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    Manual Terapi Hip Complex

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    nurul
    The document provides guidelines for manual therapy of hip complexes. It outlines goals of distinguishing anterior, lateral, and posterior hip pain and performing accurate assessments to diagnose hip issues. Common hip pains seen include anterior hip pain from femoral neck issues, lateral hip pain from piriformis syndrome, and gluteal pain from ischiadic bursitis. Specific tests and interventions are described to accurately assess range of motion, muscle function, and pain patterns to determine the source of hip pain and appropriate manual therapy interventions.

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    Manual Terapi Hip Complex

    Uploaded by

    nurul
    50 views28 pages
    The document provides guidelines for manual therapy of hip complexes. It outlines goals of distinguishing anterior, lateral, and posterior hip pain and performing accurate assessments to diagnose hip issues. Common hip pains seen include anterior hip pain from femoral neck issues, lateral hip pain from piriformis syndrome, and gluteal pain from ischiadic bursitis. Specific tests and interventions are described to accurately assess range of motion, muscle function, and pain patterns to determine the source of hip pain and appropriate manual therapy interventions.

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    Original Title

    DOC-20190304-WA0007

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    The document provides guidelines for manual therapy of hip complexes. It outlines goals of distinguishing anterior, lateral, and posterior hip pain and performing accurate assessments to diagnose hip issues. Common hip pains seen include anterior hip pain from femoral neck issues, lateral hip pain from piriformis syndrome, and gluteal pain from ischiadic bursitis. Specific tests and interventions are described to accurately assess range of motion, muscle function, and pain patterns to determine the source of hip pain and appropriate manual therapy interventions.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    50 views28 pages

    Manual Terapi Hip Complex

    Uploaded by

    nurul
    The document provides guidelines for manual therapy of hip complexes. It outlines goals of distinguishing anterior, lateral, and posterior hip pain and performing accurate assessments to diagnose hip issues. Common hip pains seen include anterior hip pain from femoral neck issues, lateral hip pain from piriformis syndrome, and gluteal pain from ischiadic bursitis. Specific tests and interventions are described to accurately assess range of motion, muscle function, and pain patterns to determine the source of hip pain and appropriate manual therapy interventions.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 28

    MANUAL TERAPI HIP

    COMPLEX
    Goals
    • Membedakan : Anterior, Lateral, and
    Posterior Hip Pain
    • Melakukan pemeriksaan yang benar dan
    mengetahui dan mendiagnosis masalah
    yang terjadi
    • Menghasilkan pemeriksaan yang benar
    Scope of the Problem

    • Dalam praktek fisioterapi terdapat pasien


    dengan keluhan nyeri hip 1 – 2 kali
    perminggu.
    • 0,61% dari semua home visit, terdapat 164
    kali pertemuan dg hip pain.
    • 14,3% pasien dg usia 60 th significant dg
    nyeri hip lebih dari 1 hari sampai 6 minggu
    Anterior Hip Pain

    • Nyeri Paha = ingat


    patologi pada hip
    Neck shaft angle of femur
    Force on the Hip

    • Berdiri : 0,3 kali berat badan


    • Berdiri dengan salah satu kaki : 2,4 – 2,6
    kali berat badan
    • Berjalan : 1,3 – 5,8 kali berat badan
    • Berjalan mendaki/naik tangga : 3 kali berat
    badan
    • Berlari : 4,5 + kali berat badan
    Pathological gait of hip pathology
    Antalgic gait Joint pain

    Duchene gait Bilateral hip arthrosis

    Trendelen berg Hip abductor weakness


    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


    Red
    flag
    Screening
    questionair
    SPECIFIC TEST
    Inguinal & pelvic pain -
    Hip Osteoarthrosis
    Degenerasi
    Over weight Over used Injury

    Fragmentasi & Nyeri & kaku hip Joint mobiliz


    erosi rawan sendi
    Duchene
    Hipertrofi subchodr. Muscle mobiliz
    Rom:extern rot<
    & osteofit
    Abd < intern rot
    Firm end feel Manipulasi
    Corpus libera corpus libera
    JPM: Nyeri akhir
    ROM / Firm end feel
    Kontraktur Weight control
    Joint blockade
    Joint blockade
    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
    PEMERIKSAAN FUNGSI GERAK
    DASAR
    • Tc
    – Nyeri dan terbatas pada semua arah
    gerakan hip joint
    – Rotasi internal nyeri/terbatas firm
    end feel
    • Tes fungsi
    – Nyeri dan terbatas dengan crepitasi
    pada gerak pasif hip joint
    – internal rotasi<abduksi<fleksi firm end
    feel  Capsular pattern
    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
    INTERVENSION
    • Intervensi
    • Joint mobilization
    • Manipulasi corpus libera
    • Active mobilization exercise
    • Weight control
    • Reevaluasi: pain
    GLUTEAL & HAMSTRINGS
    PAIN - PIRIFORMIS SYNDROME
    Patologi lain Spasm/tight Entrapment n. ischiadic

    Myofascial release
    Nyeri gluteal
    Muscle spasm/
    tightness Contract relax stretching
    Paresthesia paha Neural adhesion piriformis
    belakang

    Flx-Ext test Strengthening Exc gluteal


    ms
    Palpasi: spasm
    Palpasi
    Hindari dompet
    Contract relax Slump test disaku/berdiri lama
    stretch test +
    LLTT
    ASSESSMENT
    • Low back manouvre I: fleksi-
    adduksi-rotasi internal nyeri
    gluteal.
    • Palpasi m. piriformis hypertone dan
    nyeri.
    • Contract relax stretch test m.
    piriformis
    • Upper ischiadic nerve test
    INTERVENSI
    • Relax massage
    • Contract relax stretching m.
    piriformis
    • Menghindari duduk ditempat keras
    • Auto stretching
    • Neural mobilization
    Gluteal pain - Bursitis
    ischiadica

    Rheumatism
    Inflamasi
    Iritasi bursa ischiadica

    Nyeri gluteal Transverse friction

    ROM & isom Inflamasi kronik


    Iritasi duduk alas keras Strengthening gluteal ms
    normal

    Palpasi: Hindari duduk alas keras


    Tenderness
    PEMERIKSAAN FUNGSI GERAK
    DASAR
    • Tc
    – Fleksi panggul
    • Tes fungsi
    – Gerak pasif abduksi penuh hip joint nyeri
    – Fleksi penuh dan adduksi penuh sering nyeri
    – Terasa nyeri pada gerak isometric abduksi,
    ekstensi dan rotasi eksternal hip join
    • Tes khusus
    • Palpasi: tenderness diatas tuber ischiadicum
    menyebar ke dermatome L5
    INTERVENSI
    • Intervensi:
    • Transverse friction diatas
    tuber isciadicum
    • Active strengthening exercise
    otot gluteal

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