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Erfahrungsheilkunde 2013; 62(06): 316-320
DOI: 10.1055/s-0033-1357575
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© Karl F. Haug Verlag in MVS Medizinverlage Stuttgart GmbH & Co. KG

Bewegungssteuerung und -training bei Morbus Parkinson

Christian T. Haas
,
Magnus Liebherr
,
Patric Schubert
,
Lars Jäger
Further Information

Publication History

Publication Date:
02 January 2014 (online)

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Zusammenfassung

Bewegungs- und Trainingsprogramme weisen ein bedeutendes Potenzial bei der Behandlung von Morbus Parkinson auf. Vor allem durch gezielt variable Trainingsinhalte können hier krankheitsbedingte Störungen im Bereich der Gang- und Gleichgewichtsmotorik reduziert werden. Zudem gibt es Hinweise, dass ein solches Bewegungstraining über die Freisetzung neurotropher Faktoren neuroprotektive Funktionen hat.

Die Übersicht erläutert die aktuelle Studienlage zur Bewegungsvariabilität und gibt einen Ausblick auf infrage kommende Trainingsansätze.

Abstract

Exercise programs have a considerable potential in the treatment of Parkinson’s disease. Especially variable exercises could be identified having positive effects on disturbances in gait and postural control. Moreover, there are evidences that these exercise patterns are associated with neuroprotective function through the release of neurotrophic factors.

This review presents current research on movement variability and approaches for future training concepts.

Schlüsselwörter

Morbus Parkinson - Bewegungssteuerung - Bewegungstraining - Koordination - Gleichgewicht - Gehfähigkeit - Variabilität

Keywords

Morbus Parkinson - motor control - training - coordination of movement - postural control - gait - variability
 

