SKILLS
M I N O R M U S C U L O S K E L E T A A L
,Inhoudsopgave
6Vaardigheid schouder 1 en 2 onderzoek .................................................................................................................................... 6
Palpaties .................................................................................................................................................................................................... 6
Spierkracht/weerstandstesten ............................................................................................................................................................ 6
Humero Scapular Motion Interface (HSMI) – isometrische retroflexie ............................................................................... 6
Humero Scapular Motion Interface (HSMI) – isometrische abductie ................................................................................... 6
Humero Scapular Motion Interface (HSMI) – isometrische adductie ................................................................................... 7
Humero Scapular Motion Interface (HSMI) – isometrische exorotatie................................................................................ 7
Humero Scapular Motion Interface (HSMI) – isometrische endorotatie ............................................................................. 7
Angulaire mobilisatie............................................................................................................................................................................. 7
Stenvers testen ...................................................................................................................................................................................... 10
Okselhaargrens / angulus inferior............................................................................................................................................. 10
Clavicula-rol ..................................................................................................................................................................................... 11
Caudaalglijden van de scapula ................................................................................................................................................... 11
Cervico-thoracale-overgang-rotatie (CTO-rotatie) .............................................................................................................. 12
Passief horizontale adductie........................................................................................................................................................ 12
Tractie in ruststand (MLPP) ................................................................................................................................................................ 13
Instabiliteitstesten ................................................................................................................................................................................ 13
Apprehension test (provocatietest) ........................................................................................................................................... 13
Augmentation test .......................................................................................................................................................................... 14
Relocation test (reductietest) ...................................................................................................................................................... 14
Release test (provocatietest)........................................................................................................................................................ 14
Specifieke tracties................................................................................................................................................................................. 15
Rol-glij technieken ............................................................................................................................................................................... 16
AC-Gewricht; onderzoek joint play ................................................................................................................................................. 18
Primair en secundair impingement.................................................................................................................................................. 18
Instabiliteitstesten glenohumeraal .................................................................................................................................................. 21
Ruptuurtesten ........................................................................................................................................................................................ 24
Vaardigheid schouder 1 en 2 therapie ......................................................................................................................................... 26
Kubis tractie voor AC ........................................................................................................................................................................... 26
Kubis tractie voor SC ........................................................................................................................................................................... 27
Vaardigheid elleboog 3 en 4 onderzoek ...................................................................................................................................... 27
Passief ( + pas. Stabiliteit) ................................................................................................................................................................. 27
Weerstandstesten ................................................................................................................................................................................. 30
Palpaties .................................................................................................................................................................................................. 32
Screeningstesten................................................................................................................................................................................... 32
Stabiliteitstesten ................................................................................................................................................................................... 33
Tracties en translaties in ruststand (l.p.p.) en in eindstand (c.p.p.) ................................................................................ 35
Rol-glij bewegingen humero-ulnair.......................................................................................................................................... 36
Rol-glij beweging humero-radiaal ............................................................................................................................................ 38
Vaardigheid elleboog 3 en 4 therapie .......................................................................................................................................... 39
Spierrekken....................................................................................................................................................................................... 39
1
,Vaardigheid pols 5 en 6 onderzoek .............................................................................................................................................. 45
Palpaties ............................................................................................................................................................................................ 45
Artrogene mobiliteit....................................................................................................................................................................... 45
TFCC provocatie test in supinatie en pronatie ....................................................................................................................... 48
Tractie ................................................................................................................................................................................................ 50
Translatie dorsaalflexie verbetering.......................................................................................................................................... 50
Translatie plantairflexie verbetering ......................................................................................................................................... 50
Instabiliteitsonderzoek.................................................................................................................................................................. 51
Rol-glij dorsaalflexie ..................................................................................................................................................................... 53
Rol-glij palmairflexie ..................................................................................................................................................................... 54
Rol-glij radiaal- en ulnairabductie ............................................................................................................................................ 55
Vaardigheid enkel 7 en 8 onderzoek............................................................................................................................................ 58
Art. subtalaris (OSG) ...................................................................................................................................................................... 59
Lijn van Lisfranc (artt. tarsometatarsales I-V) ........................................................................................................................ 61
Functionele instabiliteitstesten ......................................................................................................................................................... 62
Schuifladetest (anterior drawer test) ......................................................................................................................................... 62
Ligamentaire stresstesten ............................................................................................................................................................ 62
Palpatie .............................................................................................................................................................................................. 63
Joint-play art. tibiofibularis proximalis .................................................................................................................................... 63
HVT-manipulatie – fibula naar ventrolateraal ........................................................................................................................ 63
Onderzoek syndesmosis tibiofibularis distalis ...................................................................................................................... 64
Fibula naar dorsaal ......................................................................................................................................................................... 64
Tibia naar dorsaal ........................................................................................................................................................................... 64
Varus-kliktest .................................................................................................................................................................................. 65
Artrogeen onderzoek .......................................................................................................................................................................... 65
Art. talocruralis ..................................................................................................................................................................................... 65
