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exercise is medicine

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A common complaint in the musculoskeletal system is the anterior knee pain (AKP) or the so called patellofemoral pain syndrome (PFPS). The large number of contributing factors that lead to the symptoms make a proper diagnosis and targeted physiotherapeutic treatment management difficult. With regard to symptom-complex-oriented physiotherapeutic care, the question arises as to which therapy methods should be used for individuals with AKP. In order to be able to identify adequate physical therapy methods, an understanding of the clinical condition and the chosen treatment method is essential. This article aims to present a heuristic model of objectives and situational physiotherapeutic treatment methods.
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Patients with a patellofemoral pain are either in an acute state after a patellofemoral dislocation or are suffering from a chronic anterior knee pain (AKP), whereas AKP might be accompanied by patellar instability without dislocation. Whereas the acute state after a dislocation is mostly clear and its examination limited, the examination of a AKP is much more complex. A profound knowledge of the anatomy, the painful structures and patellofemoral biomechanics is essential in order to find the underlying pathology within the heterogeneous and diverse etiologies. Furthermore, a meticulous and precise examination is key to find the adequate treatment for AKP.
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Lateral patellar dislocation (PD) has multifactorial origin. Its treatment will depend on the physical demands of the patient, triggering event and injury mechanism of PD, number of dislocation episodes, patellofemoral joint morphology, and concomitant injuries. After primary PD, despite the risk of recurrence being 33-77%, first treatment option is mostly conservative, except if an osteochondral fragment needs to be refixed or removed.
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Clinical imaging in patellofemoral disorders is fundamental for the understanding of the pathology, and to find the adequate treatment option. Anatomical risk factors such as trochlear dysplasia, patella alta, lateralized tibiale tubercle (measured by the tibiale tubercle trochlear groove distance), torsional or coronal lower limb alignment that are the origine of patellar maltracking or even patellar dislocation, can be assessed with high reliability on conventional radiographs combined with MR imaging.
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Patients with a patellofemoral pain are either in an acute state after a patellofemoral dislocation or are suffering from a chronic anterior knee pain (AKP), whereas AKP might be accompanied by patellar instability without dislocation. Whereas the acute state after a dislocation is mostly clear and its examination limited, the examination of a AKP is much more complex. A profound knowledge of the anatomy, the painful structures and patellofemoral biomechanics is essential in order to find the underlying pathology within the heterogeneous and diverse etiologies. Furthermore, a meticulous and precise examination is key to find the adequate treatment for AKP.
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Objectives: The objectives of this study were to observe the developmental trajectories of motivation types among young children from 8 to 12 years using a more comprehensive scale of physical education motivation. We also tested the relations between these trajectories and objective physical activity during this period.
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Physical inactivity is a known risk factor for stroke. The interaction between exercise and risk of stroke is complex. Physical activity has a beneficial effect on most risk factors for stroke, which may show reciprocal potentiation (e.g. obesity, sleep apnea, atrial fibrillation). Advice on physical activity is of importance in primary prevention of stroke. Hereby, type, amount and intensity of physical activity may be distinguished and adjusted according to comorbidities (e.g. in case of heart failure).
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There is a continuous increase in dementia partly due to increasing life-expectance. Currently there are no causal therapies for dementia, neither for dementias with vascular etiology nor for neurodegenerative dementias such as Alzheimer’s disease. Main risk factors for the development of dementia are low physical activity, hypertonia and diabetes mellitus. Physical activity has shown to exert beneficial effects on cardiovascular and metabolic risk factors und is closely connected with cognitive disturbance and the development and the course of dementia. Therefore, the implementation of physical activity in preventive and therapeutic strategies of dementia is recom­mended.
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