Effect of Physical Therapy on Range of Motion and Pain in Cases of Femoral Head Avascular Necrosis after Kidney Transplantation

Avascular necrosis of femoral head (ANFH) is a common complication affecting about 25% of the patients treated with corticosteroids after kidney transplantation. Patient complains of severe pain, limitation of hip range of motion especially abduction and external rotation, also affect the gait and activity of daily living. The current study was conducted to detect the effect of faradic stimulation, stretching and strengthening exercises on range of motion of hip joint and the level of pain. Thirty patients from Cairo university Hospitals with avascular necrosis of the head of femur after kidney transplantation were divided into two groups; study group (faradic and exercises) and control group. Their ages ranged from 30-45 years. All participants were evaluated before treatment and at the end of treatment after three months using: Physical evaluation which include hip range of motion, thigh girth, visual analogue scale and squat test, time up and down stairs. Comparing the hip range of motion measured at the beginning of the study and after three months using t-test (p<0.001), Showed increased in hip flexion from 9.83%, extension 100%, abduction 42.1%, adduction 28.15%, external rotation increased 55.45%, internal rotation 39.75%. Squat test increased 50.56%. Thigh girth increased 2.99% and visual analogue scale decreased 31.27% while time up and down stairs decreased 16.56% for the study group. Results of control group reveled a decrease in the range of motion of flexion 1.85%, extension 8.88%, abduction 5.66%, adduction 8.33%, external rotation decreased 9.21%, internal rotation 8.89%. Visual analogue scale increased 1.3%. Thigh girth 1.07 and squat test 10.84% while time up and down stairs 7.67%. The results showed that stretching and strengthening exercise accompanied by faradic stimulation around the hip joint were very helpful for avascular necrosis patients, and could prevent a progressive deterioration in hip joint mobility.