Sportverletz Sportschaden 2010; 24(1): 17-25
DOI: 10.1055/s-0030-1251512
Sportphysiotherapie aktuell

© Georg Thieme Verlag KG Stuttgart ˙ New York

Segmentale Stabilisation zur Behandlung von lumbalen Rückenschmerzen: Ein systematisches Review

Melanie Kriese1 , Ron Clijsen1 , Jan Taeymans1 , Jan Cabri2
  • 1University College Physiotherapy "Thim van der Laan", Landquart, CH
  • 2Dept. Physical Performance, The Norwegian School of Sport Sciences, Oslo (NO)
Further Information

Publication History

Publication Date:
16 March 2010 (online)

Also available at
 

1. Einleitung

Lumbale Rückenschmerzen (low back pain, LBP) sind ein großes Problem in der westlichen Welt. In industrialisierten Ländern leiden über 70 % mindestens einmal in ihrem Leben daruner. Es wird zwischen akutem LBP (< 6 Wochen), subakutem LBP (6–12 Wochen), chronischem LBP (> 12 Wochen) und wiederkehrendem LBP unterschieden [3].

Übungstherapie ist wirksam bei der Reduzierung von Schmerz und funktionellen Limitationen. Die Cochrane Collaboration zeigt mit einem systematischen Review über die Effekte von Erfindungen im Gesundheitsbereich, dass dies für chronischen LBP zutrifft. Für akuten LBP steht in der Literatur, dass Übungstherapie ebenso effektiv ist wie entweder keine Behandlung oder eine konservative Behandlung [18]. Eine Form von Übungstherapie, die in den letzten Jahren populär wurde, ist die Ausführung von segmentalen Stabilisationsübungen (Segmental stabilizing exercises, SSE).

Bergmark (1989) präsentierte ein Modell, in welchem die stabilisierenden Muskeln entweder lokal oder global sind. Die lokalen Muskeln haben eine primäre Verantwortung für die segmentale Stabilität, weil sie ein oder mehrere Segmente kreuzen und so die intervertebrale Bewegung kontrollieren (M. transversus abdominis, M. multifidus) [6]. Basierend auf den anatomischen Begebenheiten von Bergmark und Panjabi, entwickelte eine wissenschaftliche Gruppe an der University of Queensland in Australien (Queensland research group: Carolyn Richardson, Julie Hides, Paul Hodges) ein spezifisches Übungsprogramm mit SSE [40]. Die Methode fokussiert sich auf das Erlernen eines präzisen Ko-Kontraktionsmusters der tiefen Rumpfmuskulatur. Das Ziel ist es, die aktive segmentale Stabilisation zu verbessern und somit die Gelenke vor schmerzhafter Belastung und Verletzungen zu schützen [39].

Diese Art von Übungen mit niedriger Last und hoher Repetition wird auch lumbar/ core/ segmental stabilization, core strengthening, lumbar/ dynamic/ trunk stabilization, motor control, neutral spine control oder muscular fusion genannt [1], [42].

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Korrespondenzadresse:

Ron Clijsen

Weststraße 8

CH-7302 Landquart

Email: r.clijsen@physioschule.ch