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Samenvatting Ergotherapie in de geriatrie 2
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Samenvatting ergotherapie in de geriatrie 2 Cursus PPT
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By: nieljo63 • 5 year ago
By: rosemarievanderhaeghen • 5 year ago
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GERIATRIE 2Inhoudsopgave
1 NIET AANGEBOREN HERSENLETSEL BIJ VOLWASSENEN: CVA..........................................................4
1.1 HC1: CVA: CEREBRO VASCULAIR ACCIDENT..........................................................................................4
1.2 SOORTEN........................................................................................................................................4
1.3 VORMEN:.......................................................................................................................................5
1.3.1 ISCHEMISCH CVA (INFARCT).................................................................................................................5
1.3.2 HEMORRAGISCH (BLOEDING)................................................................................................................5
1.4 RISICOFACTOREN EN OORZAKEN..........................................................................................................5
1.5 DIAGNOSTIEK..................................................................................................................................6
1.6 GEVOLGEN......................................................................................................................................6
1.6.1 FUNCTIESTOORNISSEN.........................................................................................................................6
1.6.2 SPASTISCH PATROON.........................................................................................................................10
1.6.3 FACIALISPARESE................................................................................................................................11
1.6.4 TRACTUS CORTICOSPINALIS.................................................................................................................11
1.7 VRAGEN:......................................................................................................................................11
1.7.1 SECUNDAIRE SYMPTOMEN..................................................................................................................12
1.7.2 SENSORISCHE STOORNISSEN................................................................................................................14
1.7.3 SENSORISCHE SYMPTOMEN.................................................................................................................14
1.7.4 HERSTEL.........................................................................................................................................15
1.7.5 COMMUNICATIEVE STOORNISSEN.........................................................................................................21
1.7.6 SOCIALE, EMOTIONELE EN GEDRAGSSTOORNISSEN...................................................................................21
2 NORMALISEREN VAN DE HOUDINGSTONUS.................................................................................22
2.1 TONUS NORMALISEREN BL – OEFENEN OL...........................................................................................22
2.1.1 MANIEREN OM DIT TE VERKRIJGEN:.....................................................................................................22
2.2 TONUS NORMALISEREN HEUPEN – OEFENEN OL....................................................................................22
2.3 OEFENINGEN VORIGE HC.................................................................................................................23
3 PIJN EN CVA..................................................................................................................................24
3.1 VORMEN......................................................................................................................................24
3.1.1 COMPLEX REGIONAAL PIJN SYNDROOM (CRPS)......................................................................................24
3.1.2 PIJN TEN GEVOLGE VAN SPASTICITEIT....................................................................................................25
3.1.3 PIJN TEN GEVOLGE VAN GLENOHUMERALE SUBLUXATIE EN CONTRACTUREN.................................................25
3.1.4 PIJN SCHALEN..................................................................................................................................26
4 ERGOTHERAPEUTISCHE PRAKTIJK.................................................................................................26
4.1 ASSESSMENTS................................................................................................................................26
4.1.1 CANADIAN OCCUPATIONAL PERFORMANCE MEASURE (COPM)................................................................26
4.1.2 ACTIVITY CARD SORT........................................................................................................................27
4.1.3 OCCUPATIONAL PERFORMANCE HISTORY INTERVIEW (OPHI-II NL)...........................................................27
4.2 SAMENVATTING MEETINSTRUMENT CVA.............................................................................................28
,4.2.1 ERGOTHERAPIE EN CVA.....................................................................................................................33
4.3 BEHANDELSTRATEGIE.......................................................................................................................33
4.3.1 NDT/BOBATH.................................................................................................................................33
4.3.2 AFFOLTER/ GUIDING.........................................................................................................................34
4.3.3 CONSTRAINT INDUCED MOVEMENT THERAPY (CIMT).............................................................................35
5 NIET AANGEBOREN HERSENLETSEL BIJ VOLWASSENEN: CVA........................................................35
5.1 TAAKGEORIËNTEERDE TRAINING.........................................................................................................35
5.1.1 TAAKGEORIËNTEERDE TRAINING: CARAS..............................................................................................35
5.1.2 DOELSTELLINGEN..............................................................................................................................37
