MANUAL TERAPI ANKLE AND FOOT
Transcript of MANUAL TERAPI ANKLE AND FOOT
MANUAL TERAPI MANUAL TERAPI ANKLE AND FOOTANKLE AND FOOT
INTERVENSIINTERVENSI
Oleh:Oleh:SugijantoSugijanto
Disampaikan pada kuliah reguler Disampaikan pada kuliah reguler Manualterapi IIManualterapi II
TUJUAN INSTRUKSIONALTUJUAN INSTRUKSIONAL Mahasiswa memahami Intervensi pada Mahasiswa memahami Intervensi pada
kasuistik Ankle and foot complex dengan kasuistik Ankle and foot complex dengan cara :cara :
Mampu menjelaskan metoda dan dosis Mampu menjelaskan metoda dan dosis intervensi manualterapi kasus intervensi manualterapi kasus Ankle and Ankle and foot complexfoot complex
Mampu membedakan indikasi antara Mampu membedakan indikasi antara metoda dengan pemeriksaan khusus.metoda dengan pemeriksaan khusus.
Mampu mempraktek intervensi Mampu mempraktek intervensi manualterapi kasus Ankle and foot complexmanualterapi kasus Ankle and foot complex
Mampu menilai tentang hasil intervensi Mampu menilai tentang hasil intervensi manualterapi kasus Ankle and foot complex. manualterapi kasus Ankle and foot complex.
PERTANYAAN STUDIPERTANYAAN STUDI Sebutkan indikasi intervensi metoda Sebutkan indikasi intervensi metoda
manualterapi bila dijumpai patologi muscle pain manualterapi bila dijumpai patologi muscle pain sec. Tendinitis, Muscle tightness/contracture, sec. Tendinitis, Muscle tightness/contracture, Capsular pattern hypomobility, Joint Capsular pattern hypomobility, Joint hypermobility, Joint instability, dan sensoric hypermobility, Joint instability, dan sensoric deficit sec nerve entrapment.deficit sec nerve entrapment.
Uraikan dan praktekkan Teknik transverse Uraikan dan praktekkan Teknik transverse friction pada: lig. Talofibulare; lig. friction pada: lig. Talofibulare; lig. Talocalcaneal, lig. Tibiofibulare, lig. tibiotalare; Talocalcaneal, lig. Tibiofibulare, lig. tibiotalare; tendon achilles; m. peroneus longus, m. tendon achilles; m. peroneus longus, m. peroneus brevis, m. tibialis anterior; m. tibialis peroneus brevis, m. tibialis anterior; m. tibialis posterior. posterior.
Uraikan dan praktekkan Joint mobilisation Uraikan dan praktekkan Joint mobilisation traksi, translasi dan roll slide pada sendi traksi, translasi dan roll slide pada sendi Ankle, subtalar, chopard, MTP and PIP-DIP.Ankle, subtalar, chopard, MTP and PIP-DIP.
Uraikan dan praktekkan mobilisasi otot Uraikan dan praktekkan mobilisasi otot dan contract relax stretching pada dan contract relax stretching pada tightness/contracture m. Gastrocnemius, tightness/contracture m. Gastrocnemius, m. soleus, m tibialis anterior.m. soleus, m tibialis anterior.
Jelaskan dan praktekkan terapi latihan Jelaskan dan praktekkan terapi latihan pada Ankle and foot complex.pada Ankle and foot complex.
Jelaskan dan praktekkan pengukuran hasil Jelaskan dan praktekkan pengukuran hasil pada intervensi Ankle and foot complex.pada intervensi Ankle and foot complex.
INTERVENTIONINTERVENTION MASSAGEMASSAGE
Oedeme reduce massageOedeme reduce massage
MUSCLE MOBILIZATIONMUSCLE MOBILIZATION Muscle manipulationMuscle manipulation
MUSCLE STRETCHINGMUSCLE STRETCHING Gastroc nemius m.Gastroc nemius m. Soleus m.Soleus m.
TRANSVESE FRICTIONTRANSVESE FRICTION Gastrocnemius mGastrocnemius m
Achilles tendon:Achilles tendon: Permukaan posteriorPermukaan posterior Permukaan lateral-medialPermukaan lateral-medial Permukaan anteriorPermukaan anterior
Anterior tibial m.Anterior tibial m. Aterior tibial tendonAterior tibial tendon Peroneus longus and Peroneus longus and
brevis msbrevis ms Peroneus longus and Peroneus longus and
brevis tendonbrevis tendon
JOINT MOBILIZATIONJOINT MOBILIZATION Translation of distal Translation of distal
tibiofibular jointtibiofibular joint Dorsal translationDorsal translation
Traction of Ankle joint :Traction of Ankle joint : In MLPPIn MLPP (Awal mobilisasi/ aktualitas tinggi)(Awal mobilisasi/ aktualitas tinggi)
In Limited dorsal flexionIn Limited dorsal flexion (Menambah ROM dorsal flexion)(Menambah ROM dorsal flexion) In Limited plantar flexionIn Limited plantar flexion (Menambah ROM dorsal flexion)(Menambah ROM dorsal flexion)
Translation of Ankle joint :Translation of Ankle joint : In Limited dorsal flexionIn Limited dorsal flexion (Menambah ROM dorsal (Menambah ROM dorsal
flexion)flexion) In Limited plantar flexionIn Limited plantar flexion (Menambah ROM dorsal (Menambah ROM dorsal
flexion)flexion)
Intermetatarsal Intermetatarsal TranslationTranslation Dorsal and plantar Dorsal and plantar
translation MT1, translation MT1, MT3, MT4 and MT5MT3, MT4 and MT5
Koreksi transverse Koreksi transverse arcarc
Traction to MTP joint I (II,III,IV & V):Traction to MTP joint I (II,III,IV & V): In MLPPIn MLPP
Awal mobilisasi/aktualitas tinggiAwal mobilisasi/aktualitas tinggi In Limited dorsal flexionIn Limited dorsal flexion
(Menambah ROM dorsal flexion)(Menambah ROM dorsal flexion) In Limited plantar flexionIn Limited plantar flexion
(Menambah ROM plantar flexion)(Menambah ROM plantar flexion)
Translation to MTP joint I Translation to MTP joint I (II,III,IV & V):(II,III,IV & V): In Limited dorsal flexionIn Limited dorsal flexion (Menambah ROM dorsal (Menambah ROM dorsal
flexion)flexion) In Limited plantar flexionIn Limited plantar flexion (Menambah ROM plantar (Menambah ROM plantar
flexion)flexion)
Manipulation to lesion.Manipulation to lesion.
