terapi latihan pada ektremitas bawah
Summary
TLDRThe video discusses exercises focused on the lower extremities, particularly the knee and ankle joints. It highlights the importance of these exercises for preventing conditions like knee osteoarthritis and ligament issues, which often stem from muscular imbalances. The speaker explains key concepts such as open and closed kinetic chains, emphasizing how improper alignment and muscle shortening can affect joint stability. Various exercises, including isometric training and ankle pumping, are covered to improve muscle strength, reduce pain, and enhance joint function. The video aims to educate on the importance of proper exercise techniques to prevent injury and improve mobility.
Takeaways
- 💪 The video discusses the importance of exercises for the lower extremities, especially the knee and ankle, due to conditions like osteoarthritis (OA) or ligament injuries.
- 🦵 Knee joint pathologies can be caused by imbalances in the surrounding muscles, leading to problems like patella alta (elevated patella).
- 🧠 The discussion highlights that proper alignment and muscle function around the knee are crucial for preventing joint damage, especially in areas like the medial or lateral sides of the knee.
- 📉 Overstretching of ligaments, such as the anterior cruciate ligament (ACL), can result from muscle instability around the knee, often due to poor landing techniques in sports.
- 🏋️♂️ Closed Kinetic Chain (CKC) exercises, like bridging, are recommended for knee stability as they involve fixed distal points (feet on the ground), compared to Open Kinetic Chain (OKC) exercises where the distal part is free.
- 🧘♂️ Isometric exercises (where muscle length doesn’t change) are beneficial for reducing muscle atrophy, minimizing spasms, and reducing pain through contraction and improved blood flow.
- ⛓ The video discusses how muscles that cross two joints (such as the quadriceps) need special attention during exercises to prevent hyperextension or improper muscle shortening.
- 🔄 Exercises like straight leg raises (SLR) target the quadriceps and are a combination of concentric (lifting), isometric (holding), and eccentric (lowering) contractions.
- 🦶 Ankle exercises are highlighted for their importance in improving venous return and preventing conditions like deep vein thrombosis (DVT).
- 🩺 Elevation and support during certain exercises are important to consider for patients with heart issues, as increased blood flow can put strain on the heart.
Q & A
Why are exercises for the knee and ankle joint important in rehabilitation?
-Exercises for the knee and ankle are important because they help address pathologies such as osteoarthritis or ligament injuries. Strengthening muscles around these joints can prevent conditions like joint misalignment and excessive pressure on certain areas, which may lead to cartilage damage.
What role do muscles play in knee pathologies such as osteoarthritis?
-Muscles play a key role in knee pathologies because imbalances or tightness in the surrounding muscles, like the quadriceps, can affect joint alignment. For example, shortening of the quadriceps can cause the patella to shift upward, leading to further complications like patella alta.
What is the difference between medial and lateral knee osteoarthritis?
-Medial knee osteoarthritis occurs when there's degeneration or excessive pressure on the inner side of the knee, while lateral knee osteoarthritis affects the outer side. The imbalance in muscle strength around the knee can influence which side becomes more affected.
Why is it important to assess stability in the knee joint for athletes?
-Assessing stability in the knee is crucial for athletes to prevent injuries. Stable knees help maintain correct alignment during activities like jumping or landing, reducing the risk of ligament strain or other injuries caused by excessive joint movement.
What are Close Kinetic Chain (CKC) and Open Kinetic Chain (OKC) exercises?
-Close Kinetic Chain (CKC) exercises involve movement where the distal part of the limb (like the foot) is fixed, such as during a squat. Open Kinetic Chain (OKC) exercises involve movement where the distal part is free, like a leg extension. CKC exercises are generally preferred for joint stabilization.
How does isometric exercise benefit muscle function?
-Isometric exercises involve muscle contractions without changing the length of the muscle, which can minimize muscle atrophy, reduce spasms, and alleviate pain. They also promote muscle strengthening, especially for stabilizing muscles around joints like the knee.
What is patella alta, and how is it caused?
-Patella alta is a condition where the patella (kneecap) is positioned higher than normal. It is caused by the shortening of the quadriceps muscle, which pulls the patella upward. This misalignment can lead to joint instability and other knee issues.
Why is proper positioning important during exercises targeting the quadriceps?
-Proper positioning is important to avoid hyperextension of the knee and to ensure the correct muscle groups are activated. For example, using supports to keep the heel in the right position during quadriceps exercises can prevent knee strain and enhance muscle activation.
What are the benefits of ankle pumping exercises?
