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Instrumentelle Gang- und Bewegungsanalyse bei muskuloskelettalen Erkrankungen

Instrumented gait and movement analysis of musculoskeletal diseases

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Zusammenfassung

Instrumentelle dreidimensionale (3-D-)Ganganalysen werden zur Beurteilung von Gang- bzw. Bewegungsstörungen bei muskuloskelettalen Erkrankungen zunehmend für orthopädische und/oder neurologische Fragestellungen herangezogen. Infolge einer hohen Reliabilität der Messergebnisse sind sie sowohl für die Diagnostik als auch für die Verlaufskontrolle von Effekten einer konservativen oder operativen Therapie geeignet. Mittels Ganganalyse können im Gegensatz zu klinischen Standarduntersuchungen zusätzliche Parameter evaluiert werden. Diese zeigen auf, in wieweit ein normalisiertes Gangbild mit Verbesserung der kinematischen und kinetischen Kenngrößen erreicht werden konnte. Für einen adäquaten Einsatz bei klinisch relevanten Fragestellungen sind jedoch auch die Limitierungen und Grenzen zu beachten. Ein hoher apparativer als auch zeitlicher und kostenintensiver Aufwand für die instrumentellen 3-D-Ganganalysen lassen sie nicht zur täglichen klinischen Routine werden, jedoch bieten diese eine ausgezeichnete Basis für die Beantwortung wissenschaftlicher Fragestellungen. Im vorliegenden Beitrag werden ausgewählte wesentliche Messverfahren und -techniken anhand von Fallbeispielen dargestellt, um die vielfältigen Möglichkeiten zu verdeutlichen.

Abstract

Instrumented 3-dimensional gait analysis is increasingly being used for the evaluation of movement disorders in orthopedic and neurological musculoskeletal diseases. Due to the high reliability of the measurements the procedures are appropriate for diagnostic purposes as well as for outcome assessment after conservative or surgical interventions. Contrary to conventional clinical assessments gait analysis parameters are able to demonstrate a normal physiological gait pattern that can be achieved with improved kinematic and kinetic parameters. For a suitable application in clinically relevant problems the limitations of the procedures should be taken into account. Due to the high instrumental involvement combined with time and cost expenditure instrumented gait analysis will probably not develop to a clinical routine procedure. Nevertheless, an excellent set of information for answering clinical questions is provided. The present contribution presents selected measurement procedures and technologies and illustrates the wide variety of possibilities with the use of selected clinical examples.

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Sander, K., Rosenbaum, D., Böhm, H. et al. Instrumentelle Gang- und Bewegungsanalyse bei muskuloskelettalen Erkrankungen. Orthopäde 41, 802–819 (2012). https://doi.org/10.1007/s00132-012-1947-2

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