Von der Biomechanik zur klinischen Anwendung

Zusammenfassung

Biomechanische Analysen sind in der Lage, menschliche Bewegungen valide und umfassend zu erfassen und auszuwerten. Neben den beiden großen Bereichen Kinetik und Kinematik bietet die Elektromyografie (EMG) eine zuverlässige Möglichkeit, die neuromuskuläre Aktivität zu analysieren. Mithilfe des EMG können neuromuskuläre Parameter erhoben werden, die präzise Aussagen beispielsweise zur inter- und intramuskulären Koordination, der Muskelfaserverteilung, des Ermüdungsverhaltens oder des Timings zulassen.

Für verlässliche Daten sind im klinischen Setting jedoch einige wichtige Faktoren zu berücksichtigen. Diese sind von großer Bedeutung und sollten vor einer Analyse beachtet werden. Daneben hängt ein effektiver Einsatz des EMG im klinischen Setting von der Integration in den Clinical-Reasoning-Prozess ab. Die jeweilige individuelle Patientensituation benötigt eine klare Fragestellung. Dazu kann auf ein Ebenenmodell aufgebaut werden, welches die biomechanischen Steuerungsgrößen in der klinischen Anwendung berücksichtigt.

Der Artikel stellt die physiologischen Grundlagen der Elektromyografie, die Einflüsse von Verletzungen auf die Muskelfaserzusammensetzung, die grundlegende Signalverarbeitung und Dateninterpretation, ein Ebenenmodell für die klinische Anwendung sowie Einsatzfelder in der Physiotherapie vor.

Abstract

Biomechanical analysis is able to validly record and comprehensively evaluate human movements. Along with the two major domains of kinetics and kinematics, electromyography (EMG) is a reliable tool for the analysis of neuromuscular activities. EMG may be used to collect neuromuscular parameters that permit precise assessment of, for example, the inter- and intramuscular coordination, muscle fibre distribution, fatigue behavior and timing.

However, some important factors must be considered for reliable data within the clinical setting. These factors have high relevance and should be kept in mind before each analysis. Moreover, the effective use of EMG in a clinical setting depends on its integration into the clinical reasoning process. Each individual patient situation requires a clear objective. For this purpose a multi-level model may be used which incorporates the biomechanical control parameters for clinical application.

This article portrays the physiological basics of electromyography, the influences of injuries on muscle fibre composition, the fundamental signal processing and data interpretation and a multi-level model for the clinical application as well as for operational application in physiotherapy.

Schlüsselwörter

Elektromyografie - Physiotherapie - neuromuskuläre Aktivität - Rehabilitation - Ebenenmodell

Keywords

electromyography - physiotherapy - neuromuscular activity - rehabilitation - multi-level model

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