Download Responsi Elektrofisika dan Sumber Fisis Pertemuan 6

PENERAPAN ELEKTROTERAPI
PADA KASUS KNEE DYSFUNCTION
Oleh:
Sugijanto
Disampaikan pada:
Kuliah MK Elektrofisika dan sumberfisis II
CLINICAL CASE OF KNEE
DYSFUNCTION
Quadriceps m. strain dan
Hamstring m. strain atau rupture.
• Krn cedera olah raga
• Tes isometric nyeri/lemah/timbul celah
• Intervensi:
– Stadium acute: PRICE
– Stadium lanjut: US/ Diathermy, Transverse
friction, manual stretching dan contract relax
stretching.
Anterior/posterior cruciat lig
sprain/rupture
• Oleh anterior/posterior knee injury (bumper
injury/jatuh berlutut)
• Test anterior/posterior shearing nyeri atau
hypermobile
• Intervensi:
– Disamping treatment standar diberikan sbb:
– Passive stabilization dgn knee cage atau knee
support.
– Active stabilization exc.
Collateral medial/lateral knee
sprain/rupture
• Injury valgus/varus
• Valgus/varus test lutut nyeri/hypermobile.
• Intervensi:
– Stadium acute: PRICE
– Stadium lanjut: US, Transverse friction,
– Passive stabilization dgn knee cage / knee
support
– Active stabilization exc.
Iliotibial band friction syndrome
 Genu varus pd pelari
 Tendinitis iliotibial band setinggi condylus lateralis
femur.
 Gerak pasif nyeri dan snapping pd condylus
lateralis femur
 Palpasi pada condylus lateralis femur nyeri
 Intervensi:


US dan transverse friction
Lateral wedge shoes
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
Elastic knee support
HYDROPS
•Patologi intra articular
•Permukaan sendi, meniscus,
lig.meniscotibiale, capsule
•Injury, Rheumathid arthritis,
Osteoarthrosis, Meniscus
lesion,
Ballotement test
Fluctuation test.
Intervensi tergantung penyebab.
US dan elastic bandaging
Osteoarthrosis Lutut
Degenerasi
Modalitas fisis
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
Corpus libera
Kontraktur
Joint blockade
JPM: Nyeri akhir
ROM / Firm end feel
Joint blockade
Manipul corpus
libera
Weight control
Chondromalacia patellae
Degenerasi
Cidera trtm
odd facet
Erosi
Penebalan tl
subchondral
Osteofit
Iritasi jar
Micro injury
Genu valgus
Nyeri patella
Nyeri posisi
300 flex
Compression
test +
Ballotement ±
Lemah m.vastus
medialis
Medial wedge
shoes
Friction
Strength m.vastus
medialis
Modalities
Pes anserinus syndrome
Genu valgus
Lig. Collateral medial laxity
Osteoarthrosis
Muscle spasm
Nyeri
medial lutut
Strocking-effleurage
Tendomyosis
Antalgic gait
Transverse friction
Tendinitis
Tender &
spasm palpated
Medial wedge shoes
Modalilities
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
Unicompartmental,
umumnya medial
Unconstrain
arthroplasty
Unconstrain hinge
arthroplasty
ARTHROPLASTY
Cemented
Non cemented
Early
mobilization
Must stable
mobilization
Ukur ROM sebelum
operasi
Isometric exercise
Mulai sejak 24 jam
pertama post op
Range secara bertahap
Kelemahan
quadriceps
Mobilisasi pasif
patella
Dlm 7-14 hr post op
flexion 70 - 900
Max 1100 flx
Continous Passive Movement
Hr 3 jalan dgn
back splint