Artoza Si Periartrita Scapulohumerala

7/25/2019 Artoza Si Periartrita Scapulohumerala

1/11

ARTROZA SCAPULO- HUMERAL.PERIARTRITA SCAPULO- HUMERAL

2013

INTRODUCERE

Umrul ese !e" m"# m$%#l "r#!ul"e " !$r'ulu#( ")*+, '$"e !e" m"# #m'ere!!$"'"re " su'r"e&el$r "r#!ul"re.

Arr$" ese !e" m"# re!)e+ suer#+/ "r#!ul"r # " 2-" !"u ,e #+)"l#,#"e l"'ers$"+ele ,e 'ese 0 ,e "+#( ,u' %$"l" #s!em#! !$r$+"r#"+( !ee" !e $ r"+s$rm #+r-$",e)"r"" 'r$%lem ,e s+"e 'u%l#!.


2/11

Per#"rr#" s!"'ul$-umer"l ese # "!e"s" ,esul ,e ,es +"l+#( "e!*+, "m%elese4e( su%#e!/# "!#)#( ,"r !u #+!#,e+" m"4#m l" !e# 'ese 50 ,e "+#.

A#u,#+e"( me,#!"/#" # s'r#6#+ul me,#!"l( 6$"! u+ r$l #m'$r"+ + ,e!##" lu" ,e'"!#e+/## !"re suer ,e "rr$ s"u 'er#"rr#( ,e " rm*+e "!#)# # ,e " 're)e+# "+,#!"'ul

##!.

1. Arr$" s!"'ul$-umer"l

7$"l" "rr$#! ese $ "rr$'"#e ,e8e+er"#)( mul#"!$r#"l # eer$8e+(!"r"!er#" 'r#+ ,e8r","re" 'r$8res#) " !"r#l"6ulu# "r#!ul"r( #+s$/# ,e $ re"!/#e#'err$#! " $sulu# su%!$+,r"l 9!ee" !e "re ,re' !$+se!#+/ $ +$u $rm"re ,e $s # !"r#l"6:# )"r#"e re"!/## "le !el$rl"le sru!ur# "r#!ul"re 9s#+$)#"l"( !"'sul": e4'r#m"e 'r#+m$,##!r# !l#+#!e # r",#$l$8#!e !"r"!er#s#!e.

L$!"l#"re" 're,#le! " 'r$!esulu# "rr$#! ese l" +#)elul "r#!ul"/##l$r !u $ m"rem$%#l#"e( + u+!/#$+"re" !r$r" !"r#l"6ul 6$"! u+ r$l #m'$r"+( "" !um ese # umrul.

Arr$" ese $ "e!u+e reum"#! ,e8e+er"#) !r$+#!( !e "e!e" + s'e!#"l'ers$"+ele ,e 'ese 50 ,e "+#( ,"r se '$"e +*l+#(m"# r"r( # #+ !"ul #+er#l$r. Are e)$lue+!e"( ,"r 'r$8res#)( '$"e !"u" '#er,ere" m$%#l#"##.

Pr$!esul "rr$#! l" +#)elul "r#!ul"/#e# s!"'ul$umer"le ese m"# r"r #+*l+# ,e!* l""r#!ul"/## !um su+ !$l$"+" )ere%r"l( $l,ul( 8e+u+!#ul( ,"$r# l#'se# u+$r 'res#u+# s"us"r!#+# sem+##!"#)e l" "!es +#)el. Arr$" umrulu# "'"re ,$"r e4!e'/#$+"l.


3/11

E#$l$8#" "rr$e# +u ese !u+$s!u( !" # + !"ul %$l#l$r reum"#!e #+l"m"$r##( ,"r"u $s #,e+##!"/# +umer$# "!$r# ")$r#"+/# ;

- Ere,#"e"-


4/11

Tr""me+ul "rr$e# !u'r#+,e m"# mule "s'e!e !um su+ +,e'r"re" "!$r#l$r")$r#"+/#( ##$>#+e$er"'#e ",e!)" # r""me+ me,#!"me+$s.

