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physioscience 2013; 9(4): 142-150
DOI: 10.1055/s-0033-1355939
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

FES-Cycling bei Menschen mit Querschnittlähmung – Auswirkung auf subjektives Empfinden und Aktivitäten des täglichen Lebens

FES-Cycling in Persons with Spinal Cord Injury – Impact on Subjective Perception and Activities of Daily Living
D. Kuhn
1   Berufsgenossenschaftliche Kliniken Halle/Saale, Klinik für Physikalische und Rehabilitative Medizin
,
V. Leichtfried
2   Privatuniversität für Gesundheitswissenschaften, Medizinische Informatik und Technologie UMIT, A-Hall in Tirol, Institut für Sport-, Alpinmedizin und Gesundheitstourismus
,
W. Schobersberger
2   Privatuniversität für Gesundheitswissenschaften, Medizinische Informatik und Technologie UMIT, A-Hall in Tirol, Institut für Sport-, Alpinmedizin und Gesundheitstourismus
,
K. Röhl
3   Berufsgenossenschaftliche Kliniken Halle/Saale, Zentrum für Rückenmarkverletzte und Klinik für Orthopädie
› Author Affiliations
Further Information

Publication History

19 April 2013

14 August 2013

Publication Date:
26 November 2013 (online)

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Zusammenfassung

Hintergrund: Bei rückläufiger stationärer Aufenthaltsdauer von Patienten bestehen die Notwendigkeit einer bestmöglichen Unterstützung und damit Effektivierung der funktionsorientierten Physiotherapie. Insbesondere bei Menschen mit Querschnittlähmung könnten Therapiehilfsmittel die Behandlung sinnvoll ergänzen und sollten daher wissenschaftlich spezifiziert und weiterführend evaluiert werden. Die funktionelle Elektrostimulation (FES) wäre eine solche Ergänzung; bisherige Studien untersuchten jedoch nur primär messbare Effekte. Da die subjektive Patientenwahrnehmung für die Nutzung von Therapiegeräten im nachstationären Zeitraum von fundamentaler Bedeutung ist, sollte sie ebenfalls erfasst werden.

Ziel: Diese prospektive Kohortenstudie untersuchte die Auswirkungen von FES auf funktionelle Fähigkeiten und Leistungsparameter sowie das persönliche Schmerz- und Gesundheitsempfinden bei Patienten mit Querschnittlähmung.

Methode: Am FES-Cycling-Programm nahmen 30 Patienten (13 mit Tetra- und 17 mit Paraplegie) teil. Vor und nach jedem Training wurden das subjektive Schmerzempfinden mit einer Numeric Rating Scale (NRS), sowohl initial als auch abschließend die Aktivitäten des täglichen Lebens mit dem Spinal Cord Independence Measure III (SCIM III) und das gesundheitsbezogene Wohlbefinden (Short Form 36 Health Survey) beurteilt sowie die Leistungsdaten des Beinergometers ausgewertet.

Ergebnisse: Der SCIM stieg nach 4-wöchigem Training von 42 (Beginn FES-Cycling) auf 51 Punkte an (p = 0,004). Die Ergebnisse des SF 36 (subjektive Schmerzbeurteilung, Vitalität, psychisches Wohlbefinden) verbesserten sich deutlich (p < 0,001). Sowohl bei den Patienten mit kompletter Querschnittlähmung als auch bei denen mit inkompletter Querschnittlähmung nahmen die durchschnittliche Aktivleistung (p = 0,035 bzw. p = 0,002) und die geleistete physikalische Arbeit signifikant zu (p = 0,025 bzw. p = 0,001).

Schlussfolgerung: Die Ergebnisse lassen vermuten, dass FES-Cycling die akute funktionelle Rehabilitation und die Motivation zum weiterführenden Selbsttraining bei Patienten mit Querschnittlähmung unterstützen kann.

Abstract

Background: An increasingly shorter inpatient stay accents the need for the best possible support and consequently the effectiveness of function-oriented physiotherapy. Predominantly in patients with spinal cord injury therapy devices may complement the intervention and therefore should be scientifically specified and further evaluated. Functional electrical stimulation could be such a complement; however, previous studies investigated only primarily measurable effects. As the patient’s subjective perception is of fundamental importance for the use of therapy devices during the post-inpatient period it should also be recorded.

Objective: This prospective cohort study evaluated the FES-cycling’s impact on functional abilities and performance parameters as well as the subjective pain and health perception of patients with spinal cord injury.

Method: 30 patients (13 with tetraplegia, 17 with paraplegia) participated in the FES-cycling programme. Before and after each session pain perception was assessed using the Numeric Rating Scale (NRS). In addition, activities of daily living (Spinal Cord Independence Measure III, SCIM III), health-related well-being (Short Form 36 Health Survey), and performance data of the leg ergometer were collected.

Results: After 4 weeks’ training, the SCIM rose from 42 to 51 points (p = 0.004). The results of the SF-36 (subjective pain perception, vitality, mental well-being) improved significantly (p < 0.001). In Patients both with complete as well as incomplete paraplegia the average active performance (p = 0.035 vs. p = 0.002) and physical work (p = 0.025 vs. p = 0.001) increased significantly.

Conclusions: The results suggest that FES-cycling can support acute functional rehabilitation as well as motivation for continuing self-exercise in patients with spinal cord injury.

Schlüsselwörter

Querschnittlähmung - funktionelle Elektrostimulation - FES-Cycling - Schmerz - gesundheitsbezogene Lebensqualität

Key words

spinal cord injury - functional electrical stimulation - FES-cycling - pain - health-related quality of life
 

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