De primaire frozen shoulder Stenvers, Jan Derek

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1 De primaire frozen shoulder Stenvers, Jan Derek IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check the document version below. Document Version Publisher's PDF, also known as Version of record Publication date: 1994 Link to publication in University of Groningen/UMCG research database Citation for published version (APA): Stenvers, J. D. (1994). De primaire frozen shoulder: een retrospectief onderzoek naar de behandeling door middel van fysiotherapie Groningen: s.n. Copyright Other than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons). Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Downloaded from the University of Groningen/UMCG research database (Pure): For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Download date:

2 RIJKSUNIVERSITEIT GRONINGEN DE PRIMAIRE FROZEN SHOULDER EEN RETROSPECTIEF ONDERZOEK NAAR DE BEHANDELING DOOR MIDDEL VAN FYSIOTHERAPIE Proefschrift ter verkrijging van het doctoraat in de Geneeskunde aan de Rijksuniversiteit Groningen op gezag van de Rector Magnificus Dr. S.K. Kuipers in het openbaar te verdedigen op woensdag 5 januari 1994 des namiddags te 2.45 uur door Jan Derek Stenvers geboren op 24 juli 1946 te Haren

3 Promotores: Prof. drs. W.H. Eisma Prof. dr. H.J. de Jongh Prof. dr. J.W.F. Beks Promotiecommissie: Prof.dr. P.J.M. Helders Prof.dr.H.K.L. Nielsen Prof.dr. C.J.P. Thijn Paranimfen: W.J. Overbeek J.L.M. Franssen

4 Inleiding 9 Hoofdstuk Beschrijving van het ziektebeeld Historisch overzicht Etiologie Primaire frozen shoulder Secundaire frozen shoulder 17 Hoofdstuk 2 19 Anatomie Benige structuren Het glenohumerale gewricht Schoudermusculatuur Bursa subacromialis en bursa subdeltoidea Het acromioclaviculaire gewricht Het sternoclaviculaire gewricht Anatomie van het coracoclaviculaire weefsel 36 Hoofdstuk 3 39 Lichamelijk onderzoek Inspectie Bewegingsonderzoek 40 Cervicale wervelkolom 40 Schouder 40 Elleboog en pols Spierkracht Oriënterend neurologisch onderzoek Palpatie 45 Hoofdstuk 4 47 Beeldvormende technieken Radiologische overzichtsopnamen Arthrografie Arthroscopie Echografie Röntgencinematografie onderzoektechniek passieve anteflexie; normale schouder 50 3

5 4.5.3 passieve anteflexie; primaire frozen shoulder Bespreking van het doorlichtingsbeeld mtc pertechnetate scanning MRI bij de primaire frozen shoulder Korte beschrijving van de uitslagen Conclusie 61 Hoofdstuk 5 62 Overzicht van de toegepaste therapieën Manipulatie onder narcose Open manipulatie Joint distension Capsulotomie tijdens arthroscopie Injectietherapie Orale medicamenteuze therapie Conservatieve therapie 66 Hoofdstuk 6 68 De Fysiotherapeutische behandeling 68 Methoden van mobiliseren Tot op heden gebruikte oefenvormnen Door ons gebruikte wijze van mobiliseren Motivatie van keuze van behandelen Uitvoering van de behandeling 75 Hoofdstuk 7 76 Opzet van het onderzoek en resultaten Behandeling Keuze van onderzoek Wijze van onderzoek Het lichamelijk onderzoek Uitvoering van de testen Meting van de bewegingsuitslagen Resultaten van de enquête Leeftijd en geslacht Klachten Beroep, sport en hobby Beroep Arbeidsongeschiktheid 85 4

6 Sport Hobby Behandeling Duur van de behandeling Resultaat van de behandeling Pijnlijkheid van de behandeling Restklachten Resultaten lichamelijk onderzoek Klachten Lichamelijk onderzoek Inspectie Mobiliteit: Pijn Kracht Vergelijking pijnklachten enquete en lichamelijk onderzoek 96 Conclusie 97 Klinisch beeld 97 Pathologische anatomie 97 Beeldvormende technieken 98 Behandeling 98 Samenvatting 101 Literatuurlijst 104 Bijlage Patiëntengegevens primaire frozen shoulder 111 Bijlage Patiëntengegevens secundaire frozen shoulder 125 Bijlage Enquête 126 BIJLAGE NAONDERZOEK PATIËNTEN 134 LICHAMELIJK ONDERZOEK 134 MOBILITEIT 135 KRACHT 135 UITSLAGEN VAN DE METINGEN BIJ LICHAMELIJK NA0NDERZOEK 136 5

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