>υ</strong><strong>τ</strong><strong>ε</strong>ρ<strong>ε</strong>ύον<strong>τ</strong><strong>ε</strong>ς <strong>π</strong><strong>ε</strong>ριορι<strong>σ</strong><strong>τ</strong>ικούς <strong>π</strong>αράγον<strong>τ</strong><strong>ε</strong>ς<br />

<strong>σ</strong><strong>τ</strong>ο γόνα<strong>τ</strong>ο µ<strong>ε</strong> <strong>π</strong>ροβληµα<strong>π</strong>κό <strong>π</strong>ρό<strong>σ</strong>θ\ο χ\α<strong>σ</strong><strong>τ</strong>ό, <strong>αν</strong> ο\ α-<br />

<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις έκ<strong>τ</strong>α<strong>σ</strong>ης γίνον<strong>τ</strong><strong>αν</strong> µ<strong>ε</strong> άκρι<strong>τ</strong>ο <strong>τ</strong>ρό<strong>π</strong>ο. Πρό<strong>τ</strong><strong>ε</strong>ιν<strong>αν</strong> να γίν<strong>ε</strong><strong>τ</strong>αι ή 1<br />

ά<strong>σ</strong>κη<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ην όρθια θέ<strong>σ</strong>η, για να <strong>ε</strong><strong>π</strong>ι<strong>τ</strong>ρέψ<strong>ε</strong>ι <strong>σ</strong><strong>τ</strong>ις δ<strong>υ</strong>νάµ<strong>ε</strong>ις βαρ<strong>υ</strong><strong>τ</strong>ικής<br />

φόρ<strong>τ</strong>ι<strong>σ</strong>ης, µέ<strong>σ</strong>α α<strong>π</strong>ό <strong>τ</strong>ην αξονική <strong>σ</strong><strong>υ</strong>µ<strong>π</strong>ί<strong>ε</strong><strong>σ</strong>η <strong>τ</strong>ων αρθρικών <strong>ε</strong><strong>π</strong>ιφ<strong>αν</strong><strong>ε</strong>ιών<br />

<strong>π</strong>ο<strong>υ</strong> <strong>π</strong>ροκαλούν, να <strong>π</strong><strong>ε</strong>ριορί<strong>σ</strong>ο<strong>υ</strong>ν <strong>τ</strong>ην <strong>π</strong>ρό<strong>σ</strong>θια <strong>π</strong>αρ<strong>ε</strong>κ<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>η<br />

<strong>τ</strong>ης κνήµης <strong>π</strong>άνω <strong>σ</strong><strong>τ</strong>ο µηριαίο, κα<strong>τ</strong>ά <strong>τ</strong>η <strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong>.<br />

Σ<strong>ε</strong> <strong>υ</strong><strong>π</strong>ο<strong>σ</strong><strong>τ</strong>ήριξη α<strong>υ</strong><strong>τ</strong>ής <strong>τ</strong>ης <strong>υ</strong><strong>π</strong>όθ<strong>ε</strong><strong>σ</strong>ης, ο Ηenning et al. (1985),<br />

δηµο<strong>σ</strong>ί<strong>ε</strong><strong>υ</strong><strong>σ</strong><strong>αν</strong> <strong>τ</strong>η δική <strong>τ</strong>ο<strong>υ</strong>ς µ<strong>ε</strong>λέ<strong>τ</strong>η για <strong>τ</strong>ην <strong>τ</strong>ά<strong>σ</strong>η <strong>π</strong>άνω <strong>σ</strong><strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο<br />

χια<strong>σ</strong><strong>τ</strong>ό. Η µ<strong>ε</strong>λέ<strong>τ</strong>η <strong>π</strong>ραγµα<strong>τ</strong>ο<strong>π</strong>οιήθηκ<strong>ε</strong>, βάζον<strong>τ</strong>ας ένα µ<strong>ε</strong><strong>τ</strong>ρη<strong>τ</strong>ή <strong>τ</strong>ά<strong>σ</strong>ης<br />

<strong>π</strong>άνω <strong>σ</strong><strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό διαφόρων α<strong>τ</strong>όµων και µ<strong>ε</strong><strong>τ</strong>ά µ<strong>ε</strong><strong>τ</strong>ρών<strong>τ</strong>α

<strong>τ</strong>ην <strong>τ</strong>ά<strong>σ</strong>η <strong>π</strong>άνω <strong>σ</strong>' α<strong>υ</strong><strong>τ</strong>όν, κα<strong>τ</strong>ά <strong>τ</strong>η διάρκ<strong>ε</strong>ια διαφόρων α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ων<br />

<strong>τ</strong>ο<strong>υ</strong> κά<strong>τ</strong>ω άκρο<strong>υ</strong>.<br />

Βρήκ<strong>αν</strong> ό<strong>τ</strong>ι η ι<strong>σ</strong>οµ<strong>ε</strong><strong>τ</strong>ρική έκ<strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος <strong>σ</strong><strong>τ</strong>ις 0° και 22° <strong>π</strong>αρήγαγ<strong>ε</strong><br />

5 ως 17 φορές <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρη <strong>τ</strong>ά<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό,<br />

α<strong>π</strong>ό <strong>τ</strong>ις α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις κλ<strong>ε</strong>ι<strong>σ</strong><strong>τ</strong>ής κινη<strong>τ</strong>ικής αλ<strong>υ</strong><strong>σ</strong>ίδας, δηλαδή µ<strong>ε</strong> φόρ<strong>τ</strong>ι<strong>σ</strong>η<br />

<strong>τ</strong>ων <strong>π</strong>οδιών, ό<strong>π</strong>ως <strong>ε</strong>ίναι <strong>τ</strong>ο <strong>σ</strong><strong>τ</strong>α<strong>τ</strong>ικό <strong>π</strong>οδήλα<strong>τ</strong>ο, <strong>τ</strong>ο <strong>π</strong><strong>ε</strong>ρ<strong>π</strong>ά<strong>τ</strong>ηµα <strong>σ</strong><strong>ε</strong><br />

<strong>ε</strong><strong>π</strong>ί<strong>π</strong><strong>ε</strong>δο µ<strong>ε</strong> κλί<strong>σ</strong>η, <strong>τ</strong>ο <strong>σ</strong>χοινάκι ή <strong>τ</strong>ο ηµικάθι<strong>σ</strong>µα <strong>σ</strong><strong>τ</strong>ο ένα <strong>π</strong>όδι. Θα<br />

<strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να <strong>τ</strong>ονι<strong>σ</strong><strong>τ</strong><strong>ε</strong>ί ό<strong>τ</strong>ι <strong>σ</strong><strong>τ</strong>η µ<strong>ε</strong>λέ<strong>τ</strong>η χρη<strong>σ</strong>ιµο<strong>π</strong>οιήθηκ<strong>αν</strong> µόνο δύο<br />

ά<strong>τ</strong>οµα κι ό<strong>τ</strong>ι έδ<strong>ε</strong>ιξ<strong>ε</strong> <strong>π</strong>λα<strong>τ</strong>ιά <strong>π</strong>οικιλό<strong>τ</strong>η<strong>τ</strong>α <strong>σ</strong><strong>τ</strong>ην <strong>τ</strong>ά<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong><br />

χια-<strong>σ</strong><strong>τ</strong>ού µ<strong>ε</strong><strong>τ</strong>αξύ <strong>τ</strong>ων δύο α<strong>τ</strong>όµων, <strong>ε</strong>νώ δ<strong>ε</strong>ν έκ<strong>αν</strong><strong>ε</strong> καθόλο<strong>υ</strong><br />

<strong>αν</strong>αφορά <strong>σ</strong><strong>τ</strong>η γωνία <strong>τ</strong>ης άρθρω<strong>σ</strong>ης κα<strong>τ</strong>ά <strong>τ</strong>ις α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις µ<strong>ε</strong> φόρ<strong>τ</strong>ι<strong>σ</strong>η<br />

βάρο<strong>υ</strong>ς. Παρά <strong>τ</strong>α <strong>τ</strong><strong>ε</strong>λ<strong>ε</strong><strong>υ</strong><strong>τ</strong>αία, θ<strong>ε</strong>ωρ<strong>ε</strong>ί<strong>τ</strong>αι µια <strong>σ</strong>ηµαδιακή µ<strong>ε</strong>λέ<strong>τ</strong>η, <strong>π</strong>ο<strong>υ</strong><br />

έδ<strong>ε</strong>ιξ<strong>ε</strong> για <strong>π</strong>ρώ<strong>τ</strong>η φορά, ό<strong>τ</strong>ι ο <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλος µ<strong>π</strong>ορ<strong>ε</strong>ί να δ<strong>υ</strong>ναµωθ<strong>ε</strong>ί,<br />

χωρίς να µ<strong>π</strong>αίν<strong>ε</strong>ι <strong>σ</strong><strong>ε</strong> κίνδ<strong>υ</strong>νο <strong>τ</strong>ο <strong>υ</strong><strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong><strong>τ</strong>α<strong>τ</strong>ο</strong> <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong><br />

χια<strong>σ</strong><strong>τ</strong>ού, ό<strong>τ</strong><strong>αν</strong> <strong>σ</strong><strong>τ</strong>ο άκρο γίνον<strong>τ</strong>αι α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις µ<strong>ε</strong> φόρ<strong>τ</strong>ι<strong>σ</strong>η µ<strong>ε</strong> βάρος ή<br />

ό<strong>π</strong>ως χαρακ<strong>τ</strong>ηρίζον<strong>τ</strong>αι, α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις « κλ<strong>ε</strong>ι<strong>σ</strong><strong>τ</strong>ής κινη<strong>τ</strong>ικής αλ<strong>υ</strong><strong>σ</strong>ίδας<br />

». Έ<strong>τ</strong><strong>σ</strong>ι, οι α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις α<strong>υ</strong><strong>τ</strong>ές <strong>π</strong>αρέχο<strong>υ</strong>ν <strong>ε</strong><strong>π</strong>ι<strong>π</strong>ρό<strong>σ</strong>θ<strong>ε</strong><strong>τ</strong>α µέ<strong>σ</strong>α<br />

α<strong>σ</strong>φαλούς δ<strong>υ</strong>ναµώµα<strong>τ</strong>ος <strong>τ</strong>ο<strong>υ</strong> κά<strong>τ</strong>ω άκρο<strong>υ</strong> κα<strong>τ</strong>ά <strong>τ</strong>ις <strong>π</strong>ρώιµ<strong>ε</strong>ς<br />

µ<strong>ε</strong><strong>τ</strong><strong>ε</strong>γχ<strong>ε</strong>ιρη<strong>τ</strong>ικές φά<strong>σ</strong><strong>ε</strong>ις.<br />

Οι δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς κλ<strong>ε</strong>ι<strong>σ</strong><strong>τ</strong>ής κινη<strong>τ</strong>ικής αλ<strong>υ</strong><strong>σ</strong>ίδας <strong>ε</strong>ξ<strong>ε</strong><strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>ηκ<strong>αν</strong> και<br />

µ<strong>ε</strong> βά<strong>σ</strong>η <strong>σ</strong><strong>υ</strong><strong>σ</strong><strong>τ</strong>ήµα<strong>τ</strong>α <strong>αν</strong>αφοράς <strong>π</strong>ο<strong>υ</strong> <strong>σ</strong>χ<strong>ε</strong><strong>τ</strong>ίζον<strong>τ</strong>αι µ<strong>ε</strong> <strong>τ</strong>α διαγνω<strong>σ</strong><strong>τ</strong>ικά<br />

<strong>τ</strong><strong>ε</strong><strong>σ</strong><strong>τ</strong> <strong>τ</strong>ο<strong>υ</strong> γονά<strong>τ</strong>ο<strong>υ</strong>. Πάλι ο Henning <strong>τ</strong>ο 1985, µαζί µ<strong>ε</strong> άλλο<strong>υ</strong>ς, για να<br />

<strong>π</strong>ρο<strong>σ</strong>δώ<strong>σ</strong>ο<strong>υ</strong>ν µια καλύ<strong>τ</strong><strong>ε</strong>ρη α<strong>π</strong><strong>ε</strong>ικόνι<strong>σ</strong>η <strong>τ</strong>ων δρα<strong>σ</strong><strong>τ</strong>ηριο<strong>τ</strong>ή<strong>τ</strong>ων α<strong>υ</strong><strong>τ</strong>ών,<br />

κα<strong>τ</strong>έγραψ<strong>αν</strong>, <strong>τ</strong>ην <strong>τ</strong>ά<strong>σ</strong>η <strong>π</strong>άνω <strong>σ</strong><strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό, <strong>σ</strong><strong>ε</strong> <strong>σ</strong>ύγκρι<strong>σ</strong>η<br />

µ<strong>ε</strong> µια δύναµη <strong>αν</strong>αφοράς, <strong>τ</strong>ης <strong>τ</strong>άξης <strong>τ</strong>ων 801ο, <strong>π</strong>ο<strong>υ</strong> <strong>π</strong>αραγό<strong>τ</strong><strong>αν</strong><br />

κα<strong>τ</strong>ά <strong>τ</strong>η διαδικα<strong>σ</strong>ία <strong>τ</strong>ο<strong>υ</strong> χ<strong>ε</strong>ιρι<strong>σ</strong>µού <strong>τ</strong>ο<strong>υ</strong> Lachman Το <strong>π</strong>οδήλα<strong>τ</strong>ο<br />

<strong>π</strong>αρήγαγ<strong>ε</strong> ένα 7% <strong>τ</strong>ης <strong>ε</strong><strong>π</strong>ιµήκ<strong>υ</strong>ν<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>π</strong>ο<strong>υ</strong><br />

<strong>π</strong>αράγ<strong>ε</strong><strong>τ</strong>αι α<strong>π</strong>ό ένα Lachman test <strong>τ</strong>ης <strong>τ</strong>άξης <strong>τ</strong>ων 801b. Ένα ηµικάθι<strong>σ</strong>µα<br />

<strong>σ</strong><strong>τ</strong>ο ένα <strong>π</strong>όδι, <strong>π</strong>αρήγαγ<strong>ε</strong> <strong>τ</strong>ο 21% και η <strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong><br />

α<strong>π</strong>έν<strong>αν</strong><strong>τ</strong>ι <strong>σ</strong><strong>τ</strong>ο βάρος <strong>τ</strong>ων 201b <strong>ε</strong>νός <strong>π</strong>έδιλο<strong>υ</strong> <strong>σ</strong><strong>τ</strong>ις 45°

κάµψης, <strong>π</strong>αρήγαγ<strong>ε</strong> <strong>τ</strong>ο 50% <strong>τ</strong>ης <strong>ε</strong><strong>π</strong>ιµήκ<strong>υ</strong>ν<strong>σ</strong>ης <strong>π</strong>ο<strong>υ</strong> <strong>π</strong>αράγ<strong>ε</strong><strong>τ</strong>αι κα<strong>τ</strong>ά<br />

<strong>τ</strong>ο χ<strong>ε</strong>ιρι<strong>σ</strong>µό <strong>αν</strong>αφοράς. Οι <strong>σ</strong><strong>υ</strong><strong>σ</strong><strong>π</strong>ά<strong>σ</strong><strong>ε</strong>ις <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong> κον<strong>τ</strong>ά <strong>σ</strong><strong>τ</strong>ο<br />

<strong>τ</strong><strong>ε</strong>λικό <strong>ε</strong>ύρος <strong>τ</strong>ης έκ<strong>τ</strong>α<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, <strong>π</strong>αρήγαγ<strong>αν</strong> <strong>ε</strong><strong>π</strong>ιµηκ<strong>υ</strong>ν<strong>τ</strong>ικές<br />

δ<strong>υ</strong>νάµ<strong>ε</strong>ις, <strong>π</strong>ο<strong>υ</strong> έφ<strong>τ</strong><strong>αν</strong><strong>αν</strong> <strong>τ</strong>ο 87% µ<strong>ε</strong> 121% α<strong>υ</strong><strong>τ</strong>ών κα<strong>τ</strong>ά <strong>τ</strong>ο 8015 χ<strong>ε</strong>ιρι<strong>σ</strong>µό<br />

<strong>αν</strong>αφοράς <strong>τ</strong>ο<strong>υ</strong> Lachman. Μια <strong>αν</strong>αλ<strong>υ</strong><strong>τ</strong>ική <strong>π</strong>αρο<strong>υ</strong><strong>σ</strong>ία<strong>σ</strong>η για <strong>τ</strong>ο<br />

<strong>π</strong>ώς η κλ<strong>ε</strong>ι<strong>σ</strong><strong>τ</strong>ή κινη<strong>τ</strong>ική αλ<strong>υ</strong><strong>σ</strong>ίδα <strong>π</strong><strong>ε</strong>ριορίζ<strong>ε</strong>ι <strong>τ</strong>ην <strong>τ</strong>ά<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο<br />

χια<strong>σ</strong><strong>τ</strong>ό, θα ή<strong>τ</strong><strong>αν</strong> χρή<strong>σ</strong>ιµη.<br />

2.1.1 Α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις Κλ<strong>ε</strong>ι<strong>σ</strong><strong>τ</strong>ής και Ανοικ<strong>τ</strong>ής Κινη<strong>τ</strong>ικής Αλ<strong>υ</strong><strong>σ</strong>ίδας (<br />

Θέµα<strong>τ</strong>α <strong>σ</strong><strong>τ</strong>ην µ<strong>ε</strong><strong>τ</strong><strong>ε</strong>γχ<strong>ε</strong>ιρη<strong>τ</strong>ική α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού<br />

<strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong> <strong>σ</strong><strong>τ</strong>ο γόνα<strong>τ</strong>ο)<br />

* Χρή<strong>σ</strong>η ΑΒΑ και ΚΒΑ <strong>σ</strong><strong>τ</strong>ην α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η.<br />

Άρθρω<strong>σ</strong>η γόνα<strong>τ</strong>ος<br />

Τά<strong>σ</strong>η <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>.<br />

Κα<strong>τ</strong>ά <strong>τ</strong>η δ<strong>ε</strong>κα<strong>ε</strong><strong>τ</strong>ία <strong>τ</strong>ο<strong>υ</strong> '80, η <strong>τ</strong>ο<strong>π</strong>οθέ<strong>τ</strong>η<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> µο<strong>σ</strong>χ<strong>ε</strong>ύµα<strong>τ</strong>ος <strong>τ</strong>ο<strong>υ</strong><br />

<strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού κα<strong>τ</strong>ά <strong>τ</strong>η χ<strong>ε</strong>ιρο<strong>υ</strong>ργική <strong>ε</strong><strong>π</strong>έµβα<strong>σ</strong>η γινό<strong>τ</strong><strong>αν</strong> µ<strong>ε</strong> <strong>τ</strong>έ<strong>τ</strong>οιο<br />

<strong>τ</strong>ρό<strong>π</strong>ο <strong>π</strong>ο<strong>υ</strong> <strong>ε</strong>ίχ<strong>ε</strong> <strong>π</strong>ολλές φορές <strong>τ</strong>η <strong>σ</strong><strong>υ</strong>νέ<strong>π</strong><strong>ε</strong>ια να α<strong>υ</strong>ξάν<strong>ε</strong><strong>τ</strong>αι <strong>υ</strong><strong>π</strong><strong>ε</strong>ρβολικά<br />

η <strong>τ</strong>ά<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ο µό<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µα καθώς <strong>τ</strong>ο γόνα<strong>τ</strong>ο <strong>ε</strong>κιν<strong>ε</strong>ί<strong>τ</strong>ο α<strong>π</strong>ό <strong>τ</strong>ην κάµψη<br />

<strong>π</strong>ρος <strong>τ</strong>ην <strong>π</strong>λήρη έκ<strong>τ</strong>α<strong>σ</strong>η, χωρίς <strong>τ</strong>ο µό<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µα να κα<strong>τ</strong>α<strong>π</strong>ον<strong>ε</strong>ί<strong>τ</strong>αι α<strong>π</strong>ό<br />

<strong>υ</strong><strong>π</strong><strong>ε</strong>ρβολική <strong>τ</strong>ά<strong>σ</strong>η ( Einhorn et al1993).<br />

Σκο<strong>π</strong>ός µας <strong>σ</strong><strong>τ</strong>ην α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>ε</strong>ίναι να <strong>ε</strong><strong>π</strong><strong>αν</strong>αφέρο<strong>υ</strong>µ<strong>ε</strong> <strong>τ</strong>ον<br />

α<strong>σ</strong>θ<strong>ε</strong>νή <strong>σ</strong><strong>τ</strong>ις φ<strong>υ</strong><strong>σ</strong>ιολογικές <strong>τ</strong>ο<strong>υ</strong> δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς, χωρίς όµως να <strong>τ</strong>ο<strong>υ</strong><br />

δηµιο<strong>υ</strong>ργή<strong>σ</strong>ο<strong>υ</strong>µ<strong>ε</strong> άλλα <strong>π</strong>ροβλήµα<strong>τ</strong>α.<br />

Ο Υach et al <strong>τ</strong>ο 1993 <strong>ε</strong>ξέ<strong>τ</strong>α<strong>σ</strong><strong>ε</strong> <strong>τ</strong>ην <strong>π</strong>ρό<strong>σ</strong>θια µ<strong>ε</strong><strong>τ</strong>α<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>η <strong>τ</strong>ης κνή-<br />

µης κα<strong>τ</strong>ά <strong>τ</strong>η διάρκ<strong>ε</strong>ια <strong>τ</strong>ης έκ<strong>τ</strong>α<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος <strong>υ</strong><strong>π</strong>ό <strong>αν</strong><strong>τ</strong>ί<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η (<br />

ά<strong>σ</strong>κη<strong>σ</strong>η ΑΒΑ ) και κα<strong>τ</strong>ά <strong>τ</strong>ο βαθύ κάθι<strong>σ</strong>µα µ<strong>ε</strong> <strong>τ</strong>α <strong>π</strong>έλµα<strong>τ</strong>α <strong>π</strong>αράλληλα<br />

( ά<strong>σ</strong>κη<strong>σ</strong>η ΚΒΑ ) <strong>σ</strong><strong>ε</strong> 11 ά<strong>τ</strong>οµα µ<strong>ε</strong> κάκω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού<br />

<strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>. Η µέ<strong>τ</strong>ρη<strong>σ</strong>η <strong>τ</strong>ης <strong>π</strong>ρό<strong>σ</strong>θιας µ<strong>ε</strong><strong>τ</strong>α<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>ης <strong>τ</strong>ης κνήµης έγι-

ν<strong>ε</strong> και <strong>σ</strong><strong>τ</strong>ο <strong>υ</strong>γιές και <strong>σ</strong><strong>τ</strong>ο <strong>π</strong>ά<strong>σ</strong>χον µέλος κάθ<strong>ε</strong> α<strong>τ</strong>όµο<strong>υ</strong>. Ο Υach et<br />

al, <strong>αν</strong>αφέρ<strong>ε</strong>ι αύξη<strong>σ</strong>η <strong>τ</strong>ης <strong>π</strong>ρό<strong>σ</strong>θιας µ<strong>ε</strong><strong>τ</strong>α<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>ης <strong>τ</strong>ης κνήµης <strong>σ</strong><strong>τ</strong>ο<br />

<strong>π</strong>ά<strong>σ</strong>χον µέλος κα<strong>τ</strong>ά <strong>τ</strong>η διάρκ<strong>ε</strong>ια <strong>τ</strong>ης έκ<strong>τ</strong>α<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος <strong>υ</strong><strong>π</strong>ό<br />

µορφή ΑΒΑ, <strong>σ</strong><strong>ε</strong> <strong>σ</strong>ύγκρι<strong>σ</strong>η µ<strong>ε</strong> <strong>τ</strong>ο µ<strong>ε</strong>ρικό βαθύ κάθι<strong>σ</strong>µα (ΚΒΑ) <strong>σ</strong><strong>ε</strong><br />

<strong>τ</strong>ροχιά κίνη<strong>σ</strong>ης 66° ως 10° κάµψης. Παράλληλα δ<strong>ε</strong>ν<br />

<strong>π</strong>αρα<strong>τ</strong>ηρήθηκ<strong>αν</strong> αλλαγές <strong>σ</strong><strong>τ</strong>ο <strong>υ</strong>γιές γόνα<strong>τ</strong>ο. Κα<strong>τ</strong>ά <strong>τ</strong>ις µ<strong>ε</strong><strong>τ</strong>ρή<strong>σ</strong><strong>ε</strong>ις<br />

<strong>τ</strong>ά<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>, <strong>υ</strong><strong>π</strong>ο<strong>σ</strong><strong>τ</strong>ηρίζο<strong>υ</strong>ν ό<strong>τ</strong>ι οι<br />

α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις µ<strong>ε</strong> φόρ<strong>τ</strong>ι<strong>σ</strong>η (ΚΒΑ), α<strong>σ</strong>κούν µικρό<strong>τ</strong><strong>ε</strong>ρη <strong>τ</strong>ά<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ον<br />

<strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µο α<strong>π</strong>ό <strong>τ</strong>ις α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong><br />

µ<strong>υ</strong>ός α<strong>π</strong>ό θέ<strong>σ</strong>η µη φόρ<strong>τ</strong>ι<strong>σ</strong>ης (ΑΒΑ).<br />

Ο bynum et al 1995 και Ηenning et al 1985 <strong>π</strong>ι<strong>σ</strong><strong>τ</strong><strong>ε</strong>ύο<strong>υ</strong>ν ό<strong>τ</strong>ι η<br />

χρή<strong>σ</strong>η <strong>τ</strong>ων α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ων ΑΒΑ µ<strong>ε</strong> <strong>σ</strong><strong>τ</strong>όχο <strong>τ</strong>η β<strong>ε</strong>λ<strong>τ</strong>ίω<strong>σ</strong>η <strong>τ</strong>ης δύναµης <strong>τ</strong>ο<strong>υ</strong><br />

<strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong> <strong>π</strong>ροκαλ<strong>ε</strong>ί <strong>υ</strong><strong>π</strong>έρµ<strong>ε</strong><strong>τ</strong>ρη φόρ<strong>τ</strong>ι<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ο µό<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µα <strong>τ</strong>ο<strong>υ</strong><br />

<strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού.<br />

Ο Ηenning 1985 <strong>σ</strong><strong>υ</strong>µ<strong>π</strong>έρ<strong>αν</strong><strong>ε</strong> ό<strong>τ</strong>ι η <strong>ε</strong>νδ<strong>υ</strong>νάµω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong><br />

µ<strong>υ</strong>ός <strong>σ</strong><strong>τ</strong>η µ<strong>ε</strong><strong>τ</strong><strong>ε</strong>γχ<strong>ε</strong>ιρη<strong>τ</strong>ική α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού<br />

<strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong> θα <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να <strong>ε</strong><strong>π</strong>ι<strong>τ</strong><strong>υ</strong>γχάν<strong>ε</strong><strong>τ</strong>αι µέ<strong>σ</strong>α α<strong>π</strong>ό δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς,<br />

ό<strong>π</strong>ως <strong>τ</strong>ο <strong>π</strong>οδήλα<strong>τ</strong>ο και <strong>τ</strong>ο µ<strong>ε</strong>ρικό βαθύ κάθι<strong>σ</strong>µα , ώ<strong>σ</strong><strong>τ</strong><strong>ε</strong><br />

να α<strong>π</strong>οφ<strong>ε</strong>ύγ<strong>ε</strong><strong>τ</strong>αι η ά<strong>σ</strong>κη<strong>σ</strong>η <strong>υ</strong><strong>π</strong><strong>ε</strong>ρβολικής <strong>τ</strong>ά<strong>σ</strong>ης κα<strong>τ</strong>ά <strong>τ</strong>η διάρκ<strong>ε</strong>ια<br />

<strong>τ</strong>ης διαδικα<strong>σ</strong>ίας <strong>ε</strong><strong>π</strong>ούλω<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>. Σ<strong>υ</strong>ν<strong>ε</strong><strong>π</strong>ώς,<br />

α<strong>π</strong>οθαρρύνο<strong>υ</strong>ν <strong>τ</strong>ην έκ<strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος <strong>υ</strong><strong>π</strong>ό <strong>τ</strong>η µορφή α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ων<br />

ΑΒΑ <strong>σ</strong><strong>ε</strong> όλη <strong>τ</strong>ην <strong>τ</strong>ροχιά <strong>τ</strong>ης κίνη<strong>σ</strong>ης κα<strong>τ</strong>ά <strong>π</strong>ρώ<strong>τ</strong>ο χρόνο µ<strong>ε</strong><strong>τ</strong>ά <strong>τ</strong>ην<br />

κάκω<strong>σ</strong>η και <strong>τ</strong>η χ<strong>ε</strong>ιρο<strong>υ</strong>ργική α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού<br />

<strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>.<br />

Ο ίδιος <strong>ε</strong>ρ<strong>ε</strong><strong>υ</strong>νη<strong>τ</strong>ής <strong>αν</strong>αφέρ<strong>ε</strong>ι <strong>ε</strong>ιδικό<strong>τ</strong><strong>ε</strong>ρα ό<strong>τ</strong>ι <strong>σ</strong><strong>τ</strong>ο (ΚΒΑ) <strong>π</strong>ροκάλ<strong>ε</strong><strong>σ</strong><strong>ε</strong><br />

µικρό<strong>τ</strong><strong>ε</strong>ρη <strong>ε</strong><strong>π</strong>ιµήκ<strong>υ</strong>ν<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong> α<strong>π</strong>ό ό<strong>τ</strong>ι η<br />

<strong>αν</strong>ύψω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> άκρο<strong>υ</strong> µ<strong>ε</strong> βάρος 20 Κς (ΑΒΑ).<br />

Ο Βynum et al 1995, PRENTICE WE 1994 και ο \Λ/ilk et al <strong>τ</strong>ο 1996,<br />

<strong>αν</strong>αφέρο<strong>υ</strong>ν ό<strong>τ</strong>ι η ΚΒΑ <strong>π</strong>ρο<strong>σ</strong>φέρ<strong>ε</strong>ι µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρη α<strong>σ</strong>φάλ<strong>ε</strong>ια <strong>σ</strong><strong>τ</strong>ον α-

<strong>σ</strong>θένη <strong>σ</strong><strong>ε</strong> <strong>σ</strong>χέ<strong>σ</strong>η µ<strong>ε</strong> <strong>τ</strong>ην ΑΒΑ, <strong>ε</strong><strong>π</strong><strong>ε</strong>ιδή η φόρ<strong>τ</strong>ι<strong>σ</strong>η <strong>π</strong>ο<strong>υ</strong> α<strong>σ</strong>κ<strong>ε</strong>ί<strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ο<br />

µό<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µα <strong>ε</strong>ίναι µικρό<strong>τ</strong><strong>ε</strong>ρη και <strong>ε</strong><strong>π</strong>οµένως µ<strong>ε</strong>ιών<strong>ε</strong><strong>τ</strong>αι η <strong>π</strong>ιθ<strong>αν</strong>ό<strong>τ</strong>η<strong>τ</strong>α<br />

<strong>π</strong>ρόκλη<strong>σ</strong>ης <strong>π</strong>όνο<strong>υ</strong> <strong>σ</strong><strong>τ</strong>ην <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδοµηριαία άρθρω<strong>σ</strong>η.<br />

Ο Κevin et al <strong>τ</strong>ο 1996 <strong>αν</strong>αφέρ<strong>ε</strong>ι ό<strong>τ</strong>ι <strong>σ</strong><strong>τ</strong>ην Ανοιχ<strong>τ</strong>ή αλ<strong>υ</strong><strong>σ</strong>ίδα<br />

<strong>π</strong>αρα<strong>τ</strong>ηρούµ<strong>ε</strong> <strong>τ</strong>ά<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µο, αλλά όχι <strong>σ</strong><strong>ε</strong><br />

όλο <strong>τ</strong>ο <strong>ε</strong>ύρος <strong>τ</strong>ροχιάς <strong>π</strong>αρά µόνο <strong>σ</strong><strong>τ</strong>ο <strong>τ</strong>όξο 40° - 0° κάµψη <strong>σ</strong><strong>τ</strong>ο γόνα<strong>τ</strong>ο<br />

και η µέγι<strong>σ</strong><strong>τ</strong>η <strong>τ</strong>ιµή να <strong>σ</strong>ηµ<strong>ε</strong>ιών<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ις 14° κάµψης <strong>σ</strong><strong>τ</strong>ο γόνα<strong>τ</strong>ο.<br />

* Πρό<strong>σ</strong>θια <strong>π</strong>αρ<strong>ε</strong>κ<strong>τ</strong>ό<strong>τ</strong><strong>τ</strong>ι<strong>σ</strong>η κνήµης<br />

Οι Renstorm et al 1986 και ο Solomonow et al 1987 <strong>ε</strong>ρ<strong>ε</strong>ύνη<strong>σ</strong><strong>αν</strong> <strong>τ</strong>ην<br />

<strong>ε</strong><strong>π</strong>ίδρα<strong>σ</strong>η <strong>τ</strong>ων ο<strong>π</strong>ί<strong>σ</strong>θιων µηριαίων ως <strong>αν</strong><strong>τ</strong>ίθ<strong>ε</strong><strong>τ</strong>η δύναµη <strong>σ</strong><strong>τ</strong>ο <strong>π</strong>ρό<strong>σ</strong>θιο<br />

<strong>σ</strong><strong>π</strong>ρώξιµο <strong>τ</strong>ης κνήµης <strong>π</strong>ο<strong>υ</strong> <strong>π</strong>ροκαλ<strong>ε</strong>ί<strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ον <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο. Και οι<br />

δύο <strong>σ</strong><strong>υ</strong>µ<strong>π</strong>έρ<strong>αν</strong><strong>αν</strong> ό<strong>τ</strong>ι ο <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλος ή<strong>τ</strong><strong>αν</strong> <strong>υ</strong><strong>π</strong><strong>ε</strong>ύθ<strong>υ</strong>νος για <strong>τ</strong>ην <strong>π</strong>ρό<strong>σ</strong>θια<br />

µ<strong>ε</strong><strong>τ</strong>α<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>η <strong>τ</strong>ης κνήµης κα<strong>τ</strong>ά <strong>τ</strong>ην ΑΒΑ <strong>σ</strong><strong>ε</strong> δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong>α έκ<strong>τ</strong>α<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong><br />

γόνα<strong>τ</strong>ος και ό<strong>τ</strong>ι <strong>τ</strong>ο <strong>π</strong>ο<strong>σ</strong>ο<strong>σ</strong><strong>τ</strong>ό µ<strong>ε</strong><strong>τ</strong>α<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>ης µ<strong>π</strong>ορ<strong>ε</strong>ί να µ<strong>ε</strong>ιωθ<strong>ε</strong>ί ό<strong>τ</strong><strong>αν</strong> οι<br />

ο<strong>π</strong>ί<strong>σ</strong>θιοι µηριαίοι <strong>ε</strong>ν<strong>ε</strong>ργο<strong>π</strong>οιηθούν.<br />

Έρ<strong>ε</strong><strong>υ</strong>ν<strong>ε</strong>ς <strong>τ</strong>ο<strong>υ</strong> Lutz et al 1990 α<strong>π</strong>έδ<strong>ε</strong>ιξ<strong>αν</strong> ό<strong>τ</strong>ι η <strong>π</strong>αραδο<strong>σ</strong>ιακή ΑΒΑ<br />

<strong>ε</strong>νδ<strong>υ</strong>ναµών<strong>ε</strong>ι <strong>τ</strong>ον <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο, <strong>υ</strong><strong>π</strong>οβάλλον<strong>τ</strong>ας <strong>σ</strong><strong>ε</strong> <strong>π</strong>ραγµα<strong>τ</strong>ικές δ<strong>υ</strong>νάµ<strong>ε</strong>ις<br />

α<strong>π</strong>οδόµη<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>. Α<strong>υ</strong><strong>τ</strong>ές οι<br />

α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις α<strong>π</strong>οµονώνο<strong>υ</strong>ν <strong>τ</strong>η <strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong>. Η <strong>π</strong>ρό<strong>σ</strong>θια<br />

µ<strong>ε</strong><strong>τ</strong>α<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>η <strong>τ</strong>ης κνήµης α<strong>π</strong>ό <strong>τ</strong>ο µηριαίο <strong>ε</strong>ίναι α<strong>υ</strong>ξηµένη, καθώς <strong>ε</strong><strong>π</strong>ί<strong>σ</strong>ης<br />

και η <strong>π</strong>αραγωγή <strong>υ</strong><strong>π</strong><strong>ε</strong>ρβολικής φόρ<strong>τ</strong>ι<strong>σ</strong>ης <strong>σ</strong><strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό. Το<br />

φορ<strong>τ</strong>ίο <strong>σ</strong><strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό α<strong>υ</strong>ξάν<strong>ε</strong>ι δραµα<strong>τ</strong>ικά κα<strong>τ</strong>ά <strong>τ</strong>η διάρκ<strong>ε</strong>ια<br />

έκ<strong>τ</strong>α<strong>σ</strong>ης α<strong>π</strong>ό <strong>τ</strong>ις 30° κάµψη. Σ<strong>ε</strong> <strong>αν</strong><strong>τ</strong>ίθ<strong>ε</strong><strong>σ</strong>η, η ΑΒΑ ά<strong>σ</strong>κη<strong>σ</strong>ης<br />

<strong>ε</strong>νδ<strong>υ</strong>νάµω<strong>σ</strong>ης <strong>τ</strong>ων ι<strong>σ</strong>χιοκνηµιαίων <strong>π</strong>ροκαλ<strong>ε</strong>ί µικρό φορ<strong>τ</strong>ίο <strong>σ</strong><strong>τ</strong>ον<br />

<strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό. Σ<strong>τ</strong>ην ά<strong>σ</strong>κη<strong>σ</strong>η ΚΒΑ, <strong>σ</strong><strong>τ</strong>ην ο<strong>π</strong>οία έχο<strong>υ</strong>ν <strong>σ</strong><strong>υ</strong>ν<strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α-<strong>σ</strong>η<br />

<strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong> και <strong>τ</strong>ων ι<strong>σ</strong>χιοκνηµιαίων, βοηθά<strong>ε</strong>ι <strong>σ</strong><strong>τ</strong>ο να µ<strong>ε</strong>ιωθ<strong>ε</strong>ί η<br />

<strong>π</strong>ρό<strong>σ</strong>θια <strong>π</strong>αρ<strong>ε</strong>κ<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>η <strong>τ</strong>ης κνήµης και <strong>ε</strong><strong>π</strong>ί<strong>σ</strong>ης µ<strong>ε</strong>ιών<strong>ε</strong>ι <strong>τ</strong>ο

φορ<strong>τ</strong>ίο <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού. Η ΚΒΑ <strong>π</strong>ροωθ<strong>ε</strong>ί <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρο <strong>τ</strong>η<br />

λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργική <strong>ε</strong><strong>π</strong>ιβάρ<strong>υ</strong>ν<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ην <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>η µ<strong>ε</strong>γάλων µ<strong>υ</strong>ϊκών οµάδων<br />

<strong>τ</strong>ων κά<strong>τ</strong>ω άκρων. Σ<strong>ε</strong> <strong>αν</strong><strong>τ</strong>ίθ<strong>ε</strong><strong>σ</strong>η οι α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις ΑΒΑ <strong>σ</strong><strong>τ</strong>ο<strong>υ</strong>ς ι<strong>σ</strong>χιοκνηµιαίο<strong>υ</strong>ς<br />

<strong>π</strong>ρο<strong>σ</strong>φέρο<strong>υ</strong>ν <strong>σ</strong><strong>τ</strong>ον αθλη<strong>τ</strong>ή <strong>αν</strong>α<strong>τ</strong>ιµηµένη ν<strong>ε</strong><strong>υ</strong>ροµ<strong>υ</strong>ϊκή<br />

<strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>η µ<strong>ε</strong> <strong>π</strong>λ<strong>ε</strong>ον<strong>ε</strong>κ<strong>τ</strong>ήµα<strong>τ</strong>α, ό<strong>π</strong>ως <strong>τ</strong>αχύ<strong>τ</strong>η<strong>τ</strong>α, ι<strong>σ</strong>ορρο<strong>π</strong>ία και <strong>σ</strong><strong>υ</strong>ν<strong>ε</strong>ργα<strong>σ</strong>ία.<br />

Γi’α<strong>υ</strong><strong>τ</strong>ούς <strong>τ</strong>ο<strong>υ</strong>ς λόγο<strong>υ</strong>ς ο Lytz et al δίν<strong>ε</strong>ι έµφα<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ο<br />

<strong>π</strong>ρόγραµµα α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης και <strong>σ</strong><strong>τ</strong>ην ΑΒΑ ι<strong>σ</strong>χιοκνηµιαίων.<br />

Ο Wilk et ai 1996 µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό έρ<strong>ε</strong><strong>υ</strong>ν<strong>ε</strong>ς <strong>αν</strong>έφ<strong>ε</strong>ρ<strong>ε</strong> ό<strong>τ</strong>ι η <strong>π</strong>ρό<strong>σ</strong>θια µ<strong>ε</strong><strong>τ</strong>α<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>η<br />

<strong>τ</strong>ης κνήµης <strong>ε</strong>µφ<strong>αν</strong>ίζ<strong>ε</strong><strong>τ</strong>αι ό<strong>τ</strong><strong>αν</strong> κάνο<strong>υ</strong>µ<strong>ε</strong> α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις <strong>σ</strong><strong>ε</strong> <strong>αν</strong>οικ<strong>τ</strong>ή<br />

βιοκινη<strong>τ</strong>ική αλ<strong>υ</strong><strong>σ</strong>ίδα <strong>σ</strong><strong>ε</strong> ένα <strong>ε</strong>ύρος µ<strong>ε</strong><strong>τ</strong>αξύ 10° - 38° κάµψης <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος.<br />

Η µέγι<strong>σ</strong><strong>τ</strong>η <strong>τ</strong>ιµή <strong>π</strong>ο<strong>υ</strong> <strong>σ</strong>ηµ<strong>ε</strong>ιών<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>ε</strong> µια θέ<strong>σ</strong>η κάµψης <strong>σ</strong><strong>τ</strong>ο<br />

γόνα<strong>τ</strong>ο <strong>ε</strong>ίναι <strong>π</strong><strong>ε</strong>ρί<strong>π</strong>ο<strong>υ</strong> 259Νt και φαίν<strong>ε</strong><strong>τ</strong>αι ό<strong>τ</strong>ι δ<strong>ε</strong>ν <strong>υ</strong><strong>π</strong>άρχο<strong>υ</strong>ν αξιο<strong>σ</strong>η-<br />

µ<strong>ε</strong>ίω<strong>τ</strong><strong>ε</strong>ς διαφορές ως <strong>π</strong>ρος <strong>τ</strong>η φά<strong>σ</strong>η <strong>αν</strong>όδο<strong>υ</strong> και <strong>τ</strong>η φά<strong>σ</strong>η καθόδο<strong>υ</strong><br />

<strong>τ</strong>ης ά<strong>σ</strong>κη<strong>σ</strong>ης. Αν<strong>τ</strong>ίθ<strong>ε</strong><strong>τ</strong>α <strong>σ</strong><strong>τ</strong>ην ΚΒΑ δ<strong>ε</strong>ν <strong>υ</strong><strong>π</strong>άρχ<strong>ε</strong>ι καµία ένδ<strong>ε</strong>ιξη ό<strong>τ</strong>ι ο<br />

<strong>π</strong>ρό<strong>σ</strong>θιος χια<strong>σ</strong><strong>τ</strong>ός δέχ<strong>ε</strong><strong>τ</strong>αι <strong>τ</strong>έ<strong>τ</strong>οι<strong>ε</strong>ς δ<strong>υ</strong>νάµ<strong>ε</strong>ις.<br />

Οι DREZ ET AL και YACK ET AI βρήκ<strong>αν</strong> <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικά µικρό<strong>τ</strong><strong>ε</strong>ρη <strong>π</strong>ρό<strong>σ</strong>θια<br />

κνηµιαία µ<strong>ε</strong><strong>τ</strong>α<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ο γόνα<strong>τ</strong>ο µ<strong>ε</strong> <strong>αν</strong><strong>ε</strong><strong>π</strong>άρκ<strong>ε</strong>ια <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού<br />

<strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong> µ<strong>ε</strong> ά<strong>σ</strong>κη<strong>σ</strong>η ΚΒΑ <strong>σ</strong><strong>ε</strong> <strong>σ</strong>ύγκρι<strong>σ</strong>η µ<strong>ε</strong> α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις ΑΒΑ.<br />

Σ<strong>ε</strong> <strong>αν</strong><strong>τ</strong>ίθ<strong>ε</strong><strong>σ</strong>η µ<strong>ε</strong> ό<strong>τ</strong>ι έχ<strong>ε</strong>ι <strong>αν</strong>αφ<strong>ε</strong>ρθ<strong>ε</strong>ί µέχρι <strong>τ</strong>ώρα για <strong>τ</strong>ην <strong>π</strong>ρό<strong>σ</strong>θια<br />

<strong>π</strong>αρ<strong>ε</strong>κ<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>η <strong>τ</strong>ης κνήµης ο Shoemaker και Μarkolf <strong>τ</strong>ο 1985 <strong>π</strong>ρο<strong>σ</strong>διόρι<strong>σ</strong><strong>αν</strong><br />

ό<strong>τ</strong>ι κα<strong>τ</strong>ά <strong>τ</strong>ην αύξη<strong>σ</strong>η <strong>τ</strong>ης <strong>αν</strong><strong>τ</strong>ί<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης, <strong>σ</strong><strong>ε</strong> ά<strong>σ</strong>κη<strong>σ</strong>η ΚΒΑ, α<strong>υ</strong>ξήθηκ<strong>ε</strong><br />

και <strong>τ</strong>ο <strong>π</strong>ο<strong>σ</strong>ό <strong>τ</strong>ης <strong>π</strong>ρό<strong>σ</strong>θιας µ<strong>ε</strong><strong>τ</strong>α<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>ης.<br />

* Ε<strong>π</strong>ίδρα<strong>σ</strong>η ΑΒΑ και ΚΒΑ <strong>σ</strong><strong>τ</strong>ις <strong>ε</strong>φ<strong>ε</strong>λκι<strong>σ</strong><strong>τ</strong>ικές δ<strong>υ</strong>νάµ<strong>ε</strong>ις<br />

Οι Grood 1984, Ηenning et al 1985, Jurist et al 1985 kai Yasuda et<br />

ai 1987 <strong>αν</strong>έφ<strong>ε</strong>ρ<strong>αν</strong> µια <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ική <strong>π</strong>ρό<strong>σ</strong>θια µ<strong>ε</strong><strong>τ</strong>α<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>η <strong>τ</strong>ης κνήµης και<br />

µια <strong>π</strong>ρό<strong>σ</strong>θια <strong>ε</strong>φ<strong>ε</strong>λκι<strong>σ</strong><strong>τ</strong>ική δύναµη <strong>σ</strong><strong>ε</strong> ά<strong>σ</strong>κη<strong>σ</strong>η έκ<strong>τ</strong>α<strong>σ</strong>ης γόνα<strong>τ</strong>ος <strong>σ</strong><strong>ε</strong><br />

ΑΒΑ. Α<strong>υ</strong><strong>τ</strong>ή η <strong>π</strong>ρό<strong>σ</strong>θια µ<strong>ε</strong><strong>τ</strong>α<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>η <strong>αν</strong>αφέρ<strong>ε</strong>ι ο Daniel et al 1994 και<br />

ο Ηawkins et al 1986 <strong>π</strong>ρο<strong>ε</strong>ρχόµ<strong>ε</strong>νη α<strong>π</strong>ό µια

<strong>ε</strong>φ<strong>ε</strong>λκι<strong>σ</strong><strong>τ</strong>ική δύναµη <strong>σ</strong><strong>τ</strong>ις κνηµοµηριαί<strong>ε</strong>ς και <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδοµηριαί<strong>ε</strong>ς αρθρώ<strong>σ</strong><strong>ε</strong>ις<br />

µ<strong>π</strong>ορ<strong>ε</strong>ί <strong>ε</strong><strong>π</strong>ί<strong>σ</strong>ης να έχο<strong>υ</strong>ν <strong>ε</strong><strong>π</strong>ιβλαβή α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λέ<strong>σ</strong>µα<strong>τ</strong>α <strong>σ</strong><strong>τ</strong>ον αρθρικό χόνδρο.<br />

Ο Lutz 1993 <strong>ε</strong>ξ<strong>ε</strong><strong>τ</strong>άζον<strong>τ</strong>ας 5 <strong>υ</strong>γιή ά<strong>τ</strong>οµα <strong>ε</strong>κ<strong>τ</strong><strong>ε</strong>λών<strong>τ</strong>ας µέγι<strong>σ</strong><strong>τ</strong>η ι<strong>σ</strong>οµ<strong>ε</strong><strong>τ</strong>ρική<br />

<strong>σ</strong><strong>υ</strong><strong>σ</strong><strong>τ</strong>ολή <strong>σ</strong><strong>τ</strong>ις 30°, 60° και 90° κάµψης <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος <strong>σ</strong><strong>ε</strong> ΑΒΑ και ΚΒΑ <strong>αν</strong>έφ<strong>ε</strong>ρ<strong>ε</strong><br />

µ<strong>ε</strong>γάλη <strong>π</strong>ρό<strong>σ</strong>θια <strong>ε</strong>φ<strong>ε</strong>λκι<strong>σ</strong><strong>τ</strong>ική δύναµη <strong>σ</strong><strong>τ</strong>ην ά<strong>σ</strong>κη<strong>σ</strong>η έκ<strong>τ</strong>α<strong>σ</strong>ης γόνα<strong>τ</strong>ος (<br />