O%#e!#)ele re!u'err## + "rr$" umrulu# su+;

?

"mel#$r"re" e+$me+el$r ,urer$"se # #+l"m"$r##=? !$re!"re" '$#/##l$r )#!#$"se( ,"! ese !"ul=? re"!ere" 8r",el$r +$rm"le ,e m$%#l#"e # #+re/#+ere" m$%#l#/## +$rm"le "

"r#!ul"/#e# "e!"e=? +re/#+ere" $+usulu# mus!ul"r +$rm"l=? re"!ere" 8esu"l#"/## !$#,#e+e=? e)#"re" uu$r "!$r#l$r ,e sress me!"+#!=? 're)e+#re" "+,#!"'ulu# ##!.

A!ese $%#e!#)e se re"l#e" 'r#+;

? me,#!"/#e "+"l8e#!e( "+##+l"m"$"re( ",m#+#sr"e $r"l@#.m s"u l$!"l 9#+#lr"/##:? "'l#!"re" ,e re!e l$!"l + s",##le "!ue( ,e !"l,ur + !ele !r$+#!e= !$m'rese re!#

'e+ru re,u!ere" ,urer##( "'$# !"l,e 'e+ru rel"4"re" mu!#l$r ,#+ 6urul "r#!ul"/#e#,urer$"se

? ele!r$er"'#e "+"l8e#!( "+##+l"m"$r#e( e4!#$m$$r#e 9 TENS( ,#",#+"m#!(Tr"%er:

? r""me+ %"l+e$##!"l; %# !"l,e( #,r$er"'#e( m'"!er# !u '"r"#+( ,#"erm#e(#+r"r$##( ulr"su+ee

? m"s"6?

>#+e$er"'#e( #,r$>#+e$er"'#e

+ u+!/#e ,e s",#ul %$l##( se '$"e "l!u# u+ 'r$8r"m !$m'le4 ,e re!u'er"re ,e !"re'$"e %e+e#!#" u+ %$l+") !u "rr$" s!"'ul$umer"l".

Me,#!"/#" "+"l8e#! # "+##+l"m"$"re "mel#$re"" # /#+ su% !$+r$l ,urere"%$l+")ulu# + 'r#m" ".

O," !u re8res#u+e" e+$me+el$r ,urer$"se se #+r$,u! >#+e$er"'#" + m$,

'r$8res#) # m"s"6ul.

M"s"6ul er"'eu#! re're#+ u#l#"re" "!esu#" + r""me+ul "rr$e#( ")*+, !"$%#e!#) ")$r#"re" 'r$!esel$r ,e )#+,e!"re # ,e re!u'er"re u+!#$+"l( "lur# ,e "l/#"!$r# er"'eu#!#.

O%#e!#)ele m"s"6ulu# er"'eu#! su+;

- ,#m#+u"re" ,urer#l$r=

- m%u+/#re" !#r!ul"/#e# s"+8u#+e # r$#!#"/## l$!"le=

- m%u+/#re" $+usulu# # e4!#"%#l#/## mus!ul"re=


5/11

- 're8#re" %$l+")ulu# 'e+ru >#+e$er"'#e.

M"s"6ul "r#!ul"/#e# umrulu# m%u+/ee !#r!ul"/#" s"+8u#+ l$!"l( su'le/e"$rm"/#u+#l$r !"'sul$l#8"me+"re # m$%#l#"e" "r#!ul"r.

I+#/#"l se re!$m"+," u+ m"s"6 se,"#) # m#$rel"4"+ !e $l$see m"+e)re !u#+e+s#"e m#! # le+e. Eleur"6ul se e4e!u 'e '"re" "+er#$"r # '$ser#$"r " umrulu#(

'*+" + re8#u+e" su'r"!l")#!ul"r # su'r"s'#+$"s( urm"e ,e rm*+r# u$"re( ","'"ese+s#%#l#/## l$!"le # )#%r"/## #+e ee!u"e !u '"lm"( 'e+ru rel"4"re.

