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Kim, joeki, kait, julia, Thijs

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Aanvulling bevind zich op de laatste pagina

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2 oefeningen bovenste extremiteiten

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Assignment 16-4 treatment 1 and 3 months

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Assignment 16-4 treatment 1 and 3 months

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kim, joekie, kait, julia, Thijs

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JD, Gijs, Bas

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Fieke, Guus, Daisy

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13.30-14.30 Group 1 + 2
14.30-15.30 Group 3 + 4
Before you see me, discuss your plan with the other group.

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Julia, Kaitl, Thijs

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Structure probelmatic action 62 year surgeon

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Daisy, Guus, Fieke ( NOG NIET AF)

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plus 1 + 1+1 -20
https://youtu.be/5XvAGXzFN7U
https://youtu.be/Bvov9UDuNl8

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plus 1+1 +1 +1 +1+1+1

https://youtu.be/J_I8C2_AIxQ

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One of the problems is restriction of movement in the ankle due to swelling resulting from trauma and subsequent.

surgery. In addition, the haircut device has become tighter. In the first or 2nd treatment you will start walking. Exercises aimed at walking (with or without crutch) in combination with muscle strengthening exercises depending on the degree of load. in position or otherwise. You are less likely to opt for exercises against the wall. Prefer to sit with leg up. Mobilizing for ankle. Muscle strengthening in supine or partial position. So the choice for this kind of exercises are less logical.

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1st Treatment Wendy_Knee surgery_ Kaitlyn, Warren, Joekie

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Plus 1

bas
gijs

https://www.youtube.com/watch?v=bzhgIUhYOJ8

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Scheme student functional physiotherapy

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plus 1 +1, Julia, Thijs, Paul, Guus, Kim

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Posts about Shoulders written by adammeakins

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1e behandeling Wendy Breke Bene Bas, Gijs en Daisy

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1e behandeling Wendy Breke Bene Bas, Gijs en Daisy

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Feedback IN:
Maak de koppeling/transfer naar ADL en integreer jouw oefeningen. Bedenk oefeningen die ze makkelijk tijdens het lopen kan doen, of gerelateerd zijn aan lopen. Een van de belangrijkste elementen is het herwinnen van het looppatroon.
-Step up: kan nog te zwaar/moelijk zijn op 1 been. Bedenk nog een tussen stap.

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Jan Douwe, Guus, Fieke
Feedback IN:
-Bespreking angst is prima. Beschrijf daarbij de onderwerpen die je bespreekt.
-1 van de eerste doelen is lopen, oefenen met lopen. Dat is het eerste wat Mw ook nodig zal hebben in haar ADL. Betrek deze ADL handeling in jouw 1e behandeling. Oefeningen in/met het lopen.
-De step oef is in deze fase wellicht moeilijk.

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Julia, Kim, Thijs
Feedback IN:
-Describe whick musculature decreased in strength.
-besides flexion, you also expect an extension problem
-I don't understand the choice for the exercise with the ankle.
That's more of an exercise that you do on a chair for circulation or enlargement of rom

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Feedback IN: I agree, what you've have described. You can also think of decreased strength of her hip and pelvic muscles due to her previous problems. The movement chain is disrupted.

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Treatment plan_Knee surgery_ Kaitlyn, Warren, Joekie

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Fieke, Guus, JD
Feedback IN:
-Schrijf de problematische handeling specifieker uit te schrijven. Zie de deelhandelingen van het looppatroon. Beschrijf wat je in welke fase verwacht te zien.
-reductie: zou bv andere ondergrond kunnen. provocatie: uitlokken de standfase te verlengen.
-Behandeldoel: verbetering kracht,mobiliteit van wat?
-ADL fase: is belangrijk om angst, ADL handeling lopen aan te koppelen

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CAS 2 status na cruris fractuur fieke, guus, JD

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Assignement 2 Case mvr. Breke bene.  Gijs, Daisy, Bas

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Assignement 2 Case mvr. Breke bene.  Gijs, Daisy, Bas

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-Schrijf de problematische handeling specifieker uit te schrijven. Zie de deelhandelingen van het looppatroon. Beschrijf wat je in welke fase verwacht te zien.
-Je kunt verwachten dat er ook vermindering in kracht is te zien van haar heup en bekkenmusculatuur, gezien haar problematiek in het verleden. De ''keten is verstoord''
-Een beschrijving van welke musculatuur in kracht is verminderd, ontbreekt
-Het doel van de toevoeging  naviculair drop test is onduidelijk