5.1.3 EPIDEMIOLOGIE................................................................................................................................37
5.1.4 ONDERLIGGENDE RISICOFACTOREN.......................................................................................................38
5.1.5 RISICOFACTOREN ONTSTAAN ARTROSE..................................................................................................38
5.1.6 RISICOFACTOREN PROGRESSIEVE ARTROSE.............................................................................................38
5.1.7 BEHANDELING..................................................................................................................................39
5.2 TOTALE HEUPPROTESE.....................................................................................................................39
5.2.2 TOTALE KNIEPROTHESE......................................................................................................................41
5.2.3 SOORTEN TKP.................................................................................................................................41
5.2.4 REVALIDATIE....................................................................................................................................42
6 AMPUTATIE ONDERSTE LIDMAAT.................................................................................................42
6.1.1 INCIDENTIE......................................................................................................................................42
6.1.2 OORZAAK........................................................................................................................................42
6.1.3 OVERWEGINGEN OPERATIE.................................................................................................................43
6.1.4 BEPALEN AMPUTATIENIVEAU..............................................................................................................43
6.1.5 HOGE AMPUTATIE............................................................................................................................43
6.1.6 TRANSTIBIAAL (OF LAGER)..................................................................................................................43
6.1.7 TRANSTIBIAAL VS TRANSFEMORAAL......................................................................................................44
6.1.8 WANNEER AMPUTEREN?...................................................................................................................44
6.1.9 BELANG PREOPERATIEVE MOGELIJKHEDEN.............................................................................................44
6.1.10 KNIE-EXARTICULATIE?......................................................................................................................44
6.1.11 VOORLICHTING...............................................................................................................................44
6.1.12 POSTOPERATIEF..............................................................................................................................45
6.1.13 PIJN.............................................................................................................................................45
6.1.14 COMPLICATIES...............................................................................................................................45
6.1.15 MOBILITEIT...................................................................................................................................46
6.1.16 POSTOPERATIEVE REVALIDATIE..........................................................................................................46
6.1.17 PSYCHISCHE PROBLEMEN..................................................................................................................46
6.1.18 REVALIDATIE: PREOPERATIEF.............................................................................................................46
6.1.19 REVALIDATIE: POSTOPERATIEF...........................................................................................................46
6.1.20 REVALIDATIE: PROTHESEFASE............................................................................................................47
6.1.21 WERKHERVATTING..........................................................................................................................47
6.1.22 NEGATIEVE FACTOREN.....................................................................................................................47
6.1.23 PROTHESETRAINING: VOORWAARDEN.................................................................................................48
6.1.24 PROTHESETRAINING........................................................................................................................48
6.1.25 VERLOOP PROTHESE........................................................................................................................48
6.1.26 GROEPEN VOOR PROTHESE...............................................................................................................48
6.1.27 BELANG GROEPEN..........................................................................................................................49
6.1.28 SOORTEN VOETEN...........................................................................................................................49
,6.1.29 SOORTEN KNIEËN...........................................................................................................................49
6.1.30 OPHANGING..................................................................................................................................49
6.1.31 DEFINITIEVE PROTHESE....................................................................................................................49
7 PSYCHOGERIATRIE........................................................................................................................50
7.1 DEMENTIE.....................................................................................................................................51
7.1.1 SOORTEN DEMENTIE.........................................................................................................................55
7.1.2 DIFFERENTIAALDIAGNOSE..................................................................................................................57
7.2 PSYCHOGERIATRIE BELEVINGSGERICHTE BENADERING..............................................................................61
7.2.1 FASEN:...........................................................................................................................................63
7.2.2 OMGAAN MET EEN PERSOON MET DEMENTIE.........................................................................................65