<strong>π</strong>ροκαλούµ<strong>ε</strong>νη <strong>π</strong>άν<strong>τ</strong>α α<strong>π</strong>ό <strong>τ</strong>ον <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο ) <strong>σ</strong><strong>τ</strong>ις 30° κάµψης (285+_ 120<br />

Νt) και µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρη <strong>π</strong>ρό<strong>σ</strong>θια <strong>ε</strong>φ<strong>ε</strong>λκι<strong>σ</strong><strong>τ</strong>ική δύναµη ( 1780 +699 Νΐ) ό<strong>τ</strong><strong>αν</strong><br />

<strong>ε</strong>κ<strong>τ</strong><strong>ε</strong>λέ<strong>σ</strong><strong>τ</strong>ηκ<strong>ε</strong> α<strong>π</strong>ό <strong>τ</strong>ις 90° κάµψης <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος. Η ΚΒΑ έδ<strong>ε</strong>ιξ<strong>ε</strong> λιγό<strong>τ</strong><strong>ε</strong>ρη<br />

<strong>π</strong>ρό<strong>σ</strong>θια <strong>ε</strong>φ<strong>ε</strong>λκι<strong>σ</strong><strong>τ</strong>ική δύναµη <strong>σ</strong><strong>ε</strong> όλ<strong>ε</strong>ς <strong>τ</strong>ις µοίρ<strong>ε</strong>ς <strong>σ</strong><strong>υ</strong>γκρινόµ<strong>ε</strong>νη µ<strong>ε</strong> <strong>τ</strong>ην ΑΒΑ.<br />

Ε<strong>π</strong>ί<strong>σ</strong>ης, ο ίδιος <strong>ε</strong>ρ<strong>ε</strong><strong>υ</strong>νη<strong>τ</strong>ής <strong>αν</strong>έφ<strong>ε</strong>ρ<strong>ε</strong> ό<strong>τ</strong>ι η ΚΒΑ <strong>π</strong>αράγ<strong>ε</strong>ι µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρ<strong>ε</strong>ς<br />

<strong>σ</strong><strong>υ</strong>µ<strong>π</strong>ι<strong>ε</strong><strong>σ</strong><strong>τ</strong>ικές δ<strong>υ</strong>νάµ<strong>ε</strong>ις <strong>σ</strong><strong>τ</strong>ην άρθρω<strong>σ</strong>η α<strong>υ</strong>ξάνον<strong>τ</strong>ας <strong>τ</strong>ην <strong>σ</strong><strong>υ</strong>ν -<strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η<br />

<strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong> και ι<strong>σ</strong>χιοκνηµιαίων <strong>σ</strong><strong>τ</strong>ις ίδι<strong>ε</strong>ς µοίρ<strong>ε</strong>ς, <strong>π</strong>ο<strong>υ</strong> α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις ΑΒΑ<br />

<strong>π</strong>ροκαλούν µέγι<strong>σ</strong><strong>τ</strong>η <strong>π</strong>ρό<strong>σ</strong>θια <strong>ε</strong>φ<strong>ε</strong>λκι<strong>σ</strong><strong>τ</strong>ική δύναµη.<br />

* Η <strong>ε</strong><strong>π</strong>ίδρα<strong>σ</strong>η <strong>τ</strong>ης ΚΒΑ και ΑΒΑ <strong>σ</strong><strong>τ</strong>ις <strong>σ</strong><strong>υ</strong>µ<strong>π</strong>ι<strong>ε</strong><strong>σ</strong><strong>τ</strong>ικές δ<strong>υ</strong>νάµ<strong>ε</strong>ις<br />

Οι Οhkoski et al και Ρalmitier et al <strong>τ</strong>ο 1991 <strong>σ</strong><strong>ε</strong> <strong>ε</strong>ρ<strong>ε</strong><strong>υ</strong>νά <strong>τ</strong>ο<strong>υ</strong>ς δήλω<strong>σ</strong><strong>αν</strong> ό<strong>τ</strong>ι,<br />

ό<strong>τ</strong><strong>αν</strong> η κινη<strong>τ</strong>ική αλ<strong>υ</strong><strong>σ</strong>ίδα <strong>ε</strong>ίναι κλ<strong>ε</strong>ι<strong>σ</strong><strong>τ</strong>ή, <strong>υ</strong><strong>π</strong>άρχ<strong>ε</strong>ι µια αύξη<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ις <strong>σ</strong><strong>υ</strong>µ<strong>π</strong>ι<strong>ε</strong><strong>σ</strong><strong>τ</strong>ικές<br />

δ<strong>υ</strong>νάµ<strong>ε</strong>ις και µια µ<strong>ε</strong>ίω<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ις <strong>ε</strong>φ<strong>ε</strong>λκι<strong>σ</strong><strong>τ</strong>ικές δ<strong>υ</strong>νάµ<strong>ε</strong>ις, <strong>τ</strong>ο <strong>αν</strong><strong>τ</strong>ίθ<strong>ε</strong><strong>τ</strong>ο µ<strong>π</strong>ορούµ<strong>ε</strong><br />

να <strong>τ</strong>ο <strong>π</strong>ούµ<strong>ε</strong> ό<strong>τ</strong><strong>αν</strong> η κινη<strong>τ</strong>ική αλ<strong>υ</strong><strong>σ</strong>ίδα <strong>ε</strong>ίναι <strong>αν</strong>οικ<strong>τ</strong>ή. Πιθ<strong>αν</strong>ή <strong>ε</strong>ξήγη<strong>σ</strong>η γι΄ α<strong>υ</strong><strong>τ</strong>ό<br />

<strong>ε</strong>ίναι η <strong>π</strong>αρο<strong>υ</strong><strong>σ</strong>ία <strong>τ</strong>ης µ<strong>ε</strong><strong>τ</strong>αφοράς βάρο<strong>υ</strong>ς και <strong>τ</strong>ης <strong>σ</strong><strong>υ</strong>ν - <strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>ης <strong>τ</strong>ων<br />

ο<strong>π</strong>ί<strong>σ</strong>θιων µηριαίων και <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong>, η ο<strong>π</strong>οία <strong>υ</strong><strong>π</strong>άρχ<strong>ε</strong>ι κα<strong>τ</strong>ά <strong>τ</strong>ην κλ<strong>ε</strong>ι<strong>σ</strong><strong>τ</strong>ή<br />

βιοκι-νη<strong>τ</strong>ική αλ<strong>υ</strong><strong>σ</strong>ίδα αλλά α<strong>π</strong>ο<strong>υ</strong><strong>σ</strong>ιάζ<strong>ε</strong>ι α<strong>π</strong>ό <strong>τ</strong>ης ΑΒΑ. Σ<strong>υ</strong>µ<strong>π</strong>ληρωµα<strong>τ</strong>ικά, ο<br />

<strong>υ</strong><strong>π</strong>οκνηµίδιος <strong>σ</strong><strong>υ</strong><strong>σ</strong><strong>π</strong>ά<strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ον α<strong>σ</strong><strong>τ</strong>ράγαλο και <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρο<strong>π</strong>οι<strong>ε</strong>ί <strong>τ</strong>ην κνήµη<br />

έχον<strong>τ</strong>ας <strong>π</strong>αράδοξη <strong>ε</strong><strong>π</strong>ίδρα<strong>σ</strong>η ως α<strong>π</strong>ο<strong>τ</strong>έλ<strong>ε</strong><strong>σ</strong>µα <strong>τ</strong>η µ<strong>ε</strong>ίω<strong>σ</strong>η <strong>τ</strong>ων <strong>ε</strong>φ<strong>ε</strong>λκι<strong>σ</strong><strong>τ</strong>ικών<br />

δ<strong>υ</strong>νάµ<strong>ε</strong>ων <strong>σ</strong><strong>τ</strong>ην <strong>π</strong>ρό<strong>σ</strong>θια <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ια <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος.

Ο Steinkamp et al 1993 <strong>π</strong>αρα<strong>τ</strong>ήρη<strong>σ</strong><strong>ε</strong> ό<strong>τ</strong>ι κα<strong>τ</strong>ά <strong>τ</strong>η διάρκ<strong>ε</strong>ια<br />

<strong>τ</strong>ωνα<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ων ΑΒΑ καθώς <strong>τ</strong>ο γόνα<strong>τ</strong>ο κιν<strong>ε</strong>ί<strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ην κάµψη <strong>τ</strong>ων<br />

90 <strong>ε</strong> <strong>π</strong>ρος <strong>τ</strong>ην <strong>π</strong>λήρη έκ<strong>τ</strong>α<strong>σ</strong>η, <strong>τ</strong>α <strong>σ</strong><strong>υ</strong>µ<strong>π</strong>ι<strong>ε</strong><strong>σ</strong><strong>τ</strong>ικά φορ<strong>τ</strong>ία <strong>σ</strong><strong>τ</strong>ην<br />

<strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδοµηριαια άρθρω<strong>σ</strong>η α<strong>υ</strong>ξάνον<strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρά. Οµοίως κα<strong>τ</strong>ά<br />

<strong>τ</strong>η διάρκ<strong>ε</strong>ια <strong>τ</strong>ης ά<strong>σ</strong>κη<strong>σ</strong>ης ΚΒΑ, καθώς <strong>τ</strong>ο γόνα<strong>τ</strong>ο κιν<strong>ε</strong>ί<strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ην<br />

<strong>π</strong>λήρη έκ<strong>τ</strong>α<strong>σ</strong>η <strong>π</strong>ρος <strong>τ</strong>ην <strong>π</strong>λήρη κάµψη 90°, η <strong>τ</strong>ά<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ην<br />

<strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδοµηριαια άρθρω<strong>σ</strong>η α<strong>υ</strong>ξάν<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρά.<br />

Ο Gooch et al 1993 <strong>αν</strong>έφ<strong>ε</strong>ρ<strong>αν</strong> <strong>π</strong>ληροφορί<strong>ε</strong>ς για <strong>τ</strong>ις<br />

<strong>σ</strong><strong>υ</strong>µ<strong>π</strong>ι<strong>ε</strong><strong>σ</strong><strong>τ</strong>ικές δ<strong>υ</strong>νάµ<strong>ε</strong>ις <strong>π</strong>άνω <strong>σ</strong><strong>τ</strong>ην <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδοµηριαια άρθρω<strong>σ</strong>η<br />

κα<strong>τ</strong>ά <strong>τ</strong>η διάρκ<strong>ε</strong>ια α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ων έκ<strong>τ</strong>α<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος (ΑΒΑ).<br />

Αναλύον<strong>τ</strong>ας α<strong>υ</strong><strong>τ</strong>ό <strong>ε</strong>ί<strong>π</strong><strong>αν</strong> ό<strong>τ</strong>ι η <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ια <strong>ε</strong><strong>π</strong>αφής µ<strong>ε</strong><strong>τ</strong>αξύ <strong>τ</strong>ης<br />

<strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδας και <strong>τ</strong>ο<strong>υ</strong> µηριαίο<strong>υ</strong> µ<strong>ε</strong>ιώνον<strong>τ</strong>αι και οι <strong>σ</strong><strong>υ</strong>µ<strong>π</strong>ι<strong>ε</strong><strong>σ</strong><strong>τ</strong>ικές<br />

δ<strong>υ</strong>νάµ<strong>ε</strong>ις <strong>σ</strong><strong>τ</strong>ην <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδοµηριαια α<strong>υ</strong>ξάνον<strong>τ</strong>αι καθώς <strong>τ</strong>ο γόνα<strong>τ</strong>ο<br />

<strong>ε</strong>κ<strong>τ</strong><strong>ε</strong>ίν<strong>ε</strong><strong>τ</strong>αι <strong>ε</strong>νάν<strong>τ</strong>ια <strong>σ</strong><strong>ε</strong> φορ<strong>τ</strong>ίο. Α<strong>υ</strong><strong>τ</strong>ή η κα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η µ<strong>π</strong>ορ<strong>ε</strong>ί να έχ<strong>ε</strong>ι ως<br />

α<strong>π</strong>ο<strong>τ</strong>έλ<strong>ε</strong><strong>σ</strong>µα βλάβη <strong>σ</strong><strong>τ</strong>ις χόν-δριν<strong>ε</strong>ς <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ι<strong>ε</strong>ς. Σ<strong>τ</strong>ις α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις όµως<br />

ΚΒΑ { <strong>π</strong>.χ. βαθύ κάθι<strong>σ</strong>µα, Ιeg press ) η δύναµη <strong>π</strong>ο<strong>υ</strong> λαµβάν<strong>ε</strong>ι χώρα<br />

µ<strong>ε</strong> <strong>τ</strong>ην κάµψη <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος <strong>ε</strong>ίναι α<strong>υ</strong>ξηµένη, αλλά η <strong>ε</strong><strong>π</strong>αφή µ<strong>ε</strong><strong>τ</strong>αξύ<br />

<strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδας και µηριαίο<strong>υ</strong> <strong>ε</strong>ίναι µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρη και <strong>π</strong>ροκαλ<strong>ε</strong>ί <strong>τ</strong>ην<br />

α<strong>υ</strong>ξ<strong>αν</strong>όµ<strong>ε</strong>νη δύναµη. Έ<strong>τ</strong><strong>σ</strong>ι α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις φόρ<strong>τ</strong>ι<strong>σ</strong>ης µ<strong>π</strong>ορ<strong>ε</strong>ί να <strong>ε</strong>ίναι<br />

<strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρο ωφέλιµ<strong>ε</strong>ς α<strong>π</strong>ό α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις µη φόρ<strong>τ</strong>ι<strong>σ</strong>ης για αθλη<strong>τ</strong>ές µ<strong>ε</strong><br />

<strong>π</strong>όνο <strong>σ</strong><strong>τ</strong>ην <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδοµη-ριαία.<br />

Ο Jonsson 1994 χρη<strong>σ</strong>ιµο<strong>π</strong>οιών<strong>τ</strong>ας <strong>τ</strong>ην <strong>τ</strong>ρι<strong>σ</strong>διά<strong>σ</strong><strong>τ</strong>α<strong>τ</strong>η ακ<strong>τ</strong>ινογραφική<br />

<strong>σ</strong><strong>τ</strong><strong>ε</strong>ρ<strong>ε</strong>οφω<strong>τ</strong>ογραµµική <strong>αν</strong>άλ<strong>υ</strong><strong>σ</strong>η, <strong>αν</strong>έφ<strong>ε</strong>ρ<strong>αν</strong> µια <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ική<br />

<strong>π</strong><strong>ε</strong>ριφ<strong>ε</strong>ρική µ<strong>ε</strong><strong>τ</strong>α<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>η καθώς και µια έ<strong>σ</strong>ω - έξω <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>τ</strong>ροφή <strong>τ</strong>ης<br />

κνήµης ως <strong>π</strong>ρος <strong>τ</strong>ο µηριαίο και για α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις 3ρ<strong>υ</strong>3ΐ (ΚΒΑ) και<br />

<strong>ε</strong>ν<strong>ε</strong>ργη<strong>τ</strong>ικής κάµψης και έκ<strong>τ</strong>α<strong>σ</strong>ης (ΑΒΑ).<br />

Ο Νyland et al 1994 <strong>αν</strong>αφέρ<strong>ε</strong>ι <strong>σ</strong><strong>τ</strong>ο άρθρο <strong>τ</strong>ο<strong>υ</strong> ό<strong>τ</strong>ι κα<strong>τ</strong>ά <strong>τ</strong>η διάρκ<strong>ε</strong>ια<br />

<strong>τ</strong>ης <strong>ε</strong>κ<strong>τ</strong>έλ<strong>ε</strong><strong>σ</strong>ης <strong>τ</strong>ης ά<strong>σ</strong>κη<strong>σ</strong>ης µ<strong>ε</strong> ΚΒΑ ό<strong>π</strong>ως <strong>τ</strong>ο Squat, οι δ<strong>υ</strong>να<strong>τ</strong>ές<br />

<strong>σ</strong><strong>υ</strong><strong>σ</strong><strong>π</strong>ά<strong>σ</strong><strong>ε</strong>ις <strong>τ</strong>ων ι<strong>σ</strong>χιοκνηµιαίων <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρο<strong>π</strong>οιούν δ<strong>υ</strong>ναµικά <strong>τ</strong>ην κα-

µ<strong>π</strong><strong>τ</strong>ική ροή <strong>τ</strong>ο<strong>υ</strong> ι<strong>σ</strong>χίο<strong>υ</strong>. Ένα δ<strong>ε</strong>ύ<strong>τ</strong><strong>ε</strong>ρο α<strong>π</strong>ο<strong>τ</strong>έλ<strong>ε</strong><strong>σ</strong>µα α<strong>υ</strong><strong>τ</strong>ής <strong>τ</strong>ης δ<strong>υ</strong>να-<br />

µικής <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρο<strong>π</strong>οίη<strong>σ</strong>ης <strong>ε</strong>ίναι η <strong>ε</strong>λά<strong>τ</strong><strong>τ</strong>ω<strong>σ</strong>η <strong>τ</strong>ων δια<strong>τ</strong>µη<strong>τ</strong>ικών δ<strong>υ</strong>νάµ<strong>ε</strong>ων<br />

<strong>σ</strong><strong>τ</strong>ο γόνα<strong>τ</strong>ο. Α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις ΑΒΑ, <strong>π</strong>ο<strong>υ</strong> α<strong>π</strong>οµονώνο<strong>υ</strong>ν ξ<strong>ε</strong>χωρι<strong>σ</strong><strong>τ</strong>ές αρθρώ<strong>σ</strong><strong>ε</strong>ις<br />

, ό<strong>π</strong>ως η έκ<strong>τ</strong>α<strong>σ</strong>η γόνα<strong>τ</strong>ος α<strong>π</strong>ό καθι<strong>σ</strong><strong>τ</strong>ή θέ<strong>σ</strong>η δ<strong>ε</strong>ν <strong>π</strong>αίρνο<strong>υ</strong>ν<br />

<strong>ε</strong><strong>π</strong>αρκή <strong>π</strong>λ<strong>ε</strong>ον<strong>ε</strong>κ<strong>τ</strong>ήµα<strong>τ</strong>α α<strong>υ</strong><strong>τ</strong>ής <strong>τ</strong>ης δ<strong>υ</strong>ναµικής <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρο<strong>π</strong>οίη<strong>σ</strong>ης άλλων<br />

µ<strong>υ</strong>ών <strong>τ</strong>ης κινη<strong>τ</strong>ικής αλ<strong>υ</strong><strong>σ</strong>ίδας <strong>τ</strong>ο<strong>υ</strong> κά<strong>τ</strong>ω άκρο<strong>υ</strong>. Α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις ΚΒΑ<br />

<strong>π</strong>αράγο<strong>υ</strong>ν µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρ<strong>ε</strong>ς <strong>σ</strong><strong>υ</strong>µ<strong>π</strong>ι<strong>ε</strong><strong>σ</strong><strong>τ</strong>ικές δ<strong>υ</strong>νάµ<strong>ε</strong>ις <strong>σ</strong><strong>τ</strong>ην άρθρω<strong>σ</strong>η α<strong>π</strong>ό<br />

ό<strong>τ</strong>ι η ΑΒΑ µ<strong>ε</strong> α<strong>π</strong>ο<strong>τ</strong>έλ<strong>ε</strong><strong>σ</strong>µα µ<strong>ε</strong>ίω<strong>σ</strong>η <strong>τ</strong>ων δια<strong>τ</strong>µη<strong>τ</strong>ικών.<br />

Οι Shoemaker και MARKOLF α<strong>π</strong>οφάνθηκ<strong>αν</strong> ό<strong>τ</strong>ι <strong>τ</strong>ο µέγ<strong>ε</strong>θος <strong>τ</strong>ης<br />

<strong>π</strong>ρό<strong>σ</strong>θιας µ<strong>ε</strong><strong>τ</strong>α<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>ης { άρα και <strong>τ</strong>ο µέγ<strong>ε</strong>θος <strong>τ</strong>ης <strong>τ</strong>ά<strong>σ</strong>ης <strong>π</strong>ο<strong>υ</strong> α<strong>σ</strong>κ<strong>ε</strong>ί<strong>τ</strong>αι<br />

<strong>σ</strong><strong>τ</strong>ον <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µένο <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό ) µ<strong>π</strong>ορ<strong>ε</strong>ί να <strong>ε</strong>λα<strong>τ</strong><strong>τ</strong>ωθ<strong>ε</strong>ί <strong>ε</strong>-<br />

ν<strong>τ</strong><strong>υ</strong><strong>π</strong>ω<strong>σ</strong>ιακά <strong>αν</strong> α<strong>σ</strong>κηθούν <strong>σ</strong><strong>τ</strong>ην κνηµοµηριαία άρθρω<strong>σ</strong>η µ<strong>ε</strong>γάλα<br />

<strong>σ</strong><strong>υ</strong>µ<strong>π</strong>ι<strong>ε</strong><strong>σ</strong><strong>τ</strong>ικά φορ<strong>τ</strong>ία ( ό<strong>π</strong>ως ακριβώς <strong>σ</strong><strong>υ</strong>µβαίν<strong>ε</strong>ι <strong>σ</strong><strong>ε</strong> µια ά<strong>σ</strong>κη<strong>σ</strong>η ΚΒΑ<br />

). Αν<strong>τ</strong>ίθ<strong>ε</strong><strong>τ</strong>α <strong>σ</strong><strong>τ</strong>ις α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις ΑΒΑ µ<strong>π</strong>ορ<strong>ε</strong>ί να µην έχο<strong>υ</strong>µ<strong>ε</strong> <strong>υ</strong>ψηλά <strong>σ</strong><strong>υ</strong>-<br />

µ<strong>π</strong>ι<strong>ε</strong><strong>σ</strong><strong>τ</strong>ικά φορ<strong>τ</strong>ία, έχο<strong>υ</strong>µ<strong>ε</strong> όµως <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικά µ<strong>ε</strong>γάλη <strong>ε</strong><strong>π</strong>ιβάρ<strong>υ</strong>ν<strong>σ</strong>η<br />

<strong>σ</strong><strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό.<br />

* Η <strong>ε</strong><strong>π</strong>ίδρα<strong>σ</strong>η <strong>τ</strong>ις ΑΒΑ και ΚΒΑ <strong>σ</strong><strong>τ</strong>ον <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδοµηριαίο <strong>π</strong>όνο<br />

Σ<strong>τ</strong>ην <strong>σ</strong><strong>υ</strong>χνά <strong>αν</strong>αφ<strong>ε</strong>ρόµ<strong>ε</strong>νη µ<strong>ε</strong>λέ<strong>τ</strong>η <strong>τ</strong>ων Shelbourne & Nitz 1990<br />

κα<strong>τ</strong>ά <strong>τ</strong>ην <strong>τ</strong>αχ<strong>ε</strong>ία α<strong>π</strong>οθ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong>ία δίν<strong>ε</strong><strong>τ</strong>αι έµφα<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ο γ<strong>ε</strong>γονός ό<strong>τ</strong>ι οι<br />

α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις ΚΒΑ <strong>ε</strong>λά<strong>τ</strong><strong>τ</strong>ω<strong>σ</strong><strong>αν</strong> <strong>τ</strong>ον <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδοµηριαίο <strong>π</strong>όνο και <strong>τ</strong>η <strong>σ</strong><strong>υ</strong>χνό<strong>τ</strong>η<strong>τ</strong>α<br />

καµ<strong>π</strong><strong>τ</strong>ικής <strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>ης χωρίς <strong>ε</strong><strong>π</strong>ιδ<strong>ε</strong>ίνω<strong>σ</strong>η <strong>τ</strong>ης <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρό<strong>τ</strong>η<strong>τ</strong>ας.<br />

Όµως η µ<strong>ε</strong>λέ<strong>τ</strong>η α<strong>υ</strong><strong>τ</strong>ή <strong>αν</strong>αφ<strong>ε</strong>ρό<strong>τ</strong><strong>αν</strong> µόνο <strong>σ</strong><strong>τ</strong>ο 29,5% <strong>τ</strong>ων 247<br />

α<strong>σ</strong>θ<strong>ε</strong>νών µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό δύο χρόνια.<br />

Παρόλα α<strong>υ</strong><strong>τ</strong>ά <strong>τ</strong>α α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λέ<strong>σ</strong>µα<strong>τ</strong>α δ<strong>ε</strong>ίχνο<strong>υ</strong>ν ό<strong>τ</strong>ι οι α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις ΚΒΑ<br />

έχο<strong>υ</strong>ν <strong>π</strong>λ<strong>ε</strong>ον<strong>ε</strong>κ<strong>τ</strong>ήµα<strong>τ</strong>α. Η οµάδα <strong>τ</strong>ης ΚΒΑ έχο<strong>υ</strong>ν λιγό<strong>τ</strong><strong>ε</strong>ρο <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδοµηριαίο<br />

<strong>π</strong>όνο, δ<strong>ε</strong>ίχνον<strong>τ</strong>ας ό<strong>τ</strong>ι οι α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις ΚΒΑ έχο<strong>υ</strong>ν λιγό<strong>τ</strong><strong>ε</strong>ρη<br />

έν<strong>τ</strong>α<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ην <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδοµηριαία άρθρω<strong>σ</strong>η. Α<strong>υ</strong><strong>τ</strong>ό <strong>ε</strong>ίναι <strong>π</strong>ολύ <strong>π</strong>ιθ<strong>αν</strong>

να <strong>σ</strong><strong>υ</strong>µβαίν<strong>ε</strong>ι λόγω <strong>τ</strong>ης µ<strong>ε</strong>ίω<strong>σ</strong>ης <strong>τ</strong>ων δ<strong>υ</strong>νάµ<strong>ε</strong>ων <strong>π</strong>ο<strong>υ</strong> <strong>ε</strong><strong>π</strong>ιδρούν<br />

<strong>σ</strong><strong>τ</strong>ην <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδοµηριαία άρθρω<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>η διάρκ<strong>ε</strong>ια <strong>τ</strong>ων α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ων<br />

ΚΒΑ, <strong>π</strong>ο<strong>υ</strong> γ<strong>ε</strong>νικά <strong>ε</strong>κ<strong>τ</strong><strong>ε</strong>λούν<strong>τ</strong>αι <strong>σ</strong>χ<strong>ε</strong>δόν <strong>σ</strong><strong>ε</strong> <strong>π</strong>λήρη έκ<strong>τ</strong>α<strong>σ</strong>η<br />

<strong>σ</strong><strong>υ</strong>γκρι<strong>τ</strong>ικά µ<strong>ε</strong> <strong>ε</strong>κ<strong>ε</strong>ίν<strong>ε</strong>ς <strong>τ</strong>ις δ<strong>υ</strong>νάµ<strong>ε</strong>ις <strong>π</strong>ο<strong>υ</strong> δηµιο<strong>υ</strong>ργούν<strong>τ</strong>αι µ<strong>ε</strong> <strong>τ</strong>ις<br />

α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις ΑΒΑ <strong>σ</strong><strong>ε</strong> ένα <strong>ε</strong>ύρος κίνη<strong>σ</strong>ης 60° µ<strong>ε</strong> 90°.<br />

Σ<strong>τ</strong>ην ίδια έρ<strong>ε</strong><strong>υ</strong>να η οµάδα <strong>τ</strong>ης ΚΒΑ <strong>π</strong>ο<strong>υ</strong> χρη<strong>σ</strong>ιµο<strong>π</strong>οίη<strong>σ</strong><strong>ε</strong> <strong>τ</strong>ο<br />

δροιΐ ΟΟΓΟΙ ή<strong>τ</strong><strong>αν</strong> <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρο ικ<strong>αν</strong>ο<strong>π</strong>οιηµένη µ<strong>ε</strong> <strong>τ</strong>ο <strong>τ</strong><strong>ε</strong>λικό<br />

α<strong>π</strong>ο<strong>τ</strong>έλ<strong>ε</strong><strong>σ</strong>µα <strong>τ</strong>ων χ<strong>ε</strong>ιρο<strong>υ</strong>ργικών <strong>ε</strong><strong>π</strong><strong>ε</strong>µβά<strong>σ</strong><strong>ε</strong>ων και <strong>τ</strong>ης<br />

α<strong>π</strong>οθ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong>ίας <strong>τ</strong>ο<strong>υ</strong> και µ<strong>ε</strong> α<strong>υ</strong><strong>τ</strong>ά <strong>ε</strong><strong>π</strong>έ<strong>σ</strong><strong>τ</strong>ρ<strong>ε</strong>ψ<strong>αν</strong> <strong>σ</strong><strong>τ</strong>ις φ<strong>υ</strong><strong>σ</strong>ιολογικές<br />

καθηµ<strong>ε</strong>ρινές δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς και <strong>σ</strong><strong>π</strong>ορ γρηγορό<strong>τ</strong><strong>ε</strong>ρα α<strong>π</strong>ό <strong>τ</strong>ην<br />

οµάδα <strong>τ</strong>ης ΑΒΑ. Α<strong>υ</strong><strong>τ</strong>ό γίν<strong>ε</strong><strong>τ</strong>αι <strong>π</strong>ιθ<strong>αν</strong>ώς, λόγω <strong>τ</strong>ης λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργικής<br />

οµοιό<strong>τ</strong>η<strong>τ</strong>ας <strong>τ</strong>ων α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ων ΚΒΑ και <strong>τ</strong>ων φ<strong>υ</strong><strong>σ</strong>ιολογικών<br />

<strong>ε</strong><strong>π</strong>ιδρά<strong>σ</strong><strong>ε</strong>ων <strong>σ</strong><strong>τ</strong>η µ<strong>υ</strong>ϊκή ι<strong>σ</strong>χύ, <strong>αν</strong><strong>τ</strong>οχή και ιδιοδ<strong>ε</strong>-κ<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>α.<br />

* Ι∆ΙΟ∆ΕΚΤΙΚΟΤΗΤΑ ΓΟΝΑΤΟΣ<br />

Ο Sherrighton <strong>τ</strong>ο 1906 όρι<strong>σ</strong><strong>ε</strong> <strong>τ</strong>ην ιδιοδ<strong>ε</strong>κ<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>α <strong>σ</strong><strong>αν</strong> <strong>τ</strong>η γνώ<strong>σ</strong>η<br />

<strong>τ</strong>ης θέ<strong>σ</strong>ης και <strong>π</strong>ράξης <strong>τ</strong>µηµά<strong>τ</strong>ων <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong>ώµα<strong>τ</strong>ος α<strong>π</strong>ό « διορα<strong>τ</strong>ικές »<br />

αι<strong>σ</strong>θή<strong>σ</strong><strong>ε</strong>ις. Η ιδιοδ<strong>ε</strong>κ<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>α <strong>σ</strong><strong>υ</strong>ν<strong>ε</strong><strong>π</strong>άγ<strong>ε</strong><strong>τ</strong>αι και <strong>σ</strong><strong>υ</strong>ν<strong>ε</strong>ργα<strong>σ</strong>ία α<strong>π</strong>ό αι<strong>σ</strong>θή<strong>σ</strong><strong>ε</strong>ις<br />

<strong>τ</strong>ων αρθρικών θ<strong>υ</strong>λάκων <strong>τ</strong>ο<strong>υ</strong> δέρµα<strong>τ</strong>ος, <strong>τ</strong>ων <strong>τ</strong><strong>ε</strong>νόν<strong>τ</strong>ων,<br />

<strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µων και µ<strong>υ</strong>ών και <strong>π</strong>ληροφορί<strong>ε</strong>ς <strong>π</strong>ο<strong>υ</strong> λαµβάνον<strong>τ</strong>αι α<strong>π</strong>ό ιδιοϋ<strong>π</strong>οδοχ<strong>ε</strong>ίς<br />

<strong>π</strong>ο<strong>υ</strong> χρη<strong>σ</strong>ιµι<strong>π</strong>οιούν<strong>τ</strong>αι για να <strong>ε</strong>λέγξο<strong>υ</strong>ν <strong>τ</strong>ις <strong>αν</strong>θρώ<strong>π</strong>ιν<strong>ε</strong>ς<br />

κινή<strong>σ</strong><strong>ε</strong>ις.<br />

Ακολο<strong>υ</strong>θών<strong>τ</strong>ας <strong>τ</strong>ην ολοκλήρω<strong>σ</strong>η α<strong>υ</strong><strong>τ</strong>ού <strong>τ</strong>ο<strong>υ</strong> <strong>ε</strong>ρ<strong>ε</strong>θί<strong>σ</strong>µα<strong>τ</strong>ος, α<strong>π</strong>ό<br />

<strong>τ</strong>ην κινη<strong>τ</strong>ική <strong>π</strong><strong>ε</strong>ριοχή <strong>τ</strong>ο<strong>υ</strong> <strong>ε</strong>γκ<strong>ε</strong>φαλικού φλοιού α<strong>π</strong><strong>αν</strong><strong>τ</strong>ά, µ<strong>ε</strong> <strong>τ</strong>α κα<strong>τ</strong>άλληλα<br />

α<strong>π</strong>αγωγά ν<strong>ε</strong><strong>υ</strong>ρικά <strong>ε</strong>ρ<strong>ε</strong>θί<strong>σ</strong>µα<strong>τ</strong>α για να <strong>π</strong>αράγ<strong>ε</strong>ι κινη<strong>τ</strong>ικές <strong>π</strong>ρο<strong>σ</strong>αρµογές<br />

και έλ<strong>ε</strong>γχο ι<strong>σ</strong>ορρο<strong>π</strong>ίας. Γ<strong>ε</strong>νικά α<strong>υ</strong><strong>τ</strong>ό <strong>τ</strong>ο <strong>ε</strong>ξοδούχο <strong>ε</strong>ρέθι<strong>σ</strong>µα,<br />

η <strong>σ</strong>ύνθ<strong>ε</strong><strong>σ</strong>η <strong>τ</strong>ης λύ<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ροβλήµα<strong>τ</strong>ος <strong>τ</strong>ης µηχ<strong>αν</strong>ικής <strong>ε</strong>κµάθη<strong>σ</strong>ης<br />

<strong>ε</strong>ίναι <strong>π</strong>ρόδηλη, ό<strong>π</strong>ως α<strong>υ</strong><strong>τ</strong>ή <strong>σ</strong><strong>υ</strong>ν<strong>τ</strong>ονίζ<strong>ε</strong>ι <strong>π</strong>ολλο<strong>π</strong>λά <strong>π</strong>ρο<strong>σ</strong>αγωγά<br />

ν<strong>ε</strong><strong>υ</strong>ρικά <strong>ε</strong>ρ<strong>ε</strong>θί<strong>σ</strong>µα<strong>τ</strong>α και <strong>αν</strong><strong>τ</strong>ι<strong>σ</strong><strong>τ</strong>αθµίζ<strong>ε</strong>ι <strong>τ</strong>α <strong>ε</strong>µ<strong>π</strong>όδια και <strong>τ</strong>η <strong>σ</strong><strong>τ</strong>ιγ-

µιαία <strong>αν</strong>α<strong>σ</strong><strong>τ</strong>ά<strong>τ</strong>ω<strong>σ</strong>η µ<strong>ε</strong> <strong>π</strong>ροοδ<strong>ε</strong><strong>υ</strong><strong>τ</strong>ικά <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρο ικ<strong>αν</strong>ο<strong>π</strong>οιη<strong>τ</strong>ικές<br />

<strong>σ</strong><strong>τ</strong>ρα<strong>τ</strong>ηγικές α<strong>π</strong>αγωγών ν<strong>ε</strong><strong>υ</strong>ρικών α<strong>π</strong><strong>αν</strong><strong>τ</strong>ή<strong>σ</strong><strong>ε</strong>ων.<br />

Ο Lutz et al 1991 <strong>αν</strong>αφέρον<strong>τ</strong>ας ένα <strong>π</strong>ρόγραµµα<br />

α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης <strong>π</strong>ο<strong>υ</strong> χρη<strong>σ</strong>ιµο<strong>π</strong>οιήθηκ<strong>ε</strong> <strong>σ</strong><strong>τ</strong>ην κλινική Μ3γο για<br />

αθλη<strong>τ</strong>ές µ<strong>ε</strong> <strong>αν</strong><strong>ε</strong><strong>π</strong>άρκ<strong>ε</strong>ια <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού, <strong>π</strong><strong>ε</strong>ριγράφο<strong>υ</strong>ν ένα<br />

<strong>σ</strong><strong>τ</strong>άδιο <strong>ε</strong>κ<strong>π</strong>αίδ<strong>ε</strong><strong>υ</strong><strong>σ</strong>ης <strong>τ</strong>ης <strong>ε</strong><strong>υ</strong>κινη<strong>σ</strong>ίας <strong>σ</strong><strong>ε</strong> <strong>σ</strong><strong>υ</strong>γκ<strong>ε</strong>κριµένο άθληµα,<br />

Το µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρο <strong>τ</strong>µήµα α<strong>υ</strong><strong>τ</strong>ού <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong><strong>τ</strong>αδίο<strong>υ</strong> <strong>ε</strong>ίναι βα<strong>σ</strong>ι<strong>σ</strong>µένο <strong>σ</strong><strong>τ</strong>ην<br />

<strong>αν</strong>ά<strong>π</strong><strong>τ</strong><strong>υ</strong>ξη <strong>ε</strong>νός <strong>αν</strong><strong>τ</strong><strong>αν</strong>ακλα<strong>σ</strong><strong>τ</strong>ικού <strong>τ</strong>όξο<strong>υ</strong> µηχαιοϋ<strong>π</strong>οδοχέων <strong>σ</strong><strong>τ</strong>ον<br />

<strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό, <strong>τ</strong>ο ο<strong>π</strong>οίο <strong>π</strong><strong>ε</strong>ριλαµβάν<strong>ε</strong>ι <strong>τ</strong>ην οµάδα <strong>τ</strong>ων<br />

γα<strong>σ</strong><strong>τ</strong>ροκνηµίων µ<strong>υ</strong>ών. Α<strong>υ</strong><strong>τ</strong>ό <strong>τ</strong>ο ν<strong>ε</strong><strong>υ</strong>ροµ<strong>υ</strong>ϊκό <strong>τ</strong>όξο <strong>π</strong>ι<strong>σ</strong><strong>τ</strong><strong>ε</strong>ύ<strong>ε</strong><strong>τ</strong>αι ό<strong>τ</strong>ι<br />

<strong>ε</strong>ίναι <strong>υ</strong><strong>π</strong><strong>ε</strong>ύθ<strong>υ</strong>νο για <strong>τ</strong>ην <strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ρά<strong>τ</strong><strong>ε</strong><strong>υ</strong><strong>σ</strong>η <strong>τ</strong>ων γα<strong>σ</strong><strong>τ</strong>ροκνηµίων, <strong>σ</strong><strong>ε</strong><br />

µέθοδο <strong>σ</strong><strong>υ</strong>ν - <strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>ης µ<strong>ε</strong>ιώνον<strong>τ</strong>ας έ<strong>τ</strong><strong>σ</strong>ι <strong>τ</strong>ον άξονα <strong>σ</strong><strong>τ</strong>ροφής.<br />

Α<strong>υ</strong><strong>τ</strong>ή η µ<strong>ε</strong>ίω<strong>σ</strong>η <strong>π</strong>ροκαλ<strong>ε</strong>ί<strong>τ</strong>αι µέ<strong>σ</strong>α α<strong>π</strong>ό <strong>τ</strong>η χρή<strong>σ</strong>η<br />

δρα<strong>σ</strong><strong>τ</strong>ηριο<strong>τ</strong>ή<strong>τ</strong>ων ι<strong>σ</strong>ορρο<strong>π</strong>ίας <strong>π</strong>άνω <strong>σ</strong><strong>ε</strong> <strong>σ</strong><strong>αν</strong>ίδα. Α<strong>υ</strong><strong>τ</strong>ές οι<br />

δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς αρχίζο<strong>υ</strong>ν α<strong>π</strong>ό µια καθι<strong>σ</strong><strong>τ</strong>ή θέ<strong>σ</strong>η, <strong>σ</strong><strong>ε</strong> µια<br />

<strong>π</strong>ρο<strong>σ</strong><strong>π</strong>άθ<strong>ε</strong>ια <strong>ε</strong><strong>π</strong><strong>αν</strong>α-<strong>π</strong>όκ<strong>τ</strong>η<strong>σ</strong>ης <strong>τ</strong>ης ιδιοδ<strong>ε</strong>κ<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>ας,<br />

<strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρό<strong>τ</strong>η<strong>τ</strong>ας και µ<strong>υ</strong>ϊκή <strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ρά<strong>τ</strong><strong>ε</strong><strong>υ</strong><strong>σ</strong>η <strong>σ</strong><strong>ε</strong> λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργικό µον<strong>τ</strong>έλο.<br />

Η <strong>ε</strong>λ<strong>ε</strong>γχόµ<strong>ε</strong>νη α<strong>π</strong>ό<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η <strong>τ</strong>ης <strong>π</strong>ρο<strong>σ</strong>οχής <strong>σ</strong><strong>ε</strong> α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις<br />

ιδιοδ<strong>ε</strong>κ<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>ας <strong>αν</strong>αφέρθηκ<strong>ε</strong> ως ένα <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικό κοµµά<strong>τ</strong>ι. Ο \Λ/ells<br />

et al 1994 βρήκ<strong>ε</strong> <strong>σ</strong><strong>τ</strong>ην άρθρω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος <strong>σ</strong><strong>ε</strong> ένα έργο ΑΒΑ<br />

να <strong>ε</strong>ίναι <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικά χ<strong>ε</strong>ιρό<strong>τ</strong><strong>ε</strong>ρη κά<strong>τ</strong>ω α<strong>π</strong>ό <strong>σ</strong><strong>υ</strong>νθήκ<strong>ε</strong>ς <strong>τ</strong>α<strong>υ</strong><strong>τ</strong>όχρονης<br />

α<strong>π</strong>ό<strong>σ</strong><strong>π</strong>α<strong>σ</strong>ης. Οι µ<strong>ε</strong><strong>τ</strong>έχον<strong>τ</strong><strong>ε</strong>ς <strong>ε</strong>ίχ<strong>αν</strong> <strong>τ</strong>ο δ<strong>ε</strong>ξί <strong>τ</strong>ο<strong>υ</strong>ς γόνα<strong>τ</strong>ο<br />

<strong>τ</strong>ο<strong>π</strong>οθ<strong>ε</strong><strong>τ</strong>ηµένο <strong>π</strong>αθη<strong>τ</strong>ικά <strong>σ</strong><strong>τ</strong>ις γωνί<strong>ε</strong>ς <strong>τ</strong>ων 45°, 60° και 80°<br />

κάµψης, ξ<strong>ε</strong>κινών<strong>τ</strong>ας α<strong>π</strong>ό µια <strong>τ</strong>ο<strong>π</strong>οθέ<strong>τ</strong>η<strong>σ</strong>η <strong>σ</strong><strong>ε</strong> 35° κάµψης και<br />

<strong>τ</strong>ο<strong>υ</strong>ς ζή<strong>τ</strong>η<strong>σ</strong><strong>ε</strong> να <strong>τ</strong>αιριάξο<strong>υ</strong>ν <strong>τ</strong>η γωνία <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος µ<strong>ε</strong> <strong>τ</strong>ο αρι<strong>σ</strong><strong>τ</strong><strong>ε</strong>ρό<br />

<strong>τ</strong>ο<strong>υ</strong>ς <strong>π</strong>όδι. Εδώ <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να <strong>αν</strong>αφέρο<strong>υ</strong>µ<strong>ε</strong> ό<strong>τ</strong>ι <strong>τ</strong>ο δ<strong>ε</strong>ξί <strong>τ</strong>ο<strong>υ</strong>ς <strong>π</strong>όδι<br />

ή<strong>τ</strong><strong>αν</strong> καλ<strong>υ</strong>µµένο µ<strong>ε</strong> κο<strong>υ</strong>ρ<strong>τ</strong>ίνα. Ό<strong>τ</strong><strong>αν</strong> ζη<strong>τ</strong>ήθηκ<strong>ε</strong> κα<strong>τ</strong>ά <strong>τ</strong>ην <strong>ε</strong>νέργ<strong>ε</strong>ια<br />

α<strong>υ</strong><strong>τ</strong>ή να <strong>ε</strong>κ<strong>τ</strong><strong>ε</strong>λέ<strong>σ</strong>ο<strong>υ</strong>ν µαθηµα<strong>τ</strong>ικούς <strong>υ</strong><strong>π</strong>ολογι<strong>σ</strong>µούς ( <strong>π</strong>.χ. 23 Χ 22<br />

= 506 ), η µ<strong>ε</strong>ίω<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ην ακρίβ<strong>ε</strong>ια <strong>τ</strong>ης <strong>τ</strong>ο<strong>π</strong>οθέ<strong>τ</strong>η<strong>σ</strong>ης <strong>ε</strong>µφ<strong>αν</strong>ί<strong>σ</strong>θηκ<strong>ε</strong><br />

µόνο <strong>σ</strong><strong>τ</strong>η µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρη γωνία <strong>τ</strong>ο<strong>υ</strong> test <strong>σ</strong><strong>τ</strong>ις 80°.

