Traumatic brain injuries can be worsen during hospitalization by
pelvic limb neurogenic arthropathies (NA). The NA is responsible for
painful periarticular and muscular inflammatory phenomena, which
develop into partial ossification of the periarticular soft structures.
This partial ossification will be responsible for muscular and articular
retractions limiting walking. The purpose of the report was to
demonstrate the contribution of cryotherapy and joint mobilization
techniques in limiting the progression of NA. The patient was 25 years
old and was admitted to the physical medicine and rehabilitation
department 6 months after a severe head injury. Nervous system
disorders were represented by a frontal syndrome and significant
spasticity in the pelvic limbs. Deficiencies found were pain, multiple
joint stiffness of the pelvic limbs, and induration of the thighs related
to arthropathies objectified to the standard x-ray of the thighs.
Rehabilitation consisted of posture sessions on a standing table and
cryotherapy at the end of the session. The gait rehabilitation was done
gradually between the parallel bars and then with a deanbulator.
Rehabilitation led to functional improvement, with the patient
returning to independent walking using English walking sticks. The
presentation of this case study provided an overview of this pathology,
its functional consequences, and the role of physical and rehabilitation
medicine in the management of NA. The techniques we used helped
to reduce the NA by limiting inflammation with cryotherapy sessions
and recovering joint amplitude with progressive posture techniques.
The presence of nervous system disorder such as frontal syndrome
could have limited rehabilitation, but thanks to collaboration with
psychiatrists, the evolution was favorable and allowed the patient to
actively participate in his rehabilitation. The case also underlined the
importance of multidisciplinary patient management, which should be
a goal for all practitioners.

arthropathies; cryotherapy; neurogenic; rehabilitation; traumatic brain injury