PRAKTIJK FYSIOTHERA-
PIE
Cursus C (minor Fysiotherapie & Kinderen)
,INHOUDSOPGAVE
Standaard onderzoek ............................................................................................................................ 4
State volgens Prechtl ........................................................................................................................... 4
Femurfractuur ........................................................................................................................................ 5
Pathologie ............................................................................................................................................ 5
Onderzoek en behandeling ................................................................................................................. 5
Enkelklachten ........................................................................................................................................ 6
Pathologie ............................................................................................................................................ 6
Onderzoek ........................................................................................................................................... 6
Voorste schuifladetest ...................................................................................................................... 6
OMNI- of BORG-schaal ................................................................................................................... 6
Behandeling ......................................................................................................................................... 6
Spierversterking ............................................................................................................................... 6
Scoliose ................................................................................................................................................. 8
Pathologie ............................................................................................................................................ 8
Onderzoek ........................................................................................................................................... 8
Behandeling ......................................................................................................................................... 8
Cystische fibrose .................................................................................................................................. 9
Pathologie ............................................................................................................................................ 9
Onderzoek ........................................................................................................................................... 9
Obstructie van de luchtwegen ........................................................................................................ 10
Behandeling ....................................................................................................................................... 10
Sputummobilisatie .......................................................................................................................... 11
Verbeteren adempatroon ............................................................................................................... 11
Verbeteren ademvoorwaarden ...................................................................................................... 11
Verbeteren inspanningstolerantie & activiteiten/participatie .......................................................... 12
Tetralogie van Fallot ........................................................................................................................... 13
Onderzoek en behandeling ............................................................................................................... 13
Cerebrale parese ................................................................................................................................. 14
Pathologie .......................................................................................................................................... 14
Classificaties ...................................................................................................................................... 15
Zancolli classificatie ....................................................................................................................... 15
Classificatie van House .................................................................................................................. 15
Onderzoek ......................................................................................................................................... 15
Functionele mobiliteitsschaal (FMS) .............................................................................................. 15
Gross Motor Function Measurement (GMFM) ............................................................................... 16
Gross Motor Function Classification System (GMFCS) ................................................................. 16
Loopvaardigheid ............................................................................................................................ 17
1
, Tardieu schaal ............................................................................................................................... 17
Manual Ability Classification System (MACS) ................................................................................ 18
Abilhand-Kids ................................................................................................................................. 19
Assisting Hand Assessment .......................................................................................................... 19
Erbse parese ........................................................................................................................................ 20
Pathologie .......................................................................................................................................... 20
Onderzoek ......................................................................................................................................... 20
Mallet-classificatie .......................................................................................................................... 20
Behandeling ....................................................................................................................................... 20
Ziekte van Duchenne .......................................................................................................................... 21
Pathologie .......................................................................................................................................... 21
Onderzoek ......................................................................................................................................... 22
Motor Function Measure (MFM) .................................................................................................... 22
Behandeling ....................................................................................................................................... 23
Fysieke training .............................................................................................................................. 24
Behandelen van contracturen ........................................................................................................ 24
De behandeling van scoliose ......................................................................................................... 25
Spina Bifida.......................................................................................................................................... 26
Pathologie .......................................................................................................................................... 26
Classificaties ...................................................................................................................................... 26
Classificatie van Hoffer .................................................................................................................. 26
Modificatie van Schoenmakers ...................................................................................................... 26
Onderzoek ......................................................................................................................................... 27
Behandeling ....................................................................................................................................... 27
Lopen ............................................................................................................................................. 27
Somatisch Onvoldoende Lichamelijke Klachten (SOLK) ................................................................ 28
Pathologie .......................................................................................................................................... 28
Onderzoek ......................................................................................................................................... 28
Behandeling ....................................................................................................................................... 28
