Your SlideShare is downloading. ×

Bab 9 kecederaan bahagian bawah tubuh

2,828
views

Published on


0 Comments
4 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
2,828
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
136
Comments
0
Likes
4
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. Department of Sport & Exercise ScienceKECEDERAAN DAN REHABILITASI SUKAN (DKK 4114) KECEDERAAN BAHAGIAN BAWAH Khairul Azlan Taib BSc .(hons) UiTM
  • 2. KECEDERAAN LUTUT
  • 3. Medial Collateral Ligament Sprain• Cause – Medially directed valgus force from lateral side or external rotation• Signs of injury – Grade 1 • Few ligament fibers are torn or stretched, joint stable during valgus stress test • Tenderness & stiffness below medial line.
  • 4. Sambungan.. – Grade 2 • A complete tear of deep capsular ligament and partial tear of the superficial layer of MCL. • Minimum slight laxity during full Extension • Inability to actively extension knee (joint tightness) • Slight or absent swelling. • Loss passive ROM • Pain in medial aspects, with general weakness and instability.
  • 5. – Grade 3 • Complete tear of ligaments • Loss of medial stability • Minimum to moderate swelling • Loss ROM • Valgus stress reveals some joint opening
  • 6. Medial Collateral Ligament Sprain
  • 7. Medial Collateral Ligament Sprain• Treatment – RICE for at least twenty-four hours – Crutches are prescribed if the athlete is unable to walk without a limp. – Cryokinetics - including 5 min of ice pack treatment, combination of cold and compression or ultra sound.
  • 8. Lateral Collateral Ligaments Sprain• Cause – Laterally directed varus force from medial side or from internal rotation of tibia• Signs – Grade 1 • Ligament fibers are torn or stretched, joint stable during varus stress test • Tenderness & stiffness below lateral line.
  • 9. Sambungan .. – Grade 2 • moderate tearing or partial separation • Pain in lateral aspects – Grade 3 • Complete tear of ligaments • Loss of medial stability • Swelling • Loss ROM • Varus stress reveals some joint opening
  • 10. Lateral Collateral Ligaments Sprain
  • 11. Lateral collateral ligament sprain• Treatment – RICE sekurang kurangnya 24 jam pertama – Crutches diberikan jika atlet tidak dapat berjalan. – Brace – untuk sokongan pada knee. – Cryokinetics - including 5 min of ice pack treatment, combination of cold and compression or ultra sound.
  • 12. Anterior Cruciate Ligament Injury• Penyebab – Femur & leg bones twist dalam arah yang berlawanan.• Signs – Bunyi “Pop” semasa kecederaan terjadi – Immediate disability. – Bengkak pada joint line. – Intense pain initially then begin feel the knee not badly hurt
  • 13. Anterior Cruciate Ligament Injury• Treatment – RICE untuk minggu pertama untuk mengawal bengkak(swelling) – Electrical muscles stimulation untuk mengawal sakit dan merangsang contraction muscles. – Ultrasound untuk meningkatkan pengaliran darah. – Menggunakan crutches – weight shifting. – Massage – Mobilization techniques.
  • 14. Anterior Cruciate Ligament Injury
  • 15. Posterior Cruciate Ligament Injury• Penyebab –Terjatuh dengan berat badan sepenuhnya pada lutut pada keadaan knee hyperflexed atau knee flexed pada 90• Tanda-tanda kecederaan – Terasa atau terdengar bunyi ―pop‖ pada bahagian belakang knee – Sakit apabila di palpitasi – Bengkak
  • 16. Posterior Cruciate Ligament Injury• Treatment – RICE untuk minggu pertama untuk mengawal bengkak(swelling) – Electrical muscles stimulation untuk mengawal sakit dan merangsang contraction muscles. – Ultrasound untuk meningkatkan pengaliran darah. – Menggunakan crutches – weight shifting. – Massage – Mobilization techniques.
