[go: up one dir, main page]
Skip to main content
SpringerLink
Log in

Armrehabilitation

Aktueller Kenntnisstand und Therapieansätze

Arm rehabilitation

Current concepts and therapeutic options

  • Leitthema
  • Published:
Der Nervenarzt Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Armlähmungen nach einem Schlaganfall sind eine zentrale Ursache für Behinderung.

Ziel der Arbeit

Es werden therapeutische Optionen und ihre Wirksamkeit in der Armrehabilitation nach einem Schlaganfall dargestellt.

Material und Methoden

Basierend auf einer systematischen Bewertung randomisierter kontrollierter Studien werden therapeutische Verfahren für die Armparese nach einem Schlaganfall im Kontext ihrer Wirksamkeit vorgestellt, dazu gehören u. a. Robot-Therapie, Spiegeltherapie, „constraint-induced movement therapy“, Armbasistraining, Armfähigkeitstraining, neuromuskuläre Elektrostimulation, bilaterales und aufgabenspezifisches Training, mentales Training und transkranielle Stimulationsverfahren („repetitive transcranial magnetic stimulation“ [rTMS], „transcranial direct current stimulation“ [tDCS]).

Ergebnisse und Diskussion

Eine Reihe therapeutischer Verfahren mit geprüfter Wirksamkeit steht für die Armrehabilitation nach einem Schlaganfall zur Verfügung. Ihre differenzielle Indikationsstellung wird vorgestellt und mit einem Fazit für die Praxis verbunden.

Abstract

Background

Arm paralysis after a stroke is a major cause of impairment.

Objective

Presentation of therapeutic options and the efficacy in arm rehabilitation after stroke.

Material and methods

Based on a systematic critical appraisal of randomized controlled trials (RCT) the therapeutic procedures for arm paralysis after stroke in the context of their effectiveness are introduced, including robotic therapy, mirror therapy, constraint-induced movement therapy (CIMT), arm basis training, arm ability training, neuromuscular electrical stimulation, bilateral and task-specific training, mental training and transcranial stimulation techniques, such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS).

Results and discussion

Several therapeutic procedures with proven efficacy are currently available for arm rehabilitation after stroke. Their differential indications are presented and associated with conclusions for clinical practice.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Coupar F, Pollock A, Wijck F van, Morris J, Langhorne P (2010) Simultaneous bilateral training for improving arm function after stroke. Cochrane Database Syst Rev 4:CD006432

    PubMed  Google Scholar 

  2. Delden AL van, Peper CL, Nienhuys KN, Zijp NI, Beek PJ, Kwakkel G (2013) Unilateral versus bilateral upper limb training after stroke: The Upper Limb Training After Stroke Clinical Trial. Stroke 44:2613–2616

    Article  PubMed  Google Scholar 

  3. French B, Thomas L, Leathley M, Sutton C, McAdam J, Forster A et al (2010) Does repetitive task training improve functional activity after stroke? A Cochrane systematic review and meta-analysis. J Rehabil Med 42:9–14

    Article  PubMed  Google Scholar 

  4. Hsu WY, Cheng CH, Liao KK, Lee IH, Lin YY (2012) Effects of repetitive transcranial magnetic stimulation on motor functions in patients with stroke: A meta-analysis. Stroke 43:1849–1857

    Article  PubMed  Google Scholar 

  5. Ietswaart M, Johnston M, Dijkerman HC, Joice S, Scott CL, MacWalter RS, Hamilton SJC (2011) Mental practice with motor imagery in stroke recovery: Randomized controlled trial of efficacy. Brain 134(Pt 5):1373–1386

    Article  PubMed  PubMed Central  Google Scholar 

  6. Kho AY, Liu KP, Chung RC (2014) Meta-analysis on the effect of mental imagery on motor recovery of the hemiplegic upper extremity function. Aust Occup Ther J 61(2):38–48

    Article  PubMed  Google Scholar 

  7. Masiero S, Armani M, Ferlini G, Rosati G, Rossi A (2013) Randomized trial of a robotic assistive device for the upper extremity during early inpatient stroke rehabilitation. Neurorehabil Neural Repair. doi:10.1177/1545968313513073

