KINESITHERAPIE BIJ KINDEREN –
PEDIATRIE SAMENVATTING
Ragne Deleu
,INHOUD
NEURO EN ORTHOPEDISCHE STOORNISSEN
Inleiding ............................................................................................................................................ 10
Neurologische stoornissen ................................................................................................................. 12
Wat kan het zenuwstelsel beschadigen? .......................................................................................... 12
Stoornissen van het zenuwstelsel.................................................................................................... 12
Neurologsiche stoornissen bij kinderen ........................................................................................... 13
Centraal neurologische stoornissen ................................................................................................ 13
Perifeer neurologsiche stoornissen ................................................................................................. 14
Defenitie, incidentie en etiologie ......................................................................................................... 15
Overview incidentie ........................................................................................................................ 15
Overview neuromotor disease by cause ........................................................................................... 16
Incidentie versus prevalentie .......................................................................................................... 16
Waarom classificaties? .................................................................................................................. 16
Disorders of the central nervous system - BRAIN .............................................................................. 16
Cerebrale parese ........................................................................................................................ 17
Verworven/acquired brain injury en Traumatic brain injury............................................................. 44
Dravet ........................................................................................................................................ 46
Disorders of the central nervous system – SPINAL CORD .................................................................. 49
Spina Bifida ................................................................................................................................ 49
Hereditary spastic paraparesis .................................................................................................... 52
Disorders o the peripheral nervous system – NERVES ....................................................................... 54
Spinal muscular atrophy ............................................................................................................. 54
Charcot marie tooth .................................................................................................................... 58
Traumatic nerve injury – brachial plexus ....................................................................................... 59
Sensorineural hearing loss .......................................................................................................... 60
Disorders of the peripheral nervous system – NEUROMUSCULAR JUNCTION..................................... 63
Myasthenia Gravis ...................................................................................................................... 63
Disorders ofthe peripheral nervous system – MUSCLE ...................................................................... 65
Muscular dystrophie ................................................................................................................... 65
Overview ........................................................................................................................................ 69
Siganlen en symptomen ..................................................................................................................... 70
Signalen versus symptomen ........................................................................................................... 70
Disorders of the central nervous system – BRAIN ............................................................................. 70
Cerebrale parese ........................................................................................................................ 70
Traumatic brain injury ................................................................................................................. 75
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, Seizure disrders – Dravet ............................................................................................................. 77
Disorders of the central nervous system – SPINAL CORD .................................................................. 77
Spina bifida ................................................................................................................................ 77
Hereditary spastic paraparesis .................................................................................................... 93
Disorders of the peripheral nervous system – NERVES ...................................................................... 93
Spinal muscular atrophy ............................................................................................................. 93
Charcot Marie Thoot ................................................................................................................... 94
Traumatic nerve Injury – Brachial Plexus ....................................................................................... 94
Sensorineural hearing impairment ............................................................................................... 96
Disorders of the peripheral nervous system - NEUROMUSCULAIRE JUNCTIE ..................................... 97
Myasthenia Gravis ...................................................................................................................... 97
Disorders of the peripheral nervous system – MUSCLE ..................................................................... 97
Muscular Dystrophy .................................................................................................................... 97
Overzicht ....................................................................................................................................... 99
Evaluatie ......................................................................................................................................... 100
Disorders of the central nervous system – bRAIN ............................................................................ 100
Cerebrale parese ...................................................................................................................... 100
Traumatic brain injury ............................................................................................................... 110
Dravet ...................................................................................................................................... 111
Disorders of the central nervous system – spinal cord .................................................................... 113
Spina bifida .............................................................................................................................. 113
Hereditary spastic paraparesis .................................................................................................. 116
Disorders of the peripheral nervous system – NERVE ...................................................................... 118
Spinal Muscular Atrophy ........................................................................................................... 118
Traumatic nerve injury – brachialis plexus .................................................................................. 118
Charcot marie tooth .................................................................................................................. 119
Sensorineural hearing impairment ............................................................................................. 119
Disorders of the peripheral nervous system – Neuromusculaire junctie ........................................... 120
Myasthenia Gravis .................................................................................................................... 120
Disorders of the periphral nervous system – Muscle ....................................................................... 120
Muscular Dystrophy .................................................................................................................. 120
Behandeling .................................................................................................................................... 122
Door wie? .................................................................................................................................... 122
Wat? ............................................................................................................................................ 123
Disorders of the central nervous system – BRAIN ........................................................................... 123
Cerebrale parese ...................................................................................................................... 123
Dravet ...................................................................................................................................... 132
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, Disorders of the central nervous sytem - SPINAL CORD .................................................................. 134
