Evaluation of physiotherapy in the treatment of Legg-Calvé-Perthes disease.

INTRODUCTION Physiotherapy using muscle strengthening and stretching exercises is claimed to have beneficial effects in the treatment of Legg-Calvé-Perthes disease; however, no scientific evidence is available concerning effectiveness of treatment. PURPOSE The purpose of the present study was to clinically evaluate possible effects of the proposed physiotherapeutic effects compared to observational follow-up in patients with Legg-Calvé-Perthes disease. METHOD A prospective follow-up study was conducted in 17 patients with unilateral Legg-Calvé-Perthes disease, divided into 2 groups: Group A (observational follow-up) and Group B (physiotherapeutic follow-up). In order to evaluate the outcome of the adopted treatments, the following parameters were assessed: articular range of motion, level of muscular strength, level of articular dysfunction, and radiographic status, both before and after the treatment. RESULTS Group B exhibited significant improvement in articular range of motion concerning hip flexion, extension, abduction, adduction, medial rotation, and lateral rotation, while in Group A an equally significant worsening occurred concerning abduction, adduction, and medial rotation. Muscular strength also improved in Group B, mainly in the set of hip flexor muscles, while Group A showed no changes. Articular dysfunction after therapy compared to pretherapy was significantly reduced in Group B and increased in Group A. Patients undergoing physiotherapy exercises showed no changes in their radiographic features. CONCLUSION Physiotherapy produced significant improvement in articular range of motion, muscular strength, and articular dysfunction in patients with Legg-Calvé-Perthes disease, but these improvements were not evident on radiographs.