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Klinisch beeld aandoeningen CNA
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Per aandoening een overzicht van het klinisch beeld
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Functie Cortex Basale kernen Cerebellum Ruggenmerg TestenSpierkracht Parese/paralyse (hemiparese) x x Parese/paralyse onder de MRC
laesie
Sensibiliteit Anesthesie / hypo-esthesie X X Anesthesie / Hypo-esthesie Globaal (watje,
prikker etc.)
Spiertonus Spasticiteit in anti-zwaartekracht Rigiditeit (alle spieren) X Hypotonie of Spasticiteit (door PRPM
spieren reflexkring in banensysteem)
Hypotonie
Knipmesfenomeen
Sturing Selectiviteit Bradykinesie Ataxie Geen sturing Cerebellum testen
Akinesie (alleen cerebellum)
Hypokinesie
Balans Hemibeeld Verstoorde Te veel reacties Geen reacties BBS
opvangreactie POMA-B
Gangpatroon Hemibeeld Schuifelen Dronkenmansloop Hanentrend POMA-M
Slepen Kleine pasjes Brede gang 6MWT
Circumductie traag Veel bewegingen 10MWT
FAC
Behandeling Neoniveau schade Compenseren Paleoniveau schade compenseren: Hulpmiddel (rolstoel)
(compenseren Cognitief verwerken is moeilijk dus Compenseren bewegen in
) impliciete instructies Expliciete instructies gesloten keten,
geven. verzwaren.
Veel herhalen
Voordoen / nadoen Cognitieve strategie Strategie
Automatiseren Cueing
Weinig verbale instructies Big & loud
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