MSK 5: THEORIE + CASUS
ragne deleu
[BEDRIJFSNAAM] [Bedrijfsadres]
,Theorie: MCQ 40%
Praktijk: 2 mini-casussen met demonstratie van bijhorende techniek(en) met schriftelijke voorbereiding
60%
INHOUDSOPGAVE
behandeling van cervicale klachten (opname) ___________________________________ 8
(Chronische) niet-specifieke nekpijn__________________________________________________ 8
Classificatie voor de nek pain task force ______________________________________________ 8
Natuurlijk beloop van een klacht _____________________________________________________ 8
Natuurlijk beloop van ‘gewone/normale’ nekpijn, graad 1 of 2 ___________________________________ 9
Behandelprofiel A ____________________________________________________________________ 9
Behandelprofiel B ___________________________________________________________________ 10
Behandelprofiel C___________________________________________________________________ 11
Welke onderdelen kan je onderscheiden in de therapieën? ___________________________ 12
Educatie ___________________________________________________________________________________ 12
Oefentherapie ______________________________________________________________________________ 13
Mobilisaties ________________________________________________________________________________ 17
Conclusie EB- behandeling/richtlijnen ________________________________________________________ 17
Radiculaire klachten ________________________________________________________________ 18
Hoe differentiëren tussen graad 2 en 3 ________________________________________________________ 18
Nekpijn en somatische gerefereerde pijn _____________________________________________________ 19
Behandeling somatische gerefereerde pijn ____________________________________________________ 19
Cervicaal radiculair syndroom _______________________________________________________________ 19
Klachten bovenste kwadrant ________________________________________________________ 23
Kans definitie _______________________________________________________________________ 24
Diagnostisch proces ________________________________________________________________________ 24
Analyse / profielbepaling ____________________________________________________________________ 24
Informeren en adviseren _____________________________________________________________________ 25
Casus ______________________________________________________________________________ 26
Pathofysiologische mechanismen + accenten in de therapie _________________________ 27
Conclusie van de gehele les _________________________________________________________ 28
Outcome assessment _______________________________________________________________ 28
PSK – patiënt specifieke klachten ____________________________________________________________ 28
GPE – global perceived effect ________________________________________________________________ 29
NDI – neck disability index ___________________________________________________________________ 29
Voorbeelden ________________________________________________________________________ 31
Casus 1 ____________________________________________________________________________________ 31
Casus 2 ____________________________________________________________________________________ 32
Rotator cuff (RCRSP) (opname) ________________________________________________ 33
1
, Inleiding ____________________________________________________________________________ 33
Meest voorkomende schouderpijn diagnosen _________________________________________________ 33
Evolutie ____________________________________________________________________________________ 34
De schouder________________________________________________________________________________ 34
Impingement syndroom _____________________________________________________________________ 35
Diagnostische schoudertesten _______________________________________________________________ 36
Klinisch onderzoek__________________________________________________________________ 37
Wat is RCRSP? _____________________________________________________________________________ 37
Meer bewijs voor de intrinsieke rol van het peesprobleem ______________________________________ 37
3 meest voorkomende aangedane pezen _____________________________________________________ 38
Assessment van rcrsp – anamnese ___________________________________________________________ 39
Onderzoek _________________________________________________________________________________ 39
Revalidatie _________________________________________________________________________ 40
Studie voor effectiviteit van conservatieve behandeling van RCRSP _____________________________ 40
Load het beschadigde weefsel _______________________________________________________________ 41
Hoe moet oefentherapie er uit zien? __________________________________________________________ 43
Hoe frequent moet je ze zien in de praktijk ____________________________________________________ 43
Wat maakt niet uit bij oefentherapie? _________________________________________________________ 45
Mag de patiënt pijn ervaren tijdens de oefeningen _____________________________________________ 45
Enkele overwegingen over RCRSP oefeningen _________________________________________________ 45
Oefentherapie gecombineerd met manuele therapie __________________________________________ 46
Conclusie over RCRSP Revalidatie ___________________________________________________________ 47
Zelfstudie anatomie en artrokinematica ________________________________________ 48
Anatomie en arthrokinematica bovenste lidmaat _____________________________________ 48
