الفهرس 
الفصل الأول الإطار العام للبحثيوجد فقط 14 صفحة متاحة للعرض العام
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المستخلص
Due to the tremendous development in the application of different sciences as well as the effects of the industrial revolution and the advancement of machines in the life of contemporary man, which facilitated much of the physical work that he had done before, which resulted in giving man several hours of leisure and lack of physical activity. physical education and sports must play a role in this field In order to provide the body with the organized physical activity that works to maintain its vitality and diligence.
We find that the technological progress has negative effects due to lack of movement and lack of effort in performance .Modern machines are now doing most of the work, as well as frequent accidents and injuries. Strong muscles then turned into weak muscles and joints were stiff also, wrong positions during the period of daily life and injury may be due to lack of fitness .Thus, individuals are susceptible to many general injuries, including the knee joint in particular.
The knee joint is the largest joint in the body and consists of the convergence of three bones and those are Femur, Tibia and Patella. Between the bones of the Femur and the Tibia are hemispheric cartilages that work as shock absorbers. The presence of four ligaments between the Femur and Tibia bones maintains the stability of the knee those are, the anterior and posterior cruciate ligament, and the Collateral Ligament Medial and Lateral ligaments.
Osteoarthritis Knee is a common injury caused by weight gain and weakness in the thigh muscles, especially The Qudriceps Femoris Which causes pain in the knee joint especially during walking, climbing up or down the stairs and hearing the sound of the joint when moving, difficulty sitting or prostrating on the ground.
Physical and rehabilitational exercises are a major pillar in our daily life. Without them, many diseases may result from lack of movement. Exercise is performed to improve the body in general, and rehabilitation exercises are performed to treat and rehabilitate a part of the body that has been injured.
Rehabilitation is the restoration of the full function of the injured part of the body, it depends mainly on the identification of the causes of the injury and correct and treatment methods, and rehabilitation of the normal patient so that he can do the necessary functions and burdens without disturbance such as walking and climbing the stairs and meeting the demands of daily life naturally.
Rehabilitation is one of the main axes in the treatment of many injuries because it aims at removing the mal functioning of the injured part, by taking care of the weakness of some muscles, ligaments and joints.
Massage science is one of the preventive and curative natural sciences. Its purpose is to overcome fatigue, pain, health prevention, relaxation and healing.
Massage and motion sports therapy are the basis of physical therapy, which derives its influence from the scientific uses of various natural elements to treat human injuries, fatigue and exhaustion. These natural methods have no side effects, as is the case in many non-natural ways. It is used for the healthy or the patient a gradual and regularized movent of the different joints of the body in light of anatomical facts and to the range allowed by the joint of the movement.
Through the work of the researcher in the field of physical rehabilitation and sports injuries, the researcher noted the prevalence of knee joint injuries in general and the prevalence of knee Osteoarthritis in particular, due to lack of physical activity and weight gain and low physical efficiency and muscle weakness.
After reviewing the previous research and scientific studies, Within the limits of the researcher’s knowledge, the researcher noted the lack of previous studies that dealt with the problem of knee Osteoarthritis, especially from the age of 40 to 45 years Since the knee joint is the main pillar on which the human body is based, it carries the weight of the body as well as the weight gain, low physical efficiency and weakness of the muscles working on the knee joint during this age. This is what urged the researcher to work on the development of a physical rehabilitation program accompanied by massage for the patients of knee Osteoarthritis of this stage.
The importance of the research:
1. Scientific importance:
The scientific importance of the current study is that it is one of the scientific attempts to develop a physical rehabilitation program accompanied by massage to correct the injury of knee Osteoarthritis for men aged 40 to 45 years and achieve to the normal function of the joint, which contributes to the attention of researchers to address similar research problems.
2. Practical importance:
The practical importance of the current study is that it is a modern attempt to identify the effectiveness of a physical rehabilitation program accompanied by massage to treat knee Osteoarthritis for men aged from 40 to 45, and the possibility of benefiting from it by those who are interested as well as specialists in the field of injuries and physical rehabilitation, and the use of this program in similar cases shortening rehabilitation time And return to the normal functional state of the joint.
Research goals:
The research aims at:
1. Design a physical rehabilitation program accompanied by massage for knee Osteoarthritis.
2. Identify the effect of the proposed program for the rehabilitation of the affected knee for each of the following variables:
- Degree of pain
- Range Of Motion
- Muscular Strength
Research hypotheses:
In light of the research objectives, the researcher assumes:
1. There are differences between the before and after measuring in favor of the after in the degree of pain.
2. There are differences between the before and after measuring in favor of the after in the range of motion of the knee joint. (Flexion)
3. There are differences between the before and after measuring in favor of the after in Muscular Strength of the muscles working on the knee joint. (Leg muscles)
The Research procedures:
Research Methodology:
The researcher used the experimental method in the before and after measurement of one experimental group in order to suit the nature of the objectives and research hypotheses.
