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Samenvatting

Samenvatting pediatrie KBK
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Samenvatting pediatrie KBK hoofdstukken: - INLEIDING PEDIATRIE (NEUROMOTORISCHE & ORTHOPEDISCHE STOORNISSEN) - Definitie, incidentie & prevalentie + Etiologie en Pathogenese - Types, topografie & classificaties - Tekenen & Klinische symptomen - Evaluatie - Behandeling -> CP, TBI/ABI, a...

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  • 3 december 2024
  • 106
  • 2023/2024
  • Samenvatting

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Kinesitherapie bij kinderen (Pediatrie)
INLEIDING PEDIATRIE (NEUROMOTORISCHE & ORTHOPEDISCHE STOORNISSEN) ______________ 6

Pathologie ______________________________________________________________________________________ 6

Neurologische stoornissen _________________________________________________________________________ 6
Het zenuwstelsel _______________________________________________________________________________ 6
Wat kan het zenuwstelstel beschadigen? ___________________________________________________________ 6
Stoornissen van het zenuwstelsel __________________________________________________________________ 6
Neurologische stoornissen bij kinderen _____________________________________________________________ 7
Aandoeningen van het centraal zenuwstelsel ________________________________________________________ 8
Aandoeningen van het perifeer zenuwstelsel ________________________________________________________ 8
___________________________________________________________________________________________ 8
Perifere zenuw ______________________________________________________________________________ 9
Neuromusculaire junctie ______________________________________________________________________ 9
Neuromusculaire junctie aandoeningen __________________________________________________________ 9
Spierschade _________________________________________________________________________________ 9


PEDIATRISCHE KINESITHERAPIE ___________________________________________________ 10

1. Definitie, incidentie & prevalentie + 2. Etiologie en Pathogenese_______________________________________ 10
Incidentie  prevalentie _______________________________________________________________________ 12
Aandoeningen van het centrale zenuwstelsel: HERSENEN _____________________________________________ 12
1. Cerebral Palsy (CP) ________________________________________________________________________ 12
Definities: _______________________________________________________________________________ 12
Incidentie _______________________________________________________________________________ 13
Prevalentie ______________________________________________________________________________ 13
Risico op CP _____________________________________________________________________________ 13
Etiologie – pathogenese ___________________________________________________________________ 14
_______________________________________________________________________________________ 15
Risico’s in preterme kindjes_________________________________________________________________ 15
Mechanismen Preterm ____________________________________________________________________ 16
Risico’s bij voldragen (term) kindjes __________________________________________________________ 17
Mechanismen Term _______________________________________________________________________ 17
Samenvatting CP _________________________________________________________________________ 18
2. traumatisch/ verworven hersenletsel (TBI/ABI) _________________________________________________ 18
Definitie (TBI) ____________________________________________________________________________ 18
Incidentie _______________________________________________________________________________ 19
Acquired brain injury (ABI) / Niet-aangeboren hersenaandoening (NAH) ____________________________ 19
3. Aanvalstoornissen: bijvoorbeeld Dravet _______________________________________________________ 19
Definitie ________________________________________________________________________________ 20
Incidentie _______________________________________________________________________________ 20
Oorzaken _______________________________________________________________________________ 20
Aandoeningen van het centrale zenuwstelsel: RUGGENMERG __________________________________________ 20
4. Spina bifida ______________________________________________________________________________ 20
Definitie ________________________________________________________________________________ 21
Prevalentie ______________________________________________________________________________ 21
Oorzaken _______________________________________________________________________________ 21
Preventie _______________________________________________________________________________ 22
Embryonale fase _________________________________________________________________________ 22
Diagnose________________________________________________________________________________ 22
ARNOLD CHIARI-malformatie _______________________________________________________________ 22
5. Hereditary spastic paraparesie (HSP) _________________________________________________________ 22
Definitie ________________________________________________________________________________ 22
Incidentie _______________________________________________________________________________ 23
Aandoeningen van het Perifere zenuwstelsel: ZENUWEN ______________________________________________ 23
6. Spinal Muscular Atrophy (SMA) ______________________________________________________________ 23

1

, Definitie ________________________________________________________________________________ 24
Incidentie _______________________________________________________________________________ 24
Types __________________________________________________________________________________ 24
7. Charcot Marie Tooth (CMT) _________________________________________________________________ 25
Definitie ________________________________________________________________________________ 25
Incidentie _______________________________________________________________________________ 25
8. Traumatic Nerve injury _____________________________________________________________________ 25
Definitie ________________________________________________________________________________ 26
Plexus brachialis__________________________________________________________________________ 26
Incidentie _______________________________________________________________________________ 26
Obstetric brachial plexus injury – Locatie ______________________________________________________ 26
9. Sensorineural Hearing loss __________________________________________________________________ 26
Incidentie _______________________________________________________________________________ 27
Aandoeningen van het Perifere zenuwstelsel: NEUROMUSCULAIRE JUNCTIE ______________________________ 27
10. Mysthenia Gravis ________________________________________________________________________ 27
Definitie ________________________________________________________________________________ 27
Incidentie _______________________________________________________________________________ 28
Etiologie ________________________________________________________________________________ 28
Aandoeningen van het Perifere zenuwstelsel: SPIEREN _______________________________________________ 28
11. Muscular Dystrophy ______________________________________________________________________ 28
Definitie ________________________________________________________________________________ 29
Duchenne _______________________________________________________________________________ 29
Incidentie _______________________________________________________________________________ 29
Pathogenese ____________________________________________________________________________ 29
Overview ____________________________________________________________________________________ 30