  • Literatur

  • 1 De Lau LM, Breteler MM. Epidemiology of Parkinson’s disease. Lancet Neurol 2006; 5 (6): 525-535
    CrossrefPubMedGoogle Scholar
  • 2 Keller S, Kessler T, Meuser T et al. Analyse der direkten Kosten in der Parkinson-Therapie. Nervenarzt 2003; 12: 1105-1109
    PubMedGoogle Scholar
  • 3 Gerlach M, Reichmann H, Riederer P. Die Parkinson-Krankheit. Grundlagen − Klinik − Therapie. Wien: Springer; 2003.
    Google Scholar
  • 4 Kish SJ, Shannak K, Hornykiewicz O. Uneven pattern of dopamine loss in the striatum of patients with idiopathic Parkinson’s disease. N Engl J Med 1988; 14: 876-880
    PubMedGoogle Scholar
  • 5 Braak H, Rüb U, Braak E. Neuroanatomie des Morbus Parkinson. Nervenarzt 2000; 6: 459-469
    PubMedGoogle Scholar
  • 6 Hurtig HI. Problems with current pharmacological treatment of Parkinson’s disease. Exp Neurol 1997; 144 (1): 10-16
    CrossrefPubMedGoogle Scholar
  • 7 Benabid AL, Koudsie A, Benazzouz A et al. Deep brain stimulation of the corpus luysi (subthalamic nucleus) and other targets in Parkinson’s disease. Extension to new indications such as dystonia and epilepsy. J Neurol 2001; 248 (Suppl 3): S37-S47
    CrossrefPubMedGoogle Scholar
  • 8 Meissner W, Trottenberg T, Klaffke S et al. Apomorphintherapie versus tiefe Hirnstimulation. Nervenarzt 2001; 12: 924-927
    PubMedGoogle Scholar
  • 9 Giladi N, Treves TA, Simon ES et al. Freezing of gait in advanced Parkinson’s disease. J Neur Transm 2001; 108 (1): 53-61
    CrossrefPubMedGoogle Scholar
  • 10 Schwed M, Haas CT. Effekte trainingstherapeutischer Maßnahmen bei Morbus Parkinson, Teil A: Intrinsische Trainingsmaßnahmen. PT Zeitschr Physiother 2011; 8: 6-17
    PubMedGoogle Scholar
  • 11 Schwed M, Haas CT. Effekten trainingstherapeutischer Maßnahmen bei Morbus Parkinson, Teil B: Extrinsische Trainingsmaßnahmen. PT Zeitschr Physiother 2001; 9: 6-19
    PubMedGoogle Scholar
  • 12 Falvo MJ, Schilling BK, Earhart GM. Parkinson’s disease and resistive exercise: rationale, review, and recommendations. Mov Disord 2008; 23 (1): 1-11
    CrossrefPubMedGoogle Scholar
  • 13 Schrag A, Jahanshahi M, Quninn N. What contributes to quality of life in patients with Parkinson’s disease?. J Neurol Neurosurg Psychiatry 2000; 69 (3): 308-312
    CrossrefPubMedGoogle Scholar
  • 14 Ashburn A, Stack E, Pickering RM et al. A community-dwelling sample of people with Parkinson’s disease: characteristics of fallers and non-fallers. Age Aging 2001; 30 (1): 47-52
    PubMedGoogle Scholar
  • 15 Karlsen KH, Tandberg E, Arsland D et al. Health related quality of life in Parkinson’s disease: a prospective longitudinal study. J Neurol Neurosurg Psychiatry 2000; 69 (5): 584-589
    CrossrefPubMedGoogle Scholar
  • 16 Turbanski S, Haas CT, Schmidtbleicher D. Effects of random whole-body-vibration on postural stability in Parkinson’s Disease. Res Sports Med 2005; 13 (3): 243-257
    CrossrefPubMedGoogle Scholar
  • 17 Schwed M, Haas CT. Morbus Parkinson. Cueing, Chunking und Cross-Modal Interaction. Interdisziplinäre Erklärungsansätze für die Gangtherapie bei Morbus Parkinson. Physiother med 2009; 5: 5-10
    PubMedGoogle Scholar
  • 18 Schwed M, Kersten S, Scholl N, Haas CT. Assessments von neurologischen Gangstörungen. Bewegungstherapie Gesundheitssport 2009; 14-23
    PubMedGoogle Scholar
  • 19 Morris ME, Iansek R, Matyas TA et al. Stride length regulation in Parkinson’s disease. Normalization strategies and underlying mechanisms. Brain 1996; 119 (Pt 2): 551-568
    CrossrefPubMedGoogle Scholar
  • 20 Morris ME, Iansek R, Matyas TA et al. The pathogenesis of gait hypokinesia in Parkinson’s disease. Brain 1194; 117 (Pt 5): 1169-1181
    PubMedGoogle Scholar
  • 21 Blin O, Ferrandez AM, Pailhous J et al. Dopa-sensitive and dopa-resistant gait parameters in Parkinson’s disease. J Neurol Sci 1991; 103 (1): 51-54
    CrossrefPubMedGoogle Scholar
