Bewegungskontrolle und Bewegungsdysfunktion (1) Unterscheidung am Beispiel der LWS

Zusammenfassung

Bei muskuloskelettalen Beschwerden gibt es wissenschaftlich nachgewiesen keine wirkungsvollere Behandlung als eine auf Bewegung und Übungen basierende Therapie. Zur Diagnostik gehören das Beurteilen der Bewegungsqualität und Tests, die Aufschluss über mangelnde Bewegungskontrolle und Bewegungsdysfunktionen geben. Angepasste Übungen, Training und ein verbessertes Bewusstsein für das eigene Bewegungsverhalten sowie eine verbesserte Wahrnehmung für den eigenen Körper durchbrechen bei vielen Betroffenen muskuloskelettale Schmerzmechanismen und führen zurück in ein schmerzfreies Leben. Die folgenden Artikel zeigen exemplarisch am Beispiel Rückenschmerzen die Bedeutung von Bewegungskontrolle und Körperwahrnehmung.

Publikationsverlauf

Artikel online veröffentlicht:
20. Juni 2023

• Literatur

• 1 Rasmussen-Barr E, Nilsson-Wikmar L, Arvidsson I. Stabilizing training compared with manual treatment in sub-acute and chronic low-back pain. Man Ther 2003; 8: 233-241
• 2 Dankaerts W, O’Sullivan P, Burnett A. et al. Altered patterns of superficial trunk muscle activation during sitting in nonspecific chronic low back pain patients: importance of subclassification. Spine (Phila Pa 1976) 2006; 31: 2017-2023
• 3 Dankaerts W, O’Sullivan P, Burnett A. et al. Differences in sitting postures are associated with nonspecific chronic low back pain disorders when patients are subclassified. Spine (Phila Pa 1976) 2006; 31: 698-704
• 4 Dankaerts W, O’Sullivan PB, Straker LM. et al. The inter-examiner reliability of a classification method for non-specific chronic low back pain patients with motor control impairment. Man Ther 2006; 11: 28-39
• 5 Luomajoki H, Kool J, de Bruin ED. et al. Reliability of movement control tests in the lumbar spine. BMC Musculoskelet Disord 2007; 8: 90
• 6 Luomajoki H, Kool J, de Bruin E. et al. Movement control tests of the low back; evaluation of the difference between patients with low back pain and healthy controls. BMC Musculoskelet Disord 2008; 9: 170
• 7 Fersum KV, Dankaerts W, O’Sullivan PB. et al. Integration of sub-classification strategies in RCTs evaluating manual therapy treatment and exercise therapy for non-specific chronic low back pain (NSCLBP): a systematic review. Br J Sports Med 2010; 44: 1054-1062
• 8 Astfalck RG, O’Sullivan PB, Straker LM. et al. Sitting Postures and Trunk Muscle Activity in Adolescents with and without Nonspecific Chronic Low Back Pain: An Analysis Based on Subclassification. Spine (Phila Pa 1976) 2010; 35: 1387-1395
• 9 Delitto A, George SZ, van Dillen LR. et al. Low back pain. J Orthop Sports Phys Ther 2012; 42: A1-A57
• 10 Lehtola V, Luomajoki H, Leinonen V. et al. Sub-classification based specific movement control exercises are superior to general exercise in sub-acute low back pain when both are combined with manual therapy: a randomized controlled trial. BMC Musculoskelet Disord 2016; 17: 135
• 11 Saner J, Sieben JM, Kool J. et al. A tailored exercise program versus general exercise for a subgroup of patients with low back pain and movement control impairment: short-term results of a randomised controlled trial. J Bodywork Movement Ther 2016; 20: 189-202
• 12 Harris-Hayes M, van Dillen LR. The inter-tester reliability of physical therapists classifying low back pain problems on the movement system impairment classification system. PM R 2009; 1: 117-126
• 13 Harris-Hayes M, Sahrmann SA, van Dillen LR. Relationship between the hip and low back pain in athletes who participate in rotation-related sports. J Sport Rehabil 2009; 18: 60-75
• 14 Van Dillen LR, Sahrmann SA, Norton BJ. et al. Reliability of physical examination items used for classification of patients with low back pain. Phys Ther 1998; 78: 979-988
• 15 Van Dillen LR, Sahrmann SA, Norton BJ. et al. The effect of modifying patient-preferred spinal movement and alignment during symptom testing in patients with low back pain: a preliminary report. Arch Phys Med Rehabil 2003; 84: 313-322
• 16 Van Dillen LR, Maluf KS, Sahrmann SA. Further examination of modifying patient-preferred movement and alignment strategies in patients with low back pain during symptomatic tests. Man Ther 2009; 14: 52-60
• 17 Sahrmann S. Diagnosis and Treatment of Movement Impairment Syndromes. St. Louis: Mosby; 2002
• 18 Comerford M, Mottram S. Functional stability re-training: principles and strategies for managing mechanical dysfunction. Man Ther 2001; 6: 3-14
• 19 Comerford M, Mottram S. Movement and stability dysfunction – contemporary developments. Man Ther 2001; 6: 15-26
• 20 Dankaerts W, O’Sullivan PB, Burnett AF. et al. Reliability of EMG measurements for trunk muscles during maximal and sub-maximal voluntary isometric contractions in healthy controls and CLBP patients. J Electromyogr Kinesiol 2004; 14: 333-342
• 21 Dankaerts W, O’Sullivan P, Burnett A. et al. Discriminating healthy controls and two clinical subgroups of nonspecific chronic low back pain patients using trunk muscle activation and lumbosacral kinematics of postures and movements: a statistical classification model. Spine (Phila Pa 1976) 2009; 34: 1610-1618