-Ankle pumping exercises are important for improving blood circulation, particularly in preventing venous thrombosis. These exercises help the veins move blood back to the heart by using the one-way valve system, reducing the risk of blood clots.
What is the Burger's exercise, and when is it used?
-Burger's exercise is used to improve blood flow in cases of arterial insufficiency, such as in patients with vascular problems caused by smoking. It involves elevating the legs and performing specific movements to encourage arterial circulation.
Outlines
🦵 Introduction to Lower Extremity Exercises
The paragraph introduces the importance of exercises targeting the knee and ankle, especially in addressing various pathologies like osteoarthritis (OA) and ligament injuries. It emphasizes that such issues are often influenced by surrounding muscles rather than just being direct injuries. The alignment of the knee joint, affected by muscle imbalances, can lead to problems such as patella alta, knee instability, and hyperextension. The text stresses the role of muscles like the quadriceps in stabilizing the knee and how imbalances can cause damage to ligaments and other joint components.
💪 The Role of Isometric Exercises
This section explains the benefits of isometric exercises, which involve muscle contraction without changing muscle length. Isometric exercises help minimize muscle atrophy, reduce spasms through post-contraction relaxation, and alleviate pain by improving blood flow and changing pH levels in the muscles. The paragraph also discusses how different postures affect muscle contraction, emphasizing that proper alignment and muscle length are key for effective isometric exercises. The focus is on the quadriceps, highlighting the need for graded extension exercises for balanced muscle development.
🦶 Importance of Functional and Ankle Exercises
The final paragraph covers functional exercises like bridging for strengthening different parts of the body, including the anterior, posterior, medial, and lateral muscles. It also introduces ankle pumping exercises to prevent thrombosis, emphasizing the importance of blood flow and how valves in veins prevent backflow. Elevation techniques are also discussed, with a caution to consult with a medical professional in cases of heart conditions to avoid overwhelming the heart with increased blood flow. The section concludes with a brief mention of 'Burger exercises' for arterial health, particularly relevant for smokers.
Mindmap
Keywords
💡Lower extremity
💡Osteoarthritis (OA)
💡Ligament
💡Patella Alta
💡Closed Kinetic Chain (CKC)
💡Open Kinetic Chain (OKC)
💡Isometric exercise
💡Quadriceps muscle
💡Functional exercises
💡Venous return
Highlights
Discussion on the importance of lower extremity exercises for the knee and ankle, particularly in addressing pathologies like osteoarthritis and ligament issues.
Clarification that knee issues such as medial calcification are often influenced by surrounding muscle imbalances, not just joint problems.
Explanation of how shortened quadriceps can lead to patella alta (elevated kneecap), affecting knee alignment and function.
Focus on stability and alignment in knee joint exercises to prevent ligament overstretching and injuries.
Introduction to Closed Kinetic Chain (CKC) and Open Kinetic Chain (OKC) exercises, with CKC being prioritized in therapy.
Demonstration of CKC exercise examples, such as bridging, where the foot remains in contact with the ground to enhance stability.
Detailed explanation of isometric exercises and their benefits in minimizing muscle atrophy, reducing spasms, and decreasing pain.
Discussion on how quadriceps exercises can vary in focus, depending on the position (e.g., seated vs. lying down), and how this impacts muscle contraction effectiveness.
Guidance on proper positioning during isometric exercises to avoid hyperextension and ensure effective engagement of targeted muscles.
Illustration of three types of muscle contractions during quadriceps exercises: concentric (lifting), isometric (holding), and eccentric (lowering).
Explanation of ankle pumping exercises to prevent deep vein thrombosis (DVT) by promoting blood flow and preventing venous stasis.
Discussion on the significance of vein valves in preventing backflow of blood and the potential complications if they malfunction.
Recommendation for elevating the legs during certain exercises and consulting with a physician in cases involving heart issues.
Introduction of the 'Burger's exercise,' which is used to address arterial blockages and is particularly relevant in patients with smoking-related conditions.
Conclusion with an invitation for further questions and discussion about the presented exercises and rehabilitation strategies.
