Aktivierende Therapien bei Parkinson-Syndromen

A. O. Ceballos-Baumann; F. E. Schroeteler; U. M. Fietzek; K. Ziegler

doi:10.1055/s-0038-1641684

Nervenheilkunde, Inhaltsverzeichnis

Nervenheilkunde 2018; 37(04): 264-271
DOI: 10.1055/s-0038-1641684

Morbus Parkinson

Schattauer GmbH

Aktivierende Therapien bei Parkinson-Syndromen

Non-pharmacological therapies in Parkinsonian syndromes

A. O. Ceballos-Baumann

¹Schön Klinik München-Schwabing, Abt. für Neurologie und klinische Neurophysiologie mit Parkinson-Fachklinik

,

F. E. Schroeteler

¹Schön Klinik München-Schwabing, Abt. für Neurologie und klinische Neurophysiologie mit Parkinson-Fachklinik

,

U. M. Fietzek

¹Schön Klinik München-Schwabing, Abt. für Neurologie und klinische Neurophysiologie mit Parkinson-Fachklinik

,

K. Ziegler

¹Schön Klinik München-Schwabing, Abt. für Neurologie und klinische Neurophysiologie mit Parkinson-Fachklinik

› Institutsangaben

Abstract

Zusammenfassung

Trotz wachsender Möglichkeiten in der Pharmakotherapie und der tiefen Hirnstimulation können bei der Mehrzahl der Parkinson-Patienten im Verlauf wesentliche Funktionen wie Gleichgewicht, Gehen, Sprechen, Schlucken und Kognition langfristig nur unzureichend gebessert werden. Den aktivierenden Therapien wie Physio-, Sprech-, Schluck- und Ergotherapie kommt hierbei eine zunehmen de Rolle zu. Der Empfehlungsgrad in den S3-Leitlinien erreicht für die Haupttherapie-formen Level A (Physiotherapie) und B (Logopädie, Schlucktherapie, Ergotherapie). Für die Physiotherapie finden sich die meisten Studien. Neue Ansätze mit Krafttraining, Tanzen, Tai Chi sowie gerätegestützte Ansätze wie Laufbandtraining kombiniert mit neuen Entwicklungen wie virtueller Realität und Spielkonsolen („Exergaming“) weisen eine gute Studienevidenz auf. Die S3-Leitlinie der DGN fordert für alle Patienten in allen Stadien Zugang zu einer zeitlich ausreichenden Physiotherapie. Dieser CME Artikel fasst den Stand der aktivierenden Therapien in der Langzeitversorgung von Parkinson-Patienten zusammen.

Summary

Despite advances in pharmacotherapy and deep brain stimulation most patients with Parkinson’s disease (PD) experience impairments in balance, gait, speech, voice, swallowing and cognition. Non-pharmacological (“Activating”) therapies such as physiotherapy, occupational, swallowing, voice and speech therapy play an important role in alleviating these symptoms. The recommendation level in the German guidelines is the highest for physiotherapy, for occupational and speech therapy it is second highest. Most trials have been performed in physiotherapy. New approaches with progressive resistance training, weight lifting, dance, Tai chi, thread mills combined with virtual reality and exergaming show good evidence in randomised trials. The German S3 guidelines demand that all PD patients in all stages have access to sufficient time resources of physiotherapy. This CME article summarises the role of activating interventions in the long term care of PD patients.

Schlüsselwörter

Parkinson-Syndrome - Physiotherapie - Ergotherapie - Schluck- - Stimm- und Sprechtherapie - Cues - Freezing

Keywords

Parkinson’s disease - physiotherapy - occupational - swallowing - voice and speech therapy - cues - freezing

