physioscience 2014; 10(3): 97-104
DOI: 10.1055/s-0034-1384932
Fachwissen: Parkinson-Syndrom
© Georg Thieme Verlag KG Stuttgart · New York

Evidenzbasierte Physiotherapie bei idiopathischem Parkinson-Syndrom (IPS)[1]

Evidence-Based Physiotherapy in Parkinson’s Disease (PD)
F. E. Schroeteler
Further Information

Publication History

Publication Date:
04 September 2014 (online)

Zusammenfassung

Hintergrund: Das früher Morbus Parkinson genannte idiopathische Parkinson-Syndrom (IPS) gilt in Nordamerika und Europa als zweithäufigste neurodegenerative Erkrankung nach Alzheimer. Es betrifft motorische und nicht motorische Funktionskreisläufe, die in komplexen kortikothalamokortikalen Loops moduliert werden. Motorisch kommt es bei dieser Bewegungsstörung unter anderem zu überschießender bzw. verminderter Willkürmotorik, die im Verlauf zunehmend schwerer kontrolliert werden kann.

Ziel/Methode: Die Arbeit gibt einen Überblick über die aktuellen Studienergebnisse zu evidenzbasierter Physiotherapie bei IPS.

Ergebnisse: Zur Erhaltung der mobilen Selbstständigkeit der Patienten sollte die evidenzbasierte Physiotherapie ihren Schwerpunkt auf Cueing, Schulung motorischer Strategien, Geh- und funktionelles Training von Kraft, Ausdauer und Gleichgewichtssinn legen.

Schlussfolgerung: Die heutige Studienlage zeigt, mit welchen signifikanten Effekten eine evidenzbasierte Physiotherapie rechnen kann, sofern sie sich auf aktivierende Trainingsverfahren und hohe Behandlungsfrequenz stützt.

Abstract

Background: In Northern America and Europe Parkinson’s disease (PD), in the past known as Morbus Parkinson, is considered to be the second leading neurodegenerative disease behind Alzheimer’s. It affects motor and non-motor functional cycles that are modulated in complex cortico-thalamo-cortical loops. As to motor function in this movement disorder, among others, overshooting or reduced arbitrary motor activity occurs which can hardly be controlled in the further course.

Objective/Method: This article gives an overview of the current trial results for evidence-based physiotherapy in Parkinson’s disease.

Results: In order to maintain the patients’ autonomy evidence-based physiotherapy should direct its focus on cueing, training of motor strategies, gait and functional training of strength, endurance and sense of balance.

Conclusion: The current state of studies shows which significant effects may be anticipated by evidence-based physiotherapy, provided that it is based on activating training modalities and high treatment incidence.