The Research sample:
The sample was intentionally selected from the men who were in the sports medicine unit in Fayoum governorate, who had second degree knee Osteoarthritis injury according to the diagnosis of the specialist physician and they were 9 patients.
Conditions for sample selection:
1. Members of the research sample are volunteers and have a desire to participate in the research application.
2. They should have the second degree knee Osteoarthritis.
3. Commitment and continuation of the proposed program throughout the research period.
4. They cannot be subject to any other remedial or rehabilitation programs during the qualifying program.
5. They should be males between the ages of 40 to 45.
6. They don’t have any other physical injuries.
7. They cannot have had any previous injuries to the knee joint, and have never had knee surgery.
8. They do not suffer from any diseases such as diabetes, blood pressure and heart disease.
Data collection tools and means:
• Restameter to measure total body length.
• Medical balance for weight measurement.
• Visual analog scale(vas).
• goniometer for measuring the range of motion of the knee joint.
• The dynamometer to measure the muscular strength of the muscles of the legs.
• Measurement and data form for each patient.
• Expert consultation form in the proposed rehabilitation program.
Implementation of the proposed rehabilitation program:
After designing the questionnaire for the rehabilitation program and presenting it to the experts and identifying their views in the proposed program.
The proposed rehabilitation program has been finalized and has been scheduled for 8 weeks for people with second - degree knee Osteoarthritis according to a specialist’s diagnosis.
The program was applied to the research sample of 9 people individually because of the difference in the timing of the injury and their presence in the Sports Medicine Unit. The program took 8 weeks, divided into (4) stages of the period of each stage is 2 weeks 3 rehabilitation units per week with the total number of units of the program (24) units within (8) weeks of program implementation period.
The rehabilitation unit time ranged from 60 minutes to 90 minutes.30 minutes for the massage, 20 minutes at the beginning of the rehabilitation unit to stimulate blood circulation of the muscles working on the knee joint, and then 10 minutes at the end of the unit to cool down (5minutes per leg), and many types of massage were used (effeurage, petrissage, beating, vibration)
The main objectives of the program are as follows:
1) Eliminate the level of pain.
2) increase the range of motion of the knee joint.
3) Elevation of the muscle strength of the leg muscles working on the knee joint.
During the implementation of the proposed rehabilitation program, the following conditions were considered:
• The rehabilitation program is applied individually on each case.
• The rehabilitation unit begins with a massage of the muscles of the legs (muscles working on the knee joint) for approximately 10 minutes for each leg, with a total of 20 minutes at the beginning of the rehabilitation unit and 10 minutes at the end of the unit for cooling down (5 minutes per leg).
• Starting with passive static exercises and then positive motion exercises.
• Graduating from simple exercises to complex exercises and from easy ones to harder ones.
• Exercising to the limits of pain.
• Each step should include exercises to stretch the muscles of the two legs and flexibility exercises for knee joints to increase the range of motion of the knees and exercises to strengthen the muscle group working on the knee joint.
• Graduating in training loads, taking into account inter periods of rest.
• Taking into account the psychological state of the injured and working to gain his confidence.
• Ice coolers are used after the knee joint rehabilitation unit in case of a fatigue sensation to reduce the risk of pain and any associated performance spans for a period of 5: 7 minutes per joint.
Conclusions:
In the light of statistical analysis and through the presentation and discussion of the specific results of the research, the researcher reached the following conclusions:
1. Rehabilitation program led to the passing of pain in the knee joint.
2. The rehabilitation program increased the range of motion of the knee joint.
3. Rehabilitation program led to the development of muscle strength of the muscles working on the knee joint.
4. Use of massage, exercises of fixed and motional muscle strength, flexibility exercises, stretching and ice packs, have had a great impact on injured subjects in restoring their ability to perform their normal daily activities.
Recommendations:
In light of the objectives and research hypotheses and through the results, the researcher recommends to:
1. Following the rehabilitation program when rehabilitating second degree injury of knee Osteoarthritis.
2. Focusing on the use of static muscle strength exercises in the initial stages of training and motional exercises of muscular strength in advanced stages.
3. The importance of performing flexibility and muscle stretching exercises of the muscles working on the knee joint.
4. The need to use massage and ice packs in the rehabilitation of knee Osteoarthritis and similar injuries.
5. Patients should be encouraged to follow healthy diets and exercise to reduce weight and reduce the burden on the knee joint.
6. Benefit from the proposed rehabilitation program when developing other rehabilitation programs for similar injuries.