Samenvatting

Abstract

In a quadriceps tendon rupture (QTR) the active knee extension gets lost. As result, there are no possibilities in the area of activities and participation. In matter to solve this, a re-insertion operation often takes place. There is no guideline for intervention after a QTR. e-health intervention after a QTR is not found in the literature. The purpose of this Case Report is to describe the intervention and experiences of an e-health treatment, for developing the strength after surgery re-insertion of a QTR. The question is: are there clinical relevant improvements possible through e-health physiotherapeutic treatment, for developing the strength, after surgery re-insertion of a QTR.
The patients request: fully return to work as a manager therefor works the patient eight hours a day four days a week, with an average of 8000 steps and fifteen floors of stairs climbing. At the first evaluation the patient scored by the Medical Research Council (MRC) strength scale (0-5) scored 3. By the Patient Specific Function Scale (PSFS) (0-10) whereby 10 is unable to perform, was walking 5, stairs climbing 7 and biking 10. The Timed Up And Go Test (TUGT) 10 seconds and by the one Repetition Maximum estimate test (1RM) at the leg press, scored left side 50 kilogram (kg) and right side 75 kg.
The e-health treatment was in week 14-21 organized for strength improvement of the Muscle Quadriceps, the integrity of the tendon and overall condition. The interventions build up was from static-concentric to eccentric exercises. The exercises were functionally oriented.
After seven weeks of e-health treatment the MRC score was 4. PSK walking 2, stair climbing 2 and biking 0. TUGT 7.2 seconds. The 1RM strength right side was 105 kg and left side 60 kg.
After seven weeks of e-health treatment there was a change of 20% in muscle strength and the client improved towards normal function in activities and participation. Future studies must describe an QTR intervention also in further stadiums of rehabilitation, and the difference in e-Health and physiotherapy at practice during same stadium of rehabilitation.
Keywords: quadriceps tendon rupture; e-health intervention; functional strength exercise