  • 17. Posterior Cruciate Ligament Injury
  • 18. Meniscus Injuries• Penyebab:- – Weight bearing with rotational force while extension or flexion knee – Koyakan pada cartilage yang tidak sembuh disebabkan oleh kekurangan pembekalan darah. – Some peripheral meniscus able to heal due to adequate blood supply• Tanda-tanda kecederaan – sakit pada joint line dan pergerakan lutut yang terbatas. – Sakit ketika mencangkung dan kekurangan ROM
  • 19. Treatment• RICE therapy dalam jangkamasa 72 jam.• Arthroscopic surgery untuk membuang sebahagian meniscus.• Menggunakan bracing dan crunches untuk menyokong full weight bearing.
  • 20. Meniscus Injuries
  • 21. TAKE 5
  • 22. PENILAIANKECEDERAAN LUTUT
  • 23. Fungsi Ligament dan Rawan pada Lutut• Anterior Cruciate Ligaments – ligamen yang menghadkan regangan extension yang berlebihan pada lutut.• Posterior Cruciate Ligaments – ligamen ini mengelakan posterior tibia bergerak ke hadapan apabila lutut dibengkok kan .• Lateral Collateral Ligaments – menstabilkan bahagian lateral lutut dari sebarang daya yang akan menolak lutut secara lateral dan menyebabkan kecederaan.
  • 24. Fungsi Ligament dan Rawan pada Lutut• Medial Collateral ligaments- ligamen ini membantu menstabilkan bahagian medial lutut dan ia juga menstabilkan lutut dari dari sebarang daya yang akan menolak lutut secara medial dan menyebabkan kecederaan.• Meniscus – dua rawan berserat antara tibial dan femoral yang akan menolong mengimbangi bentuk tulang yang tidak rata dan membantu dalam penyebaran cecair synovial.
  • 25. Penilaian Kecederaan Lutut• Sejarah Kecederaan – untuk mengenal pasti tahap kecederaan yang berlaku.• Pemerhatian terhadap kecederaan – Cara berjalan - Leg alignment = genu valgum or knock kness, genu varum bowlegs, genu recurvatum or hyperextended knees. – pergerakan aktif• Sentuhan – struktur tulang pada lutut - struktur tisu lembut pada lutut.
  • 26. Special Test• Knee stability test – Valgus (medial) stress test special testKnee Exam Valgus Stress Test.flv and varus (lateral) stress test special testvarus test..78&ipbits=8&expire=1219652765&key=yt1&sver=2• Anterior cruciate ligament test: – Drawer test at 90° of flexion special testAnterior Drawer Test - Knee.flv – Lachman drawer test special testLachman Test [www.keepvid.com].flv – Pivot shift test special testKnee Exam (22 of 27)_ Pivot shift [www.keepvid.com].flv – Jerk testspecial testJerk Test [www.keepvid.com].flv
  • 27. Valgus and varus test– Laxity of the medial & lateral collateral ligaments– Lie supine with leg extended– Test medial collateral ligament – valgus test applied– Test lateral collateral ligament – varus test applied
  • 28. Valgus and varus stress test
  • 29. Drawer test at 90° of flexion• The athlete lies on the training table with the injured leg flexed.• The examiner stands facing the anterior aspect of the athlete’s leg, with both hands encircling the upper portion of the leg.• Immediately below the knee joint.• The finger examiner are positioned in the popliteal space of the affected leg, with the thumbs on the medial and lateral joint lines.• The index fingers of the examiner are placed on the hamstring tendon to ensure that it is relaxed.
  • 30. Drawer test at 90° of flexion
  • 31. Lachman’s Test– Check integrity of anterior cruciate ligaments (ACL)– Knee approximately 30 with lying on back– One hand stabilizes leg (grasp distal end of thigh)– One hand grasp proximal aspect of tibia– Attempting move anteriorly– Positive = movement of tibia
  • 32. Lachman test
  • 33. Pivot shift test• The athlete lies supine, one hand examiner is pressed against the head of the fibula, and the other hand grasps the athlete ankle.• The lower leg is internally rotated and the knee full extended.• The thigh is then flexed 30 at the hip while the knee is also flexed and simultaneous valgus force and axial load are applied by the examiner upper hand.
