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Bewegungskontrolldysfunktion als Subgruppe von unspezifischen Rückenschmerzen

Movement control impairment as a subgroup of non-specific low back pain

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Zusammenfassung

Schmerzen des untere Rückens sind meist unspezifisch, d. h. es gibt keinen spezifischen medizinischen Grund für die Schmerzen. Eine Subgruppierung unspezifischer Rückenschmerzen wurde deswegen als einer der wichtigsten Forschungsschwerpunkte genannt. Eine mögliche Subgruppe ist die Bewegungskontrolldysfunktion, bei der der Patient seine Bewegungen nicht bewusst kontrollieren kann. Eine Testbatterie wurde entwickelt und validiert, um diese Patientengruppe zu untersuchen und zu behandeln. Sie besteht aus 6 Bewegungstests und wurde als reliabel bewertet. Mit diesem Testverfahren können Personen mit Rückenschmerzen zuverlässig von gesunden Personen unterschieden werden. Ebenfalls untersucht wurde der Zusammenhang mit der Körperwahrnehmung. Dabei zeigte sich, dass Zweipunktdiskriminationsfähigkeit mit der verschlechterten Bewegungskontrolle des Rückens korreliert. Eine Fallserienstudie (n=38) ergab, dass diesen Patienten mit spezifischen Übungen gut geholfen werden kann. Da es in dieser Studie keine Kontrollgruppe gab, kann jedoch eine Kausalität nicht hergestellt werden.

Abstract

Low back pain (LBP) is in most cases non-specific, meaning that there is no clear medical cause for the problem. Subgrouping of these patients has been declared as one of main research areas of LBP. One possible subgroup of LBP is movement control dysfunction which means that patients cannot actively control movements of the lower back. A test battery consisting of six movement control tests was created to examine this dysfunction and was found to be reliable. The test battery can discriminate between patients with LBP and healthy controls. It was also shown that patients with movement control deficits have a distorted body image which can be measured with two-point discrimination tests. In a case series study (n = 38) patients with movement control dysfunction could be extensively improved in their disability, pain and function. However, as there was no control group in the study no causal conclusions can be drawn.

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Literatur

  1. Airaksinen O, Brox J, Cedraschi C et al (2006) Chapter 4: European guidelines for the management of chronic nonspecific low back pain. Eur Spine J 15(Suppl 2):192–300

    Article  Google Scholar 

  2. Cheung KM, Karppinen J, Chan D et al (2009) Prevalence and pattern of lumbar magnetic resonance imaging changes in a population study of one thousand forty-three individuals. Spine 34:934–940

    Article  PubMed  Google Scholar 

  3. Dankaerts W, O’Sullivan PB, Straker LM et al (2006) The inter-examiner reliability of a classification method for non-specific chronic low back pain patients with motor control impairment. Man Ther 11:28–39

    Article  PubMed  CAS  Google Scholar 

  4. Fersum KV, Dankaerts W, O’Sullivan PB et al (2009) Integration of sub-classification strategies in RCTs evaluating manual therapy treatment and exercise therapy for non-specific chronic low back pain (NSCLBP): a systematic review. Br J Sports Med (Epub ahead of print)

  5. Luomajoki H (2010) Movement control impairment as a subgroup of non-specific low back pain. Dissertation, University of Eastern Finland

  6. Luomajoki HKJ, De Bruin ED, Airaksinen O (2007) Reliability of movement control tests of lumbar spine. International LBP and Pelvic Pain Congress, Barcelona

  7. Luomajoki H, KOOL J, De Bruin ED, Airaksinen O (2008) Movement control tests of the low back; evaluation of the difference between patients with low back pain and healthy controls. BMC Musculoskelet Disord 9:170

    Article  PubMed  Google Scholar 

  8. Luomajoki H, Kool J, De Bruin ED, Airaksinen O (2010) Improvement in low back movement control, decreased pain and disability, resulting from specific exercise intervention. Sports Med Arthrosc Rehabil Ther Technol 2:11

    Article  PubMed  Google Scholar 

  9. Luomajoki H, Moseley GL (2011) Tactile acuity and lumbopelvic motor control in patients with back pain and healthy controls. Br J Sports Med 45:437–440

    Article  PubMed  CAS  Google Scholar 

  10. O’Sullivan P (2005) Diagnosis and classification of chronic low back pain disorders: maladaptive movement and motor control impairments as underlying mechanism. Man Ther 10:242–255

    Article  Google Scholar 

  11. Sahrmann SA (2002) Diagnosis and treatment of movement impairment syndromes. Mosby, St. Louis

  12. Luomajoki H (2011) Testistö selkäpotilaiden liikekontrollihäriöiden tunnistamiseksi. Fysioterapia 58:4–8

    Google Scholar 

  13. Van Dillen LR, Sahrmann SA, Norton BJ et al (1998) Reliability of physical examination items used for classification of patients with low back pain. Physical Ther 78:979–988

    Google Scholar 

  14. Lehtola V, Luomajoki H, Leinonen V et al (2012) Efficacy of movement control exercises versus general exercises on recurrent sub-acute nonspecific low back pain in a sub-group of patients with movement control dysfunction. Protocol of a randomized controlled trial. BMC Musculoskelet Disord 13:55. DOI 10.1186/1471-2474-13-55

    Article  PubMed  Google Scholar 

  15. Saner J, Kool J Bie de RA et al (2011) Movement control exercise versus general exercise to reduce disability in patients with low back pain and movement control impairment. A randomised controlled trial. BMC Musculoskelet Disord 12(1):207. DOI 10.1186/1471-2474-12-207

    Article  PubMed  Google Scholar 

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Correspondence to H. Luomajoki or J. Saner M.Sc..

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Dieser Beitrag beruht auf der Dissertation von Hannu Luomajoki an der Universität von Ostfinnland mit dem Titel „Movement control impairment as a sub-group of non-specific low back pain – evaluation of movement control test battery as a practical tool in the diagnosis of movement control impairment and treatment of this dysfunction“.

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Luomajoki, H., Saner, J. Bewegungskontrolldysfunktion als Subgruppe von unspezifischen Rückenschmerzen. Manuelle Medizin 50, 387–392 (2012). https://doi.org/10.1007/s00337-012-0948-x

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  • DOI: https://doi.org/10.1007/s00337-012-0948-x

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