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Arthritis und Rheuma 2020; 40(01): 15-19
DOI: 10.1055/a-1075-6854
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© Georg Thieme Verlag KG Stuttgart · New York

Physikalische Therapie bei systemischer Sklerose (Sklerodermie)

Physical therapy in systemic sclerosis
Gerald Küther∗
1   Klinik für Rehabilitationsmedizin, Medizinische Hochschule Hannover
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Publication History

Publication Date:
26 February 2020 (online)

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ZUSAMMENFASSUNG

Die Physikalische Therapie bietet verschiedene Verfahren zur Behandlung unterschiedlicher Symptome der systemischen Sklerose (Sklerodermie) an. Einzelne randomisiert-kontrollierte Studien konnten zeigen, dass mit der manuellen Lymphdrainage eine Ödemreduktion und verbesserte Handfunktion zu erzielen war und mit der Bindegewebsmassage in Verbindung mit Techniken der manuellen Therapie eine verbesserte Gelenkbeweglichkeit und Handfunktion. Sogar mit Selbstübungsprogrammen für Dehnübungen konnte eine verbesserte Beweglichkeit im Finger- und orofazialen Bereich erreicht werden. Widersprüchliche Befunde liegen zur Wirkung von Paraffinbädern vor. Keine randomisiert-kontrollierten Studien sind bisher zur Wirkung von CO2-Bädern bei der Sklerodermie bekannt, obwohl eine verbesserte kapilläre Perfusion in den Extremitäten auch bei dieser Erkrankung nachweisbar war. Vielversprechend sind erste Befunde zur Wirkung eines aeroben Trainings auf die periphere Mikrozirkulation, die auf die Möglichkeit einer nicht nur symptomatischen, sondern auch in den Pathomechanismus der Vaskulopathie eingreifenden Therapie bei der systemischen Sklerose hinweisen.

ABSTRACT

Physical therapy provides several approaches for a treatment of different symptoms of systemic sclerosis. Single randomized-controlled trials showed reduced hand edema and improved hand function after manual lymphatic drainage, and improvements in joint motion and hand function after connective tissue massage and manual therapy. Even home-based stretching programs were effective in increasing mobility of fingers and the orofacial region. Conflicting reports exist of the effects of paraffin baths. As randomized controlled studies on the clinical effects of CO2-baths in scleroderma patients are not yet available, an improved acral capillary perfusion has been demonstrated in clinical trails. Promising results on the effects of aerobic exercise on the peripheral microcirculation were found in several studies, which point to a pathophysiologically based treatment of vasculopathy in systemic sclerosis.

Schlüsselwörter

Sklerodermie - Physikalische Therapie - Handfunktion - orofaziale Therapie

Keywords

Systemic sclerosis - physical therapy - hand function - orofacial therapy
 

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