Transcript Manual Terapi 2 Pertemuan 13

MANUAL TERAPI
ANKLE AND FOOT
INTERVENSI
Oleh:
Sugijanto
Disampaikan pada kuliah reguler
Manualterapi II
TUJUAN INSTRUKSIONAL
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Mahasiswa memahami Intervensi pada kasuistik
Ankle and foot complex dengan cara :
Mampu menjelaskan metoda dan dosis
intervensi manualterapi kasus Ankle and foot
complex
Mampu membedakan indikasi antara metoda
dengan pemeriksaan khusus.
Mampu mempraktek intervensi manualterapi
kasus Ankle and foot complex
Mampu menilai tentang hasil intervensi
manualterapi kasus Ankle and foot complex.
PERTANYAAN STUDI
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Sebutkan indikasi intervensi metoda
manualterapi bila dijumpai patologi muscle pain
sec. Tendinitis, Muscle tightness/contracture,
Capsular pattern hypomobility, Joint
hypermobility, Joint instability, dan sensoric
deficit sec nerve entrapment.
Uraikan dan praktekkan Teknik transverse
friction pada: lig. Talofibulare; lig. Talocalcaneal,
lig. Tibiofibulare, lig. tibiotalare; tendon achilles;
m. peroneus longus, m. peroneus brevis, m.
tibialis anterior; m. tibialis posterior.
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Uraikan dan praktekkan Joint mobilisation traksi,
translasi dan roll slide pada sendi Ankle,
subtalar, chopard, MTP and PIP-DIP.
Uraikan dan praktekkan mobilisasi otot dan
contract relax stretching pada
tightness/contracture m. Gastrocnemius, m.
soleus, m tibialis anterior.
Jelaskan dan praktekkan terapi latihan pada
Ankle and foot complex.
Jelaskan dan praktekkan pengukuran hasil pada
intervensi Ankle and foot complex.
INTERVENTION
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MASSAGE
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MUSCLE MOBILIZATION
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Oedeme reduce massage
Muscle manipulation
MUSCLE STRETCHING
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Gastroc nemius m.
Soleus m.
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TRANSVESE FRICTION
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Gastrocnemius m
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Achilles tendon:
Permukaan posterior
 Permukaan lateral-medial
 Permukaan anterior
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Anterior tibial m.
Aterior tibial tendon
Peroneus longus and brevis ms
Peroneus longus and brevis
tendon
JOINT MOBILIZATION
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Translation of distal
tibiofibular joint
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Dorsal translation
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Traction of Ankle joint :
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In MLPP
(Awal mobilisasi/ aktualitas tinggi)
In Limited dorsal flexion
(Menambah ROM dorsal flexion)
In Limited plantar flexion
(Menambah ROM dorsal flexion)
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Translation of Ankle joint :
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In Limited dorsal flexion
(Menambah ROM dorsal flexion)
In Limited plantar flexion
(Menambah ROM dorsal flexion)
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Intermetatarsal
Translation
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Dorsal and plantar
translation MT1, MT3,
MT4 and MT5
Koreksi transverse arc
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Traction to MTP joint I (II,III,IV & V):
 In MLPP
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In Limited dorsal flexion
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Awal mobilisasi/aktualitas tinggi
(Menambah ROM dorsal flexion)
In Limited plantar flexion
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(Menambah ROM plantar flexion)
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Translation to MTP joint I
(II,III,IV & V):
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In Limited dorsal flexion
(Menambah ROM dorsal
flexion)
In Limited plantar flexion
(Menambah ROM plantar
flexion)
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Manipulation to lesion.
Passive stabilization
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Elastic bandage
Tapping
Medial arc support
Medial wedge shoe
AFO
EXERCISE
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MUSCLE REEDUCATION.
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Active stabilization exercises.
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Active strengthening exercises
EVALUASI
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Pain: VAS/ VRS/ VDS
ROM: Goneometer
Strength: MMT/Hand held
dynamometer/Spigmomanometer.
Flat foot
Bawaan
Nyeri medial
foot (knee)
Antalgi gait
Navicular
nonjol medial
Calcaneal
valgus
Pronation foot
Over weight
Palpasi nyeri
navicular
Stretch test
lig. Plantar
foot
Strength test
Pengukuran
longit arc
External rotated leg
Medial arc support
shoes
Strengthening exc.
Toes flexors
Plantar fasciitis – calcaneal spur
Degenerasi
Over weight
Repetitive Stretching
apponeurosis plantaris
Nyeri tumit/plantar
Antalgic gait, heel
strike-foot flat ±
Palpasi nyeri
plantar fascia &
calcaneus
Stretch test Plantar
fascia
Strength test otot
flexors
US
Transverse friction
Donnut pad-medial
arc suport shoes
Ankle sprain
Active unstable foot
Nyeri lateral
(medial) foot
Riwayat injury
Inversion injury
Rest
Acute Akt.
tinggi
Acute edema
Compression
Elevation
Antalgic gait
Nyeri inversi
(eversi) ROM ±
Ice
KronikAkt.
rendah
Joint mobilization
Active stabilization
Gouty arthritis
Metabolism
Endapan purin
Inflamasi
Awal MTP I
Nyeri tajam ibu jari kaki
Gait analysis Toe off
Medicamentosa
ROM MTP I terbatas
Non capsular pattern
Palpasi: Tenderness
Joint blockade arah
tertentu
US under water
Joint mobilization
DAFTAR PUSTAKA
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Cook CE, Osthopaedic Manual Therapy, Pearson Prentice Hall, New
Jersey, 2007
Goodmann & Boissaunnault, Pathology implication for physiotherapy. WB
Saunders co, London, 2000.
Helting D & Kessler RM, Management of common musculoskeletal
disorder, ippincott Williams and Wilkins, Philadelphia, 2006.
Makofsky HW, Spinal Manual Therapy, Slack inc, NJ USA, 2003
Meadows JTS, Orthopaedic Differential Diagnosis in Physisal therapy, Mc
Graw-Hill, NY, 1999.
Van der El, A, Lunacek, P and Wagemaker, A, Manuele therapie,
wervelkolom onderzoek, deel 1, Uitgeverij Manuwel, Roterdam, Ed. I,
1983.
Van der El, A, Lunacek, P and Wagemaker, A, Manuele therapie
Wervelkolom Behandeling, deel 2, Uitgeverij Manuwel, Roterdam, Ed. I,
1989.
Dvorak, J and Dvorak, V, Medical checklists Manual Medicine, Gerg
Thieme Verlag Stuttgart, New York, 1991.