  • 34. Pivot shift test
  • 35. Jerk test• The jerk test reverses the direction of the pivot shift. The position of the knee is identical to that for the pivot shift test except that the knee is moved from the position.
  • 36. Jerk test
  • 37. Special test• Posterior cruciate ligamnent test – Posterior drawer test – External rotation recurvatum test – Posterior sag test (godfrey’s test)• Meniscal test – McMurray meniscal test – Apley compression test – Apley distraction test
  • 38. Posterior drawer test• Performed with the knee flexed at the 90° and the foot in neutral.• Force is exerted in a posterior direction at the proximal tibia plateau.
  • 39. Posterior drawer test
  • 40. External rotation recurvatum test• The examiner grasp the great toe and lifts off the table.• If the tibia externally rotates and slides posterior, there may be injury to the posterior cruciate ligament.
  • 41. External rotation recurvatum test
  • 42. Posterior sag test• With the athlete supine, both knees are flexed to 90°.• Observing laterally on the injured side.• The tibia will appear to sag posteriorly when compared with the opposite extremity if the posterior cruciate ligament is damaged.
  • 43. Posterior sag test
  • 44. McMurray’s meniscal test• The athlete is positioned face up on the table with the injured leg fully flexed.• The examiner places one hand on the foot and one hand over the top of the knee, finger touching the medial joint line.• The ankle hand describe a small circle and pulls the leg into extension.• The hand on the knees feels for clicking response
  • 45. McMurray’s meniscal test
  • 46. Apley’s CompressionTest– Identify meniscus injury– Lying face down– Affected leg flexed to 90°– Down hard pressure is applied to leg– Leg the rotated back– Medial meniscal tear -> external rotation– Lateral meniscal tear -> internal rotation– Positive = pain
  • 47. Apley’s CompressionTest
  • 48. Apley distraction test
  • 49. Functional examination• Testing quadriceps strength• Testing hamstring strength• Walking (forward, backward, straight line, curve)• Jogging (straight, curve, uphill, downhill)• Running• Sprinting
  • 50. Testing quadriceps strength
  • 51. Testing hamstring strength
  • 52. Patellar examinations• Palpation of patella – Patellar compression – Patellar grinding – Apprehension tests
  • 53. Patellar compression test
  • 54. Patellar grind test
  • 55. PROGRAMREHABILITAS IALATAN & TEKNIK RAHABILITASI
  • 56. Prevention of Knee Injuries• Physical conditioning & Rehabilitation – Strength – Flexibility – Cardiovascular – Muscle endurance – Agility – Speed – Balance• Shoe type• Functional & phophylactic Brace – Reduce severity of knee injuries
  • 57. Rehabilitasi• Flexibility• Muscular strength• Non weight bearing exercises• Knee joint mobilization
  • 58. Program fleksibiliti• Matlamat program = meningkatkan flexibiliti otot pada bahagian lutut.• Frekuensi = boleh di lakukan setiap hari.• Intensiti = meregangan otot sehingga rasa ketidak selesa.• Masa = setiap latihan di lakukan 20 saat/ 3 set• Jenis latihan = heel side, knee to chest, hamstring stretch, quadriceps stretch, calf stretch
  • 59. Senaman fleksibilitiHeel side stretch Knee to chest stretch
  • 60. Senaman fleksibiliti Hamstring stretch
  • 61. Program senaman kekuatan• Matlamat program = meningkatkan kekuatan otot pada bahagian lutut.• Frekuensi = dilakukan 3 hari seminggu.• Intensiti = menggunakan pemberat untuk memberi rintangan pada otot (20 RM per set).• Masa = latihan dilakukan 20 ulangan/ 3 set• Jenis latihan = leg extension, quadriceps contraction, water resistance, half squat, lateral steps up, straight leg raising and hip extension.
