Summary
Samenvatting Blok 8 - Praktijk - aspecifieke rugklachten
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Korte en krachtige casusuitwerking waardoor jij jouw IP8 met een 8 gaat halen!!
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By: Shannon86 • 7 year ago
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Aspecifieke rugklachtenScreening
- aanmelden
- hulpvraag inventariseren
- pluis / niet- pluis (rode vlaggen)
- infomeren over bevindingen van de screening
Anamnese
-
Inspectie
Totaal
- scoliose
- lordose
- kyfose
Lokaal
- hypertrofie / atrofie
Functioneel
- voorwerp pakken van de grond
Palpatie
, - tonus
Bewegingsonderzoek
- LWK, heup, CWK
- repeated movements
- instabiliteit transversus abdominus aanspannen
- PA’s
- local stabilizers
Specifieke testen
- KEMP, - SLR, spierkracht en viingervloerafstand (> 25 cm)
- SI-testen van der Wurff (1 been optillen en kijken of de
- hakval
- pin prik test
Spierkracht myotomen
-L2: Heup flexie
-L3: Knie extensie
-L4: Dorsaalflexie
-L5: Extensie grote teen
-S1: Eversie, contracteren ‘buttock’, knie flexie
-S2: Knie flexie, staan op teen
Sensibiliteit (dermatomen)
Peesreflexen (knie femoralis L3-L4, Achilles tibialis S1-S2)
Meetinstrumenten
Vragenlijsten
- NRS / VAS pijn
- PSK
- QBPDS
Diagnose
Centralisatie en periferlisatie derangement
SLR, spierkracht en viingervloerafstand (> 25 cm) rode vlaggen voor
radiculopathie
Behandelingsdoelen
- Binnen 1 week heeft Mw. inzicht gekregen in haar klachten
- Binnen 2 weken is Mw. zich er bewust van dat bewegen juist goed is en wandelt elke dag 30
minuten.
- De uitstralende pijn en de gestoorde sensibiliteit in het linker been is na 1 week verdwenen.
- De pijn in de onderrug is binnen 2 weken gedaald van VAS 8 naar VAS 4.
- Na 3 weken kan Mw. zelf haar klachten behandelen.
Behandeling
Leergesprek (belasting, vinger van Dijksta + lendenrol)
Biomechanische counselen (tillen)
Graded activity (profiel 3)
KA
Actief mobiliseren
NAGS’s SNAG’s
Prognose
- acuut (0-6 weken)
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