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group 2- JanDouwe, Guus, Fieke

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English:
https://www.youtube.com/watch?v=_7eaQ2s6ifE
https://www.youtube.com/watch?v=27o3Ru2A06k

NL:
https://www.youtube.com/watch?v=r8IpJ8pzdd8
https://www.youtube.com/watch?v=oHc6exs7dP0

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Example related items CANS, RPS (Warren, Joekie, Kaitlyn)

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Example related items CANS, RPS (Warren, Joekie, Kaitlyn)

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Feedback IN: Well-developed treatment plan with treatment. Good to keep information / advice coming back every treatment

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Feedback IN: Prima uitgewerkte behandeling. Een detail, maar bij de bridge oef. zie ik de connectie met ADL niet echt. Het plaatje uitleg stress, is meer voor een fysio, dan passend bij pt. Het kan bij pt, wel korte, begrijpelijke uitleg erbij.

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Feedback IN: Well-developed treatment. A detail, but I don't see the choice for just a push-up. Instead of 2 or 3 strengthening exercises. And I don't know if the application of electro, Tens or massage is in line with a treatment goal. I don't apply that type of intervention.

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Daisy, Bas, Gijs
Feedback IN: prima uitgewerkte behandeling.
Zoals aangegeven in feedback bij opdracht 1, zorg dat je selecteert en van tevoren bedenkt watvoor type info je Mw gaat geven.

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Guus, Jan-Douwe, Fieke. assigment donderdag KANS RPS form

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Guus, Jan-Douwe, Fieke. assigment donderdag KANS RPS form

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Posture and pain and not well linked in the research

This means no if's, no but's, no maybe's or even worse...... "in my experience", which of course is completely ludicrous as someone else may have had exactly the opposite experience.

Who is right? Who the f**k knows? That's why we have science!!!!

Evidence based practice is a game of probabilities and the probabilities are well stacked against posture being a cause of many musculoskeletal problems.

There are far to many papers to list, so here is one each for some different areas of the body. If you think I have just cherry picked these, there really is shit loads of this stuff out there so go and have a look if you don't believe me!
Shoulder posture Cervical posture Lumbar posture Thoracic posture
For a more detailed discussion on posture please check this out on joint centration

We have no gold standard for what is good and bad posture. So what people base their correction or postural goal on has to be a reasonably arbitrary measure.

But just because we do not have a gold standard does not mean the research into posture is invalid because it is not studied in that way anyway!

Most papers seem to take a bunch of people in pain and then a bunch of people NOT in pain and then compare the postures between the two groups not against a gold standard of perfect posture.

Can a posture ever become a problem?

Yes.

Especially if it is the only one you have. But that is a movement problem not a postural problem.

The lumbar spine paper above shows this. There were no differences in the lordosis angle of people suffering with LBP but they did move slower and have less range of movement.

Even what we might consider a really good posture could be a problem if it does not have any movement!

We often swap something (bad) for something else (good - maybe) but we should be swapping it for 'something's' (plural) in the form of movement and the ability to move into many different postural positions.

The postures you adopt for too long may cause problems as well. Take your amazing posture and sit in front of the computer for 8 hours and it may start to let you know about it. The key again maybe the lack of moving not the posture you had to start with.

We have some cool sensors called Acid Sensing Ion Channels or ASICS within our tissues that sense changes in the ph value. If we don't move around, or put strain on our muscles and nerves that may reduce blood flow, then these little bad boys can sense the tissue becoming more acidic and transduce this into a sensation of discomfort or even pain.

Ever sat for to long in a lecture or seminar and felt the need to get up and stretch as you are feeling a bit sore? You probably just went through this process. ASICs may get even better at sensing changes if the cell body decides to pop some more ion channels down to the terminal ending so that sodium can get into the cell more easily and make you more sensitive to acidosis of the tissue.

What cause poor posture?

Well it could be pain.

In fact you may have looked at the problem the wrong way round. Pain may have been a driver to adopt an adaptive or potentially maladaptive position to reduce pain.

People with "poor posture" suffer from bouts of pain like us all, but if posture were the only driver for their pain they would probably be in permanent pain as, lets be honest people rarely seem to change their posture.

The habits people have will also probably outweigh the occasional stretch and strengthening that they do.This paper discusses exactly that!