Du' rem#s#u+e" ,urer#l$r( se re!$m"+, m"+e)re ,e s#mul"re # $+##ere mus!ul"r"'e+ru 're)e+#re" #'$r$#e#( u#l#*+, r#!/#u+# !u ,e8eele # "'$"me+ su% $rm ,e%$r# + )e+u s"u $!"( re"l#*+, $$," 're8"#re" %$l+")ulu# 'e+ru >#+e$er"'#e.M"s"6ul "r#!ul"/#e# se "!e "'l#!*+, r#!/#u+# !u )*rur#le ,e8eel$r( 'e '"re" "+er#$"r "!"'sule#( ,u' rer$le4#" %r"/ulu#( # 'e '"re" '$ser#$"r " !"'sule# ,u' "+ele4#" %r"/ulu#(

+ s!$'ul "su'l#r## !"'sule#( l#8"me+el$r # "mel#$rr## m$%#l#/## "r#!ul"re. Pr$!e,ur#le ,e#,r$m"s"6( ,u-m"s"6 # ,uul su%"!)"#! se '$ u#l#" !u "!ele"# ee!e.

B#+e$er"'#" re're#+ '#l$+ul 'r#+!#'"l "l re!*s#8r## "m'l#u,#+## "r#!ul"re(","'" # e" s",#ulu# %$l##( )"r##+, ,e l" '$surr#( !$+r"!/## #$mer#!e( m#!r# '"s#)e("u$'"s#)e('"s#)$-"!#)e( "!#)e-"s#s"e("!#)e( '*+ l" e4er!#/## ,e !resere " $r/e# mus!ul"re# " s"%#l#/## umrulu#.

Ee!u"re" ,e e4er!#/## + m$, re8ul"( re're#+ u+" ,#+re !ele m"# %u+e me$,e'r#+ !"re 'ers$"+ele !"re suer ,e "rr$ '$ +!e#+# 'r$8res#" %$l## l$r( '$ #m%u+/#

!$+,#/#" ##! + 8e+er"l # !#"r '$ "mel#$r" ,urere" 'e erme+ lu+8.

De "lel( >#+e$er"'#" + "' s"u #,r$>#+e$er"'#e ese $"re #+,#!" + "rr$e #"rr#e. +$ul ese u+ e4er!#/#u #,e"l ,e$"re!e "6u l" #+r#re" "r#!ul"/##l$r "e!"e "r" s le$r/ee.

E4er!#/##le ,e sre!#+8 9+#+,ere:( $r/ # 8#m+"s#! "er$%#!" "6u '"!#e+/## +,#er#e m$,ur#.

E4er!#ul ##! urmree #e !reere" $r&e# mus!ul"re( #e m$%#l#"re" "r#!ul"r( #e!$$r,$+"re" +eur$m$$r#e s"u "%#l#"e".

Re"!ere" m$%#l## ese 'r#mul $%#e!#) re!u'er"$r 'e+ru umr( !" ,e "lel 'e+ru$"e "r#!ul"#le mem%rulu# su'er#$r.

E4em'le ,e e4er!#/## !e '$ # u#l#"e + "rr$" s!"'ul$umer"l;

- pentru ntinderea umerilor- "!ese e4er!#/## 'erm# ,e%l$!"re" umer#l$r rel"4*+, "*mus!ul"ur" l$r( !* # 'e !e" " 8*ulu#.


6/11

E4er!#ul 1 + $r$s"#sm( !u ,e8eele m*#+#l$r 'r#+se ,u' !e" # !u !$"ele +,re'"e+"#+e.Se )" r"8e u$r !$"ele s're s'"e( #+s'#r*+, 'r$u+,. Se #+e res'#r"/#" !#r!" se!u+,e "'$#e4'#r( re",u!*+, !$"ele + "/( '*+ !e se "#+8.