Art. subtalaris ........................................................................................................................................................................................ 67
Mobilisatie mediaal voetgewelf................................................................................................................................................... 71
Mobilisatie lateraal voetgewelf ................................................................................................................................................... 72
Mobilisatie van de tenen (tractie, rol/schuif, kantel)............................................................................................................ 73
Vaardigheid knie 9 en 10 onderzoek ........................................................................................................................................... 75
Ottawa knee rules................................................................................................................................................................................. 75
Palpatie .................................................................................................................................................................................................... 75
Angulair onderzoek ............................................................................................................................................................................. 75
Art. genus – oriëntatie in gesloten keten................................................................................................................................. 75
Passieve instabiliteitstesten ............................................................................................................................................................... 79
Varus (0 en 20° flexie) ................................................................................................................................................................... 79
Apprehension-test patella (vrij naar Fairbanks) .................................................................................................................... 80
Hydropstesten ....................................................................................................................................................................................... 80
Art. genus – palpatie – intra-articulaire zwelling .................................................................................................................. 80
Art. genus – palpatie – ‘ballottement’ van de patella ........................................................................................................... 81
Kruisbandtesten .................................................................................................................................................................................... 82
Voorste kruisband ................................................................................................................................................................................ 82
Hyperextensietest ........................................................................................................................................................................... 82
Achterste kruisband............................................................................................................................................................................. 84
Menicustesten........................................................................................................................................................................................ 86
Bohler ....................................................................................................................................................................................................... 87
2
, Tracties .................................................................................................................................................................................................... 90
Rolglijden – flexie ................................................................................................................................................................................. 90
Rolglijden – extensie...................................................................................................................................................................... 92
HVT-manipulaties .......................................................................................................................................................................... 93
Functionele stabiliteitstesten (samengesteld door G. Koel) ..................................................................................................... 95
Vaardigheid heup 11 onderzoek ................................................................................................................................................... 95
Angulair onderzoek ............................................................................................................................................................................. 95
Tracties/ translaties in ruststand ................................................................................................................................................... 102
Palpatie .................................................................................................................................................................................................. 103
Tractie specifiek .................................................................................................................................................................................. 103
Lokale belastbaarheidsonderzoek ................................................................................................................................................. 108
Rol/schuif flexie.................................................................................................................................................................................. 112
• Uitgangshouding patiënt: Rugligging. De therapeut draagt met de gelijknamige onderarm het onderbeen
van de patiënt...................................................................................................................................................................................... 112
Rol/schuif abductie ............................................................................................................................................................................ 113
Rol/schuif extensie ............................................................................................................................................................................ 113
Vaardigheid wervelkolom 1 SI onderzoek ................................................................................................................................. 114
Voert screening uit waarbij rode vlaggen worden uitgesloten .............................................................................................. 114
DTF-verslag maken conform de richtlijn verslaglegging ........................................................................................................ 114
Palpaties ................................................................................................................................................................................................ 115
Cristae .............................................................................................................................................................................................. 116
SIAS ................................................................................................................................................................................................... 116
SIPS.................................................................................................................................................................................................... 116
SIG testen, als provocatietesten ..................................................................................................................................................... 117
Distractietest .................................................................................................................................................................................. 117
Thigh thrust test ........................................................................................................................................................................... 117
Compressietest.............................................................................................................................................................................. 117
Faber-test (Patrick-test) ............................................................................................................................................................. 118
Test volgens Gaenslen ................................................................................................................................................................ 118
Passief functieonderzoek ................................................................................................................................................................. 119
HVT-manipulatie ilium anterior ............................................................................................................................................... 119
HVT-manipulatie ilium posterior ............................................................................................................................................. 119
(Active) Straight Leg Raise voor bekkeninstabiliteit.................................................................................................................. 120
Vaardigheid wervelkolom 2 SIG LWK onderzoek ...................................................................................................................... 120
Belast onderzoek in stand ((geleid) actief), regionaal .............................................................................................................. 120
1D Flexie ......................................................................................................................................................................................... 120
1D Extensie .................................................................................................................................................................................... 120
1D Lateroflexie .............................................................................................................................................................................. 121
Belast onderzoek in zit (geleid actief), regionaal ...................................................................................................................... 121
3D homoniem ...................................................................................................................................................................................... 121
Flexie ................................................................................................................................................................................................ 121
Extensie ........................................................................................................................................................................................... 122
3D heteroniem ............................................................................................................................................................................... 122
Flexie ................................................................................................................................................................................................ 122
