PDF herunterladen
Aktuelle Rheumatologie 2012; 37(03): 174-188
DOI: 10.1055/s-0032-1308962
Übersichtsarbeit
© Georg Thieme Verlag KG Stuttgart · New York

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

Exercise for Lower Back Pain, Hip and Knee Osteoarthritis, and Fibromyalgia: Effects on Pain - A Literature Review
N. Reimers
1    Hegau-Bodensee-Klinikum Singen, Klinik für Unfall- und Handchirurgie, Singen
,
C. D. Reimers
2    Neurologie, Zentralklinik Bad Berka, Bad Berka
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
17. April 2012 (online)

Auch verfügbar auf
    Lizenzen und Reprints

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
 

  • Literatur

  • 1 Mead GE, Morley W, Campbell P et al. Exercise for depression. Cochrane Database Syst Rev 2009; CD004366
    PubMedGoogle Scholar
  • 2 Paluska SA, Schwenk TL. Physical activity and mental health: current concepts. Sports Med 2000; 29: 167-180
    CrossrefPubMedGoogle Scholar
  • 3 Bartholomew JB, Lewis BP, Linder DE et al. Post-exercise analgesia: Replication and extension. J Sports Sci 1996; 14: 329-334
    PubMedGoogle Scholar
  • 4 Bement MKH, Dicapo J, Rasiarmos R et al. Dose response of isometric contractions on pain perception in healthy adults. Med Sci Sports Exerc 2008; 40: 1880-1889
    PubMedGoogle Scholar
  • 5 Black J, Chesher GB, Starmer GA. The painlessness of the long distance runner. Med J Aust 1979; 1: 522-523
    PubMedGoogle Scholar
  • 6 Droste C, Greenlee MW, Schreck M et al. Experimental pain thresholds and plasma beta-endorphin levels during exercise. Med Sci Sports Exerc 1991; 23: 334-342
    PubMedGoogle Scholar
  • 7 Fuller AK, Robinson ME. A test of exercise analgesia using signal detection theory and within-subjects design. Percept Mot Skills 1993; 76: 1299-1310
    CrossrefPubMedGoogle Scholar
  • 8 Guieu R, Blin O, Pouget J et al. Nociceptive threshold and physical activity. Can J Neurol Sci 1992; 19: 69-71
    PubMedGoogle Scholar
  • 9 Gurevich M, Kohn PM, Davis C. Exercise-induced analgesia and the role of reactivity in pain sensitivity. J Sports Sci 1994; 12: 549-559
    CrossrefPubMedGoogle Scholar
  • 10 Haier RJ, Quaid K, Mills JSC. Naloxone alters pain perception after Jogging. Psychiatr Res 1981; 5: 231-232
    CrossrefPubMedGoogle Scholar
  • 11 Hoffman MD, Shepanski MA, Ruble SB et al. Intensity and duration threshold for aerobic exercise-induced analgesia to pressure pain. Arch Phys Med Rehabil 2004; 85: 1183-1187
    CrossrefPubMedGoogle Scholar
  • 12 Hoffman MD, Shepanski MA, MacKenzie SP et al. Experimentally induced pain perception is acutely reduced by aerobic exercise in people with chronic low back pain. J Rehabil Res Develop 2005; 42: 183-190
    CrossrefPubMedGoogle Scholar
  • 13 Hoffman MD, Lee J, Zhao H et al. Pain perception after running a 100-mile ultramarathon. Arch Phys Med Rehabil 2007; 88: 1042-1048
    CrossrefPubMedGoogle Scholar
  • 14 Janal MN, Colt EWD, Clark C et al. Pain sensitivity, mood and plasma endocrine levels in man following long-distance running: effects of naloxone. Pain 1984; 19: 13-25
    Google Scholar
  • 15 Kemppainen P, Pertovaara A, Huopaniemi T et al. Modification of dental pain and cutaneous thermal sensitivity by physical exercise in man. Brain Res 1985; 360: 33-40
    CrossrefPubMedGoogle Scholar
  • 16 Kemppainen P, Pertovaara A, Huopaniemi T et al. Elevation of dental pain threshold induced in man by physical exercise is not reversed by cyproheptadine-mediated suppression of growth hormone release. Neurosci Lett 1986; 70: 388-392
    CrossrefPubMedGoogle Scholar
  • 17 Kemppainen P, Paalasmaa P, Pertovaara A et al. Dexamethasone attenuates exercise-induced dental analgesia in man. Brain Res 1990; 519: 329-332
    CrossrefPubMedGoogle Scholar
  • 18 Koltyn KF, Arbogast RW. Perception of pain after resistance exercise. Br J Sports Med 1998; 32: 20-24
    CrossrefPubMedGoogle Scholar
  • 19 Koltyn KF, Garwin AW, Gardiner RL et al. Perception of pain following aerobic exercise. Med Sci Sports Exerc 1996; 28: 1418-1421
