2-Intervensi Latihan Regio Shoulder
2-Intervensi Latihan Regio Shoulder
2-Intervensi Latihan Regio Shoulder
REGIO SHOULDER
MU’JIZATILLAH, S.FT.PHYSIO,M.KES
STRUKTUR & FUNGSI SHOULDER
Tulang servikal
• Antara vertebra C3-C4 atau C4 dan C5
• Akar saraf C4 atau C5
Wand exercise
• Patient position and procedure: Initiate A-AROM using a
cane, wand, or T-bar in the supine position.
• Motions usually included are flexion, abduction, flexion in
the plane of the scapula and rotation (Fig. 17.21A).
• If it is necessary to relieve stress on the anterior capsule,
such as following surgical repair of the capsule or labrum,
place a folded towel under the humerus to position the
humerus anterior to the midline of the body when the
patient performs internal or external rotation (Fig. 17.21B).
• When treating a shoulder impingement (primary or
secondary), have the patient grasp the wand with the
forearm supinated when flexing and abducting to
emphasize external rotation.
Ball rolling atau Table Top Dusting
• Patient position and procedure: Sitting with
the arm resting on a table and hand placed
on a 15-20 cm ball or towel and the shoulder
in the plane of the scapula.
• Have the patient initiate gentle circular
motions of the shoulder by moving the trunk
forward, backward, and to the side, allowing
the hand to roll the ball or “dust the table.”
• As pain subsides, have the patient use the
shoulder muscles to actively move the ball or
cloth through greater ROMs.
Wall (window) washing
• Patient position and procedure: Standing
with hand placed against a wall
supporting a towel or a ball.
• Instruct the patient to perform clockwise
and counterclockwise circular motions
with the hand moving the towel or rolling
the ball.
• Progress this activity by having the
patient reach upward and outward as
far as tolerated without causing
symptoms.
Pendulum (Codman’s) exercise
• Patient position and procedure: Standing, with the trunk flexed at the hips
about 90. The arm hangs loosely downward in a position between 60 and 90
flexion or scaption (Fig. 17.22).
• A pendulum or swinging motion of the arm is initiated by having the patient
move the trunk slightly back and forth.
• Motions of flexion, extension, and horizontal abduction, adduction, and
circumduction can be done.
• Increase the arc of motion as tolerated. This technique should not cause pain.
• If the patient cannot maintain balance while leaning over, have the patient
hold on to a solid structure or lie prone on a table.
• If the patient experiences back pain from bending over, use the prone
position.
• Adding a weight to the hand or using wrist cuffs causes a greater distraction
force on the GH joint. Weights should be used only when joint stretching
maneuvers are indicated late in the subacute and chronic stages—and then
only if the scapula is stabilized by the therapist or a belt is placed around the
thorax and scapula so the stretch force is directed to the joint, not the soft
tissue of the scapulothoracic region.
Latihan mengganti “persneling”
• Patient position and
procedure: Sitting with
the involved arm at the
side, holding a cane or
wand with the tip resting
on the floor to support
the weight of the arm.
• Instruct the patient to
move the pole forward
and back, diagonally, or
laterally and medially in a
motion similar to shifting
gears in a car with a floor
shift (Fig. 17.23).
Wall climbing Overhead pulleys
Kontrol neuromuskular dini
Active
Passive (self)
Stretching stretching
Mobilisasi
sendi
Meningkatkan flexi shoulder = stretch shoulder ekstensors
• Meningkatkan hyperekstensi
shoulder
= mengulur shoulder
fleksor
• Meningkatkan abduksi
shoulder
= stretch otot2 adductor