3. Types, topografie & classificaties _________________________________________________________________ 30
Classificaties, waarom? _________________________________________________________________________ 30
Classificaties op verschillende niveau’s van het ICF ___________________________________________________ 30
Aandoeningen van het centrale zenuwstelsel: HERSENEN _____________________________________________ 31
1. CP _____________________________________________________________________________________ 31
Bewegingen in CP ________________________________________________________________________ 31
Klinisch type: obv lokalisatie in de hersenen ___________________________________________________ 31
Samenvattende tabel: _____________________________________________________________________ 35
Types obv topografie ______________________________________________________________________ 36
Types volgens ernst _______________________________________________________________________ 37
2. Traumatic Brain injury _____________________________________________________________________ 40
Types volgens ernst _______________________________________________________________________ 40
Topografie ______________________________________________________________________________ 41
Classificaties _____________________________________________________________________________ 41
3. Seizure disorders _________________________________________________________________________ 41
Types __________________________________________________________________________________ 41
Aandoeningen van het centrale zenuwstelsel: RUGGENMERG __________________________________________ 42
4. Spina Bifida (SB) __________________________________________________________________________ 42
Types __________________________________________________________________________________ 42
Topografie ______________________________________________________________________________ 42
Classificatie _____________________________________________________________________________ 43
5. Heriditary spastic paraperesis _______________________________________________________________ 43
Types __________________________________________________________________________________ 43
Aandoeningen van het Perifere Zenuwstelsel: ZENUWEN _____________________________________________ 44
6. Spinal muscular atrophy (SMA) ______________________________________________________________ 44
Types __________________________________________________________________________________ 44
7. Charcot Marie. tooth ______________________________________________________________________ 45
Types __________________________________________________________________________________ 45
8. Traumatisch zenuwletsel ___________________________________________________________________ 45
Types __________________________________________________________________________________ 45
Topografie ______________________________________________________________________________ 46
9. Sensorineuraal gehoorverlies________________________________________________________________ 46
Etiologie (type) ___________________________________________________________________________ 46
Lokalisatie van het tekort (topografie) ________________________________________________________ 46
Ernst van het gehoorverlies (classificatie) _____________________________________________________ 47
2

, Aandoeningen van het Perifere Zenuwstelsel: NEUROMUSCULAIRE JUNCTIE ______________________________ 47
10. Myasthenia Gravis (MG)___________________________________________________________________ 47
Types __________________________________________________________________________________ 47
Aandoeningen van het Perifere Zenuwstelsel: SPIEREN _______________________________________________ 47
11. Muscular Dystrophy ______________________________________________________________________ 47
Types __________________________________________________________________________________ 47

4. Tekenen & Klinische symptomen _________________________________________________________________ 50
Aandoeningen van het centrale zenuwstelsel: HERSENEN _____________________________________________ 51
CP _______________________________________________________________________________________ 51
Klinische tekens __________________________________________________________________________ 52
Spiertonus ______________________________________________________________________________ 52
Beweging en coördinatie ___________________________________________________________________ 52
Reflexen ________________________________________________________________________________ 53
Houding en balans ________________________________________________________________________ 53
Grove motoriek __________________________________________________________________________ 53
Fijne motoriek ___________________________________________________________________________ 53
Orale motoriek ___________________________________________________________________________ 54
Geassocieerde problemen _________________________________________________________________ 54
Indeling volgens leeftijd ___________________________________________________________________ 54
TBI _______________________________________________________________________________________ 55
Dravet: Seizure disorders _____________________________________________________________________ 56
Aandoeningen van het centrale zenuwstelsel: RUGGENMERG __________________________________________ 57
Spina Bifida ________________________________________________________________________________ 57
Dysplasie van zenuwbaan __________________________________________________________________ 57
Spinabifida occulta________________________________________________________________________ 57
Menignocele ____________________________________________________________________________ 57
Myelomeningocele _______________________________________________________________________ 58
Geordend volgens leeftijd __________________________________________________________________ 60
Hereditary spastische parese _________________________________________________________________ 60
Tekens en klinische symptomen _____________________________________________________________ 60
Pure HSP ________________________________________________________________________________ 61
Additionele symptomen in gecompliceerde gevallen ____________________________________________ 61
Aandoeningen van het Perifere Zenuwstelsel: ZENUWEN _____________________________________________ 61
SMA ______________________________________________________________________________________ 61
CMT ______________________________________________________________________________________ 62
Traumatic Nerve Injury ______________________________________________________________________ 62
Plexus brachialis__________________________________________________________________________ 62
Erb’s palsy (C5-C6) ________________________________________________________________________ 62
Klumpke palsy (C8-T1) _____________________________________________________________________ 63
Sensorineurale hearing impairment ____________________________________________________________ 63
Aandoeningen van het Perifere Zenuwstelsel: NEUROMUSCULAIRE JUNCTIE ______________________________ 64
Myastenia Gravis (MS) ______________________________________________________________________ 64
Aandoeningen van het Perifere Zenuwstelsel: SPIEREN _______________________________________________ 64
Spierdystrofie ______________________________________________________________________________ 64
Duchenne _______________________________________________________________________________ 65
Becker spierdystrofie ______________________________________________________________________ 65
Indeling volgens leeftijd ___________________________________________________________________ 66
Samenvatting: ______________________________________________________________________________ 66