Transcripts
alualaikum warahmatullah wabarakatuh
Hari ini kita mau bahas tentang lower
extremity latihan pada lutut dan
pgelangan kaki ya
terutama kita lihat Kenapa sih harus
dilakukan lati-latihan ini karena banyak
patologi misalnya patologi pada lutut
misal
oa osis at pengapuran ya atau
kasus-kasus pada ligamen itu sebenarnya
bukan cuma kasus
yang benar-benar tanda kutip masalah itu
aja artinya bukan karena ya memang
legamennya strein atau adanya pengapuran
di medial atau lateral tapi kita melihat
ee kenapa bisa terjadi pengapuran di
bagian medial kenapa enggak lateral
misalnya itu atau kebalikannya Nah itu
semua dipengaruhi oleh otot yang bekerja
di sekitar lutut
ini atom lutut ya lutut ada fernya ada
tibianya dan juga patela untuk lutut
sendiri sebenarnya cangnya ini ya ini
Ini ada fibula tapi kalau dibilang
bentuk sendi lutut fibula tidak termasuk
sendi lutut ya
tapi
dan nah ini e contoh sendi yang bagus
Misalnya ini bagian medialnya tidak ada
pengapuran bayangkan kalau misalnya ada
sebuah alignment yang menyebabkan
terkenakan penekan berlebih pada bagian
medial maka kerusakan pada pada
permukaan ini akan terjadi misal pada
pengapuran atau adanya patela Alta
misalnya adanya temprungnya naik ke atas
gitu itu kan bukan karena patelannya
Manjat ya atau bergeser ya tapi karena
eh quadrepnya shorten memendek gitu kan
sehingga menarik patelanya Mak yang kita
intervensi bukan cuma pnya kita turunkan
gitu selama itu masih memendek ototnya
maka pat tap akan naik ya atau
posisi-posisi di mana unstab ni lututnya
enggak stabil sehingga terjadi
genatumnya hipkstensi misalnya tentunya
mempengaruhi ligamen misalnya crusatum
anterior ya terjadi eh over terusmenerus
akhirnya ligamennya bermasalah gitu kan
Nah kitaokus ini kan sudah over mau
diapain lagi tidak kita lihat Kenapa dia
bisa overstetch di luar dari misalnya
cedera ya cedera pun sebenarnya kita
bisa analisis di mana kalau misalnya
punya stabilitas lutut yang baik maka
posisi lutut tuh tetap di tengah makanya
kita lihat atlet-atlet yang berprestasi
gitu saat loncat lalu jumping dan
landing itu lututnya tetap di tempat
karena memang punya namanya stabilitas
pada lutut
Oke sebelum ke latihannya kita harus
tahu tentang close Kinetic chain dan
Open Kinetic chain menurut saya sih ini
Sudah dipelajari di terapi latihan dasar
ya ya apa tapi kita review sedikitlah
Apa itu e ckc yaitu gerak aktif di mana
bagian distal tubuh terfiksasi seperti
tak kaki menyentuh tanah ini contohnya
pada bridging ini ini kakinya kan yang
distalnya tempel di tanah kan lalu dia
latihan seperti ini ya kebalikannya
Kalau open kinetik
gerakan aktif bagian tubuh tidak
terfiksasi ini
contohnyaing ini ya dia naik ke atas ini
gak menyentuh tanah
ya yang sifatnya terapek
maka di mulai D dahulu sebelum Open k
Oke ini Conto tah
padaiak seak juga ya ini
gline-nya Leadernya buat ni nanti kita
lihat masing-masing eh pasien Seperti
apa ada masih dikhususkan gitu kan
misalnya yang seperti kita lihat tadi
ternyata pasiennya eh masal imbalance
nih bagian medialnya lebih shorten gitu
kan sehingga menyebabkan posisi lututnya
Berubah itu kan tentu Enggak seperti ini
ya Oke kita mulai dari yang pertama
yaitu setting exercise Apa itu ituan
latihan isometrik ingat ya ini isometrik
jadi tidak ada perubahan panjang otot ya
isometrik Dar otot grup
ototadr otot berapa ada EMP otot ya
tanpa melawan tahanan ya Gunanya buat
apa minimalisir atropi otot hampir semua
fungsi isometrik sih sebenarnya jadi
bisa
buaturangat karat dikraks pergak
Kenapa bisa mengurangi spasme isometrik
karena ada
teori apaation after contraction dan
Tunya mengurangi nyeri mengurangi karena
apa dari mulai teori
eh asam basa juga bisa mengurangi nyeri
ya karena adanya kontraksi adanya flow
sehingga menyebabkan eh Odo lebih banyak
maka ph-nya Berubah itu kan mengurang
