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MSK – Muskuloskelettale Physiotherapie 2022; 26(03): 147-155
DOI: 10.1055/a-1827-2724
Fallbericht

Psychosoziales Screening in der Physiotherapie: Wo verläuft die Grenze zur Komorbidität?

FallberichtPsychosocial Screening in Physiotherapy: Where Is the Boundary to Comorbidity?Case Report
Matthias Kalmring
Praxis NOAH, Gnas, Österreich
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Zusammenfassung

Die Behandlung von Patient*innen mit chronischen Schmerzen stellt sich häufig als sehr komplex dar und benötigt oft eine multimodale Therapiestrategie. Daher hat der Einbezug von psychosozialen Faktoren in die physiotherapeutische Therapieplanung und Behandlung bei Patient*innen mit chronischen muskuloskelettalen Schmerzen in den letzten Jahren immer mehr an Bedeutung gewonnen. Allerdings scheint es in der Physiotherapie eine Herausforderung darzustellen, psychosoziale Einflüsse zu erheben, zu interpretieren und aus ihnen therapeutische Konsequenzen zu ziehen.

Dieser Fallbericht eines 44 Jahre alten Patienten mit Schulterschmerzen soll die Bedeutsamkeit eines standardisierten Screening Protokolls zur Bewertung von psychosozialen Einflussfaktoren bei Patient*innen mit chronischen muskuloskelettalen Beschwerden aufzeigen. Die Ergebnisse aus der Herzratenvariabilitätsmessung und dem Fragebogen „Maslach Burnout Inventory“ deuteten auf eine erhöhte Belastung des Patienten durch psychosoziale Stressoren, die eine Burnout-Gefährdung anzeigten. Neben der schulterspezifischen funktionellen Physiotherapie wurden, in interdisziplinärer Absprache, die Erholungsfähigkeit und Stresskompensation des Patienten in der Therapie adressiert. Die mit diesen Maßnahmen ergänzte Physiotherapie konnte Verbesserungen auf der Funktions- und Schmerzebene erzielen.

Abstract

Therapy for patients with chronic pain can be very complex and often requires a multimodal treatment strategy. As a result, in recent years the consideration of psychosocial factors has become an increasingly important element in physiotherapy planning and treatment of patients with chronic musculoskeletal pain. However, it appears as if in physiotherapy, screening for psychosocial influences, interpreting them and drawing conclusions for treatment is a challenge.

This case study of a 44-year-old patient with shoulder pain aims to demonstrate the importance of a standardized screening protocol for the assessment of psychosocial influences in patients with chronic musculoskeletal complaints. The results from the heart rate variability measurement and the “Maslach Burnout Inventory” questionnaire yielded an increased burden of psychosocial stressors on the patient, indicating a burnout risk. In interdisciplinary consultation, the patient’s therapy, apart from including shoulder-specific functional physiotherapy, also addressed his capacity to recover and his stress compensation. Supplemented by these measures, physiotherapy achieved improvements regarding function and pain.

Schlüsselwörter

Screening - psychosozial - Physiotherapie - Komorbidität

Key words

screening - psychosocial - physiotherapy - comorbidity


Publication History

Received: 17 August 2021

Accepted: 15 October 2021

Article published online:
19 July 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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