• 22 O’Sullivan P, Phyty G, Twomey L. et al. Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine (Phila Pa 1976) 1997; 22: 2959-2967
• 23 O’Sullivan P, Twomey L, Allison G. et al. Altered patterns of abdominal muscle activation in patients with chronic low back pain. Aust J Physiother 1997; 43: 91-98
• 24 O’Sullivan PB. Masterclass. Lumbar segmental ‘instability’: clinical presentation and specific stabilizing exercise management. Man Ther 2000; 5: 2-12
• 25 O’Sullivan P. Diagnosis and classification of chronic low back pain disorders: maladaptive movement and motor control impairments as underlying mechanism. Man Ther 2005; 10: 242-255
• 26 O’Sullivan PB, Dankaerts W, Burnett AF. et al. Effect of different upright sitting postures on spinal-pelvic curvature and trunk muscle activation in a pain-free population. Spine (Phila Pa 1976) 2006; 31: E707-E712
• 27 O’Sullivan P, Dankaerts W, Burnett A. et al. Lumbopelvic kinematics and trunk muscle activity during sitting on stable and unstable surfaces. J Orthop Sports Phys Ther 2006; 36: 19-25
• 28 Vibe Fersum K, O’Sullivan PB, Kvåle A. et al. Inter-examiner reliability of a classification system for patients with non-specific low back pain. Man Ther 2009; 14: 555-561
• 29 Vibe Fersum K, O’Sullivan P, Skouen JS. et al. Efficacy of classification-based cognitive functional therapy in patients with non-specific chronic low back pain: a randomized controlled trial. Eur J Pain 2013; 17: 916-928
• 30 Hartvigsen J, Hancock MJ, Kongsted A. et al. What low back pain is and why we need to pay attention. Lancet 2018; 391: 2356-2367
• 31 Foster NE, Anema JR, Cherkin D. et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet 2018; 391: 2368-2383
• 32 Buchbinder R, van Tulder M, Oberg B. et al. Low back pain: a call for action. Lancet 2018; 391: 2384-2388
• 33 Koes BW, Backes D, Bindels PJE. Pharmacotherapy for chronic non-specific low back pain: current and future options. Expert Opin Pharmacother 2018; 19: 537-545
• 34 Fernandez M, Ferreira ML, Refshauge KM. et al. Surgery or physical activity in the management of sciatica: a systematic review and meta-analysis. Eur Spine J 2016; 25: 3495-3512
• 35 Delitto A, Piva SR, Moore CG. et al. Surgery versus nonsurgical treatment of lumbar spinal stenosis: a randomized trial. Ann Intern Med 2015; 162: 465-473
• 36 Qaseem A, Harris RP, Forciea MA. Clinical Guidelines Committee of the American College of P. Management of Acute and Recurrent Gout: A Clinical Practice Guideline from the American College of Physicians. Ann Intern Med 2017; 166: 58-68
• 37 Qaseem A, Wilt TJ, McLean RM. et al. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline from the American College of Physicians. Ann Intern Med 2017; 166: 514-530
• 38 Airaksinen O, Brox J, Cedraschi C. et al. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J 2006; 15 (Suppl. 2) S192-S300
• 39 Smith BE, Littlewood C, May S. An update of stabilisation exercises for low back pain: a systematic review with meta-analysis. BMC Musculoskelet Disord 2014; 15: 416
• 40 Luomajoki HA, Bonet Beltran MB, Careddu S. et al. Effectiveness of movement control exercise on patients with non-specific low back pain and movement control impairment: a systematic review and meta-analysis. Musculoskelet Sci Pract 2018; 36: 1-11
• 41 Aasa B, Berglund L, Michaelson P. et al. Individualized low-load motor control exercises and education versus a high-load lifting exercise and education to improve activity, pain intensity, and physical performance in patients with low back pain: a randomized controlled trial. J Orthop Sports Phys Ther 2015; 45: 77-85 B1–4
• 42 Van Tulder M, Becker A, Bekkering T. et al. Chapter 3. European guidelines for the management of acute nonspecific low back pain in primary care. Eur Spine J 2006; 15 (Suppl. 2) S169-S191
• 43 Brinjikji W, Luetmer PH, Comstock B. et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol 2015; 36: 811-816
• 44 Kendall NLS, Main C. Guide to assessing psychosocial yellow flags in acute low back pain. Wellington: National Health Committee; 1997
• 45 Linton SJ. A review of psychological risk factors in back and neck pain. Spine (Phila Pa 1976) 2000; 25: 1148-1156
• 46 Ostelo R, van Tulder M, Vlaeyen J. et al. Behavioural treatment for chronic low-back pain. Cochrane Database Syst Rev 2005; (1) CD002014
• 47 Van Tulder MW, Ostelo R, Vlaeyen JW. et al. Behavioral treatment for chronic low back pain: a systematic review within the framework of the Cochrane Back Review Group. Spine (Phila Pa 1976) 2000; 25: 2688-2699
• 48 Vlaeyen JW, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain 2000; 85: 317-332
• 49 Henry SM, van Dillen LR, Ouellette-Morton RH. et al. Outcomes are not different for patient-matched versus nonmatched treatment in subjects with chronic recurrent low back pain: a randomized clinical trial. Spine J 2014; 14: 2799-2810

• Quelle

• Luomajoki H. Bewegungsdysfunktion und Bewegungskontrolle – Physiotherapeutische Tests und Übungen für Nacken, Rumpf und Extremitäten. Stuttgart: Thieme; 2023