Volltext

Referenzen

Literatur
1 Ceballos-Baumann A, Ebersbach G. (Hrsg.) Aktivierende Therapien bei Parkinson-Syndromen. 3. Aufl. Stuttgart: Thieme; 2017
2 Tucha S. Psychotherapeutische Interventionen bei Morbus Parkinson aus klinischer Sicht. Nervenheilkunde 2018; 37: 257-263.
3 Clarke CE. et al. Physiotherapy and Occupational Therapy vs No Therapy in Mild to Moderate Parkinson Disease: A Randomized Clinical Trial. JAMA Neurol 2016; 73 (03) 291-299.
4 Tomlinson CL. et al. Physiotherapy versus placebo or no intervention in Parkinson’s disease. Cochrane Database Syst Rev 2013; (09) CD002817.
5 David FJ. et al. Exercise improves cognition in Parkinson’s disease: The PRET-PD randomized, clinical trial. Mov Disord 2015; 30 (12) 1657-1663.
6 Cusso ME, Donald KJ, Khoo TK. The Impact of Physical Activity on Non-Motor Symptoms in Parkinson’s Disease: A Systematic Review. Front Med (Lausanne) 2016; 03: 35.
7 Reynolds GO, Otto MW, Ellis TD, Cronin-Golomb A. The Therapeutic Potential of Exercise to Improve Mood, Cognition, and Sleep in Parkinson’s Disease. Mov Disord 2016; 31 (01) 23-38.
8 Petzinger GM, Fisher BE, McEwen S, Beeler JA, Walsh JP, Jakowec MW. Exerciseenhanced neuroplasticity targeting motor and cognitive circuitry in Parkinson’s disease. Lancet Neurol 2013; 12 (07) 716-726.
9 Kintz N, Petzinger GM, Jakowec MW. Treadmill exercise modifies dopamine receptor expression in the prefrontal cortex of the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-lesioned mouse model of Parkinson’s disease. Neuroreport 2017; 28 (15) 987-995.
10 Sasco AJ, Paffenbarger Jr RS, Gendre I, Wing AL. The role of physical exercise in the occurrence of Parkinson’s disease. Arch Neurol 1992; 49 (04) 360-365.
11 Yang F. et al. Physical activity and risk of Parkinson’s disease in the Swedish National March Cohort. Brain 2015; 138 (Pt 2): 269-275.
12 LaHue SC, Comella CL, Tanner CM. The best medicine? The influence of physical activity and inactivity on Parkinson’s disease. Mov Disord 2016; 31 (10) 1444-1454.
13 Hely MA, Morris JG, Reid WG, Trafficante R. Sydney Multicenter Study of Parkinson’s disease: non-L-dopa-responsive problems dominate at 15 years. Mov Disord 2005; 20 (02) 190-199.
14 DGN Ld. Idiopathisches Parkinson-Syndrom, Entwicklungsstufe: S3, Stand: 1. Januar 2016, Gültig bis: 31. Dezember 2020, AWMF-Register-nummer: 030/010. https://wwwdgnorg/leitlinien/3219–030–010-idiopathisches-parkinson-syndrom 2016.
15 Li F. et al. Tai chi and postural stability in patients with Parkinson’s disease. N Engl J Med 2012; 366 (06) 511-519.
16 Raglio A. Music Therapy Interventions in Parkinson’s Disease: The State-of-the-Art. Front Neurol 2015; 06: 185.
17 Elefant C, Baker FA, Lotan M, Lagesen SK, Skeie GO. The effect of group music therapy on mood, speech, and singing in individuals with Parkinson’s disease – a feasibility study. J Music Ther 2012; 49 (03) 278-302.
18 Shih LC, Piel J, Warren A, Kraics L, Silver A, Vanderhorst V. et al. Singing in groups for Parkinson’s disease (SING-PD): a pilot study of group singing therapy for PD-related voice/speech disorders. Parkinsonism Relat Disord 2012; 18 (05) 548-552.
19 Hackney ME, Earhart GM. Health-related quality of life and alternative forms of exercise in Parkinson disease. Parkinsonism Relat Disord 2009; 15 (09) 644-648.
20 Ziegler K. E-health in der Physiotherapie bei Parkinson-Patienten. Nervenheilkunde 2015; 34: 129-137.
21 Keus L. et al. Europäische Physiotherapie-Leitlinie zum idiopatischen Parkinson-Syndrom Entwickelt von zwanzig europäischen Physiotherapieverbänden. http://wwwparkinsonnetinfo/guidelines 2015.
22 Sturkenboom et al. Guidelines for Occupational Therapy in Parkinson’s Disease Rehabilitation. http://wwwparkinsonnetinfo/media/14820461/ot_guidelines_final-npf_3_pdf 2011.
23 Kalf H. et al. Guidelines for Speech-Language Therapy in Parkinson’s Disease. http://wwwpar-kinsonnetinfo/media/14829977/dutch_slp_guidelines-finalpdf 2011.
24 NICE. Parkinson’s disease in adults: diagnosis and management. Full guideline NG71. Methods, evidence and recommendations. 2017 July.
25 George S, Tuschkan S. Ergotherapie. In: Ceballos-Bauman A, Ebersbach G. editors. Aktivierende Therapien bei Parkinson-Syndromen. 3 Auflage. Stuttgart: Thieme; 2017: 95-105.
26 Frank MJ, Seeberger LC, O’Reilly R C. By carrot or by stick: cognitive reinforcement learning in parkinsonism. Science 2004; 306 (5703): 1940-3.
27 Nieuwboer A. et al. Cueing training in the home improves gait-related mobility in Parkinson’s disease: the RESCUE trial. J Neurol Neurosurg Psychiatry 2007; 78 (02) 134-40.