Spina bifida .............................................................................................................................. 134
Disorders of the peripheral nervous system – NERVE ...................................................................... 142
Spinal Muscular Atrophy ........................................................................................................... 142
Traumatic nerve injury – Brachial Plexus ..................................................................................... 145
Charcot Marie Tooth ................................................................................................................. 145
Disorders of the peripheral nervous system – NEUROMUSCLAR JUNCTION ..................................... 146
Myasthenia Gravis .................................................................................................................... 146
Disorders of the peripheral nervous system – MUSCLE ................................................................... 147
Muscular dystrophy .................................................................................................................. 147
Praktijkles: Klinische examinatie in kinderen met neuromotorische stoornis .................................... 149
Inhoud klinische examinatie ...................................................................................................... 149
CP – concept ............................................................................................................................ 149
ROM ......................................................................................................................................... 150
Spasticiteit ............................................................................................................................... 154
Kracht en selectiviteit ................................................................................................................ 155
Alignement ............................................................................................................................... 157
Voet deformiteiten .................................................................................................................... 158
Praktijkles: facilitaties .................................................................................................................. 158
Definitie facilitatie ..................................................................................................................... 158
Definitie spasticiteit .................................................................................................................. 159
Facilitatie van ruglig naar buiklig ................................................................................................ 159
Facilitatie van zit naar handen-knieën positie ............................................................................. 160
Facilitatie van handen-knieënstand naar knieën stand ................................................................ 160
Facilitatie knieën naar stand ...................................................................................................... 161
Facilitatie stappen .................................................................................................................... 161
Praktijles/ facilitaties met casus .................................................................................................... 161
Lichaamszwaartepunt ............................................................................................................... 161
Casus Kasper 2013 ................................................................................................................... 163
Neurochirurgie: SDR ................................................................................................................. 164
Classificatie CP ........................................................................................................................ 165
Evaluatie .................................................................................................................................. 166
Lycra en neoprene suits en splinting .......................................................................................... 168
Loopband training ..................................................................................................................... 168
Paardrijden ............................................................................................................................... 168
Zwemmen en hydrotherapie ...................................................................................................... 168
Posturale controle: evaluatie en training binnen pediatrische doelgroepen ......................................... 169
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PEDIATRIE SAMENVATTING
Ragne Deleu
,INHOUD
NEURO EN ORTHOPEDISCHE STOORNISSEN
Inleiding ............................................................................................................................................ 10
Neurologische stoornissen ................................................................................................................. 12
Wat kan het zenuwstelsel beschadigen? .......................................................................................... 12
Stoornissen van het zenuwstelsel.................................................................................................... 12
Neurologsiche stoornissen bij kinderen ........................................................................................... 13
Centraal neurologische stoornissen ................................................................................................ 13
Perifeer neurologsiche stoornissen ................................................................................................. 14
Defenitie, incidentie en etiologie ......................................................................................................... 15
Overview incidentie ........................................................................................................................ 15
Overview neuromotor disease by cause ........................................................................................... 16
Incidentie versus prevalentie .......................................................................................................... 16
Waarom classificaties? .................................................................................................................. 16
Disorders of the central nervous system - BRAIN .............................................................................. 16
Cerebrale parese ........................................................................................................................ 17
Verworven/acquired brain injury en Traumatic brain injury............................................................. 44
Dravet ........................................................................................................................................ 46
Disorders of the central nervous system – SPINAL CORD .................................................................. 49
Spina Bifida ................................................................................................................................ 49
Hereditary spastic paraparesis .................................................................................................... 52
Disorders o the peripheral nervous system – NERVES ....................................................................... 54
Spinal muscular atrophy ............................................................................................................. 54
Charcot marie tooth .................................................................................................................... 58
Traumatic nerve injury – brachial plexus ....................................................................................... 59
Sensorineural hearing loss .......................................................................................................... 60
Disorders of the peripheral nervous system – NEUROMUSCULAR JUNCTION..................................... 63
Myasthenia Gravis ...................................................................................................................... 63
Disorders ofthe peripheral nervous system – MUSCLE ...................................................................... 65
Muscular dystrophie ................................................................................................................... 65
Overview ........................................................................................................................................ 69
Siganlen en symptomen ..................................................................................................................... 70
Signalen versus symptomen ........................................................................................................... 70
Disorders of the central nervous system – BRAIN ............................................................................. 70
Cerebrale parese ........................................................................................................................ 70
Traumatic brain injury ................................................................................................................. 75
1
, Seizure disrders – Dravet ............................................................................................................. 77
