physiopraxis 2021; 19(03): 24-29
DOI: 10.1055/a-1368-2396
Therapie

Handschuhe, Helm und Schweregefühl – Das T4-Syndrom

Sebastian Löscher

Bilaterale Parästhesien der Finger, Hände und Unterarme in Kombination mit Kopfschmerzen und interskapulären Beschwerden. Was zunächst wie eine willkürliche Ansammlung von Symptomen klingt, wird in der manuellen Medizin oft als T4-Syndrom zusammengefasst. Ob die weitverbreitete Theorie einer thorakal lokalisierten sympathischen Dysfunktion mit dem Gefühl des Patienten, Handschuhe und einen Helm zu tragen, überhaupt haltbar ist, ist fraglich.



Publication History

Article published online:
12 March 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • Literaturverzeichnis

  • 1 Maitland G. D.. Vertebral manipulation. London; Boston: Butterworths; 1977
  • 2 Conroy J. L., Schneiders A. G.. “The T4 syndrome,”. Man. Ther. 10 (04) 292-296 Nov 2005; DOI: 10.1016/j.math.2005.01.007.
  • 3 Karas S., Pannone A.. “T4 Syndrome: A Scoping Review of the Literature,”. J. Manipulative Physiol. Ther. 40 (02) 118-125 Feb 2017; DOI: 10.1016/j.jmpt.2016.11.002.
  • 4 Jowsey P., Perry J.. “Sympathetic nervous system effects in the hands following a grade III postero-anterior rotatory mobilisation technique applied to T4: A randomised, placebo-controlled trial,”. Man. Ther. 15 (03) 248-253 Jun 2010; DOI: 10.1016/j.math.2009.12.008.
  • 5 Jeangros P.. “T-4 Syndrom,” in Klinische Muster in der Manuellen Therapie: IMTA Kurshandbuch Level 2a und b; 35 Tabellen, P. Westerhuis and R. Wiesner, Eds. Stuttgart: Thieme; 2011
  • 6 Evans P.. “The T4 Syndrome: Some Basic Science Aspects,”. Physiotherapy 83 (04) 186-189 Apr 1997; DOI: 10.1016/S0031-9406(05)66077-4.
  • 7 Lipschitz M., Bernstein-Lipschitz L., Nathan H.. “Thoracic Sympathetic Trunk Compression by Osteophytes Associated with Arthritis of the Costovertebral Joint,”. Cells Tissues Organs 132 (01) 48-54 1988; DOI: 10.1159/000146550.
  • 8 Nathan H.. “Osteophytes of the spine compressing the sympathetic trunk and splanchnic nerves in the thorax.,”. Spine 12 (06) 527-532 1987; DOI: 10.1097/00007632-198707000-00003.
  • 9 Kommuru H.. “Thoracic Part of Sympathetic Chain and its Branching Pattern Variations in South Indian Cadavers,”. J. Clin. Diagn. Res. 2014 DOI: 10.7860/JCDR/2014/9274.5246
  • 10 Slater H., Vicenzino B, Wright A.. “‘Sympathetic Slump’: The Effects of a Novel Manual Therapy Technique on Peripheral Sympathetic Nervous System Function,”. J. Man. Manip. Ther. 2 (04) 156-162 Jan 1994; DOI: 10.1179/jmt.1994.2.4.156.
  • 11 Schiller Y.. “The anatomy and physiology of the sympathetic innervation to the upper limbs,”. Clin. Auton. Res. 13 (00) 1-1 Dec 2003; DOI: 10.1007/s10286-003-1102-6.
  • 12 Darby S. A.. “Neuroanatomy of the Autonomic Nervous System,” in Clinical anatomy of the spine, spinal cord, and ANS, 3rd ed. St. Louis, Mo: Elsevier; 2014: 413-507
  • 13 Jänig W.. “Autonomic nervous system and pain,” in Science of Pain, 1. ed., A. I. Basbaum and C. Bushnell, Eds. Amsterdam: Academic Press, Elsevier; 2009: 193-225
