Evidenz für Kryotherapie bei Verletzungen und Erkrankungen des Bewegungsapparates

U. Wolf

doi:10.1055/s-2005-858736

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physioscience 2005; 1(3): 120-128
DOI: 10.1055/s-2005-858736

Originalarbeit

Evidenz für Kryotherapie bei Verletzungen und Erkrankungen des Bewegungsapparates

Evidence of Cryotherapy for musculoskeletal disordersU. Wolf¹

¹Klinikum der Philipps-Universität Marburg, Bereich Physiotherapie

Further Information

Publication History

eingereicht: 15.07.2005

angenommen: 27.09.2005

Publication Date:
27 October 2005 (online)

Abstract
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Zusammenfassung

Hintergrund: Kryotherapie gehört in vielen Kliniken und Praxen zum Standardrepertoire, obwohl ihre Wirksamkeit nicht eindeutig beweisen ist.

Ziel: Die Literaturarbeit sollte die Evidenz der Kryotherapie prüfen und Hinweise für eine sinnvolle Indikationsstellung bei der Behandlung muskuloskelettaler Verletzungen liefern.

Methode: Die Recherche wurde in den Datenbanken Medline, Cochrane und PEDro durchgeführt. Für Erkrankungen und Verletzungen des Bewegungsapparates wurden 14 klinische und 4 Übersichtsarbeiten in Bezug auf ihre Methodik bewertet und zur Beantwortung der Fragestellung herangezogen.

Ergebnisse: Bei Muskelverletzungen konnten eine Schmerz lindernde und Funktion verbessernde und bei der Gonarthrose eine Resorption fördernde Wirkung sowie in der Kreuzbandchirurgie eine Verringerung der postoperativen Blutverlusts belegt werden.

Schlussfolgerungen: Gerade in den Bereichen, in denen die Kryotherapie bevorzugt Anwendung findet, ist ihre Wirksamkeit nicht belegt. Vor allem die fehlende Evidenz für Schmerzlinderung überrascht. Postoperative Schwellungszustände sind nicht beeinflussbar. Angesichts der Gefahr von Wundheilungsstörungen und Nervenschädigungen sollte sich auf die zeitlich eng begrenzte Anwendung der Akutversorgung von Weichteilverletzungen beschränkt werden.

Abstract

Background: Cryotherapy belongs to the standard procedures in many hospitals and practices, although its effectiveness is not clearly documented.

Objective: The literature review was supposed to prove the evidence of cryotherapy and to deliver suggestions for reasonable indication in the management of musculoskeletal disorders.

Method: The literature research was performed in the databases Medline, Cochrane und PEDro. 14 clinical trials and 4 reviews dealing with diseases and lesions of the musculoskeletal system were assessed in view of its methods in order to answer the posed question.

Results: In the case of muscular injuries reduction of pain and improvement of function could be proved. In osteoarthritis of the knee the resorption as well as the reduction of blood loss after cruciate ligament reconstruction were validated.

Conclusions: Cryotherapy is not proved to be effective in the field were it is most frequently used. Above all, the lack of evidence for pain reduction is surprising. Postoperative oedema cannot be influenced. As it may disturb tissue repair and cause nerval damage it should only be used for temporary treatment of acute soft tissue lesions.

Schlüsselwörter

Kryotherapie - Bewegungsapparat - Behandlungsergebnisse

Key words

Cryotherapy - musculoskeletal system - treatment outcome

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Udo Wolf, PT, BSc

Klinikum der Philips-Universität Marburg, Bereich Physiotherapie

Baldingerstr. 1

35033 Marburg

Email: udo.wolf@med.uni-marburg.de