Syndroom van Down........................................................................................................................... 30
Pathologie .......................................................................................................................................... 30
Onderzoek ......................................................................................................................................... 31
Tonusonderzoek volgens Amiel-Tison ........................................................................................... 31
Basismotorische vaardigheden van kinderen met het syndroom van Down ................................. 31
Gross Motor Function Measure (GMFM) ....................................................................................... 32
Behandeling ....................................................................................................................................... 32
Motorisch gedrag in buikligging ..................................................................................................... 32
Motorisch gedrag in rugligging ....................................................................................................... 34
Motorisch gedrag tijdens omrollen ................................................................................................. 36
Motorisch gedrag in zithouding ...................................................................................................... 37
Motorisch gedrag tijdens voortbewegen over de grond ................................................................. 39
2
, Motorisch gedrag tijdens houdingsveranderingen rondom de zithouding ...................................... 40
Motorisch gedrag tijdens staan ...................................................................................................... 41
Motorisch gedrag tijdens lopen ...................................................................................................... 43
Spierkracht en uithoudingsvermogen............................................................................................... 45
Onderzoek van de spierkracht ........................................................................................................... 45
MRC-schaal ................................................................................................................................... 45
RM-methode .................................................................................................................................. 45
Functionele Spierkracht Meting (FSM) .......................................................................................... 45
Handheld Dynamometer (HHD) ..................................................................................................... 45
Onderzoek van het inspanningsvermogen ........................................................................................ 46
Shuttle-run-test .............................................................................................................................. 46
Godfrey protocol ............................................................................................................................ 46
Bruce test ....................................................................................................................................... 46
Coopertest ..................................................................................................................................... 47
6-minutenwandeltest (6-MWT) ....................................................................................................... 47
Ebbeling test .................................................................................................................................. 47
Åstrand test .................................................................................................................................... 47
Behandeling ......................................................................................................................................... 49
VVV-Principes ................................................................................................................................... 49
Motorische leerfasen & leerstrategieën ............................................................................................. 50
3
, STANDAARD ONDERZOEK
STATE VOLGENS PRECHTL
Om een kindje te onderzoeken/observeren moet hij/zij in de juiste State (3-4) zijn. Wanneer
een kindje slaapt (state 1-2) of huilt (state 5), kan je een kindje niet onderwerpen aan onder-
zoeken of testen. Eén van de varianten van de State volgens Prechtl is:
§ State 1: rustige slaap (non-REM).
§ State 2: actieve slaap (REM).
§ State 3: rustig wakker.
§ State 4: actief wakker.
§ State 5: huilen.
4
PIE
Cursus C (minor Fysiotherapie & Kinderen)
,INHOUDSOPGAVE
Standaard onderzoek ............................................................................................................................ 4
State volgens Prechtl ........................................................................................................................... 4
Femurfractuur ........................................................................................................................................ 5
Pathologie ............................................................................................................................................ 5
Onderzoek en behandeling ................................................................................................................. 5
Enkelklachten ........................................................................................................................................ 6
Pathologie ............................................................................................................................................ 6
Onderzoek ........................................................................................................................................... 6
Voorste schuifladetest ...................................................................................................................... 6
OMNI- of BORG-schaal ................................................................................................................... 6
Behandeling ......................................................................................................................................... 6
Spierversterking ............................................................................................................................... 6
Scoliose ................................................................................................................................................. 8
Pathologie ............................................................................................................................................ 8
Onderzoek ........................................................................................................................................... 8
Behandeling ......................................................................................................................................... 8
Cystische fibrose .................................................................................................................................. 9
Pathologie ............................................................................................................................................ 9
Onderzoek ........................................................................................................................................... 9
Obstructie van de luchtwegen ........................................................................................................ 10
Behandeling ....................................................................................................................................... 10
Sputummobilisatie .......................................................................................................................... 11
Verbeteren adempatroon ............................................................................................................... 11
Verbeteren ademvoorwaarden ...................................................................................................... 11
Verbeteren inspanningstolerantie & activiteiten/participatie .......................................................... 12
Tetralogie van Fallot ........................................................................................................................... 13
Onderzoek en behandeling ............................................................................................................... 13
Cerebrale parese ................................................................................................................................. 14
Pathologie .......................................................................................................................................... 14
Classificaties ...................................................................................................................................... 15
Zancolli classificatie ....................................................................................................................... 15
Classificatie van House .................................................................................................................. 15
