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‘Functionele Hallux Limitus Test’ Les4 : De Voorvoet : Sagittal plane fascilitation of motion.

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Presentatie over: "‘Functionele Hallux Limitus Test’ Les4 : De Voorvoet : Sagittal plane fascilitation of motion."— Transcript van de presentatie:

1 ‘Functionele Hallux Limitus Test’ Les4 : De Voorvoet : Sagittal plane fascilitation of motion.

2 Functionele hallux Limitus Wat je moet weten of opzoeken Achtergrond Wat is het (niet)? Uitganghouding patiënt Uitgangshouding therapeut Parameters Hoe waarde toekennen? Interpretatie Compensatie ‘sagitaal blok’ Literatuur

3  Achtergrond van Sagittal Plane Fascilitation of motion.  Wat is betrouwbaarheid?  Wat is validiteit?  MTP 1: Soort gewricht? ROM? Beweging? Wat je moet weten of opzoeken

4 Sagittal plane fascilitation of motion Principles this theory is based on:  The foot must be able to resist forces that are applied to it.  This must co-ordinate with the power input which is required to move the body forward over the foot.  The foot has its 3 autosupportive mechanisms - Dananberg, H.: Functional Hallux Limitus and its effect on normal ambulation. Current Podiatric Medicine 34, pp.1-16, Dananberg, H.: Functional Hallux Limitus and its relationship to Gait Efficiency. JAPMA Vol.76, November, Dananberg, H.: Gait Style as an Etiology to chronic Postural Pain, part 1 functional hallux limitus. JAPMA Vol.83, Augustus, 1993.

5 Autosupport 1: Hicks (1954): Windlass Mechanism Sagittal plane fascilitation of motion - Dananberg, H.: Gait Style as an Etiology to Chronic Postural Pain, Part II, postural compensatory process. JAPMA Vol.83, November, Dananberg, H.: Chronic Low-Back Pain and its Response to custom-Made Foot Orthoses. JAPMA Vol.89, maart, 1999.

6  Plantaire fascia spant aan  Voetboog komt omhoog  Tibia gaat exo roteren  Calcaneum gaat inverteren Autosupport : Hicks et al. (1954)

7 Autosupport 2: Bösjen-Mollor (1979): -close packing of calcaneocuboid joint -high gear/low gear push off Sagittal plane fascilitation of motion - Payne, CB.: Sagittal Plane Facilitation of the foot. Australasian Journal of Podiatric Medicine 31, pp. 7-11, Lee, W.E.: Podiatric Biomechanics: An Historical appraisal and Discussion of the Root Model as a Clinical System of Approach in the Present Context of Theoretical Uncertainty. Clinics in podiatric Medicine and Surgery 18 (4), pp , October Bojsen-Moller F.: Calcaneocuboid joint and stability of the longitudinal arch of the foot at high and low gear push off. Journal of Anatomy 129(1), pp , 1979.

8 Autosupport 3: Locked Wedge Effect  Posterior Tibial muscle and Peroneus Longus keep the base together.  The shape of the bones in the midfoot are more or less trapezium shaped.  In function it will support itself… Sagittal plane fascilitation of motion

9 Autosupport 3: Locked Wedge Effect  Posterior Tibial muscle and Peroneus Longus keep the base together. Sagittal plane fascilitation of motion

10 Uitgangshouding patiënt OnbelastBelast

11  Zittend, voor de voet van de patiënt  Knielend voor de voet van de patiënt Uitgangshouding Therapeut

12 Differentiaal diagnose : Hallux Rigidus = structureelHallux Limitus = structureel Functionele Hallux Limitus = functioneel

13 RX : Hallux Rigidus = géén mobiliteit

14  Extensie mogelijkheid, open kinetische keten.  Extensie mogelijkheid mét en zonder weerstand van de therapeut.  Extensie mogelijkheid mét en zonder weerstand van de GRK Parameters

15 Positive functional hallux limitus test  A: A load is applied to the first metatarsal head to simulate ground reaction force.  B: As dorsi flexion of the toe is attempted, there is a jamming at the first metatarso phalangeal joint. Interpretatie

16 Negative functional hallux limitus test  A: Plantar flexion of the first metatarsal.  B: Stability of the arch is achieved through the windlass mechanism once dorsiflexion of the first MTP joint is achieved

17 Compensaties voor ‘sagitaal blok’ 1.Veranderde hiellift  Vertraagd (Mid foot brake/collaps)  Afwezig gedurende ‘single support phase’ 2.Verticale Toe Off 3.Geïnverteerd stappatroon 4.Geabduceerd stappatroon 5.Flexie compensatie van het lichaam

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19 Clinical pearls clinical pearl : een korte, straightforward, stukje klinisch advies By Mark Russel

20 Clinical pearls clinical pearl : een korte, straightforward, stukje klinisch advies By 1 ste podo

21 Clinical pearls clinical pearl : een korte, straightforward, stukje klinisch advies By 1 ste podo

22  Dananberg HJ. Gait style as an etiology to chronic postural pain. Part 1. Functional hallux limitus. J Am Podiatr Med Assoc 1993;83(8):  Payne C, Chuter V, Miller K. Sensitivity and specificity of the functional hallux limitus test to predict foot function. J Am Podiatr Med Assoc 2002;92(5):  Dananberg HJ. Sagittal plane biomechanics. In: Subotnick SI, ed. Sports Medicine of the Lower Extremity. New York: Churchill Livingstone;1999:  Van Gheluwe B, Dananberg HJ, Hagman F, Vanstaen K. Effects of hallux limitus on plantar foot pressure and foot kinematics during walking. J Am Podiatr Med Assoc 2006;96(5):  s_PF.pdf Literatuur


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