Schouder __________________________________________________________________________________ 48
Elleboog ___________________________________________________________________________________ 52
Pols en hand _______________________________________________________________________________ 57
Test BB: anatomie en artrokinematica bovenste lidmaat______________________________ 65
Anatomie WK _______________________________________________________________________ 66
Inleiding____________________________________________________________________________________ 66
Cervicale wervelkolom ______________________________________________________________________ 68
Thoracale wervelkolom ______________________________________________________________________ 88
Biomechanica WK (thoracaal-cervicaal) _____________________________________________ 97
Kinematica/biomechanica ___________________________________________________________________ 97
Oriëntatie facetgewrichten __________________________________________________________________ 98
Thoracale kenmerken _______________________________________________________________________ 98
Overgangsgebieden ________________________________________________________________ 101
Analyse van bewegingen ___________________________________________________________ 101
Spieren ____________________________________________________________________________ 103
Toets BB WK _______________________________________________________________________ 103
Schouderprothese ___________________________________________________________ 107
Introductie ________________________________________________________________________ 107
2
, Populatie en ouderdom ____________________________________________________________________ 107
Artrose ____________________________________________________________________________________ 108
Resultaten ________________________________________________________________________________ 108
Toekomst _________________________________________________________________________________ 108
Totale gewrichtsprothese: een succes verhaal _______________________________________________ 109
Leeftijdsgerelateerde veranderingen_________________________________________________________ 109
Waarom een schouderprothese? ___________________________________________________ 109
De eerste schouderprothese ________________________________________________________________ 109
Indicaties voor schouder prothese __________________________________________________________ 110
Normale schouder VS schouder met artrose _________________________________________________ 110
Doelen van een schouderprothese __________________________________________________________ 111
Verschillende types schouderprothesen ____________________________________________ 111
Karakteristieken van indicatie voor bepaalde soorten prothese ________________________________ 111
Totale anatomische schouderprothese – complicaties? _______________________________________ 112
Omgekeerde schouderprothese_____________________________________________________________ 112
Nederlands Arthroplastiek Register 2024 ____________________________________________________ 113
Chirurgische benadering ___________________________________________________________________ 114
Algemene revalidatieprincipes _____________________________________________________ 116
4 belangrijkste voorspellers/mediatoren van + behandelingsresultaat __________________________ 116
Algemene principes van revalidatie na arthroplastiek _________________________________________ 117
Assessment _______________________________________________________________________________ 117
Revalidatie na een schouderprothese ______________________________________________ 118
Vroege vs vertraagde revalidatie _____________________________________________________________ 118
Elleboog _____________________________________________________________________ 122
Lokalisatie van de klachten_________________________________________________________ 122
Aangedane structuur _______________________________________________________________ 122
Spier-pees aandoeningen __________________________________________________________________ 122
Golfers elleboog ___________________________________________________________________________ 134
Distale bicepspees problematiek ___________________________________________________________ 134
Instabiliteit ________________________________________________________________________ 135
Anatomie _________________________________________________________________________________ 135
Ontstaan __________________________________________________________________________________ 136
Onderzoek ________________________________________________________________________________ 136
Behandeling _______________________________________________________________________________ 136
Fracturen __________________________________________________________________________ 137
Neurogeen_________________________________________________________________________ 137
Pronator teres syndroom ___________________________________________________________________ 137
N.ulnaris entrapment ______________________________________________________________________ 138
N. interosseus posterior syndroom __________________________________________________________ 138
Varia ______________________________________________________________________________ 139
Cursus elleboog______________________________________________________________ 140
Spier-peesaandoeningen ___________________________________________________________ 140