  • 62. Muscular strength Leg extension
  • 63. Muscular strength Water resistanceQuadricep contraction
  • 64. Muscular strengthSingle leg half squat Lateral steps up
  • 65. Non weight bearing exercises Electrical bicycle
  • 66. Non weight Bearing Exercises In a exercises pool
  • 67. Equipment aqua therapy
  • 68. TAKE 5
  • 69. KECEDERAANPERGELANGAN KAKI
  • 70. Kecederaan Pergelangan kaki.• Inversion sprain Grade I — – Kecederaan yang kerap berlaku pada atlet iaitu terseliuh ( sprain ) ia berlaku ketika berlari dan melompat. – Terdapat hanya kumpulan kecil ligamen dan fiber otot yang terkoyak, jadi akan terdapat sedikit cecair pada kawasan ini dan kesakitan yang sederhana. Walaubagaimana pun kekuatan otot masih normal. – Symptom and sign = kesakitan yang sederhana dan ketidakupayaan akan berlaku. Keseimbangan untuk menampung berat badan akan terjejas. Sign are point tenderness and swelling over the ligament with no joint laxity.
  • 71. Inversion sprain Grade I
  • 72. Inversion sprain Grade I• Rawatan – Rice therapy (20 minit setiap 2 jam dalam 72 jam). – Menggunakan horseshoes pad untuk mengawal pndarahan(hemorrhages). – Menggunakan elastic wrap dapat memberikan tekanan yang selesa.
  • 73. Kecederaan Pergelangan kaki• Inversion sprain Grade II — – Koyakan penuh pada anterior talofibular ligamen dan koyakan pada calceneofibular ligament. Kesakitan lebih teruk ketika menggerakan kaki dan kemasukan cecair pada kawasan yang cedera. Bengkak yang sederhana dan lebam. Akan kehilangan sedikit kekuatan pada otot. – Symptom and sign = atlet akan mengadu terdapat bunyi pop semasa mendarat dan terseliuh pada bahagian luar. Kesakitan yang lebih teruk dan kehilangan fungsi dan kaki tidak dapat menampung berat badan. Terdapat kemasukan cecair pada bagaian yang tercedera.
  • 74. Inversion sprain Grade II
  • 75. Inversion sprain Grade II• Rawatan – RICE therapy (20minit untuk 2 jam selama 72 jam). – Ice massage (jika perlu) – Menggunakan tongkat untuk 5 hingga 10 hari sehingga atlet boleh berjalan tanpa sokongan limp lateral. – Memakai elastic wrap semasa berjalan. – Tinggikan kaki sedikit ketika tidur dan duduk.
  • 76. Ankle fracture • Ankle Fracture -biasanya disebabkan oleh eversion. Fibula biasanya patah. • Symptoms and sign - Bengkak(swelling) dan sakit(pain). • Management - RICE digunakan secepat mungkin untuk mengawal pendarahan(hemorrhage) dan bengkak(swelling) - menggunakan cast atau brace.(penahan)
  • 77. Acute Achilles tendon rupture • Achilles tendon rupture – third degree strain oleh tendon dan chronic inflammation serta gradual degeneration disebabkan oleh micro tears(koyak). – Symptom and sign = pain is immediate but rapidly subsides. Point tenderness, swelling and discoloration. – Management = RICE, menggunakan crunches dan pembedahan(surgical repair).
  • 78. Medial Tibial Stress Syndrome• Medial tibial stress syndrome juga dikenali sebagai Shin splints, menunjukkan simptom sakit pada bahagian anterior part of shin.• Keadaan seperti stress fractures, muscles strains dan chronic anterior compartment syndrome juga dikenali sebagai shin splints.• Ia disebabkan oleh micro trauma yang berulang(biasanya di dalam sukan bola keranjang, berlari dan juga gimnastik)
  • 79. Medial Tibial Stress Syndrome• Symptom and sign = sakit sepanjang masa tetapi kesakitan akan menjadi lebih teruk selepas latihan atau pergerakan. =sakit apabila dipalpate.• Treatment = RICE, ice massage, gentle static stretching di bahagian anterior dan posterior muscles 3 kali sehari. = taping.
