ERGOTHERAPIE IN DE GERIATRIE: SAMENVATTING (KUNI)
Inhoudstafel
Ergotherapie in de geriatrie: samenvatting (Kuni)....................................................................................................1
Hoorcollege 1: Hersenletsel......................................................................................................................................4
Aangeboren vs. niet-aangeboren hersenletsel (NAH)..........................................................................................4
Aangeboren hersenletsel..................................................................................................................................4
Niet-aangeboren hersenletsel...........................................................................................................................4
CerebroVasculair Accident (CVA)..........................................................................................................................4
Definitie CVA......................................................................................................................................................5
Vormen CVA......................................................................................................................................................5
Preventie...........................................................................................................................................................5
Herken een beroerte: FAST (snel handelen!)....................................................................................................6
Gevolgen van een CVA......................................................................................................................................6
Neurologische uitvalsverschijnselen TGV een CVA...........................................................................................6
Motorische gevolgen.............................................................................................................................................7
Hemiplegie (hemiparese)..................................................................................................................................7
Gezicht...........................................................................................................................................................7
Tonus...............................................................................................................................................................10
Spasticiteit.......................................................................................................................................................11
(Abnormale) synergie......................................................................................................................................13
Pushersyndroom.............................................................................................................................................14
Tonische reflexen............................................................................................................................................15
Geassocieerde reactie en geassocieerde beweging.......................................................................................16
Clonus..............................................................................................................................................................16
Hoorcollege 2: hersenletsel deel 2..........................................................................................................................16
Sensorische gevolgen..........................................................................................................................................16
Sensomotoriek................................................................................................................................................17
Het sensorisch systeem: het initiatie en feedback systeem...........................................................................17
Sensoriek.........................................................................................................................................................17
Achtergrondinformatie: receptoren...............................................................................................................19
Therapie...........................................................................................................................................................19
Feedback en feedforward...............................................................................................................................20
Cognitieve gevolgen............................................................................................................................................21
Cognitive Disabilities Model (CDM).................................................................................................................21
Aandacht.........................................................................................................................................................22
Pagina 1 van 57
, Geheugen........................................................................................................................................................23
Executief functioneren....................................................................................................................................24
Gnosis en praxis...............................................................................................................................................25
Communicatieve gevolgen..................................................................................................................................26
Afasie...............................................................................................................................................................26
Motorisch leren...................................................................................................................................................27
Inleiding...........................................................................................................................................................27
Engramtheorie (Adams, Lashley)....................................................................................................................28
Schematheorie (Schmidt)................................................................................................................................29
Ecologische theorie (Newell)...........................................................................................................................30
Strategieën waardoor we tot motorisch leren komen...................................................................................31
Hoorcollege 3: hersenletsel deel 3..........................................................................................................................32
Pijn...................................................................................................................................................................32
Therapie...........................................................................................................................................................34
Hoorcollege 4: gastcollege protheses.....................................................................................................................37
Voorstelling VIGO................................................................................................................................................37
Amputatie............................................................................................................................................................37
Oorzaken........................................................................................................................................................37
Amputatie van Axel.........................................................................................................................................37
Protheses.............................................................................................................................................................38
Algemeen........................................................................................................................................................38
Prothese vasthangen aan uw lichaam............................................................................................................38
Bewegen met prothese...................................................................................................................................38
Zwachtelen......................................................................................................................................................39
Hoorcollege 5 – deel 1: amputatie onderste lidmaat.............................................................................................39
Soorten amputatie..............................................................................................................................................39
Amputatie............................................................................................................................................................40
Incidentie.........................................................................................................................................................40
Oorzaak............................................................................................................................................................40
Overwegingen operatie...................................................................................................................................40
Bepalen amputatieniveau...............................................................................................................................40
Soorten amputatie..........................................................................................................................................41
Wanneer amputeren?.....................................................................................................................................41