  • 22 Baltadjieva R, Giladi N, Gruendlinger L et al. Marked alterations in the gait timing and rhythmicity of patients with de novo Parkinson’s disease. Eur J Neurosci 2006; 24 (6): 1815-1820
    CrossrefPubMedGoogle Scholar
  • 23 Turbanski S.  Zur posturalen Kontrolle bei Morbus Parkinson: biomechanische Diagnose und Training [Dissertation]. Frankfurt: : 2006
    Google Scholar
  • 24 Schubert P, Kirchner M, Schmidtbleicher D, Haas CT. About the structure of posturography: Sampling duration, parametrization, focus of attention (part I). J Biomed Sci Eng 2012; 5: 496-507
    CrossrefPubMedGoogle Scholar
  • 25 Hausdorff JM. Gait dynamics, fractals and falls: finding meaning in the stride-to-stride fluctuations of human walking. Hum Mov Sci 2007; 26 (4): 555-589
    CrossrefPubMedGoogle Scholar
  • 26 Hausdorff JM. Gait dynamics in Parkinson’s disease: common and distinct behavior among stride length, gait variability, and fractal-like scaling. Chaos 2009; 19 (2) 026113
    PubMedGoogle Scholar
  • 27 Schubert P, Kirchner M. Ellipse area calculations and their applicability in posturography. Gait Posture. (In press)
    Google Scholar
  • 28 Błaszczyk JW, Orawiec R. Assessment of postural control in patients with Parkinson’s disease: sway ratio analysis. Hum Mov Sci 2011; 30 (2): 396-404
    CrossrefPubMedGoogle Scholar
  • 29 Schubert P. Die Anwendung nichtlinearer Verfahren zur Charakterisierung der menschlichen Variabilität aus Zeitreihen. Deutsche Zeit Sportmed 2013; 64 (5): 132-140
    PubMedGoogle Scholar
  • 30 Schmit JM, Riley MA, Dalvi A et al. Deterministic center of pressure patterns characterize postural instability in Parkinson’s disease. Exp Brain Res 2006; 168 (3): 357-367
    CrossrefPubMedGoogle Scholar
  • 31 Galna B, Lord S, Rochester L. Is gait variability reliable in older adults and Parkinson’s disease? Towards an optimal testing protocol. Gait Posture 2013; 37 (4): 580-585
    CrossrefPubMedGoogle Scholar
  • 32 Frenkel-Toledo S, Giladi N, Peretz C et al. Treadmill walking as an external pacemaker to improve gait rhythm and stability in Parkinson’s disease. Mov Disord 2005; 20 (9): 1109-1114
    CrossrefPubMedGoogle Scholar
  • 33 Harbourne RT, Stergiou N. Movement variability and the use of nonlinear tools: principles to guide physical therapist practice. Phys Ther 2009; 89 (3): 267-282
    CrossrefPubMedGoogle Scholar
  • 34 Stergiou N, Harbourne R, Cavanaugh J. Optimal movement variability: a new theoretical perspective for neurologic physical therapy. J Neurol Phys Ther 2006; 30 (3): 120-129
    CrossrefPubMedGoogle Scholar
  • 35 Haas CT, Blischke K. Bedeutung der Repetition für das motorische Lernen. Lehren aus der Sportwissenschaft. Neuroreha 2009; 1: 19-26
    PubMedGoogle Scholar
  • 36 Haas CT, Kersten S, Lutz C et al. Deviance-based gait training in multiple sclerosis. Isokinet Exerc Sci 2010; 2: 82-83
    PubMedGoogle Scholar
  • 37 Nelson LM, den Eeden SK, Tanner CM. Incidence of idiopathic Parkinson’s disease (PD) in a health maintenance organization (HMO): variation by age, gender and race/ethnicity. Neurology 1997; 48 (Suppl 2) A334
    PubMedGoogle Scholar
  • 38 Jenkins IH, Brooks DJ, Nixon PD et al. Motor sequence learning: a study with positron emission tomography. J Neurosci 1994; 14 (6): 3775-3790
    PubMedGoogle Scholar
  • 39 Penhune VB, Doyon J. Dynamic cortical and subcortical networks in learning and delayed recall of timed motor sequences. J Neurosci 2002; 22 (4): 1397-1406
    PubMedGoogle Scholar
  • 40 Playford ED, Jenkins IH, Passingham RE et al. Impaired medial frontal and putamen activation in Parkinson’s Disease: a positronen emission tomography study. Ann Neurol 1992; 32 (2): 151-161
    CrossrefPubMedGoogle Scholar
  • 41 Jahanshahi M, Frith CD. Willed action and its impairments. Cogn Neuropsychol 1998; 15 (6−8): 483-533
    CrossrefPubMedGoogle Scholar
