Psychiatrie und Psychotherapie up2date 2009; 3(02): 121-136
DOI: 10.1055/s-0028-1090119
Störungsübergreifende Themen und Methoden

Sport- und bewegungstherapeutische Programme in der Behandlung psychischer Erkrankungen: Theorie und Praxis

Andreas Broocks
,
Dirk Wedekind
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Kernaussagen

  • Bewegungsmangel führt nicht nur zu Hypertonus, Übergewicht, Schlafstörungen und Angstzuständen, sondern stellt auch einen Risikofaktor für depressive Störungen dar.

  • Sport- und bewegungstherapeutische Behandlungsformen kommen heute in praktisch allen psychiatrisch-psychotherapeutischen und psychosomatischen Kliniken zum Einsatz, wobei über eine Verbesserung der körperlichen Fitness und des Körpergefühls positive Auswirkungen auf die psychische Befindlichkeit erzielt sowie Kommunikation und Interaktion gefördert werden sollen.

  • Für depressive Störungen und Angsterkrankungen konnte in kontrollierten Studien eine therapeutische Wirksamkeit von Ausdauertraining – und z. T. auch Krafttraining – gezeigt werden. Die Wirkung von Sport bei Psychosen aus dem schizophrenen Formenkreis, Suchterkrankungen und anderen psychischen Erkrankungen ist noch nicht ausreichend empirisch abgesichert.

  • Um sporttherapeutische Maßnahmen in der Praxis umzusetzen, sind die Motivierung und Anleitung des Patienten wesentlich. Techniken der motivierenden Gesprächsführung, wie z. B. die sog. Entscheidungsbalance, sollten vermehrt Anwendung finden. Die Trainingsintensität darf am Anfang nicht zu hoch sein, um insbesondere bei depressiven Patienten keine Überforderung und Frustration auszulösen.

  • Ausdauertraining hat direkte Effekte auf den Hirnstoffwechsel: Es führt zu einer veränderten Empfindlichkeit zentraler serotonerger Rezeptoren und zu einem Anstieg von ANP und von BDNF. Darüber hinaus stärkt Ausdauertraining die innere Überzeugung des Betroffenen, dass er selbst etwas zur Verbesserung seiner Situation tun kann und beeinflusst die Eigenwahrnehmung und das Selbstwertgefühl positiv.



Publication History

Publication Date:
16 February 2009 (online)

© Georg Thieme Verlag KG Stuttgart · New York

 

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