Ανέφ<strong>ε</strong>ρ<strong>ε</strong> <strong>ε</strong><strong>π</strong>ί<strong>σ</strong>ης, ό<strong>τ</strong>ι µια µη <strong>ε</strong>λ<strong>ε</strong>γχόµ<strong>ε</strong>νη α<strong>π</strong>ό<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η µ<strong>π</strong>ορ<strong>ε</strong>ί να<br />

<strong>σ</strong><strong>υ</strong>νδ<strong>υ</strong>ά<strong>σ</strong><strong>ε</strong>ι <strong>τ</strong>ην ι<strong>σ</strong>ορρο<strong>π</strong>ία, <strong>τ</strong>ο <strong>σ</strong><strong>υ</strong>ν<strong>τ</strong>ονι<strong>σ</strong>µό και <strong>τ</strong>ο <strong>σ</strong>χ<strong>ε</strong>δια<strong>σ</strong>µό <strong>τ</strong>ης<br />

κίνη<strong>σ</strong>ης, <strong>τ</strong>ο<strong>π</strong>οθ<strong>ε</strong><strong>τ</strong>ών<strong>τ</strong>ας ένα ήδη <strong>τ</strong>ρω<strong>τ</strong>ό α<strong>σ</strong>θ<strong>ε</strong>νή <strong>σ</strong><strong>ε</strong> ένα<br />

<strong>υ</strong>ψηλό<strong>τ</strong><strong>ε</strong>ρο κίνδ<strong>υ</strong>νο <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µού <strong>σ</strong><strong>τ</strong>η διάρκ<strong>ε</strong>ια <strong>τ</strong>ης<br />

θ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong>ίας. Α<strong>π</strong>ό <strong>τ</strong>ην άλλη µ<strong>ε</strong>ριά, η <strong>ε</strong>ι<strong>σ</strong>αγωγή µιας<br />

<strong>ε</strong>λ<strong>ε</strong>γχόµ<strong>ε</strong>νης <strong>αν</strong><strong>τ</strong>ί<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης µ<strong>π</strong>ορ<strong>ε</strong>ί να <strong>π</strong>ροκαλέ<strong>σ</strong><strong>ε</strong>ι µια θ<strong>ε</strong><strong>τ</strong>ική<br />

<strong>ε</strong><strong>π</strong>ίδρα<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ην <strong>αν</strong>ά<strong>π</strong><strong>τ</strong><strong>υ</strong>ξη κινη<strong>τ</strong>ικών ικ<strong>αν</strong>ο<strong>τ</strong>ή<strong>τ</strong>ων, ό<strong>π</strong>ως<br />

<strong>π</strong>ροοδ<strong>ε</strong>ύ<strong>ε</strong>ι ο α<strong>σ</strong>θ<strong>ε</strong>νής <strong>σ</strong><strong>τ</strong>ην α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η.<br />

Ο MR RUSSEL ET AL 1998 <strong>σ</strong><strong>ε</strong> <strong>ε</strong>ρ<strong>ε</strong><strong>υ</strong>νά <strong>τ</strong>ο<strong>υ</strong> για <strong>τ</strong>ην ικ<strong>αν</strong>ό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ης<br />

<strong>αν</strong>θρώ<strong>π</strong>ινης ιδιοδ<strong>ε</strong>κ<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>ας <strong>σ</strong><strong>τ</strong>ην άρθρω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, <strong>σ</strong><strong>τ</strong>ην<br />

ο<strong>π</strong>οία χρη<strong>σ</strong>ιµο<strong>π</strong>οιήθηκ<strong>αν</strong> α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις ΑΒΑ χωρίς φόρ<strong>τ</strong>ι<strong>σ</strong>η, <strong>αν</strong>έφ<strong>ε</strong>ρ<strong>ε</strong><br />

ό<strong>τ</strong>ι οι α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις ΑΒΑ α<strong>π</strong>οµονώνο<strong>υ</strong>ν ορι<strong>σ</strong>µένο<strong>υ</strong>ς µύ<strong>ε</strong>ς και<br />

<strong>π</strong>ροκαλούν α<strong>υ</strong>ξηµένο <strong>σ</strong><strong>τ</strong>ρ<strong>ε</strong>ς <strong>σ</strong><strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ο <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µο <strong>σ</strong><strong>ε</strong><br />

κινή<strong>σ</strong><strong>ε</strong>ις έκ<strong>τ</strong>α<strong>σ</strong>ης και <strong>σ</strong><strong>τ</strong>ον ο<strong>π</strong>ί<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ο <strong>σ</strong><strong>ε</strong> κινή<strong>σ</strong><strong>ε</strong>ις κάµψη<br />

<strong>σ</strong><strong>υ</strong>γκρινόµ<strong>ε</strong>νη µ<strong>ε</strong> <strong>τ</strong>ις α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις ΚΒΑ. Σ<strong>τ</strong>ην ΚΒΑ έχ<strong>ε</strong>ι βρ<strong>ε</strong>θ<strong>ε</strong>ί ό<strong>τ</strong>ι<br />

<strong>π</strong>αράγ<strong>ε</strong>ι <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικά λιγό<strong>τ</strong><strong>ε</strong>ρη <strong>ε</strong><strong>π</strong>ιβάρ<strong>υ</strong>ν<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ο<strong>υ</strong>ς χια<strong>σ</strong><strong>τ</strong>ούς<br />

<strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>ς και οφ<strong>ε</strong>ίλ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>η χρή<strong>σ</strong>η <strong>π</strong>ολλών µ<strong>υ</strong>ϊκών οµάδων.<br />

Ως α<strong>π</strong>ο<strong>τ</strong>έλ<strong>ε</strong><strong>σ</strong>µα α<strong>υ</strong><strong>τ</strong>ών, η α<strong>υ</strong>ξηµένη χρή<strong>σ</strong>η <strong>π</strong>ολλών µ<strong>υ</strong>ϊκών<br />

οµάδων και η µ<strong>ε</strong>ιωµένη <strong>ε</strong><strong>π</strong>ιβάρ<strong>υ</strong>ν<strong>σ</strong>η <strong>τ</strong>ων χια<strong>σ</strong><strong>τ</strong>ών κα<strong>τ</strong>ά <strong>τ</strong>η διάρκ<strong>ε</strong>ια<br />

έργο<strong>υ</strong> ΚΒΑ µ<strong>π</strong>ορ<strong>ε</strong>ί να <strong>π</strong>ροβλέ<strong>π</strong><strong>ε</strong>ι λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργικά διαφορ<strong>ε</strong><strong>τ</strong>ικά<br />

<strong>ε</strong><strong>π</strong><strong>αν</strong>α<strong>τ</strong>ρο-φοδό<strong>τ</strong>η<strong>σ</strong>η ιδιοδ<strong>ε</strong>κ<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>ας <strong>σ</strong><strong>ε</strong> ένα ά<strong>τ</strong>οµο, ό<strong>τ</strong><strong>αν</strong><br />

<strong>σ</strong><strong>υ</strong>γκρίν<strong>ε</strong><strong>τ</strong>αι µ<strong>ε</strong> έργο ΑΒΑ µ<strong>ε</strong> <strong>π</strong><strong>ε</strong>ριορι<strong>σ</strong>µένο αριθµό µ<strong>υ</strong>ών, <strong>π</strong>ο<strong>υ</strong><br />

<strong>σ</strong><strong>υ</strong>µµ<strong>ε</strong><strong>τ</strong>έχο<strong>υ</strong>ν και α<strong>υ</strong>ξηµέν<strong>ε</strong>ς δ<strong>υ</strong>νάµ<strong>ε</strong>ι <strong>σ</strong><strong>τ</strong>ο<strong>υ</strong>ς χια<strong>σ</strong><strong>τ</strong>ούς <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>ς.<br />

* ΑΒΑ και ΚΒΑ <strong>σ</strong><strong>τ</strong>η µ<strong>υ</strong>ϊκή <strong>ε</strong>νδ<strong>υ</strong>νάµω<strong>σ</strong>η<br />

Οι Αugustsson et al 1998 <strong>ε</strong>ρ<strong>ε</strong>ύνη<strong>σ</strong><strong>αν</strong> <strong>σ</strong><strong>ε</strong> µια οµάδα µ<strong>ε</strong> 16 φοι<strong>τ</strong>η<strong>τ</strong>ές<br />

αρ<strong>σ</strong><strong>ε</strong>νικού γένο<strong>υ</strong>ς και 8 θηλ<strong>υ</strong>κού γένο<strong>υ</strong>ς, <strong>υ</strong>γιής και γ<strong>ε</strong>νικά <strong>σ</strong><strong>ε</strong><br />

καλή κα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η, µ<strong>ε</strong> <strong>σ</strong><strong>υ</strong>µ<strong>π</strong><strong>τ</strong>ωµα<strong>τ</strong>ικά λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργία <strong>τ</strong>ης <strong>π</strong>λά<strong>τ</strong>ης, <strong>τ</strong>ο<strong>υ</strong> ι-<br />

<strong>σ</strong>χίο<strong>υ</strong> ή <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, έλαβ<strong>αν</strong> µέρος <strong>σ</strong><strong>ε</strong> <strong>τ</strong>ρία <strong>τ</strong><strong>ε</strong><strong>σ</strong><strong>τ</strong>,<strong>π</strong>ο<strong>υ</strong> <strong>τ</strong>α α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λέ-

<strong>σ</strong>µα<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong>ς αξιολογήθικ<strong>αν</strong> . Τα <strong>τ</strong><strong>ε</strong><strong>σ</strong><strong>τ</strong> ή<strong>τ</strong><strong>αν</strong> .α) άρ<strong>σ</strong>ης βάρο<strong>υ</strong>ς <strong>σ</strong><strong>ε</strong> βαθύ<br />

κάθι<strong>σ</strong>µα µ<strong>ε</strong> <strong>τ</strong>ρι<strong>π</strong>λές <strong>ε</strong><strong>π</strong><strong>αν</strong>αλήψ<strong>ε</strong>ις (ΚΒΑ), β)ένα <strong>τ</strong><strong>ε</strong><strong>σ</strong><strong>τ</strong> ι<strong>σ</strong>οκινη<strong>τ</strong>ικής έκ<strong>τ</strong>α<strong>σ</strong>ης<br />

<strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος µ<strong>ε</strong> µονές <strong>ε</strong><strong>π</strong><strong>αν</strong>αλύψ<strong>ε</strong>ις ΑΒΑ και<br />

γ) ένα <strong>τ</strong><strong>ε</strong><strong>σ</strong><strong>τ</strong> <strong>ε</strong><strong>π</strong>ι<strong>τ</strong>ό<strong>π</strong>ιο<strong>υ</strong> κα<strong>τ</strong>ακόρ<strong>υ</strong>φο<strong>υ</strong> άλµα<strong>τ</strong>ος (ΚΒΑ).<br />

Η οµάδα <strong>τ</strong>ης ΚΒΑ <strong>σ</strong><strong>τ</strong>ο <strong>τ</strong><strong>ε</strong><strong>σ</strong><strong>τ</strong> <strong>τ</strong>ης άρ<strong>σ</strong>ης βαρών <strong>σ</strong><strong>ε</strong> βαθύ κάθι<strong>σ</strong>µα (ΚΒΑ)<br />

β<strong>ε</strong>λ<strong>τ</strong>ιώθηκ<strong>ε</strong> κα<strong>τ</strong>ά 31% <strong>π</strong>ο<strong>υ</strong> ή<strong>τ</strong><strong>αν</strong> <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικά µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρη α<strong>π</strong>ό <strong>τ</strong>ην κα<strong>τ</strong>ά 13%<br />

β<strong>ε</strong>λ<strong>τ</strong>ίω<strong>σ</strong>η, <strong>π</strong>ο<strong>υ</strong> <strong>π</strong>αρα<strong>τ</strong>ηρήθηκ<strong>ε</strong> <strong>σ</strong><strong>τ</strong>ην οµάδα <strong>τ</strong>ης κλ<strong>ε</strong>ι<strong>σ</strong><strong>τ</strong>ής κινη<strong>τ</strong>ικής<br />

αλ<strong>υ</strong><strong>σ</strong>ίδας. Η οµάδα <strong>τ</strong>ης ΚΒΑ β<strong>ε</strong>λ<strong>τ</strong>ιώθηκ<strong>ε</strong> κα<strong>τ</strong>ά 5%, <strong>σ</strong><strong>τ</strong>ο δ<strong>ε</strong>ύ<strong>τ</strong><strong>ε</strong>ρο <strong>τ</strong><strong>ε</strong><strong>σ</strong><strong>τ</strong><br />

ι<strong>σ</strong>οκίνη<strong>σ</strong>ης, <strong>ε</strong>νώ η οµάδα <strong>τ</strong>ης ΑΒΑ β<strong>ε</strong>λ<strong>τ</strong>ιώθηκ<strong>ε</strong> κα<strong>τ</strong>ά 2% αλλαγές, οι<br />

ο<strong>π</strong>οί<strong>ε</strong>ς θ<strong>ε</strong>ωρούν<strong>τ</strong>αι α<strong>σ</strong>ήµ<strong>αν</strong><strong>τ</strong><strong>ε</strong>ς. Σ<strong>τ</strong>ο <strong>τ</strong>ρί<strong>τ</strong>ο <strong>σ</strong><strong>ε</strong><strong>τ</strong> <strong>ε</strong><strong>π</strong>ι<strong>τ</strong>ό<strong>π</strong>ιο<strong>υ</strong> άλµα<strong>τ</strong>ος η οµάδα<br />

<strong>τ</strong>ης ΚΒΑ, β<strong>ε</strong>λ<strong>τ</strong>ιώθηκ<strong>ε</strong> <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικά κα<strong>τ</strong>ά 10%, <strong>ε</strong>νώ µόνο 7% β<strong>ε</strong>λ<strong>τ</strong>ίω<strong>σ</strong>ης<br />

<strong>π</strong>αρα<strong>τ</strong>ηρήθηκ<strong>ε</strong> <strong>σ</strong><strong>τ</strong>ην οµάδα <strong>τ</strong>ης ΑΒΑ.<br />

Οι ΟοΙΙι'θηάθ<strong>π</strong> 3ηύ Τθδοίι <strong>π</strong>αρα<strong>τ</strong>ήρη<strong>σ</strong><strong>αν</strong> µια αύξη<strong>σ</strong>η 8% <strong>σ</strong><strong>τ</strong>ο ύ· ψος<br />

<strong>τ</strong>ο<strong>υ</strong> <strong>ε</strong><strong>π</strong>ι<strong>τ</strong>ό<strong>π</strong>ιο<strong>υ</strong> κα<strong>τ</strong>ακόρ<strong>υ</strong>φο<strong>υ</strong> άλµα<strong>τ</strong>ος <strong>σ</strong><strong>ε</strong> 11 <strong>ε</strong>ξ<strong>ε</strong><strong>τ</strong>αζόµ<strong>ε</strong>νο<strong>υ</strong>ς µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό µια<br />

<strong>π</strong><strong>ε</strong>ρίοδο ι<strong>σ</strong>οκινη<strong>τ</strong>ικής <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>ης µ<strong>ε</strong> βάρη 12 <strong>ε</strong>βδοµάδων, <strong>π</strong>ο<strong>υ</strong> <strong>ε</strong>ίναι<br />

<strong>ε</strong>φάµιλλη µ<strong>ε</strong> <strong>τ</strong>ην 10% β<strong>ε</strong>λ<strong>τ</strong>ίω<strong>σ</strong>η <strong>π</strong>ο<strong>υ</strong> <strong>π</strong>αρα<strong>τ</strong>ηρήθηκ<strong>ε</strong> <strong>σ</strong><strong>τ</strong>ην <strong>ε</strong>ν λόγω µ<strong>ε</strong>λέ<strong>τ</strong>η<br />

<strong>σ</strong><strong>τ</strong>ην οµάδα <strong>τ</strong>ης ΚΒΑ.<br />

Σ<strong>ε</strong> έρ<strong>ε</strong><strong>υ</strong>να <strong>τ</strong>ο<strong>υ</strong> ο Α<strong>υ</strong>ς<strong>υ</strong>δίδδοη θί 3ΐ <strong>τ</strong>ο 1998 <strong>σ</strong><strong>ε</strong> 24 <strong>υ</strong>γι<strong>ε</strong>ίς α<strong>σ</strong>θ<strong>ε</strong>ν<strong>ε</strong>ίς<br />

δοκιµά<strong>σ</strong><strong>τ</strong>ηκ<strong>αν</strong> <strong>σ</strong><strong>τ</strong>ο 3ς<strong>υ</strong>3ί ή <strong>σ</strong><strong>τ</strong>ην έκ<strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος και <strong>π</strong>ρο<strong>σ</strong>αγωγή<br />

ι<strong>σ</strong>χίο<strong>υ</strong> µ<strong>ε</strong> διάφορ<strong>ε</strong>ς <strong>αν</strong><strong>τ</strong>ι<strong>σ</strong><strong>τ</strong>ά<strong>σ</strong><strong>ε</strong>ις µηχ<strong>αν</strong>ηµά<strong>τ</strong>ων και µ<strong>ε</strong> µέγι<strong>σ</strong><strong>τ</strong>η <strong>ε</strong>κ<strong>τ</strong>έλ<strong>ε</strong><strong>σ</strong>η,<br />

<strong>σ</strong><strong>ε</strong> <strong>π</strong>ροοδ<strong>ε</strong><strong>υ</strong><strong>τ</strong>ικό <strong>π</strong>ρόγραµµα µ<strong>ε</strong> βάρη 2 φορές <strong>τ</strong>ην <strong>ε</strong>βδοµάδα για 6<br />

<strong>ε</strong>βδοµάδ<strong>ε</strong>ς. Όλοι οι <strong>υ</strong><strong>π</strong>οψήφιοι <strong>ε</strong>ξ<strong>ε</strong><strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>ηκ<strong>αν</strong> <strong>π</strong>ροηγο<strong>υ</strong>µένως <strong>σ</strong><strong>τ</strong>ην<br />

<strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>η και κα<strong>τ</strong>ά <strong>τ</strong>ην α<strong>π</strong>ο<strong>π</strong><strong>ε</strong>ρά<strong>τ</strong>ω<strong>σ</strong>η <strong>τ</strong>ης <strong>π</strong>ρο<strong>π</strong>ονη-<strong>τ</strong>ικής <strong>π</strong><strong>ε</strong>ριόδο<strong>υ</strong>.<br />

Οι 3 <strong>σ</strong><strong>ε</strong> µέγι<strong>σ</strong><strong>τ</strong>η δύναµη <strong>ε</strong><strong>π</strong><strong>αν</strong>αλήψ<strong>ε</strong>ις <strong>σ</strong><strong>τ</strong>ο δς<strong>υ</strong>θί, η ι<strong>σ</strong>οκινη<strong>τ</strong>ική έκ<strong>τ</strong>α<strong>σ</strong>η<br />

<strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος µ<strong>ε</strong> 1 µέγι<strong>σ</strong><strong>τ</strong>η <strong>ε</strong><strong>π</strong><strong>αν</strong>άληψη και <strong>τ</strong>ο κα<strong>τ</strong>ακόρ<strong>υ</strong>φο άλµα<br />

χρη<strong>σ</strong>ιµο<strong>π</strong>οιήθηκ<strong>αν</strong> για να µ<strong>ε</strong><strong>τ</strong>ρή<strong>σ</strong>ο<strong>υ</strong>ν <strong>τ</strong>α α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λέ<strong>σ</strong>µα<strong>τ</strong>α <strong>τ</strong>ης<br />

<strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>ης. Σηµ<strong>αν</strong><strong>τ</strong>ικές β<strong>ε</strong>λ<strong>τ</strong>ιώ<strong>σ</strong><strong>ε</strong>ις <strong>σ</strong>ηµ<strong>ε</strong>ιώθηκ<strong>αν</strong> και <strong>σ</strong><strong>τ</strong>ις δύο οµάδ<strong>ε</strong>ς<br />

<strong>σ</strong><strong>τ</strong>ο δς<strong>υ</strong>θί, µ<strong>ε</strong> 3 µέγι<strong>σ</strong><strong>τ</strong><strong>ε</strong>ς δ<strong>υ</strong>νάµ<strong>ε</strong>ις <strong>ε</strong><strong>π</strong><strong>αν</strong>α-λύψ<strong>ε</strong>ις.

Η οµάδα <strong>τ</strong>ης κλ<strong>ε</strong>ι<strong>σ</strong><strong>τ</strong>ής βιοκινη<strong>τ</strong>ικής αλ<strong>υ</strong><strong>σ</strong>ίδας β<strong>ε</strong>λ<strong>τ</strong>ιώθηκ<strong>ε</strong> 23Κ9<br />

(31%), <strong>π</strong>ο<strong>υ</strong> <strong>ε</strong>ίναι <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικά µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρη α<strong>π</strong>ό <strong>τ</strong>α 12Κς (13%) αύξη<strong>σ</strong>ης<br />

<strong>τ</strong>ης οµάδας <strong>τ</strong>ης <strong>αν</strong>οικ<strong>τ</strong>ής βιοκινη<strong>τ</strong>ικής αλ<strong>υ</strong><strong>σ</strong>ίδας. Σ<strong>τ</strong>ο κα<strong>τ</strong>ακόρ<strong>υ</strong>φο<br />

άλµα, η οµάδα <strong>τ</strong>ης κλ<strong>ε</strong>ι<strong>σ</strong><strong>τ</strong>ής βιοκινη<strong>τ</strong>ικής αλ<strong>υ</strong><strong>σ</strong>ίδας <strong>ε</strong>ίχ<strong>ε</strong> <strong>σ</strong>η-<br />

µ<strong>αν</strong><strong>τ</strong>ική αύξη<strong>σ</strong>η, 5αη (10%), <strong>ε</strong>νώ <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικές αλλαγές δ<strong>ε</strong>ν <strong>υ</strong><strong>π</strong>ήρξ<strong>αν</strong><br />

<strong>σ</strong><strong>τ</strong>ην οµάδα <strong>τ</strong>ης <strong>αν</strong>οικ<strong>τ</strong>ής βιοκινη<strong>τ</strong>ικής αλ<strong>υ</strong><strong>σ</strong>ίδας. Μια µ<strong>ε</strong>γάλη αύξη<strong>σ</strong>η<br />

<strong>σ</strong><strong>τ</strong>α φορ<strong>τ</strong>ία <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>ης <strong>π</strong>αρα<strong>τ</strong>ηρήθηκ<strong>ε</strong> και <strong>σ</strong><strong>τ</strong>ις δύο οµάδ<strong>ε</strong>ς,<br />

όµως οι β<strong>ε</strong>λ<strong>τ</strong>ιώ<strong>σ</strong><strong>ε</strong>ις <strong>τ</strong>ης ι<strong>σ</strong>ο<strong>τ</strong>ονικής δύναµης δ<strong>ε</strong> µ<strong>ε</strong><strong>τ</strong>αφέρθηκ<strong>αν</strong> κα<strong>τ</strong>αγράφηκ<strong>αν</strong><br />

<strong>σ</strong><strong>τ</strong>ην ι<strong>σ</strong>οκινη<strong>τ</strong>ική έκ<strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος.<br />

2.1.2 ΣΥ - ΣΥΣΠΑΣΗ ΤΩΝ ΙΣΧΙΟΚΝΗΜΙΑΙΩΝ<br />

Α<strong>π</strong>ό µια θ<strong>ε</strong>ωρη<strong>τ</strong>ική <strong>σ</strong>κο<strong>π</strong>ιά, η µ<strong>ε</strong>ίω<strong>σ</strong>η <strong>τ</strong>ης <strong>τ</strong>ά<strong>σ</strong>ης <strong>σ</strong><strong>τ</strong>ον<br />

<strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό <strong>π</strong>ο<strong>υ</strong> <strong>π</strong>αρα<strong>τ</strong>ηρ<strong>ε</strong>ί<strong>τ</strong>αι κα<strong>τ</strong>ά <strong>τ</strong>ις α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις µ<strong>ε</strong><br />

φόρ<strong>τ</strong>ι<strong>σ</strong>η βάρο<strong>υ</strong>ς, έχ<strong>ε</strong>ι <strong>ε</strong>ξηγηθ<strong>ε</strong>ί α<strong>π</strong>ό <strong>τ</strong>ο γ<strong>ε</strong>γονός ό<strong>τ</strong>ι<br />

δρα<strong>σ</strong><strong>τ</strong>ηριο<strong>π</strong>οιούν<strong>τ</strong>αι οι ι<strong>σ</strong>χιοκνη-µιαίοι, Η <strong>σ</strong><strong>υ</strong>-<strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η<br />

α<strong>υ</strong><strong>τ</strong>ής <strong>τ</strong>ης µ<strong>υ</strong>ϊκής οµάδας, βοηθά<strong>ε</strong>ι <strong>σ</strong><strong>τ</strong>ην <strong>ε</strong>ξο<strong>υ</strong>δ<strong>ε</strong><strong>τ</strong>έρω<strong>σ</strong>η <strong>τ</strong>ης<br />

<strong>τ</strong>ά<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong> να <strong>π</strong>ροκαλ<strong>ε</strong>ί <strong>π</strong>ρό<strong>σ</strong>θια <strong>π</strong>αρ<strong>ε</strong>κ<strong>τ</strong>ό<strong>π</strong>ι<strong>σ</strong>η<br />

<strong>τ</strong>ης κνήµης.<br />

Η <strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η <strong>τ</strong>ων ι<strong>σ</strong>χιοκνηµιαίων κα<strong>τ</strong>ά <strong>τ</strong>ην έκ<strong>τ</strong>α<strong>σ</strong>η<br />

<strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, φαίν<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ην αρχή να <strong>ε</strong>ίναι <strong>π</strong>αράδοξη,<br />

αφού α<strong>υ</strong><strong>τ</strong>ή η µ<strong>υ</strong>ϊκή οµάδα, κα<strong>τ</strong>αγράφ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>αν</strong> βα<strong>σ</strong>ική<br />

για <strong>τ</strong>ην κάµψη <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος. Ε<strong>π</strong>ί<strong>σ</strong>ης, <strong>π</strong>αρόλο <strong>π</strong>ο<strong>υ</strong><br />

διάφοροι <strong>σ</strong><strong>υ</strong>γγραφ<strong>ε</strong>ίς έχο<strong>υ</strong>ν δ<strong>ε</strong>ίξ<strong>ε</strong>ι ό<strong>τ</strong>ι η <strong>σ</strong><strong>υ</strong><strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η<br />

<strong>τ</strong>ων ι<strong>σ</strong>χιοκνηµιαίων <strong>π</strong>αρα<strong>τ</strong>ηρ<strong>ε</strong>ί<strong>τ</strong>αι και<br />

κα<strong>τ</strong>ά <strong>τ</strong>ις α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις, χωρίς βαρ<strong>υ</strong><strong>τ</strong>ική φόρ<strong>τ</strong>ι<strong>σ</strong>η. Ο<br />

Draganich (1989) α<strong>π</strong>έδ<strong>ε</strong>ιξ<strong>ε</strong> ό<strong>τ</strong>ι α<strong>υ</strong><strong>τ</strong>ή η <strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η<br />

<strong>ε</strong>ίναι αρκ<strong>ε</strong><strong>τ</strong>ά µικρή και ο Rentrom (1986) έδ<strong>ε</strong>ιξ<strong>ε</strong> ό<strong>τ</strong>ι<br />

<strong>ε</strong>ίναι <strong>σ</strong>χ<strong>ε</strong><strong>τ</strong>ικά <strong>αν</strong>α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong><strong>σ</strong>µα<strong>τ</strong>ική <strong>σ</strong><strong>τ</strong>ον <strong>π</strong><strong>ε</strong>ριορι<strong>σ</strong>µό <strong>τ</strong>ης <strong>τ</strong>ά<strong>σ</strong>ης<br />

<strong>π</strong>άνω <strong>σ</strong><strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό. Ω<strong>σ</strong><strong>τ</strong>ό<strong>σ</strong>ο, κα<strong>τ</strong>ά <strong>τ</strong>ις α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις µ<strong>ε</strong><br />

φόρ<strong>τ</strong>ι<strong>σ</strong>η βάρο<strong>υ</strong>ς, ό<strong>π</strong>ως <strong>ε</strong>ίναι <strong>τ</strong>ο βαθύ κάθι<strong>σ</strong>µα, <strong>π</strong>ροκαλ<strong>ε</strong>ί<strong>τ</strong>αι<br />

<strong>π</strong>ολύ <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικό<strong>τ</strong><strong>ε</strong>ρη <strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ο<strong>υ</strong>ς ι<strong>σ</strong>χιοκνηµιαίο<strong>υ</strong>ς.

Αφού οι ι<strong>σ</strong>χιοκνηµιαίοι <strong>ε</strong>ίναι διαρθρικοί µύ<strong>ε</strong>ς και λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργούν <strong>ε</strong><strong>π</strong>ί<strong>σ</strong>ης<br />

και <strong>σ</strong><strong>αν</strong> δ<strong>υ</strong>να<strong>τ</strong>οί <strong>ε</strong>κ<strong>τ</strong><strong>ε</strong>ίνον<strong>τ</strong><strong>ε</strong>ς <strong>σ</strong><strong>τ</strong>ο ι<strong>σ</strong>χίο, <strong>π</strong>ροκαλ<strong>ε</strong>ί<strong>τ</strong>αι δ<strong>υ</strong>να<strong>τ</strong>ή<br />

<strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η για να <strong>αν</strong><strong>τ</strong>ι<strong>σ</strong><strong>τ</strong>αθµί<strong>σ</strong><strong>ε</strong>ι <strong>τ</strong>η ρο<strong>π</strong>ή <strong>τ</strong>ο<strong>υ</strong> ορθού µηριαίο<strong>υ</strong>, ο<br />

ο<strong>π</strong>οίος δρα καµ<strong>π</strong><strong>τ</strong>ικά <strong>σ</strong><strong>τ</strong>ο ι<strong>σ</strong>χίο. Η ψηλή <strong>τ</strong>ά<strong>σ</strong>η <strong>σ</strong>' α<strong>υ</strong><strong>τ</strong>ή <strong>τ</strong>η µ<strong>υ</strong>ϊκή<br />

οµάδα, έχ<strong>ε</strong>ι <strong>τ</strong>ό<strong>τ</strong><strong>ε</strong> µια δ<strong>ε</strong><strong>υ</strong><strong>τ</strong><strong>ε</strong>ρ<strong>ε</strong>ύο<strong>υ</strong><strong>σ</strong>α <strong>ε</strong><strong>π</strong>ίδρα<strong>σ</strong>η <strong>π</strong>άνω <strong>σ</strong><strong>τ</strong>ο γόνα<strong>τ</strong>ο.<br />

Η δρα<strong>σ</strong><strong>τ</strong>ική µ<strong>ε</strong>ίω<strong>σ</strong>η <strong>π</strong>άνω <strong>σ</strong><strong>τ</strong>ην <strong>τ</strong>ά<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό <strong>π</strong>ο<strong>υ</strong><br />

<strong>π</strong>ροκύ<strong>π</strong><strong>τ</strong><strong>ε</strong>ι, µ<strong>π</strong>ορ<strong>ε</strong>ί να <strong>π</strong>αρα<strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ί µ<strong>ε</strong> α<strong>π</strong>λά δι<strong>αν</strong><strong>υ</strong><strong>σ</strong>µα<strong>τ</strong>ικά<br />

διαγράµµα<strong>τ</strong>α <strong>τ</strong>ων δ<strong>υ</strong>νάµ<strong>ε</strong>ων.<br />

3.Η ΕΠΑΝΑΠΟΚΤΗΣΗ ΤΗΣ ΜΥΪΚΗΣ ΕΥΚΑΜΨΙΑΣ ΜΕΤΑ<br />

ΤΟΝ ΤΡΑΥΜΑΤΙΣΜΟ<br />

Ε<strong>υ</strong>καµψία <strong>ε</strong>ίναι η ικ<strong>αν</strong>ό<strong>τ</strong>η<strong>τ</strong>α <strong>ε</strong><strong>π</strong>ιµήκ<strong>υ</strong>ν<strong>σ</strong>ης <strong>τ</strong>ων µαλακών<br />

µορίων <strong>π</strong>έρα α<strong>π</strong>ό <strong>τ</strong>ο φ<strong>υ</strong><strong>σ</strong>ικό <strong>ε</strong>ύρος κίνη<strong>σ</strong>ης, και <strong>ε</strong>ξαρ<strong>τ</strong>ά<strong>τ</strong>αι<br />

α<strong>π</strong>ό <strong>τ</strong>ην ηλικία <strong>τ</strong>ο φύλο και <strong>τ</strong>ο <strong>ε</strong><strong>π</strong>ί<strong>π</strong><strong>ε</strong>δο ά<strong>σ</strong>κη<strong>σ</strong>ης. Μ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό<br />

µία κάκω<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ο µ<strong>υ</strong>ο-<strong>σ</strong>κ<strong>ε</strong>λ<strong>ε</strong><strong>τ</strong>ικό <strong>σ</strong>ύ<strong>σ</strong><strong>τ</strong>ηµα, <strong>π</strong><strong>ε</strong>ριορίζ<strong>ε</strong><strong>τ</strong>αι<br />

<strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικά η κίνη<strong>σ</strong>η.<br />

Α<strong>υ</strong><strong>τ</strong>ό οφ<strong>ε</strong>ίλ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ις αλλαγές <strong>π</strong>ο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>µβαίνο<strong>υ</strong>ν <strong>σ</strong><strong>τ</strong>ο<br />

κολλαγόνο Εκ<strong>τ</strong>ός α<strong>π</strong>ό <strong>τ</strong>ην <strong>αν</strong>αφ<strong>ε</strong>ρόµ<strong>ε</strong>νη <strong>σ</strong>χ<strong>ε</strong><strong>τ</strong>ική α<strong>τ</strong>ροφία <strong>τ</strong>ης<br />

γα<strong>σ</strong><strong>τ</strong>έρας α<strong>π</strong>ό <strong>τ</strong>κ ίν<strong>ε</strong>ς <strong>τ</strong>ύ<strong>π</strong>ο<strong>υ</strong> 1, οι αλλαγές <strong>σ</strong><strong>τ</strong>ις µηχ<strong>αν</strong>ικές<br />

ιδιό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>νδ<strong>ε</strong><strong>τ</strong>ικοί ι<strong>σ</strong><strong>τ</strong>ού έχο<strong>υ</strong>ν ως α<strong>π</strong>ο<strong>τ</strong>έλ<strong>ε</strong><strong>σ</strong>µα <strong>τ</strong>η<br />

<strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ική µ<strong>ε</strong>ίω<strong>σ</strong>η <strong>τ</strong>ης <strong>ε</strong>λα<strong>σ</strong><strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>ας. Οι <strong>ε</strong>γκάρ<strong>σ</strong>ι<strong>ε</strong>ς αλ<strong>υ</strong><strong>σ</strong>ίδ<strong>ε</strong>ς<br />

<strong>π</strong>ο<strong>υ</strong> « α<strong>σ</strong>φαλίζο<strong>υ</strong>ν » <strong>τ</strong>ο<strong>υ</strong>ς κολλαγόνο<strong>υ</strong>*:

ι<strong>σ</strong><strong>τ</strong>ούς <strong>π</strong><strong>ε</strong>ριορίζο<strong>υ</strong>ν <strong>τ</strong>ην <strong>ε</strong>κ<strong>τ</strong>α<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>α όχι µόνο <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>γκ<strong>ε</strong>κριµένο<strong>υ</strong><br />

µ<strong>υ</strong>ός, αλλά ολόκληρης <strong>τ</strong>ης άρθρω<strong>σ</strong>ης.<br />

Σκο<strong>π</strong>ός λοι<strong>π</strong>όν <strong>σ</strong><strong>τ</strong>ο <strong>σ</strong><strong>τ</strong>άδιο α<strong>υ</strong><strong>τ</strong>ό <strong>τ</strong>ης α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης <strong>ε</strong>ίναι µ<strong>ε</strong> <strong>ε</strong>-<br />

ν<strong>ε</strong>ργη<strong>τ</strong>ικές, <strong>ε</strong>ν<strong>ε</strong>ργο<strong>π</strong>αθη<strong>τ</strong>ικές και δια<strong>τ</strong>α<strong>τ</strong>ικές α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις να α<strong>π</strong>οκ<strong>τ</strong>ηθ<strong>ε</strong>ί<br />

<strong>τ</strong>ο <strong>ε</strong>ύρος <strong>τ</strong>ροχιάς <strong>τ</strong>ης κίνη<strong>σ</strong>ης <strong>τ</strong>ης άρθρω<strong>σ</strong>ης. Ο φ<strong>υ</strong><strong>σ</strong>ιοθ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong><strong>υ</strong><strong>τ</strong>ής<br />

<strong>ε</strong>κ<strong>τ</strong>ός α<strong>π</strong>ό <strong>τ</strong>ις θ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong><strong>υ</strong><strong>τ</strong>ικές α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις θα χρη<strong>σ</strong>ιµο<strong>π</strong>οίη<strong>σ</strong>η και διάφορα<br />

φ<strong>υ</strong><strong>σ</strong>ικά µέ<strong>σ</strong>α θ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong>ίας ( Υ<strong>π</strong>έρηχοι, µάλαξη, δινόλο<strong>υ</strong><strong>τ</strong>ρα )<br />

για να δοθ<strong>ε</strong>ί η <strong>ε</strong><strong>υ</strong>καιρία <strong>σ</strong><strong>τ</strong>ο<strong>υ</strong>ς ι<strong>σ</strong><strong>τ</strong>ούς µ<strong>ε</strong> <strong>τ</strong>ην αύξη<strong>σ</strong>η <strong>τ</strong>ης θ<strong>ε</strong>ρµοκρα<strong>σ</strong>ίας<br />

να δια<strong>τ</strong>αθούν.<br />

4. ΕΠΑΝΑΠΟΚΤΗΣΗ ΤΗΣ ΜΥΪΚΗΣ ∆ΥΝΑΜΗΣ<br />

Ένα άλλο θέµα <strong>π</strong>ο<strong>υ</strong> <strong>αν</strong>ακύ<strong>π</strong><strong>τ</strong><strong>ε</strong>ι <strong>σ</strong><strong>υ</strong>χνά <strong>σ</strong><strong>τ</strong>η βιβλιογραφία, <strong>ε</strong>ίναι η<br />

<strong>αν</strong>άγκη για <strong>ε</strong><strong>π</strong><strong>αν</strong>άκ<strong>τ</strong>η<strong>σ</strong>η <strong>τ</strong>ης µ<strong>υ</strong>ϊκής δύναµης µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό <strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ική<br />

<strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού. Μ<strong>ε</strong>ρικά α<strong>π</strong>ό <strong>τ</strong>α ζη<strong>τ</strong>ήµα<strong>τ</strong>α α<strong>υ</strong><strong>τ</strong>ού <strong>τ</strong>ο<strong>υ</strong> µέρο<strong>υ</strong>ς έ-<br />

χο<strong>υ</strong>ν ήδη <strong>σ</strong><strong>υ</strong>ζη<strong>τ</strong>ηθ<strong>ε</strong>ί <strong>π</strong>αρα<strong>π</strong>άνω, αλλά <strong>ε</strong>ίναι <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικό να <strong>τ</strong>ονι<strong>σ</strong><strong>τ</strong><strong>ε</strong>ί<br />

ό<strong>τ</strong>ι <strong>π</strong>αρα<strong>τ</strong>ηρ<strong>ε</strong>ί<strong>τ</strong>αι <strong>π</strong>ολύ <strong>π</strong>ροχωρηµένη µ<strong>υ</strong>ϊκή α<strong>τ</strong>ροφία <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong><br />

<strong>σ</strong><strong>ε</strong> <strong>σ</strong>χέ<strong>σ</strong>η µ<strong>ε</strong> <strong>τ</strong>η ρήξη <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού. Οι <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρ<strong>ε</strong>ς<br />

<strong>αν</strong>αφορές έχο<strong>υ</strong>ν α<strong>π</strong>ο<strong>τ</strong>ύχ<strong>ε</strong>ι να δ<strong>ε</strong>ίξο<strong>υ</strong>ν <strong>τ</strong>έλ<strong>ε</strong>ια <strong>ε</strong><strong>π</strong><strong>αν</strong>αφορά <strong>τ</strong>ης<br />

δύναµης <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong> <strong>σ</strong><strong>ε</strong> φ<strong>υ</strong><strong>σ</strong>ιολογικά <strong>ε</strong><strong>π</strong>ί<strong>π</strong><strong>ε</strong>δα <strong>σ</strong>' α<strong>υ</strong><strong>τ</strong>ούς<br />

<strong>τ</strong>ο<strong>υ</strong>ς α<strong>σ</strong>θ<strong>ε</strong>ν<strong>ε</strong>ίς, ό<strong>τ</strong><strong>αν</strong> <strong>σ</strong><strong>υ</strong>γκρίν<strong>ε</strong><strong>τ</strong>αι <strong>τ</strong>ο <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µένο <strong>π</strong>όδι µ<strong>ε</strong> <strong>τ</strong>ο καλό,<br />

<strong>π</strong>αρά <strong>τ</strong>ο ό<strong>τ</strong>ι η µ<strong>ε</strong><strong>τ</strong><strong>ε</strong>γχ<strong>ε</strong>ιρη<strong>τ</strong>ική αξιολόγη<strong>σ</strong>η γίν<strong>ε</strong><strong>τ</strong>αι <strong>π</strong>ολύ αργό<strong>τ</strong><strong>ε</strong>ρα<br />

α<strong>π</strong>ό <strong>τ</strong>ο χ<strong>ε</strong>ιρο<strong>υ</strong>ργ<strong>ε</strong>ίο. Η έρ<strong>ε</strong><strong>υ</strong>να <strong>π</strong>ρο<strong>σ</strong><strong>π</strong>άθη<strong>σ</strong><strong>ε</strong> να α<strong>π</strong>οκαλύψ<strong>ε</strong>ι <strong>τ</strong>ο<strong>υ</strong>ς<br />

<strong>τ</strong>ύ<strong>π</strong>ο<strong>υ</strong>ς <strong>τ</strong>ων µ<strong>υ</strong>ϊκών ινών <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong>, οι ο<strong>π</strong>οί<strong>ε</strong>ς µ<strong>π</strong>ορ<strong>ε</strong>ί να<br />

α<strong>τ</strong>ροφή<strong>σ</strong>ο<strong>υ</strong>ν δ<strong>υ</strong><strong>σ</strong><strong>αν</strong>άλογα <strong>σ</strong><strong>ε</strong> <strong>σ</strong>ύγκρι<strong>σ</strong>η µ<strong>ε</strong> άλλ<strong>ε</strong>ς, <strong>σ</strong><strong>ε</strong> µια <strong>π</strong>ροα<strong>σ</strong><strong>π</strong>άθ<strong>ε</strong>ια<br />

να καθορι<strong>σ</strong><strong>τ</strong>ούν οι <strong>τ</strong>αχύ<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς µ<strong>ε</strong> <strong>τ</strong>ις ο<strong>π</strong>οί<strong>ε</strong>ς ο άρρω<strong>σ</strong><strong>τ</strong>ος θα ή-<br />

<strong>τ</strong><strong>αν</strong> <strong>π</strong>ρο<strong>τ</strong>ιµό<strong>τ</strong><strong>ε</strong>ρο να κάν<strong>ε</strong>ι <strong>τ</strong>ις α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις κα<strong>τ</strong>ά <strong>τ</strong>ην α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η. Οι<br />

ι<strong>σ</strong><strong>τ</strong>ολογικές µ<strong>ε</strong>λέ<strong>τ</strong><strong>ε</strong>ς έχο<strong>υ</strong>ν, ω<strong>σ</strong><strong>τ</strong>ό<strong>σ</strong>ο, δ<strong>ε</strong>ίξ<strong>ε</strong>ι µια οµοιόµορφη µ<strong>ε</strong>ίω<strong>σ</strong>η<br />

<strong>σ</strong><strong>τ</strong>ις αργές και γρήγορ<strong>ε</strong>ς µ<strong>υ</strong>ϊκές ίν<strong>ε</strong>ς, <strong>π</strong>ράγµα <strong>π</strong>ο<strong>υ</strong> δ<strong>ε</strong>ίχν<strong>ε</strong>ι ό<strong>τ</strong>ι <strong>ε</strong>ίναι

<strong>ε</strong>ξί<strong>σ</strong>ο<strong>υ</strong> <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικό <strong>τ</strong>ο µ<strong>υ</strong>ϊκό δ<strong>υ</strong>νάµωµα <strong>σ</strong><strong>ε</strong> όλ<strong>ε</strong>ς <strong>τ</strong>ις δ<strong>υ</strong>να<strong>τ</strong>ές <strong>τ</strong>αχύ<strong>τ</strong>η<strong>τ</strong><strong>ε</strong><br />

Ο ρόλος <strong>τ</strong>ων ι<strong>σ</strong>χιοκνηµιαίων <strong>σ</strong><strong>τ</strong>ις <strong>αν</strong>άγκ<strong>ε</strong>ς <strong>σ</strong><strong>ε</strong> δύναµη µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό<br />

<strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ική <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού, <strong>ε</strong>ίναι <strong>αν</strong><strong>τ</strong>ικ<strong>ε</strong>ίµ<strong>ε</strong>νο αµφι<strong>σ</strong>βη<strong>τ</strong>ή<strong>σ</strong><strong>ε</strong>ων. Ο<br />

<strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλος, <strong>ε</strong>ίναι γνω<strong>σ</strong><strong>τ</strong>ό ό<strong>τ</strong>ι α<strong>τ</strong>ροφ<strong>ε</strong>ί <strong>σ</strong><strong>ε</strong> <strong>π</strong>ολύ µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρη<br />

έκ<strong>τ</strong>α<strong>σ</strong>η α<strong>π</strong>ό <strong>τ</strong>ο<strong>υ</strong>ς ι<strong>σ</strong>χιοκνηµιαίο<strong>υ</strong>ς, και γι’α<strong>υ</strong><strong>τ</strong>ό <strong>τ</strong>ο λόγο µ<strong>ε</strong>ρικοί<br />

<strong>σ</strong><strong>υ</strong>γγραφ<strong>ε</strong>ίς έχο<strong>υ</strong>ν δώ<strong>σ</strong><strong>ε</strong>ι έµφα<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ο ό<strong>τ</strong>ι <strong>ε</strong>ίναι <strong>π</strong>ρο<strong>τ</strong>ιµό<strong>τ</strong><strong>ε</strong>ρο <strong>τ</strong>ο<br />

δ<strong>υ</strong>νάµωµα <strong>σ</strong><strong>τ</strong>ο<strong>υ</strong>ς <strong>ε</strong>κ<strong>τ</strong><strong>ε</strong>ίνον<strong>τ</strong><strong>ε</strong>ς <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος. Αλλοι έχο<strong>υ</strong>ν α<strong>π</strong>οδ<strong>ε</strong>ίξ<strong>ε</strong>ι<br />

<strong>τ</strong>ο ρόλο <strong>τ</strong>ων ι<strong>σ</strong>χιοκνηµιαίων <strong>σ</strong><strong>αν</strong> ένα δ<strong>υ</strong>ναµικό <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρο<strong>π</strong>οιη<strong>τ</strong>ικό<br />

<strong>π</strong>αράγον<strong>τ</strong>α <strong>σ</strong><strong>τ</strong>ο γόνα<strong>τ</strong>ο. Έχο<strong>υ</strong>ν α<strong>π</strong>οκαλ<strong>υ</strong>φθ<strong>ε</strong>ί <strong>αν</strong><strong>τ</strong><strong>αν</strong>ακλα<strong>σ</strong><strong>τ</strong>ικά<br />

<strong>τ</strong>όξα <strong>π</strong>ο<strong>υ</strong> ξ<strong>ε</strong>κινούν α<strong>π</strong>ό <strong>τ</strong>ον <strong>αν</strong>έ<strong>π</strong>αφο <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό και <strong>τ</strong>ον<br />

αρθρικό θύλακα, <strong>τ</strong>α ο<strong>π</strong>οία <strong>υ</strong><strong>π</strong>ο<strong>σ</strong><strong>τ</strong>ηρίζο<strong>υ</strong>ν <strong>τ</strong>ην <strong>π</strong>ιθ<strong>αν</strong>ό<strong>τ</strong>η<strong>τ</strong>α ό<strong>τ</strong>ι οι<br />

ι<strong>σ</strong>χιοκνηµιαίοι λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργούν φ<strong>υ</strong><strong>σ</strong>ιολογικά για να α<strong>π</strong>ο<strong>τ</strong>ρέψο<strong>υ</strong>ν<br />

<strong>υ</strong><strong>π</strong><strong>ε</strong>ρφόρ<strong>τ</strong>ω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού. Γι΄’ α<strong>υ</strong><strong>τ</strong>ό <strong>τ</strong>ο λόγο, µ<strong>ε</strong>ρικοί<br />

<strong>σ</strong><strong>υ</strong>γγραφ<strong>ε</strong>ίς έχο<strong>υ</strong>ν θέ<strong>σ</strong><strong>ε</strong>ι <strong>σ</strong><strong>τ</strong>όχο<strong>υ</strong>ς δύναµης <strong>π</strong>έρα α<strong>π</strong>ό <strong>τ</strong>ο<br />

φ<strong>υ</strong><strong>σ</strong>ιολογικό, για <strong>τ</strong>ο<strong>υ</strong>ς ι<strong>σ</strong>χιοκνηµιαίο<strong>υ</strong>ς, <strong>σ</strong><strong>ε</strong> µια <strong>π</strong>ρο<strong>σ</strong><strong>π</strong>άθ<strong>ε</strong>ια να<br />

<strong>π</strong>ρο<strong>σ</strong><strong>τ</strong>α<strong>τ</strong><strong>ε</strong><strong>υ</strong><strong>τ</strong><strong>ε</strong>ί <strong>τ</strong>ο <strong>υ</strong><strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong><strong>τ</strong>α<strong>τ</strong>ο</strong> <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού και να<br />

β<strong>ε</strong>λ<strong>τ</strong>ιωθ<strong>ε</strong>ί η ικ<strong>αν</strong>ό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong> α<strong>σ</strong>θ<strong>ε</strong>νή να <strong>αν</strong><strong>τ</strong>έχ<strong>ε</strong>ι <strong>σ</strong><strong>τ</strong>ις <strong>σ</strong>οβαρές<br />

φορ<strong>τ</strong>ί<strong>σ</strong><strong>ε</strong>ις <strong>π</strong>ο<strong>υ</strong> δέχ<strong>ε</strong><strong>τ</strong>αι ο <strong>σ</strong>ύνδ<strong>ε</strong><strong>σ</strong>µος κά<strong>τ</strong>ω α<strong>π</strong>ό <strong>αν</strong><strong>τ</strong>αγωνι<strong>σ</strong><strong>τ</strong>ικές<br />

<strong>σ</strong><strong>υ</strong>νθήκ<strong>ε</strong>ς. Ο Giove et al (1983) έχο<strong>υ</strong>ν α<strong>π</strong>οδ<strong>ε</strong>ίξ<strong>ε</strong>ι ό<strong>τ</strong>ι ψηλό<strong>τ</strong><strong>ε</strong>ρα<br />

<strong>ε</strong><strong>π</strong>ί<strong>π</strong><strong>ε</strong>δα <strong>σ</strong><strong>υ</strong>µµ<strong>ε</strong><strong>τ</strong>οχής <strong>σ</strong><strong>ε</strong> <strong>σ</strong><strong>π</strong>ορ, <strong>π</strong>αρα<strong>τ</strong>ηρούν<strong>τ</strong>αι <strong>σ</strong><strong>ε</strong> α<strong>σ</strong>θ<strong>ε</strong>ν<strong>ε</strong>ίς µ<strong>ε</strong><br />

<strong>π</strong>ροβληµα<strong>τ</strong>ικό <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό, <strong>π</strong>ο<strong>υ</strong> η δύναµη <strong>τ</strong>ων<br />

ι<strong>σ</strong>χιοκνηµιαίων <strong>τ</strong>ο<strong>υ</strong> <strong>ε</strong>ίναι ί<strong>σ</strong>η ή µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρη α<strong>π</strong>ό α<strong>υ</strong><strong>τ</strong>ή <strong>τ</strong>ο<strong>υ</strong><br />

<strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong>. Σ' α<strong>υ</strong><strong>τ</strong>ά <strong>τ</strong>α ά<strong>τ</strong>οµα, η δύναµη <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong><br />

έγιν<strong>ε</strong> καλύ<strong>τ</strong><strong>ε</strong>ρη για να φ<strong>τ</strong>ά<strong>σ</strong><strong>ε</strong>ι κον<strong>τ</strong>ά <strong>σ</strong><strong>τ</strong>α φ<strong>υ</strong><strong>σ</strong>ιολογικά <strong>ε</strong><strong>π</strong>ί<strong>π</strong><strong>ε</strong>δα,<br />

<strong>τ</strong>ων ι<strong>σ</strong>χιοκνηµιαίων <strong>σ</strong><strong>ε</strong> ψηλό<strong>τ</strong><strong>ε</strong>ρα α<strong>π</strong>ό <strong>τ</strong>α φ<strong>υ</strong><strong>σ</strong>ιολογικά <strong>ε</strong><strong>π</strong>ί<strong>π</strong><strong>ε</strong>δα,<br />

ό<strong>τ</strong><strong>αν</strong> <strong>σ</strong><strong>υ</strong>γκρίν<strong>ε</strong><strong>τ</strong>αι µ<strong>ε</strong> <strong>τ</strong>ην καλή <strong>π</strong>λ<strong>ε</strong><strong>υ</strong>ρά,<br />

Ο ηλ<strong>ε</strong>κ<strong>τ</strong>ρικός µ<strong>υ</strong>ϊκός <strong>ε</strong>ρ<strong>ε</strong>θι<strong>σ</strong>µός (Ε.Μ.S : Elektrical Muscle<br />

Stimulation) <strong>ε</strong>ίναι ένα <strong>υ</strong><strong>π</strong>όθ<strong>ε</strong>µα µέ<strong>σ</strong>α <strong>σ</strong><strong>τ</strong>ο γ<strong>ε</strong>νικό ζή<strong>τ</strong>ηµα <strong>τ</strong>ης<br />