3
M I N O R M U S C U L O S K E L E T A A L
,Inhoudsopgave
6Vaardigheid schouder 1 en 2 onderzoek .................................................................................................................................... 6
Palpaties .................................................................................................................................................................................................... 6
Spierkracht/weerstandstesten ............................................................................................................................................................ 6
Humero Scapular Motion Interface (HSMI) – isometrische retroflexie ............................................................................... 6
Humero Scapular Motion Interface (HSMI) – isometrische abductie ................................................................................... 6
Humero Scapular Motion Interface (HSMI) – isometrische adductie ................................................................................... 7
Humero Scapular Motion Interface (HSMI) – isometrische exorotatie................................................................................ 7
Humero Scapular Motion Interface (HSMI) – isometrische endorotatie ............................................................................. 7
Angulaire mobilisatie............................................................................................................................................................................. 7
Stenvers testen ...................................................................................................................................................................................... 10
Okselhaargrens / angulus inferior............................................................................................................................................. 10
Clavicula-rol ..................................................................................................................................................................................... 11
Caudaalglijden van de scapula ................................................................................................................................................... 11
Cervico-thoracale-overgang-rotatie (CTO-rotatie) .............................................................................................................. 12
Passief horizontale adductie........................................................................................................................................................ 12
Tractie in ruststand (MLPP) ................................................................................................................................................................ 13
Instabiliteitstesten ................................................................................................................................................................................ 13
Apprehension test (provocatietest) ........................................................................................................................................... 13
Augmentation test .......................................................................................................................................................................... 14
Relocation test (reductietest) ...................................................................................................................................................... 14
Release test (provocatietest)........................................................................................................................................................ 14
Specifieke tracties................................................................................................................................................................................. 15
Rol-glij technieken ............................................................................................................................................................................... 16
AC-Gewricht; onderzoek joint play ................................................................................................................................................. 18
Primair en secundair impingement.................................................................................................................................................. 18
Instabiliteitstesten glenohumeraal .................................................................................................................................................. 21
Ruptuurtesten ........................................................................................................................................................................................ 24
Vaardigheid schouder 1 en 2 therapie ......................................................................................................................................... 26
Kubis tractie voor AC ........................................................................................................................................................................... 26
Kubis tractie voor SC ........................................................................................................................................................................... 27
Vaardigheid elleboog 3 en 4 onderzoek ...................................................................................................................................... 27
Passief ( + pas. Stabiliteit) ................................................................................................................................................................. 27
Weerstandstesten ................................................................................................................................................................................. 30
Palpaties .................................................................................................................................................................................................. 32
Screeningstesten................................................................................................................................................................................... 32
Stabiliteitstesten ................................................................................................................................................................................... 33
Tracties en translaties in ruststand (l.p.p.) en in eindstand (c.p.p.) ................................................................................ 35
Rol-glij bewegingen humero-ulnair.......................................................................................................................................... 36
Rol-glij beweging humero-radiaal ............................................................................................................................................ 38
Vaardigheid elleboog 3 en 4 therapie .......................................................................................................................................... 39
Spierrekken....................................................................................................................................................................................... 39
1
,Vaardigheid pols 5 en 6 onderzoek .............................................................................................................................................. 45
Palpaties ............................................................................................................................................................................................ 45
Artrogene mobiliteit....................................................................................................................................................................... 45
TFCC provocatie test in supinatie en pronatie ....................................................................................................................... 48
Tractie ................................................................................................................................................................................................ 50
Translatie dorsaalflexie verbetering.......................................................................................................................................... 50
Translatie plantairflexie verbetering ......................................................................................................................................... 50
Instabiliteitsonderzoek.................................................................................................................................................................. 51
Rol-glij dorsaalflexie ..................................................................................................................................................................... 53
Rol-glij palmairflexie ..................................................................................................................................................................... 54
Rol-glij radiaal- en ulnairabductie ............................................................................................................................................ 55
Vaardigheid enkel 7 en 8 onderzoek............................................................................................................................................ 58
Art. subtalaris (OSG) ...................................................................................................................................................................... 59
Lijn van Lisfranc (artt. tarsometatarsales I-V) ........................................................................................................................ 61
Functionele instabiliteitstesten ......................................................................................................................................................... 62
Schuifladetest (anterior drawer test) ......................................................................................................................................... 62
Ligamentaire stresstesten ............................................................................................................................................................ 62
Palpatie .............................................................................................................................................................................................. 63
Joint-play art. tibiofibularis proximalis .................................................................................................................................... 63
HVT-manipulatie – fibula naar ventrolateraal ........................................................................................................................ 63
Onderzoek syndesmosis tibiofibularis distalis ...................................................................................................................... 64
Fibula naar dorsaal ......................................................................................................................................................................... 64
Tibia naar dorsaal ........................................................................................................................................................................... 64
Varus-kliktest .................................................................................................................................................................................. 65
Artrogeen onderzoek .......................................................................................................................................................................... 65
Art. talocruralis ..................................................................................................................................................................................... 65