-pentru refacerea mobilitii articulare;

E4er!#ul 1 P"!#e+ul + ,e!u%# ,$rs"l( !u %r"&ul r#,#!" + le4#e m"4#m 9'e l*+8ure!#: # 8e+u+!## le!" ; u+ s"! ,e +#s#' "e" 'e %r"& l me++e + "!e"s '$sur !$ul +#+s.

E4er!#/## Au$'"s#)e;

E4er!#ul 1 Au$m$%#l#"re !u m*+" s+$"s( !"re 'r#+,e re#me" #+er#$"r ""+e%r"&ulu#- se e4e!u "u$le4#"( "u$"%,u!"( "u$",,u!".

E4er!#ul 2 Su%#e!ul + $r$s"#sm( !u "&" l" s'"l#er( l" $ ,#s"+& ,e $ lu+8#me ,e MS -"'u! %"r" ,e l" +#)elul umer#l$r- le!e" re'" 8e+u+!## se re"l#e" "u$le4#".

E4er!#ul 3 D#+ $r$s"#sm( !u u+ %"s$+ 'r#+s !u "m%ele m*#+#( se e4e!u le4##-e4e+s##-"%,u!#-",,u!# "6u$rul ese 'r#m# ,e l" MS s+$s. Pe+ru "u$le4#e- se

'r#+,e( + "&" !$r'ulu#( %"s$+ul !u "m%ele m*#+# # se r#,#! + le4#e !* m"# mul= 'e+ru"u$e4e+s#e %"s$+ul se +e l" s'"e # se "!e e4e+s#" = 'e+ru "u$"%,u!e #"u$",,u!e- !"'eele %"s$+ulu# su+ 'r#+se + '$,ul '"lmel$r + 'l"+ "+er#$r !$r'ulu#(m$%#l#*+,u-se +r-$ '"re # "l".

-pentru refacere fortei musculare;

E4er!#ul 1 P"!#e+ul + ,e!u%# ,$rs"l( !u MS r#,#!" l" )er#!"l( + m*+ !u $ 8"+er('e !"re +!e"r! s $ r#,#!e( !ee" !e "+re+e" "%,u!" s!"'ule#.

E4er!#ul 2 + $r$s"#sm. !u s'"ele l" 'eree( '#!#$"rele +,e'r"e ,e #, ; se ,es'r#+,es'"ele ,e 'eree( m'#+8*+, + m*#+# 9MS +#+se( '"lmele 'e #,:.

2. Per#"rr#" s!"'ul$-umer"l

Per#"rr#" s!"'ul$-umer"l 9PSH: re're#+ u+ s#+,r$m !l#+#! !"r"!er#" 'r#+,urere( re,$"re "r#!ul"r # #m'$e+/ u+!/#$+"l ,eerm#+" ,e 'r$!ese '"$l$8#!e l$!"l#"el" +#)elul umrulu# # !"re "e!e" sru!ur#le 'er#"r#!ul"re; l#8"me+e( !"'sul" "r#!ul"r(e+,$"+e( %urs" # mu!#.

Ae!"re" "r#!ul"r 'r$'r#u-#s se l#m#e" m"# "les l" +#)elul "r#!ul"/##l$r"!r$m#$!l")#!ul"r # ser+$!l")#!ul"r( ,e$"re!e "r#!ul"/#" s!"'ul$umer"l "re !e" m"#


7/11

#m'ere! !$"'"re #( ,#+ "!es m$#) +u "6u+8e ,e $%#!e#( 'r#+ e" #+s#( s ,eerm#+e,#su+!/#$+"l#/#.

