Zerebral bedingte Paresen und Spastik

Zusammenfassung

Ziel der physiotherapeutischen Intervention ist die Verbesserung alltagsrelevanter, selbstständiger motorischer Fertigkeiten. Eine evidenzbasierte Therapie zur motorischen Funktionsrestitution beinhaltet die Komponenten Ziel-und Aufgabenorientierung, Repetition und “shaping”. Bei ausgeprägten Paresen sind zusätzlich mentales Training, apparative Verfahren, EMG-initialisierte elektrische Muskelstimulation und eventuell auch Bewegungsbeobachtung und “Spiegeltraining” sinnvoll. Tonuserhöhungen und Muskelverkürzungen im Rahmen der Spastik erfordern auch passive Maßnahmen (Muskeldehnungen, Lagerungen, zirkuläre Gipsverbände, Lagerungsschienen, Fahrrad-Bewegungstrainer). Zur Bewältigung funktioneller Anforderungen müssen Hilfsmittel und/oder Orthesen eingesetzt werden.

Summary

The goal of physiotherapeutic intervention is to improve motor skills relevant for the activities of daily living. An evidence-based therapy for the restitution of motor function has to comprise the components of repetition, shaping, and has to be goal-directed and task orientated. In addition, with severe paresis motor imagery, movement observation and “mirror training” can be helpful as well as mechanistic techniques and EMG triggered electrical stimulation. Increase of muscle tone and muscle shortening due to spasticity require passive strategies such as muscle stretching, positioning, circular casting, splinting, reciprocal movements. For functional requirements devices and orthosis have to be given.

Schlüsselwörter

Physiotherapie - Schlaganfall - Aufgaben-orientiertes Vorgehen - Spastik

Keywords

Physiotherapy - stroke - task orientated approach - spasticity

• Literatur

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