Krafttraining bei Frauen mit generalisierter Hypermobilität: Machbarkeit, Beschwerden und Effekte – Eine Pre-post-Studie

Zusammenfassung

Hintergrund Eine generalisierte Hypermobilität liegt vor, wenn die Beweglichkeit in mehreren Gelenken das übliche Maß übersteigt. Bis zu 30 % der Frauen und 10 % der Männer sind davon betroffen. Hypermobilität ist keine Pathologie, wenn sie jedoch mit Schmerzen und weiteren Symptomen einhergeht, kann sie die Gesundheit und Alltagsfunktionen beeinträchtigen. Zur physiotherapeutischen Behandlung gibt es wenige Studien, wobei Krafttraining eine mögliche Intervention sein könnte.

Ziel Erfassung der Machbarkeit und des Effekts eines Krafttrainings für Frauen mit generalisierter Hypermobilität.

Methode Pre-post-Studie, in der hypermobile Frauen (Beighton-Score > 5) zwischen 20 und 40 Jahren während 12 Wochen ein Krafttraining an Geräten, fokussiert auf Beine und Rücken, absolvierten. Mithilfe eines Protokolls und wöchentlicher Fragebogen wurden das Training und dadurch ausgelöste Beschwerden analysiert. Vor und nach dem Training wurde die Kraft der Knieflexoren und -extensoren sowie der Muskelquerschnitt am Oberschenkel gemessen. Die Analyse erfolgte primär deskriptiv, zusätzlich erfolgte ein Vergleich von 2 Subgruppen mittels Mann-Whitney-U und Chi²-Test.

Ergebnisse 46 Teilnehmerinnen (26,3 ± 4,3 Jahre) absolvierten das Training. 6 davon brachen die Studie vorzeitig ab, davon eine wegen Rückenschmerzen aufgrund einer Diskushernie. 72,5 % der verbleibenden 40 Teilnehmerinnen absolvierten 20 oder mehr Trainings. In 34 % der Trainingswochen wurden geringe Beschwerden angegeben, mehrheitlich an Knie und Rücken. Der Einsatz der verwendeten Gewichte war oft tief, so wurde auf der Legpress mit durchschnittlich 44,8 % des Körpergewichts begonnen, nach 12 Wochen lag das Trainingsgewicht im Mittel bei 52,2 kg, was 85,7 % des Körpergewichts entspricht. Bei der Kraft und beim Muskelquerschnitt wurden keine signifikanten Verbesserungen erreicht, wobei bis zu 17 Teilnehmerinnen (42,5 %) eine Verbesserung von mehr als 10 % erreichten.

Schlussfolgerung Das Krafttraining war für die meisten Teilnehmerinnen machbar und gut verträglich. Das mehrheitlich selbstgesteuerte Training war zu wenig intensiv, um eindeutige Auswirkungen auf Kraft oder Muskelmasse zu erreichen, obwohl einzelne Teilnehmerinnen durchaus davon profitierten. In weiteren Studien sollten individuellere und enger begleitete Trainingsprogramme untersucht werden.

Abstract

Background Generalised hypermobility is when the mobility in several joints exceeds the usual level. Up to 30 % of women and 10 % of men are affected. Hypermobility is not a pathology, but when it is accompanied by pain and other symptoms, it can affect health and daily function. There are few studies on physiotherapy treatment, although strength training could be a possible intervention.

Aim To assess the feasibility and effect of strength training for women with generalised hypermobility.

Methods In a pre-post study, hypermobile women (Beighton-Score> 5) aged 20–40 years underwent 12 weeks of strength training on machines focused on legs and back. A training protocol and weekly questionnaires were used to analyse the training and the resulting symptoms. The strength of the knee flexors and extensors and the muscle cross-section of the thigh were measured before and after the training.

Results 46 participants (26.3 ± 4.3 years) completed the training. 6 of them dropped out prematurely, one because of back pain due to lumbar disc hernia. 72.5 % of the remaining 40 participants completed 20 or more training sessions. In 34 % of the training weeks mostly minor complaints were reported, mainly in the knees and back. The weights used were often low, i. e., on the leg press they started with an average of 44.8 % of body weight and after 12 weeks the average weight was 52.2 kg, which corresponds to 85.7 % of body weight. Whether strength nor cross-sectional area showed significant improvements, however up to 17 participants (42.5 %) achieved improvements of more than 10 %.

Conclusion Strength training was feasible and well tolerated by most participants. The mostly self-directed training was not intensive enough to achieve clear effects on strength or muscle mass, even if some participants have clearly benefited. More individualised and closely supervised programmes should be investigated in future studies.

Schlüsselwörter

Hypermobilitätssyndrom - Maximalkraft - Schnellkraft - Muskelquerschnitt - Physiotherapie

Key words

hypermobility syndrome - maximum strength - rate of force development - muscle cross-section - physiotherapy

Publication History

Received: 15 August 2022

Accepted: 11 February 2023

Article published online:
29 March 2023

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