Assessments und Behandlungsansätze bei Sensibilitätsstörungen – vom Schattendasein zum Übungsprogramm

Zusammenfassung

Sensibilität ist ein wichtiger Teilbereich der Wahrnehmung. Dazu gehören: Tast-, Vibrations- und Berührungsempfinden, Temperatur- und Schmerzempfinden sowie die Fähigkeit, Gelenkstellungen und Bewegungen wahrzunehmen. Patienten mit Sensibilitätsstörungen sind in ihrem Alltag eingeschränkt, da sie Reize verzögert, unsicher oder falsch interpretieren und auch die Motorik beeinflusst sein kann. Dieser Artikel gibt einen Überblick über Sensibilitätstests, erklärt den Unterschied zwischen passivem und aktivem Sensibilitätstraining und gibt praktische Tipps für die Therapie. Nützlich sind auch die vielen Internethinweise, die den Lesern zusätzliche Informationen bieten. Klaus Starrost

• 1 Acerra NE, Souvlis T, Moseley G. Does mirror-box therapy improve sensory and motor changes in the early post-stroke population? A randomised controlled trial. Aust J Physiother 2005; 51(4-e Suppl): S7
• 2 Busse M, Tyson S. How many body locations need to be tested when assessing sensation after stroke? An investigation of redundancy in the Rivermead Assessment of Somatosensory Performance. Clin Rehabil 2009; 23: 91-95
• 3 Cambier DC, De Corte E, Danneels LA et al. Treating sensory impairments in the post-stroke upper limb with intermittent pneumatic compression. Results of a preliminary trial. Clinical Rehabilitation 2003; 17: 14-20
• 4 Carey LM, Matyas TA, Oke LE. Sensory loss in stroke patients: effective training of tactile and proprioceptive discrimination. Arch Phys Med Rehabil 1993; 74: 602-611
• 5 Carey L, Macdonell R, Matyas TA. SENSe: Study of the Effectiveness of Neurorehabilitation on Sensation: A Randomized Controlled Trial. Neurorehabil Neural Repair 2011; 25: 304
• 6 Chang JJ, Tsau JC, Lin YT. Predictors of shoulder subluxation in stroke patients. Gaoxiong Yi Xue Ke Xue Za Zhi 1995; 11: 250-256
• 7 Chen JC, Liang CC, Shaw FZ. Facilitation of sensory and motor recovery by thermal intervention for the hemiplegic upper limb in acute stroke patients. Stroke 2005; 36: 2665-2669
• 8 Dannenbaum RM, Michaelsen SM, Desrosoiers J. Development and evaluation of two new sensory tests of the hand for patients with stroke. Clin Rehab 2002; 16: 630-639
• 9 Dinse HR, Kattenstroh JC, Tegenthoff M et al. Plastizität, motorisches Lernen und sensible Stimulation. In: Dettmers C, Stephan KM, Hrsg. Motorische Therapie nach Schlaganfall. 1. Aufl. Bad Honnef: Hippocampus Verlag; 2011
• 10 Doyle S, Bennett S, Fasoli SE et al. Interventions for sensory impairment in the upper limb after stroke. Cochrane Database of Systematic Reviews 2010; (6)
• 11 Dukelow SP, Herter TM, Moore KD et al. Quantitative assessment of limb position sense following stroke. Neurorehabil Neural Repair 2010; 24: 178-187
• 12 French B. Does repetitive task training improve functional activity after stroke? A systematic review and meta-analysis. J Rehabil Med 2010; 42: 9-15
• 13 Gamble GE, Barberan E, Bowsher D et al. Post stroke shoulder pain: more common than previously realized. Eur J Pain 2000; 4: 313-315
• 14 Huber M. Feedback als therapeutische Technik. Weniger ist manchmal mehr. physiopraxis 2007; JR31225-15: 36-39
