MSAw profielen onderzoek + behandeling
Inhoudsopgave
Radiculair syndroom................................................................................................................................ 3
Vinger-bodem afstand ......................................................................................................................... 3
Straight Leg Raise (passive) .................................................................................................................. 3
Ganganalyse hakken/tenen ................................................................................................................. 4
Myotomen ............................................................................................................................................ 4
Dermatomen ........................................................................................................................................ 6
Reflextesten ......................................................................................................................................... 7
Omgekeerde SLR .................................................................................................................................. 7
Gekruiste laseque ................................................................................................................................. 8
Behandeling...................................................................................................................................... 8
Stenose..................................................................................................................................................... 9
Zelfde testen als bij radiculair syndroom ............................................................................................. 9
Vinger-bodem afstand ................................................................................................................. 9
Straight Leg Raise ......................................................................................................................... 9
Ganganalyse hakken/tenen ......................................................................................................... 9
Myotomen .................................................................................................................................... 9
Dermatomen ................................................................................................................................ 9
Reflextesten ................................................................................................................................. 9
Omgekeerde SLR .......................................................................................................................... 9
Gekruiste laseque ......................................................................................................................... 9
Mobiliteitsonderzoek ........................................................................................................................... 9
Behandeling.................................................................................................................................... 13
Artrose ................................................................................................................................................... 14
Mobiliteitsonderzoek ......................................................................................................................... 14
Behandeling.................................................................................................................................... 14
Reduced/excessive motor control ........................................................................................................ 15
Inspectie ............................................................................................................................................. 15
Actieve flexie ...................................................................................................................................... 16
Posterior-anterior springtest ............................................................................................................. 16
Prone instability test .......................................................................................................................... 17
Straight Leg Raise (active) .................................................................................................................. 18
Luomajakio ......................................................................................................................................... 18
Waiters bow ............................................................................................................................... 18
1
, Sitting knee extension ................................................................................................................ 19
Rocking backwards ..................................................................................................................... 19
Rocking forwards ........................................................................................................................ 20
Dorsal tilt of pelvis...................................................................................................................... 20
Prone lying active knee flexion .................................................................................................. 21
Uitvalspas ........................................................................................................................................... 21
Bruggetje op 1 been ........................................................................................................................... 22
Single leg stance ................................................................................................................................. 22
lokale spieren testen .......................................................................................................................... 23
hypermobiliteit................................................................................................................................... 23
behandeling .................................................................................................................................... 23
Spondylolisthesis ................................................................................................................................... 24
Palpatie “trapje” ................................................................................................................................. 24
Behandeling.................................................................................................................................... 24
Bechterew .............................................................................................................................................. 24
Mobiliteit ............................................................................................................................................ 24
Behandeling.................................................................................................................................... 24
SI-gewricht ............................................................................................................................................. 25
Inspectie ............................................................................................................................................. 25
Testen van Van der Wurff .................................................................................................................. 26
Distraction test/gapping test ..................................................................................................... 26
Compression test/approximation test ....................................................................................... 27
Thigh trust test/femoral shear test ............................................................................................ 27
Patrick’s sign/faber test ............................................................................................................. 28
Gaenslen’s test/pelvic torsion test ............................................................................................ 28
Straight Leg Raise (active) .................................................................................................................. 29
Straight Leg Raise (active) met compressie ....................................................................................... 29
Behandeling.................................................................................................................................... 30
bijlage 1 McKenzie ................................................................................................................................. 30
2
,Radiculair syndroom
Vinger-bodem afstand
Straight Leg Raise (passive)
Eerst been omhoog tot het pijn doet, dan naar beneden tot de pijn weg is, dan dorsaalflexie maken
tot de pijn terug is, dan weer afbouwen tot de pijn weg is, dan kin op de borst.
3
,Ganganalyse hakken/tenen
Myotomen
4
,5
,Dermatomen
- L1: binnenkant bovenbeen
- L2: midden bovenbeen
- L3: buitenkant bovenbeen
- L4: binnenkant onderbeen
- L5: midden onderbeen + voet
- S1: buitenkant onderbeen + voet
6
,Reflextesten
Omgekeerde SLR
7
, Gekruiste laseque
Behandeling
kijken naar performance en hulpvraag. Pijn komt door zenuwbeklemming of ontstekingsmediatoren.
- Bewegen zonder pijn/zonder provocatie
- Afknellingsmomenten voorkomen (eindstanden) bijv. zitinstructie gericht op klacht
- Doorverwijzen huisarts voor medicatie
- Uitleg heel belangrijk!! Dus eerst kijken of de PT snapt wat er aan de hand is (leventhaler of
hoe je dat ook schrijft)
- Eventueel McKenzie
Kans na radiculair syndroom op reduced motor control is groot omdat de discus verkleind waardoor
de neutrale ruimte toeneemt. (dit moet je in je achterhoofd houden en in de gaten houden)
Voornamelijk belangrijk om de patiënt te helpen met de provocerende bewegingen te kunnen
ontwijken in het ADL en zo de situatie leefbaarder te maken.