Their conclusion being:
"objective data to indicate that exercise will lead to postural deviations are lacking. It is likely that exercise programs are of insufficient duration and frequency to induce adaptive changes in muscle tendon length"
In some cases, other factors such as our visual and vestibular systems may affect our postures too so it is not simply "short and tight" and "long and weak" muscles and if it does not seem to cause pain, then who cares anyway?!

Are you justified in attempting to change posture?

We may have to realize that success in trying to change posture maybe due to the process (through exercise or movement) of trying to change posture. This maybe the most important element in helping painful body parts become less painful, and not the outcome such as an actual significant change in the posture. So you would be totally justified giving a body part that has a lack of options (stuck) some more options (varied movement).

In fact rehab programs designed to change posture can help people out of pain without changing their posture as we see with resting scapular position!

As discussed before, if it is the only posture someone has - such as we may see at the lumbar spine with being hyper extended - focusing on this can often help. Whether success is contingent on getting a change in the posture is quite another matter entirely.

If your goal is to change the aesthetics of your or somebody else's body by trying to alter your posture then its up to you..... but good luck with that!
Are you a THERAPIST wanting to know more about a NO BS & evidenced based approach to helping your patients? Are you a TRAINER wanting to know more about a NO BS & evidenced based approach to helping your Clients?

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The definitive guide to posture & pain in 3 minutes flat! - Cor Kinetic

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This means no if's, no but's, no maybe's or even worse...... "in my experience", which of course is completely ludicrous as someone else may have had exactly the opposite experience. Who is right? Who the f**k knows? That's why we have science!!!!

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wat is de aard, de ernst, het beloop en de duur van de klachten?

Lichamelijk onderzoek

Cognitief: Eigen ideeën en gedachten over de klachten

Waaraan schrijft u de klachten toe?

Heeft bepaald gedrag invloed op de klachten (leidt tot meer of minder klachten), bewegingsangst?

Welke verwachtingen heeft u over het beloop (klachtenverergerende cognities, zoals dramatiseren of catastroferen of is er sprake van accepterende cognities)

Zijn er beheersingsmogelijkheden (denkt u invloed te hebben op de klachten, is er een gevoel van controle)?

Wat verwacht u van de huisarts?

Emoties: Gevoelens in relatie tot de klachten

Bent u wanhopig, angstig, boos, ongerust, moedeloos?

Wat is de aanleiding voor deze gevoelens?

Gedrag: Acties in verband met de klachten

Vermijdt u activiteiten? Wat is de reden? Helpt het?

Gaat u zo gewoon mogelijk door met uw activiteiten? Is er een reden om de activiteiten niet aan te passen? Helpt het?

Is er sprake van werkverzuim?

Sociaal: Welke invloed is er op het dagelijks leven?

Wat wil je graag doen en lukt het?

Ligt de nadruk op fysieke beperkingen of psychologische problemen

Hoe belangrijk zijn de ervaren beperkingen?

Hoe reageert de omgeving (bezorgd, onverschillig, negatief?)

Hoe gaat het op het werk?

Zijn er financiële consequenties?

2. Vermoeden

Bij vermoeden van depressie, angststoornis of alcoholproblematiek zijn de volgende voorbeeldvragen mogelijk:

Bent u de laatste tijd somber?

Heeft u de laatste tijd nog plezier?

Bent u de laatste tijd angstig, of maakt u zich zorgen?

Hoe reëel is die angst?

Welke invloed is er op het functioneren?

Vindt u (of uw omgeving) dat u teveel drinkt?

3. Voorbeelden

Voorbeelden in stand houdende biopsychosociale factoren

Biologisch-fysiologisch

Psychologisch

Sociaal

Uitputting

Spierspanning

Conditieverlies

Over/onderactiviteit

Angst-depressie

Hevige emoties

Inadequate cognities, zoals catastroferen

Inadequate coping zoals verzet of gedrevenheid

Gebrek aan sociale steun

Patiëntenrol-ziektewinst

Niet serieus genomen worden

Verlies van werk

De bouwstenen in de leerlijn SOLK

De leerlijnen

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wat is de aard, de ernst, het beloop en de duur van de klachten? Lichamelijk onderzoek Cognitief: Eigen ideeën en gedachten over de klachten Waaraan schrijft u de klachten toe? Heeft bepaald gedrag invloed op de klachten (leidt tot meer of minder klachten), bewegingsangst?

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Article SCEBS Method (Dutch: SCEGS Methode)

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Article SCEBS Method (Dutch: SCEGS Methode)

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Thuesday 7-4

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You can use X box-GAME Bar
Or press the windowsbutton and G together