Fysieke en geriatrische
revalidatie
Inhoud van het theoretisch deel: Inhoud van de BWC:
2. Algemene inleiding
3. Traumatische letsels aan de lumbale 1. Ergotherapie in de fysieke revalidatie: ( Eva
wervelkolom Es )
4 + 5 + 6. Heup -en knie -en schouderprothesen - Heup -en knie –en schouderprothesen
7. Frozen shoulder ( zelfstudie ) - Toepassen van rugbesparende technieken
8. Dwarslaesie ( Rugschool )
9. Tetraplegie - Rolstoeltraining voor gevorderden
10. Paraplegie - Neuromotorische behandelconcepten:
11. Loophulpmiddelen ( zelfstudie ) Affolter in praktijk
12. Neuromotorisch: Affolter concept - Mobilisatie en oefenen: Open en gesloten
(zelfstudie) ketens
13. Open en gesloten ketens - Het maken van een handelingsassessment
14. Multiple sclerose - Eénhandigheid bij ADL –en huishoudelijke
15. Coma activiteiten (zelfstudie)
16. Inleiding in de geriatrische revalidatie en zorg Herhalingscollege
17. Locomotorische problemen bij ouderen
18. Reumatoïde artritis 2. Ergotherapie in de geriatrische revalidatie:
19. Zitorthesen ( R. De Henau )
20. Dysfagie - Gewrichtsbesparing -en economie
21. Respiratoire problemen - Preventieve revalidatie
22. Communicatiestoornissen - Assessments
Data practica onder voorbehoud: zie steeds Toledo!
Eerste zittijd:
1.Het theoretische aspect van het OPO wordt geëxamineerd met een schriftelijk examen. Er wordt
gepeild naar kennis (1/3 en inzicht (2/3). (60% van het eindpunt).
2. De praktijkvaardigheden worden mondeling geëxamineerd, waarbij de student aan de hand van
een concrete vraag, casus en/of situatie zijn kennis toepast en de desbetreffende vaardigheden
demonstreert (40% van het eindpunt ).
Hiervoor kan de student ook gebruik maken van het aanwezige assessment materiaal.
Praktijkexamen zal on campus worden georganiseerd en het theoretisch examen via XToledo
De 2 delen kunnen onderling niet gecompenseerd worden. Het eindpunt van het OPO is de som van
de deelpunten.
Tweede zittijd:
Het deel waar je een onvoldoende op behaald hebt wordt hernomen in tweede zittijd. Deelpunten
kunnen niet meegenomen worden naar het volgende academiejaar.
,Inhoud
Wat is ergo in de fysieke revalidatie...................................................................................................6
Hoofdstuk 2 het bilan............................................................................................................................6
1.1 Het opstellen van een functioneel bilan.......................................................................................6
1.2 Het opstellen van een motorisch, sensorisch en cognitief bilan...................................................7
1.3 Het doel van het opstellen van een bilan.....................................................................................7
PowerPoint 2 : traumatische letsels aan de lumbale wervelzuil.............................................................8
2.1 traumatische letsels van de discus................................................................................................8
Wervels en discussen......................................................................................................................8
Discus bulging/hernia.....................................................................................................................9
2.1.1 posterieure discusuitstulping...............................................................................................10
1. lichte posterieure bulging.........................................................................................................10
2. ernstige posterieure bulging.....................................................................................................10
2.1.2 posterolaterale siscusuitstulping.........................................................................................11
2.1.3 circulaire discusuitstulping...................................................................................................11
2.2 traumatische letsels van de lumbale wervels.............................................................................11
2.2.1 fracturen en fractuurluxaties...............................................................................................11
2.2.2 stressfracturen ter hoogte van de wervels..........................................................................12
2.3 degeneratieve aandoeningen van de lumbale wervelzenuwen..................................................13
2.3.1 degeneratie van de discus...................................................................................................13
2.3.2 degeneratie van lumbale gewrichtsstructuren....................................................................14
2.3.3. spinaal kanaal stenose........................................................................................................15
2.3.4 vernauwing zenuwwortelkanaal..........................................................................................15
2.4 Chirurgische ingrepen.................................................................................................................15
1. Discectomie..............................................................................................................................15
2. Laminectomie...........................................................................................................................16
Een cervicale spinale stenose...........................................................................................................16
2.5 revalidatie-aspecten...................................................................................................................17
Revalidatie-aspecten bij discusbulging/hernia in acute fase........................................................17
Revalidatiedoelstellingen in chronische fase................................................................................18
Powerpoint 3: heupprothesen..............................................................................................................19
Het heupgewricht.............................................................................................................................19
3.1 indicatie tot heupprothesen.......................................................................................................20
3.2 soorten heupprothese................................................................................................................20
3.2.1 Cementloze prothese...........................................................................................................21
, 3.2.2 Gecementeerde prothese....................................................................................................21
3.2.3 volgens type.........................................................................................................................21
3.3 de operatie – volgens de toegangsweg.......................................................................................22
3.3.1 posterolaterale ingreep.......................................................................................................22
3.3.2 anterolaterale ingreep.........................................................................................................22
3.3.3 anterieure ingreep...............................................................................................................23
3.4 mogelijke complicaties...............................................................................................................23
3.4.1 infecties...............................................................................................................................23
3.4.2 Postoperatieve flebitis en embolie......................................................................................23
3.4.3 Luxatie en instabiliteit..........................................................................................................24
3.4.4 Heterotope ossificatie..........................................................................................................24
3.4.5 Beenlengteverschil...............................................................................................................24
