Übungsansatz bei HWS-Störungen: Wie fließen die Ergebnisse der Forschung in die Praxis ein?

Zusammenfassung

Nackenschmerzen treten episodenartig und wiederkehrend auf. Eine der großen Herausforderungen der Rehabilitation ist es, die schmerzhaften Episoden der Betroffenen zu verringern. Ein wichtiger Aspekt eines multimodalen Therapieansatzes besteht darin sicherzustellen, dass das muskuläre System für eine angemessene Unterstützung und Kontrolle der Bewegungen und Haltungen in den zervikalen Segmenten sorgen kann. Schmerzen und Verletzungen führen nachweislich zu deutlichen Veränderungen der motorischen Kontrolle in der Zervikalregion. Die Muskeln verändern ihr zeitliches und räumliches Verhältnis und verlieren an Kraft und Ausdauer. Bei vielen Personen fanden sich im Zusammenhang mit Nackenschmerzen zudem Störungen der zervikalen somatosensorischen Funktionen, die sich mit Symptomen wie Schwindel, Unsicherheit und visuellen Störungen manifestieren. Ein Trainingsprogramm, das diese Forschungsergebnisse integriert, sollte für die therapeutischen Übungen bei zervikalen Störungen einen motorischen Lernansatz verfolgen, um neben den konventionellen Übungen zur Kräftigung und Ausdauererhöhung die Defizite in der muskulären Kontrolle zu beheben. Im Einzelfall werden spezifische Übungen für fehlenden zervikalen Bewegungssinn, Gleichgewicht und Augenmuskelkontrolle implementiert.

Abstract

Neck pain is a recurrent, episodic condition. A major challenge in rehabilitation is to intervene to reduce the episodes of pain over an individual’s lifetime. An important aspect of a multimodal rehabilitation programme is to ensure that the muscle system can provide adequate support and control for the cervical segments’ movement and posture. Research has revealed that pain and injury induce major reorganisation in motor control strategies in the cervical region, and muscles change their temporal and spatial relationships as well as losing strength and endurance. In addition, disturbances in cervical somatosensory function have been identified in many individuals in association with neck pain, and manifest with symptoms such as dizziness, unsteadiness and visual disturbances. An exercise programme informed by this research, suggests that therapeutic exercise for cervical disorders should incorporate a motor learning approach to address the deficiencies in muscle control in addition to conventional strength and endurance training. Specific exercises to address deficiencies in cervical kinaesthetic sense, balance and eye movement control are implemented as required for the individual patient.

Schlüsselwörter

Übungen - HWS - Nackenschmerzen

Key words

exercise - cervical spine - neck pain

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