Belang preoperatieve mogelijkheden.............................................................................................................41
Voorlichting (vetgedrukt is wat wij als ergo gaan geven als voorlichting)......................................................42
Postoperatief...................................................................................................................................................42
Pijn...................................................................................................................................................................43
Pagina 2 van 57
, Complicaties....................................................................................................................................................43
Mobiliteit.........................................................................................................................................................43
Psychische problemen.....................................................................................................................................43
Revalidatie.......................................................................................................................................................44
Werkhervatting................................................................................................................................................45
Protheses.............................................................................................................................................................45
Prothesetraining..............................................................................................................................................45
Verloop prothese.............................................................................................................................................46
Groepen voor prothese...................................................................................................................................46
Onderdelen prothese......................................................................................................................................47
Hoorcollege 5 – deel 2: totale heup- en knieprothese...........................................................................................48
Oorzaken.........................................................................................................................................................48
Epidemiologie artrose.....................................................................................................................................48
Symptomen artrose.........................................................................................................................................48
Risicofactoren artrose.....................................................................................................................................49
Verloop behandeling: stepped care................................................................................................................50
Diagnose..........................................................................................................................................................51
Meetinstrumenten..........................................................................................................................................52
Doelen therapie...............................................................................................................................................52
Totale heupprothese.......................................................................................................................................52
Totale knieprothese........................................................................................................................................55
Patiënttevredenheid........................................................................................................................................56
Werkhervatting................................................................................................................................................56
Sporthervatting...............................................................................................................................................57
Pagina 3 van 57
, HOORCOLLEGE 1: HERSENLETSEL
AANGEBOREN VS. NIET-AANGEBOREN HERSENLETSEL (NAH)
AANGEBOREN HERSENLETSEL
- Ontstaat voor (ontwikkeling van de foetus), tijdens de geboorte of binnen de 6 maanden na de
geboorte.
- Oorzaak:
o Genetische afwijkingen
o Zuurstoftekort tijdens de zwangerschap of geboorte
Vb: cerebrale parese (CP)
NIET-AANGEBOREN HERSENLETSEL
- Ontstaat ten minste 6 maanden na de geboorte
- Oorzaak:
o Traumatisch: verstoort de normale werking van de hersenen, letsels kunnen variëren
van mild tot ernstig
Vb: auto-ongeval, slag op het hoofd met een stomp voorwerp
o Niet-traumatisch (niet door externe invloeden)
Vb: CVA, tumor, waterhoofd (hydrocefalie), vergiftiging
o Progressieve neurologische aandoening
Vb: Parkinson, Huntington, MS, verschillende vormen van dementie
CEREBROVASCULAIR ACCIDENT (CVA)
Pagina 4 van 57
Inhoudstafel
Ergotherapie in de geriatrie: samenvatting (Kuni)....................................................................................................1
Hoorcollege 1: Hersenletsel......................................................................................................................................4
Aangeboren vs. niet-aangeboren hersenletsel (NAH)..........................................................................................4
Aangeboren hersenletsel..................................................................................................................................4
Niet-aangeboren hersenletsel...........................................................................................................................4
CerebroVasculair Accident (CVA)..........................................................................................................................4
Definitie CVA......................................................................................................................................................5
Vormen CVA......................................................................................................................................................5
Preventie...........................................................................................................................................................5
Herken een beroerte: FAST (snel handelen!)....................................................................................................6
Gevolgen van een CVA......................................................................................................................................6
Neurologische uitvalsverschijnselen TGV een CVA...........................................................................................6
Motorische gevolgen.............................................................................................................................................7
Hemiplegie (hemiparese)..................................................................................................................................7
Gezicht...........................................................................................................................................................7
Tonus...............................................................................................................................................................10
Spasticiteit.......................................................................................................................................................11
(Abnormale) synergie......................................................................................................................................13
Pushersyndroom.............................................................................................................................................14
Tonische reflexen............................................................................................................................................15
Geassocieerde reactie en geassocieerde beweging.......................................................................................16
Clonus..............................................................................................................................................................16
Hoorcollege 2: hersenletsel deel 2..........................................................................................................................16
Sensorische gevolgen..........................................................................................................................................16
Sensomotoriek................................................................................................................................................17
Het sensorisch systeem: het initiatie en feedback systeem...........................................................................17
Sensoriek.........................................................................................................................................................17
Achtergrondinformatie: receptoren...............................................................................................................19
Therapie...........................................................................................................................................................19
Feedback en feedforward...............................................................................................................................20
Cognitieve gevolgen............................................................................................................................................21
Cognitive Disabilities Model (CDM).................................................................................................................21
Aandacht.........................................................................................................................................................22
Pagina 1 van 57