    PubMedGoogle Scholar
  • 20 Koltyn KF, Trine MR, Stegner AJ et al. Effect of isometric exercise on pain perception and blood pressure in men and women. Med Sci Sports Exerc 2001; 33: 282-290
    PubMedGoogle Scholar
  • 21 Kosek E, Ekholm J. Modulation of pressure pain thresholds during and following isometric contraction. Pain 1995; 61: 481-486
    CrossrefPubMedGoogle Scholar
  • 22 Kosek E, Ekholm J, Hansson P. Modulation of pressure pain threshold during and following isometric contraction in patients with fibromyalgia and in healthy controls. Pain 1996; 64: 415-423
    CrossrefPubMedGoogle Scholar
  • 23 Olausson B, Eriksson E, Ellmarker L et al. Effects of naloxone on dental pain threshold following muscle exercise and low frequency transcutaneous nerve stimulation: a comparative study in man. Acta Physiol Scand 1986; 126: 299-305
    CrossrefPubMedGoogle Scholar
  • 24 Padawer WJ, Levine FM. Exercise-induced analgesia: fact or artifact?. Pain 1992; 48: 131-135
    CrossrefPubMedGoogle Scholar
  • 25 Persson AL, Hansson G-Å, Kalliomäki J et al. Pressure pain threshold and electromyographically defined muscular fatigue induced by a muscular endurance test in normal women. Clin J Pain 2000; 16: 155-163
    CrossrefPubMedGoogle Scholar
  • 26 Pertovaara A, Huopaniemi T, Virtanen A et al. The influence of exercise on dental pain thresholds and the release of stress hormones. Physiol Behav 1984; 33: 923-926
    CrossrefPubMedGoogle Scholar
  • 27 Ruble SB, Hoffman MD, Shepanski MA et al. Thermal pain perception after aerobic exercise. Arch Phys Med Rehabil 2005; 86: 1019-1023
    CrossrefPubMedGoogle Scholar
  • 28 Sternberg WF, Bailin D, Grant M et al. Competition alters the perception of noxious stimuli in male and female athletes. Pain 1998; 76: 231-238
    CrossrefPubMedGoogle Scholar
  • 29 Umeda M, Newcomb LW, Koltyn KF. Influence of blood pressure elevations by isometric exercise on pain perception in women. Int J Psychophysiol 2009; 74: 49-52
    PubMedGoogle Scholar
  • 30 Umeda M, Newcomb LW, Ellingson LD et al. Examination of the dose-response relationship between pain perception and blood pressure elevations induced by isometric exercise in men and women. Biol Psychol 2010; 85: 90-96
    CrossrefPubMedGoogle Scholar
  • 31 Vecchiet L, Marini I, Colozzi A et al. Effects of aerobic exercise on muscular pain sensitivity. Clin Ther 1984; 6: 354-363
    PubMedGoogle Scholar
  • 32 Choi BKL, Verbeek JH, Tam WWS et al. exercises for prevention of recurrences of low-back pain. Cochrane Database Syst Rev 2010; CD006555
    PubMedGoogle Scholar
  • 33 Schmidt CO, Raspe H, Pfingsten M et al. Back pain in the German adult population: prevalence, severity and sociodemographic correlates in a multiregional survey. Spine 2007; 32: 2005-2011
    CrossrefPubMedGoogle Scholar
  • 34 Reuter P. Springer Lexikon Medizin. Berlin, Heidelberg, New York: 2004
    Google Scholar
  • 35 Hughes AL, Seymour RB, Campbell R et al. Impact of the Fit and Strong Intervention on older adults with osteoarthritis. 2004; 44: 217-228
    PubMedGoogle Scholar
  • 36 Song R, Lee E-O, Lam P et al. Effects of Tai Chi exercise on pain, balance, muscle strength, and perceived difficulties in physical functioning in older women with osteoarthritis: a randomized clinical trial. J Rheumatol 2003; 30: 2039-2044
    PubMedGoogle Scholar
  • 37 Fransen M, McConnell S. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev 2008; CD004376
    PubMedGoogle Scholar
  • 38 Keefe FJ, Blumenthal J, Baucom D et al. Effects of spouse-assisted coping skills training and exercise training in patients with osteoarthritic knee pain: a randomized controlled study. Pain 2004; 110: 539-549
    CrossrefPubMedGoogle Scholar
  • 39 Lange AK, Vanwanseele B, Fiantarone Singh MA. Strength training for treatment of osteoarthritis of the knee: a systematic review. Arthritis Rheum 2008; 59: 1488-1494
    CrossrefPubMedGoogle Scholar