P"$l$8#!( PSH "re ,re' su%sr" + 'r#mul r*+, le#u+#le ,e8e+er"#)e "lee+,$"+el$r( + s'e!#"l "le su'r"s'#+$sulu# # %#!e'sulu#( !"r"!er#"e 'r#+ +e!r$e !"re ,u! l"

ru'ur# '"r/#"le # 'r#+ !"l!##!r#. + 'r#)#+/" "+um#$r# "!$r#( !um "r # u+ele r"um"#sme( $su'r"s$l#!#"re s"u $ e4'u+ere l" r#8( le#u+#l$r ,e8e+er"#)e l# se ","u8 u+ 'r$!es#+l"m"$r( + 'r#mul r*+, "l e+,$"+el$r( %$l+")## "!u*+, ,urer# ,e #+e+s#"e me,#e # u+8r", )"r#"%#l ,e #m'$e+/ u+!/#$+"l.

PSH are 5 forme clinico-anatomo-funcionale rel"#) %#+e !$+ur"e ; umr ,urer$s s#m'lu(

"!u #'er"l8#!( m#4( %l$!" # umr 'seu,$'"r"l##!.Umrul ,urer$s s#m'lu "re l" %" e+,#+#"( %urs#"( s"u e+$s#+$)#"( 'u*+, 'ree+" !l#+#!(u+ s",#u "!u !"re e)$lue" s're su%"!u( urm" ,e u+ s",#u erm#+"l( "'$# ,e )#+,e!"re.

Umrul m#4 ese $ "s$!#ere ,#+re u+ umr ,urer$s ,e $r#8#+e e+,#+$"s # $ l#m#"re "m#!r## 'r#+ !$+r"!ur mus!ul"r "+"l8#! + r$"$r#( le4$r# s"u@# ",,u!$r## umrulu#.

Umrul %l$!" "re !" su%sr" !"'sul#" rer"!#l # se !"r"!er#e" 'r#+ l#m#"re" m"r!" "m$%#l#/## umrulu#.

Umrul 'seu,$'"r"l##! "re l" %" 'er$r"re"( ru'ur" ,e ,#)erse 8r",e " m"+$+ulu#r$"$rulu#( "'ru ,e $%#!e# 'e u+ $+, ,e8e+er"#) ,"r 'u*+, # sem+"l" # l" #+er# ,u'u+ r"um"#sm.

Principalele cauze de producere a PSH

r"um"#smele # m#!r$r"um"#smele re'e"e(

e4'u+ere" l" r#8(

"!$r# ")$r#"+# !e /#+ ,e s#semul +er)$s 9"e!/#u+# "le s#semul +er)$s !e+r"l;

"!!#,e+ )"s!ul"r !ere%r"l( %$"l" P"r>#+s$+( r"um"#sm !ere%r"l( s#+,r$m "l"m#!= #"e!#u+# "le s#semulu# +er)$s 'er#er#!; +e)r"l8#e !er)#!$-%r"#"l"( $+" $ser:(

"e!#u+# "le $r8"+el$r #+r"$r"!#!e !"re '$ ")$r#" 'e !"le rele4 ,e)$l"re" u+e#PSH 9T7C 'ulm$+"r" "'#!"l"( IMA( #+er)e+/## !#rur8#!"le #+r"$r"!#!e e!:

P"r"!l#+#!( 'e+ru " ,#"8+$s#!" $ 'er#"rr# s!"'ul$-umer"l se ul#l#e"; RMN!"re ,ee!e" u+ s'e!ru l"r8 ,e "e!/#u+#( ,e l" ,e8e+er"re '*+ l" ru'ur" '"r/#"l s"u$"l. M"# '$"e e)#,e+/#" le#u+# "le /esuur#l$r m$# # ese ,e$se%# ,e u#l + urmr#re"e)$lu/#e# '$s$'er"$r##.

E!$8r"#" m#$-e+e$-$se$-"r#!ul"r '$"e # # e" u#l ,e!el*+, ru'ur# me,## l" +#)elul


8/11

r$"$r#l$r.Ele!r$m#$8r"#" # su,#ul )el$!#/## !$+,u!er## #+lu4ulu# +er)$s su+ $%l#8"$r## "u+!#!"+, $ "e!"re +eur$l$8#!" ese sus'e!".

