Zusammenfassung
Hintergrund: Aufgrund steigender Lebenserwartung nimmt die Inzidenz der Gonarthrose zu, Krafttraining
gilt als etablierte therapeutische Maßnahme. Ziel war es, im Vergleich dazu die Effektivität
des Vibrationstrainings zu überprüfen.
Patienten und Methoden: Aus 39 Teilnehmern von Gonarthrosesportgruppen wurden 39 Patienten randomisiert in
eine Vibrationstrainingsgruppe, eine Krafttrainingsgruppe und in eine Kontrollgruppe
eingeteilt. Das Krafttraining für die Oberschenkelmuskulatur fand 8 Wochen lang zweimal
pro Woche über 45 min, das Vibrationstraining über 16 min mit gleicher Häufigkeit
statt. Vor und nach dem Training wurde die isometrische Maximalkraft der Extensoren
bei 60° Knieflexion und die isokinetische Flexions- und Extensionskraft bei 60°/s
in der Konzentrik beider Beine gemessen. Aufgrund der Anamnese erfolgte eine Unterscheidung
in ein mehr oder weniger von der Gonarthrose betroffenes Bein. Während des Trainings
wurde täglich ein Schmerztagebuch geführt.
Ergebnisse: Die isometrische Extensionskraft nahm in beiden Interventionsgruppen signifikant
zu, aber nur in der Vibrationsgruppe ausgeprägter am betroffenen Bein. Die isokinetische
Flexions- und Extensionskraft nahm in beiden Gruppen ebenfalls signifikant zu, in
der Vibrationsgruppe etwas ausgeprägter die Flexion. Während der Intervention gingen
die Gonarthrose bedingten Schmerzen in beiden Gruppen zurück. In der Kontrollgruppe
fanden sich zu allen Messungen keine signifikanten Veränderungen.
Schlussfolgerung: Vibrationstraining zeigt sich bei Gonarthrosepatienten gleichwertig zum herkömmlichen
Krafttraining im Hinblick auf Kraftentwicklung und Schmerzreduktion, erscheint aber
im Hinblick auf den weniger als halb so hohen Zeitaufwand effektiver.
Abstract
Background: The diagnosis of osteoarthritis of the knee is becoming more common as life expectancy
increases. Strength training has been proven to be an effective treatment. The aim
of the present study was to investigate the effect of whole body vibration in comparison
to strength training to treat patients with osteoarthritis of the knee. 39 persons
participating in special outpatient groups for osteoarthritis of the knee agreed to
take part in the study. They were randomly distributed into a vibration group (15),
a strength training group (15) and a control group (9). The traditional strength training
for the thigh muscles was performed twice a week for 45 min, and the vibration training
was also done twice a week for 16 min for a total of 8 weeks. Before and after training,
the isometric strengths for the extensors were measured at 60° knee flexion and the
isokinetic strengths for flexion and extension at 60°/s in the concentric mode for
both legs. Based on the anamnesis the legs were defined as the more effected and the
less effected leg. During the training period, knee pain was monitored daily using
a visual scale.
Results: Isometric extension strength increased in both groups significantly, with slightly
more increase seen in the effected leg of the vibration group. The isokinetic flexion
and extension strength also increased in both groups; flexion strength increasing
slightly more in the vibration group. During the intervention pain decreased in both
groups. In the control group, no significant changes occurred at any measurement points.
Conclusion: Vibration training yields similar results as traditional strength training for strength
gain and reduction of pain, but is more efficient with respect to the training time
necessary.
Schlüsselwörter
Krafttraining - Vibrationstraining - Gonarthrose - Prävention - Rehabilitation
Key words
strength training - vibration training - osteoarthritis - prevention - rehabilitation
Literatur
- 1
Rabenda V, Manette C, Lemmens R. et al .
Direct and indirect costs attributable to osteoarthritis in active subjects.
J Rheumatol.
2006;
33
1152-1158
- 2
Fransen M, Crosbie J, Edmonds J.
Physical therapy is effective for patients with osteoarthritis of the knee: a randomized
controlled clinical trial.
J Rheumatol.
2001;
28
156-164
- 3
Horstmann T, Mayer F, Heitkamp HC. et al .
Individual isokinetic strength training in patients with gonarthrosis.
Z Rheumatol.
2000;
59
93-100
- 4
Bennell K, Hinman R.
Exercise as a treatment for osteoarthritis.
Curr Opin Rheumatol.
2005;
17
634-640
- 5
Slemenda C, Brandt KD, Heilman DK. et al .
Quadriceps weakness and osteoarthritis of the knee.