<strong>ε</strong>νδ<strong>υ</strong>νάµω<strong>σ</strong>ης <strong>π</strong>ο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>ζη<strong>τ</strong>ά<strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>η βιβλιογραφία. Ο <strong>π</strong>ρω<strong>τ</strong>αρχικός<br />

<strong>σ</strong><strong>τ</strong>όχος <strong>σ</strong><strong>τ</strong>η

χρή<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> ηλ<strong>ε</strong>κ<strong>τ</strong>ρικού µ<strong>υ</strong>ϊκού <strong>ε</strong>ρ<strong>ε</strong>θι<strong>σ</strong>µού, <strong>ε</strong>ίναι η <strong>ε</strong>λαχι<strong>σ</strong><strong>τ</strong>ο<strong>π</strong>οίη<strong>σ</strong>η <strong>τ</strong>ης<br />

µ<strong>ε</strong><strong>τ</strong><strong>ε</strong>γχ<strong>ε</strong>ιρη<strong>τ</strong>ικής α<strong>τ</strong>ροφίας. Πολ<strong>υ</strong>άριθµα άρθρα έχο<strong>υ</strong>ν α<strong>π</strong><strong>ε</strong><strong>υ</strong>θ<strong>υ</strong>νθ<strong>ε</strong>ί <strong>σ</strong>'<br />

α<strong>υ</strong><strong>τ</strong>ή <strong>τ</strong>ην <strong>τ</strong><strong>ε</strong>χνική µ<strong>ε</strong> κά<strong>π</strong>ως <strong>αν</strong><strong>τ</strong>ιφα<strong>τ</strong>ικά α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λέ<strong>σ</strong>µα<strong>τ</strong>α. Οι Dellit o et al<br />

(1988), NITZ και Dobner (1987) κι άλλοι, έχο<strong>υ</strong>ν <strong>π</strong><strong>ε</strong>ριγράψ<strong>ε</strong>ι <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικά<br />

κλινικά κέρδη α<strong>π</strong>ό <strong>τ</strong>η χρή<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> ηλ<strong>ε</strong>κ<strong>τ</strong>ρικού µ<strong>υ</strong>ϊκού <strong>ε</strong>ρ<strong>ε</strong>θι<strong>σ</strong>µού <strong>σ</strong><strong>τ</strong>ο<strong>υ</strong>ς<br />

µύ<strong>ε</strong>ς <strong>τ</strong>ο<strong>υ</strong> µηρού αρρώ<strong>σ</strong><strong>τ</strong>ων µ<strong>ε</strong> ένα <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µένο, ακινη<strong>τ</strong>ο<strong>π</strong>οιηµένο<br />

άκρο. Τα κέρδη <strong>π</strong>ο<strong>υ</strong> έχο<strong>υ</strong>ν <strong>αν</strong>αφ<strong>ε</strong>ρθ<strong>ε</strong>ί, <strong>π</strong><strong>ε</strong>ριλαµβάνο<strong>υ</strong>ν µ<strong>ε</strong>ιωµένο<br />

χά<strong>σ</strong>ιµο δύναµης <strong>σ</strong><strong>τ</strong>ην <strong>π</strong>ρώιµη µ<strong>ε</strong><strong>τ</strong><strong>ε</strong>γχ<strong>ε</strong>ιρη<strong>τ</strong>ική φά<strong>σ</strong>η, <strong>τ</strong>αχύ<strong>τ</strong><strong>ε</strong>ρα κέρδη<br />

<strong>σ</strong><strong>τ</strong>ο <strong>ε</strong>ύρος κίνη<strong>σ</strong>ης, καλύ<strong>τ</strong><strong>ε</strong>ρη <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδική κινη<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>α, <strong>π</strong><strong>ε</strong>ριορι<strong>σ</strong>µό<br />

<strong>τ</strong>ης <strong>π</strong>ιθ<strong>αν</strong>ό<strong>τ</strong>η<strong>τ</strong>ας για αρθρική ίνω<strong>σ</strong>η και <strong>τ</strong><strong>ε</strong>λικά α<strong>υ</strong>ξηµένη <strong>τ</strong>αχύ<strong>τ</strong>η<strong>τ</strong>α<br />

<strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ροφής <strong>σ</strong><strong>τ</strong>ην αθλη<strong>τ</strong>ική δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong>α. Άλλοι <strong>σ</strong><strong>υ</strong>γγραφ<strong>ε</strong>ίς έχο<strong>υ</strong>ν<br />

<strong>αν</strong>αφέρ<strong>ε</strong>ι λιγό<strong>τ</strong><strong>ε</strong>ρο αι<strong>σ</strong>ιόδοξα α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λέ<strong>σ</strong>µα<strong>τ</strong>α, δια<strong>τ</strong><strong>υ</strong><strong>π</strong>ώνον<strong>τ</strong>ας <strong>τ</strong>ην<br />

ά<strong>π</strong>οψη ό<strong>τ</strong>ι ο ηλ<strong>ε</strong>κ<strong>τ</strong>ρικός µ<strong>υ</strong>ϊκός <strong>ε</strong>ρ<strong>ε</strong>θι<strong>σ</strong>µός δ<strong>ε</strong>ν <strong>ε</strong>ίναι <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρο<br />

α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong><strong>σ</strong>µα<strong>τ</strong>ικός α<strong>π</strong>ό <strong>τ</strong>η θ<strong>ε</strong>ληµα<strong>τ</strong>ική ά<strong>σ</strong>κη<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>η δια<strong>τ</strong>ήρη<strong>σ</strong>η <strong>τ</strong>ης<br />

µ<strong>υ</strong>ϊκής δύναµης <strong>τ</strong>ο<strong>υ</strong> µηρού, <strong>σ</strong><strong>τ</strong>ις µ<strong>ε</strong>λέ<strong>τ</strong><strong>ε</strong>ς <strong>τ</strong>ο<strong>υ</strong>ς. Εξαι<strong>τ</strong>ίας <strong>τ</strong>ης <strong>π</strong>ολύ<br />

µ<strong>ε</strong>γάλης <strong>π</strong>οικιλό<strong>τ</strong>η<strong>τ</strong>ας <strong>π</strong>ο<strong>υ</strong> <strong>υ</strong><strong>π</strong>άρχ<strong>ε</strong>ι <strong>σ</strong><strong>τ</strong>η χρή<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> ηλ<strong>ε</strong>κ<strong>τ</strong>ρικού µ<strong>υ</strong>ϊκού<br />

<strong>ε</strong>ρ<strong>ε</strong>θι<strong>σ</strong>µού, <strong>ε</strong>ίναι <strong>π</strong>ολύ δύ<strong>σ</strong>κολο να <strong>σ</strong><strong>υ</strong>γκριθούν ξ<strong>ε</strong>χωρι<strong>σ</strong><strong>τ</strong>ές µ<strong>ε</strong>λέ<strong>τ</strong><strong>ε</strong>ς.<br />

Μ<strong>ε</strong>ρικοί <strong>π</strong>αράγον<strong>τ</strong><strong>ε</strong>ς µ<strong>π</strong>ορ<strong>ε</strong>ί να <strong>σ</strong><strong>υ</strong>µβάλλο<strong>υ</strong>ν <strong>σ</strong><strong>ε</strong> µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρη<br />

α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong><strong>σ</strong>µα<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>α <strong>σ</strong><strong>τ</strong>η χρή<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> ηλ<strong>ε</strong>κ<strong>τ</strong>ρικού µ<strong>υ</strong>ϊκού <strong>ε</strong>ρ<strong>ε</strong>θι<strong>σ</strong>µού.<br />

Α<strong>υ</strong><strong>τ</strong>οί <strong>π</strong><strong>ε</strong>ριλαµβάνο<strong>υ</strong>ν <strong>τ</strong>ην ικ<strong>αν</strong>ό<strong>τ</strong>η<strong>τ</strong>α µ<strong>ε</strong>ρικών α<strong>τ</strong>όµων να δέχον<strong>τ</strong>αι<br />

µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρ<strong>ε</strong>ς <strong>ε</strong>ν<strong>τ</strong>ά<strong>σ</strong><strong>ε</strong>ις <strong>ε</strong>ρ<strong>ε</strong>θι<strong>σ</strong>µού κι έ<strong>τ</strong><strong>σ</strong>ι να <strong>π</strong><strong>ε</strong><strong>τ</strong><strong>υ</strong>χαίνον<strong>τ</strong>αι µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρ<strong>ε</strong>ς<br />

<strong>σ</strong><strong>ε</strong> µαζικό<strong>τ</strong>η<strong>τ</strong>α <strong>σ</strong><strong>υ</strong><strong>σ</strong><strong>π</strong>ά<strong>σ</strong><strong>ε</strong>ις, <strong>τ</strong>η δ<strong>υ</strong>να<strong>τ</strong>ό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong> άµ<strong>ε</strong><strong>σ</strong>ο<strong>υ</strong> ηλ<strong>ε</strong>κ<strong>τ</strong>ρικού<br />

<strong>ε</strong>ρ<strong>ε</strong>θι<strong>σ</strong>µού να ξ<strong>ε</strong><strong>π</strong><strong>ε</strong>ρά<strong>σ</strong><strong>ε</strong>ι <strong>τ</strong>ην <strong>αν</strong><strong>τ</strong><strong>αν</strong>ακλα<strong>σ</strong><strong>τ</strong>ική µ<strong>υ</strong>ϊκή <strong>αν</strong>α<strong>σ</strong><strong>τ</strong>ολή <strong>π</strong>ο<strong>υ</strong><br />

<strong>π</strong>ροκαλ<strong>ε</strong>ί<strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ον <strong>π</strong>όνο <strong>τ</strong>ων <strong>π</strong><strong>ε</strong>ριαρθρικών δοµών και <strong>τ</strong>ην<br />

<strong>π</strong>ιθ<strong>αν</strong>ό<strong>τ</strong>η<strong>τ</strong>α <strong>ε</strong>νός φαινοµένο<strong>υ</strong> µ<strong>π</strong>λοκαρί<strong>σ</strong>µα<strong>τ</strong>ος <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>όνο<strong>υ</strong> α<strong>π</strong>ό <strong>τ</strong>ον<br />

ηλ<strong>ε</strong>κ<strong>τ</strong>ρικό <strong>ε</strong>ρ<strong>ε</strong>θι<strong>σ</strong>µό. Οι µ<strong>ε</strong>λέ<strong>τ</strong><strong>ε</strong>ς, <strong>σ</strong><strong>τ</strong>ις ο<strong>π</strong>οί<strong>ε</strong>ς <strong>ε</strong>ξ<strong>ε</strong><strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>ηκ<strong>αν</strong> <strong>υ</strong>γιή ά<strong>τ</strong>οµα,<br />

<strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να διαφορο<strong>π</strong>οιηθούν α<strong>π</strong>ό α<strong>υ</strong><strong>τ</strong>ές <strong>π</strong>ο<strong>υ</strong> α<strong>σ</strong>χολήθηκ<strong>αν</strong> µ<strong>ε</strong><br />

µ<strong>ε</strong><strong>τ</strong><strong>ε</strong>γχ<strong>ε</strong>ιρη<strong>τ</strong>ικούς α<strong>σ</strong>θ<strong>ε</strong>ν<strong>ε</strong>ίς. Η χρή<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> ηλ<strong>ε</strong>κ<strong>τ</strong>ρικού µ<strong>υ</strong>ϊκού<br />

<strong>ε</strong>ρ<strong>ε</strong>θι<strong>σ</strong>µού <strong>σ</strong><strong>ε</strong> <strong>υ</strong>γιή ά<strong>τ</strong>οµα <strong>ε</strong>ίναι

γνω<strong>σ</strong><strong>τ</strong>ό ό<strong>τ</strong>ι <strong>π</strong>αράγ<strong>ε</strong>ι κέρδη <strong>σ</strong><strong>τ</strong>η δύναµη, <strong>π</strong>αρόµοια µ<strong>ε</strong> α<strong>υ</strong><strong>τ</strong>ά,<br />

κα<strong>τ</strong>ά <strong>τ</strong>η θ<strong>ε</strong>ληµα<strong>τ</strong>ική ά<strong>σ</strong>κη<strong>σ</strong>η. Ο άµ<strong>ε</strong><strong>σ</strong>ος ηλ<strong>ε</strong>κ<strong>τ</strong>ρικός µ<strong>υ</strong>ϊκός<br />

<strong>ε</strong>ρ<strong>ε</strong>θι<strong>σ</strong>µός, µ<strong>π</strong>ορ<strong>ε</strong>ί να έχ<strong>ε</strong>ι <strong>τ</strong>η δ<strong>υ</strong>να<strong>τ</strong>ό<strong>τ</strong>η<strong>τ</strong>α να έχ<strong>ε</strong>ι ένα<br />

µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρο κέρδος α<strong>π</strong>ό <strong>τ</strong>η θ<strong>ε</strong>ληµαρ<strong>τ</strong>ική ά<strong>σ</strong>κη<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ο να<br />

<strong>ε</strong>λαχι<strong>σ</strong><strong>τ</strong>ο<strong>π</strong>οι<strong>ε</strong>ί <strong>τ</strong>ην <strong>π</strong><strong>τ</strong>ώ<strong>σ</strong>η <strong>τ</strong>ης µ<strong>υ</strong>ϊκής δύναµης, η ο<strong>π</strong>οία<br />

<strong>π</strong>ροχωρά µ<strong>ε</strong> δραµα<strong>τ</strong>ική <strong>τ</strong>αχύ<strong>τ</strong>η<strong>τ</strong>α κα<strong>τ</strong>ά <strong>τ</strong>ο άµ<strong>ε</strong><strong>σ</strong>ο µ<strong>ε</strong><strong>τ</strong><strong>ε</strong>γχ<strong>ε</strong>ιρη<strong>τ</strong>ικό<br />

διά<strong>σ</strong><strong>τ</strong>ηµα<br />

1<br />

1<br />

41 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20<br />

Ε<strong>π</strong><strong>αν</strong>αλήψ<strong>ε</strong>ις<br />

Εικόνα 35: 2 Σχέ<strong>σ</strong>η <strong>ε</strong><strong>π</strong><strong>αν</strong>αλήψ<strong>ε</strong>ων και βάρο<strong>υ</strong>ς (Αύξη<strong>σ</strong>η Αν<strong>τ</strong>οχής: Πολλές <strong>ε</strong><strong>π</strong><strong>αν</strong>αλήψ<strong>ε</strong>ις,<br />

µικρό βάρος 3 ΚΑΙ Αύξη<strong>σ</strong>η ∆ύναµης: Λίγ<strong>ε</strong>ς <strong>ε</strong><strong>π</strong><strong>αν</strong>αλήψ<strong>ε</strong>ις,µ<strong>ε</strong>γάλο βάρο<br />

5. ΜΥΪΚΗ ΑΝΤΟΧΗ ΜΕΤΑ ΤΟΝ ΤΡΑΥΜΑΤΙΣΜΟ<br />

Σ<strong>τ</strong>ο <strong>π</strong>ρόγραµµα α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης, µ<strong>ε</strong> <strong>σ</strong>κο<strong>π</strong>ό να α<strong>υ</strong>ξηθ<strong>ε</strong>ί η δύναµη,<br />

α<strong>υ</strong>ξάν<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>υ</strong>γχρόνως και η <strong>αν</strong><strong>τ</strong>οχή και <strong>ε</strong>ίναι αδύνα<strong>τ</strong>ο να γίν<strong>ε</strong>ι ένας<br />

διαχωρι<strong>σ</strong>µός µ<strong>ε</strong><strong>τ</strong>αξύ <strong>τ</strong>ων <strong>ε</strong>ννοιών α<strong>υ</strong><strong>τ</strong>ών. Σ<strong>ε</strong> κάθ<strong>ε</strong> <strong>π</strong>ρο<strong>π</strong>ονη<strong>τ</strong>ι-

κή <strong>σ</strong><strong>υ</strong>ν<strong>ε</strong>δρία, <strong>π</strong>ο<strong>υ</strong> γίν<strong>ε</strong><strong>τ</strong>αι µ' ένα οργ<strong>αν</strong>ωµένο <strong>τ</strong>ρό<strong>π</strong>ο, <strong>αν</strong><strong>τ</strong>οχή και<br />

δύναµη α<strong>υ</strong>ξάνον<strong>τ</strong>αι <strong>τ</strong>α<strong>υ</strong><strong>τ</strong>όχρονα. Μόνο, ό<strong>π</strong>ως έχ<strong>ε</strong>ι λ<strong>ε</strong>χθ<strong>ε</strong>ί, οι ι<strong>σ</strong>οµ<strong>ε</strong><strong>τ</strong>ρικές<br />

α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις δ<strong>ε</strong>ν <strong>αν</strong>α<strong>π</strong><strong>τ</strong>ύ<strong>σ</strong><strong>σ</strong>ο<strong>υ</strong>ν <strong>τ</strong>ην <strong>αν</strong><strong>τ</strong>οχή και <strong>σ</strong>' α<strong>υ</strong><strong>τ</strong>ό η <strong>σ</strong><strong>υ</strong>ν<strong>ε</strong>ι<strong>σ</strong>φορά<br />

<strong>τ</strong>ων α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ων α<strong>υ</strong><strong>τ</strong>ών <strong>ε</strong>ίναι <strong>π</strong>ολύ µικρή. Τα <strong>π</strong>ρογράµµα<strong>τ</strong>α<br />

ι<strong>σ</strong>ο<strong>τ</strong>ονικών και ι<strong>σ</strong>οκινη<strong>τ</strong>ικών α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ων µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό ένα <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µό,<br />

ό<strong>τ</strong><strong>αν</strong> <strong>τ</strong>ο <strong>ε</strong><strong>π</strong>ι<strong>τ</strong>ρέ<strong>π</strong>ο<strong>υ</strong>ν ο <strong>π</strong>όνος και η <strong>τ</strong>ροχιά <strong>τ</strong>ης άρθρω<strong>σ</strong>ης, βοηθούν<br />

<strong>σ</strong><strong>τ</strong>ην <strong>αν</strong>ά<strong>π</strong><strong>τ</strong><strong>υ</strong>ξη <strong>τ</strong>ης δύναµης, αλλά και <strong>τ</strong>ης <strong>αν</strong><strong>τ</strong>οχής.<br />

Μ<strong>ε</strong>γάλη <strong>σ</strong>ηµα<strong>σ</strong>ία έχ<strong>ε</strong>ι η <strong>αν</strong>ά<strong>π</strong><strong>τ</strong><strong>υ</strong>ξη µέ<strong>σ</strong>α α<strong>π</strong>ό <strong>τ</strong>η φ<strong>υ</strong><strong>σ</strong>ική κα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η,<br />

<strong>ε</strong>κ<strong>τ</strong>ός <strong>τ</strong>ων άλλων δ<strong>ε</strong>ξιο<strong>τ</strong>ή<strong>τ</strong>ων, και <strong>τ</strong>ης <strong>αν</strong><strong>τ</strong>οχής <strong>τ</strong>ο<strong>υ</strong> αθλη<strong>τ</strong>ή. Ό<strong>τ</strong><strong>αν</strong> <strong>σ</strong><strong>τ</strong>η<br />

διαδικα<strong>σ</strong>ία <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong><strong>τ</strong>αδίο<strong>υ</strong> α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης <strong>ε</strong><strong>π</strong>ι<strong>τ</strong><strong>ε</strong><strong>υ</strong>χθ<strong>ε</strong>ί ο <strong>σ</strong><strong>τ</strong>όχος δύναµη,<br />

δίν<strong>ε</strong><strong>τ</strong>αι έµφα<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ην <strong>αν</strong>ά<strong>π</strong><strong>τ</strong><strong>υ</strong>ξη <strong>τ</strong>ης <strong>αν</strong><strong>τ</strong>οχής.<br />

Ι<strong>σ</strong>ο<strong>τ</strong>ονικά, η αύξη<strong>σ</strong>η <strong>τ</strong>ης <strong>αν</strong><strong>τ</strong>οχής <strong>ε</strong><strong>π</strong>ι<strong>τ</strong><strong>υ</strong>γχάν<strong>ε</strong><strong>τ</strong>αι µ<strong>ε</strong> µικρή <strong>ε</strong><strong>π</strong>ιβάρ<strong>υ</strong>ν<strong>σ</strong>η<br />

και <strong>π</strong>ολλές <strong>ε</strong><strong>π</strong><strong>αν</strong>αλήψ<strong>ε</strong>ις, <strong>ε</strong>νώ ι<strong>σ</strong>οκινη<strong>τ</strong>ικά, µ<strong>ε</strong> <strong>τ</strong>ην αύξη<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ο<br />

χρόνο <strong>π</strong>ο<strong>υ</strong> <strong>ε</strong>κ<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί<strong>τ</strong>αι κάθ<strong>ε</strong> ά<strong>σ</strong>κη<strong>σ</strong>η.<br />

Αρκ<strong>ε</strong><strong>τ</strong>ές δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς <strong>ε</strong>µ<strong>π</strong><strong>ε</strong>ριέχο<strong>υ</strong>ν <strong>τ</strong>ο <strong>σ</strong><strong>τ</strong>οιχ<strong>ε</strong>ίο <strong>τ</strong>ης <strong>υ</strong><strong>π</strong>οµέγι-<strong>σ</strong><strong>τ</strong>ης<br />

<strong>αν</strong><strong>τ</strong>ί<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης µ<strong>ε</strong> <strong>π</strong>αρα<strong>τ</strong><strong>ε</strong><strong>τ</strong>αµένο χρόνο.<br />

6. ΛΕΙΤΟΥΡΓΙΚΕΣ ∆ΡΑΣΤΗΡΙΟΤΗΤΕΣ ΜΕΤΑ ΤΟΝ ΤΡΑΥΜΑ-ΤΙΣΜΟ<br />

Ένας αθλη<strong>τ</strong>ής για να φ<strong>τ</strong>ά<strong>σ</strong><strong>ε</strong>ι <strong>σ</strong><strong>τ</strong>ις λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργικές δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς<br />

<strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να ακολο<strong>υ</strong>θή<strong>σ</strong><strong>ε</strong>ι όλη <strong>τ</strong>η διαδικα<strong>σ</strong>ία <strong>σ</strong><strong>τ</strong>ο <strong>π</strong>ρόγραµµα α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης.<br />

Ικ<strong>αν</strong>ό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς <strong>τ</strong>ο<strong>υ</strong> αθλη<strong>τ</strong>ή, ό<strong>π</strong>ως η <strong>ε</strong><strong>υ</strong>καµψία, <strong>ε</strong><strong>υ</strong>λ<strong>υ</strong>γι<strong>σ</strong>ία και ο<br />

<strong>σ</strong><strong>υ</strong>ν<strong>τ</strong>ονι<strong>σ</strong>µός, <strong>ε</strong><strong>π</strong><strong>αν</strong>α<strong>π</strong>οκ<strong>τ</strong>ών<strong>τ</strong>αι <strong>σ</strong>' ένα µ<strong>ε</strong>γάλο βαθµό µ<strong>ε</strong> δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς,<br />

<strong>π</strong>ο<strong>υ</strong> ο αθλη<strong>τ</strong>ής <strong>ε</strong>κ<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί <strong>σ</strong><strong>τ</strong>ο <strong>π</strong>αιχνίδι ή <strong>σ</strong><strong>τ</strong>ην <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>η και<br />

<strong>ε</strong>ν<strong>σ</strong>ωµα<strong>τ</strong>ώνον<strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ο <strong>τ</strong><strong>ε</strong>λ<strong>ε</strong><strong>υ</strong><strong>τ</strong>αίο <strong>σ</strong><strong>τ</strong>άδιο <strong>τ</strong>ης α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης, <strong>π</strong>ριν<br />

<strong>τ</strong>ην <strong>ε</strong><strong>π</strong>άνοδο <strong>σ</strong><strong>τ</strong>ην αθλη<strong>τ</strong>ική δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong>α.<br />

Ό<strong>τ</strong><strong>αν</strong> ο αθλη<strong>τ</strong>ής ξ<strong>ε</strong><strong>π</strong><strong>ε</strong>ρά<strong>σ</strong><strong>ε</strong>ι <strong>τ</strong>α <strong>π</strong>ροβλήµα<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>όνο<strong>υ</strong> και <strong>τ</strong>ης<br />

φλ<strong>ε</strong>γµονής και έχ<strong>ε</strong>ι <strong>ε</strong><strong>π</strong><strong>αν</strong>α<strong>π</strong>οκ<strong>τ</strong>ή<strong>σ</strong><strong>ε</strong>ι <strong>τ</strong>ο <strong>ε</strong>ύρος <strong>τ</strong>ροχιάς <strong>τ</strong>ης κίνη<strong>σ</strong>ης, <strong>τ</strong>η<br />

µ<strong>υ</strong>ϊκή δύναµη και <strong>τ</strong>ην <strong>αν</strong><strong>τ</strong>οχή, <strong>τ</strong>ό<strong>τ</strong><strong>ε</strong> αρχίζ<strong>ε</strong>ι η <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>η <strong>π</strong>ο<strong>υ</strong>

<strong>π</strong><strong>ε</strong>ριλαµβάν<strong>ε</strong>ι <strong>π</strong><strong>ε</strong>ρ<strong>π</strong>ά<strong>τ</strong>ηµα, <strong>τ</strong>ρέξιµο, <strong>τ</strong>ζοκινγκ, α<strong>τ</strong>οµικές α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις <strong>ε</strong>-<br />

<strong>π</strong>ιδ<strong>ε</strong>ξιό<strong>τ</strong>η<strong>τ</strong>ας, οµαδικές α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις και <strong>τ</strong><strong>ε</strong>λικά <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>η µ<strong>ε</strong> <strong>τ</strong>ο <strong>σ</strong><strong>π</strong>ορ<br />

και <strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ροφή <strong>σ</strong><strong>τ</strong>ην <strong>ε</strong>ν<strong>ε</strong>ργό αθλη<strong>τ</strong>ική δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong>α.<br />

Ό<strong>τ</strong><strong>αν</strong> ο αθλη<strong>τ</strong>ής µ<strong>π</strong>ορ<strong>ε</strong>ί να <strong>ε</strong>κ<strong>τ</strong><strong>ε</strong>λέ<strong>σ</strong><strong>ε</strong>ι α<strong>υ</strong><strong>τ</strong>ές <strong>τ</strong>ις δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς µ'<br />

ένα <strong>σ</strong>ύνθ<strong>ε</strong><strong>τ</strong>ο <strong>τ</strong>ρό<strong>π</strong>ο και <strong>αν</strong><strong>ε</strong>βάζ<strong>ε</strong>ι µ<strong>ε</strong> α<strong>σ</strong>φάλ<strong>ε</strong>ια <strong>τ</strong>ο φορ<strong>τ</strong>ίο <strong>σ</strong><strong>τ</strong>ην <strong>τ</strong>ρα<strong>υ</strong>-<br />

µα<strong>τ</strong>ι<strong>σ</strong>µένη άρθρω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, αρχίζ<strong>ε</strong>ι η <strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ροφή <strong>σ</strong><strong>τ</strong>ο <strong>σ</strong><strong>π</strong>ορ,<br />

<strong>π</strong>ρο<strong>σ</strong><strong>ε</strong>κ<strong>τ</strong>ικά <strong>σ</strong><strong>τ</strong>ην αρχή µ<strong>ε</strong> βαθµιαία αύξη<strong>σ</strong>η <strong>τ</strong>ης έν<strong>τ</strong>α<strong>σ</strong>ης.<br />

Είναι αρκ<strong>ε</strong><strong>τ</strong>ά δύ<strong>σ</strong>κολο να α<strong>π</strong>οφα<strong>σ</strong>ί<strong>σ</strong><strong>ε</strong>ι η θ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong><strong>υ</strong><strong>τ</strong>ική οµάδα <strong>π</strong>ό<strong>τ</strong><strong>ε</strong><br />

ο αθλη<strong>τ</strong>ής <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να <strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ρέψ<strong>ε</strong>ι <strong>σ</strong><strong>τ</strong>ο <strong>σ</strong><strong>π</strong>ορ. Ο χρόνος <strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ροφής<br />

κρίν<strong>ε</strong><strong>τ</strong>αι µέ<strong>σ</strong>α α<strong>π</strong>ό µία γ<strong>ε</strong>νική <strong>ε</strong>κ<strong>τ</strong>ίµη<strong>σ</strong>η και tests. Πρέ<strong>π</strong><strong>ε</strong>ι να <strong>υ</strong><strong>π</strong>άρχ<strong>ε</strong>ι<br />

<strong>π</strong>λήρ<strong>ε</strong>ς <strong>ε</strong>ύρος κίνη<strong>σ</strong>ης <strong>τ</strong>ης άρθρω<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, να µην <strong>υ</strong><strong>π</strong>άρχ<strong>ε</strong>ι<br />

οίδηµα, <strong>π</strong>όνος, και α<strong>π</strong>αραί<strong>τ</strong>η<strong>τ</strong>α να έχ<strong>ε</strong>ι <strong>ε</strong><strong>π</strong><strong>αν</strong>α<strong>π</strong>οκ<strong>τ</strong>ηθ<strong>ε</strong>ί η δύναµη<br />

και η <strong>αν</strong><strong>τ</strong>οχή. Αν <strong>τ</strong>α <strong>π</strong>αρα<strong>π</strong>άνω <strong>ε</strong>ίναι θ<strong>ε</strong><strong>τ</strong>ικά και α<strong>π</strong>οφα<strong>σ</strong>ι<strong>σ</strong><strong>τ</strong><strong>ε</strong>ί η <strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ροφή<br />

<strong>τ</strong>ο<strong>υ</strong> αθλη<strong>τ</strong>ή, <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να γίν<strong>ε</strong>ι µ<strong>ε</strong> κάθ<strong>ε</strong> <strong>π</strong>ροφύλαξη, για να<br />

α<strong>π</strong>οφ<strong>ε</strong><strong>υ</strong>χθούν <strong>υ</strong><strong>π</strong>ο<strong>τ</strong>ρο<strong>π</strong>ές. Α<strong>υ</strong><strong>τ</strong>ό <strong>π</strong><strong>ε</strong><strong>τ</strong><strong>υ</strong>χαίν<strong>ε</strong><strong>τ</strong>αι µ<strong>ε</strong> <strong>π</strong><strong>ε</strong>ρίδ<strong>ε</strong><strong>σ</strong>η ή <strong>αν</strong>άλογο<strong>υ</strong>ς<br />

νάρθηκ<strong>ε</strong>ς, µ<strong>ε</strong> <strong>σ</strong>κο<strong>π</strong>ό <strong>τ</strong>ην <strong>π</strong>ρο<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ία <strong>τ</strong>ης <strong>ε</strong><strong>υ</strong>αί<strong>σ</strong>θη<strong>τ</strong>ης άρθρω<strong>σ</strong>ης<br />

<strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος.<br />

Τζοκινγκ:<br />

Είναι η δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong>α <strong>π</strong>ο<strong>υ</strong> <strong>τ</strong>ο<strong>π</strong>οθ<strong>ε</strong><strong>τ</strong><strong>ε</strong>ί µ<strong>ε</strong>γάλ<strong>ε</strong>ς <strong>ε</strong><strong>π</strong>ιβαρύν<strong>σ</strong><strong>ε</strong>ις <strong>σ</strong><strong>τ</strong>ο<br />

µ<strong>υ</strong>ο<strong>σ</strong>κ<strong>ε</strong>λ<strong>ε</strong><strong>τ</strong>ικο <strong>σ</strong>ύ<strong>σ</strong><strong>τ</strong>ηµα. Ο <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µένος αθλη<strong>τ</strong>ής <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να έχ<strong>ε</strong>ι<br />

<strong>τ</strong>ην <strong>υ</strong><strong>π</strong>οµονή για ν' αρχίζ<strong>ε</strong>ι <strong>τ</strong>ο <strong>τ</strong>ζοκινγκ <strong>π</strong>ο<strong>υ</strong> καθορίζ<strong>ε</strong>ι <strong>τ</strong>ο βαθµό α-<br />

<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong>. Σ<strong>τ</strong>ην αρχή <strong>τ</strong>ο <strong>τ</strong>ρέξιµο <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να γίν<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>ε</strong> ξ<strong>ε</strong>ρή<br />

<strong>ε</strong><strong>π</strong>ί<strong>π</strong><strong>ε</strong>δη <strong>ε</strong><strong>π</strong>ιφάν<strong>ε</strong>ια, κα<strong>τ</strong>ά <strong>π</strong>ρο<strong>τ</strong>ίµη<strong>σ</strong>η <strong>σ</strong><strong>ε</strong> χόρ<strong>τ</strong>ο µ<strong>ε</strong> <strong>π</strong>α<strong>π</strong>ού<strong>τ</strong><strong>σ</strong>ια <strong>ε</strong><strong>π</strong>ί<strong>π</strong><strong>ε</strong>δα<br />

και η α<strong>π</strong>ό<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η να <strong>ε</strong>ίναι µικρή. Τα 100 - 200 µέ<strong>τ</strong>ρα <strong>σ</strong><strong>τ</strong>ην αρχή<br />

<strong>ε</strong>ίναι αρκ<strong>ε</strong><strong>τ</strong>ά για να δ<strong>ε</strong>ίξο<strong>υ</strong>ν <strong>αν</strong> η <strong>π</strong>ορ<strong>ε</strong>ία <strong>τ</strong>ο<strong>υ</strong> αθλη<strong>τ</strong>ή <strong>ε</strong>ίναι θ<strong>ε</strong><strong>τ</strong>ική<br />

και δ<strong>ε</strong>ν <strong>π</strong>ονά<strong>ε</strong>ι. Το <strong>τ</strong>ρέξιµο <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να α<strong>υ</strong>ξάν<strong>ε</strong><strong>τ</strong>αι βαθµιαία µ<strong>ε</strong> κρι<strong>τ</strong>ήριο<br />

<strong>π</strong>άν<strong>τ</strong>ο<strong>τ</strong><strong>ε</strong> <strong>τ</strong>ο όριο <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>όνο<strong>υ</strong> και ο αθλη<strong>τ</strong>ής <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι ν' <strong>αν</strong>αφέρ<strong>ε</strong>ι

<strong>σ</strong><strong>τ</strong>ον <strong>π</strong>ρο<strong>π</strong>ονη<strong>τ</strong>ή κάθ<strong>ε</strong> <strong>τ</strong>ι <strong>π</strong>ο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>µβαίν<strong>ε</strong>ι <strong>σ</strong><strong>τ</strong>η διαδικα<strong>σ</strong>ία α<strong>υ</strong><strong>τ</strong>ή. Ο<br />

ρ<strong>υ</strong>θµός <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong>ζοκινγκ αρχικά <strong>ε</strong>ίναι βραδύς και <strong>π</strong>ροοδ<strong>ε</strong><strong>υ</strong><strong>τ</strong>ικά α<strong>υ</strong>ξάν<strong>ε</strong><strong>τ</strong>αι<br />

δίνον<strong>τ</strong>ας <strong>τ</strong>ην <strong>ε</strong><strong>υ</strong>καιρία <strong>σ</strong><strong>τ</strong>ον αθλη<strong>τ</strong>ή να α<strong>υ</strong>ξή<strong>σ</strong><strong>ε</strong>ι <strong>τ</strong>ις <strong>π</strong>ρο<strong>σ</strong>αρµογές.<br />

Ό<strong>τ</strong><strong>αν</strong> <strong>ε</strong><strong>π</strong>ι<strong>τ</strong><strong>ε</strong><strong>υ</strong>χθ<strong>ε</strong>ί µία ικ<strong>αν</strong>ο<strong>π</strong>οιη<strong>τ</strong>ική <strong>π</strong>ρόοδος <strong>σ</strong><strong>τ</strong>ο <strong>τ</strong>ζοκινγκ και ο<br />

αθλη<strong>τ</strong>ής µ<strong>π</strong>ορ<strong>ε</strong>ί να καλύψ<strong>ε</strong>ι µια α<strong>π</strong>ό<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η 2.000 µέ<strong>τ</strong>ρων <strong>σ</strong>χ<strong>ε</strong><strong>τ</strong>ικά<br />

γρήγορα, <strong>π</strong>ρο<strong>σ</strong><strong>τ</strong>ίθ<strong>ε</strong>ν<strong>τ</strong>αι α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις <strong>τ</strong>αχύ<strong>τ</strong>η<strong>τ</strong>ας.<br />

Οι <strong>ε</strong>ναλλαγές <strong>τ</strong>ο<strong>υ</strong> ρ<strong>υ</strong>θµού έχο<strong>υ</strong>ν <strong>σ</strong>κο<strong>π</strong>ό να α<strong>υ</strong>ξή<strong>σ</strong>ο<strong>υ</strong>ν ακόµα <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρο<br />

<strong>τ</strong>ις <strong>π</strong>ρο<strong>σ</strong>αρµογές και να δώ<strong>σ</strong>ο<strong>υ</strong>ν <strong>τ</strong>ο <strong>ε</strong>ρέθι<strong>σ</strong>µα για <strong>π</strong>λήρη<br />

<strong>αν</strong>άκ<strong>τ</strong>η<strong>σ</strong>η. Το <strong>τ</strong>ζοκινγκ µ<strong>π</strong>ορ<strong>ε</strong>ί να <strong>σ</strong><strong>υ</strong>νδ<strong>υ</strong>α<strong>σ</strong><strong>τ</strong><strong>ε</strong>ί µ<strong>ε</strong> <strong>τ</strong>αχύ<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς <strong>σ</strong><strong>τ</strong>ην<br />

αρχή µικρής <strong>ε</strong><strong>π</strong>ιβάρ<strong>υ</strong>ν<strong>σ</strong>ης και <strong>π</strong>ροοδ<strong>ε</strong><strong>υ</strong><strong>τ</strong>ικά δίν<strong>ε</strong><strong>τ</strong>αι µια αύξη<strong>σ</strong>η<br />

<strong>σ</strong><strong>τ</strong>ην έν<strong>τ</strong>α<strong>σ</strong>η. Η αύξη<strong>σ</strong>η <strong>τ</strong>ης <strong>ε</strong><strong>π</strong>ιβάρ<strong>υ</strong>ν<strong>σ</strong>ης γίν<strong>ε</strong><strong>τ</strong>αι <strong>π</strong>άν<strong>τ</strong>ο<strong>τ</strong><strong>ε</strong> µ<strong>ε</strong> κρι<strong>τ</strong>ήριο<br />

<strong>τ</strong>ον <strong>π</strong>όνο και <strong>αν</strong> ο αθλη<strong>τ</strong>ής <strong>π</strong>ονά<strong>ε</strong>ι, ακολο<strong>υ</strong>θ<strong>ε</strong>ί<strong>τ</strong>αι <strong>τ</strong>ο <strong>π</strong>ρόγραµµα<br />

<strong>τ</strong>ης <strong>π</strong>ροηγούµ<strong>ε</strong>νης µέρας. Σ<strong>υ</strong>νί<strong>σ</strong><strong>τ</strong>α<strong>τ</strong>αι όµως µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό <strong>τ</strong>ην <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>η<br />

να <strong>τ</strong>ο<strong>π</strong>οθ<strong>ε</strong><strong>τ</strong><strong>ε</strong>ί<strong>τ</strong>αι <strong>π</strong>άγος για 15- 20 λ<strong>ε</strong><strong>π</strong><strong>τ</strong>ά <strong>σ</strong><strong>τ</strong>ην άρθρω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong><br />

γόνα<strong>τ</strong>ος.<br />

Άλµα<strong>τ</strong>α :<br />

Ό<strong>τ</strong><strong>αν</strong> ο ρ<strong>υ</strong>θµός <strong>τ</strong>ων δροµικών δρα<strong>σ</strong><strong>τ</strong>ηριο<strong>τ</strong>ή<strong>τ</strong>ων έχ<strong>ε</strong>ι α<strong>υ</strong>ξηθ<strong>ε</strong>ί, <strong>σ</strong><strong>τ</strong>ο<br />

<strong>π</strong>ρόγραµµα <strong>π</strong>ρο<strong>σ</strong><strong>τ</strong>ίθ<strong>ε</strong>ν<strong>τ</strong>αι α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις ό<strong>π</strong>ως <strong>τ</strong>' άλµα<strong>τ</strong>α και οι <strong>αν</strong>α<strong>π</strong>ηδή<strong>σ</strong><strong>ε</strong>ις.<br />

Σκο-<strong>π</strong>ός <strong>τ</strong>ων α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ων α<strong>υ</strong><strong>τ</strong>ών <strong>ε</strong>ίναι να <strong>ε</strong><strong>π</strong>ι<strong>τ</strong><strong>ε</strong><strong>υ</strong>χθ<strong>ε</strong>ί ικ<strong>αν</strong>ο<strong>π</strong>οιη<strong>τ</strong>ική<br />

ι<strong>σ</strong>ορρο<strong>π</strong>ία, <strong>ε</strong>νώ µ<strong>π</strong>ορ<strong>ε</strong>ί να <strong>ε</strong>ίναι ένδ<strong>ε</strong>ιξη ό<strong>τ</strong>ι έχ<strong>ε</strong>ι <strong>ε</strong><strong>π</strong>ι<strong>τ</strong><strong>ε</strong><strong>υ</strong>χθ<strong>ε</strong>ί<br />

ένα ικ<strong>αν</strong>ο<strong>π</strong>οιη<strong>τ</strong>ικό <strong>ε</strong><strong>π</strong>ί<strong>π</strong><strong>ε</strong>δο <strong>αν</strong><strong>τ</strong>οχής. Σ<strong>τ</strong>ην αρχή γίνον<strong>τ</strong>αι µικρές α-<br />

να<strong>π</strong>ηδή<strong>σ</strong><strong>ε</strong>ις <strong>σ</strong><strong>τ</strong>α δύο <strong>π</strong>όδια, κα<strong>τ</strong>ό<strong>π</strong>ιν <strong>σ</strong><strong>τ</strong>ο <strong>υ</strong>γιές <strong>π</strong>όδι και <strong>π</strong>ροοδ<strong>ε</strong><strong>υ</strong><strong>τ</strong>ικά<br />

<strong>σ</strong><strong>τ</strong>ο <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µένο. Ό<strong>τ</strong><strong>αν</strong> οι α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις α<strong>υ</strong><strong>τ</strong>ές γίνον<strong>τ</strong>αι µ<strong>ε</strong> <strong>ε</strong><strong>υ</strong>κολία<br />

η <strong>π</strong>ρόοδος <strong>σ</strong><strong>υ</strong>ν<strong>ε</strong>χίζ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>ε</strong> <strong>αν</strong>α<strong>π</strong>ηδή<strong>σ</strong><strong>ε</strong>ις µ<strong>ε</strong> <strong>τ</strong>η βοήθ<strong>ε</strong>ια <strong>ε</strong>νός <strong>σ</strong>χοινιού,<br />

<strong>σ</strong><strong>τ</strong>α δύο <strong>π</strong>όδια και κα<strong>τ</strong>ό<strong>π</strong>ιν <strong>σ</strong><strong>τ</strong>ο γ<strong>ε</strong>ρό, <strong>σ</strong><strong>τ</strong>ο <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µένο και<br />

<strong>ε</strong>ναλλάξ. Οδηγός για <strong>τ</strong>ο α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong><strong>σ</strong>µα<strong>τ</strong>ικό <strong>ε</strong><strong>π</strong>ί<strong>π</strong><strong>ε</strong>δο <strong>τ</strong>ο<strong>υ</strong> αθλη<strong>τ</strong>ή <strong>ε</strong>ίναι

<strong>π</strong><strong>ε</strong>ρί<strong>π</strong>ο<strong>υ</strong> 100 άλµα<strong>τ</strong>α, <strong>π</strong>ο<strong>υ</strong> δ<strong>ε</strong>ίχνο<strong>υ</strong>ν ό<strong>τ</strong>ι η <strong>π</strong>ορ<strong>ε</strong>ία α<strong>π</strong>όδο<strong>σ</strong>ης ως <strong>π</strong>ρος<br />

<strong>τ</strong>η δύναµη και <strong>αν</strong><strong>τ</strong>οχή <strong>ε</strong>ίναι θ<strong>ε</strong><strong>τ</strong>ική.<br />

Α<strong>τ</strong>οµικές α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις :<br />

Γίνον<strong>τ</strong>αι µ<strong>ε</strong> <strong>σ</strong>κο<strong>π</strong>ό ο αθλούµ<strong>ε</strong>νος να <strong>ε</strong><strong>π</strong><strong>αν</strong>ακ<strong>τ</strong>ή<strong>σ</strong><strong>ε</strong>ι <strong>τ</strong>ην ι<strong>σ</strong>ορρο<strong>π</strong>ία και<br />

<strong>σ</strong><strong>υ</strong>ν<strong>τ</strong>ονι<strong>σ</strong>µό <strong>π</strong>ο<strong>υ</strong> χάνον<strong>τ</strong>αι µ<strong>ε</strong><strong>τ</strong>ά <strong>τ</strong>ον <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µό. Μία δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong>α<br />

<strong>π</strong>ο<strong>υ</strong> <strong>ε</strong>κ<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί<strong>τ</strong>αι <strong>σ</strong><strong>ε</strong> <strong>π</strong>ολλά αθλήµα<strong>τ</strong>α και η κιναι<strong>σ</strong>θη<strong>τ</strong>ική <strong>ε</strong>ικόνα <strong>τ</strong>ης ο<strong>π</strong>οίας<br />

χάν<strong>ε</strong><strong>τ</strong>αι, <strong>ε</strong>ίναι <strong>τ</strong>ο <strong>τ</strong>ρέξιµο <strong>π</strong>ρος <strong>τ</strong>α <strong>π</strong>ί<strong>σ</strong>ω. Η ά<strong>σ</strong>κη<strong>σ</strong>η α<strong>υ</strong><strong>τ</strong>ή αρχικά<br />

<strong>ε</strong>κ<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί<strong>τ</strong>αι µ<strong>ε</strong> βάδι<strong>σ</strong>µα <strong>π</strong>ί<strong>σ</strong>ω και <strong>π</strong>λάγια µ<strong>ε</strong> <strong>τ</strong>αχύ<strong>τ</strong>η<strong>τ</strong>α <strong>π</strong>ο<strong>υ</strong> α<strong>υ</strong>ξάν<strong>ε</strong><strong>τ</strong>αι<br />

βαθµιαία. Κα<strong>τ</strong>ό<strong>π</strong>ιν <strong>π</strong>ρο<strong>σ</strong><strong>τ</strong>ίθ<strong>ε</strong><strong>τ</strong>αι <strong>τ</strong>ζοκινγκ µ<strong>ε</strong> <strong>τ</strong>ην ίδια φορά και µ<strong>ε</strong><br />

α<strong>υ</strong>ξ<strong>αν</strong>όµ<strong>ε</strong>νο ρ<strong>υ</strong>θµό. Ό<strong>τ</strong><strong>αν</strong> α<strong>υ</strong><strong>τ</strong>ές οι δύο δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς <strong>ε</strong>κ<strong>τ</strong><strong>ε</strong>λούν<strong>τ</strong>αι µ<strong>ε</strong><br />

<strong>ε</strong><strong>υ</strong>κολία, ο φ<strong>υ</strong><strong>σ</strong>ιο-θ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong><strong>υ</strong><strong>τ</strong>ής ή ο <strong>π</strong>ρο<strong>π</strong>ονη<strong>τ</strong>ής <strong>π</strong>ρο<strong>σ</strong>θέ<strong>τ</strong><strong>ε</strong>ι<br />

δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς <strong>σ</strong><strong>τ</strong>ις κ<strong>ε</strong>ρκίδ<strong>ε</strong>ς <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong><strong>τ</strong>αδίο<strong>υ</strong>. Οι α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις α<strong>υ</strong><strong>τ</strong>ές <strong>ε</strong>ίναι<br />

ωφέλιµ<strong>ε</strong>ς και δ<strong>ε</strong>ίχνο<strong>υ</strong>ν ό<strong>τ</strong>ι ο αθλούµ<strong>ε</strong>νος βρί<strong>σ</strong>κ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>ε</strong> ικ<strong>αν</strong>ο<strong>π</strong>οιη<strong>τ</strong>ικό<br />

<strong>ε</strong><strong>π</strong>ί<strong>π</strong><strong>ε</strong>δο και <strong>ε</strong>ίναι έ<strong>τ</strong>οιµος να <strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ρέψ<strong>ε</strong>ι <strong>σ</strong><strong>τ</strong>ο<strong>υ</strong>ς αγών<strong>ε</strong>ς. Αρχικά <strong>αν</strong><strong>ε</strong>βαίν<strong>ε</strong>ι<br />

<strong>τ</strong>α <strong>σ</strong>καλιά <strong>τ</strong>ρέχον<strong>τ</strong>ας και κα<strong>τ</strong>ό<strong>π</strong>ιν κα<strong>τ</strong><strong>ε</strong>βαίν<strong>ε</strong>ι αργά και κα<strong>τ</strong>ό<strong>π</strong>ιν<br />

<strong>ε</strong><strong>π</strong><strong>αν</strong>αλαµβάν<strong>ε</strong>ι <strong>τ</strong>η διαδικα<strong>σ</strong>ία α<strong>υ</strong><strong>τ</strong>ή <strong>αν</strong><strong>ε</strong>βαίνον<strong>τ</strong>ας και κα<strong>τ</strong><strong>ε</strong>βαίνον<strong>τ</strong>ας µ<strong>ε</strong><br />