, Geheugen........................................................................................................................................................23
Executief functioneren....................................................................................................................................24
Gnosis en praxis...............................................................................................................................................25
Communicatieve gevolgen..................................................................................................................................26
Afasie...............................................................................................................................................................26
Motorisch leren...................................................................................................................................................27
Inleiding...........................................................................................................................................................27
Engramtheorie (Adams, Lashley)....................................................................................................................28
Schematheorie (Schmidt)................................................................................................................................29
Ecologische theorie (Newell)...........................................................................................................................30
Strategieën waardoor we tot motorisch leren komen...................................................................................31
Hoorcollege 3: hersenletsel deel 3..........................................................................................................................32
Pijn...................................................................................................................................................................32
Therapie...........................................................................................................................................................34
Hoorcollege 4: gastcollege protheses.....................................................................................................................37
Voorstelling VIGO................................................................................................................................................37
Amputatie............................................................................................................................................................37
Oorzaken........................................................................................................................................................37
Amputatie van Axel.........................................................................................................................................37
Protheses.............................................................................................................................................................38
Algemeen........................................................................................................................................................38
Prothese vasthangen aan uw lichaam............................................................................................................38
Bewegen met prothese...................................................................................................................................38
Zwachtelen......................................................................................................................................................39
Hoorcollege 5 – deel 1: amputatie onderste lidmaat.............................................................................................39
Soorten amputatie..............................................................................................................................................39
Amputatie............................................................................................................................................................40
Incidentie.........................................................................................................................................................40
Oorzaak............................................................................................................................................................40
Overwegingen operatie...................................................................................................................................40
Bepalen amputatieniveau...............................................................................................................................40
Soorten amputatie..........................................................................................................................................41
Wanneer amputeren?.....................................................................................................................................41
Belang preoperatieve mogelijkheden.............................................................................................................41
Voorlichting (vetgedrukt is wat wij als ergo gaan geven als voorlichting)......................................................42
Postoperatief...................................................................................................................................................42
Pijn...................................................................................................................................................................43
Pagina 2 van 57
, Complicaties....................................................................................................................................................43
Mobiliteit.........................................................................................................................................................43
Psychische problemen.....................................................................................................................................43
Revalidatie.......................................................................................................................................................44
Werkhervatting................................................................................................................................................45
Protheses.............................................................................................................................................................45
Prothesetraining..............................................................................................................................................45
Verloop prothese.............................................................................................................................................46
Groepen voor prothese...................................................................................................................................46
Onderdelen prothese......................................................................................................................................47
Hoorcollege 5 – deel 2: totale heup- en knieprothese...........................................................................................48
Oorzaken.........................................................................................................................................................48
Epidemiologie artrose.....................................................................................................................................48
Symptomen artrose.........................................................................................................................................48
Risicofactoren artrose.....................................................................................................................................49
Verloop behandeling: stepped care................................................................................................................50
Diagnose..........................................................................................................................................................51
Meetinstrumenten..........................................................................................................................................52
Doelen therapie...............................................................................................................................................52
Totale heupprothese.......................................................................................................................................52
Totale knieprothese........................................................................................................................................55
Patiënttevredenheid........................................................................................................................................56
Werkhervatting................................................................................................................................................56
Sporthervatting...............................................................................................................................................57
Pagina 3 van 57
, HOORCOLLEGE 1: HERSENLETSEL
AANGEBOREN VS. NIET-AANGEBOREN HERSENLETSEL (NAH)
AANGEBOREN HERSENLETSEL
- Ontstaat voor (ontwikkeling van de foetus), tijdens de geboorte of binnen de 6 maanden na de
geboorte.
- Oorzaak:
o Genetische afwijkingen
o Zuurstoftekort tijdens de zwangerschap of geboorte
Vb: cerebrale parese (CP)
NIET-AANGEBOREN HERSENLETSEL
- Ontstaat ten minste 6 maanden na de geboorte
- Oorzaak:
o Traumatisch: verstoort de normale werking van de hersenen, letsels kunnen variëren
van mild tot ernstig
Vb: auto-ongeval, slag op het hoofd met een stomp voorwerp
o Niet-traumatisch (niet door externe invloeden)
Vb: CVA, tumor, waterhoofd (hydrocefalie), vergiftiging
o Progressieve neurologische aandoening
Vb: Parkinson, Huntington, MS, verschillende vormen van dementie
CEREBROVASCULAIR ACCIDENT (CVA)
Pagina 4 van 57