Disorders of the central nervous system – SPINAL CORD .................................................................. 77
Spina bifida ................................................................................................................................ 77
Hereditary spastic paraparesis .................................................................................................... 93
Disorders of the peripheral nervous system – NERVES ...................................................................... 93
Spinal muscular atrophy ............................................................................................................. 93
Charcot Marie Thoot ................................................................................................................... 94
Traumatic nerve Injury – Brachial Plexus ....................................................................................... 94
Sensorineural hearing impairment ............................................................................................... 96
Disorders of the peripheral nervous system - NEUROMUSCULAIRE JUNCTIE ..................................... 97
Myasthenia Gravis ...................................................................................................................... 97
Disorders of the peripheral nervous system – MUSCLE ..................................................................... 97
Muscular Dystrophy .................................................................................................................... 97
Overzicht ....................................................................................................................................... 99
Evaluatie ......................................................................................................................................... 100
Disorders of the central nervous system – bRAIN ............................................................................ 100
Cerebrale parese ...................................................................................................................... 100
Traumatic brain injury ............................................................................................................... 110
Dravet ...................................................................................................................................... 111
Disorders of the central nervous system – spinal cord .................................................................... 113
Spina bifida .............................................................................................................................. 113
Hereditary spastic paraparesis .................................................................................................. 116
Disorders of the peripheral nervous system – NERVE ...................................................................... 118
Spinal Muscular Atrophy ........................................................................................................... 118
Traumatic nerve injury – brachialis plexus .................................................................................. 118
Charcot marie tooth .................................................................................................................. 119
Sensorineural hearing impairment ............................................................................................. 119
Disorders of the peripheral nervous system – Neuromusculaire junctie ........................................... 120
Myasthenia Gravis .................................................................................................................... 120
Disorders of the periphral nervous system – Muscle ....................................................................... 120
Muscular Dystrophy .................................................................................................................. 120
Behandeling .................................................................................................................................... 122
Door wie? .................................................................................................................................... 122
Wat? ............................................................................................................................................ 123
Disorders of the central nervous system – BRAIN ........................................................................... 123
Cerebrale parese ...................................................................................................................... 123
Dravet ...................................................................................................................................... 132
2
, Disorders of the central nervous sytem - SPINAL CORD .................................................................. 134
Spina bifida .............................................................................................................................. 134
Disorders of the peripheral nervous system – NERVE ...................................................................... 142
Spinal Muscular Atrophy ........................................................................................................... 142
Traumatic nerve injury – Brachial Plexus ..................................................................................... 145
Charcot Marie Tooth ................................................................................................................. 145
Disorders of the peripheral nervous system – NEUROMUSCLAR JUNCTION ..................................... 146
Myasthenia Gravis .................................................................................................................... 146
Disorders of the peripheral nervous system – MUSCLE ................................................................... 147
Muscular dystrophy .................................................................................................................. 147
Praktijkles: Klinische examinatie in kinderen met neuromotorische stoornis .................................... 149
Inhoud klinische examinatie ...................................................................................................... 149
CP – concept ............................................................................................................................ 149
ROM ......................................................................................................................................... 150
Spasticiteit ............................................................................................................................... 154
Kracht en selectiviteit ................................................................................................................ 155
Alignement ............................................................................................................................... 157
Voet deformiteiten .................................................................................................................... 158
Praktijkles: facilitaties .................................................................................................................. 158
Definitie facilitatie ..................................................................................................................... 158
Definitie spasticiteit .................................................................................................................. 159
Facilitatie van ruglig naar buiklig ................................................................................................ 159
Facilitatie van zit naar handen-knieën positie ............................................................................. 160
Facilitatie van handen-knieënstand naar knieën stand ................................................................ 160
Facilitatie knieën naar stand ...................................................................................................... 161
Facilitatie stappen .................................................................................................................... 161
Praktijles/ facilitaties met casus .................................................................................................... 161
Lichaamszwaartepunt ............................................................................................................... 161
Casus Kasper 2013 ................................................................................................................... 163
Neurochirurgie: SDR ................................................................................................................. 164
Classificatie CP ........................................................................................................................ 165
Evaluatie .................................................................................................................................. 166
Lycra en neoprene suits en splinting .......................................................................................... 168
Loopband training ..................................................................................................................... 168
Paardrijden ............................................................................................................................... 168
Zwemmen en hydrotherapie ...................................................................................................... 168
Posturale controle: evaluatie en training binnen pediatrische doelgroepen ......................................... 169
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