<strong>τ</strong>ζοκινγκ. Εδώ <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να <strong>π</strong>ρο<strong>σ</strong><strong>ε</strong>χθ<strong>ε</strong>ί ιδιαί<strong>τ</strong><strong>ε</strong>ρα ο αθλούµ<strong>ε</strong>νος, για<strong>τ</strong>ί οι<br />

α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις α<strong>υ</strong><strong>τ</strong>ές µ<strong>π</strong>ορ<strong>ε</strong>ί να <strong>τ</strong>ον κο<strong>υ</strong>ρά<strong>σ</strong>ο<strong>υ</strong>ν. Σ<strong>ε</strong> <strong>π</strong><strong>ε</strong>ρί<strong>π</strong><strong>τ</strong>ω<strong>σ</strong>η <strong>π</strong>ο<strong>υ</strong> δ<strong>ε</strong>ν <strong>ε</strong>ίναι<br />

διαθέ<strong>σ</strong>ιµ<strong>ε</strong>ς κ<strong>ε</strong>ρκίδ<strong>ε</strong>ς, οι α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις α<strong>υ</strong><strong>τ</strong>ές µ<strong>π</strong>ορούν να γίνο<strong>υ</strong>ν <strong>σ</strong><strong>ε</strong> µια<br />

<strong>π</strong>λαγιά. Σ<strong>τ</strong>ο <strong>σ</strong><strong>τ</strong>άδιο α<strong>υ</strong><strong>τ</strong>ό <strong>τ</strong>ης α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης µ<strong>π</strong>ορ<strong>ε</strong>ί να γίνο<strong>υ</strong>ν<br />

α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις µ<strong>ε</strong> <strong>σ</strong><strong>υ</strong>να<strong>σ</strong>κούµ<strong>ε</strong>νο<strong>υ</strong>ς. Α<strong>υ</strong><strong>τ</strong>ές βοηθούν <strong>σ</strong><strong>τ</strong>η β<strong>ε</strong>λ<strong>τ</strong>ίω<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong><br />

χρόνο<strong>υ</strong> <strong>αν</strong><strong>τ</strong>ίδρα<strong>σ</strong>ης και ο αθλη<strong>τ</strong>ής <strong>τ</strong>ρέχ<strong>ε</strong>ι <strong>π</strong>ρο<strong>σ</strong><strong>π</strong><strong>ε</strong>ρνών<strong>τ</strong>ας <strong>τ</strong>ο<br />

<strong>σ</strong><strong>υ</strong>ναθλη<strong>τ</strong>ή <strong>τ</strong>ο<strong>υ</strong> κόβον<strong>τ</strong>ας δ<strong>ε</strong>ξιά, αρι<strong>σ</strong><strong>τ</strong><strong>ε</strong>ρά, µ<strong>π</strong>ρο<strong>σ</strong><strong>τ</strong>ά, <strong>π</strong>ί<strong>σ</strong>ω. Ε<strong>π</strong>ί<strong>σ</strong>ης ο<br />

αθλη<strong>τ</strong>ής µ<strong>π</strong>ορ<strong>ε</strong>ί να φορέ<strong>σ</strong><strong>ε</strong>ι <strong>τ</strong>α <strong>π</strong>α<strong>π</strong>ού<strong>τ</strong><strong>σ</strong>ια <strong>τ</strong>ο<strong>υ</strong> αθλήµα<strong>τ</strong>ος <strong>τ</strong>ο<strong>υ</strong> και<br />

<strong>σ</strong><strong>υ</strong>ν<strong>ε</strong>χίζον<strong>τ</strong>ας <strong>τ</strong>η διαδικα<strong>σ</strong>ία <strong>π</strong>ρο<strong>σ</strong><strong>τ</strong>ίθ<strong>ε</strong>ν<strong>τ</strong>αι α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις κύκλων ή <strong>ε</strong>λιγµών<br />

<strong>σ</strong>χήµα<strong>τ</strong>ος Ζ ή S. Α<strong>υ</strong><strong>τ</strong>ές γίνον<strong>τ</strong>αι

97<br />

<strong>σ</strong><strong>τ</strong>ην αρχή αργά και κα<strong>τ</strong>ό<strong>π</strong>ιν µ<strong>ε</strong> µ<strong>ε</strong>γάλη <strong>τ</strong>αχύ<strong>τ</strong>η<strong>τ</strong>α ( Flunter, Funk<br />

1984, Curt et al 1983).<br />

∆ρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς <strong>σ</strong><strong>ε</strong> γκρο<strong>υ</strong><strong>π</strong> :<br />

Ό<strong>τ</strong><strong>αν</strong> ο αθλούµ<strong>ε</strong>νος <strong>ε</strong>ίναι <strong>σ</strong><strong>ε</strong> θέ<strong>σ</strong>η να <strong>ε</strong>κ<strong>τ</strong><strong>ε</strong>λέ<strong>σ</strong><strong>ε</strong>ι <strong>τ</strong>ις α<strong>τ</strong>οµικές α-<br />

<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις µ<strong>ε</strong> <strong>ε</strong><strong>υ</strong>κολία, <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να αρχί<strong>σ</strong><strong>ε</strong>ι δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς <strong>σ</strong><strong>ε</strong> οµάδα.<br />

Σ<strong>τ</strong>ην αρχή όµως ο φ<strong>υ</strong><strong>σ</strong>ιοθ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong><strong>υ</strong><strong>τ</strong>ής ή ο <strong>π</strong>ρο<strong>π</strong>ονη<strong>τ</strong>ής <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να<br />

<strong>π</strong>ρο<strong>σ</strong>έξ<strong>ε</strong>ι ώ<strong>σ</strong><strong>τ</strong><strong>ε</strong> ο αθλη<strong>τ</strong>ής <strong>σ</strong><strong>τ</strong>ις οµαδικές α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις να µη φ<strong>τ</strong>ά<strong>σ</strong><strong>ε</strong>ι <strong>σ</strong><strong>ε</strong><br />

φο<strong>υ</strong>λ <strong>ε</strong><strong>π</strong>ιβάρ<strong>υ</strong>ν<strong>σ</strong>η. Σ<strong>ε</strong> αρκ<strong>ε</strong><strong>τ</strong>ές <strong>π</strong><strong>ε</strong>ρι<strong>π</strong><strong>τ</strong>ώ<strong>σ</strong><strong>ε</strong>ις όµως ο αθλη<strong>τ</strong>ής µ<strong>π</strong>ορ<strong>ε</strong>ί<br />

να <strong>ε</strong>κ<strong>τ</strong><strong>ε</strong>λέ<strong>σ</strong><strong>ε</strong>ι και λίγ<strong>ε</strong>ς <strong>ε</strong>ιδικές α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις <strong>τ</strong>ο<strong>υ</strong> αθλήµα<strong>τ</strong>ος και κα<strong>τ</strong>ό<strong>π</strong>ιν<br />

α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις <strong>σ</strong><strong>ε</strong> οµάδ<strong>ε</strong>ς. Οι α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις όµως <strong>π</strong>ο<strong>υ</strong> θα γίνο<strong>υ</strong>ν, <strong>ε</strong>ξαρ<strong>τ</strong>ών<strong>τ</strong>αι<br />

ακριβώς α<strong>π</strong>' <strong>τ</strong>ον <strong>τ</strong>ύ<strong>π</strong>ο <strong>τ</strong>ο<strong>υ</strong> αθλήµα<strong>τ</strong>ος και <strong>τ</strong>η θέ<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> α-<br />

θλούµ<strong>ε</strong>νο<strong>υ</strong>. Σ<strong>ε</strong> καθηµ<strong>ε</strong>ρινή βά<strong>σ</strong>η <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι ο αθλη<strong>τ</strong>ής να α<strong>σ</strong>κηθ<strong>ε</strong>ί α-<br />

<strong>τ</strong>οµικά <strong>σ</strong><strong>τ</strong>ην αρχή <strong>σ</strong><strong>ε</strong> κοψίµα<strong>τ</strong>α, <strong>σ</strong><strong>τ</strong>αµά<strong>τ</strong>ηµα, <strong>σ</strong><strong>τ</strong>ροφές µ<strong>ε</strong> <strong>τ</strong>ο µέ<strong>σ</strong>ο<br />

<strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>αιγνιδιού. Κα<strong>τ</strong>ό<strong>π</strong>ιν <strong>σ</strong><strong>υ</strong>ν<strong>ε</strong>χίζον<strong>τ</strong>αι οι α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις µ' ένα <strong>αν</strong><strong>τ</strong>ί<strong>π</strong>αλο,<br />

δύο <strong>αν</strong><strong>τ</strong>ί<strong>π</strong>αλο<strong>υ</strong>ς, <strong>τ</strong>ρ<strong>ε</strong>ις <strong>αν</strong><strong>τ</strong>ί<strong>π</strong>αλο<strong>υ</strong>ς. Οι οµαδικές α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις <strong>σ</strong> α<strong>υ</strong><strong>τ</strong>ή <strong>τ</strong>η<br />

φά<strong>σ</strong>η <strong>ε</strong>κ<strong>τ</strong><strong>ε</strong>λούν<strong>τ</strong>αι µέχρις ό<strong>τ</strong>ο<strong>υ</strong> ο αθλη<strong>τ</strong>ής να <strong>ε</strong>ίναι <strong>σ</strong><strong>ε</strong> θέ<strong>σ</strong>η να κάν<strong>ε</strong>ι<br />

άλµα<strong>τ</strong>α, να κιν<strong>ε</strong>ί<strong>τ</strong>αι και να µαρκάρ<strong>ε</strong>ι <strong>σ</strong><strong>τ</strong>ην ίδια <strong>π</strong><strong>ε</strong>ριοχή. Σ' α<strong>υ</strong><strong>τ</strong>ή <strong>τ</strong>η<br />

φά<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γκρο<strong>υ</strong><strong>π</strong> δ<strong>ε</strong>ν ξ<strong>ε</strong><strong>π</strong><strong>ε</strong>ρνά <strong>τ</strong>α έξι ά<strong>τ</strong>οµα. Κα<strong>τ</strong>ό<strong>π</strong>ιν <strong>σ</strong><strong>τ</strong>ην οµάδα<br />

µ<strong>π</strong>ορ<strong>ε</strong>ί να <strong>σ</strong><strong>υ</strong>µµ<strong>ε</strong><strong>τ</strong>ά<strong>σ</strong>χο<strong>υ</strong>ν <strong>π</strong>άνω α<strong>π</strong>ό δέκα ά<strong>τ</strong>οµα και η έν<strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ων<br />

α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ων α<strong>υ</strong>ξάν<strong>ε</strong><strong>τ</strong>αι. Όλη α<strong>υ</strong><strong>τ</strong>ή η <strong>π</strong>ρο<strong>σ</strong>αρµογή <strong>ε</strong>ξο<strong>π</strong>λίζ<strong>ε</strong>ι <strong>τ</strong>ον αθλη<strong>τ</strong>ή<br />

µ<strong>ε</strong> θάρρος, α<strong>υ</strong><strong>τ</strong>ο<strong>π</strong><strong>ε</strong><strong>π</strong>οίθη<strong>σ</strong>η και α<strong>π</strong>οβάλλ<strong>ε</strong>ι <strong>τ</strong>ο φόβο, αφού <strong>σ</strong><strong>υ</strong>µ-<br />

µ<strong>ε</strong><strong>τ</strong>έχ<strong>ε</strong>ι <strong>ε</strong>ν<strong>ε</strong>ργά <strong>σ</strong>' όλ<strong>ε</strong>ς <strong>τ</strong>ις φά<strong>σ</strong><strong>ε</strong>ις, <strong>π</strong>ο<strong>υ</strong> µ<strong>π</strong>ορ<strong>ε</strong>ί να <strong>σ</strong><strong>υ</strong>µβούν <strong>σ</strong><strong>τ</strong>ο<br />

<strong>π</strong>αιχνίδι.

Ε<strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ροφή <strong>σ</strong><strong>τ</strong>ην αγωνι<strong>σ</strong><strong>τ</strong>ική δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong>α :<br />

Όλοι ό<strong>σ</strong>οι α<strong>σ</strong>χολούν<strong>τ</strong>αι µ<strong>ε</strong> <strong>τ</strong>ην οµάδα, αλλά κ<strong>υ</strong>ρίως ο <strong>π</strong>ρο<strong>π</strong>ονη<strong>τ</strong>ής,<br />

αφού <strong>ε</strong>κ<strong>τ</strong>ιµή<strong>σ</strong><strong>ε</strong>ι ό<strong>τ</strong>ι ο αθλη<strong>τ</strong>ής έχ<strong>ε</strong>ι φ<strong>τ</strong>ά<strong>σ</strong><strong>ε</strong>: <strong>σ</strong><strong>ε</strong> ικ<strong>αν</strong>ο<strong>π</strong>οιη<strong>τ</strong>ικό <strong>ε</strong>-<br />

<strong>π</strong>ί<strong>π</strong><strong>ε</strong>δο α<strong>π</strong>όδο<strong>σ</strong>ης και <strong>ε</strong>κ<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί όλ<strong>ε</strong>ς <strong>τ</strong>ις δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς χωρίς <strong>π</strong>όνο<br />

και µ<strong>ε</strong> µέγι<strong>σ</strong><strong>τ</strong>η δύναµη, δίν<strong>ε</strong>ι άδ<strong>ε</strong>ια <strong>σ</strong><strong>τ</strong>ον αθλη<strong>τ</strong>ή να <strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ρέψ<strong>ε</strong>ι <strong>σ</strong><strong>τ</strong>ο<br />

<strong>π</strong>αιχνίδι. Η µ<strong>ε</strong>γάλη χρονική διάρκ<strong>ε</strong>ια <strong>π</strong>ο<strong>υ</strong> α<strong>π</strong>ο<strong>υ</strong><strong>σ</strong>ία<strong>σ</strong><strong>ε</strong> α<strong>π</strong>ό <strong>τ</strong>ο<strong>υ</strong>ς α-<br />

γών<strong>ε</strong>ς <strong>π</strong>ρο<strong>σ</strong>δίδ<strong>ε</strong>ι κά<strong>π</strong>οιο φόβο <strong>σ</strong><strong>τ</strong>ον αθλούµ<strong>ε</strong>νο, ο ο<strong>π</strong>οίος <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι,<br />

<strong>π</strong>αρ' ό<strong>τ</strong>ι <strong>ε</strong>κ<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί όλ<strong>ε</strong>ς <strong>τ</strong>ις α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις και όλα <strong>τ</strong>α <strong>τ</strong><strong>ε</strong><strong>σ</strong><strong>τ</strong> µ<strong>ε</strong> <strong>ε</strong><strong>π</strong>ι<strong>τ</strong><strong>υ</strong>χία, να<br />

<strong>π</strong>ρο<strong>ε</strong><strong>τ</strong>οιµα<strong>σ</strong><strong>τ</strong><strong>ε</strong>ί και ψ<strong>υ</strong>χολογικά, για<strong>τ</strong>ί ο µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρος κρι<strong>τ</strong>ής <strong>τ</strong>ης <strong>ε</strong><strong>π</strong>ι<strong>τ</strong><strong>υ</strong>χηµένης<br />

α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης <strong>ε</strong>ίναι <strong>τ</strong>ο <strong>π</strong>αιχνίδι.<br />

7. ΝΕΥΡΟΜΥΙΚΗ ΕΠΑΝΕΚΠΑΙ∆ΕΥΣΗ - ΠΡΟΑΘΛΗΤΙΚΗ<br />

ΠΡΟΠΟΝΗΣΗ<br />

Ένα άλλο θέµα <strong>π</strong>ο<strong>υ</strong> <strong>ε</strong><strong>π</strong><strong>αν</strong>έρχ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>η βιβλιογραφία <strong>τ</strong>ης α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης<br />

µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό <strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ική <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού, <strong>ε</strong>ίναι η <strong>αν</strong>άγκη<br />

για ν<strong>ε</strong><strong>υ</strong>ροµ<strong>υ</strong>ϊκή <strong>ε</strong><strong>π</strong><strong>αν</strong><strong>ε</strong>κ<strong>π</strong>αίδ<strong>ε</strong><strong>υ</strong><strong>σ</strong>η. Είναι γνω<strong>σ</strong><strong>τ</strong>ό, <strong>π</strong>λέον, ό<strong>τ</strong>ι ο <strong>αν</strong>έ<strong>π</strong>αφος<br />

<strong>π</strong>ρό<strong>σ</strong>θιος χια<strong>σ</strong><strong>τ</strong>ός <strong>ε</strong>ίχ<strong>ε</strong> µια <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ική ιδιοδ<strong>ε</strong>κ<strong>τ</strong>ική αι<strong>σ</strong>θη<strong>τ</strong>ική<br />

λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργικό<strong>τ</strong>η<strong>τ</strong>α µέ<strong>σ</strong>α <strong>σ</strong><strong>τ</strong>ο φ<strong>υ</strong><strong>σ</strong>ιολογικό γόνα<strong>τ</strong>ο. Έχο<strong>υ</strong>ν <strong>ε</strong>ν<strong>τ</strong>ο<strong>π</strong>ι<strong>σ</strong>θ<strong>ε</strong>ί<br />

<strong>σ</strong><strong>τ</strong>ο <strong>ε</strong><strong>σ</strong>ω<strong>τ</strong><strong>ε</strong>ρικό <strong>τ</strong>ο<strong>υ</strong> ι<strong>σ</strong><strong>τ</strong>ού <strong>τ</strong>ο<strong>υ</strong> <strong>υ</strong>γιούς <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>, µηχ<strong>αν</strong>οϋ<strong>π</strong>οδοχ<strong>ε</strong>ίς,<br />

οι ο<strong>π</strong>οίοι <strong>ε</strong>ίναι ικ<strong>αν</strong>οί να <strong>π</strong>ληροφορούν <strong>τ</strong>ο κ<strong>ε</strong>ν<strong>τ</strong>ρικό ν<strong>ε</strong><strong>υ</strong>ρικό <strong>σ</strong>ύ<strong>σ</strong><strong>τ</strong>η-<br />

µα για <strong>τ</strong>η θέ<strong>σ</strong>η <strong>τ</strong>ης άρθρω<strong>σ</strong>ης, ό<strong>π</strong>ως <strong>ε</strong><strong>π</strong>ί<strong>σ</strong>ης και για <strong>τ</strong>ις αργές και<br />

γρήγορ<strong>ε</strong>ς αλλαγές θέ<strong>σ</strong>ης <strong>τ</strong>ης άρθρω<strong>σ</strong>ης. Η µ<strong>ε</strong>ίω<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ην <strong>π</strong>ο<strong>σ</strong>ό<strong>τ</strong>η<strong>τ</strong>α<br />

<strong>τ</strong>ων ιδιοδ<strong>ε</strong>κ<strong>τ</strong>ικών αι<strong>σ</strong>θη<strong>τ</strong>ικών <strong>π</strong>ληροφοριών <strong>π</strong>ρος <strong>τ</strong>ο κ<strong>ε</strong>ν<strong>τ</strong>ρικό ν<strong>ε</strong><strong>υ</strong>ρικό<br />

<strong>σ</strong>ύ<strong>σ</strong><strong>τ</strong>ηµα, µ<strong>π</strong>ορ<strong>ε</strong>ί να <strong>ε</strong>ίναι <strong>υ</strong><strong>π</strong><strong>ε</strong>ύθ<strong>υ</strong>νη για <strong>τ</strong>ο δύ<strong>σ</strong>κολο θ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong><strong>υ</strong>-<br />

µένο χά<strong>σ</strong>ιµο <strong>τ</strong>ης µ<strong>υ</strong>ϊκής δύναµης και <strong>π</strong><strong>ε</strong>ριµέ<strong>τ</strong>ρο<strong>υ</strong> <strong>τ</strong>ο<strong>υ</strong> µηρού, <strong>π</strong>ο<strong>υ</strong><br />

<strong>τ</strong><strong>υ</strong><strong>π</strong>ικά <strong>υ</strong>φί<strong>σ</strong><strong>τ</strong><strong>αν</strong><strong>τ</strong>αι ο <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλος µ<strong>ε</strong><strong>τ</strong>ά <strong>τ</strong>η ρήξη <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού,<br />

Σ<strong>ε</strong> α<strong>π</strong>άν<strong>τ</strong>η<strong>σ</strong>η, <strong>υ</strong><strong>π</strong>άρχο<strong>υ</strong>ν <strong>π</strong>ληροφορί<strong>ε</strong>ς <strong>π</strong>ο<strong>υ</strong> δ<strong>ε</strong>ίχνο<strong>υ</strong>ν ό<strong>τ</strong>ι οι<br />

ι<strong>σ</strong>χιοκνηµιαίοι <strong>ε</strong>ίναι <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρο <strong>ε</strong>ν<strong>ε</strong>ργοί α<strong>π</strong>ό <strong>τ</strong>ο <strong>σ</strong><strong>υ</strong>νηθι<strong>σ</strong>µένο, <strong>σ</strong><strong>ε</strong>

γόνα<strong>τ</strong>α µ<strong>ε</strong> <strong>π</strong>ροβληµα<strong>τ</strong>ικό <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό, <strong>π</strong>ράγµα <strong>π</strong>ο<strong>υ</strong> δ<strong>ε</strong>ίχν<strong>ε</strong>ι ό<strong>τ</strong>ι<br />

<strong>υ</strong><strong>π</strong>άρχ<strong>ε</strong>ι <strong>π</strong>ιθ<strong>αν</strong>ό<strong>τ</strong>η<strong>τ</strong>α να δρα<strong>σ</strong><strong>τ</strong>ηριο<strong>π</strong>οιούν<strong>τ</strong>αι <strong>π</strong>ρό<strong>σ</strong>θ<strong>ε</strong><strong>τ</strong>α <strong>αν</strong><strong>τ</strong><strong>αν</strong>ακλα<strong>σ</strong><strong>τ</strong>ικά<br />

<strong>τ</strong>όξα <strong>π</strong>ο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>νδέο<strong>υ</strong>ν µ<strong>ε</strong> <strong>τ</strong>ο<strong>υ</strong>ς ι<strong>σ</strong>χιοκνηµιαίο<strong>υ</strong>ς. Α<strong>υ</strong><strong>τ</strong>ό δίν<strong>ε</strong>ι<br />

µ<strong>ε</strong>γάλη <strong>υ</strong><strong>π</strong>ο<strong>σ</strong><strong>τ</strong>ήριξη <strong>σ</strong><strong>τ</strong>ην ά<strong>π</strong>οψη ό<strong>τ</strong>ι οι ι<strong>σ</strong>χιοκνηµιαίοι <strong>π</strong>αίζο<strong>υ</strong>ν <strong>τ</strong>ο<br />

ρόλο δ<strong>υ</strong>ναµικού <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρο<strong>π</strong>οιη<strong>τ</strong>ικού <strong>π</strong>αράγον<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong> γονά<strong>τ</strong>ο<strong>υ</strong>.<br />

7.1 Ι∆ΙΟ∆ΕΚΤΙΚΗ ΠΡΟΠΟΝΗΣΗ ∆ΥΝΑΜΙΚΟΥ ΑΡΘΡΙΚΟΥ<br />

ΕΛΕΓΧΟΥ ΜΕΤΑ ΑΠΟ ΠΛΑΣΤΙΚΗ ΠΡΟΣΘΙΟΥ ΧΙΑΣΤΟΥ<br />

Για <strong>τ</strong>ο<strong>υ</strong>ς <strong>σ</strong><strong>υ</strong>νδ<strong>ε</strong><strong>σ</strong>µικούς <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µούς <strong>σ</strong><strong>τ</strong>ο γόνα<strong>τ</strong>ο, <strong>ε</strong>ίναι <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ική<br />

η <strong>ε</strong>ιδική <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>η <strong>τ</strong>ων µ<strong>υ</strong>ών γύρω α<strong>π</strong>ό <strong>τ</strong>ο γόνα<strong>τ</strong>ο, <strong>ε</strong>ί<strong>τ</strong><strong>ε</strong> α<strong>υ</strong><strong>τ</strong>οί<br />

<strong>αν</strong><strong>τ</strong>ιµ<strong>ε</strong><strong>τ</strong>ω<strong>π</strong>ί<strong>σ</strong><strong>τ</strong>ηκ<strong>αν</strong> <strong>σ</strong><strong>υ</strong>ν<strong>τ</strong>ηρη<strong>τ</strong>ικά, <strong>ε</strong>ί<strong>τ</strong><strong>ε</strong> χ<strong>ε</strong>ιρο<strong>υ</strong>ργικά. Οι <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ροι<br />

<strong>τ</strong>ύ<strong>π</strong>οι <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>ης, <strong>π</strong>έρα α<strong>π</strong>ό λίγο<strong>υ</strong>ς, <strong>ε</strong>ίναι α<strong>π</strong>λά και µόνο µ<strong>υ</strong>ϊκό<br />

δ<strong>υ</strong>νάµωµα <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρο, <strong>π</strong>αρά καλ<strong>υ</strong><strong>τ</strong>έρ<strong>ε</strong><strong>υ</strong><strong>σ</strong>η <strong>τ</strong>ης ν<strong>ε</strong><strong>υ</strong>ροµ<strong>υ</strong>ϊκής<br />

<strong>σ</strong><strong>υ</strong>ν<strong>ε</strong>ργα<strong>σ</strong>ίας. Ακόµα και <strong>αν</strong> οι ι<strong>σ</strong>χιοκνηµιαίοι ή ο <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλος<br />

δ<strong>υ</strong>ναµών<strong>ε</strong><strong>τ</strong>αι, <strong>τ</strong>ο <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικό <strong>σ</strong>ηµ<strong>ε</strong>ίο <strong>ε</strong>ίναι η κα<strong>τ</strong>άλληλη <strong>τ</strong>αχ<strong>υ</strong><strong>αν</strong><strong>τ</strong>ιδρα<strong>σ</strong><strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>ά<br />

<strong>τ</strong>ο<strong>υ</strong>ς κα<strong>τ</strong>ά <strong>τ</strong>η διάρκ<strong>ε</strong>ια κα<strong>τ</strong>α<strong>σ</strong><strong>τ</strong>ά<strong>σ</strong><strong>ε</strong>ων <strong>π</strong>ο<strong>υ</strong> µ<strong>π</strong>ορούν να<br />

<strong>π</strong>ροκαλέ<strong>σ</strong>ο<strong>υ</strong>ν <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µούς.<br />

Οι µηχ<strong>αν</strong>οϋ<strong>π</strong>οδοχ<strong>ε</strong>ίς µέ<strong>σ</strong>α και γύρω α<strong>π</strong>ό <strong>τ</strong>ο γόνα<strong>τ</strong>ο <strong>π</strong>αρέχο<strong>υ</strong>ν<br />

ό<strong>π</strong>ως <strong>π</strong>ρο<strong>αν</strong>αφέρθηκ<strong>ε</strong>, <strong>σ</strong><strong>τ</strong>ο κ<strong>ε</strong>ν<strong>τ</strong>ρικό ν<strong>ε</strong><strong>υ</strong>ρικό <strong>σ</strong>ύ<strong>σ</strong><strong>τ</strong>ηµα, <strong>π</strong>ληροφορί<strong>ε</strong>ς<br />

για <strong>τ</strong>η θέ<strong>σ</strong>η, <strong>τ</strong>ην κίνη<strong>σ</strong>η και <strong>τ</strong>ο φορ<strong>τ</strong>ίο <strong>π</strong>άνω <strong>σ</strong><strong>τ</strong>ην άρθρω<strong>σ</strong>η, <strong>τ</strong>ο<br />

ο<strong>π</strong>οίο µ<strong>ε</strong> <strong>τ</strong>η <strong>σ</strong><strong>ε</strong>ιρά <strong>τ</strong>ο<strong>υ</strong> <strong>ε</strong>ν<strong>ε</strong>ργο<strong>π</strong>οι<strong>ε</strong>ί <strong>τ</strong>ο<strong>υ</strong>ς µύ<strong>ε</strong>ς γύρω α<strong>π</strong>ό <strong>τ</strong>ο γόνα<strong>τ</strong>ο<br />

<strong>σ</strong><strong>ε</strong> δρά<strong>σ</strong>η. Υ<strong>π</strong>άρχ<strong>ε</strong>ι ένα χρονικό διά<strong>σ</strong><strong>τ</strong>ηµα - κ<strong>ε</strong>νό - µ<strong>ε</strong><strong>τ</strong>αξύ <strong>τ</strong>ο<strong>υ</strong> <strong>ε</strong>ρ<strong>ε</strong>θι<strong>σ</strong>µού<br />

<strong>τ</strong>ων αι<strong>σ</strong>θη<strong>τ</strong>ικών <strong>σ</strong><strong>υ</strong><strong>σ</strong><strong>τ</strong>ηµά<strong>τ</strong>ων και <strong>τ</strong>ης <strong>τ</strong><strong>ε</strong>λικής µ<strong>υ</strong>ϊκής <strong>αν</strong><strong>τ</strong>ίδρα<strong>σ</strong>ης.<br />

Ό<strong>σ</strong>ο µικρό<strong>τ</strong><strong>ε</strong>ρο <strong>ε</strong>ίναι <strong>τ</strong>ο διά<strong>σ</strong><strong>τ</strong>ηµα α<strong>υ</strong><strong>τ</strong>ό, <strong>τ</strong>ό<strong>σ</strong>ο λιγό<strong>τ</strong><strong>ε</strong>ρο <strong>τ</strong>ο<br />

φορ<strong>τ</strong>ίο <strong>π</strong>άνω <strong>σ</strong><strong>τ</strong>ο<strong>υ</strong>ς <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>ς και <strong>σ</strong><strong>ε</strong> άλλ<strong>ε</strong>ς δοµές <strong>σ</strong><strong>τ</strong>ο γόνα<strong>τ</strong>ο.<br />

Τ<strong>ε</strong>λ<strong>ε</strong><strong>υ</strong><strong>τ</strong>αία, έχ<strong>ε</strong>ι δοθ<strong>ε</strong>ί βάρος <strong>σ</strong><strong>τ</strong>ην <strong>π</strong>ρο<strong>π</strong>ονη<strong>τ</strong>ική <strong>τ</strong><strong>ε</strong>χνική δ<strong>υ</strong>ναµικού<br />

αρθρικού <strong>ε</strong>λέγχο<strong>υ</strong>, για <strong>τ</strong>ον <strong>π</strong><strong>ε</strong>ριορι<strong>σ</strong>µό <strong>τ</strong>ο<strong>υ</strong> χρονικού κ<strong>ε</strong>νού α-

ν<strong>τ</strong>ίδρα<strong>σ</strong>ης <strong>τ</strong>ων ι<strong>σ</strong>χιοκνηµιαίων κα<strong>τ</strong>ά <strong>τ</strong>η <strong>σ</strong><strong>υ</strong>ν<strong>τ</strong>ηρη<strong>τ</strong>ική <strong>αν</strong><strong>τ</strong>ιµ<strong>ε</strong><strong>τ</strong>ώ<strong>π</strong>ι<strong>σ</strong>η<br />

µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µό <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού, αλλά και µ<strong>ε</strong><strong>τ</strong>ά <strong>τ</strong>ην<br />

<strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ική <strong>τ</strong>ο<strong>υ</strong>. Ειδικό<strong>τ</strong><strong>ε</strong>ρα, <strong>σ</strong><strong>τ</strong>η δ<strong>ε</strong>ύ<strong>τ</strong><strong>ε</strong>ρη <strong>π</strong><strong>ε</strong>ρί<strong>π</strong><strong>τ</strong>ω<strong>σ</strong>η η <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>η<br />

α<strong>υ</strong><strong>τ</strong>ού <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong>ύ<strong>π</strong>ο<strong>υ</strong> κρίθηκ<strong>ε</strong> α<strong>π</strong>αραί<strong>τ</strong>η<strong>τ</strong>η, έ<strong>τ</strong><strong>σ</strong>ι ώ<strong>σ</strong><strong>τ</strong><strong>ε</strong> να <strong>ε</strong><strong>π</strong>ι<strong>τ</strong><strong>ε</strong><strong>υ</strong>χθ<strong>ε</strong>ί καλύ<strong>τ</strong><strong>ε</strong>ρη<br />

<strong>τ</strong>αχ<strong>υ</strong><strong>αν</strong><strong>τ</strong>ιδρα<strong>σ</strong><strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>ά <strong>τ</strong>ων ι<strong>σ</strong>χιοκνηµιαίων, <strong>π</strong>ράγµα <strong>π</strong>ο<strong>υ</strong> θα<br />

<strong>π</strong><strong>ε</strong>ριορί<strong>σ</strong><strong>ε</strong>ι <strong>τ</strong>ις <strong>π</strong>ιθ<strong>αν</strong>ό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς για <strong>αν</strong>ά<strong>π</strong><strong>τ</strong><strong>υ</strong>ξη ψηλών φορ<strong>τ</strong>ίων <strong>π</strong>άνω <strong>σ</strong><strong>τ</strong>ο<br />

µό<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µα κα<strong>τ</strong>ά <strong>τ</strong>η διάρκ<strong>ε</strong>ια <strong>τ</strong>ης α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης αλλά και <strong>τ</strong>ων<br />

µ<strong>ε</strong><strong>τ</strong>έ<strong>π</strong><strong>ε</strong>ι<strong>τ</strong>α αθλη<strong>τ</strong>ικών δρα<strong>σ</strong><strong>τ</strong>ηριο<strong>τ</strong>ή<strong>τ</strong>ων. Α<strong>υ</strong><strong>τ</strong>ή η καλύ<strong>τ</strong><strong>ε</strong>ρη <strong>τ</strong>αχ<strong>υ</strong><strong>αν</strong><strong>τ</strong>ιδρα<strong>σ</strong><strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>ά<br />

<strong>τ</strong>ων ι<strong>σ</strong>χιοκνηµιαίων, <strong>π</strong>ο<strong>υ</strong> α<strong>π</strong>οδ<strong>ε</strong>ίχ<strong>τ</strong>ηκ<strong>ε</strong> ό<strong>τ</strong>ι <strong>π</strong><strong>ε</strong><strong>τ</strong><strong>υ</strong>χαίν<strong>ε</strong><strong>τ</strong>αι<br />

µέ<strong>σ</strong>α α<strong>π</strong>ό <strong>τ</strong>ην <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>η δ<strong>υ</strong>ναµικού αρθρικού <strong>ε</strong>λέγχο<strong>υ</strong>,<br />

α<strong>π</strong>οδίδ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ο ό<strong>τ</strong>ι µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό <strong>τ</strong>ην κα<strong>τ</strong>α<strong>σ</strong><strong>τ</strong>ροφή <strong>τ</strong>ο<strong>υ</strong> <strong>αν</strong><strong>τ</strong><strong>αν</strong>ακλα<strong>σ</strong><strong>τ</strong>ικού<br />

<strong>τ</strong>όξο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού - ι<strong>σ</strong>χιοκνηµιαίων, δρα<strong>σ</strong><strong>τ</strong>ηριο<strong>π</strong>οιούν<strong>τ</strong>αι άλλα<br />

ν<strong>ε</strong><strong>υ</strong>ρικά κ<strong>υ</strong>κλώµα<strong>τ</strong>α ( <strong>π</strong>ο<strong>υ</strong> ξ<strong>ε</strong>κινούν α<strong>π</strong>ό άλλ<strong>ε</strong>ς <strong>π</strong><strong>ε</strong>ριοχές <strong>τ</strong>ο<strong>υ</strong> γονά<strong>τ</strong>ο<strong>υ</strong> ),<br />

<strong>τ</strong>α ο<strong>π</strong>οία <strong>υ</strong><strong>π</strong>οκαθι<strong>σ</strong><strong>τ</strong>ούν <strong>τ</strong>ο <strong>π</strong>ρώ<strong>τ</strong>ο µ<strong>ε</strong> <strong>τ</strong>ον καλύ<strong>τ</strong><strong>ε</strong>ρο <strong>τ</strong>ρό<strong>π</strong>ο, ώ<strong>π</strong>ος<br />

φαίν<strong>ε</strong><strong>τ</strong>αι. Η <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>η α<strong>υ</strong><strong>τ</strong>ή α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί<strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>έ<strong>σ</strong><strong>σ</strong><strong>ε</strong>ρα βα<strong>σ</strong>ικά<br />

<strong>σ</strong><strong>υ</strong><strong>σ</strong><strong>τ</strong>α<strong>τ</strong>ικά ;<br />

Α) Λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργική <strong>αν</strong>ά<strong>π</strong><strong>τ</strong><strong>υ</strong>ξη <strong>τ</strong>ης ικ<strong>αν</strong>ό<strong>τ</strong>η<strong>τ</strong>ας <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>οδιού να γ<strong>αν</strong><strong>τ</strong>ζών<strong>ε</strong>ι <strong>τ</strong>ο<br />

<strong>π</strong>ά<strong>τ</strong>ωµα, <strong>π</strong>ράγµα <strong>π</strong>ο<strong>υ</strong> <strong>ε</strong>ίναι <strong>π</strong>ολύ χρή<strong>σ</strong>ιµο για<strong>τ</strong>ί µ<strong>ε</strong><strong>τ</strong>α<strong>τ</strong>ρέ<strong>π</strong><strong>ε</strong>ι <strong>τ</strong>α δάκ<strong>τ</strong><strong>υ</strong>λα<br />

και <strong>τ</strong>ο <strong>π</strong>έλµα <strong>σ</strong><strong>ε</strong> δέκ<strong>τ</strong><strong>ε</strong>ς <strong>π</strong>ρό<strong>σ</strong>θ<strong>ε</strong><strong>τ</strong>ων µηχ<strong>αν</strong>ικών - αι<strong>σ</strong>θη<strong>τ</strong>ικών<br />

<strong>π</strong>ληροφοριών, <strong>π</strong>ο<strong>υ</strong> θα µ<strong>π</strong>ορού<strong>σ</strong><strong>αν</strong> ί<strong>σ</strong>ως να <strong>υ</strong><strong>π</strong>οκα<strong>τ</strong>α<strong>σ</strong><strong>τ</strong>ή<strong>σ</strong>ο<strong>υ</strong>ν α<strong>υ</strong><strong>τ</strong>ές<br />

α<strong>π</strong>ό <strong>τ</strong>ο γόνα<strong>τ</strong>ο <strong>π</strong>ο<strong>υ</strong> δ<strong>ε</strong>ν κα<strong>τ</strong>αλήγο<strong>υ</strong>ν <strong>σ</strong><strong>τ</strong>ο κ<strong>ε</strong>ν<strong>τ</strong>ρικό ν<strong>ε</strong><strong>υ</strong>ρικό <strong>σ</strong>ύ<strong>σ</strong><strong>τ</strong>ηµα<br />

λόγω <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µού <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού ή και άλλων δοµών<br />

µαζί.<br />

Β) ∆ια<strong>τ</strong>ήρη<strong>σ</strong>η <strong>τ</strong>ης ι<strong>σ</strong>ορρο<strong>π</strong>ίας <strong>π</strong>άνω <strong>σ</strong><strong>ε</strong> <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρή <strong>π</strong>λα<strong>τ</strong>φόρµα για να<br />

καλ<strong>υ</strong><strong>τ</strong><strong>ε</strong>ρέψ<strong>ε</strong>ι ο ν<strong>ε</strong><strong>υ</strong>ροµ<strong>υ</strong>ϊκός <strong>σ</strong><strong>υ</strong>ν<strong>τ</strong>ονι<strong>σ</strong>µός.<br />

Γ) Β<strong>ε</strong>λ<strong>τ</strong>ίω<strong>σ</strong>η <strong>τ</strong>ης <strong>αν</strong><strong>τ</strong>ίδρα<strong>σ</strong>ης <strong>σ</strong><strong>τ</strong>η ξαφνική <strong>π</strong>ρό<strong>σ</strong>θ<strong>ε</strong><strong>τ</strong>η δύναµη <strong>π</strong>ο<strong>υ</strong><br />

δίν<strong>ε</strong><strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ο θ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong><strong>υ</strong><strong>τ</strong>ή και<br />

∆) Γρήγορη µ<strong>ε</strong><strong>τ</strong>αφορά <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong>ωµα<strong>τ</strong>ικού βάρο<strong>υ</strong>ς α<strong>π</strong>ό <strong>τ</strong>ο ένα <strong>σ</strong>ώµα <strong>σ</strong><strong>τ</strong>ο<br />

άλλο για να α<strong>π</strong>ο<strong>τ</strong>ρα<strong>π</strong><strong>ε</strong>ί η <strong>υ</strong><strong>π</strong><strong>ε</strong>ρβολική φόρ<strong>τ</strong>ι<strong>σ</strong>η, <strong>σ</strong><strong>τ</strong>ιγµιαία, <strong>π</strong>άνω

<strong>σ</strong>' ένα α<strong>σ</strong><strong>τ</strong>αθές γόνα<strong>τ</strong>ο, <strong>ε</strong><strong>π</strong><strong>ε</strong>ιδή και <strong>τ</strong>α δύο <strong>π</strong>όδια <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να <strong>π</strong>ρο<strong>π</strong>ονούν<strong>τ</strong>αι<br />

<strong>τ</strong>α<strong>υ</strong><strong>τ</strong>όχρονα.<br />

Η <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>η δ<strong>υ</strong>ναµικού αρθρικού <strong>ε</strong>λέγχο<strong>υ</strong>, <strong>π</strong>ο<strong>υ</strong> θα <strong>π</strong><strong>ε</strong>ριγραφ<strong>ε</strong>ί<br />

<strong>αν</strong>αλ<strong>υ</strong><strong>τ</strong>ικό<strong>τ</strong><strong>ε</strong>ρα <strong>π</strong>αρακά<strong>τ</strong>ω, <strong>ε</strong>µ<strong>π</strong><strong>ε</strong>ριέχ<strong>ε</strong>ι και <strong>τ</strong>α <strong>τ</strong>έ<strong>σ</strong><strong>σ</strong><strong>ε</strong>ρα α<strong>υ</strong><strong>τ</strong>ά <strong>σ</strong><strong>υ</strong><strong>σ</strong><strong>τ</strong>α<strong>τ</strong>ικά<br />

και <strong>ε</strong>ίναι έ<strong>τ</strong><strong>σ</strong>ι <strong>σ</strong>χ<strong>ε</strong>δια<strong>σ</strong>µένη ώ<strong>σ</strong><strong>τ</strong><strong>ε</strong> να <strong>π</strong>αρέχ<strong>ε</strong>ι <strong>σ</strong><strong>τ</strong>αδιακά α<strong>υ</strong>ξ<strong>αν</strong>όµ<strong>ε</strong>νη<br />

δ<strong>υ</strong><strong>σ</strong>κολία και <strong>σ</strong><strong>τ</strong>α 4 α<strong>υ</strong><strong>τ</strong>ά <strong>σ</strong><strong>υ</strong><strong>σ</strong><strong>τ</strong>α<strong>τ</strong>ικά.<br />

Για να <strong>ε</strong>κ<strong>τ</strong>ιµηθ<strong>ε</strong>ί <strong>αν</strong><strong>τ</strong>ικ<strong>ε</strong>ιµ<strong>ε</strong>νικά η α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong><strong>σ</strong>µα<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ης <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>ης<br />

δ<strong>υ</strong>ναµικού αρθρικού <strong>ε</strong>λέγχο<strong>υ</strong>, έγιν<strong>αν</strong> διάφορ<strong>ε</strong>ς µ<strong>ε</strong>λέ<strong>τ</strong><strong>ε</strong>ς κα<strong>τ</strong>ά <strong>τ</strong>ις<br />

ο<strong>π</strong>οί<strong>ε</strong>ς χρη<strong>σ</strong>ιµο<strong>π</strong>οιήθηκ<strong>ε</strong> <strong>τ</strong>ο ι<strong>σ</strong>οκινη<strong>τ</strong>ικό δ<strong>υ</strong>ναµόµ<strong>ε</strong><strong>τ</strong>ρο Κίη - ΟΟΠΙ για <strong>τ</strong>ην<br />

<strong>π</strong>ραγµα<strong>τ</strong>ο<strong>π</strong>οίη<strong>σ</strong>η <strong>τ</strong>ων µ<strong>ε</strong><strong>τ</strong>ρή<strong>σ</strong><strong>ε</strong>ων. Η <strong>σ</strong><strong>τ</strong>α<strong>τ</strong>ι<strong>σ</strong><strong>τ</strong>ική <strong>αν</strong>άλ<strong>υ</strong><strong>σ</strong>η <strong>τ</strong>ων<br />

µ<strong>ε</strong><strong>τ</strong>ρικών <strong>π</strong>ληροφοριών κα<strong>τ</strong>ά <strong>τ</strong>α διάφορα <strong>σ</strong><strong>τ</strong>άδια <strong>τ</strong>ης <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>ης<br />

έδ<strong>ε</strong>ιξ<strong>ε</strong> ό<strong>τ</strong>ι καθώς η <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>η <strong>π</strong>ροχωρού<strong>σ</strong><strong>ε</strong>, κα<strong>τ</strong>αγράφον<strong>τ</strong><strong>αν</strong> κάθ<strong>ε</strong><br />

φορά καλύ<strong>τ</strong><strong>ε</strong>ροι χρόνοι µ<strong>υ</strong>ϊκής <strong>αν</strong><strong>τ</strong>ίδρα<strong>σ</strong>ης α<strong>π</strong>ό <strong>τ</strong>ο<strong>υ</strong>ς ι-<strong>σ</strong>χιοκνηµιαίο<strong>υ</strong>ς.<br />

Ο χρόνος <strong>αν</strong>ά<strong>π</strong><strong>τ</strong><strong>υ</strong>ξης <strong>τ</strong>ης µέγι<strong>σ</strong><strong>τ</strong>ης ρο<strong>π</strong>ής <strong>σ</strong><strong>τ</strong>ο<strong>υ</strong>ς ι<strong>σ</strong>χιοκνηµιαίο<strong>υ</strong>ς µ<strong>ε</strong><strong>τ</strong>ά<br />

<strong>τ</strong>ην 12 η <strong>ε</strong>βδοµάδα <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>ης, όχι µόνο <strong>ε</strong><strong>π</strong>έ<strong>σ</strong><strong>τ</strong>ρ<strong>ε</strong>ψ<strong>ε</strong> <strong>σ</strong><strong>ε</strong> φ<strong>υ</strong><strong>σ</strong>ιολογικά<br />

<strong>ε</strong><strong>π</strong>ί<strong>π</strong><strong>ε</strong>δα, αλλά έφ<strong>τ</strong>α<strong>σ</strong><strong>ε</strong> ακόµα και <strong>σ</strong><strong>ε</strong> ψηλό<strong>τ</strong><strong>ε</strong>ρο <strong>ε</strong><strong>π</strong>ί<strong>π</strong><strong>ε</strong>δο. Α<strong>υ</strong><strong>τ</strong>ό<br />

<strong>σ</strong><strong>υ</strong>ν<strong>ε</strong><strong>π</strong>άγ<strong>ε</strong><strong>τ</strong>αι µια µ<strong>ε</strong>γάλη <strong>π</strong>ιθ<strong>αν</strong>ό<strong>τ</strong>η<strong>τ</strong>α να καθορι<strong>σ</strong><strong>τ</strong><strong>ε</strong>ί η <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>η<br />

δ<strong>υ</strong>ναµικού αρθρικού <strong>ε</strong>λέγχο<strong>υ</strong>, <strong>σ</strong>α µια α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong><strong>σ</strong>µα<strong>τ</strong>ική µέθοδος <strong>π</strong>ο<strong>υ</strong><br />

<strong>π</strong><strong>ε</strong>ριορίζ<strong>ε</strong>ι <strong>τ</strong>ο χρονικό κ<strong>ε</strong>νό µ<strong>ε</strong><strong>τ</strong>αξύ <strong>τ</strong>ο<strong>υ</strong> αι<strong>σ</strong>θη<strong>τ</strong>ικού ιδιοδ<strong>ε</strong>κ<strong>τ</strong>ικού<br />

<strong>ε</strong>ρ<strong>ε</strong>θι<strong>σ</strong>µού και <strong>τ</strong>ης µ<strong>υ</strong>ϊκής α<strong>π</strong>άν<strong>τ</strong>η<strong>σ</strong>ης.<br />

Α<strong>π</strong>ό <strong>τ</strong>η <strong>σ</strong><strong>τ</strong>ιγµή <strong>π</strong>ο<strong>υ</strong> η <strong>σ</strong><strong>τ</strong>α<strong>τ</strong>ι<strong>σ</strong><strong>τ</strong>ική <strong>αν</strong>άλ<strong>υ</strong><strong>σ</strong>η δ<strong>ε</strong>ίχν<strong>ε</strong>ι ό<strong>τ</strong>ι ο χρόνος<br />

µ<strong>υ</strong>ϊκής <strong>αν</strong><strong>τ</strong>ίδρα<strong>σ</strong>ης αρχίζ<strong>ε</strong>ι να γίν<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικά καλύ<strong>τ</strong><strong>ε</strong>ρος κα<strong>τ</strong>ά <strong>τ</strong>ην<br />

8 η <strong>π</strong>ρο<strong>π</strong>ο-νη<strong>τ</strong>ική <strong>ε</strong>βδοµάδα, <strong>ε</strong>ίναι <strong>π</strong>ιθ<strong>αν</strong>ό α<strong>υ</strong><strong>τ</strong>ό να µ<strong>ε</strong><strong>τ</strong>αφράζ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ο ό<strong>τ</strong>ι<br />

οι <strong>ε</strong><strong>π</strong>ιδρά<strong>σ</strong><strong>ε</strong>ις <strong>τ</strong>ης <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>ης αρχίζο<strong>υ</strong>ν να γίνον<strong>τ</strong>αι φ<strong>αν</strong><strong>ε</strong>ρές κα<strong>τ</strong>ά <strong>τ</strong>ην<br />

8 η βδοµάδα. Η διάρκ<strong>ε</strong>ια α<strong>υ</strong><strong>τ</strong>ής <strong>τ</strong>ης <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>ης δ<strong>ε</strong>ν έχ<strong>ε</strong>ι ξ<strong>ε</strong>καθαρι<strong>σ</strong><strong>τ</strong><strong>ε</strong>ί<br />

ακόµα, αλλά η <strong>ε</strong><strong>π</strong>ίµονη <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>η µ<strong>ε</strong>ρικές φορές <strong>τ</strong>η βδοµάδα, θα<br />

ή<strong>τ</strong><strong>αν</strong> α<strong>π</strong>αραί<strong>τ</strong>η<strong>τ</strong>η για να δια<strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ωθούν οι <strong>ε</strong><strong>π</strong>ιδρά<strong>σ</strong><strong>ε</strong>ις <strong>τ</strong>ης.

