Physiologie der Entstehung von Gelenkkontrakturen

J. Schomacher

doi:10.1055/s-2005-858172

manuelletherapie, Table of Contents

manuelletherapie 2005; 9(2): 82-95
DOI: 10.1055/s-2005-858172

Originalarbeit

Physiologie der Entstehung von Gelenkkontrakturen[1]

Physiology of the Development of Joint ContracturesJ. Schomacher¹

¹PT-Schule Ortenau

Abstract

Zusammenfassung

Gelenkkontrakturen sind ein häufiges Problem der physikalischen Rehabilitation. Anhand einer Literaturanalyse wurde eine Übersicht zu den Folgen der Ruhigstellung von Gelenken erstellt, wobei besonders der Beginn negativer Immobilisationsfolgen sowie die Auswirkungen auf die einzelnen Gewebe und ihre biochemisch wichtigen Bestandteile gesucht wurden. Ab der 1. Immobilisationswoche beginnen histologische und ab der 2. Woche makroskopisch sichtbare Veränderungen. Neben katabolen und degenerativen Veränderungen wuchert die Synovia in die Gelenkhöhle. Das freie Bewegen nach Immobilisation führte bei mehreren Versuchstieren nicht zur Wiederherstellung der Beweglichkeit. Bei der Kontrakturbehandlung sind physikalische und biologische Wirkungen der Physiotherapie zu beachten.

Abstract

In physical rehabilitation joint contractures are a widespread problem. This literature analysis provides an overview of the consequences of joint immobilisation. Special attention was paid to the onset of negative consequences of immobilisation as well as the effects on individual tissues and their biochemically important components. From the first immobilisation week onwards histological changes may be detected and from the second week on macroscopically visible changes begin to emerge. In addition to catabolic and degenerative changes the synovia proliferates into the joint cavity. The return to unrestricted movement after immobilisation did not re-establish mobility in several laboratory animals. The physical and biological effects of physiotherapy must be considered in the treatment of contractures.

Schlüsselwörter

Gelenkkontraktur - Immobilisation - Entstehungsmechanismen - Synovia - Knorpel - Kollagen - GAG - Crosslinks

Key words

Joint contracture - immobilisation - mechanisms of development - synovia - cartilage - collagen - GAG - crosslinks

Full Text

References

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1 Überarbeitete Version einer Hausarbeit im Rahmen des Studiengangs Physiotherapie der Fachhochschule Fulda und Universität Marburg.

PT, Jochen Schomacher

PT-Schule Ortenau

Birkenstr. 5

D-77731 Willstätt-Eckartsweier