Stellenwert ambulanter, gerätegestützter Trainingstherapie bei Atemwegs- und Lungenkrankheiten

Zusammenfassung

Die körperliche Trainingstherapie gilt als eine der wichtigsten Therapieoptionen für Patienten mit chronischen Atemwegs- und Lungenkrankheiten: Die Effekte des Ausdauer- und Krafttrainings auf Atemnot, körperliche Leistungsfähigkeit und Lebensqualität sind unbestritten. Dennoch wird die Trainingstherapie im ambulanten Bereich durch die Rahmenvereinbarungen der Bundesarbeitsgemeinschaft für Rehabilitation (BAR) limitiert: Nur der in Gruppen angeleitete Lungensport wird über längere Zeiträume von den Kostenträgern finanziert, das gerätegestützte Training bleibt ausgeschlossen, obwohl sich dessen herausragende Effizienz durch zahlreiche randomisiert kontrollierte Studien nachweisen lässt.

In diesem Übersichtsartikel werden neben der Methodik und den Effekten auch die aktuellen organisatorischen Strukturen einer ambulanten, gerätegestützten Trainingstherapie für Patienten mit chronischen Atemwegs- und Lungenkrankheiten in Deutschland aufgezeigt und kritisch diskutiert.

Abstract

Exercise training is one of the most important components in disease management for patients with chronic respiratory diseases. The clinically relevant benefits of endurance and strength training on dyspnea, exercise capacity and quality of life have been evaluated very well. However, there are some legal limitations by the German Working Group for Rehabilitation (BAR) concerning outpatient exercise training programs (beyond pulmonary rehabilitation): only group-based callisthenic training programs receive funding from health care insurances while professional equipment-based training programs are excluded despite their outstanding effectiveness.

This review provides an overview on the methodology and the benefits of outpatient exercise training programs for patients with chronic respiratory diseases, and it critically discusses the organizational structures of these programs in Germany.

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