  • 40 Wolfe F, Smythe HA, Yunus MB et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum 1990; 33: 160-172
    CrossrefPubMedGoogle Scholar
  • 41 Wolfe F. Stop the using the American College of Rheumatology Criteria in the clinic. J Rheumatol 2003; 30: 1671-1672
    PubMedGoogle Scholar
  • 42 Neeck G, Brückle W. Fibromyalgie. In: Zeidler H, Zacher J, Hiepe F. Hrsg Interdisziplinäre klinische Rheumatologie. 2. Aufl. Springer; Heidelberg: 2008: 1023-1032
    CrossrefGoogle Scholar
  • 43 Kuipers JG, Rihl M, Zeidler H. Degenerative Gelenk- und Wirbelsäulenerkrankungen. In: Gerok W, Huber C, Meinertz T, Zeidler H. Hrsg Die Innere Medizin. 11. Aufl. Schattauer; Stuttgart, New York: 2007: 894-896
    Google Scholar
  • 44 Sandmann GH, Imhoff AB. Knorpelschaden. In: Halle M, Schmidt-Trucksäss A, Hambrecht R, Berg A. Hrsg Sporttherapie in der Medizin. Evidenzbasierte Prävention und Therapie. Schattauer; Stuttgart, New York: 2008: 353-361
    Google Scholar
  • 45 Reimers CD. Fibromyalgie. In: Reimers CD, Brooks Hrsg Neurologie, Psychiatrie und Sport. Thieme; Stuttgart, New York: 2003: 168-173
    Google Scholar
  • 46 http://www.dosb.de/de/organisation/philosophie/sportdefinition/ Stand: 04.06.2011
    PubMed
  • 47 http://www.cochrane.de/de/evidenz-empfehlung
    PubMed
  • 48 Diener HC Putzki Hrsg Leitlinien für Diagnostik und Therapie in der Neurologie. 4. Aufl. Thieme; Stuttgart, New York: 2088 S. XI
    Google Scholar
  • 49 Cuesta-Vargas AL, Garcia-Romero JC Arroyo-Morales et al. Exercise, manual therapy, and education with or without high-intensity deep-water running for nonspecific chronic low back pain. A pragmatic randomized controlled trial. Am J Phys Med Rehabil 2011; 90: 526-538
    CrossrefPubMedGoogle Scholar
  • 50 Donchin M, Woolf O, Kaplan L et al. Secondary prevention of low-back pain. A clinical trial. Spine 1990; 15: 1317-1320
    CrossrefPubMedGoogle Scholar
  • 51 Chan CW, Mok NW, Yeung EW. Aerobic exercise training in addition to conventional physiotherapy for chronic low back pain: a randomized controlled trial. Arch Phys Med Rehabil 2011; 92: 1681-1685
    CrossrefPubMedGoogle Scholar
  • 52 Hartvigsen J, Morsø L, Bendix T et al. Supervised and non-supervised Nordic walking in the treatment of chronic low back pain: A single blind randomized clinical trial. BMC Musculoskelet Disord 2010; 11: 30
    CrossrefPubMedGoogle Scholar
  • 53 Sculco AD, Paup DC, Fernhall B et al. Effects of aerobic exercise on low back pain patients in treatment. Spine J 2001; 1: 95-101
    CrossrefPubMedGoogle Scholar
  • 54 Kankaanpää M, Taimela S, Airaksinen O et al. The efficacy of active rehabilitation in chronic low back pain. Spine 1999; 24: 1034-1042
    CrossrefPubMedGoogle Scholar
  • 55 Kihlstrand M, Stenman B, Nilsson S et al. Water-gymnastics reduced the intensity of back/low back pain in pregnant women. Acta Obstet Gynecol Scand 1999; 78: 180-185
    CrossrefPubMedGoogle Scholar
  • 56 Kuukanen T, Mälkiä E, Kautiainen H et al. Effectiveness of a home exercise programme in low back pain: a randomized five-year follow-up study. Physiother Res 2007; 12: 213-224
    PubMedGoogle Scholar
  • 57 Pillastrini P, Mugnai R, Bertozzi L et al. Effectiveness of an at-work exercise program in the prevention and management of neck and low back complaints on nursery school teachers. Ind Health 2009; 47: 349-354
    CrossrefPubMedGoogle Scholar
  • 58 Rydeard R, Leger A, Smith D. Pilates-based therapeutic exercise: effect on subjects with nonspecific chronic low back pain and functional disability: a randomized controlled trial. J Orthop Sports Phys Ther 2006; 36: 472-484
    PubMedGoogle Scholar
  • 59 Hansen FR, Bendix T, Skov P et al. Intensive, dynamic back-muscle exercises, conventional physiotherapy, or placebo-control treatment of low-back pain. A randomized, observer-blind trial. Spine 1993; 18: 98-108
    CrossrefPubMedGoogle Scholar
  • 60 Helewa A, Goldsmith CH, Lee P et al. Does strengthening the abdominal muscles prevent low back pain – a randomized controlled trial. J Rheumatol 1999; 26: 1808-1815
