Physikalisch-medizinische Ansätze im Rahmen der ambulanten Schlaganfallrehabilitation

Zusammenfassung

Schlaganfall ist die häufigste Ursache für eine chronische Behinderung. Funktionelle Verbesserungen und Unabhängigkeit bei Alltagstätigkeiten können mit ambulanter Rehabilitation noch im chronischen Stadium erreicht werden. Physikalisch-therapeutische Interventionen sind hierfür von großer Bedeutung. Die Wirksamkeit von physikalisch-therapeutischen Maßnahmen wie unterschiedliche physiotherapeutische Methoden, Laufbandtraining, Krafttraining, Robotertraining, ergotherapeutische Konzepte, nicht invasive kortikale Stimulation und Elektrostimulation wurde in Studien belegt. Diese Methoden können durch medikamentöse und nicht medikamentöse Schmerztherapie, der medikamentösen Behandlung einer fokalen Spastizität (Botulinumtoxin) und einer evtl. bestehenden Depression unterstützt werden. Fachärzte für physikalische Medizin und allgemeine Rehabilitation evaluieren den Patienten entsprechend dem ICF-Konzept (ICF: internationale Klassifikation der Funktionsfähigkeit, Behinderung und Gesundheit) bez. der Körperfunktionen und -strukturen, Aktivitäten und Partizipation. Basierend auf dieser Evaluation sorgen sie dafür, dass die physikalisch-therapeutischen rehabilitativen Maßnahmen individuell angepasst und koordiniert werden sowie in einem strukturierten Umfeld ablaufen.

Abstract

Stroke is the leading cause of chronic disability. Postacute outpatient rehabilitation improves functional capacity and independence in personal activities of daily living. There is evidence that rehabilitation may be still beneficial in chronic stroke patients. In the rehabilitation process physical-therapeutic methods are very important. Evidence of a positive effect of several physical-therapeutic interventions like different methods of physiotherapy and exercise therapy, treadmill training, strength training, use of robotics, occupational therapy, non invasive cortical stimulation and electrostimulation has been proven in many studies. To support these interventions medicamentous and non-medicamentous treatment of pain, focal spasticity (botulinum toxin) and depression should be performed. According to the concept of ICF the specialists of Physical Medicine and Rehabilitation evaluate the individual body functions- and structures, activities and participation of the patient. Based on this evaluation they are responsible for individual adaptation and coordination of a structered rehabilitation process.

Schlüsselwörter

ambulante Rehabilitation - physikalische Medizin - Schlaganfall

Keywords

outpatient rehabilitation - physical medicine - stroke

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