  • 42 Catalan MJ, Ishii K, Honda M et al. A PET study of sequential finger movements of varying length in patients with Parkinson’s disease. Brain 1999; 122 (Pt 3): 483-495
    CrossrefPubMedGoogle Scholar
  • 43 Andreassen CS, Jakobsen J, Flyvbjerg A et al. Expression of neurotrophic factors in diabetic muscle--relation to neuropathy and muscle strength. Brain 2009; 132 (Pt 10): 2724-2733
    CrossrefPubMedGoogle Scholar
  • 44 Howells DW, Porritt MJ, Wong JY et al. Reduced BDNF mRNA expression in the Parkinson’s disease substantia nigra. Exp Neurol 2000; 166 (1): 127-135
    CrossrefPubMedGoogle Scholar
  • 45 Sarchielli P, Greco L, Stipa A et al. Brain-derived neurotrophic factor in patients with multiple sclerosis. J Neuroimmunol 2002; 132 (1−2): 180-188
    CrossrefPubMedGoogle Scholar
  • 46 Azoulay D, Vachapova V, Shihman B et al. Lower brain-derived neurotrophic factor in serum of relapsing remitting MS: reversal by glatiramer acetate. J Neuroimmunol 2005; 167 (1−2): 215-218
    CrossrefPubMedGoogle Scholar
  • 47 Mattson MP, Magnus T. Ageing and neuronal vulnerability. Nat Rev Neurosci 2006; 7 (4): 278-294
    CrossrefPubMedGoogle Scholar
  • 48 Vaynman S, Gomez-Pinilla F. License to run: exercise impacts functional plasticity in the intact and injured central nervous system by using neurotrophins. Neurorehabil Neural Repair 2005; 19 (4): 283-295
    CrossrefPubMedGoogle Scholar
  • 49 Neeper SA, Gómez-Pinilla F, Choi J et al. Physical activity increases mRNA for brain-derived neurotrophic factor and nerve growth factor in rat brain. Brain Res 1996; 726 (1−2): 49-56
    CrossrefPubMedGoogle Scholar
  • 50 Hutchinson KJ, Gomez-Pinilla F, Crowe MJ et al. Three exercise paradigms differentially improve sensory recovery after spinal cord contusion in rats. Brain 2004; 127 (Pt 6): 1403-1414
    CrossrefPubMedGoogle Scholar
  • 51 Molteni R, Wu A, Vaynman S et al. Exercise reverses the harmful effects of consumption of a high-fat diet on synaptic and behavioral plasticity associated to the action of brain-derived neurotrophic factor. Neuroscience 2004; 123 (2): 429-440
    CrossrefPubMedGoogle Scholar
  • 52 Ying Z, Roy RR, Edgerton VR et al. Exercise restores levels of neurotrophins and synaptic plasticity following spinal cord injury. Exp Neurol 2005; 193 (2): 411-419
    CrossrefPubMedGoogle Scholar
  • 53 Cohen AD, Tillersson JL, Smith AD et al. Neuroprotective effects of prior limb use in 6-hydrxydopamine-treated rats: possible role of GDNF. J Neurochem 2003; 85 (2): 299-305
    CrossrefPubMedGoogle Scholar
  • 54 Tillerson JL, Cohen AD, Caudle WM et al. Forced Nonuse in Unilateral Parkinsonian Rats Exacerbates Injury. J Neurosci 2002; 22 (15): 6790-6799
    PubMedGoogle Scholar
  • 55 Aguiar AS Jr, Speck AE, Prediger RD et al. Downhill training upregulates mice hippocampal and striatal brain-derived neurotrophic factor levels. J Neural Transm 2008; 115 (9): 1251-1255
    CrossrefPubMedGoogle Scholar
  • 56 Smith MA, Makino S, Kvetnanský R et al. Effects of stress on neurotrophic factor expression in the rat brain. Ann N Y Acad Sci 1995; 771: 234-239
    CrossrefPubMedGoogle Scholar
  • 57 Nofuji Y, Suwa M, Moriyama Y et al. Decreased serum brain-derived neurotrophic factor in trained men. Neurosci Lett 2008; 437 (1): 29-32
    CrossrefPubMedGoogle Scholar
  • 58 Podsiadlo D, Richardson S.  The timed „Up & Go“: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991; 39 (2): 142-148
    CrossrefPubMedGoogle Scholar
  • 59 Berg KO, Wood-Dauphinee SL, Williams JI et al. Measuring balance in the elderly: validation of an instrument. Can J Public Health 1992; 83 (2): S7-11
    PubMedGoogle Scholar
  • 60 Fahn S, Elton RL. Unified Parkinson’s disease rating scale. In: Fahn S, Goldstein M, Marsden D, et al., Hrsg. Recent developments in Parkinson’s disease. Vol. II. New Jersey: Mac-Millan; 1987.
    Google Scholar