3
ragne deleu
[BEDRIJFSNAAM] [Bedrijfsadres]
,Theorie: MCQ 40%
Praktijk: 2 mini-casussen met demonstratie van bijhorende techniek(en) met schriftelijke voorbereiding
60%
INHOUDSOPGAVE
behandeling van cervicale klachten (opname) ___________________________________ 8
(Chronische) niet-specifieke nekpijn__________________________________________________ 8
Classificatie voor de nek pain task force ______________________________________________ 8
Natuurlijk beloop van een klacht _____________________________________________________ 8
Natuurlijk beloop van ‘gewone/normale’ nekpijn, graad 1 of 2 ___________________________________ 9
Behandelprofiel A ____________________________________________________________________ 9
Behandelprofiel B ___________________________________________________________________ 10
Behandelprofiel C___________________________________________________________________ 11
Welke onderdelen kan je onderscheiden in de therapieën? ___________________________ 12
Educatie ___________________________________________________________________________________ 12
Oefentherapie ______________________________________________________________________________ 13
Mobilisaties ________________________________________________________________________________ 17
Conclusie EB- behandeling/richtlijnen ________________________________________________________ 17
Radiculaire klachten ________________________________________________________________ 18
Hoe differentiëren tussen graad 2 en 3 ________________________________________________________ 18
Nekpijn en somatische gerefereerde pijn _____________________________________________________ 19
Behandeling somatische gerefereerde pijn ____________________________________________________ 19
Cervicaal radiculair syndroom _______________________________________________________________ 19
Klachten bovenste kwadrant ________________________________________________________ 23
Kans definitie _______________________________________________________________________ 24
Diagnostisch proces ________________________________________________________________________ 24
Analyse / profielbepaling ____________________________________________________________________ 24
Informeren en adviseren _____________________________________________________________________ 25
Casus ______________________________________________________________________________ 26
Pathofysiologische mechanismen + accenten in de therapie _________________________ 27
Conclusie van de gehele les _________________________________________________________ 28
Outcome assessment _______________________________________________________________ 28
PSK – patiënt specifieke klachten ____________________________________________________________ 28
GPE – global perceived effect ________________________________________________________________ 29
NDI – neck disability index ___________________________________________________________________ 29
Voorbeelden ________________________________________________________________________ 31
Casus 1 ____________________________________________________________________________________ 31
Casus 2 ____________________________________________________________________________________ 32
Rotator cuff (RCRSP) (opname) ________________________________________________ 33
1
, Inleiding ____________________________________________________________________________ 33
Meest voorkomende schouderpijn diagnosen _________________________________________________ 33
Evolutie ____________________________________________________________________________________ 34
De schouder________________________________________________________________________________ 34
Impingement syndroom _____________________________________________________________________ 35
Diagnostische schoudertesten _______________________________________________________________ 36
Klinisch onderzoek__________________________________________________________________ 37
Wat is RCRSP? _____________________________________________________________________________ 37
Meer bewijs voor de intrinsieke rol van het peesprobleem ______________________________________ 37
3 meest voorkomende aangedane pezen _____________________________________________________ 38
Assessment van rcrsp – anamnese ___________________________________________________________ 39
Onderzoek _________________________________________________________________________________ 39
Revalidatie _________________________________________________________________________ 40
Studie voor effectiviteit van conservatieve behandeling van RCRSP _____________________________ 40
Load het beschadigde weefsel _______________________________________________________________ 41
Hoe moet oefentherapie er uit zien? __________________________________________________________ 43
Hoe frequent moet je ze zien in de praktijk ____________________________________________________ 43
Wat maakt niet uit bij oefentherapie? _________________________________________________________ 45
Mag de patiënt pijn ervaren tijdens de oefeningen _____________________________________________ 45
Enkele overwegingen over RCRSP oefeningen _________________________________________________ 45
Oefentherapie gecombineerd met manuele therapie __________________________________________ 46
Conclusie over RCRSP Revalidatie ___________________________________________________________ 47
Zelfstudie anatomie en artrokinematica ________________________________________ 48
Anatomie en arthrokinematica bovenste lidmaat _____________________________________ 48