5. Evaluatie _____________________________________________________________________________________ 67
Aandoeningen van het centrale zenuwstelsel: HERSENEN _____________________________________________ 67
CP _______________________________________________________________________________________ 67
Evaluatie________________________________________________________________________________ 67
Sagittale gangpatronen bij Diplegie __________________________________________________________ 68
Type 1: true ankle equinus _______________________________________________________________ 68
Type 2: jump gait ______________________________________________________________________ 69
Type 3: apparent equinus ________________________________________________________________ 70
Type 4: crouch gait _____________________________________________________________________ 71
GRF in crouch ____________________________________________________________________________ 72
Sagittale knie patronen door sutherland & davids _______________________________________________ 72
3

, Stiff knee patroon ______________________________________________________________________ 72
Recurvatum knie _______________________________________________________________________ 73
Frontaal vlak gang deviaties ________________________________________________________________ 73
Scissoring gait _________________________________________________________________________ 73
Transversaal vlak gang deviaties _____________________________________________________________ 74
Gangpatronen bij Hemiplegie _______________________________________________________________ 74
Type 1: _______________________________________________________________________________ 75
Type 2: _______________________________________________________________________________ 75
Type 3: _______________________________________________________________________________ 76
Type 4: _______________________________________________________________________________ 76
Review van meetschalen in CP ______________________________________________________________ 77
Traumatich Brain injury ______________________________________________________________________ 77
Impairment _____________________________________________________________________________ 77
Limitatie ________________________________________________________________________________ 77
Restricties_______________________________________________________________________________ 77
Dravet ____________________________________________________________________________________ 77
Impairment _____________________________________________________________________________ 77
Limitatie ________________________________________________________________________________ 78
Restricties_______________________________________________________________________________ 78
Aandoeningen van het centrale zenuwstelsel: RUGGENMERG __________________________________________ 78
Spina bifida ________________________________________________________________________________ 78
Impairment _____________________________________________________________________________ 78
Restricties_______________________________________________________________________________ 79
0-2J _________________________________________________________________________________ 79
2-6J _________________________________________________________________________________ 79
6-12J ________________________________________________________________________________ 79
12J+ _________________________________________________________________________________ 80
Heriditary spastic paraparesie ________________________________________________________________ 80
Impairment _____________________________________________________________________________ 80
Limitatie ________________________________________________________________________________ 81
Aandoeningen van het Perifere Zenuwstelsel: ZENUWEN _____________________________________________ 81
Spinal muscular atrophy (SMA) _______________________________________________________________ 81
Impairment _____________________________________________________________________________ 81
Limitatie ________________________________________________________________________________ 81
Restricties_______________________________________________________________________________ 81
Traumatisch zenuw letsel: brachiale plexus _____________________________________________________ 82
Impairment _____________________________________________________________________________ 82
Limitatie ________________________________________________________________________________ 82
Restricties_______________________________________________________________________________ 82
Charcot Marie tooth ________________________________________________________________________ 82
Impairment _____________________________________________________________________________ 82
Limitatie ________________________________________________________________________________ 82
Restricties_______________________________________________________________________________ 82
Sensoraal gehoorverlies _____________________________________________________________________ 82
Aandoeningen van het Perifere Zenuwstelsel: NEUROMUSCULAIRE JUNCTIE ______________________________ 82
Myasthenia Gravis __________________________________________________________________________ 82
Impairment _____________________________________________________________________________ 82
Limitatie ________________________________________________________________________________ 83
Restricties_______________________________________________________________________________ 83
Aandoeningen van het Perifere Zenuwstelsel: SPIEREN _______________________________________________ 83
Musculaire spierdystrofie ____________________________________________________________________ 83
Evaluatie________________________________________________________________________________ 83
Impairment _____________________________________________________________________________ 83
Limitatie ________________________________________________________________________________ 83
Restricties_______________________________________________________________________________ 85

6. Behandeling __________________________________________________________________________________ 85
Aandoeningen van het centrale zenuwstelsel: HERSENEN _____________________________________________ 85
CP _______________________________________________________________________________________ 85
Tonus management _______________________________________________________________________ 85
Medicatie ____________________________________________________________________________ 85
4

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