    PubMedGoogle Scholar
  • 61 Maul I, Läubli T, Oliveri M et al. Long-term effects of supervised physical training in secondary prevention of low back pain. Eur Spine J 2005; 14: 599-611
    CrossrefPubMedGoogle Scholar
  • 62 Chok B, Lee R, Latimer J et al. Endurance training of the trunk extensor muscles in people with subacute low back pain. Phys Ther 1999; 79: 1032-1042
    PubMedGoogle Scholar
  • 63 Frost H, Klaber Moffett JA et al. Randomised controlled trial for evaluation of fitness programme for patients with chronic low back pain. Brit Med J 1995; 310: 151-154
    CrossrefPubMedGoogle Scholar
  • 64 Frost H, Lamb SE, Klaber Mofett JA et al. A fitness programme for patients with chronic low back pain: 2-year follow-up of a randomized controlled trial. Pain 1998; 75: 273-279
    CrossrefPubMedGoogle Scholar
  • 65 Garshasbi A, Faghih Zadeh S. The effect of exercise on the intensity of low back pain in pregnant women. Int J Gynaecol Obstet 2005; 88: 271-275
    CrossrefPubMedGoogle Scholar
  • 66 Jones M, Stratton G, Reilly T et al. Recurrent non-specific low-back pain in adolescents: the role of exercise. Ergonomics 2007; 50: 1680-1688
    CrossrefPubMedGoogle Scholar
  • 67 Jones M, Stratton G, Reilly T et al. The efficacy of exercise as an intervention to treat recurrent nonspecific low back pain in adolescents. Pediat Exerc Sci 2007; 19: 349-359
    PubMedGoogle Scholar
  • 68 Kuukanen T, Mälkiä E. Effects of a three-month active rehabilitation program on psychomotor performance of lower limbs in subjects with low back pain: a controlled study with nine-month follow-up. Percept Mot Skills 1998; 87: 739-753
    CrossrefPubMedGoogle Scholar
  • 69 Pengel LHM, Refshauge KM, Maher CG et al. Physiotherapist-directed exercise, advice, or both for subacute low back pain. Ann Intern Med 2007; 146: 787-796
    CrossrefPubMedGoogle Scholar
  • 70 Tsauo J-Y, Chen W-H, Liang H-W et al. The effectiveness of a functional training programme for patients with chronic low back pain – a pilot study. Disabil Rehabil 2009; 31: 1100-1106
    CrossrefPubMedGoogle Scholar
  • 71 Hlobil H, Staal JB, Twisk J et al. The effects of a graded activity for low back pain in occupational health on sick leave, functional status and pain: 12-month results of a randomized controlled trial. J Occup Rehabil 2005; 15: 569-580
    CrossrefPubMedGoogle Scholar
  • 72 Staal BJ, Hlobil H, Twisk JWR et al. Graded activity for low back pain in occupational health care. Ann Intern Med 2004; 140: 77-84
    CrossrefPubMedGoogle Scholar
  • 73 Sherman KJ, Cherkin DC, Erro J et al. Comparing yoga, exercise, and a self-care book for chronic low back pain. Ann Intern Med 2005; 143: 849-856
    CrossrefPubMedGoogle Scholar
  • 74 Steenstra IA, Anema JR, Bongers PM et al. The effectiveness of graded activity for low back pain in occupational healthcare. Occup Environ Med 2006; 63: 718-725
    CrossrefPubMedGoogle Scholar
  • 75 Hall AM, Maher CG, Lam P et al. Tai Chi exercise for treatment of pain and disability in people with persistent low back pain: a randomized controlled trial. Arthritis Rheum 2011; 63: 1576-1583
    CrossrefPubMedGoogle Scholar
  • 76 Ettinger Jr WH, Burns R, Messier SP et al. A randomized trial of aerobic exercise and resistance exercise in older adults with knee osteoarthritis. The Fitness and Seniors Trial (FAST). JAMA 1987; 277: 25-31
    PubMedGoogle Scholar
  • 77 Halbert J, Crotty M, Weller D et al. Primary care-based physical activity programs: effectiveness in sedentary older patients with osteoarthritis symptoms. Arthritis Rheum 2001; 45: 228-234
    CrossrefPubMedGoogle Scholar
  • 78 Baker KR, Nelson ME, Felson DT et al. The efficacy of home based progressive strength training in older adults with knee osteoarthritis: a randomized controlled trial. J Rheumatol 2001; 28: 1655-1665
    PubMedGoogle Scholar
