Transcript Manual Terapi 2 Pertemuan 14

STUDI KASUS LOWER EXTREMITY
Oleh:
Sugijanto
OSTEOARTHROSIS
Degenerasi
Over weight
Over used
Fragmentasi &
erosi rawan sendi
Hipertrofi subchodr.
& osteofit
Corpus libera
Kontraktur
Joint blockade
Injury
Nyeri & kaku hip
Joint mobiliz
Duchene
Muscle mobiliz
Rom:extern rot<
Abd < intern rot
Firm end feel
Manipul corpus libera
JPM: Nyeri akhir ROM
/ Firm end feel
Weight control
Joint blockade
COLLUM FEMORIS FRACTURE
Osteoporotic
Nyeri inguinal
Injury
Fracture collum femoris
Operative AMP
Jalan nyeri trochanter
nonjol
ROM terbatas &
crepitasi
Leg discrepancy
X ray  ≠
Rehab. ambulasi
Cosevative
PIRIFORMIS SYNDROME
Patologi lain
Nyeri gluteal
Spasm/tight
Entrapment n. ischiadic
Strocking - keading
Paresthesia paha
blk
Contract relax stretching
piriformis
Palpasi: spasm
Strengthening Exc gluteal
ms
Contract relax
stretch test +
Hindari dompet
disaku/berdiri lama
BURSITIS ISCHIADICA
Rheumatism
Inflamasi
Iritasi bursa ischiadica
Nyeri gluteal
ROM & isom
normal
US
Transverse friction
Strengthening gluteal ms
Palpasi:
Tenderness
Hindari duduk alas keras
OSTEOARTHROSIS LUTUT
Degenerasi
Over weight
Over used
Fragmentasi &
erosi rawan sendi
Injury
Nyeri & kaku lutut
Joint mobiliz
Antalgic gait
Hipertrofi
subchodr. &
osteofit
Muscle mobiliz
Rom: Flx < Ext
Firm end feel
Manipul corpus libera
Corpus libera
Kontraktur
Joint blockade
JPM: Nyeri akhir
ROM / Firm end feel
Weight control
Joint blockade
MENISCUS LESION
Abd homolat-Rot kontralatkompresi + Ext (flex)
Nyeri & mengunci
Non capsular pat +
krepitasi meniskus
Meniscus test +
(tes tumit)
Meniscus rupture
Penguncian extensi (fleksi)
Manipulasi meniscus (kontra
tes)
Stabilisasi pasif
Strengthening - cycling
CHONDROMALACIA PATELLAE
Degenerasi
Cidera trtm odd
facet
Erosi
Micro injury
Genu valgus
Nyeri patella
Lemah m.vastus
medialis
Medial wedge shoes
Nyeri posisi 300
flex
Friction
Penebalan tl
subchondral
Compression test
+
Osteofit
Ballotement ±
Iritasi jar
Strength m.vastus
medialisn
KNEE INSTABILITY
Lig Laxity
Muscle dysbalance
Lig. Collateral medial
Lig. Collateral lateral
Meniscus
Varus test
Valgus test
Lig. Cruciatum anterior
Anterior shearing test
Lig.Cruciatum posterior
Posterior shearing test
Passive & active
stabilization
PES ANSERINUS SYNDROME
Genu valgus
Muscle spasm
Tendomyosis
Tendinitis
Lig. Collateral medial laxity
Nyeri medial
lutut
Antalgic gait
Tender & spasm
palpated
Osteoarthrosis
Strocking-effleurage
Transverse friction
Medial wedge shoes
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
Inversion injury
Rest
Acute Akt.
tinggi
Ice
Riwayat injury
Compression
Antalgic gait
Elevation
Nyeri inversi
(eversi) ROM ±
Acute edema
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
US under water
Palpasi: Tenderness
Joint mobilization
Joint blockade arah
tertentu
DAFTAR PUSTAKA








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.