Nervenheilkunde 2008; 27(08): 746-756
DOI: 10.1055/s-0038-1627138
Originaler Artikel
Schattauer GmbH

Aktivierende Therapien bei Parkinson- Syndromen

Activating therapies for patients with Parkinson's disease
G. Ebersbach
1   Neurologisches Fachkrankenhaus für Bewegungsstörungen/ Parkinson, Beelitz/Heilstätten
,
A. Ceballos-Baumann
2   Neurologisches Krankenhaus München, Zentrum für Parkinson-Syndrome und Bewegungsstörungen
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Eingegangen am: 29. Mai 2008

angenommen am: 29. Mai 2008

Publikationsdatum:
22. Januar 2018 (online)

Zusammenfassung

Trotz moderner Pharmakotherapie und tiefer Hirnstimulation kommt es bei der Mehrzahl der Parkinson-Patienten im Verlauf zu schwerwiegenden Behinderungen. Besonders für die Lebensqualität wesentliche Funktionen wie Gleichgewicht, Gehen, Sprechen, Schlucken und Kognition können langfristig nur unzureichend durch pharmakologische und chirurgische Verfahren gebessert werden. Aktivierenden Therapien aus den Bereichen der Physio-, Sprech-, Schluck- und Ergotherapie kommt hierbei eine zunehmende Rolle zu. Für bestimmte Problembereiche (z. B. Gleichgewichtsstörungen, motorische Blockaden, Dysarthrophonie) finden sich spezifische neurophysiologisch begründete und wissenschaftlich gut evaluierte aktivierende Therapien, die neben der Medikation einen festen Platz in der langfristigen Behandlung von Parkinson-Patienten haben sollten.

Summary

Despite advances in pharmacotherapy and deep brain stimulation most patients with Parkinson’s disease experience at some stage impairments which have a profound impact on quality of life. Pharmacotherapy and neurosurgical approaches are not satisfactory in treating impaired balance, gait, speech, voice, swallowing and cognition. Activating therapies such as physiotherapy, occupational, swallowing, voice and speech therapy may play an important role in alleviating these symptoms. This CME article focuses on specific activating interventions for certain impairments (e. g. gait and balance disorders, dysarthrophonia) which have emerged based on neurophysiological concepts and scientifically evaluated studies and which should play a role in the long term care of PD patients.

