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Der gestörte Gang

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Infantile Zerebralparese

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Zusammenfassung

Nahezu jeder gehfähige Patient mit infantiler Zerebralparese zeigt eine spezifische Gangstörung, die unterschiedlich stark ausgeprägt sein und sich im Verlauf auch ändern kann. Das auffällige Gangbild stellt die Summe von Defiziten der zentralen Steuerung, pathologischen Veränderungen am Haltungs- und Bewegungsapparat (Muskel- und Skelettsystem mit Schwäche, Spastik und Kontrakturen) und Kompensationsmechanismen dar. Da die Gangstörung mehrere Etagen und mehrere Ebenen betreffen kann, ist es notwendig, weitere Informationen über die verschiedenen Komponenten des jeweiligen pathologischen Ganges, aber auch über deren Ausmaß zu erhalten. Die Zuhilfenahme einer Gangklassifikation erleichtert die Einteilung und damit auch die Auswahl therapeutischer Möglichkeiten. Hierzu haben sich instrumentelle Hilfsmittel zur Beobachtung und insbesondere auch zur Quantifizierung von Gangstörungen etabliert. Mit der 3- dimensionalen Ganganalyse gelingt es nicht nur, die Bewegungen in allen 3 Ebenen zu erfassen, sondern auch die zugrunde liegenden Gelenkkräfte und -momente sowie die Muskelaktivitäten aufzuzeichnen. Zusammen mit den klinisch und radiologisch gewonnenen Untersuchungsdaten erhält man so ein umfassendes Bild, das die Einleitung therapeutischer Maßnahmen leichter und v. a. sicherer macht. Die Ganganalyse liefert allerdings nur Antworten auf Fragen, die man stellt, was die stetige Weiterbildung auf diesem wichtigen Gebiet zur Pflicht macht.

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  1. Orthopädische Kinderklinik, Behandlungszentrum Aschau GmbH, Orthopädische Kinderklinik, Aschau im Chiemgau, Deutschland

    Leonhard Döderlein

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Döderlein, L. (2015). Der gestörte Gang. In: Infantile Zerebralparese. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-35319-2_5

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