  • 14 Schlereth T., Birklein F.. “The Sympathetic Nervous System and Pain,”. NeuroMolecular Med. 10 (03) 141-147 Sep 2008; DOI: 10.1007/s12017-007-8018-6.
  • 15 Gutman L. B., Wilson B. J.. “The Role of Midodrine for Hypotension Outside of the Intensive Care Unit,”. J. Popul. Ther. Clin. Pharmacol. 24: 03 2017;
  • 16 Allison D. B.. et al “Controlled-Release Phentermine/Topiramate in Severely Obese Adults: A Randomized Controlled Trial (EQUIP),”. Obesity 20 (02) 330-342 Feb 2012; DOI: 10.1038/oby.2011.330.
  • 17 “Gebrauchsinformation: Information für den Anwender – Salbutamol-ratiopharm® N Dosieraerosol 0,1 mg/Sprühstoß, Druckgasinhalation (Packungsbeilage).” Nov. 2013
  • 18 Hiraim P. M., Thomson O. P.. “T4 syndrome – A distinct theoretical concept or elusive clinical entity? A case report,”. J. Bodyw. Mov. Ther. 20 (04) 722-727 Oct 2016; DOI: 10.1016/j.jbmt.2016.06.008.
  • 19 DeFranca G. G., Levine L. J.. “The T4 Syndrome,” J. Manipulative Physiol. Ther., vol. Volume 18, no. 1, 1995.
  • 20 Mellick G. A., Mellick L. B.. “clinical presentation, quantative sensory testing, and therapy of 2 patients with fourth thoracic syndrome,”. J. Manipulative Physiol. Ther. 29 (05) 6 2006;
  • 21 Geerse W.. “Bilateral leg symptoms - The T10 syndrome?” Man. Ther. 17 (03) 251-4 2012; DOI: 10.1016/j.math.2011.08.003.
  • 22 Olson K.. Manual Physical Therapy of the Spine. Philadelphia, PA: Saunders/Elsevier; 2009
  • 23 Maitland G. D.. Vertebral Manipulation. Boston: Butterworth; 1986
  • 24 McGuckin N.. “The T4 syndrome1986. p. 370-376.,” in Modern Manual Therapy of the Vertebral Column, Churchill Livingstone. 1986: 370-376
  • 25 Bogduk N.. “Research design or what is T4 syndrome. Define exactly what the phenomenon of interest is.,”. J. Physiother. 14 (03) 9-11 1986;
  • 26 Feldman E., Rot J.. “Thrust manipulation for a female patient diagnosed with T4 syndrome: a case report.,”. J. Man. Manip. Ther. 18 (04) 223-224 2010;
  • 27 Horre T.. “Fallbeispiel: Patient mit Kopfschmerzen und diffusen Hand-Unterarm-Schmerzen,”. manuelletherapie 17: 113-117 2013;
  • 28 Lanini B.. et al “Chest wall kinematics during cough in healthy subjects,”. Acta Physiol. 190 (04) 351-358 Aug 2007; DOI: 10.1111/j.1748-1716.2007.01701.x.
  • 29 Cleland J., Durall C., Scott S. A.. “Effects of Slump Long Sitting on Peripheral Sudomotor and Vasomotor Function: A Pilot Study,”. 9 2002
  • 30 Deore M., May S.. “The inter-rater and intra-rater reliability of passive physiological accessory movement assessment of lumbar spine in novice manual therapists,”. 5 2012
  • 31 Brismee J.-M.. et al “Interrater reiability of a passive physiological intervertebral motion test in the mid-thoracic spine,”. J. Manipulative Physiol. Ther. 29 (05) 6 2006;
  • 32 Slater D., Korakakis V., O’Sullivan P., Nolan D., O’Sullivan K.. “‘Sit Up Straight’: Time to Re-evaluate,”. J. Orthop. Sports Phys. Ther. 49 (08) 562-564 Aug 2019; DOI: 10.2519/jospt.2019.0610.