7.2 ΠΡΟ ΑΘΛΗΤΙΚΗ Ι∆ΙΟ∆ΕΚΤΙΚΗ ΠΡΟΠΟΝΗΣΗ<br />

( <strong>τ</strong>αχ<strong>υ</strong>δ<strong>υ</strong>ναµική - <strong>τ</strong>αχ<strong>υ</strong>κινη<strong>τ</strong>ική <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>η )<br />

Η <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>η <strong>π</strong>ρο<strong>σ</strong>βλη<strong>τ</strong>ικού <strong>τ</strong>ύ<strong>π</strong>ο<strong>υ</strong> έχ<strong>ε</strong>ι <strong>π</strong>ρο<strong>τ</strong>αθ<strong>ε</strong>ί <strong>ε</strong>δώ και µ<strong>ε</strong>ρικά<br />

χρόνια για να βοηθή<strong>σ</strong><strong>ε</strong>ι να γ<strong>ε</strong>φ<strong>υ</strong>ρωθ<strong>ε</strong>ί <strong>τ</strong>ο χά<strong>σ</strong>µα µ<strong>ε</strong><strong>τ</strong>αξύ <strong>τ</strong>ης µ<strong>ε</strong><strong>τ</strong><strong>ε</strong>γχ<strong>ε</strong>ιρη<strong>τ</strong>ικής<br />

α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης ρο<strong>υ</strong><strong>τ</strong>ίνας και <strong>τ</strong>ης <strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ροφής <strong>σ</strong><strong>ε</strong> α-<br />

γωνι<strong>σ</strong><strong>τ</strong>ική αθλη<strong>τ</strong>ική δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong>α. Ο <strong>σ</strong><strong>τ</strong>όχος <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρογράµµα<strong>τ</strong>ος<br />

<strong>π</strong>ροαθλη<strong>τ</strong>ικής <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>ης <strong>ε</strong>ίναι ό<strong>τ</strong>ι µέ<strong>σ</strong>α α<strong>π</strong>ό <strong>τ</strong>η βαθµιαία <strong>ε</strong>ι<strong>σ</strong>αγωγή<br />

αρθρικών δρα<strong>σ</strong><strong>τ</strong>ηριο<strong>τ</strong>ή<strong>τ</strong>ων µ<strong>ε</strong> όλο και µ<strong>ε</strong>γαλύ<strong>τ</strong><strong>ε</strong>ρη <strong>π</strong>ολ<strong>υ</strong><strong>π</strong>λοκό<strong>τ</strong>η<strong>τ</strong>α,<br />

ο άρρω<strong>σ</strong><strong>τ</strong>ος µ<strong>π</strong>ορ<strong>ε</strong>ί να κα<strong>τ</strong>α<strong>σ</strong><strong>τ</strong><strong>ε</strong>ί ικ<strong>αν</strong>ός να βα<strong>σ</strong>ίζ<strong>ε</strong><strong>τ</strong>αι <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρο<br />

<strong>σ</strong><strong>τ</strong>ις <strong>υ</strong><strong>π</strong>όλοι<strong>π</strong><strong>ε</strong>ς ιδιοδ<strong>ε</strong>κ<strong>τ</strong>ικές αρθρικές δοµές <strong>π</strong>ο<strong>υ</strong> <strong>τ</strong>ο<strong>υ</strong> έ-<br />

χο<strong>υ</strong>ν α<strong>π</strong>οµ<strong>ε</strong>ίν<strong>ε</strong>ι µ<strong>ε</strong><strong>τ</strong>ά <strong>τ</strong>ον <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µό <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια-<strong>σ</strong><strong>τ</strong>ού <strong>τ</strong>ο<strong>υ</strong>.<br />

Γ<strong>ε</strong>νικά α<strong>υ</strong><strong>τ</strong>ές οι δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς ξ<strong>ε</strong>κινούν αργά µέ<strong>σ</strong>α <strong>σ</strong><strong>τ</strong>ο <strong>π</strong>ρόγραµµα<br />

α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης, <strong>π</strong>ρια α<strong>π</strong>ό <strong>τ</strong>ην <strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ροφή <strong>σ</strong><strong>τ</strong>ην αθλη<strong>τ</strong>ική δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong>α.<br />

Η ιδιοδ<strong>ε</strong>κ<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>α και η <strong>τ</strong>αχ<strong>υ</strong>κινη<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>α <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να <strong>αν</strong>α<strong>π</strong><strong>τ</strong><strong>υ</strong>χθούν<br />

για να <strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ρέψ<strong>ε</strong>ι η <strong>τ</strong>έλ<strong>ε</strong>ια λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργικό<strong>τ</strong>η<strong>τ</strong>α. Αφού <strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ρέψο<strong>υ</strong>ν, η<br />

<strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρό<strong>τ</strong>η<strong>τ</strong>α, η κινη<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>α και η µ<strong>υ</strong>ϊκή δύναµη και <strong>αν</strong><strong>τ</strong>οχή, η<br />

κιναι<strong>σ</strong>θη<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>α και η ιδιοδ<strong>ε</strong>κ<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>α µ<strong>π</strong>ορ<strong>ε</strong>ί να <strong>ε</strong><strong>π</strong><strong>αν</strong>έλθ<strong>ε</strong>ι µ<strong>ε</strong>ρικά,<br />

<strong>σ</strong><strong>ε</strong> µια <strong>π</strong>ρώ<strong>τ</strong>η φά<strong>σ</strong>η µ<strong>ε</strong> <strong>τ</strong>ο ξ<strong>ε</strong>κίνηµα <strong>τ</strong>ης <strong>π</strong>ρώιµης βάδι<strong>σ</strong>ης µ<strong>ε</strong> µ<strong>ε</strong>ρική<br />

φόρ<strong>τ</strong>ι<strong>σ</strong>η. Α<strong>υ</strong><strong>τ</strong>ό <strong>ε</strong><strong>π</strong>ι<strong>τ</strong>ρέ<strong>π</strong><strong>ε</strong>ι <strong>τ</strong>ην <strong>ε</strong><strong>π</strong><strong>αν</strong><strong>ε</strong>κ<strong>π</strong>αίδ<strong>ε</strong><strong>υ</strong><strong>σ</strong>η <strong>τ</strong>ων ιδιοϋ-<strong>π</strong>οδ<strong>ε</strong>κ<strong>τ</strong>ικών<br />

ν<strong>ε</strong><strong>υ</strong>ρο<strong>σ</strong><strong>υ</strong><strong>σ</strong><strong>τ</strong>ηµά<strong>τ</strong>ων µέ<strong>σ</strong>α και γύρω α<strong>π</strong>ό <strong>τ</strong>ο γόνα<strong>τ</strong>ο, αλλά και όλο <strong>τ</strong>ο<br />

<strong>υ</strong><strong>π</strong>όλοι<strong>π</strong>ο άκρο. Η κιναι<strong>σ</strong>θη<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ης βάδι<strong>σ</strong>ης µ<strong>π</strong>ορ<strong>ε</strong>ί να<br />

α<strong>π</strong>οκα<strong>τ</strong>α<strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ί <strong>αν</strong> και ό<strong>τ</strong><strong>αν</strong> α<strong>υ</strong><strong>τ</strong>ή <strong>ε</strong><strong>π</strong><strong>αν</strong><strong>ε</strong>γκα<strong>τ</strong>α<strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ί. Σ<strong>ε</strong> ένα <strong>π</strong>ρώ<strong>τ</strong>ο<br />

<strong>σ</strong><strong>τ</strong>άδιο, µ<strong>π</strong>ορ<strong>ε</strong>ί να µην <strong>ε</strong>ίναι κα<strong>τ</strong>άλληλο <strong>τ</strong>ο να <strong>ε</strong><strong>π</strong>ι<strong>τ</strong>ρα<strong>π</strong><strong>ε</strong>ί φόρ<strong>τ</strong>ι<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong><br />

<strong>π</strong>οδιού χωρίς <strong>π</strong><strong>ε</strong>ριορι<strong>σ</strong>µούς. Ω<strong>σ</strong><strong>τ</strong>ό<strong>σ</strong>ο, <strong>τ</strong>ο <strong>π</strong><strong>ε</strong>ρ<strong>π</strong>ά<strong>τ</strong>ηµα µ<strong>ε</strong> <strong>τ</strong>η βοήθ<strong>ε</strong>ια<br />

βακ<strong>τ</strong>ηριών, διαδρόµο<strong>υ</strong> βάδι<strong>σ</strong>ης, ή <strong>τ</strong>ης άνω<strong>σ</strong>ης <strong>π</strong>ο<strong>υ</strong> <strong>π</strong>αρέχ<strong>ε</strong><strong>τ</strong>αι α<strong>π</strong>ό<br />

<strong>τ</strong>ο ν<strong>ε</strong>ρό, <strong>π</strong>αρέχ<strong>ε</strong>ι <strong>τ</strong>ην α<strong>π</strong>αραί<strong>τ</strong>η<strong>τ</strong>η <strong>υ</strong><strong>π</strong>ο<strong>σ</strong><strong>τ</strong>ήριξη <strong>σ</strong><strong>τ</strong>ο άκρο και ακόµα<br />

θα <strong>ε</strong><strong>π</strong>ι<strong>τ</strong>ρέψ<strong>ε</strong>ι να <strong>αν</strong>α<strong>π</strong><strong>τ</strong><strong>υ</strong>χθ<strong>ε</strong>ί <strong>τ</strong>ο φ<strong>υ</strong><strong>σ</strong>ιολογικό κινη<strong>τ</strong>ικό <strong>π</strong>ρό<strong>τ</strong><strong>υ</strong><strong>π</strong>ο <strong>τ</strong>ης<br />

<strong>π</strong>ρω<strong>τ</strong>αρχικής α<strong>υ</strong><strong>τ</strong>ής κινη<strong>τ</strong>ικής λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργίας.

Α<strong>π</strong>ό <strong>τ</strong>ο <strong>π</strong><strong>ε</strong>ρ<strong>π</strong>ά<strong>τ</strong>ηµα, θα µ<strong>π</strong>ορού<strong>σ</strong><strong>ε</strong> κά<strong>π</strong>οιος να <strong>π</strong>ροχωρή<strong>σ</strong><strong>ε</strong>ι <strong>σ</strong><strong>ε</strong><br />

<strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρο <strong>π</strong>ολύ<strong>π</strong>λοκο<strong>υ</strong>ς <strong>τ</strong>ύ<strong>π</strong>ο<strong>υ</strong>ς α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ων, <strong>π</strong>ο<strong>υ</strong> <strong>αν</strong>α<strong>π</strong><strong>τ</strong>ύ<strong>σ</strong><strong>σ</strong>ο<strong>υ</strong>ν<br />

<strong>τ</strong>ην <strong>τ</strong>αχ<strong>υ</strong>κίνη<strong>σ</strong>η. Η <strong>τ</strong>αχ<strong>υ</strong>δ<strong>υ</strong>ναµική - <strong>τ</strong>αχ<strong>υ</strong>κινη<strong>τ</strong>ική <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>η, <strong>ε</strong>ίναι<br />

<strong>τ</strong>ο <strong>ε</strong><strong>π</strong>όµ<strong>ε</strong>νο βήµα µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό α<strong>υ</strong><strong>τ</strong>ό <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong>ρ<strong>ε</strong>ξίµα<strong>τ</strong>ος <strong>σ</strong><strong>ε</strong> <strong>ε</strong><strong>π</strong>ί<strong>π</strong><strong>ε</strong>δο ή <strong>σ</strong><strong>ε</strong><br />

<strong>αν</strong>ηφόρα - κα<strong>τ</strong>ηφόρα ή δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς <strong>π</strong>οδηλα<strong>τ</strong>ικού <strong>τ</strong>ύ<strong>π</strong>ο<strong>υ</strong>. Η <strong>τ</strong>αχ<strong>υ</strong>κινη<strong>τ</strong>ική<br />

<strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>η <strong>π</strong><strong>ε</strong>ριέχ<strong>ε</strong>ι <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρο <strong>π</strong>ολύ<strong>π</strong>λοκ<strong>ε</strong>ς κινη<strong>τ</strong>ικές<br />

δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς ό<strong>π</strong>ως <strong>σ</strong><strong>τ</strong>ροφές <strong>τ</strong>ο<strong>υ</strong> κορµού µ<strong>ε</strong> <strong>τ</strong>α <strong>π</strong>όδια <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρο<strong>π</strong>οιηµένα,<br />

ό<strong>π</strong>ως γίν<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ις α<strong>π</strong>ό<strong>τ</strong>οµ<strong>ε</strong>ς αλλαγές κα<strong>τ</strong><strong>ε</strong>ύθ<strong>υ</strong>ν<strong>σ</strong>ης ή<br />

<strong>σ</strong><strong>τ</strong>ο <strong>τ</strong>ρέξιµο <strong>σ</strong><strong>ε</strong> <strong>σ</strong><strong>τ</strong>ροφές. Α<strong>υ</strong><strong>τ</strong>ές οι δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς δίνο<strong>υ</strong>ν <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρη<br />

έµφα<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ην <strong>τ</strong>αχ<strong>υ</strong>κίνη<strong>σ</strong>η και ιδιοδ<strong>ε</strong>κ<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>α <strong>π</strong>αρά <strong>σ</strong><strong>τ</strong>ην µ<strong>υ</strong>ϊκή<br />

δύναµη και <strong>αν</strong><strong>τ</strong>οχή. Οι <strong>τ</strong>αχ<strong>υ</strong>κινη<strong>τ</strong>ικές α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις δίνο<strong>υ</strong>ν έµφα<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>η<br />

µ<strong>ε</strong><strong>τ</strong>αβολή <strong>τ</strong>ης <strong>τ</strong>αχύ<strong>τ</strong>η<strong>τ</strong>ας κίνη<strong>σ</strong>ης και <strong>σ</strong><strong>τ</strong>ις α<strong>π</strong>ό<strong>τ</strong>οµ<strong>ε</strong>ς αλλαγές κα<strong>τ</strong><strong>ε</strong>ύθ<strong>υ</strong>ν<strong>σ</strong>ης,<br />

έ<strong>τ</strong><strong>σ</strong>ι ώ<strong>σ</strong><strong>τ</strong><strong>ε</strong> να β<strong>ε</strong>λ<strong>τ</strong>ιωθ<strong>ε</strong>ί ο ν<strong>ε</strong><strong>υ</strong>ροµ<strong>υ</strong>ϊκός έλ<strong>ε</strong>γχος και οι<br />

ι<strong>σ</strong>ορρο-<strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ικές <strong>αν</strong><strong>τ</strong><strong>αν</strong>ακλα<strong>σ</strong><strong>τ</strong>ικές <strong>αν</strong><strong>τ</strong>ιδρά<strong>σ</strong><strong>ε</strong>ις. Το <strong>τ</strong>ρέξιµο <strong>σ</strong><strong>ε</strong> οχ<strong>τ</strong>άρι<br />

<strong>ε</strong>ίναι η <strong>π</strong>ιο ή<strong>π</strong>ια και <strong>ε</strong>ίναι <strong>π</strong>ιο <strong>ε</strong>ύκολη να <strong>π</strong>ραγµα<strong>τ</strong>ο<strong>π</strong>οιηθ<strong>ε</strong>ί α<strong>π</strong>ό<br />

α<strong>υ</strong><strong>τ</strong>ές <strong>τ</strong>ις µ<strong>αν</strong>ούβρ<strong>ε</strong>ς, ό<strong>τ</strong><strong>αν</strong> γίν<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>ε</strong> µια µ<strong>ε</strong>γάλη <strong>π</strong><strong>ε</strong>ριοχή, ό<strong>π</strong>ως <strong>ε</strong>ίναι<br />

ένα γή<strong>π</strong><strong>ε</strong>δο µ<strong>π</strong>ά<strong>σ</strong>κ<strong>ε</strong><strong>τ</strong>. Ω<strong>σ</strong><strong>τ</strong>ό<strong>σ</strong>ο, καθώς <strong>τ</strong>α οχ<strong>τ</strong>άρια γίνον<strong>τ</strong>αι µικρό<strong>τ</strong><strong>ε</strong>ρα,<br />

η ά<strong>σ</strong>κη<strong>σ</strong>η γίν<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>αδιακά δ<strong>υ</strong><strong>σ</strong>κολό<strong>τ</strong><strong>ε</strong>ρη. Σ<strong>ε</strong> µια <strong>π</strong>ροχωρηµένη<br />

φά<strong>σ</strong>η, <strong>τ</strong>ο οχ<strong>τ</strong>άρι µ<strong>π</strong>ορ<strong>ε</strong>ί να <strong>αν</strong><strong>τ</strong>ικα<strong>τ</strong>α<strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ί α<strong>π</strong>ό α<strong>π</strong>ό<strong>τ</strong>οµ<strong>ε</strong>ς<br />

αλλαγές κα<strong>τ</strong><strong>ε</strong>ύθ<strong>υ</strong>ν<strong>σ</strong>ης κα<strong>τ</strong>ά 90° ή α<strong>π</strong>ό <strong>τ</strong>ρέξιµο µέ<strong>σ</strong>α και έξω α<strong>π</strong>ό<br />

κολών<strong>ε</strong>ς, ό<strong>π</strong>ως γίν<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ις κούρ<strong>σ</strong><strong>ε</strong>ς <strong>σ</strong>λάλοµ. Το <strong>π</strong>λάγιο <strong>τ</strong>ρέξιµο µ<strong>ε</strong><br />

δια<strong>σ</strong><strong>τ</strong>αύρω<strong>σ</strong>η <strong>τ</strong>ων <strong>π</strong>οδιών, <strong>ε</strong>ίναι <strong>ε</strong><strong>π</strong>ί<strong>σ</strong>ης <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικό για <strong>τ</strong>ην <strong>αν</strong>ά<strong>π</strong><strong>τ</strong><strong>υ</strong>ξη<br />

<strong>τ</strong>ης κιναι<strong>σ</strong>θη<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>ας <strong>τ</strong>ο<strong>υ</strong> κά<strong>τ</strong>ω άκρο<strong>υ</strong>. Τ<strong>ε</strong>λικά, η <strong>τ</strong>αχ<strong>υ</strong>κίνη<strong>σ</strong>η<br />

θα <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να <strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ιο<strong>π</strong>οιηθ<strong>ε</strong>ί µ<strong>ε</strong> αλ<strong>τ</strong>ικές κινή<strong>σ</strong><strong>ε</strong>ις και <strong>τ</strong>έλος µ<strong>ε</strong> α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις<br />

<strong>τ</strong>ρ<strong>ε</strong>ξίµα<strong>τ</strong>ος µ<strong>ε</strong> α<strong>π</strong>ό<strong>τ</strong>οµα ξ<strong>ε</strong>κινήµα<strong>τ</strong>α - <strong>σ</strong><strong>τ</strong>αµα<strong>τ</strong>ήµα<strong>τ</strong>α, καθώς και<br />

µ<strong>ε</strong> <strong>σ</strong><strong>π</strong>ριν<strong>τ</strong>. Η αλ<strong>τ</strong>ική <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>η <strong>π</strong><strong>ε</strong>ριέχ<strong>ε</strong>ι µια µ<strong>ε</strong>γάλη γκάµα α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ων<br />

βα<strong>σ</strong>ικό<strong>τ</strong><strong>ε</strong>ρ<strong>ε</strong>ς α<strong>π</strong>ό <strong>τ</strong>ις ο<strong>π</strong>οί<strong>ε</strong>ς <strong>ε</strong>ίναι οι <strong>π</strong>λ<strong>ε</strong>ιοµ<strong>ε</strong><strong>τ</strong>ρικές. Οι <strong>π</strong>λ<strong>ε</strong>ιο-<br />

µ<strong>ε</strong><strong>τ</strong>ρικές α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις γίνον<strong>τ</strong>αι µ<strong>ε</strong> <strong>π</strong>έ<strong>σ</strong>ιµο α<strong>π</strong>ό ένα ύψος 30 - 60οιη και<br />

<strong>π</strong>ρο<strong>σ</strong>γ<strong>ε</strong>ίω<strong>σ</strong>η <strong>τ</strong>ύ<strong>π</strong>ο<strong>υ</strong> ηµικαθί<strong>σ</strong>µα-<strong>τ</strong>ος, µ<strong>ε</strong> άµ<strong>ε</strong><strong>σ</strong>η µ<strong>υ</strong>ϊκή <strong>αν</strong><strong>τ</strong>ίδρα<strong>σ</strong>η

µ<strong>ε</strong>ιοµ<strong>ε</strong><strong>τ</strong>ρικού <strong>τ</strong>ώρα <strong>τ</strong>ύ<strong>π</strong>ο<strong>υ</strong>, <strong>π</strong>ο<strong>υ</strong> α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί ένα νέο άλµα <strong>σ</strong><strong>ε</strong> ύψος ή<br />

<strong>σ</strong><strong>ε</strong> µήκος. Α<strong>υ</strong><strong>τ</strong>ή η δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong>α α<strong>π</strong>αι<strong>τ</strong><strong>ε</strong>ί µια µαζική, µ<strong>ε</strong>ιοµ<strong>ε</strong><strong>τ</strong>ρική<br />

<strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong> µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό µια βίαιη <strong>π</strong>λ<strong>ε</strong>ιοµ<strong>ε</strong><strong>τ</strong>ρική <strong>ε</strong><strong>π</strong>ιβραδ<strong>υ</strong>ν<strong>τ</strong>ική<br />

<strong>ε</strong>ν<strong>ε</strong>ργο<strong>π</strong>οίη<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong>, κα<strong>τ</strong>ά <strong>τ</strong>ο διά<strong>σ</strong><strong>τ</strong>ηµα <strong>τ</strong>ης <strong>π</strong>ρο<strong>σ</strong>γ<strong>ε</strong>ίω<strong>σ</strong>ης.<br />

Η αρχή <strong>π</strong>ο<strong>υ</strong> <strong>ε</strong>µ<strong>π</strong>λέκ<strong>ε</strong><strong>τ</strong>αι <strong>ε</strong>δώ, δ<strong>ε</strong>ν <strong>ε</strong>ίναι διαφορ<strong>ε</strong><strong>τ</strong>ική α<strong>π</strong>' α<strong>υ</strong><strong>τ</strong>ή<br />

<strong>τ</strong>ης ΡΝΡ, κα<strong>τ</strong>ά <strong>τ</strong>ην ο<strong>π</strong>οία, η β<strong>ε</strong>λ<strong>τ</strong>ίω<strong>σ</strong>η <strong>τ</strong>ης µ<strong>υ</strong>ϊκής δύναµης και <strong>τ</strong>ο<strong>υ</strong><br />

<strong>ε</strong>ν<strong>ε</strong>ργη<strong>τ</strong>ικού <strong>ε</strong>ύρο<strong>υ</strong>ς κίνη<strong>σ</strong>ης <strong>ε</strong><strong>π</strong>ι<strong>τ</strong><strong>υ</strong>γχάν<strong>ε</strong><strong>τ</strong>αι µ<strong>ε</strong> ένα <strong>τ</strong>ρό<strong>π</strong>ο, κα<strong>τ</strong>ά <strong>τ</strong>ον<br />

ο<strong>π</strong>οίο <strong>ε</strong>ναλλά<strong>σ</strong><strong>σ</strong>ον<strong>τ</strong>αι κάµψη ή έκ<strong>τ</strong>α<strong>σ</strong>η, µ<strong>ε</strong> <strong>αν</strong><strong>τ</strong>ί<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η µ<strong>ε</strong> <strong>ε</strong>λ<strong>ε</strong>ύθ<strong>ε</strong>ρ<strong>ε</strong>ς<br />

<strong>ε</strong>ν<strong>ε</strong>ργη<strong>τ</strong>ικές <strong>ε</strong>κ<strong>τ</strong>ά<strong>σ</strong><strong>ε</strong>ις ή κάµψ<strong>ε</strong>ις. Όλ<strong>ε</strong>ς οι <strong>τ</strong><strong>ε</strong>λ<strong>ε</strong><strong>υ</strong><strong>τ</strong>αί<strong>ε</strong>ς α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις <strong>π</strong>ο<strong>υ</strong><br />

<strong>αν</strong>αφέρθηκ<strong>αν</strong>, χρ<strong>ε</strong>ιάζον<strong>τ</strong>αι <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ρο ν<strong>ε</strong><strong>υ</strong>ροµ<strong>υ</strong>ϊκό έλ<strong>ε</strong>γχο και <strong>τ</strong>ην<br />

καλύ<strong>τ</strong><strong>ε</strong>ρη α<strong>υ</strong><strong>τ</strong>ο<strong>π</strong><strong>ε</strong><strong>π</strong>οίθη<strong>σ</strong>η α<strong>π</strong>ό <strong>τ</strong>ον άρρω<strong>σ</strong><strong>τ</strong>ο, <strong>σ</strong><strong>ε</strong> <strong>σ</strong>χέ<strong>σ</strong>η µα κάθ<strong>ε</strong><br />

άλλο<strong>υ</strong> <strong>τ</strong>ύ<strong>π</strong>ο<strong>υ</strong> <strong>τ</strong>αχ<strong>υ</strong>δ<strong>υ</strong>ναµική ά<strong>σ</strong>κη<strong>σ</strong>η, και χρη<strong>σ</strong>ιµο<strong>π</strong>οιούν<strong>τ</strong>αι µόνο<br />

<strong>σ</strong><strong>τ</strong>ο <strong>τ</strong><strong>ε</strong>λικό <strong>σ</strong><strong>τ</strong>άδιο α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης για <strong>π</strong>ροχωρηµένη <strong>τ</strong>αχ<strong>υ</strong>δ<strong>υ</strong>ναµική -<br />

<strong>τ</strong>αχ<strong>υ</strong>κινη<strong>τ</strong>ική <strong>αν</strong>ά<strong>π</strong><strong>τ</strong><strong>υ</strong>ξη. Αν κα<strong>τ</strong>ά <strong>τ</strong>ις α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις α<strong>υ</strong><strong>τ</strong>ές, ο άρρω<strong>σ</strong><strong>τ</strong>ος έχ<strong>ε</strong>ι<br />

<strong>τ</strong>ην αί<strong>σ</strong>θη<strong>σ</strong>η ό<strong>τ</strong>ι <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να <strong>τ</strong>ις <strong>π</strong>ραγµα<strong>τ</strong>ο<strong>π</strong>οι<strong>ε</strong>ί µ<strong>ε</strong> <strong>τ</strong>ην <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδα<br />

<strong>τ</strong>ό<strong>τ</strong><strong>ε</strong> δ<strong>ε</strong>ν έχ<strong>ε</strong>ι φ<strong>τ</strong>ά<strong>σ</strong><strong>ε</strong>ι <strong>σ</strong><strong>τ</strong>α <strong>ε</strong><strong>π</strong>ιθ<strong>υ</strong>µη<strong>τ</strong>ά <strong>ε</strong><strong>π</strong>ί<strong>π</strong><strong>ε</strong>δα α<strong>υ</strong><strong>τ</strong>ο<strong>π</strong><strong>ε</strong><strong>π</strong>οίθη<strong>σ</strong>ης. Η<br />

ιδιοδ<strong>ε</strong>κ<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>α και η <strong>τ</strong>αχ<strong>υ</strong>κινη<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>α µ<strong>π</strong>ορούν να <strong>π</strong>ροαχθούν<br />

µέ<strong>σ</strong>α α<strong>π</strong>ό <strong>τ</strong>ην <strong>ε</strong><strong>π</strong>ι<strong>π</strong>ρό<strong>σ</strong>θ<strong>ε</strong><strong>τ</strong>η αι<strong>σ</strong>θη<strong>τ</strong>ική <strong>τ</strong>ροφοδό<strong>τ</strong>η<strong>σ</strong>η και <strong>τ</strong>η <strong>σ</strong><strong>τ</strong>α<strong>τ</strong>ική<br />

<strong>υ</strong><strong>π</strong>ο<strong>σ</strong><strong>τ</strong>ήριξη <strong>π</strong>ο<strong>υ</strong> <strong>π</strong>αρέχ<strong>ε</strong>ι η <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδα. Μ<strong>ε</strong> ή χωρίς <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδα, η<br />

<strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong> γονά<strong>τ</strong>ο<strong>υ</strong> κα<strong>τ</strong>ά <strong>τ</strong>ις δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς <strong>ε</strong>ίναι α<strong>υ</strong><strong>τ</strong>ή <strong>π</strong>ο<strong>υ</strong><br />

<strong>π</strong>ροωθ<strong>ε</strong>ί <strong>τ</strong>ην α<strong>υ</strong><strong>τ</strong>ο<strong>π</strong><strong>ε</strong><strong>π</strong>οίθη<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> αρρώ<strong>σ</strong><strong>τ</strong>ο<strong>υ</strong> για <strong>τ</strong>ις κινη<strong>τ</strong>ικές <strong>τ</strong>ο<strong>υ</strong><br />

δ<strong>υ</strong>να<strong>τ</strong>ό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς.<br />

8. ΕΞΕΛΙΞΗ ΣΤΟ ΠΡΟΓΡΑΜΜΑ ΑΠΟΚΑΤΑΣΤΑΣΗΣ<br />

Η <strong>π</strong>ροοδ<strong>ε</strong><strong>υ</strong><strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>α κα<strong>τ</strong>ά <strong>τ</strong>η µ<strong>ε</strong><strong>τ</strong>άβα<strong>σ</strong>η α<strong>π</strong>ό <strong>τ</strong>η µια δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong>α<br />

<strong>σ</strong><strong>τ</strong>ην άλλη, <strong>ε</strong>ξαρ<strong>τ</strong>ά<strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ην <strong>αν</strong><strong>τ</strong>α<strong>π</strong>όκρι<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> α<strong>σ</strong>θ<strong>ε</strong>νή <strong>σ</strong><strong>τ</strong>ην <strong>π</strong>ροηγούµ<strong>ε</strong>νη<br />

δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong>α. Αν, <strong>π</strong>.χ. οι <strong>υ</strong><strong>π</strong>ο<strong>τ</strong>ρο<strong>π</strong>ιάζο<strong>υ</strong><strong>σ</strong><strong>ε</strong>ς αρθρικές<br />

διογκώ<strong>σ</strong><strong>ε</strong>ις, ο <strong>π</strong>όνος και η αδ<strong>υ</strong>ναµία <strong>ε</strong><strong>π</strong>ιµένο<strong>υ</strong>ν µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό µια α<strong>π</strong>λή<br />

δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong>α, ό<strong>π</strong>ως <strong>ε</strong>ίναι οι α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις <strong>ε</strong>ν<strong>ε</strong>ργη<strong>τ</strong>ικού <strong>ε</strong>ύρο<strong>υ</strong>ς κίνη-

<strong>σ</strong>ης, <strong>τ</strong>ό<strong>τ</strong><strong>ε</strong> η µ<strong>ε</strong><strong>τ</strong>άβα<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ο <strong>π</strong>οδήλα<strong>τ</strong>ο <strong>ε</strong>ίναι µά<strong>τ</strong>αιη, <strong>ε</strong><strong>π</strong><strong>ε</strong>ιδή <strong>τ</strong>α <strong>σ</strong><strong>υ</strong>-<br />

µ<strong>π</strong><strong>τ</strong>ώµα<strong>τ</strong>α θα <strong>ε</strong><strong>π</strong>ι<strong>τ</strong>αθούν, µ<strong>ε</strong> <strong>π</strong>ολύ µικρά κέρδη <strong>σ</strong><strong>τ</strong>ην α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η.<br />

Έ<strong>τ</strong><strong>σ</strong>ι, <strong>ε</strong>ίναι α<strong>π</strong>αραί<strong>τ</strong>η<strong>τ</strong>ο να αξιολογούµ<strong>ε</strong> κάθ<strong>ε</strong> δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong>α <strong>π</strong>ριν<br />

<strong>π</strong>ροχωρή<strong>σ</strong>ο<strong>υ</strong>µ<strong>ε</strong> <strong>σ</strong><strong>ε</strong> µια δ<strong>υ</strong><strong>σ</strong>κολό<strong>τ</strong><strong>ε</strong>ρη και φορ<strong>τ</strong>ικό<strong>τ</strong><strong>ε</strong>ρη δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong>α.<br />

Κα<strong>τ</strong>ά <strong>τ</strong>ην <strong>υ</strong>λο<strong>π</strong>οίη<strong>σ</strong>η <strong>ε</strong>νός <strong>π</strong>ρογράµµα<strong>τ</strong>ος α<strong>π</strong>οκα<strong>τ</strong>ά<strong>τ</strong>α-<strong>σ</strong>ης, δ<strong>ε</strong> θα <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι<br />

κά<strong>π</strong>οιος να <strong>π</strong><strong>ε</strong>ριορίζ<strong>ε</strong><strong>τ</strong>αι µόνο <strong>σ</strong><strong>τ</strong>α χρονικά όρια. Θα <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να <strong>υ</strong><strong>π</strong>άρχ<strong>ε</strong>ι<br />

<strong>τ</strong>αχ<strong>τ</strong>ική <strong>ε</strong><strong>π</strong><strong>αν</strong>αξιολόγη<strong>σ</strong>η <strong>τ</strong>ης <strong>π</strong>ροοδ<strong>ε</strong><strong>υ</strong><strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>ας, <strong>τ</strong>ης <strong>ε</strong><strong>π</strong>ούλω<strong>σ</strong>ης και<br />

<strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ιθ<strong>αν</strong>ού <strong>ε</strong><strong>π</strong><strong>αν</strong>α<strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µού, καθώς <strong>ε</strong><strong>π</strong>ί<strong>σ</strong>ης και <strong>τ</strong>ης<br />

µ<strong>ε</strong><strong>τ</strong>αγχ<strong>ε</strong>ιρη<strong>τ</strong>ικής <strong>π</strong>ορ<strong>ε</strong>ίας, για να καθορί<strong>σ</strong><strong>ε</strong>ι <strong>τ</strong>ο χρόνο και <strong>τ</strong>ην<br />

κα<strong>τ</strong>αλληλό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ης µ<strong>ε</strong><strong>τ</strong>άβα<strong>σ</strong>ης <strong>σ</strong><strong>ε</strong> δ<strong>υ</strong><strong>σ</strong>κολό<strong>τ</strong><strong>ε</strong>ρη δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong>α. Α<strong>υ</strong><strong>τ</strong>ή η<br />

<strong>ε</strong><strong>π</strong><strong>αν</strong>αξιολόγη<strong>σ</strong>η <strong>τ</strong>ης <strong>π</strong>ροόδο<strong>υ</strong> και <strong>τ</strong>ης <strong>ε</strong><strong>π</strong>ούλω<strong>σ</strong>ης θα <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να γίν<strong>ε</strong><strong>τ</strong>αι<br />

<strong>σ</strong><strong>υ</strong>χνά κα<strong>τ</strong>ά <strong>τ</strong>ο<strong>υ</strong>ς <strong>π</strong>ρώ<strong>τ</strong>ο<strong>υ</strong>ς 3 -4 µήν<strong>ε</strong>ς µ<strong>ε</strong><strong>τ</strong>ά <strong>τ</strong>ην <strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ική <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong><br />

χια<strong>σ</strong><strong>τ</strong>ού <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>.<br />

9. ΒΑΣΙΚΑ ΠΡΟΒΛΗΜΑΤΑ ΣΤΟ ΣΤΑ∆ΙΟ ΤΗΣ ΑΠΟΚΑΤΑ-ΣΤΑΣΗΣ<br />

Τα βα<strong>σ</strong>ικά κλινικά <strong>π</strong>ροβλήµα<strong>τ</strong>α <strong>π</strong>ο<strong>υ</strong> µ<strong>π</strong>ορούν να <strong>π</strong>ροκύψο<strong>υ</strong>ν κα<strong>τ</strong>ά <strong>τ</strong>ην<br />

α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η, µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό <strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ική <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού, <strong>ε</strong>ίναι α<strong>υ</strong><strong>τ</strong>ά <strong>τ</strong>ο<strong>υ</strong><br />

<strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδοµηριαίο<strong>υ</strong> <strong>π</strong>όνο<strong>υ</strong> και <strong>τ</strong>ης <strong>τ</strong><strong>ε</strong>νον<strong>τ</strong>ί<strong>τ</strong>ιδας <strong>τ</strong>ο<strong>υ</strong> <strong>ε</strong><strong>π</strong>ι-γονα<strong>τ</strong>ιδικού<br />

<strong>τ</strong>ένον<strong>τ</strong>α.<br />

Η <strong>τ</strong><strong>ε</strong>νον<strong>τ</strong>ί<strong>τ</strong>ιδα φαίν<strong>ε</strong><strong>τ</strong>αι να <strong>ε</strong>ίναι <strong>τ</strong>ο <strong>π</strong>ιο κοινό <strong>π</strong>ρόβληµα <strong>σ</strong><strong>τ</strong>ην α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η<br />

και µ<strong>π</strong>ορ<strong>ε</strong>ί να <strong>σ</strong>χ<strong>ε</strong><strong>τ</strong>ίζ<strong>ε</strong><strong>τ</strong>αι µ<strong>ε</strong> <strong>τ</strong>ο ζήλο µ<strong>ε</strong> <strong>τ</strong>ον ο<strong>π</strong>οίο <strong>τ</strong>ο ά<strong>τ</strong>οµο<br />

<strong>π</strong>ρο<strong>σ</strong><strong>ε</strong>γγίζ<strong>ε</strong>ι <strong>τ</strong>ην α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η, αλλά <strong>ε</strong><strong>π</strong>ί<strong>σ</strong>ης και µ<strong>ε</strong> <strong>τ</strong>ις θέ<strong>σ</strong><strong>ε</strong>ις και <strong>τ</strong>ο<strong>υ</strong>ς<br />

<strong>τ</strong>ύ<strong>π</strong>ο<strong>υ</strong>ς δρα<strong>σ</strong><strong>τ</strong>ηριο<strong>τ</strong>ή<strong>τ</strong>ων <strong>π</strong>ο<strong>υ</strong> <strong>ε</strong><strong>π</strong>ιβάλλον<strong>τ</strong>αι. Παρόλο <strong>π</strong>ο<strong>υ</strong> φαίν<strong>ε</strong><strong>τ</strong>αι ό<strong>τ</strong>ι οι<br />

<strong>π</strong>λ<strong>ε</strong>ιοµ<strong>ε</strong><strong>τ</strong>ρικές <strong>σ</strong><strong>υ</strong><strong>σ</strong><strong>π</strong>ά<strong>σ</strong><strong>ε</strong>ις δ<strong>ε</strong>ν <strong>π</strong>ρο<strong>σ</strong>φέρο<strong>υ</strong>ν κ<strong>αν</strong>ένα <strong>π</strong>λ<strong>ε</strong>ονέκ<strong>τ</strong>ηµα<br />

α<strong>π</strong>έν<strong>αν</strong><strong>τ</strong>ι <strong>σ</strong><strong>τ</strong>ις µ<strong>ε</strong>ιοµ<strong>ε</strong><strong>τ</strong>ρικές, <strong>σ</strong><strong>ε</strong> <strong>σ</strong>χέ<strong>σ</strong>η µ<strong>ε</strong> <strong>τ</strong>ην <strong>αν</strong>ά<strong>π</strong><strong>τ</strong><strong>υ</strong>ξη <strong>τ</strong>ης µ<strong>υ</strong>ϊκής<br />

δύναµης <strong>σ</strong><strong>υ</strong>γκ<strong>ε</strong>κριµένων µ<strong>υ</strong>ϊκών οµάδων, ιδιαί<strong>τ</strong><strong>ε</strong>ρα <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong>ρακέφαλο<strong>υ</strong>,<br />

κάνο<strong>υ</strong>ν µικρό<strong>τ</strong><strong>ε</strong>ρο <strong>τ</strong>ο φορ<strong>τ</strong>ίο <strong>π</strong>άνω <strong>σ</strong><strong>τ</strong>ον <strong>ε</strong><strong>π</strong>ιγο-να<strong>τ</strong>ιδικό <strong>τ</strong>ένον<strong>τ</strong>α,<br />

<strong>π</strong><strong>ε</strong>ριορίζον<strong>τ</strong>ας έ<strong>τ</strong><strong>σ</strong>ι <strong>τ</strong>ην <strong>π</strong>ιθ<strong>αν</strong>ό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong><strong>ε</strong>νον<strong>τ</strong>ί<strong>τ</strong>ιδας.<br />

Ο <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδοµηριαίος <strong>π</strong>όνος <strong>ε</strong>ίναι και α<strong>υ</strong><strong>τ</strong>ός <strong>π</strong>ολύ κοινό<strong>τ</strong><strong>υ</strong><strong>π</strong>η

<strong>ε</strong><strong>π</strong>ι<strong>π</strong>λοκή µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό <strong>σ</strong><strong>υ</strong>νδ<strong>ε</strong><strong>σ</strong>µο<strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ικές. Α<strong>π</strong>οδίδ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ις <strong>π</strong>ολύ µ<strong>ε</strong>γάλ<strong>ε</strong>ς<br />

δ<strong>υ</strong>νάµ<strong>ε</strong>ις <strong>π</strong>ο<strong>υ</strong> µ<strong>π</strong>ορ<strong>ε</strong>ί να <strong>αν</strong><strong>π</strong><strong>τ</strong>ύ<strong>σ</strong><strong>σ</strong>ον<strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ην <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδοµηριαία<br />

άρρθω<strong>σ</strong>η, <strong>ε</strong>ί<strong>τ</strong><strong>ε</strong> α<strong>π</strong>ό <strong>τ</strong>ην <strong>ε</strong><strong>π</strong>ιµονή <strong>σ</strong><strong>ε</strong> α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις <strong>π</strong>ο<strong>υ</strong> <strong>υ</strong><strong>π</strong>οβάλλο<strong>υ</strong>ν<br />

<strong>τ</strong>ον <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο <strong>σ</strong><strong>ε</strong> <strong>αν</strong>ά<strong>π</strong><strong>τ</strong><strong>υ</strong>ξη ψηλής <strong>τ</strong>ά<strong>σ</strong>ης <strong>σ</strong><strong>ε</strong> γωνί<strong>ε</strong>ς κάµψης <strong>τ</strong>ο<strong>υ</strong><br />

γόνα<strong>τ</strong>ος <strong>π</strong>άνω α<strong>π</strong>ό 60°, <strong>ε</strong>ί<strong>τ</strong><strong>ε</strong> α<strong>π</strong>ό <strong>τ</strong>η µη δρα<strong>σ</strong><strong>τ</strong>ηριο<strong>π</strong>οίη<strong>σ</strong>η <strong>τ</strong>ης<br />

<strong>π</strong>αράλληλης <strong>σ</strong><strong>υ</strong> - <strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>ης <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong> -ι<strong>σ</strong>χιοκνηµιαίων κα<strong>τ</strong>ά <strong>τ</strong>ις<br />

δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς <strong>αν</strong>οικ<strong>τ</strong>ής αλ<strong>υ</strong><strong>σ</strong>ίδας <strong>σ</strong><strong>ε</strong> α<strong>π</strong>οµονωµέν<strong>ε</strong>ς αρθρώ<strong>σ</strong><strong>ε</strong>ις. Ο<br />

<strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδοµηριαίος <strong>π</strong>όνος, <strong>π</strong>ηγαίν<strong>ε</strong>ι <strong>π</strong>ί<strong>σ</strong>ω <strong>τ</strong>ο <strong>π</strong>ρόγραµµα<br />

α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης για<strong>τ</strong>ί <strong>π</strong><strong>ε</strong>ριορίζ<strong>ε</strong>ι <strong>τ</strong>ην ικ<strong>αν</strong>ό<strong>τ</strong>η<strong>τ</strong>α <strong>π</strong>αραγωγής<br />

ικ<strong>αν</strong>ο<strong>π</strong>οιη<strong>τ</strong>ικού <strong>π</strong>ο<strong>σ</strong>ού <strong>τ</strong>ά<strong>σ</strong>ης <strong>σ</strong><strong>τ</strong>ον <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο, <strong>π</strong>ράγµα <strong>π</strong>ο<strong>υ</strong> α<strong>π</strong>ο<strong>τ</strong>ρέ<strong>π</strong><strong>ε</strong>ι<br />

<strong>τ</strong>ην <strong>π</strong>λήρη µ<strong>υ</strong>ϊκή <strong>αν</strong>ά<strong>π</strong><strong>τ</strong><strong>υ</strong>ξη ή και <strong>τ</strong>ο <strong>π</strong>λήρ<strong>ε</strong>ς <strong>ε</strong>ύρος κίνη<strong>σ</strong>ης. Η<br />

<strong>αν</strong><strong>τ</strong>ιµ<strong>ε</strong><strong>τ</strong>ώ<strong>π</strong>ι<strong>σ</strong>η α<strong>υ</strong><strong>τ</strong>ής <strong>τ</strong>ης δια<strong>τ</strong>αραχής µέχρι <strong>τ</strong>ώρα, έχ<strong>ε</strong>ι <strong>π</strong>αραδο<strong>σ</strong>ιακά<br />

<strong>π</strong><strong>ε</strong>ριλάβ<strong>ε</strong>ι µόνο α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις <strong>σ</strong><strong>ε</strong> α<strong>π</strong>οµονωµέν<strong>ε</strong>ς αρθρώ<strong>σ</strong><strong>ε</strong>ις (<strong>σ</strong><strong>ε</strong><strong>τ</strong><br />

<strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong> και µικρού <strong>τ</strong>όξο<strong>υ</strong> έκ<strong>τ</strong>α<strong>σ</strong>ης), <strong>π</strong>ράγµα <strong>π</strong>ο<strong>υ</strong> µ<strong>π</strong>ορ<strong>ε</strong>ί να<br />

<strong>ε</strong>ξηγή<strong>σ</strong><strong>ε</strong>ι για<strong>τ</strong>ί <strong>τ</strong>ό<strong>σ</strong><strong>ε</strong>ς <strong>π</strong>ολλές α<strong>π</strong>' α<strong>υ</strong><strong>τ</strong>ές <strong>τ</strong>ις <strong>π</strong><strong>ε</strong>ρι<strong>π</strong><strong>τ</strong>ώ<strong>σ</strong><strong>ε</strong>ις <strong>ε</strong>ίναι <strong>αν</strong><strong>ε</strong><strong>π</strong>ίδ<strong>ε</strong>κ<strong>τ</strong><strong>ε</strong>ς<br />

θ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong>ί<strong>ε</strong>ς. Οι α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις κλ<strong>ε</strong>ι<strong>σ</strong><strong>τ</strong>ής κινη<strong>τ</strong>ικής αλ<strong>υ</strong><strong>σ</strong>ίδας, µ<strong>π</strong>ορούν<br />

να <strong>π</strong>αίξο<strong>υ</strong>ν ένα βα<strong>σ</strong>ικό ρόλο <strong>σ</strong><strong>τ</strong>η θ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong>ία και <strong>τ</strong>ην <strong>π</strong>ρόληψη <strong>τ</strong>ο<strong>υ</strong><br />

<strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ιδοµηριαίο<strong>υ</strong> <strong>π</strong>όνο<strong>υ</strong>, µαζί φ<strong>υ</strong><strong>σ</strong>ικά και µ<strong>ε</strong> <strong>τ</strong>α άλλα διαθέ<strong>σ</strong>ιµα<br />

µέ<strong>σ</strong>α κα<strong>τ</strong>α<strong>σ</strong><strong>τ</strong>ολής <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>όνο<strong>υ</strong> ( <strong>π</strong>αγοθ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong>ία - θ<strong>ε</strong>ρµοθ<strong>ε</strong>-ρα<strong>π</strong><strong>ε</strong>ία -<br />

διαδ<strong>ε</strong>ρµα<strong>τ</strong>ικό ηλ<strong>ε</strong>κ<strong>τ</strong>ρικό ν<strong>ε</strong><strong>υ</strong>ρικό <strong>ε</strong>ρ<strong>ε</strong>θι<strong>σ</strong>µό κ.α.).<br />

10. ΝΑΡΘΗΚΕΣ<br />

Ο ρόλος <strong>τ</strong>ης χρή<strong>σ</strong>ης ναρθήκων µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό <strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ική <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong><br />

χια<strong>σ</strong><strong>τ</strong>ού, α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί <strong>π</strong>ολύ <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ικό θέµα <strong>τ</strong>ο ο<strong>π</strong>οίο <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να <strong>σ</strong><strong>υ</strong>ζη<strong>τ</strong>ηθ<strong>ε</strong>ί.<br />

Υ<strong>π</strong>άρχο<strong>υ</strong>ν <strong>τ</strong>ρ<strong>ε</strong>ις βα<strong>σ</strong>ικές κα<strong>τ</strong>ηγορί<strong>ε</strong>ς <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδων, <strong>π</strong>ο<strong>υ</strong> χρη<strong>σ</strong>ι-<br />

