Lumbale wervelkolom
,2
,Inhoudsopgave
Kinematica – LWK......................................................................................................................... 5
Lage rugpijn ................................................................................................................................. 8
Screening ................................................................................................................................... 13
KNGF-Richtlijn LRP...................................................................................................................... 17
CPR ............................................................................................................................................ 21
Onderzoek ................................................................................................................................. 26
Functieonderzoek LWK ...................................................................................................................... 29
Actief regionaal functieonderzoek belast (stand) ........................................................................ 29
Geleid actief regionaal/segmentaal functieonderzoek belast (zit) .............................................. 33
Passief functieonderzoek onbelast (in lig) .................................................................................... 37
PA-testen ........................................................................................................................................... 41
Lumbale instabiliteitstesten (MCI) .................................................................................................... 43
Functieonderzoek SIG ........................................................................................................................ 44
Neurologisch onderzoek .................................................................................................................... 50
Zenuwlengtetesten en zenuwmobilisatie .................................................................................... 50
Zenuwcompressie testen.............................................................................................................. 55
Kennspieren (myotomen) ............................................................................................................. 56
Sensibiliteitstesten........................................................................................................................ 56
Reflexen ........................................................................................................................................ 56
Spierlengtetesten .............................................................................................................................. 57
MTrP .................................................................................................................................................. 58
Vragenlijsten ..................................................................................................................................... 60
Behandeling ............................................................................................................................... 61
Manipulaties/Mobilisaties belast...................................................................................................... 61
Manipulaties/Mobilisaties onbelast ................................................................................................. 64
Stabilisatie/Spierversterking ............................................................................................................. 71
Manipulaties/Mobilisaties SI............................................................................................................. 72
Pathologie LWK .......................................................................................................................... 75
Lumbosacraal Radiculair Syndroom .................................................................................................. 75
Lumbale HNP ..................................................................................................................................... 79
Pseudoradiculair syndroom............................................................................................................... 80
Lumbale spinale stenose ................................................................................................................... 80
Spondylolyse/Spondylolisthesis......................................................................................................... 83
Instabiliteit/Motor control impairment ............................................................................................ 84
3
, Morbus Bechterew (Spondylitis ankylopoetica) ................................................................................ 87
SI-problematiek ................................................................................................................................. 88
Hip-spine syndroom .......................................................................................................................... 89
Artikelen .................................................................................................................................... 90
Onderzoekshypothesen .............................................................................................................. 92
ICD ..................................................................................................................................................... 92
ICF...................................................................................................................................................... 94
Pijn..................................................................................................................................................... 96
Onderzoeks- en behandeltechnieken .......................................................................................... 97
Onderzoeken ..................................................................................................................................... 97
Manipulaties/Mobilisaties ................................................................................................................ 98
Skills LWK................................................................................................................................... 99
4
,2
,Inhoudsopgave
Kinematica – LWK......................................................................................................................... 5
Lage rugpijn ................................................................................................................................. 8
Screening ................................................................................................................................... 13
KNGF-Richtlijn LRP...................................................................................................................... 17
CPR ............................................................................................................................................ 21
Onderzoek ................................................................................................................................. 26
Functieonderzoek LWK ...................................................................................................................... 29
Actief regionaal functieonderzoek belast (stand) ........................................................................ 29
Geleid actief regionaal/segmentaal functieonderzoek belast (zit) .............................................. 33
Passief functieonderzoek onbelast (in lig) .................................................................................... 37
PA-testen ........................................................................................................................................... 41
Lumbale instabiliteitstesten (MCI) .................................................................................................... 43
Functieonderzoek SIG ........................................................................................................................ 44
Neurologisch onderzoek .................................................................................................................... 50
Zenuwlengtetesten en zenuwmobilisatie .................................................................................... 50
Zenuwcompressie testen.............................................................................................................. 55
Kennspieren (myotomen) ............................................................................................................. 56
Sensibiliteitstesten........................................................................................................................ 56
Reflexen ........................................................................................................................................ 56
Spierlengtetesten .............................................................................................................................. 57
MTrP .................................................................................................................................................. 58
Vragenlijsten ..................................................................................................................................... 60
Behandeling ............................................................................................................................... 61
Manipulaties/Mobilisaties belast...................................................................................................... 61
Manipulaties/Mobilisaties onbelast ................................................................................................. 64
Stabilisatie/Spierversterking ............................................................................................................. 71
Manipulaties/Mobilisaties SI............................................................................................................. 72
Pathologie LWK .......................................................................................................................... 75
Lumbosacraal Radiculair Syndroom .................................................................................................. 75
Lumbale HNP ..................................................................................................................................... 79
Pseudoradiculair syndroom............................................................................................................... 80
Lumbale spinale stenose ................................................................................................................... 80
Spondylolyse/Spondylolisthesis......................................................................................................... 83
Instabiliteit/Motor control impairment ............................................................................................ 84
3
, Morbus Bechterew (Spondylitis ankylopoetica) ................................................................................ 87
SI-problematiek ................................................................................................................................. 88
Hip-spine syndroom .......................................................................................................................... 89
Artikelen .................................................................................................................................... 90
Onderzoekshypothesen .............................................................................................................. 92
ICD ..................................................................................................................................................... 92
ICF...................................................................................................................................................... 94
Pijn..................................................................................................................................................... 96
Onderzoeks- en behandeltechnieken .......................................................................................... 97
Onderzoeken ..................................................................................................................................... 97
Manipulaties/Mobilisaties ................................................................................................................ 98
Skills LWK................................................................................................................................... 99
4
