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FMH VKB conservatief

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Fysiotherapeutisch methodisch handelen bij een voorste kruisband ruptuur met conservatieve behandeling. Stabiliteit onderzoek, mobiliteits onderzoek, kracht onderzoek.

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VKB conservatief


FMH




V

,Inhoudsopgave
Hypotheses.................................................................................................................................................... 3

Anamnese..................................................................................................................................................... 4

KOOS vragenlijst...................................................................................................................................................4

Inspectie........................................................................................................................................................ 6

Observeer relevante activiteiten uit het dagelijks leven (ADL)........................................................................6
Observeer het gangpatroon.............................................................................................................................6

Onderzoek..................................................................................................................................................... 7

Stroke test.............................................................................................................................................................7

Onderzoek art. Patellofemorale...........................................................................................................................7

Ballottement test..................................................................................................................................................7

Test passieve structuren.......................................................................................................................................8
Intra-articulaire zwelling...................................................................................................................................8
Flexie (160 graden), zacht eindgevoel..............................................................................................................8
Extensie (10 graden), ligamentair hard eindgevoel.........................................................................................8
Exorotatie ( 45 graden), elastisch eindgevoel..................................................................................................9
Endorotatie ( 15 graden), elastisch eindgevoel................................................................................................9
Abductie met extensie (0 graden), elastisch eindgevoel.................................................................................9
Abductie met 20 graden flexie knie (11 graden), elastisch eindgevoel...........................................................9
Adductie met extensie (0 graden), elastisch eindgevoel...............................................................................10
Adductie met 20 graden flexie knie (11 graden), elastisch eindgevoel.........................................................10

Test actieve structuren.......................................................................................................................................11
Flexie...............................................................................................................................................................11
Extensie...........................................................................................................................................................11

Test passieve stabiliteit.......................................................................................................................................12
Gravity sign.....................................................................................................................................................12
Lachman 20.....................................................................................................................................................12
Schuiflade 90..................................................................................................................................................12

Actieve stabiliteit, proprioceptie.........................................................................................................................13
Y-ebt...............................................................................................................................................................13
Op één been, onstabiele ondergrond............................................................................................................14
Weerstand knie..............................................................................................................................................14
Willekeurig aanspannen van de bovenbeenmusculatuur..............................................................................14

Fysiotherapeutische diagnose...................................................................................................................... 15

Behandelplan opstellen............................................................................................................................... 15

Therapeutisch proces................................................................................................................................... 16

Stabiliteitstraining..............................................................................................................................................16

, Krachttraining.....................................................................................................................................................18
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