  • 79 Gür H, Cakin N, Akova B et al. Concentric versus combined concentric-eccentric isokinetic training: effects on functional capacity and symptoms in patients with osteoarthrosis of the knee. Arch Phys Med Rehabil 2002; 83: 308-316
    CrossrefPubMedGoogle Scholar
  • 80 Hinman RS, Heywood SE, Day AR. Aquatic physical therapy for hip and knee osteoarthritis: results of a single-blind randomized controlled trial. Phys Ther 2007; 87: 32-43
    CrossrefPubMedGoogle Scholar
  • 81 Horstmann T, Mayer F, Heitkamp HC et al. Individuelles isokinetisches Krafttraining bei Patienten mit Gonarthrose. Z Rheumatol 2000; 59: 93-100
    CrossrefPubMedGoogle Scholar
  • 82 Huang M-H, Lin Y-S, Yang R-C et al. A comparison of various therapeutic exercises on the 4 functional status of patients with knee osteoarthritis. Semin Arthritis Rheum 2003; 32: 398-406
    CrossrefPubMedGoogle Scholar
  • 83 Huang MH, Yang RC, Lee CL et al. Preliminary results of integrated therapy for patients with knee osteoarthritis. Arthritis Rheum 2005; 53: 812-820
    CrossrefPubMedGoogle Scholar
  • 84 Jan M-H, Lin J-J, Liau J-J et al. Investigation of clinical effects of high- and low-resistance training for patients with knee osteoarthritis: a randomized controlled trial. Phys Ther 2008; 88: 427-436
    CrossrefPubMedGoogle Scholar
  • 85 Lin D-N, Janice C-N, Lin Y-F et al. Efficacy of 2 non-weight-bearing interventions, proprioception training versus strength training, for patients with knee osteoarthritis: a randomized clinical trial. J Orthop Sports Phys Ther 2009; 39: 450-457
    PubMedGoogle Scholar
  • 86 Maurer BT, Stern AG, Kinossian B et al. Osteoarthritis of the knee: isokinetic quadriceps exercise versus an educational intervention. Arch Phys Med Rehabil 1999; 80: 1293-1299
    CrossrefPubMedGoogle Scholar
  • 87 O’Reilly SC, Muir KR, Doherty M. Effectiveness of home exercise on pain and disability from osteoarthritis of the knee: a randomised controlled trial. Ann Rheum Dis 1999; 58: 15-19
    CrossrefPubMedGoogle Scholar
  • 88 Petrella RJ, Bartha C. Home based exercise therapy for older patients with knee osteoarthritis: a randomized clinical trial. J Rheumatol 2000; 27: 2215-2221
    PubMedGoogle Scholar
  • 89 Schilke JM, Johnson GO, Housh TJ et al. Effects of muscle-strength training on the functional status of patients with osteoarthritis of the knee joint. Nurs Res 1996; 45: 68-72
    CrossrefPubMedGoogle Scholar
  • 90 Tak E, Staats P, Van Hespen A et al. The effects of an exercise program for older adults with osteoarthritis of the hip. J Rheumatol 2005; 32: 1106-1113
    PubMedGoogle Scholar
  • 91 Thomas KS, Muir KR, Doherty M et al. Home based exercise programme for knee pain and knee osteoarthritis: randomized controlled trial. Br Med J 2002; 325: 752
    CrossrefPubMedGoogle Scholar
  • 92 van Baar ME, Dekker J, Oostendorp RA et al. The effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee: a randomized clinical trial. J Rheumatol 1998; 25: 2432-2439
    PubMedGoogle Scholar
  • 93 Cheing GL, Hui-Chan CW, Chan KM. Does four weeks of TENS and/or isometric exercise produce cumulative reduction of osteoarthritic knee pain?. Clin Rehabil 2002; 16: 749-760
    CrossrefPubMedGoogle Scholar
  • 94 Fernandes L, Storheim K, Sandvik L et al. Efficacy of patient education and supervised exercise vs. patient education alone in patients with hip osteoarthritis: a single blind randomized clinical trial. Osteoarthritis Cartilage 2010; 18: 1237-1243
    CrossrefPubMedGoogle Scholar
  • 95 Juhakoski R, Tenhonen S, Malmivaara A et al. A pragmatic randomized controlled study of the effectiveness and cost consequences of exercise therapy in hip osteoarthritis. Clin Rehabil 2011; 25: 370-383
    CrossrefPubMedGoogle Scholar
  • 96 McKnight PE, Kasle S, Going S et al. A comparison of strength training, self-management, and the combination for early osteoarthritis of the knee. Arthritis Care res 2010; 62: 45-53
    CrossrefPubMedGoogle Scholar