 
  • Literatur

  • 1 Ashburn A, Fazakarley L, Ballinger C, Pickering R, McLellan LD, Fitton C. A randomised controlled trial of a home based exercise programme to reduce the risk of falling among people with Parkinson’s disease. J Neurol Neurosurg Psychiatry 2007; 78 (Suppl. 07) 678-84.
  • 2 Bloem BR, Hausdorff JM, Visser JE, Giladi N. Falls and freezing of gait in Parkinson’s disease: a review of two interconnected, episodic phenomena. Mov Disord 2004; 19 (Suppl. 08) 871-84.
  • 3 Ceballos-Bauman A, Ebersbach G. Aktivierende Therapien bei Parkinson-Syndromen. Stuttgart: Thieme; 2008
  • 4 Ceballos-Baumann A, Conrad B. Pathophysiologie der Bewegungsstörungen. In: Ceballos-Baumann A, Conrad B. (Ed). Bewegungsstörungen. 2 überarbeitete Auflage. Stuttgart: Thieme; 2005
  • 5 Ceballos-Baumann A, Gündel H. Bewegungsstörungen. In: Henningsen P, Gündel H, Ceballos-Baumann A. (Ed). Neuropsychosomatik. Stuttgart: Schattauer; 2006
  • 6 de Swart BJ, Willemse SC, Maassen BA, Horstink MW. Improvement of voicing in patients with Parkinson’s disease by speech therapy. Neurology 2003; 60 (Suppl. 03) 498-500.
  • 7 Deane KH, Whurr R, Clarke CE, Playford ED, Ben-Shlomo Y. Non-pharmacological therapies for dysphagia in Parkinson’s disease. Cochrane Database Syst Rev. 2001 01 CD002816.
  • 8 Dibble LE, Hale TF, Marcus RL, Droge J, Gerber JP, LaStayo PC. High-intensity resistance training amplifies muscle hypertrophy and functional gains in persons with Parkinson’s disease. Mov Disord 2006; 21 (Suppl. 09) 1444-52.
  • 9 Ebersbach G. Grundlagen der aktivierenden Therapien. In: Ceballos-Bauman A, Ebersbach G. (Eds). Aktivierende Therapien bei Parkinson-Syndromen. Stuttgart: Thieme; 2008: 19-22.
  • 10 Ebersbach G, Edler D, Kaufhold O, Wissel J. Whole body vibration versus conventional physiotherapy to improve balance and gait in Parkinson’s disease. Arch Phys Med Rehabil 2008; 89 (Suppl. 03) 399-403.
  • 11 Farley BG, Koshland GF. Training BIG to move faster: the application of the speed-amplitude relation as a rehabilitation strategy for people with Parkinson’s disease. Exp Brain Res 2005; 167 (Suppl. 03) 462-7.
  • 12 Ferraye MU, Debu B, Fraix V, Xie-Brustolin J, Chabardes S, Krack P, Benabid AL, Pollak P. Effects of subthalamic nucleus stimulation and levodopa on freezing of gait in Parkinson disease. Neurology 2008; 70 16 Pt 2 1431-7.
  • 13 Fisher BE, Petzinger GM, Nixon K, Hogg E, Bremmer S, Meshul CK, Jakowec MW. Exerciseinduced behavioral recovery and neuroplasticity in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine- lesioned mouse basal ganglia. J Neurosci Res 2004; 77 (Suppl. 03) 378-90.
  • 14 Fox CM, Ramig LO, Ciucci MR, Sapir S, McFarland DH, Farley BG. The science and practice of LSVT/LOUD: neural plasticity-principled approach to treating individuals with Parkinson disease and other neurological disorders. Semin Speech Lang 2006; 27 (Suppl. 04) 283-99.
  • 15 Frank MJ, Seeberger LC, O’Reilly RC. By carrot or by stick: cognitive reinforcement learning in parkinsonism. Science 2004; 306 5703 1940-3.
  • 16 Genever RW, Downes TW, Medcalf P. Fracture rates in Parkinson’s disease compared with age- and gender-matched controls: a retrospective cohort study. Age Ageing 2005; 34 (Suppl. 01) 21-4.
  • 17 Haas CT, Turbanski S, Kessler K, Schmidtbleicher D. The effects of random whole-body-vibration on motor symptoms in Parkinson’s disease. Neuro- Rehabilitation 2006; 21 (Suppl. 01) 29-36.
  • 18 Haslinger B, Erhard P, Kampfe N, Boecker H, Rummeny E, Schwaiger M, Conrad B, Ceballos-Baumann AO. Event-related functional magnetic resonance imaging in Parkinson’s disease before and after levodopa. Brain 2001; 124 Pt 3 558-70.
  • 19 Hely MA, Morris JG, Reid WG, Trafficante R. Sydney Multicenter Study of Parkinson’s disease: non-L-dopa-responsive problems dominate at 15 years. Mov Disord 2005; 20 (Suppl. 02) 190-9.
  • 20 Hirsch MA, Toole T, Maitland CG, Rider RA. The effects of balance training and high-intensity resistance training on persons with idiopathic Parkinson’s disease. Arch Phys Med Rehabil 2003; 84 (Suppl. 08) 1109-17.
  • 21 Inkster LM, Eng JJ. Postural control during a sitto- stand task in individuals with mild Parkinson’s disease. Exp Brain Res 2004; 154 (Suppl. 01) 33-8.
  • 22 Jobges M, Heuschkel G, Pretzel C, Illhardt C, Renner C, Hummelsheim H. Repetitive training of compensatory steps: a therapeutic approach for postural instability in Parkinson’s disease. J Neurol Neurosurg Psychiatry 2004; 75 (Suppl. 12) 1682-7.
