Inhoudsopgave
Uitwerking casus 2......................................................................................................................................... 3
3 type spieren:............................................................................................................................................... 4
Gewrichtsmobilisaties wervelkolom:.............................................................................................................. 5
PA’s.......................................................................................................................................................................5
Gradering Maitland:...................................................................................................................................... 6
Kaltenborn.................................................................................................................................................... 6
McKenzie....................................................................................................................................................... 7
Overzicht van de behandelprocedures.................................................................................................................9
Correctie van de laterale shift.............................................................................................................................10
Globale angulaire mobilisatie....................................................................................................................... 11
Mobilisatie CWK d.m.v. NAGS en reverse NAGS volgens Mulligan.................................................................12
Gele vlaggen lumbale wervelkolom:............................................................................................................. 14
Meetinstrumenten lage rugpijn:................................................................................................................... 14
Anamnese................................................................................................................................................... 14
SCEGS:......................................................................................................................................................... 16
MRC:........................................................................................................................................................... 17
m. rectus abdominis:..........................................................................................................................................18
m. obliquus internus/externus:...........................................................................................................................18
SI-gewricht testen........................................................................................................................................ 21
De Distractietest (Gapping test):........................................................................................................................22
Compressietest (Approximation test):................................................................................................................22
Thigh Thrust test (Femoral shear test):..............................................................................................................22
Gaenslen-test (Pelvic torsion test):.....................................................................................................................23
Patrick's sign (Faber-test):..................................................................................................................................23
Prone segmental instability test:........................................................................................................................24
Craniocervical flexion test:.................................................................................................................................24
Deep Neck flexor endurance test:.......................................................................................................................24
SLUMP-test:........................................................................................................................................................24
Straight leg raise test:.........................................................................................................................................25
Prone Knee Bend test:.........................................................................................................................................25
ULTT-test:............................................................................................................................................................25
,‘the bend finger’......................................................................................................................................... 26
Biomechanisch counselen: motorische leerprincipes blok 1.4.......................................................................27
Spierversterkende oefeningen:.................................................................................................................... 28
Spierkrachttraining thoracale extensoren en scapula-retractoren met gestabiliseerde wervelkolom in
verschillende functionele situaties/posities..................................................................................................28
Activatie van de transversus abdominis en multifidus in verschillende posities.............................................28
Kinesthetic awareness................................................................................................................................. 30
Treatment based classificatie:...................................................................................................................... 32
Stappen stabiliteitstraining:......................................................................................................................... 33
10 regels voor tillen:.................................................................................................................................... 34
Movement control tests (Luomajoki)............................................................................................................ 35
,Uitwerking casus 2
Waar komt de pijn vandaan?
Reffered pain + triggerpoints: onderzijde ribben + crista iliaca = m. quadrates lumborum.
Dermatoom: L1, dus NIET het SI-gewricht.
Had al eerder klachten gegeven of tijdens de bevalling. SI-gewricht geeft echt lokale pijn,
richting de piriformis. Ook geen hernia: alleen laag lumbale segmenten. Meerdere
dermatomen aangedaan.
Geen botafwijkingen, calcificaties, tussenwervelschijven gecheckt op röntgenfoto.
Pt. eerst geruststellen, (niks ernstigs). Evt. nog kijken naar de tractussen – nieren, darmen
etc.
Stoornis: pijn, -ROM, -spierfunctie: spiercoördinatie, hypertonie, spierkracht,
spieruithoudingsvermogen.
Actieve stabiliteit: motor control problemen.
Passieve stabiliteit: hyper/hypomobiliteit.
Kracht + neurogene aansturing.