  • 97 Quilty B, Tucker M, Campbell R et al. Physiotherapy, including quadriceps exercises and patellar taping, for knee osteoarthritis with predominant patello-femoral joint involvement: randomized controlled trial. J Rheumatol 2003; 30: 1311-1317
    PubMedGoogle Scholar
  • 98 Wang TJ, Belza B, Elaine Thompson F et al. Effects of aquatic exercise on flexibility, strength and aerobic fitness in adults with osteoarthritis of the hip or knee. J Adv Nurs 2007; 57: 141-152
    CrossrefPubMedGoogle Scholar
  • 99 Williamson L, Wyatt MR, Yein K et al. Severe knee osteoarthritis: a randomized controlled trial of acupuncture, physiotherapy (supervised exercise) and standard management for patients awaiting knee replacement. Rheumatology 2007; 46: 1445-1449
    CrossrefPubMedGoogle Scholar
  • 100 Hughes SL, Seymour RB, Campbell RT et al. Long-term impact of Fit and Strong! on older adults with osteoarthritis. Gerontologist 2006; 46: 801-814
    CrossrefPubMedGoogle Scholar
  • 101 Thomas KS, Miller P, Doherty M et al. Cost effectiveness of a two-year home exercise program for the treatment of knee pain. Arthritis Rheum 2005; 53: 388-394
    CrossrefPubMedGoogle Scholar
  • 102 Topp R, Woolley S, Hornyak 3rd J et al. The effect of dynamic versus isometric resistance training on pain and functioning among adults with osteoarthritis of the knee. Arch Phys Med Rehabil 2002; 83: 1187-1195
    CrossrefPubMedGoogle Scholar
  • 103 Lim J-Y, Tchai E, Jang S-N. Effectiveness of aquatic exercise for obese patients with knee osteoarthritis: a randomized controlled trial. PM R 2010; 2: 723-731
    CrossrefPubMedGoogle Scholar
  • 104 Lund H, Weile U, Christensen R et al. A randomized controlled trial of aquatic and land-based exercise in patients with knee osteoarthritis. J Rehabil Med 2008; 40: 137-144
    CrossrefPubMedGoogle Scholar
  • 105 Messier SP, Loeser RF, Miller GD et al. Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the Arthritis, Diet, and Activity Promotion Trial. Arthritis Rheum 2004; 50: 1501-1510
    CrossrefPubMedGoogle Scholar
  • 106 Thorstensson CA, Roos EM, Petersson IF et al. Six-week high-intensity exercise program for middle-aged patients with knee osteoarthritis a randomized controlled trial. BMC Musculosketal Disord 2005; 6: 27
    PubMedGoogle Scholar
  • 107 Brismée JM, Paige RL, Chyu MC et al. Group and home-based tai chi in elderly subjects with knee osteoarthritis: a randomized controlled trial. Clin Rehabil 2007; 21: 99-111
    CrossrefPubMedGoogle Scholar
  • 108 Ni G-X, Song L, Yu B et al. Tai Chi improves physical function in older Chinese women with knee osteoarthritis. J Clin Rheumatol 2010; 16: 64-67
    CrossrefPubMedGoogle Scholar
  • 109 Song R, Lee E-O, Lam P et al. Effects of a Sun-style Tai-Chi exercise on arthritic symptoms, motivation and the performance of health behaviors in women with osteoarthritis. J Korean Acad Nurs 2007; 378: 249-256
    PubMedGoogle Scholar
  • 110 Wang C, Schmid CH, Hibberd PL et al. Tai Chi is effective in treating knee osteoarthritis: A randomized controlled trial. Arthritis Rheum 2009; 61: 1545-1553
    CrossrefPubMedGoogle Scholar
  • 111 Fransen M, Nairn L, Winstanley J et al. Physical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or Tai Chi classes. Arthritis Rheum 2007; 57: 407-414
    CrossrefPubMedGoogle Scholar
  • 112 Burckhardt CS, Mannerkorpi K, Hedenberg L et al. A randomized, controlled clinical trial of education and physical training for women with fibromyalgia. J Rheumatol 1994; 21: 714-720
    PubMedGoogle Scholar
  • 113 Gusi N, Tomas-Carus P, Häkkinen A et al. Exercise in waist-high warm water decreases pain and improves health-related quality of life and strength in the lower extremities in women with fibromyalgia. Arthritis Rheum 2006; 55: 66-73
    CrossrefPubMedGoogle Scholar
  • 114 Kayo AH, Peccin MS, Sanches CM et al. Effectiveness of physical activity in reducing pain in patients with fibromyalgia: a blinded randomized clinical trial. Rheumatol Int 2011; DOI: 10.1007/s00296-011-1958-z.
