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Manuelle Therapie am Fuß

Eine narrative Übersicht

Manual therapy in the region of the foot

A narrative review

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Zusammenfassung

Hintergrund

Obwohl zahlreiche Techniken zur Manualtherapie bei Erkrankungen des Fußes gelehrt werden, fehlt eine ausreichende Absicherung dieser Maßnahmen im Rahmen kontrollierter klinischer Studien. Daher sollte eine Literatursuche durchgeführt werden, um Studien zu identifizieren, welche die Wirksamkeit manueller Therapie am Fuß stützen können.

Methodik

Es erfolgte eine Literatursuche in den Datenbanken Medline, Embase, PEDro, Cochrane Library und Index to Chiropractic Literature (ICL).

Ergebnisse

Zum Thema Manualtherapie am Fuß wurden 6 systematische Übersichten, 18 Publikationen zu kontrollierten Studien und 33 Fallbeschreibungen gefunden. Die häufigsten Indikationen zur Manualtherapie waren Sprunggelenkverletzungen (8 Artikel) und Plantarfasziitis (3 Arbeiten). Zwei Arbeiten berichteten über Beschwerden an der Großzehe, je eine Publikation hatte die primäre Metatarsalgie, die Morton-Neuralgie und die Tendopathie der Achillessehne zum Thema. Die restlichen 2 Arbeiten untersuchten die Effekte der Manualtherapie am Fuß bei Gesunden. Manualtherapie am Fuß scheint in allen Stadien nach Sprunggelenkdistorsion die Wiederherstellung zu beschleunigen, Schmerzen zu vermindern und die Beweglichkeit zu verbessern. Die Wirksamkeit bei Plantarfasziitis ist widersprüchlich. Bei Hallux abductovalgus, primärer Metatarsalgie und bei Morton-Neuralgie scheint Manualtherapie auf dem Evidenzniveau III wirksamer zu sein als eine scheinbare Elektro- bzw. Ultraschaltherapie.

Schlussfolgerung

Es gibt nach wie vor zu wenig qualitativ gute Studien, welche die Wirksamkeit der Manualtherapie am Fuß stützen. Aus den vorliegenden Arbeiten kann geschlossen werden, dass Manualtherapie eher den Bewegungsumfang verbessert und weniger die Schmerzen mindert.

Abstract

Background

Numerous techniques are taught for manual therapy in the region of the foot, but evidence from controlled clinical studies for the effectiveness of these interventions is missing. Aim of the study was to conduct a literature search to identify studies, which may support the effectiveness of manual therapy in the region of the foot.

Methods

A literature search was performed in the databases Medline, Embase, PEDro, Cochrane Library und Index to Chiropractic Literature (ICL).

Results

The query identified 6 systematic reviews, 18 publications on controlled studies and 33 case reports related to manual therapy at the foot. Ankle injuries (8 papers) and plantar fasciitis (3 papers) were the most frequent indications for manual therapy in the foot region. Two papers reported disorders of the big toe, one publication each was found for primary metatarsalgia, Morton’s neuralgia and Achilles tendonitis. The remaining 2 papers investigated the effects of manual therapy at the foot of healthy subjects. There are indications that manual therapy may accelerate functional recovery, reduce pain and increase range of motion in all stages of ankle injuries. The effectiveness for plantar fasciitis is contradictive. On evidence level III, manual therapy is more effective than sham electrotherapy or sham ultrasound in hallux abducto valgus deformity, primary metatarsalgia and Morton’s neuralgia.

Conclusion

There is still a lack of studies of good quality, which support the effectiveness of manual therapy in the foot region. It is concluded from this study, that manual therapy may rather increase the range of motion than reduce pain.

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  1. Institut für Physikalische Medizin und Rehabilitation, Hanusch-Krankenhaus, Heinrich-Collin-Straße 30, 1140, Wien, Österreich

    K. Ammer PhD

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Ammer, K. Manuelle Therapie am Fuß. Manuelle Medizin 46, 205–212 (2008). https://doi.org/10.1007/s00337-008-0623-4

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