Physio- und Ergotherapie in der Akut-Neurologie

Zusammenfassung

Ein integraler Bestandteil der Behandlung neurologischer Patienten ist die Therapie von Funktionsstörungen, die durch neurologische Krankheiten wie z. B. einen Schlaganfall hervorgerufen werden. Das Therapieziel der Physiotherapie besteht darin, bettlägerige Patienten durch aktive Bewegungs- und Gleichgewichtsübungen wieder zu mobilisieren und im Zusammenwirken mit ergotherapeutischen Übungsbehandlungen in die Lage zu versetzen, Verrichtungen alltagrelevanter Tätigkeiten möglichst selbstständig wieder ausführen zu können. Darüber hinaus wird durch multimodale aktiv-assistive Übungen sekundären Versteifungen bewegungseingeschränkter Gliedmaßen entgegengewirkt. Grundlage dieser Behandlungen sind neurophysiologisch basierte Modellvorstellungen über die postläsionelle Plastizität des Gehirns. Es wurden Skalen entwickelt, mit denen neurologische Funktionsstörungen und deren Rückbildung parametrisch und untersucherunabhängig erfasst werden können. Damit kann der Funktionszustand der Patienten dokumentiert und zwischen Behandlungseinrichtungen kommuniziert werden. Außerdem kann so die Effektivität physio- und ergotherapeutischer Maßnahmen in der Akut-Neurologie überprüft werden.

Abstract

Therapy of neurological patients comprises beyond medical treatment the treatment of functional deficits which result from a neurological disease such as stroke. Physiotherapy aims at enabling bedridden neurological patients to become mobile again using training of movement and coordination. In cooperation with occupational therapy patients are trained to become able to perform actions of daily living again. In addition, multimodal activating/assisting exercises are mandatory to counteract the deficit-related development of joint contractions. The rational for these exercises are neurophysiological findings about postlesional cerebral plasticity. Moreover, parametric scales have been developed to assess neurological disturbances and to monitor their restitution in an observer-independent fashion. This allows communication across institutions and to assess the efficacy of physiotherapy and occupational therapy.

Schlüsselwörter

Physiotherapie - Ergotherapie - Skalen - Therapieziele - Stroke Unit

Keywords

physiotherapy - occupational therapy - scales - therapeutic goals - stroke unit

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