  • 33 Christensen S. T., Hartvigsen J.. “Spinal Curves and Health: A Systematic Critical Review of the Epidemiological Literature Dealing With Associations Between Sagittal Spinal Curves and Health,”. J. Manipulative Physiol. Ther. 31 (09) 690-714 Nov 2008; DOI: 10.1016/j.jmpt.2008.10.004.
  • 34 Laferton J. A. C., Kube T., Salzmann S., Auer C. J., Shedden-Mora M. C.. “Patients’ Expectations Regarding Medical Treatment: A Critical Review of Concepts and Their Assessment,”. Front. Psychol. 8 Feb 2017; DOI: 10.3389/fpsyg.2017.00233.
  • 35 Engel G.. “The need for a new medical model: a challenge for biomedicine,”. Science 196 4286 129-136 1977; DOI: 10.1126/science.847460.
  • 36 Mardian A. S.. et al “Flipping the Pain Care Model: A Sociopsychobiological Approach to High-Value Chronic Pain Care,”. Pain Med. 21 (06) 1168-1180 Jun 2020; DOI: 10.1093/pm/pnz336.
  • 37 Borrell-Carrio F.. “The Biopsychosocial Model 25 Years Later: Principles, Practice, and Scientific Inquiry,”. Ann. Fam. Med. 2 (06) 576-582 Nov 2004; DOI: 10.1370/afm.245.
  • 38 McGuiness J., Vicenzino B., Wright A.. “Influence of a cervical mobilization technique on respiratory and cardiovascular function,”. Man. Ther. 2 (04) 216-220 Nov 1997; DOI: 10.1054/math.1997.0302.
  • 39 Sterling M., Jull G., Wright A.. “Cervical mobilisation: concurrent effects on pain, sympathetic nervous system activity and motor activity,”. Man. Ther. 6 (02) 72-81 May 2001; DOI: 10.1054/math.2000.0378.
  • 40 Chiu T. W., Wright A.. “To compare the effects of different rates of application of a cervical mobilisation technique on sympathetic outflow to the upper limb in normal subjects,”. Man. Ther. 1 (04) 198-203 Sep 1996; DOI: 10.1054/math.1996.0269.
  • 41 Petersen N., Vicenzino B., Wright A.. “The effects of a cervical mobilisation technique on sympathetic outflow to the upper limb in normal subjects,”. Physiother. Theory Pract. 9 (03) 149-156 Jan 1993; DOI: 10.3109/09593989309047454.
  • 42 Vicenzino B., Cartwright T., Collins D., Wright A.. “Cardiovascular and respiratory changes produced by lateral glide mobilization of the cervical spine,”. Man. Ther. 3 (02) 67-71 May 1998; DOI: 10.1016/S1356-689X(98)80020-9.
  • 43 Dwyer A., Aprill C., Bogduk N.. “Cervical zygapophyseal joint pain patterns. I: A study in normal volunteers,”. Spine 15 (06) 453-457 Jun 1990;
  • 44 Cloward R. B.. “Cervical diskography: a contribution to the etiology and mechanism of neck, shoulder and arm pain,”. Ann. Surg. 150 (06) 1052 1959;
  • 45 Schmid A., Brunner F., Wright A., Bachmann L. M.. “Paradigm shift in manual therapy? Evidence for a central nervous system component in the response to passive cervical joint mobilisation,”. Man. Ther. 13 (05) 387-396 Oct 2008; DOI: 10.1016/j.math.2007.12.007.
  • 46 Bialosky J. E.. et al “Unraveling the Mechanisms of Manual Therapy: Modeling an Approach,”. 11 2018
  • 47 Schmid A.. “Wie beeinflusst Manuelle Therapie den Schmerz?” manuelletherapie. 17 (04) 162-167 Sep 2013; DOI: 10.1055/s-0033-1356788.
  • 48 Wicki I.. “Aus schmerzwissenschaftlicher Sicht: Braucht das T4-Syndrom einen neuen Namen?” manuelletherapie. 17 (03) 108-112 Jul 2013; DOI: 10.1055/s-0033-1351107.