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Arthritis und Rheuma 2015; 35(04): 207-211
DOI: 10.1055/s-0037-1618375
Osteologie
Schattauer GmbH

Mechanoadaptation des Knochens

Grundlagen und Anforderungen an die BewegungstherapieMechanoadaptation of bonePrinciples and requirements for physical therapy
J. Rittweger
1   Institut für Luft- und Raumfahrtmedizin, Abteilung Weltraumphysiologie, Deutsches Zentrum für Luft- und Raumfahrt, Köln
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Publication History

Publication Date:
27 December 2017 (online)

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Zusammenfassung

Anpassung des Knochens an variable Kräfte ist über die gesamte menschliche Lebensspanne möglich. Als Erklärungsmodell bietet sich die Mechanostat-Theorie an, gemäß welcher die Knochenverformung als Regelgröße für strukturelle Anpassung des Knochens dient. Bettlägerigkeit führt zu raschem Knochenabbau aus den Beinen, der durch Krafttraining mit oder ohne Ganzkörpervibration verhindert werden kann. Rehabilitation von durch Immobilisierung hervorgerufenen Knochenverlusten ist bei vollständiger Rehabilitation der Bewegungsfähigkeit möglich und vergleichsweise einfach zu erreichen. Trotzdem ist die Primärprävention aus osteologischer Sicht vorzuziehen. Alters- und Geschlechtseffekte zur Mechanoadaptation sind beim Menschen nur spärlich untersucht worden. Jüngste Ergebnisse aus der Grundlagenforschung deuten auf eine besonders große Wirksamkeit von Torsionsverformungen als Stimulus für den Knochen hin. Aufgrund dieser Ergebnisse kann derzeit für die Bewegungstherapie gegen Knochenabbau empfohlen werden dass 1) Kräfte nahe der Maximalkraft erzeugt werden sollen, dass 2) mindestens einmal täglich geübt wird, und dass 3) die Muskulatur mit in die Bewegungstherapie einbezogen wird.

Summary

Bone adaptation to variant forces is possible throughout the human lifespan. The mechanostat theory states that bone deformations are the central entity that governs structural adaptations of our bones. Bed rest leads to rapid bone losses from the legs, and this can be effectively counteracted by resistive exercise with or without superimposed vibrations. Rehabilitation of bone losses incurred during bed rest is possible and can be achieved comparatively easily when the physical capabilities are also fully recovered. Notwithstanding, primary prevention of bed rest-induced bone losses is preferable from an osteological point of view. Relatively little is known about effects of age and gender upon bone’s mechano-adaptive capabilities. Recent results suggest that torsional deformations may constitute a particularly powerful stimulus for bone accrual. On basis of these results, it can currently be suggested for an effective physical therapy against bone loss that 1) it should entail bone loading near maximal forces, 2) these effective loads should be applied on a daily basis, and 3) that the musculature should also be involved in the exercise regimen.

Schlüsselwörter

Physiotherapie - Osteoporose - Muskel

Keywords

Physiotherapy - osteoporosis - muscle
 

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