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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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Authors and Affiliations

  1. Departement Gesundheit, Institut für Physiotherapie, Zürcher Hochschule für Angewandte Wissenschaften (ZHAW), Technikumstr. 71, 8401, Winterthur, Schweiz

    H. Luomajoki & J. Saner M.Sc.

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  1. H. Luomajoki
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  2. J. Saner M.Sc.
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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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