  • 80. Prevention of Injury to the Ankle• Stretching(Achilles tendon).• Strengthening exercise.• Proprioceptive training: balance exercises dan agility(ketangkasan)• Memakai proper footwear dan/atau tape apabila perlu.
  • 81. PENILAIAN KECEDERAANPERGELANGAN KAKI
  • 82. Assessing the Lower Leg and Ankle• History / sejarah kecederaan = untuk mengenal pasti kecederaan. – Mechanism of injury – When does it hurt? – Type of, quality of, duration of pain? – Sounds or feelings? – How long were you disabled? – Swelling? – Previous treatments?
  • 83. • Observations / pemerhatian terhadap kecederaan – Is there difficulty with walking? – Deformities, asymmetries or swelling? – Color and texture of skin, redness? – Patient in obvious pain? – Is range of motion normal?
  • 84. Palpasi/ sentuhan untuk mengenal pasti kecederaan• Tulang – Fibular head, calceneus, medial malleolus, lateral malleolus.• Tisu lembut – Achilies tendon, anterior talofibular ligament, flexor digitorum longus tendon, gastronemius and soleus muscles.
  • 85. Special test• Percussion and compression tests – Used when fracture is suspected (ankle or lower leg). – Percussion test is a blow to the tibia, fibula or heel to create vibratory force that resonates at the fracture, causing pain – Compression test (to check for fractures of the tibia or fibula) – involves compression of tibia and fibula either above or below site of concern – special testPercussion_Bump Test [www.keepvid.com].flv
  • 86. Special test• Thompson test – Squeeze calf muscle, while foot is extended off table to test the Achilles tendon rupture. – Positive results to the test in one in which there is no plantar flexion of the foot. – special testThompson_.flv• Homan’s sign – Test for deep vein thrombophlebitis. – With athlete supine position with the knee fully extended, ankle is moved into dorsiflexion so that calf muscles stretched. – Pain in calf is a positive sign and should be referred – special testHoman_.flv
  • 87. Compression Test Percussion Test Homan’s sign Thompson Test
  • 88. Ankle Stability Tests• Anterior drawer test – Used to determine damage to anterior talofibular ligament primarily and other lateral ligament secondarily. – The athlete sit on the edge of treatment table with legs and feet relaxed. – The athletic trainer grasps the lower tibia in one hand and the calcanues in the palm of the other hand. – A positive test occurs when foot slides forward and makes a clunking sound as it reaches the end point. And generally indicates a tear in the anterior talofibular ligament.
  • 89. Ankle Stability Tests• Talar tilt test – To determine extent of inversion or eversion injuries. – With foot at 90 degrees calcaneus is inverted. – And excessive motion indicates injury to calcaneofibular ligament and possibly the anterior and posterior talofibular ligaments. – If the calcaneus is everted, the deltoid ligament is tested – special testTalar Tilt Test [www.keepvid.com].flv
  • 90. Anterior Drawer Test Talar Tilt Test
  • 91. Ankle Stability Tests• Kleiger’s test – Used primarily to determine extent of damage to the deltoid ligament and may be used to evaluate distal ankle syndesmosis, including anterior/posterior tibiofibular ligaments and the interosseus membrane – The athlete should be seated with the legs over the end of the table. – One hand stabilized the lower leg while the other holds the medial aspect of the foot and rotates it laterally. – Pain over the deltoid ligament indicates injury to the structure, while pain over the lateral malleolus would like indicated injury to the syndesmosis. – special testKleiger_.flv
  • 92. Ankle Stability Tests• Medial Subtalar Glide Test – Performed to determine presence of excessive medial translation of the calcaneus on the talus in the transverse plane. – One hand of examiner hold the talus in subtalar neutral, then glides the calcaneus in the medial direction. – A positive test presents with excessive movement, indicating injury to the lateral ligaments – special testSubtalar Medial Glide [www.keepvid.com].flv
  • 93. Kleiger’s Test Medial Subtalar Glide Test
  • 94. Functional test• Walks on toes (test plantar flexion)• Walks on heels (test dorsiflexion)• Walks on lateral border of feet (test inversion)• Walks on medial border of feet (test eversion)
  • 95. TAKE 5
  • 96. PROGRAMREHABILITAS IALATAN & TEKNIK RAHABILITASI
  • 97. Rehabilitation techniques.• Non weight bearing exercises untuk mengekalkan ketahanan(endurance) cardio respiratory. (exercises in pool).