µο<strong>π</strong>οιούν<strong>τ</strong>αι <strong>σ</strong>ήµ<strong>ε</strong>ρα. Οι <strong>π</strong>ροφ<strong>υ</strong>λακ<strong>τ</strong>ικές <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδ<strong>ε</strong>ς <strong>σ</strong>χ<strong>ε</strong>διάζον<strong>τ</strong>αι για<br />

να α<strong>π</strong>ο<strong>τ</strong>ρέ<strong>π</strong>ο<strong>υ</strong>ν ή να <strong>π</strong><strong>ε</strong>ριορί<strong>σ</strong>ο<strong>υ</strong>ν <strong>τ</strong>η <strong>σ</strong>οβαρό<strong>τ</strong>η<strong>τ</strong>α <strong>ε</strong>νός <strong>τ</strong>ραύµα-

<strong>τ</strong>ι<strong>σ</strong>µού <strong>σ</strong><strong>τ</strong>ο γόνα<strong>τ</strong>ο. Οι <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδ<strong>ε</strong>ς α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης <strong>π</strong>ρο<strong>τ</strong>ίθ<strong>ε</strong>ν<strong>τ</strong>αι<br />

να <strong>ε</strong><strong>π</strong>ι<strong>τ</strong>ρέψο<strong>υ</strong>ν <strong>π</strong>ρο<strong>σ</strong><strong>τ</strong>α<strong>τ</strong><strong>ε</strong><strong>υ</strong>µένη κίνη<strong>σ</strong>η <strong>σ</strong><strong>ε</strong> <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µένα γόνα<strong>τ</strong>α<br />

<strong>π</strong>ο<strong>υ</strong> <strong>αν</strong><strong>τ</strong>ιµ<strong>ε</strong><strong>τ</strong>ω<strong>π</strong>ί<strong>σ</strong><strong>τ</strong>ηκ<strong>αν</strong> χ<strong>ε</strong>ιρο<strong>υ</strong>ργικά ή µη. Οι λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργικές <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδ<strong>ε</strong>ς<br />

<strong>π</strong>ρο<strong>σ</strong><strong>π</strong>αθούν να <strong>π</strong>ρο<strong>σ</strong>δώ<strong>σ</strong>ο<strong>υ</strong>ν <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρό<strong>τ</strong>η<strong>τ</strong>α <strong>σ</strong><strong>ε</strong> α<strong>σ</strong><strong>τ</strong>αθή γόνα<strong>τ</strong>α<br />

κα<strong>τ</strong>ά <strong>τ</strong>η διάρκ<strong>ε</strong>ια φορ<strong>τ</strong>ικών δρα<strong>σ</strong><strong>τ</strong>ηριο<strong>τ</strong>ή<strong>τ</strong>ων.<br />

Οι <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>σ</strong>ό<strong>τ</strong><strong>ε</strong>ροι χ<strong>ε</strong>ιρούργοι θα χρη<strong>σ</strong>ιµο<strong>π</strong>οιή<strong>σ</strong>ο<strong>υ</strong>ν αµέ<strong>σ</strong>ως µ<strong>ε</strong><strong>τ</strong>ά<br />

<strong>τ</strong>ο χ<strong>ε</strong>ιρο<strong>υ</strong>ργ<strong>ε</strong>ίο µια <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδα α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης, η ο<strong>π</strong>οία <strong>ε</strong><strong>π</strong>ι<strong>τ</strong>ρέ<strong>π</strong><strong>ε</strong>ι<br />

ένα <strong>π</strong><strong>ε</strong>ριορι<strong>σ</strong>µένο <strong>π</strong>ο<strong>σ</strong>ό κινη<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>ας. Μ<strong>ε</strong>ρικές <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδ<strong>ε</strong>ς έχο<strong>υ</strong>ν<br />

<strong>τ</strong>ην δ<strong>υ</strong>να<strong>τ</strong>ό<strong>τ</strong>η<strong>τ</strong>α µ<strong>ε</strong><strong>τ</strong>αβαλλόµ<strong>ε</strong>νο<strong>υ</strong> <strong>π</strong><strong>ε</strong>ριορι<strong>σ</strong>µού <strong>τ</strong>ης κάµψης και έ-<br />

κ<strong>τ</strong>α<strong>σ</strong>ης µ<strong>ε</strong> κα<strong>τ</strong>άλληλο γωνιοµ<strong>ε</strong><strong>τ</strong>ρη<strong>τ</strong>ικού <strong>τ</strong>ύ<strong>π</strong>ο<strong>υ</strong> µηχ<strong>αν</strong>ι<strong>σ</strong>µό <strong>π</strong>ο<strong>υ</strong> διαθέ<strong>τ</strong>ο<strong>υ</strong>ν.<br />

Έ<strong>τ</strong><strong>σ</strong>ι, <strong>ε</strong><strong>π</strong>ι<strong>τ</strong>ρέ<strong>π</strong>ο<strong>υ</strong>ν <strong>σ</strong><strong>τ</strong>ο χ<strong>ε</strong>ιρούργο να καθορί<strong>σ</strong><strong>ε</strong>ι <strong>τ</strong>ο <strong>π</strong>ο<strong>σ</strong>ό <strong>τ</strong>ης<br />

<strong>ε</strong><strong>π</strong>ιθ<strong>υ</strong>µη<strong>τ</strong>ής αρθρικής κινη<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>ας ή και να <strong>τ</strong>ο µ<strong>ε</strong><strong>τ</strong>αβάλλ<strong>ε</strong>ι ό<strong>π</strong>ο<strong>τ</strong><strong>ε</strong><br />

χρ<strong>ε</strong>ιάζ<strong>ε</strong><strong>τ</strong>αι, µέ<strong>σ</strong>α α<strong>π</strong>ό α<strong>π</strong>λές ρ<strong>υ</strong>θµί<strong>σ</strong><strong>ε</strong>ις.<br />

Ε<strong>π</strong>ί<strong>σ</strong>ης, χρη<strong>σ</strong>ιµο<strong>π</strong>οιούν<strong>τ</strong>αι και οι λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργικοί νάρθηκ<strong>ε</strong>ς για να<br />

<strong>π</strong>ρο<strong>σ</strong><strong>τ</strong>α<strong>τ</strong>έψο<strong>υ</strong>ν ένα <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρό γόνα<strong>τ</strong>ο µ<strong>ε</strong> <strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ική <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού.<br />

Πολλοί <strong>ε</strong>ίναι οι για<strong>τ</strong>ροί <strong>π</strong>ο<strong>υ</strong> θα <strong>π</strong>ρο<strong>τ</strong>ρέψο<strong>υ</strong>ν <strong>τ</strong>ο<strong>υ</strong>ς α<strong>σ</strong>θ<strong>ε</strong>ν<strong>ε</strong>ίς<br />

<strong>τ</strong>ο<strong>υ</strong>ς να φορούν ένα νάρθηκα α<strong>υ</strong><strong>τ</strong>ού <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong>ύ<strong>π</strong>ο<strong>υ</strong>, κα<strong>τ</strong>ά <strong>τ</strong>η διάρκ<strong>ε</strong>ια<br />

φορ<strong>τ</strong>ικών δρα<strong>σ</strong><strong>τ</strong>ηριο<strong>τ</strong>ή<strong>τ</strong>ων, αλλά έχ<strong>ε</strong>ι γίν<strong>ε</strong>ι κα<strong>τ</strong><strong>αν</strong>οη<strong>τ</strong>ό ό<strong>τ</strong>ι α<strong>υ</strong><strong>τ</strong>ά <strong>τ</strong>α<br />

<strong>σ</strong><strong>υ</strong><strong>σ</strong><strong>τ</strong>ήµα<strong>τ</strong>α <strong>ε</strong>ίναι α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong><strong>σ</strong>µα<strong>τ</strong>ικά µόνο <strong>σ</strong><strong>ε</strong> χαµηλέ <strong>ε</strong><strong>π</strong>ί<strong>π</strong><strong>ε</strong>δα φόρ<strong>τ</strong>ι<strong>σ</strong>ης<br />

<strong>τ</strong>ης άρθρω<strong>σ</strong>ης. Οι α<strong>π</strong>αι<strong>τ</strong>ή<strong>σ</strong><strong>ε</strong>ις α<strong>π</strong>ό <strong>τ</strong>ον <strong>π</strong>ρό<strong>σ</strong>θιο χια<strong>σ</strong><strong>τ</strong>ό κα<strong>τ</strong>ά<br />

<strong>τ</strong>ην αθλη<strong>τ</strong>ική δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong>α, ξ<strong>ε</strong><strong>π</strong><strong>ε</strong>ρνούν κα<strong>τ</strong>ά <strong>π</strong>ολύ <strong>τ</strong>α <strong>ε</strong><strong>π</strong>ί<strong>π</strong><strong>ε</strong>δα<br />

φορ<strong>τ</strong>ίο<strong>υ</strong>, <strong>σ</strong><strong>τ</strong>α ο<strong>π</strong>οία οι λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργικοί νάρθηκ<strong>ε</strong>ς έχο<strong>υ</strong>ν α<strong>π</strong>οδ<strong>ε</strong>ιχθ<strong>ε</strong>ί α-<br />

<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong><strong>σ</strong>µα<strong>τ</strong>ικοί. Αν και η α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong><strong>σ</strong>µα<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ων ναρθήκων δ<strong>ε</strong>ν<br />

έχ<strong>ε</strong>ι κα<strong>τ</strong><strong>αν</strong>οηθ<strong>ε</strong>ί <strong>π</strong>λήρως, <strong>π</strong>ι<strong>σ</strong><strong>τ</strong><strong>ε</strong>ύ<strong>ε</strong><strong>τ</strong>αι ό<strong>τ</strong>ι <strong>π</strong>αρέχο<strong>υ</strong>ν <strong>τ</strong>ρό<strong>π</strong>ο ή <strong>σ</strong>ηµ<strong>ε</strong>ίο<br />

αι<strong>σ</strong>θη<strong>τ</strong>ικής <strong>ε</strong><strong>π</strong><strong>αν</strong>α<strong>τ</strong>ροφοδό<strong>τ</strong>ιι<strong>σ</strong>ιις, έ<strong>τ</strong><strong>σ</strong>ι ώ<strong>σ</strong><strong>τ</strong><strong>ε</strong> ο άρρω<strong>σ</strong><strong>τ</strong>ος να <strong>ε</strong>λέγχ<strong>ε</strong>ι<br />

καλύ<strong>τ</strong><strong>ε</strong>ρα <strong>τ</strong>ο άκρο.

11. ΕΠΙΣΗΜΑΝΣΕΙΣ ΣΤΗΝ ΑΞΙΟΛΟΓΗΣΗ ΚΑΙ ∆ΗΜΙΟΥΡΓΙΑ<br />

ΠΡΟΓΡΑΜΜΑΤΟΣ ΑΠΟΚΑΤΑΣΤΑΣΗΣ<br />

ΑΞΙΟΛΟΓΗΣΗ<br />

Αξιολόγη<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> αθλη<strong>τ</strong>ή και όχι <strong>τ</strong>ης α<strong>σ</strong>θέν<strong>ε</strong>ιας.<br />

Ο Τ.Ο.Τ.Α.Ρ.5. (Talk, Οbserve, Active movements, Passive<br />

movements, Skills test)<br />

Ο Σ<strong>υ</strong>νοδά <strong>π</strong>ροβλήµα<strong>τ</strong>α.<br />

Αξιολόγη<strong>σ</strong>η όλο<strong>υ</strong> <strong>τ</strong>ο<strong>υ</strong> κά<strong>τ</strong>ω άκρο<strong>υ</strong>.<br />

Ο<strong>σ</strong>φ<strong>υ</strong>ϊκή µοίρα.<br />

Ο Ψ<strong>υ</strong>χολογική κα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η.<br />

ΑΡΧΕΣ ΣΤΗΝ ΑΞΙΟΛΟΓΗΣΗ ΤΗΣ ΚΙΝΗΣΗΣ<br />

Αρχικά γίν<strong>ε</strong><strong>τ</strong>αι έλ<strong>ε</strong>γχος <strong>τ</strong>ης φ<strong>υ</strong><strong>σ</strong>ιολογικής <strong>π</strong>λ<strong>ε</strong><strong>υ</strong>ράς.<br />

Ο Ελέγχον<strong>τ</strong>αι <strong>π</strong>ρώ<strong>τ</strong>α οι <strong>ε</strong>ν<strong>ε</strong>ργη<strong>τ</strong>ικές κινή<strong>σ</strong><strong>ε</strong>ις, µ<strong>ε</strong><strong>τ</strong>ά οι <strong>π</strong>αθη<strong>τ</strong>ικές και<br />

<strong>τ</strong>έλος οι ι<strong>σ</strong>οµ<strong>ε</strong><strong>τ</strong>ρικές µ<strong>ε</strong> <strong>αν</strong><strong>τ</strong>ί<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η.<br />

Ο Η <strong>ε</strong>φαρµογή <strong>τ</strong>ων <strong>ε</strong><strong>π</strong>ώδ<strong>υ</strong>νων κινή<strong>σ</strong><strong>ε</strong>ων γίν<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ο <strong>τ</strong>έλος και βά<strong>σ</strong>η<br />

α<strong>υ</strong><strong>τ</strong>ών <strong>π</strong>άµ<strong>ε</strong> <strong>π</strong>αρακά<strong>τ</strong>ω.<br />

Προ<strong>σ</strong>οχή <strong>σ</strong><strong>τ</strong>ην <strong>ε</strong>φαρµογή <strong>π</strong><strong>ε</strong>ραι<strong>τ</strong>έρω <strong>π</strong>ί<strong>ε</strong><strong>σ</strong>ης.<br />

Ε<strong>π</strong><strong>αν</strong>αλάβ<strong>ε</strong><strong>τ</strong><strong>ε</strong> ή δια<strong>τ</strong>ηρή<strong>σ</strong><strong>τ</strong><strong>ε</strong> µια κίνη<strong>σ</strong>η <strong>αν</strong> <strong>ε</strong>νδ<strong>ε</strong>ίκν<strong>υ</strong><strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ο ι-<br />

<strong>σ</strong><strong>τ</strong>ορικό <strong>τ</strong>ο<strong>υ</strong> α<strong>σ</strong>θ<strong>ε</strong>νή.

Ο Οι ι<strong>σ</strong>οµ<strong>ε</strong><strong>τ</strong>ρικές α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις µ<strong>ε</strong> <strong>αν</strong><strong>τ</strong>ί<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>ε</strong>κ<strong>τ</strong><strong>ε</strong>λούν<strong>τ</strong>αι α<strong>π</strong>ό θέ<strong>σ</strong>η<br />

χαλάρω<strong>σ</strong>ης.<br />

Μ<strong>ε</strong> <strong>π</strong>αθη<strong>τ</strong>ικές κινή<strong>σ</strong><strong>ε</strong>ις και έλ<strong>ε</strong>γχο <strong>τ</strong>ων <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µων <strong>ε</strong>ίναι <strong>σ</strong>ηµ<strong>αν</strong><strong>τ</strong>ική<br />

<strong>τ</strong>ό<strong>σ</strong>ο η <strong>π</strong>οιό<strong>τ</strong>η<strong>τ</strong>α ό<strong>σ</strong>ο και ο βαθµός <strong>τ</strong>ο<strong>υ</strong> <strong>ε</strong>ύρο<strong>υ</strong>ς.<br />

Για <strong>τ</strong>ον έλ<strong>ε</strong>γχο <strong>τ</strong>ων <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µων, <strong>ε</strong><strong>π</strong><strong>αν</strong>αλαµβάνο<strong>υ</strong>µ<strong>ε</strong> µ<strong>ε</strong> α<strong>υ</strong>ξ<strong>αν</strong>όµ<strong>ε</strong>νη<br />

<strong>π</strong>ί<strong>ε</strong><strong>σ</strong>η.<br />

Οι <strong>σ</strong><strong>υ</strong><strong>σ</strong><strong>π</strong>ά<strong>σ</strong><strong>ε</strong>ις θα <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να κρα<strong>τ</strong>ούν<strong>τ</strong>αι για<br />

ΕΝΕΡΓΗΤΙΚΕΣ ΑΣΚΗΣΕίΣ<br />

Πό<strong>τ</strong><strong>ε</strong> και <strong>π</strong>ού <strong>ε</strong>µφ<strong>αν</strong>ίζ<strong>ε</strong><strong>τ</strong>αι ο <strong>π</strong>όνος κα<strong>τ</strong>ά <strong>τ</strong>η διάρκ<strong>ε</strong>ια <strong>τ</strong>ης κίνη<strong>σ</strong>ης.<br />

Αν ο <strong>π</strong>όνος α<strong>υ</strong>ξάν<strong>ε</strong>ι <strong>σ</strong><strong>ε</strong> έν<strong>τ</strong>α<strong>σ</strong>η και <strong>π</strong>οιό<strong>τ</strong>η<strong>τ</strong>α µ<strong>ε</strong> <strong>τ</strong>ην <strong>ε</strong>κ<strong>τ</strong>έλ<strong>ε</strong><strong>σ</strong>η <strong>τ</strong>ης<br />

κίνη<strong>σ</strong>ης.<br />

Την <strong>αν</strong><strong>τ</strong>ίδρα<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> α<strong>σ</strong>θ<strong>ε</strong>νή <strong>σ</strong><strong>τ</strong>ον <strong>π</strong>όνο<br />

Το <strong>π</strong>ο<strong>σ</strong>ό <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>αρα<strong>τ</strong>ηρούµ<strong>ε</strong>νο<strong>υ</strong> <strong>π</strong><strong>ε</strong>ριορι<strong>σ</strong><strong>τ</strong>ικού <strong>π</strong>αράγον<strong>τ</strong>α.<br />

Το <strong>π</strong>ρό<strong>τ</strong><strong>υ</strong><strong>π</strong>ο <strong>τ</strong>ης κίνη<strong>σ</strong>ης.<br />

Ο Το ρ<strong>υ</strong>θµό και <strong>τ</strong>ην <strong>π</strong>οιό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ης κίνη<strong>σ</strong>ης.<br />

Την κίνη<strong>σ</strong>η <strong>τ</strong>ων <strong>σ</strong><strong>υ</strong><strong>σ</strong>χ<strong>ε</strong><strong>τ</strong>ιζόµ<strong>αν</strong>ων αρθρώ<strong>σ</strong><strong>ε</strong>ων.<br />

Την <strong>π</strong>ροθ<strong>υ</strong>µο<strong>π</strong>οίη<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> α<strong>σ</strong>θ<strong>ε</strong>νή να κινή<strong>σ</strong><strong>ε</strong>ι <strong>τ</strong>ο µέλος.

Κάθ<strong>ε</strong> <strong>π</strong><strong>ε</strong>ριορι<strong>σ</strong>µό και <strong>τ</strong>η φύ<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong>.<br />

ΠΑΘΗΤΙΚΕΣ ΚΙΝΗΣΕΙΣ<br />

Πό<strong>τ</strong><strong>ε</strong> και <strong>π</strong>ού αρχίζ<strong>ε</strong>ι ο <strong>π</strong>όνος κα<strong>τ</strong>ά <strong>τ</strong>ην <strong>ε</strong>κ<strong>τ</strong>έλ<strong>ε</strong><strong>σ</strong>η <strong>τ</strong>ης κίνη<strong>σ</strong>ης.<br />

Αν η κίνη<strong>σ</strong>η α<strong>υ</strong>ξάν<strong>ε</strong>ι <strong>τ</strong>ην έν<strong>τ</strong>α<strong>σ</strong>η και <strong>τ</strong>ην <strong>π</strong>οιό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>όνο<strong>υ</strong>.<br />

Το <strong>π</strong>ρό<strong>τ</strong><strong>υ</strong><strong>π</strong>ο <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong><strong>ε</strong>ριορι<strong>σ</strong>µού <strong>τ</strong>ης κίνη<strong>σ</strong>ης.<br />

Το <strong>τ</strong>έλος αί<strong>σ</strong>θη<strong>σ</strong>ης <strong>τ</strong>ης κίνη<strong>σ</strong>ης.<br />

Την κίνη<strong>σ</strong>η <strong>σ</strong><strong>υ</strong><strong>σ</strong>χ<strong>ε</strong><strong>τ</strong>ιζόµ<strong>ε</strong>νων (γ<strong>ε</strong>ι<strong>τ</strong>ονικών) αρθρώ<strong>σ</strong><strong>ε</strong>ων.<br />

Το <strong>υ</strong><strong>π</strong>άρχον <strong>ε</strong>ύρος κίνη<strong>σ</strong>ης.<br />

ΦΥΣΙΟΛΟΠΚΟ ΕΝD FΕΕL. ΣΤΟ ΓΟΝΑΤΟ<br />

Κάµψη (<strong>π</strong>λη<strong>σ</strong>ία<strong>σ</strong>µα ι<strong>σ</strong><strong>τ</strong>ών).<br />

Έκ<strong>τ</strong>α<strong>σ</strong>η ( διά<strong>τ</strong>α<strong>σ</strong>η ι<strong>σ</strong><strong>τ</strong>ών).<br />

Έ<strong>σ</strong>ω <strong>σ</strong><strong>τ</strong>ροφή <strong>τ</strong>ης κνήµης <strong>σ</strong><strong>τ</strong>ο µηριαίο ( διά<strong>τ</strong>α<strong>σ</strong>η ι<strong>σ</strong><strong>τ</strong>ών).<br />

Έξω <strong>σ</strong><strong>τ</strong>ροφή <strong>τ</strong>ης κνήµης <strong>σ</strong><strong>τ</strong>ο µηριαίο ( διά<strong>τ</strong>α<strong>σ</strong>η ι<strong>σ</strong><strong>τ</strong>ών ).<br />

Κίνη<strong>σ</strong>η <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδας (διά<strong>τ</strong>α<strong>σ</strong>η ι<strong>σ</strong><strong>τ</strong>ών - όλ<strong>ε</strong>ς οι κα<strong>τ</strong><strong>ε</strong><strong>υ</strong>θύν<strong>σ</strong><strong>ε</strong>ις

JΟΙΝΤ ΡΙΑΥ ΤΟΥ ΓΟΝΑΤΟΣ<br />

Ο<strong>π</strong>ί<strong>σ</strong>θια ολί<strong>σ</strong>θη<strong>σ</strong>η <strong>τ</strong>ης κνήµης <strong>σ</strong><strong>τ</strong>ο µηρό.<br />

Πρό<strong>σ</strong>θια ολί<strong>σ</strong>θη<strong>σ</strong>η <strong>τ</strong>ης κνήµης <strong>σ</strong><strong>τ</strong>ο µηρό.<br />

Μ<strong>ε</strong><strong>τ</strong>ακίνη<strong>σ</strong>η <strong>π</strong>ρος <strong>τ</strong>α µέ<strong>σ</strong>α <strong>τ</strong>ης κνήµης <strong>π</strong>ρος <strong>τ</strong>ο µηρό.<br />

Μ<strong>ε</strong><strong>τ</strong>ακίνη<strong>σ</strong>η <strong>π</strong>ρος <strong>τ</strong>α έξω <strong>τ</strong>ης κνήµης <strong>π</strong>ρος <strong>τ</strong>ο µηρό.<br />

Μ<strong>ε</strong><strong>τ</strong>ακίνη<strong>σ</strong>η <strong>τ</strong>ης <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδας <strong>π</strong>ρος <strong>τ</strong>α µέ<strong>σ</strong>α και <strong>π</strong>ρος <strong>τ</strong>α έξω.<br />

Κα<strong>τ</strong>αβύθι<strong>σ</strong>η <strong>τ</strong>ης <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδας.<br />

Προ<strong>σ</strong>θιο<strong>π</strong>ί<strong>σ</strong>θια κίνη<strong>σ</strong>η <strong>τ</strong>ης <strong>π</strong><strong>ε</strong>ρόνης <strong>π</strong>ρος <strong>τ</strong>ην κνήµη.<br />

ΕΛΕΓΧΟΣ ΜΥΪΚΗΣ 1ΣΧΥΟΣ<br />

Αν η <strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η <strong>π</strong>ροκαλ<strong>ε</strong>ί <strong>π</strong>όνο και, <strong>αν</strong> <strong>π</strong>ροκαλ<strong>ε</strong>ί, <strong>τ</strong>ην έν<strong>τ</strong>α<strong>σ</strong>η και <strong>τ</strong>ην<br />

<strong>π</strong>οιό<strong>τ</strong>η<strong>τ</strong>α α<strong>υ</strong><strong>τ</strong>ού.<br />

Την ι<strong>σ</strong>χύ <strong>τ</strong>ης <strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>ης.<br />

Τον <strong>τ</strong>ύ<strong>π</strong>ο <strong>τ</strong>ης <strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>ης <strong>π</strong>ο<strong>υ</strong> <strong>π</strong>ροκαλ<strong>ε</strong>ί <strong>τ</strong>ον <strong>π</strong>όνο ( µ<strong>ε</strong>ιοµ<strong>ε</strong><strong>τ</strong>ρική,<br />

ι<strong>σ</strong>οµ<strong>ε</strong><strong>τ</strong>ρική, <strong>π</strong>λ<strong>ε</strong>ιοµ<strong>ε</strong><strong>τ</strong>ρική).<br />

ΛΕΙΤΟΥΡΓΙΚΑ ΤΕΣΤ<br />

Βάδι<strong>σ</strong>η.

Ανέβα<strong>σ</strong>µα - κα<strong>τ</strong>έβα<strong>σ</strong>µα <strong>σ</strong>κάλας ( βάδι<strong>σ</strong>µα - <strong>τ</strong>ρέξιµο ).<br />

Βαθύ κάθι<strong>σ</strong>µα ( κάµψη γονά<strong>τ</strong>ων <strong>σ</strong><strong>υ</strong>µµ<strong>ε</strong><strong>τ</strong>ρικά).<br />

Βαθύ κάθι<strong>σ</strong>µα και <strong>αν</strong>α<strong>π</strong>ηδή<strong>σ</strong><strong>ε</strong>ις <strong>σ</strong><strong>τ</strong>ο <strong>τ</strong>έλος.<br />

Τρέξιµο.<br />

Τρέξιµο µ<strong>ε</strong> <strong>σ</strong><strong>τ</strong>αµά<strong>τ</strong>ηµα.<br />

Τρέξιµο µ<strong>ε</strong> <strong>π</strong><strong>ε</strong>ρι<strong>σ</strong><strong>τ</strong>ροφή ( οχ<strong>τ</strong>άρια ).<br />

Άλµα<strong>τ</strong>α και βαθύ κάθι<strong>σ</strong>µα.<br />

ΒΑΣΙΚΕΣ ΑΡΧΕΣ ΑΠΟΚΑΤΑΣΤΑΣΗΣ<br />

1. Οι <strong>ε</strong><strong>π</strong>ι<strong>π</strong><strong>τ</strong>ώ<strong>σ</strong><strong>ε</strong>ις α<strong>π</strong>ό <strong>τ</strong>ην ακινη<strong>σ</strong>ία <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να <strong>ε</strong>κµηδ<strong>ε</strong>νι<strong>σ</strong><strong>τ</strong>ούν.<br />

2. Οι <strong>τ</strong>ρα<strong>υ</strong>µα<strong>τ</strong>ι<strong>σ</strong>µένοι ι<strong>σ</strong><strong>τ</strong>οί δ<strong>ε</strong>ν <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι <strong>π</strong>ο<strong>τ</strong>έ να <strong>υ</strong><strong>π</strong><strong>ε</strong>ρδια<strong>τ</strong>αθούν.<br />

3. Ο α<strong>σ</strong>θ<strong>ε</strong>νής <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να <strong>π</strong>ληροί κά<strong>π</strong>οια κρι<strong>τ</strong>ήρια για να <strong>π</strong><strong>ε</strong>ρά<strong>σ</strong><strong>ε</strong>ι<br />

α<strong>π</strong>ό <strong>τ</strong>ο ένα <strong>σ</strong><strong>τ</strong>άδιο <strong>σ</strong><strong>τ</strong>ο άλλο.<br />

4. Το <strong>π</strong>ρόγραµµα α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να βα<strong>σ</strong>ίζ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>η<br />

<strong>σ</strong>ύγχρονη κλινική και <strong>ε</strong>ργα<strong>σ</strong><strong>τ</strong>ηριακή έρ<strong>ε</strong><strong>υ</strong>να.<br />

µένο.<br />

5. Το <strong>π</strong>ρόγραµµα α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να <strong>ε</strong>ίναι <strong>ε</strong>ξα<strong>τ</strong>οµικ<strong>ε</strong><strong>υ</strong><br />

6. Η διαδικα<strong>σ</strong>ία α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης <strong>ε</strong>ίναι µια οµαδική δο<strong>υ</strong>λ<strong>ε</strong>ιά.

ΑΡΧΕΣ ΤΟΥ ΠΡΟΓΡΑΜΜΑΤΟΣ ΑΠΟΚΑΤΑΣΤΑΣΗΣ<br />

1. Αρχή <strong>τ</strong>ης <strong>π</strong>οικιλίας.<br />

2. Αρχή <strong>τ</strong>ης α<strong>τ</strong>οµικό<strong>τ</strong>η<strong>τ</strong>ας.<br />

3. Αρχή <strong>τ</strong>ης <strong>ε</strong>ιδικό<strong>τ</strong>η<strong>τ</strong>ας.<br />

4. Αρχή <strong>τ</strong>ης <strong>π</strong>ροοδ<strong>ε</strong><strong>υ</strong><strong>τ</strong>ικής αύξη<strong>σ</strong>ης <strong>τ</strong>ης <strong>ε</strong><strong>π</strong>ιβάρ<strong>υ</strong>ν<strong>σ</strong>ης <strong>σ</strong><strong>τ</strong>ην<br />

<strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>η.<br />

ΑΡΧΗ ΤΗΣ ΠΟΙΚΙΛΙΑΣ<br />

Τρο<strong>π</strong>ο<strong>π</strong>οίη<strong>σ</strong>η ό<strong>σ</strong>ο <strong>σ</strong><strong>υ</strong>χνά χρ<strong>ε</strong>ιάζ<strong>ε</strong><strong>τ</strong>αι <strong>τ</strong>ων α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ων.<br />

Παραλλαγή <strong>σ</strong><strong>τ</strong>ο <strong>σ</strong>ύ<strong>σ</strong><strong>τ</strong>ηµα <strong>ε</strong><strong>π</strong>ιβάρ<strong>υ</strong>ν<strong>σ</strong>ης.<br />

∆ιαφορο<strong>π</strong>οίη<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ον <strong>τ</strong>ύ<strong>π</strong>ο <strong>τ</strong>ης µ<strong>υ</strong>ϊκής <strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>ης.<br />

Α<strong>υ</strong>ξοµ<strong>ε</strong>ίω<strong>σ</strong>η <strong>τ</strong>ης <strong>τ</strong>αχύ<strong>τ</strong>η<strong>τ</strong>ας <strong>τ</strong>ης <strong>σ</strong>ύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>ης.<br />

Παραλλαγή <strong>σ</strong><strong>τ</strong>ον <strong>ε</strong>ξο<strong>π</strong>λι<strong>σ</strong>µό.<br />

Αλλαγή <strong>σ</strong><strong>τ</strong>α <strong>σ</strong><strong>τ</strong>άδια <strong>τ</strong>ης α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης.<br />

ΑΡΧΗ ΤΗΣ ΑΤΟΜΙΚΟΤΗΤΑΣ<br />

Ο Εξ<strong>ε</strong>ιδίκ<strong>ε</strong><strong>υ</strong><strong>σ</strong>η µ<strong>ε</strong> <strong>τ</strong>ην ά<strong>σ</strong>κη<strong>σ</strong>η.<br />

Α<strong>τ</strong>οµική ικ<strong>αν</strong>ό<strong>τ</strong>η<strong>τ</strong>α για δο<strong>υ</strong>λ<strong>ε</strong>ιά και <strong>ε</strong><strong>π</strong>ίδο<strong>σ</strong>η.

Ε<strong>π</strong>ιβάρ<strong>υ</strong>ν<strong>σ</strong>η και ρ<strong>υ</strong>θµός <strong>αν</strong>άληψης <strong>τ</strong>ο<strong>υ</strong> αθλη<strong>τ</strong>ή.<br />

Η <strong>αν</strong>α<strong>τ</strong>οµική κα<strong>τ</strong>α<strong>σ</strong>κ<strong>ε</strong><strong>υ</strong>ή και οι βιολογικές διαφορές <strong>αν</strong>άµ<strong>ε</strong><strong>σ</strong>α <strong>σ</strong><strong>τ</strong>α<br />

φύλα.<br />

ΑΡΧΗ ΤΗΣ ΕΙ∆ΙΚΟΤΗΤΑΣ<br />

Το <strong>σ</strong>ύ<strong>σ</strong><strong>τ</strong>ηµα <strong>ε</strong>νέργ<strong>ε</strong>ιας <strong>π</strong>ο<strong>υ</strong> κ<strong>υ</strong>ριαρχ<strong>ε</strong>ί <strong>σ</strong><strong>τ</strong>η δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong>α.<br />

Οι <strong>ε</strong>ιδικές µ<strong>υ</strong>ϊκές οµάδ<strong>ε</strong>ς <strong>π</strong>ο<strong>υ</strong> <strong>σ</strong><strong>υ</strong>µµ<strong>ε</strong><strong>τ</strong>έχο<strong>υ</strong>ν.<br />

ΑΡΧΗ ΤΗΣ ΠΡΟΟ∆ΕΥΤΙΚΗΣ ΑΥΞΗΣΗΣ ΤΗΣ ΕΠΙΒΑΡΥΝΣΗΣ<br />

ΣΤΗΝ ΑΣΚΗΣΗ<br />

Φ Η λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργική ικ<strong>αν</strong>ό<strong>τ</strong>η<strong>τ</strong>α <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong>ώµα<strong>τ</strong>ος καθώς και η ικ<strong>αν</strong>ό<strong>τ</strong>η<strong>τ</strong>α για<br />

δο<strong>υ</strong>λ<strong>ε</strong>ιά α<strong>υ</strong>ξάν<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>αδιακά µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό µια µ<strong>ε</strong>γάλη <strong>π</strong><strong>ε</strong>ρίοδο.<br />

Ο Το <strong>σ</strong>ώµα <strong>αν</strong><strong>τ</strong>ιδρά <strong>αν</strong>α<strong>τ</strong>οµικά, φ<strong>υ</strong><strong>σ</strong>ιολογικά και ψ<strong>υ</strong>χολογικά <strong>σ</strong><strong>τ</strong>ις<br />

α<strong>π</strong>αι<strong>τ</strong>ή<strong>σ</strong><strong>ε</strong>ις <strong>τ</strong>ο<strong>υ</strong> α<strong>υ</strong>ξ<strong>αν</strong>όµ<strong>ε</strong>νο<strong>υ</strong> φορ<strong>τ</strong>ίο<strong>υ</strong>.<br />

Ο Ο βαθµός <strong>σ</strong><strong>τ</strong>ον ο<strong>π</strong>οίο β<strong>ε</strong>λ<strong>τ</strong>ιών<strong>ε</strong><strong>τ</strong>αι η <strong>ε</strong><strong>π</strong>ίδο<strong>σ</strong>η <strong>ε</strong>ξαρ<strong>τ</strong>ά<strong>τ</strong>αι α<strong>π</strong>ό <strong>τ</strong>ο<br />

ρ<strong>υ</strong>θµό και <strong>τ</strong>ον <strong>τ</strong>ρό<strong>π</strong>ο µ<strong>ε</strong> <strong>τ</strong>ον ο<strong>π</strong>οίο α<strong>υ</strong>ξάν<strong>ε</strong><strong>τ</strong>αι <strong>τ</strong>ο φορ<strong>τ</strong>ίο.<br />

ΟΙ ΤΕΣΣΕΡΙΣ ΒΑΣΙΚΟΙ ΝΟΜΟΙ ΣΤΗ ΜΥΪΚΗ ΕΝ∆ΥΝΑΜΩΣΗ<br />

Πριν <strong>αν</strong>α<strong>π</strong><strong>τ</strong>ύξο<strong>υ</strong>µ<strong>ε</strong> <strong>τ</strong>α άκρα <strong>αν</strong>α<strong>π</strong><strong>τ</strong>ύ<strong>σ</strong><strong>σ</strong>ο<strong>υ</strong>µ<strong>ε</strong> <strong>τ</strong>ον <strong>π</strong><strong>υ</strong>ρήνα <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong>ώµα<strong>τ</strong>ος.

· Πριν <strong>αν</strong>α<strong>π</strong><strong>τ</strong>ύξο<strong>υ</strong>µ<strong>ε</strong> <strong>τ</strong>ο<strong>υ</strong>ς βα<strong>σ</strong>ικούς κινη<strong>τ</strong>ήρ<strong>ε</strong>ς µύ<strong>ε</strong>ς <strong>αν</strong>α<strong>π</strong><strong>τ</strong>ύ<strong>σ</strong><strong>σ</strong>ο<strong>υ</strong>µ<strong>ε</strong><br />

<strong>τ</strong>ο<strong>υ</strong>ς <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρο<strong>π</strong>οιη<strong>τ</strong>ές.<br />

Πριν <strong>αν</strong>α<strong>π</strong><strong>τ</strong>ύξο<strong>υ</strong>µ<strong>ε</strong> <strong>τ</strong>η µ<strong>υ</strong>ϊκή δύναµη, δ<strong>υ</strong>ναµώνο<strong>υ</strong>µ<strong>ε</strong> <strong>τ</strong>ο<strong>υ</strong>ς <strong>τ</strong>ένον<strong>τ</strong><strong>ε</strong>ς,<br />

Πριν <strong>αν</strong>α<strong>π</strong><strong>τ</strong>ύξο<strong>υ</strong>µ<strong>ε</strong> <strong>τ</strong>η µ<strong>υ</strong>ϊκή δύναµη, <strong>αν</strong>α<strong>π</strong><strong>τ</strong>ύ<strong>σ</strong><strong>σ</strong>ο<strong>υ</strong>µ<strong>ε</strong> <strong>τ</strong>ην <strong>ε</strong><strong>υ</strong>λ<strong>υ</strong>γι<strong>σ</strong>ία<br />

<strong>τ</strong>ων <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µων.<br />

ΠΑΡΑΜΕΤΡΟΙ ΑΣΚΗΣΗΣ<br />

Η <strong>π</strong>ο<strong>σ</strong>ό<strong>τ</strong>η<strong>τ</strong>α.<br />

Η έν<strong>τ</strong>α<strong>σ</strong>η.<br />

Ο αριθµός <strong>τ</strong>ων α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ων.<br />

Η <strong>σ</strong><strong>ε</strong>ιρά <strong>τ</strong>ων α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ων.<br />

Ο αριθµός <strong>τ</strong>ων α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ων και ο ρ<strong>υ</strong>θµός <strong>τ</strong>ο<strong>υ</strong>ς / ο αριθµός <strong>τ</strong>ων <strong>σ</strong><strong>ε</strong><strong>τ</strong>.<br />

Το διάλ<strong>ε</strong>ιµµα <strong>αν</strong>άµ<strong>ε</strong><strong>σ</strong>α <strong>σ</strong><strong>τ</strong>α <strong>σ</strong><strong>ε</strong><strong>τ</strong>.<br />

Το διάλ<strong>ε</strong>ιµµα <strong>αν</strong>άµ<strong>ε</strong><strong>σ</strong>α <strong>σ</strong><strong>τ</strong>ις <strong>π</strong>ρο<strong>π</strong>ονη<strong>τ</strong>ικές µονάδ<strong>ε</strong>ς δύναµης.<br />

Η δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong>α <strong>σ</strong><strong>τ</strong>η διάρκ<strong>ε</strong>ια <strong>τ</strong>ο<strong>υ</strong> διαλ<strong>ε</strong>ίµµα<strong>τ</strong>ος.

12.ΦΥΣΙΚΟΘΕΡΑΠΕΥΤΙΚΗ ΑΝΤΙΜΕΤΩΠΙΣΗ<br />

Οι <strong>σ</strong><strong>τ</strong>όχοι <strong>τ</strong>ης α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό <strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ική <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού,<br />

<strong>ε</strong>ίναι η <strong>π</strong>ρώιµη κίνη<strong>σ</strong>η µ<strong>ε</strong><strong>τ</strong><strong>ε</strong>γχ<strong>ε</strong>ιρη<strong>τ</strong>ικά, <strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ροφή <strong>τ</strong>ης µέγι<strong>σ</strong><strong>τ</strong>ης<br />

δύναµης και <strong>σ</strong><strong>υ</strong>ν<strong>ε</strong>χόµ<strong>ε</strong>ν<strong>ε</strong>ς <strong>ε</strong>ν<strong>τ</strong>α<strong>τ</strong>ικές <strong>π</strong>ρο<strong>σ</strong><strong>π</strong>άθ<strong>ε</strong>ι<strong>ε</strong>ς µέ<strong>σ</strong>α α<strong>π</strong>ό<br />

<strong>π</strong>ροχωρηµέν<strong>ε</strong>ς δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς. Η <strong>αν</strong>άγκη να α<strong>π</strong>οφ<strong>ε</strong><strong>υ</strong>χθούν οι <strong>ε</strong>-<br />

<strong>π</strong>ι<strong>π</strong>λοκές α<strong>π</strong>ό <strong>π</strong>αρα<strong>τ</strong><strong>ε</strong><strong>τ</strong>αµένη ακινη<strong>τ</strong>ο<strong>π</strong>οίη<strong>σ</strong>η έχ<strong>ε</strong>ι <strong>σ</strong><strong>υ</strong>ζη<strong>τ</strong>ηθ<strong>ε</strong>ί, µαζί<br />

µ<strong>ε</strong> <strong>τ</strong>η <strong>σ</strong><strong>π</strong>ο<strong>υ</strong>δαιό<strong>τ</strong>η<strong>τ</strong>α <strong>ε</strong>νός <strong>ε</strong><strong>π</strong>ιθ<strong>ε</strong><strong>τ</strong>ικού <strong>π</strong>ρογράµµα<strong>τ</strong>ος <strong>ε</strong>νδ<strong>υ</strong>νάµω<strong>σ</strong>ης<br />

και ν<strong>ε</strong><strong>υ</strong>ροµ<strong>υ</strong>ϊκής <strong>ε</strong><strong>π</strong><strong>αν</strong><strong>ε</strong>κ<strong>π</strong>αίδ<strong>ε</strong><strong>υ</strong><strong>σ</strong>ης. Τα φ<strong>υ</strong><strong>σ</strong>ιοθ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong><strong>υ</strong><strong>τ</strong>ικά µέ<strong>σ</strong>α<br />

<strong>π</strong>ο<strong>υ</strong> χρη<strong>σ</strong>ιµο<strong>π</strong>οιούν<strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ην α<strong>π</strong>οκα<strong>τ</strong>ά<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού<br />

<strong>ε</strong>ίναι : κρ<strong>υ</strong>οθ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong>ία, ηλ<strong>ε</strong>κ<strong>τ</strong>ροθ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong>ία, θ<strong>ε</strong>ρµοθ<strong>ε</strong>ρα-<strong>π</strong><strong>ε</strong>ία ( διαθ<strong>ε</strong>ρ-<br />

µί<strong>ε</strong>ς), <strong>υ</strong><strong>π</strong>έρηχα, Laser και κινη<strong>σ</strong>ιοθ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong>ία.<br />

ΠΡΟΓΡΑΜΜΑ ΜΕΤΕΓΧΕΙΡΗΤΙΚΗΣ ΑΠΟΚΑΤΑΣΤΑΣΗΣ<br />

ΠΡΟΣΘΙΟΥ ΧΙΑΣΤΟΥ ΣΥΝ∆ΕΣΜΟΥ.<br />

1 η -6 η ΕΒ∆ΟΜΑ∆Α<br />

• Έλ<strong>ε</strong>γχος <strong>τ</strong>ης φλ<strong>ε</strong>γµονής - <strong>ε</strong>φαρµογή ψ<strong>υ</strong>χρών <strong>ε</strong><strong>π</strong>ιθ<strong>ε</strong>µά<strong>τ</strong>ων,<br />

• Άµ<strong>ε</strong><strong>σ</strong>η <strong>ε</strong><strong>π</strong><strong>αν</strong>αφορά <strong>τ</strong>ης έκ<strong>τ</strong>α<strong>σ</strong>ης <strong>σ</strong><strong>υ</strong>µµ<strong>ε</strong><strong>τ</strong>ρικά µ<strong>ε</strong> <strong>τ</strong>ο <strong>υ</strong>γιές γόνα<strong>τ</strong>ο (<br />

όχι µαξιλάρι κά<strong>τ</strong>ω α<strong>π</strong>ό <strong>τ</strong>ο γόνα<strong>τ</strong>ο).<br />

• Γρήγορη <strong>π</strong>λήρη <strong>τ</strong>ροχιά <strong>σ</strong><strong>τ</strong>ο γόνα<strong>τ</strong>ο ( κάµψη ή έκ<strong>τ</strong>α<strong>σ</strong>η). Α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις<br />

<strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong>, ι<strong>σ</strong>χιοκνηµιαίων και φ<strong>υ</strong><strong>σ</strong>ιολογική βάδι<strong>σ</strong>η.<br />

• Εφαρµογή <strong>τ</strong>ο<strong>υ</strong> <strong>ε</strong>ιδικού νάρθηκα και κα<strong>τ</strong>ά <strong>τ</strong>ον ύ<strong>π</strong>νο.

1 η -2 η ΕΒ∆ΟΜΑ∆Α<br />

• Προ<strong>σ</strong><strong>π</strong>άθ<strong>ε</strong>ια για κάµψη <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος α<strong>π</strong>ό 0° - 90° κρ<strong>ε</strong>µών<strong>τ</strong>ας <strong>τ</strong>ο<br />

<strong>σ</strong><strong>τ</strong>ην άκρη <strong>τ</strong>ο<strong>υ</strong> κρ<strong>ε</strong>βα<strong>τ</strong>ιού.<br />

• Σύ<strong>σ</strong><strong>π</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong> και άρ<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong>κέλο<strong>υ</strong>ς µ<strong>ε</strong> <strong>τ</strong><strong>ε</strong>ν<strong>τ</strong>ωµένο<br />

γόνα<strong>τ</strong>ο 3X10 <strong>ε</strong><strong>π</strong><strong>αν</strong>αλήψ<strong>ε</strong>ις, 4-5 φορές <strong>τ</strong>ην ηµέρα.<br />

• Προ<strong>σ</strong><strong>π</strong>άθ<strong>ε</strong>ια για <strong>π</strong>λήρη έκ<strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος µ<strong>ε</strong> µαξιλάρι κά<strong>τ</strong>ω<br />

α<strong>π</strong>ό <strong>τ</strong>ην <strong>π</strong><strong>τ</strong>έρνα.<br />

• Σ<strong>τ</strong>ο <strong>τ</strong>έλος <strong>τ</strong>ης 2 ης <strong>ε</strong>βδοµάδας α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις κάµψης <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος γλι<br />

<strong>σ</strong><strong>τ</strong>ρών<strong>τ</strong>ας <strong>τ</strong>ην <strong>π</strong><strong>τ</strong>έρνα <strong>σ</strong><strong>τ</strong>ον <strong>τ</strong>οίχο ( α<strong>π</strong>ό 0° -110°).<br />

Ι<strong>σ</strong>οµ<strong>ε</strong><strong>τ</strong>ρική ά<strong>σ</strong>κη<strong>σ</strong>η <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong><br />

Ι<strong>σ</strong>οµ<strong>ε</strong><strong>τ</strong>ρικές α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις ο<strong>π</strong>ί<strong>σ</strong>θιων µηριαίων.

