Mobilität, Lokomotion, posturale Kontrolle nach Schädel-Hirn-Trauma

Zusammenfassung

Ein wichtiges Ziel der stationären Rehabilitation von Patienten mit Schädel-Hirn-Traumata (SHT) ist die Verbesserung der Mobilität, insbesondere die Verbesserung der posturalen Kontrolle und der selbstständigen Gehleistung. Darauf ist die Physiotherapie spezialisiert.

Durch Einschränkungen der Balance und der Gehfähigkeit sind zahlreiche Alltagsleistungen wie selbstständige Toilettengänge, die Essenszubereitung sowie das Aufstehen und Hinsetzen nur mit viel Unterstützung von Hilfspersonen möglich. Dem Wiederherstellen der Mobilität kommt innerhalb der neurologischen Rehabilitation somit eine erhebliche Bedeutung zu.

• Literatur

• 1 Canning CG, Shepherd RB, Carr JH et al. A randomized controlled trial of the effects of intensive sit-to-stand training after recent traumatic brain injury on sit-to-stand performance. Clin Rehabil 2003; 17: 355-362
• 2 Clark RA, Williams G, Fini N et al. Coordination of dynamic balance during gait training in people with acquired brain injury. Arch Phys Med Rehabil 2012; 4: 636-640
• 3 Freivogel S. Motorische Rehabilitation nach Schädelhirntrauma. Klinik – Grundlagen – Therapie. München: Pflaum; 1997
• 4 Freivogel S, Mehrholz J, Husak-Sotomayor T et al. Gait training with the newly developed „LokoHelp“-system is feasible for non-ambulatory patients after stroke, spinal cord and brain injury. A feasibility study. Brain Injury 2008; 7 & 8: 625-632
• 5 Freivogel S, Schmalohr D, Mehrholz J. Improved walking ability and reduced therapeutic stress with an electromechanical gait device. Journal Rehabilitation Medicine 2009; 734-739
• 6 French B, Thomas LH, Leathley MJ et al. Repetitive task training for improving functional ability after stroke. Cochrane Database Syst Rev 2007; 4 CD006073
• 7 Geurts AC, de Haart M, van Nes IJ et al. A review of standing balance recovery from stroke. Gait Posture 2005; 3: 267-281
• 8 Hofheinz M, Mibs M, Elsner B. Balancetraining nach Schlaganfall. In: Mehrholz J, Hrsg. Neuroreha nach Schlaganfall. Stuttgart: Thieme; 2011: 95-114
• 9 Horn S, Dejong G, Smout R et al. Stroke rehabilitation patients, practice, and outcomes: Is earlier and more aggressive therapy better?. Arch Phys Med Rehabil 2005; 12 (Suppl. 01) 101-114
• 10 Johnson L, Burridge J, Demain S. Internal and external focus of attention during gait re-education: An observational study of physical therapist practice in stroke rehabilitation. Phys Ther 07/2013; 957-966
• 11 Kirker SG, Simpson DS, Jenner JR et al. Stepping before standing: Hip muscle function in stepping and standing balance after stroke. J Neurol Neurosurg Psychiatry 2000; 4: 458-464
• 12 McNevin NH, Wulf G. Attentional focus on supra-postural tasks affects postural control. Hum Mov Sci 2002; 2: 187-202
• 13 Mehrholz J, Rutte K, Pohl M. Jump training is feasible for nearly ambulatory patients after stroke. Clin Rehabil 2006; 5: 406-412
• 14 Mehrholz J, Elsner B, Werner C et al. Electromechanical-assisted training for walking after stroke. Cochrane Database of Systematic Reviews 2013; 7 CD006185
• 15 Mehrholz J, Elsner B, Pohl M. Treadmill training and body weight support for walking after stroke. Cochrane Database Systematic Reviews 2014; 1 CD002840
• 16 Mückel S, Mehrholz J. Immediate effects of two attention strategies on trunk control on patients after stroke. A randomized controlled pilot trial. Clin Rehabil 2014; Jan 22 [Epub ahead of print]
• 17 Pollock A, Durward B, Rowe P et al. What is balance?. Clin Rehabil 2000; 402-406
• 18 Schmidt R, Lee T. Motor learning and performance. From Principles to Application Human Kinetics 2014;
• 19 Shumway-Cook A, Woollacott M. Motor Control. Translating Research into Clinical Practice. Philadelphia, PA: Lippincott, Williams & Wilkins; 2007
• 20 Tyson SF, Hanley M, Chillala J et al. Balance disability after stroke. Phys Ther 2006; 1: 30-38
• 21 Tyson SF, Connell LA. How to measure balance in clinical practice. A systematic review of the psychometrics and clinical utility of measures of balance activity for neurological conditions. Clin Rehabil 2009; 9: 824-840
• 22 Tyson SF, Connell L, Busse M et al. What do acute stroke physiotherapists do to treat postural control and mobility? An exploration of the content of therapy in the UK. Clin Rehabil 2009; 11: 1051-1055
• 23 Veerbeek JM, van Wegen E, van Peppen R et al. What is the evidence for physical therapy poststroke? A systematic review and meta-analysis. PLoS One 2014; 2 e87987
• 24 Verheyden G, Vereeck L, Truijen S et al. Trunk performance after stroke and relationship with balance, gait and functional ability. Clinical Rehabilitation 2006; 5: 451-458
• 25 Werner C, Von Frankenberg S, Treig T et al. Treadmill training with partial body weight support and an electromechanical gait trainer for restoration of gait in subacute stroke patients: A randomized crossover study. Stroke 2002; 12: 2895-2901
• 26 Williams G, Clark R, Schache A et al. Training conditions influence walking kinematics and self-selected walking speed in patients with neurological impairments. J Neurotrauma 2011; 2: 281-287
• 27 Williams G, Lai D, Schache A et al. Classification of gait disorders following traumatic brain injury. J Head Trauma Rehabil 2014;
• 28 Wulf G, McNevin NH, Fuchs T et al. Attentional focus in complex skill learning. Res Q Exerc Sport 2000; 3: 229-239
• 29 Wulf G, Weigelt M, Poulter D et al. Attentional focus on suprapostural tasks affects balance learning. Q J Exp Psychol A 2003; 7: 1191-1211