1 Der Originalartikel ist erschienen in: neuroreha 2013; 3: 119 – 124.


 
  • Literatur

  • 1 Allen NE, Sherrington C, Canning CG et al. Reduced muscle power is associated with slower walking velocity and falls in people with Parkinson’s disease. Parkinsonism Relat Disord 2010; 16: 261-264
  • 2 Allen NE, Sherrington C, Paul SS et al. Balance and falls in Parkinson’s disease: a meta-analysis of the effect of exercise and motor training. Mov Disord 2011; 26: 1605-1615
  • 3 Ashburn A, Fazakarley L, Ballinger C et al. A randomised controlled trial of a home based exercise programme to reduce the risk of falling among people with Parkinson’s disease. J Neurol Neurosurg Psychiatr 2007; 78: 678-684
  • 4 Ashburn A, Stack E, Ballinger C et al. The circumstances of falls among people with Parkinson’s disease and the use of falls diaries to facilitate reporting. Disability and Rehabilitation 2008; 30: 1205-1212
  • 5 Azulay JP, Mesure S, Amblard B et al. Visual control of locomotion in Parkinson’s disease. Brain 1999; 122: 111-120
  • 6 Berardelli A, Rothwell JC, Thompson PD et al. Pathophysiology of bradykinesia in Parkinson’s disease. Brain 2001; 124: 2131-2146
  • 7 Bloch F, Houeto JL, Tezenas du Montcel S et al. Parkinson’s disease with camptocormia. Journal of Neurology, Neurosurgery and Psychiatry 2006; 77: 1223-1228
  • 8 Bloem BR, Grimbergen YA, Van Dijk JG et al. The “posture second” strategy: a review of wrong priorities in Parkinson’s disease. Journal of the Neurological Sciences 2006; 24: 196-204
  • 9 Von Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc 1982; 14: 377-381
  • 10 Cohen AD, Tillerson JL, Smith AD et al. Neuroprotective effects of prior limb use in 6-hydroxydopamine-treated rats: possible role of GDNF. J Neurochem 2003; 85: 299-305
  • 11 Dibble LE, Hale TF, Marcus RL et al. High intensity eccentric resistance training decreases bradykinesia and improves quality of life in persons with Parkinson’s disease: a preliminary study. Parkinsonism Relat Disord 2009; 15: 752-757
  • 12 Djaldetti R, Mosberg-Galili R, Sroka H. Camptocormia (bent spine) in patients with Parkinson’s disease – characterization and possible pathogenesis of an unusual phenomenon. Mov Disord 1999; 14: 443-447
  • 13 Ebersbach G, Ebersbach A, Edler D et al. Comparing exercise in Parkinson’s disease – the Berlin LSVT BIG study. Mov Disord 2010; 25: 1902-1908
  • 14 Van Eijkeren FJM, Reijmers RSJ, Kleinveld MJ et al. Nordic walking improves mobility in Parkinson’s disease. Mov Disord 2008; 23: 2239-2243
  • 15 Fahn S, Elton R. Unified Parkinson’s Disease Rating Scale. In: Fahn S, Marsden C, Goldstein M, Calne D, (eds) Recent Developments in Parkinson’s Disease. Florham Park: Macmillan Health Care Information; 1987
  • 16 Farley BG, Koshland GF. Training BIG to move faster: the application of the speed-amplitude relation as a rehabilitation strategy for people with Parkinson’s disease. Exp Brain Res 2005; 167: 462-467
  • 17 Fietzek UM, Schroeteler FE, Ziegler K et al. Randomized cross-over trial to investigate the efficacy of a two-week physiotherapy programme with repetitive exercises of cueing to reduce the severity of freezing of gait in patients with Parkinson’s disease. Clin Rehabil 2014; Apr 1. [Epub ahead of print]
  • 18 Foster ER, Golden L, Duncan RP et al. Community-based Argentine tango dance program is associated with increased activity participation among individuals with Parkinson’s disease. Arch Phys Med Rehabil 2013; 94: 240-249
  • 19 Franchignoni F, Horak F, Godi M et al. Using psychometric techniques to improve the Balance Evaluation Systems Test: the mini-BESTest. J Rehabil Med 2010; 42: 323-331
  • 20 Giladi N, Shabtai H, Simon ES et al. Construction of freezing of gait questionnaire for patients with Parkinsonism. Parkinsonism Relat Disord 2000; 6: 165-170
  • 21 Goetz CG, Fahn S, Martinez-Martin P et al. Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): Process, format, and clinimetric testing plan. Mov Disord 2007; 22: 41-47
  • 22 Goodwin VA, Richards SH, Taylor RS et al. The effectiveness of exercise interventions for people with Parkinson’s disease: a systematic review and meta-analysis. Mov Disord 2008; 23: 631-640
