Sportliches Training bei Lumbalgien, Kox- und Gonarthrose sowie Fibromyalgie-Syndrom: Effekt auf die Schmerzen – Eine Literaturübersicht

Zusammenfassung

Hintergrund:

Körperliche Aktivität führt kurzdauernd zu einer Hebung der Schmerzschwelle und/oder reduzierter Schmerzwahrnehmung. Ziel der vorliegenden Literaturübersicht ist es zu klären, ob ein systematisches sportliches Training bei orthopädisch-rheumatologischen Schmerzsyndromen (subakute bis chronische unspezifische Lumbalgien, Kox- und Gonarthrose, primäres Fibromyalgie-Syndrom) überdauernd schmerzlindernd wirkt.

Methode:

Anhand einer PubMed-Recherche wurden deutsch- oder englischsprachige randomisierte, kontrollierte Studien gesucht, in denen die Wirkung eines sportlichen Trainings einer Plazebotherapie gegenüber gestellt wurde.

Ergebnisse:

Es fanden sich 25 Studien zu Lumbalgien, 37 zu Arthrosen und 27 zum primären Fibromyalgie-Syndrom. Bei allen Schmerzsyndromen wiesen 52–64% aller Studien eine signifikante Schmerzlinderung nach, unabhängig von der eingesetzten Trainingsmodalität (aerob, Krafttraining, kombiniertes Training, Tai Chi). Krafttraining war jedoch signifikant häufiger wirksam als aerobes Ausdauertraining. Die Dauer des wöchentlichen Trainings und der Trainingsperiode hatten keinen Einfluss auf den hypalgetischen Effekt. Keine Studie zeigte eine belastungsbedingte Schmerzzunahme.

Schlussfolgerung:

Regelmäßiges körperliches Training, vor allem Krafttraining, kann bei unspezifischen Lumbalgien, Kox- und Gonarthrose sowie beim Fibromyalgie-Syndrom schmerzlindernd wirken und sollte in die Therapie integriert werden.

Abstract

Background:

Physical activity results in a short-lasting increase of pain threshold and/or decrease of pain perception. The present literature research aims to clear whether systematic sportive exercises can induce persistent pain relief in orthopaedic-rheumatological pain syndromes such as subacute to chronic unspecific lower back pain, hip and knee osteoarthritis, as well as primary fibromyalgia.

Method:

A PubMed search was performed looking for randomised controlled studies in German or English language examining the effects of sportive training as compared to no or ineffective training.

Results:

We found 25 studies dealing with lower back pain, 37 with osteoarthritis, and 27 with fibromyalgia. 52–64% of all studies, independent of the pain syndrome and training modality used (aerobic, resistive, combined training or Tai Chi), proved a significant pain relief. Strength training, however, was significantly more often effective than aerobic training. The duration both of the weekly training and the training period did not significantly influence the hypoalgetic effect. No study reported exercise-induced exacerbation of pain.

Conclusion:

Regular physical training, especially strength training, may ease pain in unspecific lower back pain, hip and knee osteoarthritis, and fibromyalgia and should therefore be part of the treatment.

Schlüsselwörter

Sport - Training - Lumbalgien - Arthrose - Fibromyalgie

Key words

exercise - training - lower back pain - osteoarthritis - fibromyalgia

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