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Samenvatting Neurokinesitherapie 3 - Swinnen

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Neurokinesitherapie 3 - Swinnen Positionering & transfers Perfetti-methode

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Neurokinesitherapie 3 – Swinnen
3e Bacherlor revaki
Ellen Buwalda




NEURO 3
REVALIDATIE VAN DE CVA-PATIËNT 2
1. BEHANDELING
1.1 Algemene richtlijnen
H2: POSITIONERINGEN CVA PATIËNTEN
1. RUGLIG
2. ZIJLIG 3
3. ZIT
H3: TRANSFERS 4
1. VERPLAATSING IN BED
2. LIG  ZIT 5
3. HERSTELLEN HOUDING IN( ROL)STOEL
4. BED  (ROL)STOEL
5. ZIT  STAND 6
6. STAND  RUGLIG
7. STAPPEN
8. TRAPPEN
H6: PERFETTI-METHODE 7
1. BELANG WAARNEMING
2. GELEIDE BEWEGINGEN
2.1 Beweging
2.2 Somatosensorische cirkel
3. AANDACHT
4. THERAPEUTISCHE HULPMIDDELEN
5 BEWUSTE CONROLE 8
5.1 Pathologische voorwaarden
5.2 Graad 1
5.3 Graad 2
5.4 Graad 3

, Neurokinesitherapie 3 – Swinnen
3e Bacherlor revaki
Ellen Buwalda



REVALIDATIE VAN DE CVA-PATIËNT
3.1 ALGEMENE RICHTLIJNEN
Voorwaarde Principes

- zo snel mogelijk na CVA - proximale stabiliteit  distale functie
- feedback over prestatie - selectiviteit van bewegen
- herhaling! - zo snel mogelijk oprichten tegen Fz
- variatie - dubbeltaken
- niveau aanpassen - zinvolle betekenis
- intensiteit aanpassen - compensaties



H1: POSITIONERINGEN CVA PATIËNTEN
3 principes positionering
1. Opstelling lichaamsdelen
2. Houdingstonus normaliseren
3. Vrije ruimte tuss P & ondergrond opvullen

Organisatie vd kamer
 hemiplegische zijde hele dag zoveel mogelijk stimuleren
- NAZ aan de kant van muur
- nachtkastje AZ
- bezoek: voor/langs AZ zitten, AZ hand vasthouden
- BD meten, thorax beluisteren,..
-…

P in abnormale houding leggen/zetten
 ↑ spastisch patroon
 ↑ BWBP
 ontstaan ‘abnormale houdingspatronen vb: spitsvoet, neglect, doorligwonden, hemiplegische schouderpijn (HPS)
 functioneringsniveau gaat achteruit
 omgeving & beschikbaar materiaal
 vatbaar voor andere ziektes vb: trombose, pneumonie,..
 ↓ globale revalidatiemogelijkheden

1. RUGLIG
Ideale houding
- hoofdkussen
- flexie hoge CWK
- heup- & knie-extensie
Hemiplegische zijde:
- kussen onder bil & BB (exorotatie & post rotatie verhinderen)
- schouder in protractie & endorotatie
- elleb ext
- pronatie
- extensie vingers

Nadelen
- ↑ abnormale reflexactiviteit  tonische symmetrische nek reflexen (flexie)
 labyrint reflexen
- doorliggen sacrum of laterale malleoli  bekken AZ: post rotatie + exo




 Doorligwonde: decubitus

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