Summary

samenvatting HOC's MOB2A

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Course
Module Onderzoek En Bahandeling IIA

Institution
Vrije Universiteit Brussel (VUB)

Dit is een samenvatting van de hoorcollege's van MOB2a. Ik heb gewerkt in puntjes en niet met volzinnen. Ik heb ook waar nodig prentjes erbij gezet ter verduidelijking. (tip: voor het examen, leer van het hoofdstuk weke delen alle cijfertjes vanbuiten want dat zal ze zeker vragen!)

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Uploaded on January 7, 2023
Number of pages 58
Written in 2022/2023
Type Summary

evidence based practice
de enkel
artrose
acute knieletsels
medische beeldvorming
weke d
musculoskeletale aandoeningen
klinisch redeneren en diagnostiek
kinesitherapeutische zorg bij amputatiepatiënten

Institution
Vrije Universiteit Brussel (VUB)
Education
Revalidatiewetenschappen En Kinesitherapie
Course
Module Onderzoek En Bahandeling IIA

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1. Musculoskeletale aandoeningen ............................................................................................................................ 1
2. Klinisch redeneren/diagnostiek .............................................................................................................................. 1
Methodisch handelen ................................................................................................................................................ 1
6 beslismomenten v/d kinesitherapeut ................................................................................................................. 2
3. Evidence based practice .......................................................................................................................................... 3
Niveaus v evidence ..................................................................................................................................................... 3
Studie design .............................................................................................................................................................. 3
Enkelinversietrauma .................................................................................................................................................. 4
Epidemiologie enkelletsel .......................................................................................................................................... 5
4. De enkel .................................................................................................................................................................. 6
De KNGF richtlijn ........................................................................................................................................................ 6
Prognose .................................................................................................................................................................... 7
Natuurlijk beloop bij acuut enkelinversietrauma ................................................................................................... 7
Functionele instabiliteit.............................................................................................................................................. 8
Factoren die bijdragen aan FI: ................................................................................................................................ 8
Screeningsproces ....................................................................................................................................................... 9
Screening op pluis/niet-pluis ................................................................................................................................ 10
Differentiaaldiagnostiek ........................................................................................................................................... 13
Distale syndesmoseruptuur ................................................................................................................................. 13
Osteochondrale laesie & osteofyten .................................................................................................................... 13
Subtalaire instabiliteit .......................................................................................................................................... 13
Inklemming littekenweefsel ................................................................................................................................. 13
Sinus tarsi syndroom ............................................................................................................................................ 13
Artrose.................................................................................................................................................................. 13
Diagnostiek ............................................................................................................................................................... 14
Functiescore ......................................................................................................................................................... 14
Mogelijke onderzoeksdoelen → mob enkel, gangpatroon, proprioceptie, spierkracht ...................................... 14
ICF-model ............................................................................................................................................................. 16
Samengevat voor diagnostisch proces ................................................................................................................. 16
Therapie acuut letsel ................................................................................................................................................ 17
De fases v herstel ................................................................................................................................................. 17
Therapie functionele instabiliteit ............................................................................................................................. 18
5. KNGF knie- & heupartrose .................................................................................................................................... 19
Klinische diagnose .................................................................................................................................................... 19
Pathologie ................................................................................................................................................................ 19
Pathogenese v knieOA ......................................................................................................................................... 20
Epidemiologie & risicofactoren ................................................................................................................................ 21
Epidemiologie ....................................................................................................................................................... 21

, Etiologie – risicofactoren ...................................................................................................................................... 22
klinisch beeld ........................................................................................................................................................ 22
Klinisch beeld → specifiek heup........................................................................................................................... 23
Klinisch beeld → specifiek knie ............................................................................................................................ 23
Prognose .................................................................................................................................................................. 23
Methodisch handelen .............................................................................................................................................. 25
Rode vlaggen ........................................................................................................................................................ 26
Instrumenten........................................................................................................................................................ 26
Indicatie voor kinesitherapie ................................................................................................................................ 26
Wanneer moet kine de behandeling stoppen...................................................................................................... 27
Aanbevelingen richtlijnen ........................................................................................................................................ 27
Niet-oefentherapeutische interventies ................................................................................................................ 27
Voorlichting & advies ........................................................................................................................................... 27
Oefentherapie ...................................................................................................................................................... 28
Inadequate pijncoping.......................................................................................................................................... 29
6. Acute knieletsels ................................................................................................................................................... 30
Epidemiologie ........................................................................................................................................................... 30
Screening .................................................................................................................................................................. 31
Onderzoek ................................................................................................................................................................ 31
Ongevalsmechanismen ........................................................................................................................................ 32
Zwelling ................................................................................................................................................................ 34
Gangpatroon ........................................................................................................................................................ 34
Therapie ................................................................................................................................................................... 34
Algemeen ............................................................................................................................................................. 34
Per letsel ............................................................................................................................................................... 35
7. Kinesitherapeutische zorg bij amputatiepatiënten ............................................................................................... 35
Oorzaken .................................................................................................................................................................. 35
Operatief .................................................................................................................................................................. 36
Hoe beginnen we eraan? ......................................................................................................................................... 36
8. Medische beeldvorming........................................................................................................................................ 41
RX (röntgen) ......................................................................................................................................................... 41
CT-scan (computer tomografie) ........................................................................................................................... 42
MRI (magnetic resonance imaging) ...................................................................................................................... 42
MSKUS (echografie, ultrasound) .......................................................................................................................... 43
9. Weke delen ........................................................................................................................................................... 44
Definitie .................................................................................................................................................................... 44
Heup ......................................................................................................................................................................... 45
knie 48
enkel en voet ............................................................................................................................................................ 51
behandeling.............................................................................................................................................................. 53

,peace & love ......................................................................................................................................................... 53

, 1. Musculoskeletale aandoeningen
• Omvatten
o Aandoeningen rechtstreeks te maken met gewrichten bv reuma, OA
o Aandoeningen v/d rug & nek bv LRP
o Rugafwijkingen bv scoliose
o Osteoporose
o Botkanker
o Musculoskeletale letsels aan ledematen
• ½ v/d gehele populatie geeft aan dat ze musculoskeletale aandoening hebben
• Musculoskeletale zijn duur
o Directe kosten → brace, doktersbezoeken,…
o Indirect → werkverzuim & bijdragen aan gemeenschap
• Elke leeftijd
o # P’en met last blijft stijgen omdat mensen steeds ouder & ouder w
o ➔ prevalentie stijgt hierdoor ook
o Jonge mensen → +/-36%
o Ouderen: 70%
• Doet QOL sterk verminderen
o Als kine: QOL verbeteren & functiebehoud belangrijkste

2. Klinisch redeneren/diagnostiek
Methodisch handelen

• Stappen die je altijd moet overlopen in praktijk als je niet weet wat je moet doen
o diagnose → prognose maken = wat is het
natuurlijke beloop v dit probleem bij deze P?
o Als we weten wat er is → wat kunnen we
doen als kine? Hoe behandelen?

• Effectieve beslissingen maken
o Klinisch redeneren hier heel belangrijk = heel complex want is afh v veel factoren → P, T,
omgeving,…
o Er is niet echt een juiste/foute redenering → zolang je EB kan argumenteren

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