1. STUDI KASUS LOWER EXTREMITY
Oleh:
Sugijanto

2. Osteoarthrosis Lutut Nyeri & kaku lutut Antalgic gait
Degenerasi
Over weight
Over used
Injury
Fragmentasi & erosi rawan sendi
Nyeri & kaku lutut
Joint mobiliz
Antalgic gait
Muscle mobiliz
Hipertrofi subchodr. & osteofit
Rom: Flx < Ext Firm end feel
Manipul corpus libera
Corpus libera
JPM: Nyeri akhir ROM / Firm end feel
Kontraktur
Weight control
Joint blockade
Joint blockade

3. Meniscus lesion Abd homolat-Rot kontralat-kompresi + Ext (flex)
Meniscus rupture
Penguncian extensi (fleksi)
Nyeri & mengunci
Manipulasi meniscus (kontra tes)
Non capsular pat + krepitasi meniskus
Stabilisasi pasif
Meniscus test + (tes tumit)
Strengthening - cycling

4. Chondromalacia patellae
Lemah m.vastus medialis
Degenerasi
Micro injury
Genu valgus
Cidera trtm odd facet
Nyeri patella
Medial wedge shoes
Nyeri posisi 300 flex
Erosi
Friction
Penebalan tl subchondral
Compression test +
Strength m.vastus medialisn
Osteofit
Ballotement ±
Iritasi jar

5. Knee instability Meniscus Lig. Collateral medial Varus test
Lig Laxity
Muscle dysbalance
Meniscus
Lig. Collateral medial
Varus test
Passive & active stabilization
Lig. Collateral lateral
Valgus test
Lig. Cruciatum anterior
Anterior shearing test
Lig.Cruciatum posterior
Posterior shearing test

6. Pes anserinus syndrome
Genu valgus
Lig. Collateral medial laxity
Osteoarthrosis
Nyeri medial lutut
Strocking-effleurage
Muscle spasm
Transverse friction
Tendomyosis
Antalgic gait
Tender & spasm palpated
Medial wedge shoes
Tendinitis

7. Flat foot Medial arc support shoes Strengthening exc. Toes flexors
Bawaan
Over weight
External rotated leg
Nyeri medial foot (knee)
Palpasi nyeri navicular
Medial arc support shoes
Antalgi gait
Stretch test lig. Plantar foot
Navicular nonjol medial
Strength test
Strengthening exc. Toes flexors
Calcaneal valgus
Pengukuran longit arc
Pronation foot

8. Plantar fasciitis – calcaneal spur
Repetitive Stretching apponeurosis plantaris
Degenerasi
Over weight
Nyeri tumit/plantar
U S
Antalgic gait, heel strike-foot flat ±
Palpasi nyeri plantar fascia & calcaneus
Transverse friction
Stretch test Plantar fascia
Donnut pad-medial arc suport shoes
Strength test otot flexors

9. Ankle sprain Rest Ice Compression Elevation Joint mobilization
Active unstable foot
Inversion injury
Rest
Nyeri lateral (medial) foot
Ice
Acute Akt. tinggi
Compression
Riwayat injury
Elevation
Antalgic gait
Joint mobilization
Nyeri inversi (eversi) ROM ±
KronikAkt. rendah
Active stabilization
Acute edema

10. Gouty arthritis Medicamentosa US under water Joint mobilization
Metabolism
Endapan purin
Inflamasi
Awal MTP I
Nyeri tajam ibu jari kaki
Gait analysis Toe off
Medicamentosa
ROM MTP I terbatas
US under water
Non capsular pattern
Palpasi: Tenderness
Joint mobilization
Joint blockade arah tertentu

11. DAFTAR PUSTAKA
Cook CE, Osthopaedic Manual Therapy, Pearson Prentice Hall, New Jersey, 2007
Goodmann & Boissaunnault, Pathology implication for physiotherapy. WB Saunders co, London, 2000.
Helting D & Kessler RM, Management of common musculoskeletal disorder, ippincott Williams and Wilkins, Philadelphia, 2006.
Makofsky HW, Spinal Manual Therapy, Slack inc, NJ USA, 2003
Meadows JTS, Orthopaedic Differential Diagnosis in Physisal therapy, Mc Graw-Hill, NY, 1999.
Van der El, A, Lunacek, P and Wagemaker, A, Manuele therapie, wervelkolom onderzoek, deel 1, Uitgeverij Manuwel, Roterdam, Ed. I,
Van der El, A, Lunacek, P and Wagemaker, A, Manuele therapie Wervelkolom Behandeling, deel 2, Uitgeverij Manuwel, Roterdam, Ed. I, 1989.
Dvorak, J and Dvorak, V, Medical checklists Manual Medicine, Gerg Thieme Verlag Stuttgart, New York, 1991.