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Nervenheilkunde 2015; 34(03): 129-137
DOI: 10.1055/s-0038-1627567
Parkinson
Schattauer GmbH

E-Health in der Physiotherapie bei Parkinson-Patienten

Verbesserung von Gleichgewicht und GangstörungE-health in physiotherapy in patients with Parkinson’s disease
K. Ziegler
1   Abteilung Neurologie und klinische Neurophysiologie, Zentrum für Parkinson-Syndrome und Bewegungsstörungen, Schön Klinik, München Schwabing
› Institutsangaben
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Publikationsverlauf

eingegangen am: 17. Dezember 2014

angenommen am: 17. Dezember 2014

Publikationsdatum:
22. Januar 2018 (online)

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Zusammenfassung

Für Parkinson-Patienten sind aufgrund der Basalganglienerkrankung Ausführung und Erwerb automatischer Bewegungen schwierig. Gehen und Balance sind besonders betroffen, was die Sturzgefahr erhöht und die Lebensqualität reduziert. Bildgebende Verfahren ermöglichen den Nachweis, dass bei Parkinson-Patienten in frühen Erkrankungsstadien Neuroplastizität als Basis für motorisches Lernen möglich ist. Bewegungslernen gelingt durch intensives, aufgabenspezifisches Üben unter kognitiver Beteiligung, ausgelöst durch Feedback. Feedback kann heute elektronisch unterstützt in Echtzeit während der Bewegung gegeben werden. In eine virtuelle Realität eingebunden, können Patienten damit bei digitalen Spielen, wie Nintendo Wii oder Kinect™ Adventure!, ihr Gleichgewicht trainieren bzw. in virtueller Umgebung auf dem Laufband (V-Time) das Gehen in ablenkenden, alltagsrelevanten Situationen verbessern. Feedback in Form von intelligentem Cueing hilft, die Gangparameter zu korrigieren und motorische Blockaden zu überwinden. Dieser Artikel fasst Basalganglienfunktion und Fähigkeit zum motorischen Lernen zusammen, und stellt die elektronisch unterstützten Möglichkeiten (E-Health) zur Therapie von Gleichgewicht und Gangstörung in der Physiotherapie vor.

Summary

In patients with Parkinson’s disease the execution and acquisition of automatic movements are challenging due to dysfunction of the basal ganglia. Especially impaired are gait and balance, resulting in higher fall risk and reduced quality of life. Imaging technologies of the brain provides evidence of neuroplasticity in Parkinson’s disease as a base for motor learning. Learning of movements is possible through intensive, taskspecific exercise with cognitive engagement triggered by feedback. Today, feedback can be provided electronically supported during movement practice in real-time. Through integration in virtual reality, patients can train their balance function using digital games as Nintendo Wii or Microsoft Kinect™ Adventure! or improve their gait with treadmill training in a virtual environment (V-time) during simulated distracting situations of daily live. Feedback provided as intelligent cueing is helpful to correct the gait parameters or to overcome motor blocks. This article summarizes the basal ganglia function as well as the ability of motor learning and describes the above mentioned electronically supported devices (e-health) for therapy of balance and gait disorders within physiotherapeutic treatment.

Schlüsselwörter

E-Health - motorisches Lernen - Feedback - intelligentes Cueing - virtuelle Realität - Exergaming - Balance - Gangstörung - Stürze

Keywords

E-health - motor learning - feedback - intelligent cueing - virtual reality - exergaming - balance - gait disorder - falls
 

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