    PubMedGoogle Scholar
  • 115 Mannerkorpi K, Nyberg B, Ahlmén M et al. Pool exercise combined with education program for patients with fibromyalgia syndrome. A prospective, randomized study. J Rheumatol 2000; 27: 2473-2481
    PubMedGoogle Scholar
  • 116 McCain GA, Bell DA, Mai FM et al. Controlled study of the effects of a supervised cardiovascular fitness training program on the manifestations of primary fibromyalgia. Arthritis Rheum 1988; 31: 1135-1141
    CrossrefPubMedGoogle Scholar
  • 117 Wigers SH, Stiles TC, Vogel PA. Effects of aerobic exercise versus stress management treatment in fibromyalgia. A 4.5 year prospective study. Scand J Rheumatol 1996; 25: 77-86
    CrossrefPubMedGoogle Scholar
  • 118 Altan L, Bingöl U, Aykaç M et al. Investigation of the effects of pool-based exercise on fibromyalgia syndrome. Rheumatol Int 2004; 24: 272-277
    PubMedGoogle Scholar
  • 119 Cedraschi C, Desmeules J, Rapiti E et al. Fibromyalgia: a randomized, controlled trial of a treatment programme based on self management. Ann Rheum Dis 2004; 63: 290-296
    CrossrefPubMedGoogle Scholar
  • 120 Da Costa D, Abrahamowicz M, Lowensteyn I et al. A randomized clinical trial of an individualized home-based exercise programme for women with fibromyalgia. Rheumatology 2005; 44: 1422-1427
    CrossrefPubMedGoogle Scholar
  • 121 King SJ, Wessel J, Bhambhani Y et al. The effects of exercise and education, individually or combined, in women with fibromyalgia. J Rheumatol 2002; 29: 2620-2627
    PubMedGoogle Scholar
  • 122 Mannerkorpi K, Nordeman L, Cider Å et al. Does moderate-to-high intensity Nordic walking improve functional capacity and pain in fibromyalgia? A prospective randomized controlled trial. Arthritis Res Ther 2010; 12: R189
    CrossrefPubMedGoogle Scholar
  • 123 McCain GA. Role of physical fitness training in the fibrositis/fibromyalgia syndrome. Am J Med 1986; 81 (Suppl. 03) 73-77
    PubMedGoogle Scholar
  • 124 Meiworm L, Strass D, Jakob E et al. Auswirkungen eines aerobe Ausdauertrainings bauf Schmerzsymptomatik und Allgemeinbefinden bei Patienten mit Fibromyalgie. Dtsch Ztschr Sportmed 1999; 50: 188-192
    PubMedGoogle Scholar
  • 125 Mengshoel AM, Førre Ø. Physical fitness training bin patients with fibromyalgia. J Musculoskelet Pain 1993; 1: 267-272
    CrossrefPubMedGoogle Scholar
  • 126 Nichols DS, Glenn TM. Effects of aerobic exercise on pain perception, affect, and level of disability in individuals with fibromyalgia. Phys Ther 1004; 74: 327-332
    PubMedGoogle Scholar
  • 127 Richards SCM, Scott DL. Prescribed exercise in people with fibromyalgia parallel group randomised controlled trial. Brit Med J 2002; 325: 185
    CrossrefPubMedGoogle Scholar
  • 128 Sañudo B, Galiano D, Carrasco L et al. Aerobic exercise versus combined exercise therapy in women with fibromyalgia syndrome: a randomized controlled trial. Arch Phys Med Rehabil 2010; 91: 1838-1843
    CrossrefPubMedGoogle Scholar
  • 129 Jones KD, Burckhardt CS, Clark SR et al. A randomized controlled trial of muscle strengthening versus flexibility training in fibromyalgia. J Rheumatol 2002; 29: 1041-1048
    PubMedGoogle Scholar
  • 130 Martin L, Nutting A, MacIntosh BR et al. An exercise program in the treatment of fibromyalgia. J Rheumatol 1996; 23: 1050-1053
    PubMedGoogle Scholar
  • 131 Munguía-Izquierdo D, Legaz-Arrese A. Exercise in warm water decreases pain and improves cognitive function in middle-aged women with fibromyalgia. Clin Exp Rheumatol 2007; 25: 823-830
    PubMedGoogle Scholar
  • 132 Rooks DS, Gautam S, Romeling M et al. Group exercise, education, and combination self-management in women with fibromyalgia. A. randomized trial. Arch Intern Med 2007; 167: 2192-2200
    CrossrefPubMedGoogle Scholar
  • 133 Tomas-Carus P, Häkkinen A, Gusi N et al. Aquatic training and detraining on fitness and quality of life in fibromyalgia. Med Sci Sports Exerc 2007; 39: 1044-1050
    CrossrefPubMedGoogle Scholar
  • 134 Tomas-Carus P, Gusi N, Häkkinen A et al. Improvements of muscle strength predicted benefits in HRQOL and postural balance in women with fibromyalgia: an 8-month randomized controlled trial. Rheumatology 2009; 48: 1147-1151
    CrossrefPubMedGoogle Scholar
