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Samenvatting voor praktijktoets LWK/TWK
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Alle informatie die je moet weten voor de praktijktoets samengevat in 1 document.
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Praktijktoets Module LWK-Bekken-TWK 1 2023-2024
,Inhoudsopgave
Screening ad modum SOMT......................................................................................................................................3
Richtlijn Lage rugpijn en LRS......................................................................................................................................8
Palpatietechnieken LWK....................................................................................................................................11
Kinematica LWK.......................................................................................................................................................13
Kinematica TWK......................................................................................................................................................15
Soorten pijn en klinische manifestatie....................................................................................................................16
Referred pain......................................................................................................................................................16
Nociceptieve pijn................................................................................................................................................16
Verhoogde neurale mechanosensitiviteit..........................................................................................................17
Neuropatische pijn/neurogene pijn...................................................................................................................17
Lumbosacraal radiculair syndroom.........................................................................................................................19
Lumbale spinale stenose....................................................................................................................................22
Spondylolyse......................................................................................................................................................23
Spondylolisthesis................................................................................................................................................23
Spondyloarthritis................................................................................................................................................25
De ziekte van Bechterew....................................................................................................................................25
Diagnostische testen...............................................................................................................................................27
Screenende tests regio bekken/lwk...................................................................................................................27
Lasegue testen...................................................................................................................................................28
Onderzoek geleidingsstoornissen......................................................................................................................28
Sensibiliteit.........................................................................................................................................................28
Spierkracht: myotomen/Kenspieren..................................................................................................................30
Diagnostiek spinale stenose...............................................................................................................................32
Onderzoek neurale mechanosensitiviteit..........................................................................................................32
Subclassificatiesystemen.........................................................................................................................................34
Diagnostiek SIG........................................................................................................................................................37
Van der Wurf et al. (2006).................................................................................................................................37
Laslett et al. (2005).............................................................................................................................................39
Active straight leg raise......................................................................................................................................43
Bewegingen SIG..................................................................................................................................................44
Bewegingsanalyse en Integratie..............................................................................................................................45
Testprotocol van Luomajoki...............................................................................................................................46
,Screening ad modum SOMT
Doel:
Het stellen van een indicatie voor het fysiotherapeutisch diagnostische proces o.b.v. een
“pluis/niet-pluis”-besluit
Omvat de volgende 6 onderdelen:
1. De eerste inventarisatie van de hulpvraag
De eerste inventarisatie van de hulpvraag heeft als doel te bepalen of die past binnen
het fysiotherapeutisch(-specialistische) domein.
Wanneer de hulpvraag zich niet bevindt binnen het fysiotherapeutisch
(specialistische) domein, is er géén indicatie voor een fysiotherapeutisch diagnostisch
proces.
2. Het mondeling bevragen/doorvragen van generieke rode vlaggen
- (Recent) trauma
- Constante niet mechanische pijn
- Nachtelijke pijn
- Langer bestaande onverklaarbare koorts
- Recent onverklaard gewichtsverlies
- Kanker in de voorgeschiedenis
- Algemeen onwelbevinden
- Uitgebreide neurologische verschijnselen
3. Het uitvragen van regiospecifieke rode vlaggen
Lumbale wervelkolom
- Generieke rode vlaggen
- Eerste episode met LRP < 20 of > 50 jr.
- Deformiteiten (bijv. lumbale kyfose, afgenomen lichaamslengte)
- Progressieve niet-mechanische pijn
- Incontinentie voor faeces en/of urine
- Rijbroekanaesthesie
- Bilaterale uitvalsverschijnselen in benen
- Ernstig beperkt gangbeeld
- Langdurig gebruik corticosteroïden
, Thoracolumbale rode vlaggen volgens systematic review Maseli et al. (2020)
Vertebrale fractuur
- Prevalentie = 0,4-5,6%
- Rode vlaggen
o Ouderdom
o Trauma
o Vrouw
o Neurologische symptomen
o NPRS 7>
o Corticosteroïden gebruik
o Osteoporose
o Osteoartritis
- Onderzoek
o Percussion test
o Afwijkend looppatroon
o Blauwe plekken
o Palpabel trappetje
o Vermindering lengte
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