Art. subtalaris ........................................................................................................................................................................................ 67
Mobilisatie mediaal voetgewelf................................................................................................................................................... 71
Mobilisatie lateraal voetgewelf ................................................................................................................................................... 72
Mobilisatie van de tenen (tractie, rol/schuif, kantel)............................................................................................................ 73
Vaardigheid knie 9 en 10 onderzoek ........................................................................................................................................... 75
Ottawa knee rules................................................................................................................................................................................. 75
Palpatie .................................................................................................................................................................................................... 75
Angulair onderzoek ............................................................................................................................................................................. 75
Art. genus – oriëntatie in gesloten keten................................................................................................................................. 75
Passieve instabiliteitstesten ............................................................................................................................................................... 79
Varus (0 en 20° flexie) ................................................................................................................................................................... 79
Apprehension-test patella (vrij naar Fairbanks) .................................................................................................................... 80
Hydropstesten ....................................................................................................................................................................................... 80
Art. genus – palpatie – intra-articulaire zwelling .................................................................................................................. 80
Art. genus – palpatie – ‘ballottement’ van de patella ........................................................................................................... 81
Kruisbandtesten .................................................................................................................................................................................... 82
Voorste kruisband ................................................................................................................................................................................ 82
Hyperextensietest ........................................................................................................................................................................... 82
Achterste kruisband............................................................................................................................................................................. 84
Menicustesten........................................................................................................................................................................................ 86
Bohler ....................................................................................................................................................................................................... 87
2
, Tracties .................................................................................................................................................................................................... 90
Rolglijden – flexie ................................................................................................................................................................................. 90
Rolglijden – extensie...................................................................................................................................................................... 92
HVT-manipulaties .......................................................................................................................................................................... 93
Functionele stabiliteitstesten (samengesteld door G. Koel) ..................................................................................................... 95
Vaardigheid heup 11 onderzoek ................................................................................................................................................... 95
Angulair onderzoek ............................................................................................................................................................................. 95
Tracties/ translaties in ruststand ................................................................................................................................................... 102
Palpatie .................................................................................................................................................................................................. 103
Tractie specifiek .................................................................................................................................................................................. 103
Lokale belastbaarheidsonderzoek ................................................................................................................................................. 108
Rol/schuif flexie.................................................................................................................................................................................. 112
• Uitgangshouding patiënt: Rugligging. De therapeut draagt met de gelijknamige onderarm het onderbeen
van de patiënt...................................................................................................................................................................................... 112
Rol/schuif abductie ............................................................................................................................................................................ 113
Rol/schuif extensie ............................................................................................................................................................................ 113
Vaardigheid wervelkolom 1 SI onderzoek ................................................................................................................................. 114
Voert screening uit waarbij rode vlaggen worden uitgesloten .............................................................................................. 114
DTF-verslag maken conform de richtlijn verslaglegging ........................................................................................................ 114
Palpaties ................................................................................................................................................................................................ 115
Cristae .............................................................................................................................................................................................. 116
SIAS ................................................................................................................................................................................................... 116
SIPS.................................................................................................................................................................................................... 116
SIG testen, als provocatietesten ..................................................................................................................................................... 117
Distractietest .................................................................................................................................................................................. 117
Thigh thrust test ........................................................................................................................................................................... 117
Compressietest.............................................................................................................................................................................. 117
Faber-test (Patrick-test) ............................................................................................................................................................. 118
Test volgens Gaenslen ................................................................................................................................................................ 118
Passief functieonderzoek ................................................................................................................................................................. 119
HVT-manipulatie ilium anterior ............................................................................................................................................... 119
HVT-manipulatie ilium posterior ............................................................................................................................................. 119
(Active) Straight Leg Raise voor bekkeninstabiliteit.................................................................................................................. 120
Vaardigheid wervelkolom 2 SIG LWK onderzoek ...................................................................................................................... 120
Belast onderzoek in stand ((geleid) actief), regionaal .............................................................................................................. 120
1D Flexie ......................................................................................................................................................................................... 120
1D Extensie .................................................................................................................................................................................... 120
1D Lateroflexie .............................................................................................................................................................................. 121
Belast onderzoek in zit (geleid actief), regionaal ...................................................................................................................... 121
3D homoniem ...................................................................................................................................................................................... 121
Flexie ................................................................................................................................................................................................ 121
Extensie ........................................................................................................................................................................................... 122
3D heteroniem ............................................................................................................................................................................... 122
Flexie ................................................................................................................................................................................................ 122
3