    PubMed  Google Scholar 

  8. Mehrholz J, Hädrich A, Platz T, Kugler J, Pohl M (2015) Electromechanical and robot-assisted arm training for improving activities of daily living, arm function, and arm muscle strength after stroke. Cochrane Database Syst Rev 11:CD006876

    PubMed  Google Scholar 

  9. Nijland R, Kwakkel G, Bakers J, Wegen E van (2011) Constraint-induced movement therapy for the upper paretic limb in acute or sub-acute stroke: A systematic review. Int J Stroke 6:425–433

    Article  PubMed  Google Scholar 

  10. Platz T (2009) Rehabilitative Therapie bei Armparese nach Schlaganfall. Neurol Rehabil 15:81–106

    Google Scholar 

  11. Platz T (2011) Leitlinien in der Rehabilitation. In: Dettmers C, Stephan KM (Hrsg) Motorische Therapie nach Schlaganfall. Hippocampus, Bad Honnef, S 284–306

    Google Scholar 

  12. Platz T (2016) Clinical applications of rTMS in motor rehabilitation after stroke. In: Platz T (Hrsg) Therapeutic rTMS in neurology, principles, evidence, and practice recommendations. Springer, Cham, S 39–62

    Chapter  Google Scholar 

  13. Platz T, Schmuck L (2016) Neurorehabilitation der Armfunktion. In: Platz T (Hrsg) Update Neurorehabilitation. Hippocampus, Bad Honnef, S 89–109

    Google Scholar 

  14. Platz T, Wissel J (2016) Die Behandlung der Spastik im rehabilitativen Kontext. In: Platz T (Hrsg) Update Neurorehabilitation. Hippocampus, Bad Honnef, S 121–132

    Google Scholar 

  15. Platz T, Kaick S van, Mehrholz J, Leidner O, Eickhof C, Pohl M (2009) Best conventional therapy versus modular impairment-oriented training for arm paresis after stroke: A single-blind, multicenter randomized controlled trial. Neurorehabil Neural Repair 23:706–716

    Article  PubMed  Google Scholar 

  16. Pomeroy VM, King L, Pollock A, Baily-Hallam A, Langhorne P (2006) Electrostimulation for promoting recovery of movement or functional ability after stroke. Cochrane Database Syst Rev 2006:CD003241

    Google Scholar 

  17. Scheidtmann K, Fries W, Müller F, Koenig E (2001) Effect of levodopa in combination with physiotherapy on functional motor recovery after stroke: A prospective, randomised, double-blind study. Lancet 358:787–790

    Article  CAS  PubMed  Google Scholar 

  18. Thieme H, Mehrholz J, Pohl M, Behrens J, Dohle C (2013) Mirror therapy for improving motor function after stroke. Stroke 44:e1–e2

    Article  PubMed  Google Scholar 

  19. Thrasher TA, Zivanovic V, McIlroy W, Popovic MR (2008) Rehabilitation of reaching and grasping function in severe hemiplegic patients using functional electrical stimulation therapy. Neurorehabil Neural Repair 22(6):706–714

    Article  PubMed  Google Scholar 

  20. Wolf SL, Winstein CJ, Miller JP et al (2006) Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke. The EXCITE randomized clinical trial. JAMA 296:2095–2104

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. BDH-Klinik Greifswald, Neurologisches Rehabilitationszentrum und Querschnittgelähmtenzentrum, An-Institut der Ernst-Moritz-Arndt Universität Greifswald, Karl-Liebknecht-Ring 26a, 17491, Greifswald, Deutschland

    T. Platz & L. Schmuck

Authors
  1. T. Platz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L. Schmuck
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to T. Platz.

Ethics declarations

Interessenkonflikt

T. Platz erhielt vom Bundesministerium für Bildung und Forschung (BMBF) Drittmittel zur Untersuchung der Wirksamkeit der schädigungsorientierten Therapieverfahren. L. Schmuck gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Platz, T., Schmuck, L. Armrehabilitation. Nervenarzt 87, 1057–1061 (2016). https://doi.org/10.1007/s00115-016-0187-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00115-016-0187-9

Schlüsselwörter

Keywords

Search

Navigation