  • 98. Rehabilitation techniques• Flexibility exercises – Gastronomies stretch – Soleus stretch – Heel stretch• Neuromuscular Control Training• Strengthening exercises
  • 99. Stretching
  • 100. Stretching
  • 101. Stretching
  • 102. • Neuromuscular Control Training – Boleh ditingkatkan oleh latihan dalam keadaan terkawal(Can be enhanced by training in controlled activities) – Permukaan yang tidak rata(uneven surfaces), BAPS boards, rocker boards, atau Dynadiscs boleh digunakan untuk melatih atlet.
  • 103. Strengthening exercises
  • 104. Strengthening exercises
  • 105. Strengthening exercises
  • 106. KECEDERAAN TAPAK KAKI
  • 107. Injuries to the Tarsal Talus• Fractures of the talus• Fractures of the calcaneus• Heel contusion• Tarsal tunnel syndrome• Retrocalcaneal bursitis
  • 108. Injuries to the Metatarsal Region• Flatfoot• High arch foot• Plantar fasciitis• Jones fractures• Metatarsal stress fractures
  • 109. Plantar fasciitis/Heel spur• Plantar fascia : – Fibrous tissue terletak sepanjang bahagian bawah kaki(bottom surface of the foot) – Merintangi daripada heel to the forefoot• Heels spur – Pertumbuhan yang tidak normal pada heel bone disebabkan oleh calcium deposits – Terjadi apabila plantar fascia pulls away daripada heel.
  • 110. Plantar Fasciitis•Plantar fasciitis ialahradang(inflammation) padaplantar fascia .•Terjadi sama rata antaraperempuan dan lelaki.
  • 111. Plantar Fasciitis• As the arch starts to flatten out,the band of ligament and themuscle in the bottom of the footabsorb the impact pressure fromstanding or walking.•Eventually they become stretched beyond their limits.•Akan menyebabkan muscle tearsdan bone spurs.
  • 112. Picture of plantar faciitis
  • 113. Plantar Facitis Cont.– Signs & Symptoms • History: stress yang berulang, kesakitan pada pagi hari(morning pain) (anterior medial heel). • Sakit selepas duduk pada waktu yang lama. • Bengkak dan sharp pain yang kuat • Sakit meningkat dengan pergerakan passive dorsiflexion of the great toe. • Point tenderness pada calcaneal insertion (calcaneal spur) • Positive test untuk tightness pada achilles (DF)
  • 114. Plantar Facitis Cont.– Treatment: • Therapy RICE dan NSAID (Nonsteroidal anti- inflammatory drugs) diperlukan untuk mengurangkan sakit dan bengkak(inflammation).– Exercises rehabilitation • Toe touch crutch walking • Begin heel cord stretching • Rolling pin exercise to increase fascia flexibility. • Foot Flexor Strengthening program
  • 115. Pain often here (Heel Spur)
  • 116. FACTORS OF PLANTAR FACIITIS• Berat yang berlebihan pada kaki disebabkan oleh obesiti.• Kenaikan berat secara tiba-tiba seperti dalam pregnancy.• Aktiviti lasak yang tiba tiba seperti dalam bersukan.• Plantar fascia yang memendek(tight) (biasanya disebabkan oleh tight calf muscles)• Excessive flattening of the arch on weight bearing.• Biomechanical problems (walking abnormalities)
  • 117. Tarsal Tunnel Syndrome• Signs & Symptoms – Localized swelling – Pain medial ankle and heel – Positive sensory test (Medial heel) – Positive motor test (planar flexion of the ankle, flexion of the toes) – Positive Tinel sign
  • 118. Tarsal Tunnel Syndrome Cont.• Treatment: – Antiinflammatory medication. – Antiinflamatory modalities (RICE, Ultrasound). – Non-weight bearing/ or altered participation
  • 119. Fracture of the Calcaneus• Etiology: terjadi akibat daripada lompatan ataupun terjatuh dari suatu ketinggian. Avulsion of Achilles tendon. Miscellaneous direct trauma.• Symptom and signs - sakit dan bengkak(immediate swelling)(tidak dapat menampung berat). -Localized tenderness.• Treatment – RICE untuk mengurangkan sakit dan bengkak sebelum menjalankan ujian x ray untuk diagnosis.