Schouder __________________________________________________________________________________ 48
Elleboog ___________________________________________________________________________________ 52
Pols en hand _______________________________________________________________________________ 57
Test BB: anatomie en artrokinematica bovenste lidmaat______________________________ 65
Anatomie WK _______________________________________________________________________ 66
Inleiding____________________________________________________________________________________ 66
Cervicale wervelkolom ______________________________________________________________________ 68
Thoracale wervelkolom ______________________________________________________________________ 88
Biomechanica WK (thoracaal-cervicaal) _____________________________________________ 97
Kinematica/biomechanica ___________________________________________________________________ 97
Oriëntatie facetgewrichten __________________________________________________________________ 98
Thoracale kenmerken _______________________________________________________________________ 98
Overgangsgebieden ________________________________________________________________ 101
Analyse van bewegingen ___________________________________________________________ 101
Spieren ____________________________________________________________________________ 103
Toets BB WK _______________________________________________________________________ 103
Schouderprothese ___________________________________________________________ 107
Introductie ________________________________________________________________________ 107
2
, Populatie en ouderdom ____________________________________________________________________ 107
Artrose ____________________________________________________________________________________ 108
Resultaten ________________________________________________________________________________ 108
Toekomst _________________________________________________________________________________ 108
Totale gewrichtsprothese: een succes verhaal _______________________________________________ 109
Leeftijdsgerelateerde veranderingen_________________________________________________________ 109
Waarom een schouderprothese? ___________________________________________________ 109
De eerste schouderprothese ________________________________________________________________ 109
Indicaties voor schouder prothese __________________________________________________________ 110
Normale schouder VS schouder met artrose _________________________________________________ 110
Doelen van een schouderprothese __________________________________________________________ 111
Verschillende types schouderprothesen ____________________________________________ 111
Karakteristieken van indicatie voor bepaalde soorten prothese ________________________________ 111
Totale anatomische schouderprothese – complicaties? _______________________________________ 112
Omgekeerde schouderprothese_____________________________________________________________ 112
Nederlands Arthroplastiek Register 2024 ____________________________________________________ 113
Chirurgische benadering ___________________________________________________________________ 114
Algemene revalidatieprincipes _____________________________________________________ 116
4 belangrijkste voorspellers/mediatoren van + behandelingsresultaat __________________________ 116
Algemene principes van revalidatie na arthroplastiek _________________________________________ 117
Assessment _______________________________________________________________________________ 117
Revalidatie na een schouderprothese ______________________________________________ 118
Vroege vs vertraagde revalidatie _____________________________________________________________ 118
Elleboog _____________________________________________________________________ 122
Lokalisatie van de klachten_________________________________________________________ 122
Aangedane structuur _______________________________________________________________ 122
Spier-pees aandoeningen __________________________________________________________________ 122
Golfers elleboog ___________________________________________________________________________ 134
Distale bicepspees problematiek ___________________________________________________________ 134
Instabiliteit ________________________________________________________________________ 135
Anatomie _________________________________________________________________________________ 135
Ontstaan __________________________________________________________________________________ 136
Onderzoek ________________________________________________________________________________ 136
Behandeling _______________________________________________________________________________ 136
Fracturen __________________________________________________________________________ 137
Neurogeen_________________________________________________________________________ 137
Pronator teres syndroom ___________________________________________________________________ 137
N.ulnaris entrapment ______________________________________________________________________ 138
N. interosseus posterior syndroom __________________________________________________________ 138
Varia ______________________________________________________________________________ 139
Cursus elleboog______________________________________________________________ 140
Spier-peesaandoeningen ___________________________________________________________ 140
3