M#6l$"!e ,e re!u'er"re + PSH

F##$er"'#e; erm$er"'#e( !r#$er"'#e( ele!r$er"'#e "+"l8e#! # ,e!$+r"!ur"+9!ure+# ,#",#+"m#!#( #+erere+/#"l#( !ure+ 8"l)"+#! e!:( l"serer"'#e( ulr"s$+$$re( m"s"6r$#!( # >#+e$er"'#e( #,r$>#+e$er"'#e.

B#+e$er"'#" ese !e" m"# #m'$r"+ ,e$"re!e 'e l*+8 re!u'er"re" u+!/#$+"l#/##um"rulu#( ese ese+/#"l + !$m%"ere" re!ure+/e#.

B#+e$er"'#" "re !" $%#e!#) 'r#+!#'"l re!u'er"re" m$%#l#/## !"re se "!e 'r#+"%$r,"re" sru!ur#l$r +e!$+r"!#le "le um"rulu# 9!"'sul"( l#8"me+e( %urs"( e+,$"+e: #

se'"r" 'r#+ "%$r,"re" sru!ur#l$r !$+r"!#le 9mu!#:.

+ "!es s#+,r$m( >#+e$er"'#" "re '"r#!ul"r#/# + u+!/#e ,e $rm" !l#+#!$-"+"$m$-u+!/#$+"l( m$#) 'e+ru !"re se !ere !u+$"ere" "!es$r $rme.

Tr""me+ul 'er#"rr#e# s!"'ul$-umer"le !u'r#+,e re'"us se8me+"r( me,#!"me+"/#e"+"l8e#!( "+##+l"m"$"re # ,e!$+r"!ur"+e( ele!r$er"'#e "+"l8e#! #"r $," !ure8res#u+e" e+$me+el$r ,urer$"se se #+r$,u!e >#+e$er"'#" + m$, 'r$8res#) # m"s"6ul.

Umrul ,urer$s s#m'lu( + s",#ul "!u( +e!es# #m$%#l#"re + '$#/#e ,e re'"us !u%r"/ul l" 3-5G + "%,u!/#e( !u $ 'er+ m#! su% "4#l # sus/#+u ,e $ e"r. + "!es s",#u

+u se e4e!u m#!r# 'e umrul "e!". Se '$ #+s e4e!u" !$+r"!/## #$mer#!e. S",#ulsu%"!u( 'erm#e #+#/#ere" m$%#l#r## s!"'ul$umer"le( ,"r 'r#+ m#!r# '"s#)e( "'$# '"s#)$-"!#)e # "!#)e "s#s"e( #"r s",#ul erm#+"l "re !" # $%#e!#)e re"!ere" $r/e# mus!ul"re "s"%#l#/## # m#!r## !$+r$l"e " umrulu#. Su+ 'erm#se $"e m#!r#le +s se 'u+e"!!e+ul 'e !ele "!#)e !u re#se+/ 'e+ru !reere" $r/e# mus!ul"re. H#,r$>#+e$er"'#" #+$ul er"'eu#! su+ me$,e l"r8 u#l#"e + "!es s",#u.

Umrul "!u #'er"l8#! ,#+ 'u+! ,e )e,ere >#+e$er"'eu#! +u '$"e %e+e#!#" ,e!*,e #m$%#l#"re" "%s$lu " %r"/ulu# + "%,u!/#e ,e 0G # u$"r le4#e. + u+!/#e ,e e)$lu/#""l8#! se )" "$+" su'$r"%#l#"e" +!e'er## m$%#l#r#l$r # se )" #+#/#" u+ 'r$8r"m>#+e$er"'eu#! 're!um 'e+ru um'rul ,urer$s s#m'lu( s",##le "!u # su%"!u.