7.3 PSYCHOGERIATRIE: ERGOTHERAPEUTISCHE INTERVENTIES:.......................................................................70
7.3.1 METHODIEKEN.................................................................................................................................71
7.3.2 OMGANG PMD: ADVIES....................................................................................................................72
8 GERIATRISCH PROFIEL...................................................................................................................73
8.1 GERIATRISCH PROFIEL......................................................................................................................74
8.1.1 DE MEEST VOORKOMENDE KENMERKEN VAN OUDEREN MET GERIATRISCHE SYNDROMEN:...............................75
8.1.2 BRADENSCHAAL...............................................................................................................................76
8.1.3 NORTONSCHAAL...............................................................................................................................76
8.1.4 VERMINDERDE HOMEOSTASE..............................................................................................................77
8.1.5 MULTIPLE, CHRONISCHE AANDOENINGEN..............................................................................................78
8.1.6 BEDREIGDE VALIDITEIT.......................................................................................................................79
8.1.7 HET RISICO VAN POLYFARMACIE..........................................................................................................79
8.1.8 GEWIJZIGDE PRESENTATIE EN VERLOOP VAN DE PATHOLOGIE....................................................................80
8.1.9 DE SOMATO-PSYCHO-SOCIALE VERWEVENHEID.......................................................................................80
8.1.10 BESLUIT........................................................................................................................................81
9 PARKINSON..................................................................................................................................81
9.1 WAT IS HET ?................................................................................................................................81
9.2 STADIA EN SYMPTOMEN..................................................................................................................82
9.3 ROL ERGOTHERAPEUT......................................................................................................................82
9.4 TYPISCHE KENMERKEN EN TERMEN.....................................................................................................82
9.4.1 PROBLEMEN BIJ STAPPEN...................................................................................................................82
9.4.2 TYPISCHE KENMERKEN.......................................................................................................................83
9.5 ERGOTHERAPIE BIJ DE ZIEKTE VAN PARKINSON......................................................................................83
9.6 EVIDENTIEPYRAMIDE VAN WET OZ....................................................................................................83
9.6.1 RICHTLIJN: ERGOTHERAPIE BIJ DE ZIEKTE VAN PARKISON...........................................................................84
10 PRAKTIJK.....................................................................................................................................85
10.1 PEO MODEL................................................................................................................................85
11 MOBILISEREN..............................................................................................................................86
11.1 STAPPENPLAN..............................................................................................................................86
11.2 OEFENINGEN...............................................................................................................................87
11.3 MOTORISCHE BEHANDELINGSPRINCIPES EN CONCEPTEN CVA:................................................................88
11.3.1 NDT............................................................................................................................................88
11.3.2 2. PRO-ACTIEVE AANPAK VOOR NEUROREHABILITATIE: AIR SPLINTS & THERAPY TOOLS (PANAT)..................89
, 11.4 P4: MOTORISCHE BEHANDELINGSPRINCIPES EN -CONCEPTEN CVA - GELEIDEN (AFFOLTER)..........................90
11.4.1 2. CONSTRAINT INDUCED MOVEMENT THERAPY (CIMT).......................................................................90
1.1 MUZIEK........................................................................................................................................91
11.5 INTERGENERATIONELE ACTIVITEITEN..................................................................................................91
1 Niet aangeboren hersenletsel bij volwassenen: CVA
NAH= Niet-aangeboren hersenletsel = hersenletsel dat ten minste 6 maanden na de geboorte
ontstaat ten gevolge van eender welke oorzaak.
Oorzaken:
- Traumatssh
- Niet-traumatssh
- Progressieve neurologisshe aandoening
aandoeningen die ontstaan tidens ontwikkeling foetus, geboorte of binnen 6 maanden na de
geboorte behoren niet tot de groep NAH.
1.1 HC1: CVA: CEREBRO VASCULAIR ACCIDENT
Aangeboren NAH
Ontstaan: Ontstaan:
o tidens ontwikkeling foetus o ten minste 6 maanden na de geboorte
o tidens de geboorte
o binnen de 6 maanden na de geboorte Oorzaak:
o traumatssh
Oorzaak: o niet-traumatssh
o genetsshe afwiikingen o progressieve neurologisshe aandoening
o zuurstoftekort
Definitie: Snel evoluerende klinisshe tekenen van fosale (of globale) verstoring van de hersenfunste
met neurologisshe uitvalsversshiinselen die 24 uur of langer duren of de dood tot gevolg hebben en
geen andere oorzaak hebben dan een stoornis in de hersensirsulate. (examenvraag)
1.2 SOORTEN
Completed stroke (CVA) Transient ischemic atack (TIA)
Kenmerken: Kenmerken:
= optreden uitvalversshiinselen die bliivend ziin = plotseling ontstaan uitvalversshiinselen die
maar niet progressief na 1uur. weer verdwiinen binnen de 24u. Gemiddelde
o Verstoring bloedtoevoer hersensirsulate duur tusen 2 – 20 min.
o Verstoring hersenfunste o Verstoring bloedtoevoer hersensirsulate
o Neurologisshe uitvalsversshiinselen Verstoring hersenfunste
o Neurologisshe uitvalsversshiinselen
o Niet meer progressief na 1 uur
Reversible ischemic neurological deficit (RIND) Stroke in evolution (CVA)
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