  • 23 Hackney ME, Earhart GM. Effects of Dance on Gait and Balance in Parkinson’s Disease: A Comparison of Partnered and Nonpartnered Dance Movement. Neurorehabilitation and Neural Repair 2009; 24: 384-392
  • 24 Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology 1967; 17: 427-442
  • 25 Jöbges M, Heuschkel G, Pretzel C et al. Repetitive training of compensatory steps: a therapeutic approach for postural instability in Parkinson’s disease. J Neurol Neurosurg Psychiatry 2004; 75: 1682-1687
  • 26 Keus S, Hendriks H, Bloem BR et al. KNGF Guidelines for physical therapy in patients with Parkinson’s disease: Clinical practice guidelines for physical therapy in patients with Parkinson’s disease. Supplement to the Dutch Journal of Physiotherapy 2004; 114
  • 27 Keus SH, Bloem BR, Hendriks EJ et al. Evidence-based analysis of physical therapy in Parkinson’s disease with recommendations for practice and research. Mov Disord 2007; 22: 451-460 ; quiz: 600
  • 28 Keus SH, Nieuwboer A, Bloem BR et al. Clinimetric analyses of the Modified Parkinson Activity Scale. Parkinsonism Relat Disord 2009; 15: 263-269
  • 29 Latt MD, Lord SR, Morris JGL et al. Clinical and physiological assessments for elucidating falls risk in Parkinson’s disease. Mov Disord 2009; 24: 1280-1289
  • 30 Li F, Harmer P, Fitzgerald K et al. Tai chi and postural stability in patients with Parkinson’s disease. N Engl J Med 2012; 366: 511-519
  • 31 Lim I, Van Wegen E, De Goede C et al. Effects of external rhythmical cueing on gait in patients with Parkinson’s disease: a systematic review. Clinical rehabilitation 2005; 19: 695-713
  • 32 Mak MKY, Hui-Chan CWY. Cued task-specific training is better than exercise in improving sit-to-stand in patients with Parkinson’s disease: A randomized controlled trial. Mov Disord 2008; 23: 501-509
  • 33 Margraf NG, Wrede A, Rohr A et al. Camptocormia in idiopathic Parkinson’s disease: a focal myopathy of the paravertebral muscles. Mov Disord 2010; 25: 542-551
  • 34 Mehrholz J, Friis R, Kugler J et al. Treadmill training for patients with Parkinson’s disease (Review). Cochrane Database Syst Rev 2010; CD007830
  • 35 Morris ME, Iansek R, Matyas TA et al. Stride length regulation in Parkinson’s disease. Normalization strategies and underlying mechanisms. Brain 1996; 119: 551-568
  • 36 Nieuwboer A, Weerdt WD, Dom R et al. Development of an Activity Scale for Individuals with Advanced Parkinson Disease: Reliability and “On-Off” Variability. Phys Ther 2000; 80: 1087-1096
  • 37 Nieuwboer A, Kwakkel G, Rochester L et al. Cueing training in the home improves gait‐related mobility in Parkinson’s disease: the RESCUE trial. J Neurol Neurosurg Psychiatry 2007; 78: 134-140
  • 38 Onla-or S, Winstein CJ. Determining the optimal challenge point for motor skill learning in adults with moderately severe Parkinson’s disease. Neurorehabil Neural Repair 2008; 22: 385-395
  • 39 Playford ED. Exercise and Parkinson’s disease. J Neurol Neurosurg Psychiatr 2011; 82: 1185
  • 40 Protas EJ, Mitchell K, Williams A. Gait and step training to reduce falls in Parkinson’s disease. NeuroRehabilitation 2005; 20: 183-190
  • 41 Reuter I, Mehnert S, Leone P et al. Effects of a flexibility and relaxation programme, walking, and nordic walking on Parkinson’s disease. J Aging Res 2011; 232473
  • 42 Schroeteler FE, Fietzek UM, Ziegler K et al. Upright posture in parkinsonian camptocormia using a high-frame walker with forearm support. Mov Disord 2011; 26: 1560-1561
  • 43 Schroeteler F, Fietzek U, Ziegler K et al. Die Hüftbeugung ist stärkster Faktor für den Körpergrößenverlust durch Kamptokormie bei Parkinson Syndromen. Hamburg: Abstractband 85. Kongress der DGN, Hamburg; 2012
  • 44 Thaut MH, McIntosh GC, Rice RR et al. Rhythmic auditory stimulation in gait training for Parkinson’s disease patients. Mov Disord 1996; 11: 193-200
  • 45 Tomlinson CL, Patel S, Meek C et al. Physiotherapy versus placebo or no intervention in Parkinson’s disease. Cochrane Database 2012; 11 CD002817
  • 46 www.awmf.org
  • 47 www.nice.org.uk
  • 48 Ziegler K, Schroeteler F, Ceballos-Baumann AO et al. A new rating instrument to assess festination and freezing gait in Parkinsonian patients. Mov Disord 2010; 25: 1012-1018