Physiotherapeutische Interventionen bei Parkinson

Zusammenfassung

Physiotherapie steigert die motorische Leistungsfähigkeit bei Parkinson bezüglich Gangparameter, Haltung und Gleichgewicht. Eine Reduktion von Stürzen durch physiotherapeutisches Training bei Parkinsonsyndromen kann bislang weder eindeutig wider- noch belegt werden. Physiotherapie reduziert signifikant eine Vielzahl der motorischen Defizite, die zu Stürzen führen. Studien zur Effektivität von physiotherapeutischen Therapieansätzen liegen nur für das idiopathische Parkinsonsyndrom vor, klinische Erfahrungen zeigen, dass auch die übrigen Parkinsonsyndrome davon profitieren. Extreme Rumpffehlstellungen bei Parkinson wie Kamptokormie oder Anterocollis erhöhen die Sturzgefahr zusätzlich zur Grunderkrankung. Diese markanten Störungen können empirisch durch physiotherapeutische Interventionen positiv beeinflusst werden: Muskuläres Krafttraining der betroffenen Muskulatur, Steigerung der Gleichgewichtsleistungen und vor allem der Einsatz geeigneter mobiler Hilfsmittel sind entscheidend.

Summary

Goal-oriented and intensive physiotherapy can improve the motor performance during gait, posture and balance in people with Parkinson’s disease (PD). Up to now, controlled studies have only been conducted in idiopathic PD. Clinical experience suggests benefits for other parkinsonian syndromes. Physical exercise was shown to significantly reduce motor risk factors for falls. There is insufficient evidence to generally support or refute the value of exercise in reducing falls. Axial deformities in PD such as camptocormia or the drop head posture are seen only rarely but further raise the risk for falls. Physiotherapy can address these postural abnormalities by muscular strengthening and improving balance. Specifically adjusted walking aids are a critical element in an effective therapeutic approach.

Schlüsselwörter

Physiotherapie - Parkinsonsyndrome - Sturzgefahr - Kamptokormie - Anterocollis

Keywords

Physiotherapy - Parkinson syndromes - risk of falls - camptocormia - drop head posture

• Literatur

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