Manual terapi lower quadrant

Oleh: Sugijanto
Disampaikan pada:
Kuliah Manual Terapi UMS
KASUS TERSERING PD
THORACO-LUMBAR
SPINE- PELVIS

Sugijanto, 2013
CONTOH NYERI PUNGGUNG
BAWAH

Buat hipotesis awal

Uji hipotesis anda dengan pemeriksaan
tingkat ICD dilanjutkan tingkat ICF dengan
menggunakan evidence base practice.
Buat diagnosis fisioterapi sesuai ICF
Buat perencanaan program
Lakukan prosedur intervensi
Lakukan evaluasi
THORACIC SPINE MOBILITY
DEFICITE

Sugijanto, 2013
FISIOTERAPI PADA PATOLOGI
MUSCULOSKELETAL LOWER
EXTREMITY

 Oleh: Sugijanto
 Disampaikan Pada:
 Work shop Clinical instructor Fisioterapi
 Denpasar, Nopember 2013

Sugijanto, 2013
FISIOTERAPI HIP
COMPLEX

Sugijanto, 2013
Pathological gait of hip
pathology
Antalgic gait Joint pain

Duchene gait Bilateral hip arthrosis

Trendelen Hip abductor weakness

berg gait

Hip flexion Hip flexion contracture

contracture gait

Pelvic torsion gait Unilat eral hip flexion

contracture

Hip abduction gait Hip abductor contract/ Plantar

flx spasticity/contr

Leg discrepancy gait Hip flexion contracture

Sugijanto, 2013
Red flag

Sugijanto, 2013
Screening
questionair

Sugijanto, 2013
NYERI LATERAL PANGGUL HINGGA
INGUINAL

• Hipotesis awal:
• Osteoartitis Coxae
• Dilakukan pemeriksaan secara
algoritme dengan menggunakan
evidence base practice untuk
menegakkan atau menolak

Sugijanto, 2013
 Inguinal & pelvic pain - Hip
Osteoarthrosis
Degenerasi

Over weight Over used Injury

Fragmentasi &
Anamnesis: Nyeri Passive test Rom
erosi rawan sendi
& kaku hip terbatas :extern
Bangun tidur nyeri rot< Abd < intern
Hipertrofi subchodr.
rot Firm end feel
& osteofit Capsule
Inspeksi Gait:
JPM: Nyeri akhir
Corpus libera Duchene
Range , elatic/Firm
end feel
Kontraktur
Joint blockade Sugijanto, 2013
 Process of Physiotherapy for Joint
surface impairment
Aktif: Nyeri Joint
range tertentu mobilization

Alignment
Gait: Antalgic
Nyeri correction
kompresi Bila
Bila negatif positif
 ganti
Compression hipotesis
test nyeri lain Active
stabilization

Distraction test
Weight
nyeri hilang
bearing
reduce
Sugijanto, 2013
 Hip Mobility Deficits
ICD-9-CM codes: 843.1 Sprain of the ischiocapsular
ligament
ICF codes: Activities and Participation Domain codes:
d4500 Walking short distances (Walking for less than a kilometer, such
as walking around rooms or hall ways, within a building or for short
distances outside.)
d4500 Walking long distances (Walking for more than a kilometer, such
as across a village or town, between villages or across open areas.)
d4154 Maintaining a standing position (Staying in a standing position for
some time as required, such as when standing in a queue.)
Body Structure code: s75001 Hip joint
Body Functions code: b7100 Mobility of a single joint

Sugijanto, 2013
TES KHUSUS
Tes khusus
◦ JPM test internal rotasi, adduksi, fleksi
hip joint, firm end feel.
◦ Cranial compression of the hip joint,
◦ Tes corpus libera
Pemeriksaan lain
◦ X ray: penyempitan sela sendi;
penebalan tulang subchondrale;
osteophyte
Sugijanto, 2013
 PENATALAKSANAAN FISIO-
MANUALTERAPI PADA PATOLOGI
REGIO PERG KAKI DAN KAKI

Sugijanto, 2013
 ANKLE & FOOT
CONTRACTURE POST
IMMOBILIZATION
Pasca
injury/fraktur dll
Joint mobilization
Imobilisasi post Awas:
op/gips: capsular Cenderung
pattern pes cavus, Capsel-lig contract/
lesi saraf, muscle tigthness/
Osteogen Neural adhesion, dll
Joint play mov:
terbatas firm end blockade, Active exercises
feel

X ray: konsulidasi?
Sugijanto, 2013
TEST & Pengkajian:
INTERVENSION ◦ Gait analisis
◦ Keterbatasan grk capsular pattern
◦ JPM test nyeri terbatas dgn firm end feel
Intervensi:
◦ Joint mobilization
◦ Balance and stability exc
◦ Gait training
Reevaluasi: pain, ROM, Balance, Gait

Sugijanto, 2013