3.5 algemene leefregels....................................................................................................................24
3.6 revalidatie na THP.......................................................................................................................25
Powerpoint 4: knieprothesen...............................................................................................................25
Het kniegewricht..............................................................................................................................25
4.1 knieprothese...............................................................................................................................26
Op basis van fixatiemethode........................................................................................................26
Op basis van keuze met of zonder patellacomponent..................................................................26
Soorten knieprothesen.................................................................................................................26
4.2 aangetaste knie...........................................................................................................................28
4.3 verloop van de operatie..............................................................................................................28
4.4 complicaties................................................................................................................................28
4.4.1 nabloeding...........................................................................................................................28
4.4.2 infectie en koorts.................................................................................................................29
4.4.3 trombose.............................................................................................................................29
4.4.4 luxatie van de knieschijf.......................................................................................................29
4.4.5 zenuwbeschadiging..............................................................................................................29
4.4.6 longembolie.........................................................................................................................29
4.4.7 decubitus.............................................................................................................................29
4.4.8 stijfheid van het gewricht....................................................................................................29
4.5 adviezen en leefregels................................................................................................................30
Powerpoint 5: schouderprothesen.......................................................................................................31
Het schoudergewricht......................................................................................................................31
Keuze van soort prothese.................................................................................................................31
Symptomen die aanleiding geven voor prothese.........................................................................31
, Afhankelijk:...................................................................................................................................31
5.1 soorte prothesen........................................................................................................................32
5.1.1 totale schouderprothese TSP...............................................................................................32
5.1.2 hemiprothese......................................................................................................................32
5.1.3 omgekeerde delta 3 totale schouderprothese (reverse).....................................................32
5.1.4 resurfacing prothese (copeland biomet).............................................................................32
5.2 doelgroep: indicatie voor schouderprothesen............................................................................32
5.3 operatie......................................................................................................................................33
5.4 complicaties................................................................................................................................34
5.4.1 specifieke.............................................................................................................................34
5.5 medisch advies...........................................................................................................................34
5.6 algemeen advies.........................................................................................................................34
Powerpoint 6: dwarslesie.....................................................................................................................37
6.1 Dwarslesie?.................................................................................................................................37
6.1.1 Functie: motorische uitval...................................................................................................37
6.1.2 Functie: sensibele uitval:.....................................................................................................37
6.1.3 functie: vegetatieve stoornissen..........................................................................................37
6.2 verloop na trauma/ziekte/oplopen letsel: spinale shock............................................................38
6.3 Uitgebreidheid, hoe ernstig is het?.............................................................................................38
6.4 Laesiehoogte, hoe omschrijf je dat?...........................................................................................40
6.4.1 Syndromen bij de incomplete letsels...................................................................................40
6.4.2 oorzaak....................................................................................................................................40
6.5 Secundaire problemen: huidproblematiek.................................................................................41
6.5.1 Blaasregulatie......................................................................................................................42
6.5.2 Het ledigen van de blaas......................................................................................................42
6.5.3 Incontinentie en rolstoelgebruik..........................................................................................42
6.6 Seksuele problemen...................................................................................................................42
6.7 Darmregulatie.............................................................................................................................44
6.8 ademhalingsstoornissen.............................................................................................................44
6.9 Belangrijke aandachtspunten tijdens de revalidatie...................................................................44
Powerpoint 7: tertraplegie...................................................................................................................46
7.1 de schouder................................................................................................................................47
7.2 de elleboog.................................................................................................................................47
7.3 de voorarm.................................................................................................................................47
7.4 de hand.......................................................................................................................................47
7.4.1 soorten tenosesigrepen.......................................................................................................48
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