Nyeri ya Saya sudah pernah Terangkan dan
juga menguatkan Kuad itu sendiri Ini
salah satu contohnya ya walaupun nanti
kita lihat lagi di mana Ini kan otot
yangartikuler ya artinya otot yang
melewati dua sendi seperti ini maka e
dua sendi itu diperhatikan misalnya
apakah e pasiennya harus duduk seperti
ini atau l down misal Terentang gitu kan
Coba bedanya gimana ya kalau misalnya
dia duduk seperti ini maka e
otot yang bagian Superior ya bagian atas
itu cenderung memendek kan ini memanjang
nah krak ppengaruhi oleh panjang awal
otot ya kalau ototnya semakin panjang
maka kontraksinya semakin maksimal lalu
juga not-nya ini ada ee ganjelan
sebaiknya memang tidak benar-benar di
sini tapi cenderung ke atas ya cenderung
ke sini menghindari apa menghindari
hiperekstensi dan dilihat karena ini
close Kinetic maka heal-nya tetap di
sini kita lihat contohnya latihannya
I kalau di
sini ini mulai Angkat angkelnya
dulu nah ini seharusnya dia tidak
ngangkat Nah dia langsung langsung
mengkoreksi
ya Iya ya berapa
lama Berapa lama kontraksinya kira-kira
6 sampai 8 detik Ya seperti halnya
kontraksi isometrik
Oke ini kebalikannya buat quad resisep
ya dari posisi
eh from position ya hampir sama ya nanti
bisa dilihat di emas ya videonya yang
kedua
adalah ya kalau ini kan Dilihat dari ee
mengangkat kaki lurus ya maka otototot e
quadrisep bagian Superior lebih ee
terstimulus dibandingkan yang inferior
maka sebenarnya kalau untuk quad kita
butuh selain tapi juga apa ini extension
ya ini extensionnya dengan bergrading
derajat-derajatnya
Oke ini
contohnya Ini dia dipt ya
mudah-mudahan UI segera jadi
dipt ya Ini awal nah ini yang strikler
rise jangan lupa Ini bisa ada tiga macam
kontraksi dari mulai konsentrik saat
nenek ke atas lalu isometrik tahan di
atas lalu turun pelan-pelan bentuknya
eksentrik ya
oke Lalu ada latihan fungsional lainnya
ya yang bisa kita desain salah satunya
mungkin ee bridging misalnya bridging
bagus juga bridging nanti kita lihat
untuk yang bagian anterior Seperti apa
latihannya posterior Seperti apa medial
dan leral seperti apa nanti saya upload
di di emas ya
Insyaallah lanjutah anle pamping
exercise anle pamping itu penting ya
satunya untuk mencegah termopabtis ya
Ee dalam bentuk gerakannya sebenarnya
hampir
Bu hampir semua gerakan pada ya
baikantar
fleksi lateral
dan apa itu inflamasi
padaenaa nih Coba kita lihat di sini ini
kan Ya itu kan dari keimal ya ke arah
jantahisaaot
parahnya Lalu ada kontraksi menekan maka
dia naik ke atas kok Gak balik lagi
yaenanya ya karena sifatnya ada one Val
ada Val yang satu arah jadi saat darah
naik ke atas lalu dia akan turun lagi ke
bawah darahnya ke bawah tapi gak akan
masuk ke bawah lagi tapi karena Val
tidak kebuka Bagaimana kalau
kebalikannya Nah akhirnya
terjadi seperti
ini ini p
Oke sebaiknya tetap diupport ya kalaupun
misalnya di kita mau support 45 derajat
maka supportnya full
segini 45 derajat ya Ee melakukan
elevasi sebaiknya dikonsultasikan untuk
kasus-kasus pada jantung ya dianyakan
dulu karena takutnya flownya banyak
sekali sedangkan jantungnya enggak ready
untuk itu
Oke selanjutnya kita ngomong bergerak
siise itu menangani
sumbatan Arteri kalau tadi kan Vena ya
ya awalnya itu burger dulu lalu ada Elen
ditambahin ya Ditambahin lagi latihannya
nanti kita lihat ini
fase-fasenya seperti
ini ini contoh latihannya dari mulai
dielevasi
dulu Ini 45 derajat ya
ya lalu selanjutnya seperti
ini dan yang terakhir
posisinya Terentang ini burger size
contohnya burger diisi itu apa sih
contoh pada kasus-kasus rokok ya wi jadi
burger B pemudarannya
bermasalah
harterinya seperti itu ini referalnya
bisa dilihat di ini Terima kasih banyak
kalau ada pertanyaan boleh ya nanti kita
bahas lagi Terima kasih asalamualaikum
warahmatullahi wabarakatuh
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