Passive stabilizationPassive stabilization
Elastic bandageElastic bandage TappingTapping Medial arc supportMedial arc support Medial wedge shoeMedial wedge shoe AFOAFO
EXERCISEEXERCISE
MUSCLE REEDUCATIONMUSCLE REEDUCATION.. Active stabilization exercises.Active stabilization exercises.
Active strengthening Active strengthening exercisesexercises
EVALUASIEVALUASI Pain: VAS/ VRS/ VDSPain: VAS/ VRS/ VDS ROM: GoneometerROM: Goneometer Strength: MMT/Hand held Strength: MMT/Hand held
dynamometer/Spigmomanometer.dynamometer/Spigmomanometer.
Flat footFlat foot
Bawaan Over weight External rotated leg
Nyeri medial foot
(knee)
Navicular nonjol medial
Calcaneal valgus
Pronation foot
Antalgi gaitMedial arc
support shoes
Strengthening exc. Toes flexors
Palpasi nyeri
navicular
Pengukuran longit arc
Stretch test lig. Plantar
foot
Strength test
Plantar fasciitis – calcaneal spurPlantar fasciitis – calcaneal spur
Degenerasi Over weight Repetitive Stretching
apponeurosis plantarisNyeri
tumit/plantarAntalgic gait,
heel strike-foot flat ±
U S
Transverse friction
Donnut pad-medial arc
suport shoes
Palpasi nyeri plantar fascia &
calcaneusStretch test
Plantar fascia
Strength test otot flexors
Ankle sprainAnkle sprain
Active unstable foot
Inversion injury
Nyeri lateral (medial) foot
Riwayat injury
Antalgic gait
Acute edema
Nyeri inversi (eversi) ROM
±
Acute Akt.
tinggi
KronikAkt. rendah
Rest Ice
Compression
Elevation
Joint mobilization
Active stabilization
Gouty arthritisGouty arthritis
Metabolism Endapan purin
Inflamasi Awal MTP I
Nyeri tajam ibu jari kaki
Gait analysis Toe off
ROM MTP I terbatas
Non capsular pattern
Joint blockade arah tertentu
Palpasi: Tenderness
Medicamentosa
US under water
Joint mobilization
DAFTAR PUSTAKADAFTAR PUSTAKA Cook CE, Cook CE, Osthopaedic Manual Therapy,Osthopaedic Manual Therapy, Pearson Prentice Hall, New Pearson Prentice Hall, New
Jersey, 2007Jersey, 2007 Goodmann & Boissaunnault, Goodmann & Boissaunnault, Pathology implication for Pathology implication for
physiotherapy. physiotherapy. WB Saunders co, London, 2000.WB Saunders co, London, 2000. Helting D & Kessler RM, Helting D & Kessler RM, Management of common musculoskeletal Management of common musculoskeletal
disorder, disorder, ippincott Williams and Wilkins, Philadelphia, 2006.ippincott Williams and Wilkins, Philadelphia, 2006. Makofsky HW, Makofsky HW, Spinal Manual Therapy,Spinal Manual Therapy, Slack inc, NJ USA, 2003 Slack inc, NJ USA, 2003 Meadows JTS, Meadows JTS, Orthopaedic Differential Diagnosis in Physisal Orthopaedic Differential Diagnosis in Physisal
therapy,therapy, Mc Graw-Hill, NY, 1999. Mc Graw-Hill, NY, 1999. Van der El, A, Lunacek, P and Wagemaker, A, Van der El, A, Lunacek, P and Wagemaker, A, Manuele therapie, Manuele therapie,
wervelkolom onderzoekwervelkolom onderzoek, deel 1, Uitgeverij Manuwel, Roterdam, Ed. , deel 1, Uitgeverij Manuwel, Roterdam, Ed. I, 1983.I, 1983.
Van der El, A, Lunacek, P and Wagemaker, A, Van der El, A, Lunacek, P and Wagemaker, A, Manuele therapie Manuele therapie Wervelkolom BehandelingWervelkolom Behandeling, deel 2, Uitgeverij Manuwel, Roterdam, , deel 2, Uitgeverij Manuwel, Roterdam, Ed. I, 1989.Ed. I, 1989.
Dvorak, J and Dvorak, V, Dvorak, J and Dvorak, V, Medical checklists Manual MedicineMedical checklists Manual Medicine, Gerg , Gerg Thieme Verlag Stuttgart, New York, 1991.Thieme Verlag Stuttgart, New York, 1991.