Ann Intern Med.
1997;
127
97-104
- 6
Cardinale M, Pope MH.
The effects of whole body vibration on humans: dangerous or advantageous?.
Acta Physiol Hung.
2003;
90
195-206
- 7
Bosco C, Colli R, Introini E. et al .
Adaptive responses of human skeletal muscle to vibration exposure.
Clin Physiol.
1999;
19
183-187
- 8
Rittweger J, Belavy D, Hunek P. et al .
Highly demanding resistive vibration exercise program is tolerated during 56 days
of strict bed-rest.
Int J Sports Med.
2006;
27
553-559
- 9
Blottner D, Salanova M, Puttmann B. et al .
Human skeletal muscle structure and function preserved by vibration muscle exercise
following 55 days of bed rest.
Eur J Appl Physiol.
2006;
97
261-271
- 10
Delecluse C, Roelants M, Diels R. et al .
Effects of whole body vibration training on muscle strength and sprint performance
in sprint-trained athletes.
Int J Sports Med.
2005;
26
662-668
- 11
Sangnier S, Tourny-Chollet C.
Comparison of the decrease in strength between hamstrings and quadriceps during isokinetic
fatigue testing in semiprofessional soccer players.
Int J Sports Med.
2007;
28
952-957
- 12
Bruyere O, Wuidart MA, Di PE. et al .
Controlled whole body vibration to decrease fall risk and improve health-related quality
of life of nursing home residents.
Arch Phys Med Rehabil.
2005;
86
303-307
- 13
Altman R, Asch E, Bloch D. et al .
Development of criteria for the classification and reporting of osteoarthritis. Classification
of osteoarthritis of the knee.
Arthritis Rheum.
1986;
29
1039-1049
- 14
Kellgren JH, Lawrence JS.
Radiological assessment of osteoathritis.
Ann Rheum Dis.
1957;
16
494-501
- 15
Heitkamp HC, Graf I, Horstmann T. et al .
Pathophysiologie und Sporttherapie der Gonarthrose aus heutiger Sicht.
Dtsch Z Sportmed.
1997;
48
349-359
- 16
Bergmann G, Graichen F, Rohlmann A. et al .
Loads acting on orthopaedic implants. Measurements and practical applications.
Orthopade.
2007;
36
195-200,
, 202–204
- 17
Delecluse C, Roelants M, Verschueren S.
Strength increase after whole-body vibration compared with resistance training.
Med Sci Sports Exerc.
2003;
35
1033-1041
- 18
Rittweger J, Felsenberg D, Maganaris C. et al .
Vertical jump performance after 90 days bed rest with and without flywheel resistive
exercise, including a 180 days follow-up.
Eur J Appl Physiol.
2007;
100
427-436
- 19
Roelants M, Delecluse C, Goris M. et al .
Effects of 24 weeks of whole body vibration training on body composition and muscle
strength in untrained females.
Int J Sports Med.
2004;
25
1-5
- 20
Melnyk M, Kofler B, Faist M. et al .
Effect of a whole-body vibration session on knee stability.
Int J Sports Med.
2008;
29
839-844
- 21
Moezy A, Olyaei G, Hadian M. et al .
A comparative study of whole body vibration training and conventional training on
knee proprioception and postural stability after anterior cruciate ligament reconstruction.
Br J Sports Med.
2008;
42
373-378
- 22
Heitkamp HC, Horstmann T, Mayer F. et al .
Gain in strength and muscular balance after balance training.
Int J Sports Med.
2001;
22
285-290
- 23
Luo J, McNamara B, Moran K.
The use of vibration training to enhance muscle strength and power.
Sports Med.
2005;
35
23-41
- 24
Torvinen S, Kannu P, Sievanen H. et al .
Effect of a vibration exposure on muscular performance and body balance. Randomized
cross-over study.
Clin Physiol Funct Imaging.
2002;
22
145-152
- 25
Torvinen S, Kannus P, Sievanen H. et al .
Effect of four-month vertical whole body vibration on performance and balance.
Med Sci Sports Exerc.
2002;
34
1523-1528
- 26
van Dijk GM, Dekker J, Veenhof C. et al .
Course of functional status and pain in osteoarthritis of the hip or knee: a systematic
review of the literature.
Arthritis Rheum.
2006;
55
779-785
Korrespondenzadresse
Dr. W. Rapp
Medizinische Universitätsklinik Tübingen
Abteilung Sportmedizin
Silcherstraße 5
72076 Tübingen
Telefon: 07071 2986470
Fax: 07071 295162
eMail: walter.rapp@med.uni-tuebingen.de