8
Inhoudsopgave
Radiculair syndroom................................................................................................................................ 3
Vinger-bodem afstand ......................................................................................................................... 3
Straight Leg Raise (passive) .................................................................................................................. 3
Ganganalyse hakken/tenen ................................................................................................................. 4
Myotomen ............................................................................................................................................ 4
Dermatomen ........................................................................................................................................ 6
Reflextesten ......................................................................................................................................... 7
Omgekeerde SLR .................................................................................................................................. 7
Gekruiste laseque ................................................................................................................................. 8
Behandeling...................................................................................................................................... 8
Stenose..................................................................................................................................................... 9
Zelfde testen als bij radiculair syndroom ............................................................................................. 9
Vinger-bodem afstand ................................................................................................................. 9
Straight Leg Raise ......................................................................................................................... 9
Ganganalyse hakken/tenen ......................................................................................................... 9
Myotomen .................................................................................................................................... 9
Dermatomen ................................................................................................................................ 9
Reflextesten ................................................................................................................................. 9
Omgekeerde SLR .......................................................................................................................... 9
Gekruiste laseque ......................................................................................................................... 9
Mobiliteitsonderzoek ........................................................................................................................... 9
Behandeling.................................................................................................................................... 13
Artrose ................................................................................................................................................... 14
Mobiliteitsonderzoek ......................................................................................................................... 14
Behandeling.................................................................................................................................... 14
Reduced/excessive motor control ........................................................................................................ 15
Inspectie ............................................................................................................................................. 15
Actieve flexie ...................................................................................................................................... 16
Posterior-anterior springtest ............................................................................................................. 16
Prone instability test .......................................................................................................................... 17
Straight Leg Raise (active) .................................................................................................................. 18
Luomajakio ......................................................................................................................................... 18
Waiters bow ............................................................................................................................... 18
1
, Sitting knee extension ................................................................................................................ 19
Rocking backwards ..................................................................................................................... 19
Rocking forwards ........................................................................................................................ 20
Dorsal tilt of pelvis...................................................................................................................... 20
Prone lying active knee flexion .................................................................................................. 21
Uitvalspas ........................................................................................................................................... 21
Bruggetje op 1 been ........................................................................................................................... 22
Single leg stance ................................................................................................................................. 22
lokale spieren testen .......................................................................................................................... 23
hypermobiliteit................................................................................................................................... 23
behandeling .................................................................................................................................... 23
Spondylolisthesis ................................................................................................................................... 24
Palpatie “trapje” ................................................................................................................................. 24
Behandeling.................................................................................................................................... 24
Bechterew .............................................................................................................................................. 24
Mobiliteit ............................................................................................................................................ 24
Behandeling.................................................................................................................................... 24
SI-gewricht ............................................................................................................................................. 25
Inspectie ............................................................................................................................................. 25
Testen van Van der Wurff .................................................................................................................. 26
Distraction test/gapping test ..................................................................................................... 26
Compression test/approximation test ....................................................................................... 27
Thigh trust test/femoral shear test ............................................................................................ 27
Patrick’s sign/faber test ............................................................................................................. 28
Gaenslen’s test/pelvic torsion test ............................................................................................ 28
Straight Leg Raise (active) .................................................................................................................. 29
Straight Leg Raise (active) met compressie ....................................................................................... 29
Behandeling.................................................................................................................................... 30
bijlage 1 McKenzie ................................................................................................................................. 30
2
,Radiculair syndroom
Vinger-bodem afstand
Straight Leg Raise (passive)
Eerst been omhoog tot het pijn doet, dan naar beneden tot de pijn weg is, dan dorsaalflexie maken
tot de pijn terug is, dan weer afbouwen tot de pijn weg is, dan kin op de borst.
3
,Ganganalyse hakken/tenen
Myotomen
4
,5
,Dermatomen
- L1: binnenkant bovenbeen
- L2: midden bovenbeen
- L3: buitenkant bovenbeen
- L4: binnenkant onderbeen
- L5: midden onderbeen + voet
- S1: buitenkant onderbeen + voet
6
,Reflextesten
Omgekeerde SLR
7
, Gekruiste laseque
Behandeling
kijken naar performance en hulpvraag. Pijn komt door zenuwbeklemming of ontstekingsmediatoren.
- Bewegen zonder pijn/zonder provocatie
- Afknellingsmomenten voorkomen (eindstanden) bijv. zitinstructie gericht op klacht
- Doorverwijzen huisarts voor medicatie
- Uitleg heel belangrijk!! Dus eerst kijken of de PT snapt wat er aan de hand is (leventhaler of
hoe je dat ook schrijft)
- Eventueel McKenzie
Kans na radiculair syndroom op reduced motor control is groot omdat de discus verkleind waardoor
de neutrale ruimte toeneemt. (dit moet je in je achterhoofd houden en in de gaten houden)
Voornamelijk belangrijk om de patiënt te helpen met de provocerende bewegingen te kunnen
ontwijken in het ADL en zo de situatie leefbaarder te maken.
8
