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Samenvatting praktijk CWZ MSK 5
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Samenvatting praktijk van de cervicale wervelzuil (MSK 5).
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Praktijkcursus MSK5 – CervicaleWervelzuil
3e bachelor Revalidatiewetenschappen
en kinesitherapie
Academiejaar 2019-2020
1
,Inhoudsopgave
1. Inleidende casus .................................................................................................................................. 5
1.1. Situatie.......................................................................................................................................... 5
1.2. Anamnese ..................................................................................................................................... 5
1.3. Hypothesen .................................................................................................................................. 6
1.4. Onderzoeksdoelstellingen ............................................................................................................ 6
1.4.1. Hoofddoelen .......................................................................................................................... 6
1.4.2. Subdoelen .............................................................................................................................. 6
2. Anamnese ............................................................................................................................................ 7
3. Inspectie .............................................................................................................................................. 8
4. Actief Functie Onderzoek – CWK....................................................................................................... 10
4.1. Analytisch: regionale flexie-extensie belast ............................................................................... 10
4.2. Analytisch: lateroflexie met/zonder schouder elevatie ............................................................. 10
4.3. Analytisch: rotatie met/zonder schouder elevatie..................................................................... 11
4.4. Analytisch: bilaterale elevatie van de schouders ....................................................................... 12
4.5. Analytisch: unilaterale elevatie van de schouders ..................................................................... 13
4.6. Analytisch: pro- en retractie van het hoofd ............................................................................... 14
5. Actief Functie Onderzoek TWK.......................................................................................................... 15
5.1. Analytisch: flexie – extensie ....................................................................................................... 15
5.2. Analytisch: lateroflexie ............................................................................................................... 15
5.3. Analytisch: rotatie ...................................................................................................................... 16
6. Functioneel Actief Functie Onderzoek .............................................................................................. 16
7. Voorbereidend onderzoek ................................................................................................................ 17
7.1 Palpatie ........................................................................................................................................ 17
7.1.1 Processi spinosi C2, C6-7, T1, T4........................................................................................... 17
7.1.2. Processi transversi C2, C6-7, T1, T4 ..................................................................................... 17
7.1.3. Fixeren ................................................................................................................................. 18
7.2. Kadering binnen het onderzoek ................................................................................................. 19
7.3 Screening radiculopathie ............................................................................................................. 20
7.3.1. Testen radiculopathie .......................................................................................................... 20
7.4. Oriënterend onderzoek .............................................................................................................. 26
7.4.1. Hoogthoracale rotatietest CTO (C7-T4) ............................................................................... 27
7.4.2. Manuele rotatietest C0-2 en C2-7 ....................................................................................... 28
7.4.3. Adapted spurling test .......................................................................................................... 29
7.4.3. Adapted spurling test .......................................................................................................... 30
8. Passief Functie Onderzoek CWK (C2-7) ............................................................................................. 31
2
, 8.1. Passieve flexie CWK C2-7............................................................................................................ 31
8.2. Passieve extensie CWK C2-7 ....................................................................................................... 32
8.3 Passieve rotatie CWK C2-7 .......................................................................................................... 33
8.4. Flexie 3D homoniem CWK .......................................................................................................... 34
8.5. Flexie 3D heteroniem CWK C2-7 ................................................................................................ 35
8.6. Extensie 3D homoniem CWK C2-7.............................................................................................. 36
8.7. Extensie 3D heteroniem CWK C2-7 ............................................................................................ 37
9. Passief Functie Onderzoek CTO C7-T4 .............................................................................................. 39
9.1. Passieve flexie CTO ..................................................................................................................... 39
9.2. Passieve extensie CTO ................................................................................................................ 40
10. Passief Functie Onderzoek TWK T4-12 ............................................................................................ 41
10.1. Passieve flexie TWK T4-T12 ...................................................................................................... 41
10.2. Passieve extensie TWK T4-T12 ................................................................................................. 42
10.3. Passieve rotatie TWK T4-T12 .................................................................................................... 43
10.4. Flexie 3D homoniem................................................................................................................. 44
10.5. Flexie 3D heteroniem ............................................................................................................... 45
10.6. Extensie 3D homoniem ............................................................................................................ 46
10.7. Extensie 3D heteroniem ........................................................................................................... 47
11. Behandeling ..................................................................................................................................... 48
11.1. Passieve mobilisaties CWK ....................................................................................................... 49
11.1.1. Aspecifieke mobilisaties .................................................................................................... 49
11.1.2. Meer specifieke mobilisaties ............................................................................................. 52
11.2. Passieve mobilisaties CTO ........................................................................................................ 53
11.2.1. Extensie ............................................................................................................................. 53
11.2.2. Rotatie (MWM) ................................................................................................................. 54
11.3. Passieve mobilisaties TWK ....................................................................................................... 55
11.3.1. Flexie-extensie ................................................................................................................... 55
11.3.2. Postero-anterieure mobilisatie ......................................................................................... 56
11.4. Actieve auto-mobilisaties ......................................................................................................... 57
11.4.1. Auto-mobilisatie CTO ........................................................................................................ 57
11.4.2. Auto-mobilisatie TWK........................................................................................................ 60
12. Onderzoek neuromusculaire controle ............................................................................................ 63
12.0. Inleiding .................................................................................................................................... 63
12.1. Oriënterende tests ................................................................................................................... 63
12.2. Coördinatie/ bewegingscontrole flexoren ............................................................................... 64
12.3. Coördinatie/ bewegingscontrole extensoren........................................................................... 66
3
, 12.4. Coördinatie/ bewegingscontrole rotatoren ............................................................................. 67
12.5. Coördinatie/ bewegingscontrole lateroflexoren ...................................................................... 68
12.6. Kracht-uithoudingstest: Grimmer test ..................................................................................... 69
12.7. Functionele uithouding ............................................................................................................ 70
13. Behandeling neuromusculaire controle .......................................................................................... 71
13.1. Craniocervicale flexoren ........................................................................................................... 72
13.1.1. Vanuit rugligging................................................................................................................ 72
13.1.2. Vanuit langzit ..................................................................................................................... 73
13.1.3. Vanuit rugligging met de nadruk op kracht (Grimmer test als oefening) ......................... 74
13.1.4. Met theraband .................................................................................................................. 75
13.1.5. Functioneel ........................................................................................................................ 75
13.2. Nekextensoren ......................................................................................................................... 76
13.2.1. Vanuit zit............................................................................................................................ 76
13.2.2. Vanuit puppy/ sfinx houding ............................................................................................. 77
13.2.3. Vanuit vierpuntshouding ................................................................................................... 78
13.2.4. Met theraband .................................................................................................................. 79
13.2.5. Cocontractie nekstabilisatoren ......................................................................................... 80
13.3. Extra oefeningen ...................................................................................................................... 80
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