• 15 Jebsen RH, Taylor N, Trieschmann RB et al. An objective and standardized test of hand function. Archives of Physical Medicine and Rehabilitation 1969; 50: 311-319
• 16 Kalra L. Stroke Rehabilitation 2009: Old Chestnuts and New Insights. Stroke 2010; 41 () e88-e90
• 17 Klingner CM, Witte OW, Günther A. Sensory syndromes. Front Neurol Neurosci 2012; 30: 4-8
• 18 Law M, Baptiste S, McColl M et al. The Canadian Occupational Performance Measure: An outcome measurement protocol for occupational therapy. Canadian Journal of Occupational Therapy 1990; 57: 82-87
• 19 Laible M, Grieshammer S, Seidel G et al. Association of Activity Changes in the Primary Sensory Cortex With Successful Motor Rehabilitation of the Hand Following Stroke. Neurorehabil Neural Repair Published online before print 06.03.2012;
• 20 Lincoln NB, Jackson JM, Adams SA. Reliability and Revision of the Nottingham Sensory Assessment for stroke patients. Physiotherapy 1998; 84: 358-365
• 21 Lyle RC. A performance test for assessment of upper limb function in physical rehabilitation treatment and research. Int J of Rehabilitation Research 1981; 4 () 483-492
• 22 Nakaten A, Govers J, Dohle C. Spiegeltherapie in der Neurologie. 1. Aufl. Idstein: Schulz-Kirchner; 2009
• 23 Mudie MH, Matyas TA. Can simultaneous bilateral movement involve the undamaged hemisphere in reconstruction of neural networks damaged by stroke?. Disabil Rehabil 2000; 22: 23-37
• 24 Platz T, Roschka S. Rehabilitative Therapie bei Armparese nach Schlaganfall. Neurol Rehabil 2009; 15: 81-106
• 25 Rand D, Gottlieb D, Weiss P. Recovery of patients with a combined motor and proprioception deficit during the first six weeks of post stroke rehabilitation. Phys Occup Ther Geriatr 2001; 18: 69-87
• 26 Renner CJ E, Hummelsheim H. Sensomotorisches Diskriminationstraining. In: Nowak D, Hrsg. Handfunktionsstörungen in der Neurologie. 1. Aufl. Berlin: Springer Verlag; 2011
• 27 Schabrun SM, Hillier S. Evidence for the retraining of sensation after stroke: a systematic review. Clin Rehabil 2009; 23: 27-27
• 28 Thieme H. Das Spiegelbild als Partner. physiopraxis 2009; 10 () 26-29
• 29 Tremblay F, Wong K, Sanderson S. Tactile spatial acuity in elderly persons: assessment with grating domes and relationship with manual dexterity. Somatosens Mot Res 2003; 20: 127-132
• 30 Van Peppen RP, Kwakkel G, Wood-Dauphinee S. The impact of physical therapy on functional outcomes after stroke: what‘s the evidence?. Clin Rehabil 2004; 18: 833-862
• 31 Weiss T, Miltner WH, Liepert J. Rapid functional plasticity in the primary somatomotor cortex and perceptual changes after nerve block. Eur J Neurosci 2004; 20: 3413-3423
• 32 Winward CE, Halligan PW, Wade DT. Current practice and clinical relevance of somatosensory assessment after stroke. Clin Rehabil 1999; 13: 48-55
• 33 Winward CE, Halligan PW, Wade DT. The Rivermead Assessment of Somatosensory Performance (RASP): standardisation and reliability data. Clin Rehabil 2002; 16: 523-533
• 34 Yekutiel M, Guttman E. A controlled trial of the retraining of the sensory function of the hand in stroke patients. J Neurol Neurosurg Psychiatry 1993; 56: 241-244
• 35 Yozbartiran N, Donmez B, Kayak N et al. Electrical stimulation of wrist and fingers for sensory and functional recovery in acute hemiplegia. Clin Rehabil 2006; 20: 4-11