  • 135 Gowans SE, deHueck A, Voss S et al. A randomized, controlled trial of exercise and education for individuals with fibromyalgia. Arthritis Care Res 1999; 12: 120-128
    CrossrefPubMedGoogle Scholar
  • 136 Jones KD, Burckhardt CS, Deodhar AA et al. A six-month randomized controlled trial of exercise and pyridostigmine in the treatment of fibromyalgia. Arthritis Rheum 2008; 58: 612-622
    CrossrefPubMedGoogle Scholar
  • 137 Redondo JR, Justo CM, Moraleda FV et al. long-term efficacy of therapy in patients with fibromyalgia: a physical exercise-based program and a cognitive-behavioral approach. Arthritis Rheum 2004; 51: 184-192
    CrossrefPubMedGoogle Scholar
  • 138 Wang C, Schmid CH, Rones R et al. A randomized trial of t ai Chi for fibromyalgia. N Engl J Med 2010; 363: 743-754
    CrossrefPubMedGoogle Scholar
  • 139 Van Middelkoop M, Rubinstein SM, Kuijpers T et al. A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain. Eur Spine J 2011; 20: 19-39
    CrossrefPubMedGoogle Scholar
  • 140 Fransen M, McConnell S, Hernandez-Molina G et al. Exercise for osteoarthritis of the hip. Cochrane Database Syst Rev 2009; CD007912
    PubMedGoogle Scholar
  • 141 Hernández-Molina G, Reichenbach S, Zhang B et al. Effect of therapeutic exercise for hip osteoarthritis pain: results of a meta-analysis. Arthritis Rheum 2008; 59: 1221-1228
    CrossrefPubMedGoogle Scholar
  • 142 Bartels EM, Lund H, Hagen KB et al. Aquatic exercise for the treatment of knee and hip osteoarthritis. Cochrane Database Syst Rev 2007; CD005523
    PubMedGoogle Scholar
  • 143 Busch AJ, Barber KA, Overend TJ et al. Exercise for treating fibromyalgia syndrome. Cochrane Database Syst Rev 2007; CD003786
    PubMedGoogle Scholar
  • 144 Busch AJ, Schachter CL, Overend TJ et al. Exercise for fibromyalgia: a systematic review. J Rheumatol 2008; 35: 1130-1144
    PubMedGoogle Scholar
  • 145 http://www.awmf.org/uploads/tx_szleitlinien/041-004l_01.pdf S. 74 (Stand: 21.01.2012)
    PubMed
  • 146 Pedersen BK, Saltin B. Evidence for prescribing exercise as therapy in chronic disease. Scand J Med Sci Sports 2006; 16 (Suppl. 01) 3-63
    CrossrefPubMedGoogle Scholar
  • 147 Brown J, Brown S. Exercise for dysmenorrhoea. Cochrane Database Syst Rev 2010; CD004142
    PubMedGoogle Scholar
  • 148 Daley AJ. Exercise and primary dysmenorrhoea. A comprehensive and critical review of the literature. Sport Med 2008; 38: 659-670
    CrossrefPubMedGoogle Scholar
  • 149 Busch V, Graul C. Exercise in migraine therapy – is there any evidence for efficacy? A critical review. Headache 2008; 48: 890-899
    CrossrefPubMedGoogle Scholar
  • 150 Darabaneanu S, Overath CH, Rubin D et al. Aerobic exercise as a therapy option for migraine: a pilot study. Int J Sports Med 2011; 32: 455-460
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 151 Kokkinos P, Sheriff H, Kheirbek R. Physical inactivity and mortality risk. Cardiol Res Pract 2011; 924945
    PubMedGoogle Scholar
  • 152 Leddy JJ, Izzo J. Hypertension in athletes. J Clin Hypertens (Greenwich) 2009; 11: 226-233
    CrossrefPubMedGoogle Scholar
  • 153 Lee IM. Physical activity and cardiac protection. Curr Sports Med Rep 2010; 9: 214-219
    CrossrefPubMedGoogle Scholar
  • 154 Halle M, Schoenberg MH. Körperliche Aktivität in der Prävention und Therapie des kolorektalen Karzinoms. Dtsch Ärztebl 2009; 106: 722-727
    PubMedGoogle Scholar
  • 155 Warburton DE, Charlesworth S, Ivey A et al. A systematic review of the evidence for Canada’s Physical Activity Guidelines for Adults. Int J Behav Nutr Phys Act 2010; 7: 39
    CrossrefPubMedGoogle Scholar
  • 156 Goldstein LB. Physical activity and the risk of stroke. Expert Rev Neurother 2010; 10: 1263-1265
    CrossrefPubMedGoogle Scholar
  • 157 Reimers CD, Knapp G, Reimers AK. Bewegung zur Prophylaxe von Schlaganfällen. Dtsch Ärztebl 2009; 106: 715-721
    PubMedGoogle Scholar
  • 158 Haskell WL, Lee IM, Pate RR et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 2007; 39: 1423-1434
    CrossrefPubMedGoogle Scholar
  • 159 Glover EI, Phillips SM. Resistance exercise and appropriate nutrition to counteract muscle wasting and promote muscle hypertrophy. Curr Opin Clin Nutr Metab Care 2010; 13: 630-634
    CrossrefPubMedGoogle Scholar