  • 120. PENILAIANKECEDERAANTAPAK KAKI
  • 121. Penilaian Kecederaan tapak kaki• Sejarah kecederaan – untuk mengenal pasti lebih jelas jenis kecederaan yang berlaku. – Adakah kecederaan pertama kali berlaku? – Bagaimana ia terjadi? – Tanda dan gejala kecederaan? – Dimanakah rasa sakit (ankle, heel, arches, toes)? – Rawatan yang pernah di lakukan?
  • 122. Penilaian Kecederaan Tapak Kaki• Observation/ Pemerhatian – Adakah atlet berjalan dalam keadaan tidak normal(limp) ataupun tidak menjejakkan kaki yang sakit ke tanah(unable to bear weight)? – Adakah bahagian yang tercedera itu bengkak(swollen), pucat(discoloured), atau deformed? – Adakah foot dalam keadaan selari(well aligned)?• Palpation / Palpasi – Bone (calcaneus, matatarsal, talar head, phalanges). – Soft tissues (plantar fascia, flexor digitorum longus tendon, tibialis posterior and anterior tendon, extensor digitorum longus tendon).
  • 123. Pernilaian Kecederaan Tapak Kaki• Ujian Fizikal – Percussion test special testPercussion_Bump Test [www.keepvid.com].flv – Tinel’s sign special testTinel_.flv – Morton’s test special testMorton_.flv• Movement - Dorsiflexion and plantarflexion. - Toe walking. - Heel walking
  • 124. PROGRAMREHABILITAS IALATAN & TEKNIK RAHABILITASI
  • 125. Program Rehabilitasi untuk senaman regangan• Kekerapan latihan :- boleh dilakukan setiap hari (untuk meningkatkan flexibiliti).• Intensiti latihan :- meregangan kan otot yang terlibat sehingga rasa ketidak selesaan.• Masa :- setiap latihan di lakukan selama 20 saat atau dalam kiraan 20 dan dilakukan 3 set.• Jenis latihan :- toe curl with towel, toe extension, heel stretch, standing calf stretch, towel stretch, rolling ball.
  • 126. Senaman regangan
  • 127. EXERCISES
  • 128. • Balance yourself during plantar stretch Slowly allow your body weight to gently stretch the calf muscles until you feel tension.
  • 129. Program Rehabilitasi Senaman Kekuatan• Kekerapan latihan :- dilakukan dalam 3 hari/seminggu (untuk menguatkan otot yang terlibat).• Intensiti latihan :- menggunakan pemberat atau rubber tubing untuk memberi rintangan.• Masa :- setiap latihan di lakukan 10 ulangan dalam 3 set.• Jenis latihan :- picking up object, gripping and spreading of toes, towel gathering, towel scoop and resisted tubing exercises.
  • 130. Rolling pin/ Ball
  • 131. Resisted tubing exercises
  • 132. Rehabilitation
  • 133. Toe curl with towel
  • 134. Picking up object and Towel gathering
  • 135. FOOT SUPPORT• To align the feet and body posture to their correct position• Untuk membentuk kembali natural angle of lower limb
  • 136. FOOT SUPPORT - Orthotic devices or shoe inserts
  • 137. Terima KasihSemoga Maju Jaya dan belajar rajin-rajin.