, 3 type spieren:
- Local stabilizers: dicht tegen wervelkolom, m. multifidus, m. transversus
abdominis
- Global stabilizers: over meerdere segmenten, rotatoir. Bijv. Schuine buikspieren,
m. sternocleidomastoideus. Grove bewegingen
- Global mobilizers: m. rectus abdominis
Uitwerking casus 2......................................................................................................................................... 3
3 type spieren:............................................................................................................................................... 4
Gewrichtsmobilisaties wervelkolom:.............................................................................................................. 5
PA’s.......................................................................................................................................................................5
Gradering Maitland:...................................................................................................................................... 6
Kaltenborn.................................................................................................................................................... 6
McKenzie....................................................................................................................................................... 7
Overzicht van de behandelprocedures.................................................................................................................9
Correctie van de laterale shift.............................................................................................................................10
Globale angulaire mobilisatie....................................................................................................................... 11
Mobilisatie CWK d.m.v. NAGS en reverse NAGS volgens Mulligan.................................................................12
Gele vlaggen lumbale wervelkolom:............................................................................................................. 14
Meetinstrumenten lage rugpijn:................................................................................................................... 14
Anamnese................................................................................................................................................... 14
SCEGS:......................................................................................................................................................... 16
MRC:........................................................................................................................................................... 17
m. rectus abdominis:..........................................................................................................................................18
m. obliquus internus/externus:...........................................................................................................................18
SI-gewricht testen........................................................................................................................................ 21
De Distractietest (Gapping test):........................................................................................................................22
Compressietest (Approximation test):................................................................................................................22
Thigh Thrust test (Femoral shear test):..............................................................................................................22
Gaenslen-test (Pelvic torsion test):.....................................................................................................................23
Patrick's sign (Faber-test):..................................................................................................................................23
Prone segmental instability test:........................................................................................................................24
Craniocervical flexion test:.................................................................................................................................24
Deep Neck flexor endurance test:.......................................................................................................................24
SLUMP-test:........................................................................................................................................................24
Straight leg raise test:.........................................................................................................................................25
Prone Knee Bend test:.........................................................................................................................................25
ULTT-test:............................................................................................................................................................25
,‘the bend finger’......................................................................................................................................... 26
Biomechanisch counselen: motorische leerprincipes blok 1.4.......................................................................27
Spierversterkende oefeningen:.................................................................................................................... 28
Spierkrachttraining thoracale extensoren en scapula-retractoren met gestabiliseerde wervelkolom in
verschillende functionele situaties/posities..................................................................................................28
Activatie van de transversus abdominis en multifidus in verschillende posities.............................................28
Kinesthetic awareness................................................................................................................................. 30
Treatment based classificatie:...................................................................................................................... 32
Stappen stabiliteitstraining:......................................................................................................................... 33
10 regels voor tillen:.................................................................................................................................... 34
Movement control tests (Luomajoki)............................................................................................................ 35
,Uitwerking casus 2
Waar komt de pijn vandaan?
Reffered pain + triggerpoints: onderzijde ribben + crista iliaca = m. quadrates lumborum.
Dermatoom: L1, dus NIET het SI-gewricht.
Had al eerder klachten gegeven of tijdens de bevalling. SI-gewricht geeft echt lokale pijn,
richting de piriformis. Ook geen hernia: alleen laag lumbale segmenten. Meerdere
dermatomen aangedaan.
Geen botafwijkingen, calcificaties, tussenwervelschijven gecheckt op röntgenfoto.
Pt. eerst geruststellen, (niks ernstigs). Evt. nog kijken naar de tractussen – nieren, darmen
etc.
Stoornis: pijn, -ROM, -spierfunctie: spiercoördinatie, hypertonie, spierkracht,
spieruithoudingsvermogen.
Actieve stabiliteit: motor control problemen.
Passieve stabiliteit: hyper/hypomobiliteit.
Kracht + neurogene aansturing.
, 3 type spieren:
- Local stabilizers: dicht tegen wervelkolom, m. multifidus, m. transversus
abdominis
- Global stabilizers: over meerdere segmenten, rotatoir. Bijv. Schuine buikspieren,
m. sternocleidomastoideus. Grove bewegingen
- Global mobilizers: m. rectus abdominis