Onderzoek ......................................................................................................................................... 15
Functionele mobiliteitsschaal (FMS) .............................................................................................. 15
Gross Motor Function Measurement (GMFM) ............................................................................... 16
Gross Motor Function Classification System (GMFCS) ................................................................. 16
Loopvaardigheid ............................................................................................................................ 17
1
, Tardieu schaal ............................................................................................................................... 17
Manual Ability Classification System (MACS) ................................................................................ 18
Abilhand-Kids ................................................................................................................................. 19
Assisting Hand Assessment .......................................................................................................... 19
Erbse parese ........................................................................................................................................ 20
Pathologie .......................................................................................................................................... 20
Onderzoek ......................................................................................................................................... 20
Mallet-classificatie .......................................................................................................................... 20
Behandeling ....................................................................................................................................... 20
Ziekte van Duchenne .......................................................................................................................... 21
Pathologie .......................................................................................................................................... 21
Onderzoek ......................................................................................................................................... 22
Motor Function Measure (MFM) .................................................................................................... 22
Behandeling ....................................................................................................................................... 23
Fysieke training .............................................................................................................................. 24
Behandelen van contracturen ........................................................................................................ 24
De behandeling van scoliose ......................................................................................................... 25
Spina Bifida.......................................................................................................................................... 26
Pathologie .......................................................................................................................................... 26
Classificaties ...................................................................................................................................... 26
Classificatie van Hoffer .................................................................................................................. 26
Modificatie van Schoenmakers ...................................................................................................... 26
Onderzoek ......................................................................................................................................... 27
Behandeling ....................................................................................................................................... 27
Lopen ............................................................................................................................................. 27
Somatisch Onvoldoende Lichamelijke Klachten (SOLK) ................................................................ 28
Pathologie .......................................................................................................................................... 28
Onderzoek ......................................................................................................................................... 28
Behandeling ....................................................................................................................................... 28
Syndroom van Down........................................................................................................................... 30
Pathologie .......................................................................................................................................... 30
Onderzoek ......................................................................................................................................... 31
Tonusonderzoek volgens Amiel-Tison ........................................................................................... 31
Basismotorische vaardigheden van kinderen met het syndroom van Down ................................. 31
Gross Motor Function Measure (GMFM) ....................................................................................... 32
Behandeling ....................................................................................................................................... 32
Motorisch gedrag in buikligging ..................................................................................................... 32
Motorisch gedrag in rugligging ....................................................................................................... 34
Motorisch gedrag tijdens omrollen ................................................................................................. 36
Motorisch gedrag in zithouding ...................................................................................................... 37
Motorisch gedrag tijdens voortbewegen over de grond ................................................................. 39
2
, Motorisch gedrag tijdens houdingsveranderingen rondom de zithouding ...................................... 40
Motorisch gedrag tijdens staan ...................................................................................................... 41
Motorisch gedrag tijdens lopen ...................................................................................................... 43
Spierkracht en uithoudingsvermogen............................................................................................... 45
Onderzoek van de spierkracht ........................................................................................................... 45
MRC-schaal ................................................................................................................................... 45
RM-methode .................................................................................................................................. 45
Functionele Spierkracht Meting (FSM) .......................................................................................... 45
Handheld Dynamometer (HHD) ..................................................................................................... 45
Onderzoek van het inspanningsvermogen ........................................................................................ 46
Shuttle-run-test .............................................................................................................................. 46
Godfrey protocol ............................................................................................................................ 46
Bruce test ....................................................................................................................................... 46
Coopertest ..................................................................................................................................... 47
6-minutenwandeltest (6-MWT) ....................................................................................................... 47
Ebbeling test .................................................................................................................................. 47
Åstrand test .................................................................................................................................... 47
Behandeling ......................................................................................................................................... 49
VVV-Principes ................................................................................................................................... 49
Motorische leerfasen & leerstrategieën ............................................................................................. 50
3
, STANDAARD ONDERZOEK
STATE VOLGENS PRECHTL
Om een kindje te onderzoeken/observeren moet hij/zij in de juiste State (3-4) zijn. Wanneer
een kindje slaapt (state 1-2) of huilt (state 5), kan je een kindje niet onderwerpen aan onder-
zoeken of testen. Eén van de varianten van de State volgens Prechtl is:
§ State 1: rustige slaap (non-REM).
§ State 2: actieve slaap (REM).
§ State 3: rustig wakker.
§ State 4: actief wakker.
§ State 5: huilen.
4