• Ο α<strong>σ</strong>θ<strong>ε</strong>νής χρη<strong>σ</strong>ιµο<strong>π</strong>οι<strong>ε</strong>ί <strong>π</strong>α<strong>τ</strong><strong>ε</strong>ρί<strong>τ</strong><strong>σ</strong><strong>ε</strong>ς µα<strong>σ</strong>χάλης για <strong>π</strong><strong>ε</strong>ρ<strong>π</strong>ά<strong>τ</strong>ηµα<br />

φορ<strong>τ</strong>ίζον<strong>τ</strong>ας <strong>τ</strong>ο χ<strong>ε</strong>ιρο<strong>υ</strong>ργηµένο κά<strong>τ</strong>ω άκρο.<br />

• ∆<strong>ε</strong>ν <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι να κο<strong>υ</strong>ράζ<strong>ε</strong><strong>τ</strong>αι ά<strong>σ</strong>κο<strong>π</strong>α <strong>τ</strong>ο <strong>π</strong>όδι. Πρέ<strong>π</strong><strong>ε</strong>ι να <strong>τ</strong>ο<strong>π</strong>οθ<strong>ε</strong><strong>τ</strong><strong>ε</strong>ί<br />

<strong>τ</strong>αι ψηλά και να <strong>ε</strong>φαρµόζον<strong>τ</strong>αι ψ<strong>υ</strong>χρά <strong>ε</strong><strong>π</strong>ιθέµα<strong>τ</strong>α για 15 λ<strong>ε</strong><strong>π</strong><strong>τ</strong>ά, 5<br />

φορές <strong>τ</strong>ην ηµέρα<br />

Το<strong>π</strong>οθέ<strong>τ</strong>η<strong>σ</strong>η <strong>π</strong>οδιού <strong>σ</strong><strong>ε</strong> <strong>αν</strong>άρρο<strong>π</strong>η θέ<strong>σ</strong>η και <strong>τ</strong>ο<strong>π</strong>οθέ<strong>τ</strong>η<strong>σ</strong>η<br />

νάρθηκα µ<strong>ε</strong><strong>τ</strong>ά <strong>τ</strong>ην <strong>ε</strong>γχ<strong>ε</strong>ίρη<strong>σ</strong>η

Παθη<strong>τ</strong>ική έκ<strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος<br />

• Η <strong>ε</strong><strong>π</strong>ικοινωνία µ<strong>ε</strong> <strong>τ</strong>ο για<strong>τ</strong>ρό ή <strong>τ</strong>ο φ<strong>υ</strong><strong>σ</strong>ιοθ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong><strong>υ</strong><strong>τ</strong>ή, για ο<strong>π</strong>οιδή<strong>π</strong>ο<strong>τ</strong><strong>ε</strong><br />

<strong>π</strong>ρόβληµα µ<strong>ε</strong> <strong>τ</strong>ο γόνα<strong>τ</strong>ο <strong>τ</strong>ο<strong>υ</strong> α<strong>σ</strong>θ<strong>ε</strong>νή ή µ<strong>ε</strong> <strong>τ</strong>ις α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις, <strong>ε</strong>ίναι α<strong>π</strong>αραί<strong>τ</strong>η<strong>τ</strong>η.<br />

Εφαρµογή ηλ<strong>ε</strong>κ<strong>τ</strong>ροθ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong>ίας µ<strong>ε</strong> δια<strong>σ</strong><strong>τ</strong>α<strong>υ</strong>ρούµ<strong>ε</strong>να ρ<strong>ε</strong>ύµα<strong>τ</strong>α

3 η - 4 η ΕΒ∆ΟΜΑ∆Α<br />

• Η χρή<strong>σ</strong>η <strong>τ</strong>ων βακ<strong>τ</strong>ηρίων (<strong>π</strong>α<strong>τ</strong><strong>ε</strong>ρί<strong>τ</strong><strong>σ</strong><strong>ε</strong>ς ) <strong>ε</strong>ίναι <strong>υ</strong><strong>π</strong>οκ<strong>ε</strong>ιµ<strong>ε</strong>νική. Αφαι<br />

ρούν<strong>τ</strong>αι <strong>αν</strong> δ<strong>ε</strong>ν κρίνον<strong>τ</strong>αι α<strong>π</strong>αραί<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς α<strong>π</strong>ό <strong>τ</strong>ον α<strong>σ</strong>θ<strong>ε</strong>νή. ∆<strong>ε</strong>ν <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι<br />

να κο<strong>υ</strong>ράζ<strong>ε</strong><strong>τ</strong>αι ά<strong>σ</strong>κο<strong>π</strong>α <strong>τ</strong>ο <strong>π</strong>όδι.<br />

• Σ<strong>υ</strong>ν<strong>ε</strong>χίζο<strong>υ</strong>µ<strong>ε</strong> να δίνο<strong>υ</strong>µ<strong>ε</strong> έµφα<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ις α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις για <strong>π</strong>λήρη έκ<strong>τ</strong>α<strong>σ</strong>η<br />

<strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος. Ο α<strong>σ</strong>θ<strong>ε</strong>νής ξα<strong>π</strong>λών<strong>ε</strong>ι µ<strong>π</strong>ρούµη<strong>τ</strong>α µ<strong>ε</strong> <strong>τ</strong>α γόνα<strong>τ</strong>α έξω<br />

α<strong>π</strong>ό <strong>τ</strong>ο κρ<strong>ε</strong>βά<strong>τ</strong>ι για <strong>π</strong>λήρη έκ<strong>τ</strong>α<strong>σ</strong>η, 2 -3 φορές <strong>τ</strong>ην ηµέρα. Ο α<strong>σ</strong>θ<strong>ε</strong><br />

νής <strong>π</strong>ρο<strong>σ</strong><strong>π</strong>αθ<strong>ε</strong>ί να <strong>ε</strong>κ<strong>τ</strong><strong>ε</strong>λέ<strong>σ</strong><strong>ε</strong>ι κάµψη <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος 90° + α<strong>π</strong>ό <strong>τ</strong>ην ίδια<br />

θέ<strong>σ</strong>η βοηθών<strong>τ</strong>ας µ<strong>ε</strong> <strong>τ</strong>ο <strong>υ</strong>γιές.<br />

• Εν<strong>ε</strong>ργη<strong>τ</strong>ικές α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις Α<strong>π</strong>αγωγών - Προ<strong>σ</strong>αγωγών 3 <strong>σ</strong><strong>ε</strong><strong>τ</strong> ΧΙΟ <strong>ε</strong><strong>π</strong>α<br />

ναλήψ<strong>ε</strong>ις <strong>τ</strong>ην ηµέρα µ<strong>ε</strong> βάρος 1-2<br />

Α<strong>π</strong>αγωγή <strong>τ</strong>ο<strong>υ</strong> ι<strong>σ</strong>χίο<strong>υ</strong><br />

• Α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις <strong>σ</strong><strong>ε</strong> µ<strong>π</strong><strong>αν</strong>ιέρα ή <strong>π</strong>ι<strong>σ</strong>ίνα (<strong>π</strong>ρο<strong>σ</strong><strong>π</strong>άθ<strong>ε</strong>ια κάµψης - έκ<strong>τ</strong>α<strong>σ</strong>ης<br />

<strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος µέ<strong>σ</strong>α <strong>σ</strong><strong>τ</strong>ο ν<strong>ε</strong>ρό).<br />

• Ο α<strong>σ</strong>θ<strong>ε</strong>νής <strong>σ</strong><strong>τ</strong>έκ<strong>ε</strong><strong>τ</strong>αι όρθιος έχον<strong>τ</strong>ας <strong>τ</strong>α <strong>π</strong>όδια <strong>ε</strong>λαφρώς <strong>αν</strong>οιχ<strong>τ</strong>ά<br />

και κρα<strong>τ</strong>ά <strong>τ</strong>ην <strong>π</strong>λά<strong>τ</strong>η µιας καρέκλας. Λ<strong>υ</strong>γίζ<strong>ε</strong>ι <strong>ε</strong>λαφρά <strong>τ</strong>α γόνα<strong>τ</strong>α <strong>σ</strong><strong>τ</strong>ις<br />

30° -40° και µέν<strong>ε</strong>ι 5 δ<strong>ε</strong><strong>υ</strong><strong>τ</strong><strong>ε</strong>ρόλ<strong>ε</strong><strong>π</strong><strong>τ</strong>α <strong>π</strong>α<strong>τ</strong>ών<strong>τ</strong>ας ολόκληρα <strong>τ</strong>α <strong>π</strong>έλµα<br />

<strong>τ</strong>α. Σηκών<strong>ε</strong><strong>τ</strong>αι αργά <strong>σ</strong><strong>τ</strong>ην αρχική θέ<strong>σ</strong>η.

• Α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις µ<strong>ε</strong> λά<strong>σ</strong><strong>τ</strong>ιχο και <strong>σ</strong><strong>τ</strong>α <strong>τ</strong>έ<strong>σ</strong><strong>σ</strong><strong>ε</strong>ρα <strong>ε</strong><strong>π</strong>ί<strong>π</strong><strong>ε</strong>δα.<br />

• Σ<strong>τ</strong>α<strong>τ</strong>ικό <strong>π</strong>οδήλα<strong>τ</strong>ο µ<strong>ε</strong><strong>τ</strong>ά <strong>τ</strong>ην 3 η βδοµάδα 5ΐβρ, α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις µονό<br />

<strong>π</strong>λ<strong>ε</strong><strong>υ</strong>ρης <strong>σ</strong><strong>τ</strong>ήριξης και <strong>ε</strong>κ<strong>π</strong>αίδ<strong>ε</strong><strong>υ</strong><strong>σ</strong>η για <strong>σ</strong>ω<strong>σ</strong><strong>τ</strong>ή βάδι<strong>σ</strong>η.<br />

• Έναρξη δ<strong>υ</strong>ναµικών α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ων ιδιοδ<strong>ε</strong>κ<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>ας,<br />

• ∆<strong>ε</strong>ν <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι ο α<strong>σ</strong>θ<strong>ε</strong>νής να ξ<strong>ε</strong>χνά<strong>ε</strong>ι <strong>τ</strong>ην <strong>ε</strong>φαρµογή ψ<strong>υ</strong>χρών <strong>ε</strong><strong>π</strong>ιθ<strong>ε</strong><br />

µά<strong>τ</strong>ων κα<strong>τ</strong>ά <strong>τ</strong>η διάρκ<strong>ε</strong>ια <strong>τ</strong>ης ηµέρας.<br />

• Έκ<strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος µ<strong>ε</strong> ΙΚ9 α<strong>π</strong>ό 90° - 40°. Α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις δια<strong>τ</strong>ά<strong>σ</strong><strong>ε</strong>ις<br />

ι<strong>σ</strong>χιο-κνηµιαίων.<br />

Μονό<strong>π</strong>λ<strong>ε</strong><strong>υ</strong>ρη <strong>σ</strong><strong>τ</strong>ήριξη <strong>τ</strong>ο<strong>υ</strong> α<strong>σ</strong>θ<strong>ε</strong>νή <strong>π</strong>οδο<strong>σ</strong>φαιρι<strong>σ</strong><strong>τ</strong>ή µ<strong>ε</strong> <strong>τ</strong>ο γόνα<strong>τ</strong>ο <strong>σ</strong><strong>ε</strong> 0°<br />

γωνία και διορθώνον<strong>τ</strong>ας <strong>τ</strong>η <strong>σ</strong><strong>τ</strong>ά<strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong><strong>τ</strong>ον καθρέφ<strong>τ</strong>η

Εκ<strong>τ</strong><strong>ε</strong>λούν<strong>τ</strong>αι ι<strong>σ</strong>οµ<strong>ε</strong><strong>τ</strong>ρικές α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong> µ<strong>ε</strong> βάρος 5<br />

5 η - 6 α ΕΒ∆ΟΜΑ∆Α<br />

• Αύξη<strong>σ</strong>η <strong>τ</strong>ης <strong>αν</strong><strong>τ</strong>ί<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>ης <strong>σ</strong><strong>τ</strong>ις α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις <strong>τ</strong>ων ο<strong>π</strong>ί<strong>σ</strong>θιων µηριαίων.<br />

• Εν<strong>τ</strong><strong>ε</strong>ίνον<strong>τ</strong>αι οι α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις για <strong>τ</strong>ην αύξη<strong>σ</strong>η <strong>τ</strong>ης <strong>τ</strong>ροχιάς <strong>τ</strong>ης κίνη<strong>σ</strong>ης<br />

<strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος ( α<strong>π</strong>ό <strong>π</strong>λήρη έκ<strong>τ</strong>α<strong>σ</strong>η <strong>σ</strong><strong>ε</strong> <strong>π</strong>λήρη κάµψη ).<br />

• Σ<strong>υ</strong>ν<strong>ε</strong>χιζόµ<strong>ε</strong>ν<strong>ε</strong>ς α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις κλ<strong>ε</strong>ι<strong>σ</strong><strong>τ</strong>ής κινη<strong>τ</strong>ικής αλ<strong>υ</strong><strong>σ</strong>ίδας ( Step ups-<br />

Squats-leg press, , <strong>π</strong>οδήλα<strong>τ</strong>ο κ.λ.<strong>π</strong>.).<br />

• Αν<strong>υ</strong>ψώ<strong>σ</strong><strong>ε</strong>ις <strong>σ</strong><strong>τ</strong>α δάκ<strong>τ</strong><strong>υ</strong>λα ( α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις γα<strong>σ</strong><strong>τ</strong>ροκνηµίο<strong>υ</strong> και ι<strong>σ</strong>ορρο<br />

<strong>π</strong>ίας).<br />

• Αφαίρ<strong>ε</strong><strong>σ</strong>η <strong>τ</strong>ο<strong>υ</strong> νάρθηκα.<br />

• Τ<strong>ε</strong>λ<strong>ε</strong>ιο<strong>π</strong>οίη<strong>σ</strong>η <strong>τ</strong>ης βάδι<strong>σ</strong>ης και <strong>ε</strong>ν<strong>τ</strong><strong>ε</strong>ίνον<strong>τ</strong>αι οι α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις ιδιοδ<strong>ε</strong>κ<strong>τ</strong>ικό-<br />

<strong>τ</strong>η<strong>τ</strong>ας.

• Έναρξη κολύµβη<strong>σ</strong>ης, α<strong>π</strong>οφ<strong>ε</strong>ύγον<strong>τ</strong>ας <strong>τ</strong>ο <strong>π</strong>ρό<strong>σ</strong>θιο,<br />

• Εφαρµογή <strong>ε</strong><strong>π</strong>ιγονα<strong>τ</strong>ίδας <strong>σ</strong><strong>τ</strong>ο γόνα<strong>τ</strong>ο <strong>τ</strong>ο<strong>υ</strong>λάχι<strong>σ</strong><strong>τ</strong>ον ό<strong>τ</strong><strong>αν</strong> ο α<strong>σ</strong>θ<strong>ε</strong>νής<br />

κιν<strong>ε</strong>ί<strong>τ</strong>αι <strong>ε</strong>κ<strong>τ</strong>ός <strong>σ</strong><strong>π</strong>ι<strong>τ</strong>ιού.<br />

Ο α<strong>σ</strong>θ<strong>ε</strong>νής µ<strong>ε</strong> <strong>τ</strong>α γόνα<strong>τ</strong>α <strong>σ</strong><strong>ε</strong> 90° <strong>π</strong>ρο<strong>σ</strong><strong>π</strong>αθ<strong>ε</strong>ί να κρα<strong>τ</strong>ή<strong>σ</strong><strong>ε</strong>ι <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρό <strong>τ</strong>ο<br />

<strong>ε</strong><strong>π</strong>ί<strong>π</strong><strong>ε</strong>δο αφού <strong>τ</strong>ο µ<strong>ε</strong><strong>τ</strong>ακιν<strong>ε</strong>ί ο Φ<strong>υ</strong><strong>σ</strong>ιοθ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong><strong>υ</strong><strong>τ</strong>ής µ<strong>π</strong>ρος-<strong>π</strong>ί<strong>σ</strong>ω<br />

Ά<strong>σ</strong>κη<strong>σ</strong>η κλ<strong>ε</strong>ι<strong>σ</strong><strong>τ</strong>ής κινη<strong>τ</strong>ικής Αλ<strong>υ</strong><strong>σ</strong>ίδας

Α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις κλ<strong>ε</strong>ι<strong>σ</strong><strong>τ</strong>ής κινη<strong>τ</strong>ικής αλ<strong>υ</strong><strong>σ</strong>ίδας ό<strong>τ</strong><strong>τ</strong>ο<strong>υ</strong> γίν<strong>ε</strong><strong>τ</strong>αι κάµψη<br />

γόνα<strong>τ</strong>ος µέχρι 90°

7 η - 12 η ΕΒ∆ΟΜΑ∆Α<br />

• Αφαιρ<strong>ε</strong>ί<strong>τ</strong>αι ο νάρθηκας και <strong>ε</strong>κ<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί<strong>τ</strong>αι <strong>ε</strong>λ<strong>ε</strong>ύθ<strong>ε</strong>ρη βάδι<strong>σ</strong>η (όχι <strong>τ</strong>ακού<br />

νια).<br />

• Α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις κάµψης - έκ<strong>τ</strong>α<strong>σ</strong>ης για <strong>τ</strong>η δια<strong>τ</strong>ήρη<strong>σ</strong>η <strong>π</strong>λήρο<strong>υ</strong>ς <strong>ε</strong>ύρο<strong>υ</strong>ς<br />

κίνη<strong>σ</strong>ης <strong>τ</strong>ο<strong>υ</strong> γόνα<strong>τ</strong>ος, χωρίς όµως βάρη.<br />

• Ανύψω<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>α δάκ<strong>τ</strong><strong>υ</strong>λα <strong>τ</strong>ων <strong>π</strong>οδιών.<br />

• Ι<strong>σ</strong>οµ<strong>ε</strong><strong>τ</strong>ρικές α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong>, ο<strong>π</strong>ί<strong>σ</strong>θιων µηριαίων, <strong>π</strong>ρο<strong>σ</strong>α<br />

γωγών και α<strong>π</strong>αγωγών µ<strong>ε</strong> λά<strong>σ</strong><strong>τ</strong>ιχο ή µ<strong>ε</strong> βάρη 1 έως 5 Κς <strong>υ</strong><strong>π</strong>ό <strong>τ</strong>ην<br />

<strong>ε</strong><strong>π</strong>ο<strong>π</strong><strong>τ</strong><strong>ε</strong>ία <strong>τ</strong>ο<strong>υ</strong> φ<strong>υ</strong><strong>σ</strong>ιοθ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong><strong>υ</strong><strong>τ</strong>ή. Σ<strong>τ</strong>ην ά<strong>σ</strong>κη<strong>σ</strong>η α<strong>υ</strong><strong>τ</strong>ή δ<strong>ε</strong>ν λιγίζ<strong>ε</strong>ι <strong>τ</strong>ο<br />

γόνα<strong>τ</strong>ο.<br />

• Ηµικαθί<strong>σ</strong>µα<strong>τ</strong>α. Ο αθ<strong>ε</strong>νής ακο<strong>υ</strong>µ<strong>π</strong>ά<strong>ε</strong>ι <strong>τ</strong>ην <strong>π</strong>λά<strong>τ</strong>η <strong>σ</strong><strong>τ</strong>ον <strong>τ</strong>οίχο και λ<strong>υ</strong><br />

γίζ<strong>ε</strong>ι <strong>τ</strong>α γόνα<strong>τ</strong>α έως 30° - 40°. Αργό<strong>τ</strong><strong>ε</strong>ρα µ<strong>π</strong>ορ<strong>ε</strong>ί να <strong>π</strong>ρο<strong>σ</strong><strong>τ</strong><strong>ε</strong>θ<strong>ε</strong>ί<br />

<strong>σ</strong><strong>τ</strong>ο<strong>υ</strong>ς ώµο<strong>υ</strong>ς µια µ<strong>π</strong>άρα έως και 15 Κ9 ( <strong>σ</strong><strong>τ</strong>ο φ<strong>υ</strong><strong>σ</strong>ιοθ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong><strong>υ</strong><strong>τ</strong>ή ριο ).<br />

Steps µικρά - µ<strong>ε</strong>γάλα (<strong>σ</strong><strong>τ</strong>ο φ<strong>υ</strong><strong>σ</strong>ιοθ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong><strong>υ</strong><strong>τ</strong>ήριο).<br />

Leg press έως 60° (<strong>σ</strong><strong>τ</strong>ο φ<strong>υ</strong><strong>σ</strong>ιοθ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong><strong>υ</strong><strong>τ</strong>ήριο).<br />

• Σ<strong>τ</strong>α<strong>τ</strong>ικό <strong>π</strong>οδήλα<strong>τ</strong>ο µ<strong>ε</strong> <strong>τ</strong>η <strong>σ</strong>έλα ψηλά <strong>σ</strong><strong>τ</strong>ην αρχή χωρίς <strong>αν</strong><strong>τ</strong>ί<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η<br />

και αργό<strong>τ</strong><strong>ε</strong>ρα µ<strong>ε</strong> <strong>αν</strong><strong>τ</strong>ί<strong>σ</strong><strong>τ</strong>α<strong>σ</strong>η <strong>π</strong>ροοδ<strong>ε</strong><strong>υ</strong><strong>τ</strong>ικά.<br />

• Α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις ιδιοδ<strong>ε</strong>κ<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>ας (<strong>σ</strong><strong>τ</strong>ο φ<strong>υ</strong><strong>σ</strong>ιοθ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong><strong>υ</strong><strong>τ</strong>ήριο). Σ<strong>τ</strong>ο <strong>σ</strong><strong>π</strong>ί<strong>τ</strong>ι<br />

βάδι<strong>σ</strong>η <strong>σ</strong><strong>ε</strong> φο<strong>υ</strong><strong>σ</strong>κωµένο <strong>σ</strong><strong>τ</strong>ρώµα θαλά<strong>σ</strong><strong>σ</strong>ης για <strong>ε</strong>κµάθη<strong>σ</strong>η ι<strong>σ</strong>ορρο<br />

<strong>π</strong>ίας - <strong>τ</strong>ραµ<strong>π</strong>ο-λίνο.

• Κολύ<strong>π</strong>µι <strong>σ</strong><strong>τ</strong>η θάλα<strong>σ</strong><strong>σ</strong>α ή <strong>σ</strong><strong>ε</strong> <strong>π</strong>ι<strong>σ</strong>ίνα, Ελ<strong>ε</strong>ύθ<strong>ε</strong>ρο ή ύ<strong>π</strong><strong>τ</strong>ιο, µ<strong>ε</strong> ή χωρίς<br />

βα<strong>τ</strong>ραχο<strong>π</strong>έδιλα και µ<strong>ε</strong> γόνα<strong>τ</strong>α <strong>τ</strong><strong>ε</strong>ν<strong>τ</strong>ωµένα ( ΟΧ! ΠΡΟΣΘΙΟ ).<br />

• Τροχάδην µέ<strong>σ</strong>α <strong>σ</strong><strong>τ</strong>ο ν<strong>ε</strong>ρό µ<strong>ε</strong> <strong>τ</strong>η <strong>σ</strong><strong>τ</strong>άθµη <strong>τ</strong>ο<strong>υ</strong> να φ<strong>τ</strong>άν<strong>ε</strong>ι <strong>σ</strong><strong>τ</strong>ο ύψος<br />

<strong>τ</strong>ο<strong>υ</strong> <strong>σ</strong><strong>τ</strong>ήθο<strong>υ</strong>ς αρχικά και <strong>τ</strong>ης κοιλιάς αργό<strong>τ</strong><strong>ε</strong>ρα.<br />

• Μ<strong>ε</strong><strong>τ</strong>ά <strong>τ</strong>ις α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις <strong>τ</strong>ο<strong>π</strong>οθ<strong>ε</strong><strong>τ</strong><strong>ε</strong>ί<strong>τ</strong>αι <strong>π</strong>άγος <strong>σ</strong><strong>τ</strong>ο γόνα<strong>τ</strong>ο (<strong>π</strong>άν<strong>τ</strong>ο<strong>τ</strong><strong>ε</strong> ).<br />

Α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις ι<strong>σ</strong>ορρο<strong>π</strong>ίας µ<strong>ε</strong> κάµψη-έκ<strong>τ</strong>α<strong>σ</strong>η <strong>σ</strong><strong>τ</strong>ο γόνα<strong>τ</strong>ο 0° - 30°<br />

ΠΡΟΣΟΧΗ: ΟΧΙ ΒΙΑΣΥΝΗ<br />

4 ος ΜΗΝΑΣ:<br />

• Σ<strong>υ</strong>ν<strong>ε</strong>χίζον<strong>τ</strong>αι οι α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις <strong>π</strong>ο<strong>υ</strong> ήδη ο α<strong>σ</strong>θ<strong>ε</strong>νής έκ<strong>αν</strong><strong>ε</strong> α<strong>π</strong>ό <strong>τ</strong>ην 7 η -<br />

12 η <strong>ε</strong>βδοµάδα.<br />

• Κολύµ<strong>π</strong>ι - <strong>π</strong>οδήλα<strong>τ</strong>ο - ηµικαθί<strong>σ</strong>µα<strong>τ</strong>α.<br />

• Τροχάδην <strong>σ</strong><strong>τ</strong>ο-ν<strong>ε</strong>ρό - ι<strong>σ</strong>οµ<strong>ε</strong><strong>τ</strong>ρικές α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong>, ο<strong>π</strong>ί<br />

<strong>σ</strong>θιων µηριαίων, <strong>π</strong>ρο<strong>σ</strong>αγωγών - α<strong>π</strong>αγωγών.

• Προ<strong>σ</strong><strong>τ</strong>ίθ<strong>ε</strong>ν<strong>τ</strong>αι και <strong>ε</strong><strong>π</strong>ι<strong>τ</strong>ό<strong>π</strong>ια άλµα<strong>τ</strong>α, <strong>σ</strong>χοινάκι, ή<strong>π</strong>ι<strong>ε</strong>ς ι<strong>σ</strong>ο<strong>τ</strong>ονικές α<br />

<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong>, ο<strong>π</strong>ί<strong>σ</strong>θιων µηριαίων.<br />

• ∆ια<strong>τ</strong>ά<strong>σ</strong><strong>ε</strong>ις όλων <strong>τ</strong>ων µ<strong>υ</strong>ϊκών <strong>σ</strong><strong>υ</strong><strong>σ</strong><strong>τ</strong>ηµά<strong>τ</strong>ων.<br />

• Ενδ<strong>υ</strong>νάµω<strong>σ</strong>η κοιλιακών.<br />

• Α<strong>π</strong>αλό <strong>τ</strong>ροχάδην <strong>σ</strong><strong>ε</strong> µαλακό έδαφος (χόρ<strong>τ</strong>ο <strong>αν</strong> µ<strong>π</strong>ορούµ<strong>ε</strong>).<br />

5 ος ΜΗΝΑΣ<br />

• Τροχάδην µ<strong>ε</strong> <strong>σ</strong><strong>τ</strong>ιγµές <strong>ε</strong><strong>π</strong>ι<strong>τ</strong>άχ<strong>υ</strong>ν<strong>σ</strong>ης - <strong>ε</strong><strong>π</strong>ιβάρ<strong>υ</strong>ν<strong>σ</strong>ης 20µ - 2µ - 20µ<br />

2µ<br />

• Τροχάδην µ<strong>ε</strong> οκ<strong>τ</strong>άρια.<br />

• Τροχάδην µ<strong>ε</strong> αλλαγές δι<strong>ε</strong>ύθ<strong>υ</strong>ν<strong>σ</strong>ης.<br />

• Α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις <strong>σ</strong><strong>ε</strong> <strong>σ</strong>καλάκια <strong>ε</strong>µ<strong>π</strong>ρός - <strong>π</strong>ί<strong>σ</strong>ω.<br />

• Εν<strong>ε</strong>ργό<strong>τ</strong><strong>ε</strong>ρ<strong>ε</strong>ς ι<strong>σ</strong>ο<strong>τ</strong>ονικές α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong> - ο<strong>π</strong>ί<strong>σ</strong>θιων µηριαίων.

6 ος ΜΗΝΑΣ<br />

* Αρχίζ<strong>ε</strong>ι α<strong>τ</strong>οµική <strong>π</strong>ρο<strong>π</strong>όνη<strong>σ</strong>η µ<strong>ε</strong> <strong>τ</strong>ην µ<strong>π</strong>άλα ( ΚΑΜΙΑ ΕΠΑΦΗ ΜΕ ΑΝΤΙ<br />

ΠΑΛΟ ΑΚΟΜΗ ).<br />

- Α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις <strong>σ</strong><strong>τ</strong>ην κ<strong>ε</strong>ρκίδα <strong>π</strong>άνω - κά<strong>τ</strong>ω<br />

ΣΗΜΕΙΩΣΗ : <strong>σ</strong><strong>ε</strong> όλ<strong>ε</strong>ς <strong>τ</strong>ις φά<strong>σ</strong><strong>ε</strong>ις <strong>σ</strong><strong>υ</strong>ν<strong>ε</strong>χίζον<strong>τ</strong>αι οι α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις ιδιοδ<strong>ε</strong>κ<strong>τ</strong>ικό<strong>τ</strong>η-<strong>τ</strong>ας<br />

( <strong>σ</strong><strong>τ</strong>ρώµα ) και δ<strong>ε</strong>ν <strong>π</strong>ρέ<strong>π</strong><strong>ε</strong>ι ο α<strong>σ</strong>θ<strong>ε</strong>νής να ξ<strong>ε</strong>χνά<strong>ε</strong>ι <strong>τ</strong>ις δια<strong>τ</strong>ά<strong>σ</strong><strong>ε</strong>ις.<br />

ΣΗΜΕΙΑ ΠΡΟΣΟΧΗΣ<br />

• Η <strong>π</strong>ρό<strong>σ</strong>θ<strong>ε</strong><strong>σ</strong>η <strong>τ</strong>ων α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ων γίν<strong>ε</strong><strong>τ</strong>αι ΠΡΟΟ∆ΕΥΤΙΚΩΣ.<br />

• Το <strong>π</strong>ρόγραµµα ΕΞΑΤΟΜΙΚΕΥΕΤΑΙ ό<strong>σ</strong>ον αφορά <strong>τ</strong>ο χρόνο, <strong>τ</strong>η<br />

διάρκ<strong>ε</strong>ια και <strong>τ</strong>ην έν<strong>τ</strong>α<strong>σ</strong>η <strong>τ</strong>ων α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ων.<br />

• Ως αδρό κρι<strong>τ</strong>ήριο <strong>τ</strong>ης οµαλής <strong>π</strong>ροόδο<strong>υ</strong> θ<strong>ε</strong>ωρούµ<strong>ε</strong> <strong>τ</strong>ο να µην <strong>π</strong>ο<br />

νά<strong>ε</strong>ι και να µην <strong>π</strong>ρίζ<strong>ε</strong><strong>τ</strong>αι <strong>τ</strong>ο γόνα<strong>τ</strong>ο.<br />

• Σ<strong>τ</strong>ο <strong>τ</strong>έλος <strong>τ</strong>ο<strong>υ</strong> 6 ο<strong>υ</strong> µήνα ο α<strong>σ</strong>θ<strong>ε</strong>νής <strong>ε</strong><strong>π</strong>ι<strong>σ</strong>κέ<strong>π</strong><strong>τ</strong><strong>ε</strong><strong>τ</strong>αι για <strong>τ</strong><strong>ε</strong>λ<strong>ε</strong><strong>υ</strong><strong>τ</strong>αία φο<br />

ρά <strong>τ</strong>ον ια<strong>τ</strong>ρό <strong>τ</strong>ο<strong>υ</strong>.<br />

• Οι ι<strong>σ</strong>ο<strong>τ</strong>ονικές α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις γίνον<strong>τ</strong>αι λ<strong>υ</strong>γίζον<strong>τ</strong>ας - <strong>τ</strong><strong>ε</strong>ν<strong>τ</strong>ώνον<strong>τ</strong>ας <strong>τ</strong>ο γό<br />

να<strong>τ</strong>ο, οι ι<strong>σ</strong>οµ<strong>ε</strong><strong>τ</strong>ρικές µ<strong>ε</strong> <strong>τ</strong>ο γόνα<strong>τ</strong>ο <strong>σ</strong><strong>υ</strong>ν<strong>ε</strong>χώς <strong>τ</strong><strong>ε</strong>ν<strong>τ</strong>ωµένο.<br />

Παρακά<strong>τ</strong>ω <strong>π</strong>αρα<strong>τ</strong>ίθ<strong>ε</strong>ν<strong>τ</strong>αι α<strong>σ</strong>κή<strong>σ</strong><strong>ε</strong>ις <strong>ε</strong>νδ<strong>υ</strong>νάµω<strong>σ</strong>ης µ<strong>ε</strong><strong>τ</strong>ά α<strong>π</strong>ό <strong>π</strong>λα<strong>σ</strong><strong>τ</strong>ική<br />

<strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>:

ΕΠΑΝΟ∆ΟΣ ΣΤΗΝ ΑΘΛΗΤΙΚΗ ∆ΡΑΣΤΗΡ1ΟΤΗΤΑ<br />

Τα κρι<strong>τ</strong>ήρια για <strong>τ</strong>ην <strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ροφή <strong>σ</strong><strong>τ</strong>ην άθλη<strong>σ</strong>η <strong>ε</strong>ίναι:<br />

α. Κλινικά<br />

- <strong>π</strong>λήρ<strong>ε</strong>ς <strong>ε</strong>ύρος κίνη<strong>σ</strong>ης<br />

- <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρό<strong>τ</strong>η<strong>τ</strong>α<br />

- α<strong>π</strong>ο<strong>υ</strong><strong>σ</strong>ία <strong>υ</strong>δράρθρο<strong>υ</strong><br />

β. Παρακλινικά<br />

- <strong>σ</strong><strong>υ</strong>γκρι<strong>τ</strong>ικός βαθµός δύναµης και ι<strong>σ</strong>χύος <strong>τ</strong>ο<strong>υ</strong> <strong>τ</strong><strong>ε</strong><strong>τ</strong>ρακέφαλο<strong>υ</strong> και<br />

<strong>τ</strong>ων ο<strong>π</strong>ί<strong>σ</strong>θιων µηριαίων <strong>τ</strong>ο<strong>υ</strong>λάχι<strong>σ</strong><strong>τ</strong>ον 85% και 90% <strong>αν</strong><strong>τ</strong>ί<strong>σ</strong><strong>τ</strong>οιχα<br />

-<strong>σ</strong><strong>υ</strong>γκρι<strong>τ</strong>ικός βαθµός <strong>τ</strong>ων λ<strong>ε</strong>ι<strong>τ</strong>ο<strong>υ</strong>ργικών δοκιµα<strong>σ</strong>ιών, δηλαδή<br />

δοκιµα<strong>σ</strong>ιών <strong>π</strong>ο<strong>υ</strong> <strong>π</strong>ρο<strong>σ</strong>οµοιάζον <strong>τ</strong>ις <strong>αν</strong>α<strong>π</strong><strong>τ</strong><strong>υ</strong><strong>σ</strong><strong>σ</strong>όµ<strong>ε</strong>ν<strong>ε</strong>ς δ<strong>υ</strong>νάµ<strong>ε</strong>ις<br />

κα<strong>τ</strong>ά <strong>τ</strong>η διάρκ<strong>ε</strong>ια Ιιορρίης και 1099109, <strong>τ</strong>ο<strong>υ</strong>λάχι<strong>σ</strong><strong>τ</strong>ον 95%<br />

- βαθµός ιδιοδ<strong>ε</strong>κ<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>ας 100%

Ο χρόνος <strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ροφής <strong>σ</strong><strong>τ</strong>ην άθλη<strong>σ</strong>η α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λ<strong>ε</strong>ί <strong>π</strong><strong>ε</strong>δίο διχογνωµίας<br />

µ<strong>ε</strong> µια οµάδα <strong>σ</strong><strong>υ</strong>γγραφέων <strong>π</strong>ο<strong>υ</strong> <strong>υ</strong><strong>π</strong>ο<strong>σ</strong><strong>τ</strong>ηρίζο<strong>υ</strong>ν <strong>τ</strong>ην <strong>π</strong>ρώιµη <strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ροφή<br />

( κα<strong>τ</strong>ά µέ<strong>σ</strong>ο όρο 5 µήν<strong>ε</strong>ς ) και άλλη οµάδα <strong>σ</strong><strong>υ</strong>γγραφέων<br />

<strong>π</strong>ο<strong>υ</strong> <strong>υ</strong><strong>π</strong>ο<strong>σ</strong><strong>τ</strong>ηρίζο<strong>υ</strong>ν <strong>τ</strong>ην καθ<strong>υ</strong><strong>σ</strong><strong>τ</strong><strong>ε</strong>ρηµένη <strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ροφή ( µ<strong>ε</strong><strong>τ</strong>ά <strong>τ</strong>ον 9°<br />

µήνα).<br />

Υ<strong>π</strong>έρ <strong>τ</strong>ης <strong>π</strong>ρώιµης <strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ροφής, µ<strong>ε</strong> <strong>τ</strong>ην <strong>π</strong>ροϋ<strong>π</strong>όθ<strong>ε</strong><strong>σ</strong>η <strong>τ</strong>ης άρι<strong>σ</strong><strong>τ</strong>ης<br />

δ<strong>υ</strong>ναµικής <strong>σ</strong><strong>τ</strong>αθ<strong>ε</strong>ρό<strong>τ</strong>η<strong>τ</strong>ας και <strong>π</strong>λήρο<strong>υ</strong>ς κινη<strong>τ</strong>ικό<strong>τ</strong>η<strong>τ</strong>ας, <strong>ε</strong>ίναι <strong>τ</strong>α γ<strong>ε</strong>γονός<br />

ό<strong>τ</strong>ι οι <strong>π</strong>λέον έν<strong>τ</strong>ον<strong>ε</strong>ς αθλη<strong>τ</strong>ικές δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong><strong>ε</strong>ς <strong>σ</strong><strong>π</strong>άνια φορ<strong>τ</strong>ίζο<strong>υ</strong>ν<br />

<strong>τ</strong>ο µό<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µα <strong>π</strong>λέον <strong>τ</strong>ο<strong>υ</strong> 50% <strong>τ</strong>ης µέγι<strong>σ</strong><strong>τ</strong>ης <strong>αν</strong><strong>τ</strong>οχής <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong><br />

χια<strong>σ</strong><strong>τ</strong>ού <strong>σ</strong><strong>υ</strong>νδέ<strong>σ</strong>µο<strong>υ</strong>.<br />

Υ<strong>π</strong>έρ <strong>τ</strong>ης καθ<strong>υ</strong><strong>σ</strong><strong>τ</strong><strong>ε</strong>ρηµένης <strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ροφής ό<strong>τ</strong><strong>αν</strong> χρη<strong>σ</strong>ιµο<strong>π</strong>οι<strong>ε</strong>ί<strong>τ</strong>αι βιολογικό<br />

α<strong>υ</strong><strong>τ</strong>οµό<strong>σ</strong>χ<strong>ε</strong><strong>υ</strong>µα, <strong>ε</strong>ίναι <strong>τ</strong>α α<strong>π</strong>ο<strong>τ</strong><strong>ε</strong>λέ<strong>σ</strong>µα<strong>τ</strong>α <strong>τ</strong>ων <strong>ε</strong>κβιοµηχ<strong>αν</strong>ικών<br />

µ<strong>ε</strong>λ<strong>ε</strong><strong>τ</strong>ών <strong>π</strong>ο<strong>υ</strong> κα<strong>τ</strong>αδ<strong>ε</strong>ικνύο<strong>υ</strong>ν η <strong>αν</strong><strong>τ</strong>οχή <strong>τ</strong>ο<strong>υ</strong> <strong>π</strong>άχο<strong>υ</strong>ς 10χιλ, Ε<strong>π</strong>ιγονα<strong>τ</strong>ιδικού<br />

µο<strong>σ</strong>χ<strong>ε</strong>ύµα<strong>τ</strong>ος <strong>τ</strong>ην ηµέρα <strong>τ</strong>ης <strong>ε</strong>µφύ<strong>τ</strong><strong>ε</strong><strong>υ</strong><strong>σ</strong>ης <strong>ε</strong>ίναι ί<strong>σ</strong>η µ<strong>ε</strong><br />

<strong>τ</strong>ο 107% <strong>τ</strong>ο<strong>υ</strong> φ<strong>υ</strong><strong>σ</strong>ιολογικού <strong>π</strong>ρό<strong>σ</strong>θιο<strong>υ</strong> χια<strong>σ</strong><strong>τ</strong>ού, <strong>σ</strong><strong>τ</strong>ο<strong>υ</strong>ς 3 µήν<strong>ε</strong>ς <strong>ε</strong>λα<strong>τ</strong><strong>τ</strong>ών<strong>ε</strong><strong>τ</strong>αι<br />

<strong>σ</strong><strong>τ</strong>ο 57%, <strong>σ</strong><strong>τ</strong>ο<strong>υ</strong>ς 6 µήν<strong>ε</strong>ς α<strong>π</strong>ό 57% και <strong>σ</strong><strong>τ</strong>ο<strong>υ</strong>ς 9 µήν<strong>ε</strong>ς α-<br />

νέρχ<strong>ε</strong><strong>τ</strong>αι <strong>σ</strong><strong>τ</strong>ο 87%.<br />

Το ζη<strong>τ</strong>ούµ<strong>ε</strong>νο όµως δ<strong>ε</strong>ν <strong>ε</strong>ίναι <strong>τ</strong>ο <strong>π</strong>ό<strong>τ</strong><strong>ε</strong> αλλά <strong>τ</strong>ο <strong>π</strong>ώς ο αθλη<strong>τ</strong>ής θα<br />

<strong>ε</strong><strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ρέψ<strong>ε</strong>ι <strong>σ</strong><strong>τ</strong>ην <strong>π</strong>ρο <strong>τ</strong>ης κάκω<strong>σ</strong>ης αθλη<strong>τ</strong>ική <strong>τ</strong>ο<strong>υ</strong> δρα<strong>σ</strong><strong>τ</strong>ηριό<strong>τ</strong>η<strong>τ</strong>α.

ΒΙΒΛΙΟΓΡΑΦΙΑ<br />

ΕΛΛΗΝΙΚΗ<br />

1 Αµ<strong>π</strong>α<strong>τ</strong>ζίδης Γ. : ΑΘΛΗΤΙΚΕΣ ΚΑΚΩΣΕΙΣ, University Studio<br />

Press, Θ<strong>ε</strong><strong>σ</strong><strong>σ</strong>αλονίκη 1995.<br />

2 Κο<strong>τ</strong>ζαηλιας ∆.: ΠΑΘΗΣΕΙΣ - ΚΑΚΩΣΕΙΣ ΜΥΟΣΚΕΛΕΤΙΚΟΥ<br />

ΣΥΣΤΗΜΑΤΟΣ, Τ.Ε.Ι.Θ., Θ<strong>ε</strong><strong>σ</strong><strong>σ</strong>αλονίκη 2001.<br />

3 ∆ούκας Νίκος : ΚΙΝΗΣΙΟΛΟΠΑ, Ια<strong>τ</strong>ρικές Εκδό<strong>σ</strong><strong>ε</strong>ις Λί<strong>τ</strong><strong>σ</strong>ας.<br />

4 Χα<strong>τ</strong>ζηµ<strong>π</strong>ούγιας Ιωάννης : ΣΤΟΙΧΕΙΑ ΑΝΑΤΟΜΙΚΗΣ ΤΟΥ<br />

ΑΝΘΡΩΠΟΥ, Θ<strong>ε</strong><strong>σ</strong><strong>σ</strong>αλονίκη 2000.<br />

5 Ρlatzer: ΕΓΧΕΙΡΙ∆ΙΟ ΑΝΑΤΟΜΙΚΗΣ ΤΟΥ ΑΝΘΡΩΠΟΥ, 1 ος<br />

<strong>τ</strong>όµος.<br />

6 Σ<strong>υ</strong>µ<strong>ε</strong>ωνίδης Π.: ΟΡΘΟΠΑΙ∆ΙΚΗ - ΚΑΚΩΣΕΙΣ ΚΑΙ ΠΑΘΗ-<br />

ΣΕΙΣ ΤΟΥ ΜΥΟΣΚΕΛΕΤΙΚΟΥ ΣΥΣΤΗΜΑΤΟΣ, 2 η Έκδο<strong>σ</strong>η,<br />

1987.<br />

7 Φραγκορά<strong>τ</strong><strong>τ</strong><strong>τ</strong>ης Ελ<strong>ε</strong><strong>υ</strong>θ.: ΕΦΑΡΜΟΣΜΕΝΗ ΗΛΕΚΤΡΟΘΕ<br />

ΡΑΠΕΙΑ, Θ<strong>ε</strong>ωρία και <strong>π</strong>ράξη µ<strong>ε</strong>θόδων ηλ<strong>ε</strong>κ<strong>τ</strong>ροθ<strong>ε</strong>ρα<strong>π</strong><strong>ε</strong>ίας,<br />

Θ<strong>ε</strong><strong>σ</strong><strong>σ</strong>αλονίκη 1994.<br />

8 Sobotta: ΑΤΛΑΝΤΑΣ ΑΝΑΤΟΜΙΚΗΣ ΤΟΥ ΑΝΘΡΩΠΟΥ, Ε<br />

<strong>π</strong>ι<strong>σ</strong><strong>τ</strong>ηµονικές <strong>ε</strong>κδό<strong>σ</strong><strong>ε</strong>ις « Γρ. Παρι<strong>σ</strong>ιάνος », Αθήνα 1995.<br />

9 Πορφ<strong>υ</strong>ριάδο<strong>υ</strong> - Αγγ<strong>ε</strong>λίδο<strong>υ</strong> Ανθούλα : ΑΘΛΗΤΙΑΤΡΙΚΗ,<br />

Τ.Ε.Ι.Θ., Θ<strong>ε</strong><strong>σ</strong><strong>σ</strong>αλονίκη 1993.<br />

10 Α<strong>υ</strong><strong>τ</strong>ο<strong>σ</strong>µίδης ∆ηµή<strong>τ</strong>ρης : ΣΗΜΕΙΩΣΕΙΣ - ΕΠΙΣΗΜΑΝΣΕΙΣ<br />

ΣΤΗΝ ΑΞΙΟΛΟΓΗΣΗ ΚΑΙ ∆ΗΜΙΟΥΡΓΙΑ ΠΡΟΓΡΑΜΜΑΤΟΣ<br />

ΑΠΟΚΑΤΑΣΤΑΣΗΣ.<br />

11 DR. Ξ<strong>ε</strong>νοφών Αρ. Ρο<strong>υ</strong><strong>σ</strong><strong>σ</strong>ης : Η ΑΘΛΗΤΙΑΤΡΙΚΗ ΣΤΗΝ<br />

ΠΡΑΞΗ, Αθήνα 1991.<br />

12 Πρακ<strong>τ</strong>ικά 4° ∆ι<strong>ε</strong>θνές Σ<strong>υ</strong>νέδριο Αθλη<strong>τ</strong>ια<strong>τ</strong>ρικής Ε<strong>τ</strong>αιρ<strong>ε</strong>ίας Βο<br />

ρ<strong>ε</strong>ίο<strong>υ</strong> Ελλάδος 19 - 22 Ιο<strong>υ</strong>νίο<strong>υ</strong> 1997.<br />

13 Πρακ<strong>τ</strong>ικά 5° ∆ι<strong>ε</strong>θνές Σ<strong>υ</strong>νέδριο Αθλη<strong>τ</strong>ια<strong>τ</strong>ρικής Ε<strong>τ</strong>αιρ<strong>ε</strong>ίας Βορ<strong>ε</strong>ίο<strong>υ</strong><br />

Ελλάδος 18-21 Νο<strong>ε</strong>µβρίο<strong>υ</strong> 1999.<br />

ΞΕΝΗ<br />

1 Anderson,L.J. George, J.F., Shephard, J.R. Torg, S.J., and<br />

Eichner, R.E: 1988,The Year Book of Sports Medicine, Chicago<br />

1988.<br />

2 ΒίΙkο, T.E., Paulos, L.E., Feagin, J.A., Lambert, K.L., and<br />

Cunningham, H.R.; Current trends in repair and rehabilitation<br />

of complete (acute) anterior cruciaye ligament injuries,1986.<br />

3 Frndak, PA, and Berasi, C.C.: Rehabilitation Concerns<br />

Program Following Anterior Cruciate Ligament Reconstruc<br />

126

tion, SPORTS MEDICINE, 1991.<br />

4 Gould, A. James and Davies, J. George : ORTHOPAEDIC<br />

AND SPORTS PHYSICAL THERAPY, TORONTO 1985.<br />

5 lhara, H. and Nakayama, A. : Dynamic joint control training<br />

for knee ligament injuries, THE AMERICAN JOYRNAL OF<br />

SPORTS MEDICINE, 1986.<br />

6 Markey, K.L., Functional Rehabilitation of the Cruciate - De<br />

ficient knee, SPORTS MEDICINE, 1991.<br />

7 Nicolaou, P.K., Seaber, Clisson, Ribbeck, B.M., and Bassett,<br />

F.H. : Anterior Cruciate Ligament allograft transplanta<br />

tion, 1986.<br />

8 Athletic training and sports Medicine. American Academy of<br />

orthopedic surgeons Chicago 1984 pp 109 - 133.<br />

9 Davis M.J. Rehabilitation of sports anjuries . A practical ap<br />

proach. In physical therapy by D.B. Bernherdt, Churchill Liv<br />

ingstone Edimburgh 1986 pp 155- 171.<br />

10 Kisner C., Colby L.A. Therapeutics exercises. Fountation<br />

and techniques. Davis Philadelphia 1985 pp 70- 100.<br />

11 Torg J., Vegso J., Torg E. Rehabilitation of Athletic injuries.<br />

An atlas of therapeutic exercise. Year book Med. Bubl. Chi<br />

cago pp 1 - 8.<br />

12 Bruce D. Beynnon, Ph.D., Robert J. Johnson, MD, Braden<br />

C. Fleming, MS Charles J.Stenkewich, MS, Per A. Renstrom,<br />

MD, Ph.D. and Claude E. Nichols, MD " The Stain<br />

Behavior of the Anterior Cruciate Ligament Dyring Squatting<br />

and Active Flexion - Extension" The American Joyrnal of<br />

Sports Medicine, Vol. 25. No 6 1997.<br />

13 Jesper Augystsson, B,Sc., P.T, Anders Esko, B,Sc., PT, Ro<br />

land Thomee, Ph.D., PT, Ulla Svantesson, Ph.D., PT. "<br />

Weight Training of the Tnigh Muscles Using Closed Vs.<br />

Open Kinetic Chain Exercises : A Comparison of Perform<br />

ance Enhancement". JOSPT. Vol. 27. No 1. January 1998.<br />

∆IA∆IKTYO<br />

1 www.kneeshop.com<br />

2 www.vourmedialsource.com<br />

3 www.public.iastate.edu<br />

4 www.kneeclinic.info<br />

5 www.bercpremiersc.org/aceiniuryprevention.html<br />

6 www.schoretsanitis.gr<br />

7 www.netfit.co.uk<br />

8 www.geocities.com<br />

9 www.phvsioroom.com<br />

10 www.iointhealing.com<br />

127

11 www.sportsci.org<br />

12 www.ortho.gr<br />

13 www.southern-ortho.com<br />

14 www.stoneclinic.com<br />

128

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