9/11

+ !"ul umrulu# m#4 "%$r,"re" ,e#!#ulu# se )" "!e se'"r" 'e+ru sru!ur#le+e!$+r"!#le # 'e+ru !ele !$+r"!#le. Pe+ru sru!ur#le +e!$+r"!#le se )$r ee!u"

'$surr#( m$%#l#r# '"s#)e # "u$-'"s#)e. H#,r$>#+e$er"'#" ese #+,#!" + umrul m#4'u*+, # "'l#!" !#"r + "ele #+#/#"le ,urer$"se. B#+e$er"'#" "re + )e,ere # e4er!#/## ,e

s"%#l#"re " m$%#l#/## !$+r$l"e.Pe+ru umrul %l$!" >#+e$er"'#" +!e'e ,e "' 'r#+ >#+e$'r$#l"4#" lu#( 'r#+

'$sur"re" !$re! " umrulu# #+l"m" + "%,u!/#e-r$"/#e e4er+-le4#e ,e %r"/ = m$%#l#"re're!$!e # re8ul" " MS l" !e# 're,#s'u# s "! $ 'er#"rr#.

Pr$8r"mul >#+e$er"'eu#! re%u#e e4e!u" ,e '"!#e+ # l" ,$m#!#l#u.

Umrul 'seu,$'"r"l##!- >#+e$er"'eu#!( se )" urmr# 're)e+#re" re!er## s're $!"'sul# rer"!#l !"re s !$m'r$m# m$%#l#"re" #e e" "!#) s"u '"s#) # re!u'er"re"u+e# $r/e mus!ul"re !* m"# %u+e. + u+!/#e ,e 8r",ul ru'ur## e+,#+$"se !* # ,e 'ree+/"

,urer## se ,#s#+8 ,$u #'ur# ,e re!u'er"re u+!/#$+"l ; r "el + '$#/#e 6$"s # !u "el+ '$#/#e +"l.

Masajul n PSH

D#+re $"e %$l#le umrulu#( 'e 'r#mul l$! se s#ue"( + $r,#+e" re!)e+/e#(suer#+/ele mu!#l$r # e+,$"+el$r( ,#+ "l !r$r "%l$u !l#+#! ,urere" ese "'r$"'e +el#'s#.E" se m"+#es +,e$se%# !u $!"#" m#!r#l$r !"re( ,#+ "!e"s !"u( su+ l#m#"e.

M"s"6ul er"'eu#! urmree ,#m#+u"re" ,urer#l$r( re,u!ere" !$+r"!ur## mus!ul"re(

m%u+#re" !#r!ul"/#e# s"+8u#+e # r$#!#/## l$!"le.Ese u+ m"s"6 se,"#) # m#$rel"4"+ !e $l$see m"+e)re !u #+e+s#"e m#!

# le+e. Eleur"6ul se e4e!u 'e '"re" "+er#$"r # '$ser#$"r " umrulu#('*+ + re8#u+e" su'r"!l")#!ul"r # su'r"s'#+$"s. Are $ "!/#u+e !"lm"+ m#!$r*+,e+$me+ul ,urer$s ,e e+s#u+e mus!ul"r l# !#"r ,e e+s#u+e 's##!. Ese 're!e," ,er"m*+r# u$"re( ","'"e se+s#%#l#/## l$!"le. Ee!ele se m"+#es 'r#+ ")$r#"re"s!#m%ur#l$r +ur##)e( me+/#+e el"s#!#"e" mu!#l$r.


10/11

7I7LIORAFIE

1. A'$s$l I. # !$l"%.( aiet documentar!(E,#ur" Om+#"( I"#2. S%e+8e T.( "inetolo#ie profilactic$ terapeutic %i de recuperare(

E,#ur" Me,#!"l( 7u!ure#( 1JK3. ';@@.s"ulme,#!ulu#.r$@Reum"#sme-,e8e+er"#)e5. ';@@.el#'er$me,.r$@%$"l"-"rr$#!".ml


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