Samenvatting Kine bij ouderen praktijk SV

Praktijk Kine bij ouderen
Inhoud
Krachttraining bij ouderen

1. Inleiding ........................................................................................................................................... 8
2. Sacropenie ....................................................................................................................................... 9
2.1 1 RM living ............................................................................................................................. 11
3. Evaluatie spierkracht ..................................................................................................................... 11
4. Preventie en behandeling ............................................................................................................. 11
4.1 Primaire preventie ................................................................................................................. 12
Richtlijnen fysieke activiteit........................................................................................................... 12
Sociaal ecologisch model............................................................................................................... 12
4.2 Secundaire preventie ............................................................................................................ 13
Geen sacropenie ............................................................................................................................ 13
Sacropenie ..................................................................................................................................... 14
5. Trainingsprincipes ......................................................................................................................... 15
6. Aanbevelingen ............................................................................................................................... 16
7. Fysiologie: hoe worden we sterker? ............................................................................................. 18
Gangrevalidatie

1. Normaal gangpatroon ................................................................................................................... 19
2. Mogelijke leeftijdsgebonden veranderingen in gangpatroon ....................................................... 19
2.1 Vaak voorkomende veranderingen ....................................................................................... 20
2.2 Oorzaken mobiliteitsverlies: Multifactorieel......................................................................... 20
3. Evaluatie (Handboek p337-339 ) ................................................................................................... 21
4. Behandelmogelijkheden ................................................................................................................ 21
4.1 Aspecten ................................................................................................................................ 21
4.2 Maatregelen .......................................................................................................................... 21
4.3 Belasting balans ..................................................................................................................... 21
4.4 Betrokken professionals ........................................................................................................ 21
4.5 Aandachtspunten .................................................................................................................. 22
5. Pathologie en wijziging gangpatroon ............................................................................................ 22


1

, 5.1 Parkinson ............................................................................................................................... 23
Cueing ............................................................................................................................................ 23
5.2 Kanaalstenose ....................................................................................................................... 24
5.3 Claudicatio intermittens ........................................................................................................ 24
Behandeling ................................................................................................................................... 24
6. Opdrachten.................................................................................................................................... 25
Wat als visuele input wegvalt? ...................................................................................................... 25
Thuisoefeningen ............................................................................................................................ 25
Casus (zie docu) ............................................................................................................................. 26
Decubitus

1. Definitie en pathogenese .............................................................................................................. 27
2. Registratie...................................................................................................................................... 27
2.1 Preventie richtlijn .................................................................................................................. 28
2.2 Bradenschaal ......................................................................................................................... 29
3. Casus .............................................................................................................................................. 34
3.1 Opdrachten............................................................................................................................ 34
Risicofactoren decubitus ............................................................................................................... 34
Bradenschaal ................................................................................................................................. 35
Interventies kinesitherapie............................................................................................................ 36
4. Preventie ....................................................................................................................................... 37
4.1 Positionering bed / stoel ....................................................................................................... 37
Ruglig ............................................................................................................................................. 38
Zithouding...................................................................................................................................... 38
Zijlig ............................................................................................................................................... 38
Buiklig ............................................................................................................................................ 38
5. Vermijden ...................................................................................................................................... 39
Houding

1. Houding ......................................................................................................................................... 40
1.1 Inleiding ................................................................................................................................. 40
1.2 Anatomische en fysiologische veranderingen ....................................................................... 41
1.3 Gewrichtsstijfheid.................................................................................................................. 42
1.4 Oefeningen ............................................................................................................................ 42


2

, 1.5 Bovenste en onderste gekruiste syndroom .......................................................................... 45
1.6 Momentwerking heup ........................................................................................................... 45
1.7 Voornaamste veranderingen in houding .............................................................................. 46
1.8 Parkinson ............................................................................................................................... 47
Oorzaken ....................................................................................................................................... 48
Gevolgen........................................................................................................................................ 48
2. Hyperkyfose ................................................................................................................................... 49
2.1 Definitie en prevalentie ......................................................................................................... 49
Jongeren ........................................................................................................................................ 49
Vrouw ............................................................................................................................................ 49
Beïnvloedbare factoren ................................................................................................................. 50
2.2 Oorzaak en pathologie .......................................................................................................... 50
2.3 Geassocieerde gezondheidsrisico’s ....................................................................................... 53
2.4 Evaluatie ................................................................................................................................ 54
Röntgen ......................................................................................................................................... 55
Cobb hoek...................................................................................................................................... 55
Debrunner kyphometer................................................................................................................. 55
Flexicurve Ruler ............................................................................................................................. 55
Spinal mouse ................................................................................................................................. 56
Inclinometer .................................................................................................................................. 56
Occiput-to-wall .............................................................................................................................. 56
Functionele testing : QoL............................................................................................................... 57
2.5 Behandeling ........................................................................................................................... 57
Oefentherapie ............................................................................................................................... 57
Proprioceptie – postural alignment .............................................................................................. 58
Postural taping .............................................................................................................................. 59
Manuele therapie .......................................................................................................................... 59
Spinale orthese .............................................................................................................................. 59
Medicamenteuze behandeling ...................................................................................................... 59
osteoporose................................................................................................................................... 59
Operatieve behandeling ................................................................................................................ 59
3. Mobiliteit, transfers en hulpmiddelen .......................................................................................... 60


3

, 3.1 Mobiliteit en transfers ........................................................................................................... 60
Zit – stand ...................................................................................................................................... 60
Rollen ............................................................................................................................................. 62
Rechtstaan ..................................................................................................................................... 63
Hulpmiddel transferbelt ................................................................................................................ 63
3.2 Hulpmiddelen ........................................................................................................................ 64
Keuze loophulpmiddel ................................................................................................................... 64




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