28 Schroeteler FE, Ceballos-Baumann AO. Münchner Anti-Freezing-Training (MAFT). Reduzierung von Gangblockaden bei Parkinson. Nervenheilkunde 2016; 35: 198-204.
29 Fietzek UM, Schroeteler FE, Ziegler K, Zwosta J, Ceballos-Baumann AO. Randomized crossover 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; 28 (09) 902-911.
30 Fietzek UM, Zwosta J, Schroeteler FE, Ziegler K, Ceballos-Baumann AO. Levodopa changes the severity of freezing in Parkinson’s disease. Parkinsonism Relat Disord. 2013
31 Ziegler K, Schroeteler F, Ceballos-Baumann AO, Fietzek UM. A new rating instrument to assess festination and freezing gait in Parkinsonian patients. Mov Disord 2010; 25 (08) 1012-1018.
32 Ziegler K. Stürze bei Patienten mit leichtem und fortgeschrittenem Parkinsonsyndrom und ihre Prophylaxe durch Physiotherapie. Nervenheilkunde 2018; 37: 249-256.
33 Mirelman A. et al. Addition of a non-immersive virtual reality component to treadmill training to reduce fall risk in older adults (V-TIME): a randomised controlled trial. Lancet 2016; 388 10050 1170-1182.
34 Jobges M, Heuschkel G, Pretzel C, Illhardt C, Renner C, Hummelsheim H. Repetitive training of compensatory steps: a therapeutic approach for postural instability in Parkinson’s disease. J Neurol Neurosurg Psychiatry 2004; 75 (12) 1682-1687.
35 Barry G, Galna B, Rochester L. The role of exergaming in Parkinson’s disease rehabilitation: a systematic review of the evidence. J Neuroeng Rehabil 2014; 11: 33.
36 Corcos DM. et al. A two-year randomized controlled trial of progressive resistance exercise for Parkinson’s disease. Mov Disord 2013; 28 (09) 1230-1240.
37 Dibble LE, Hale TF, Marcus RL, Droge J, Gerber JP, LaStayo PC. High-intensity resistance training amplifies muscle hypertrophy and functional gains in persons with Parkinson’s disease. Mov Disord 2006; 21 (09) 1444-1452.
38 Nikfekr E, Kerr K, Attfield S, Playford DE. Trunk movement in Parkinson’s disease during rising from seated position. Mov Disord 2002; 17 (02) 274-282.
39 Inkster LM, Eng JJ. Postural control during a sitto-stand task in individuals with mild Parkinson’s disease. Exp Brain Res 2004; 154 (01) 33-38.
40 Schroeteler F. LSVT-BIG: Motorisches Trainingskonzept für Menschen mit Parkinson. Nervenheilkunde 2018; 37: 243-248.
41 Bartolo M. et al. Four-week trunk-specific rehabilitation treatment improves lateral trunk flexion in Parkinson’s disease. Mov Disord 2010; 25 (03) 325-331.
42 Schroeteler F, Ziegler K. Physiotherapie bei Parkinson-Syndromen. In: Ceballos-Bauman A, Ebersbach G. editors. Aktivierende Therapien bei Parkinson-Syndromen. Stuttgart: Thieme; 2017: 95-105.
43 Schroeteler FE, Fietzek UM, Ziegler K, Ceballos-Baumann AO. Upright posture in parkinsonian camptocormia using a high-frame walker with forearm support. Mov Disord 2011; 26 (08) 1560-1561.
44 Gerton BK, Theeler B, Samii A. Backpack treatment for camptocormia. Mov Disord 2010; 25 (02) 247-248.
45 Sturkenboom IH. et al. Efficacy of occupational therapy for patients with Parkinson’s disease: a randomised controlled trial. Lancet Neurol 2014; 13 (06) 557-566.
46 Hely MA, Reid WG, Adena MA, Halliday GM, Morris JG. The Sydney multicenter study of Parkinson’s disease: the inevitability of dementia at 20 years. Mov Disord 2008; 23 (06) 837-844.
47 Ramig LO. et al. Intensive voice treatment (LSVT) for patients with Parkinson’s disease: a 2 year follow up. J Neurol Neurosurg Psychiatry 2001; 71 (04) 493-498.
48 Piechler K, Maillen G. Die Sprech- und Stimmstörung beim idiopathischen Parkinson-Syndrom. In: Ceballos-Bauman A, Ebersbach G. editors. Aktivierende Therapien bei Parkinson-Syndromen. Stuttgart: Thieme; 2017: 41-5.
49 Herd CP. et al. Comparison of speech and language therapy techniques for speech problems in Parkinson’s disease. Cochrane Database Syst Rev 2012; (08) CD002814.
50 Wagner-Sonntag E. Schluckstörungen bei Parkinson-Syndromen. In: Ceballos-Bauman A, Ebersbach G. (Hrsg.) Aktivierende Therapien bei Parkinson-Syndromen. Stuttgart: Thieme; 2017: 49-57.
51 Sharkawi AE. et al. Swallowing and voice effects of Lee Silverman Voice Treatment (LSVT): a pilot study. J Neurol Neurosurg Psychiatry 2002; 72 (01) 31-36.
52 Baijens LW, Speyer R, Passos VL, Pilz W, van der Kruis J, Haarmans S. et al. Surface electrical stimulation in dysphagic Parkinson patients: a randomized clinical trial. Laryngoscope 2013; 123 (11) E38-E44.
53 Manor Y, Mootanah R, Freud D, Giladi N, Cohen JT. Video-assisted swallowing therapy for patients with Parkinson’s disease. Parkinsonism Relat Disord 2013; 19 (02) 207-211.
54 Troche MS. et al. Aspiration and swallowing in Parkinson disease and rehabilitation with EMST: a randomized trial. Neurology 2010; 75 (21) 1912-1919.