  • 23 Leplow B. Parkinson. Göttingen: Hogrefe; 2007
  • 24 Macht M, Ellgring H. Psychologische Interventionen bei der Parkinson-Erkrankung. Ein Behandlungsmanual. Stuttgart: Kohlhammer; 2003
  • 25 Marchese R, Diverio M, Zucchi F, Lentino C, Abbruzzese G. The role of sensory cues in the rehabilitation of parkinsonian patients: a comparison of two physical therapy protocols. Mov Disord 2000; 15 (Suppl. 05) 879-83.
  • 26 McIntosh GC, Brown SH, Rice RR, Thaut MH. Rhythmic auditory-motor facilitation of gait patterns in patients with Parkinson’s disease. J Neurol Neurosurg Psychiatry 1997; 62 (Suppl. 01) 22-6.
  • 27 Miyai I, Fujimoto Y, Ueda Y, Yamamoto H, Nozaki S, Saito T, Kang J. Treadmill training with body weight support: its effect on Parkinson’s disease. Arch Phys Med Rehabil 2000; 81 (Suppl. 07) 849-52.
  • 28 Morris ME, Iansek R, Matyas TA, Summers JJ. Stride length regulation in Parkinson’s disease. Normalization strategies and underlying mechanisms. Brain 1996; 119 Pt 2 551-68.
  • 29 National CCfCC.. Parkinson’s disease: national clinical guideline for diagnosis and management in primary and secondary care. London: Royal College of Physicians; 2006
  • 30 Nieuwboer A, Kwakkel G, Rochester L, Jones D, van Wegen E, Willems AM, Chavret F, Hetherington V, Baker K, Lim I. Cueing training in the home improves gait-related mobility in Parkinson’s disease: the RESCUE trial. J Neurol Neurosurg Psychiatry 2007; 78 (Suppl. 02) 134-40.
  • 31 Nikfekr E, Kerr K, Attfield S, Playford DE. Trunk movement in Parkinson’s disease during rising from seated position. Mov Disord 2002; 17 (Suppl. 02) 274-82.
  • 32 Pinto S, Ozsancak C, Tripoliti E, Thobois S, Limousin-Dowsey P, Auzou P. Treatments for dysarthria in Parkinson’s disease. Lancet Neurol 2004; 3 (Suppl. 09) 547-56.
  • 33 Ramig LO, Sapir S, Countryman S, Pawlas AA, O’Brien C, Hoehn M, Thompson LL. Intensive voice treatment (LSVT) for patients with Parkinson’s disease: a 2 year follow up. J Neurol Neurosurg Psychiatry 2001; 71 (Suppl. 04) 493-8.
  • 34 Schroeteler F, Ziegler K. Physiotherapie bei Parkinson- Syndromen. In: Ceballos-Baumann A, Ebersbach G. (Eds). Aktivierende Therapien bei Parkinson-Syndromen. Stuttgart: Thieme; 2008: 46-65.
  • 35 Sharkawi AE, Ramig L, Logemann JA, Pauloski BR, Rademaker AW, Smith CH, Pawlas A, Baum S, Werner C. Swallowing and voice effects of Lee Silverman Voice Treatment (LSVT): a pilot study. J Neurol Neurosurg Psychiatry 2002; 72 (Suppl. 01) 31-6.
  • 36 Spielman JL, Borod JC, Ramig LO. The effects of intensive voice treatment on facial expressiveness in Parkinson disease: preliminary data. Cogn Behav Neurol 2003; 16 (Suppl. 03) 177-88.
  • 37 Spottke EA, Volkmann J, Lorenz D, Krack P, Smala AM, Sturm V, Gerstner A, Berger K, Hellwig D, Deuschl G, Freund HJ, Oertel WH, Dodel RC. Evaluation of healthcare utilization and health status of patients with Parkinson’s disease treated with deep brain stimulation of the subthalamic nucleus. J Neurol 2002; 249 (Suppl. 06) 759-66.
  • 38 Suteerawattananon M, Morris GS, Etnyre BR, Jankovic J, Protas EJ. Effects of visual and auditory cues on gait in individuals with Parkinson’s disease. J Neurol Sci 2004; 219 1–2 63-9.
  • 39 van Wegen E, de Goede C, Lim I, Rietberg M, Nieuwboer A, Willems A, Jones D, Rochester L, Hetherington V, Berendse H, Zijlmans J, Wolters E, Kwakkel G. The effect of rhythmic somatosensory cueing on gait in patients with Parkinson’s disease. J Neurol Sci 2006; 248 1–2 210-4.
  • 40 Wagner-Sonntag E. Schluckstörungen bei Parkinson- Syndromen. In: Ceballos-Baumann A, Ebersbach G. (Ed). Aktivierende Therapien bei Parkinson- Syndromen. Stuttgart: Thieme; 2008: 31-39.
  • 41 Wielinski CL, Erickson-Davis C, Wichmann R, Walde-Douglas M, Parashos SA. Falls and injuries resulting from falls among patients with Parkinson’s disease and other parkinsonian syndromes. Mov Disord 2005; 20 (Suppl. 04) 410-5.
  • 42 Willems AM, Nieuwboer A, Chavret F, Desloovere K, Dom R, Rochester L, Kwakkel G, van Wegen E, Jones D. Turning in Parkinson’s disease patients and controls: the effect of auditory cues. Mov Disord 2007; 22 (Suppl. 13) 1871-8.
  • 43 Woodford H, Walker R. Emergency hospital admissions in idiopathic Parkinson’s disease. Mov Disord 2005; 20 (Suppl. 09) 1104-8.
  • 44 Liotti M. et al. Hypophonia in Parkinson’s disease. Neurology 2003; 60: 432-40.
  • 45 Macht M, Ellgring H. Psychologische Interventionen bei der Parkinson-Erkrankung. Nervenheilkunde 2008; 27: 729-32.