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Nervenheilkunde 2018; 37(04): 243-248
DOI: 10.1055/s-0038-1641681
Morbus Parkinson
Schattauer GmbH

LSVT-BIG

Motorisches Trainings konzept für Menschen mit Morbus ParkinsonLSVT-BIG Training for people with Parkinson’s disease
F. E. Schroeteler
1   Abteilung für Neurologie und klinische Neurophysiologie mit Parkinson Fachklinik, Schön Klinik München-Schwabing
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Further Information

Publication History

eingegangen am: 20 December 2017

angenommen am: 08 January 2018

Publication Date:
02 April 2018 (online)

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Zusammenfassung

Die Bewegungsamplitude ist einziger Trainingsfokus bei LSVT-Konzepten und Antwort auf die hyperkinetische Symptomatik bei Parkinson. Innerhalb der Sprechtherapie eingeführt (LSVT-LOUD; Lee Silverman Voice Treatment), wurde dies als motorisches Trainingskonzept im letzten Jahrzehnt zusätzlich auf die Bewegungstherapie bei Parkinson als LSVT-BIG ausgeweitet. Der vorliegende Artikel beschreibt das Trainingskonzept LSVT-BIG vor dem Hintergrund anderer Evidenz- basierter, physiotherapeutischer Trainingsverfahren für Menschen mit Parkinson, mit dem Ziel motorische Fähigkeiten und die motorische Selbstständigkeit zu verbessern.

Die sensorische Kalibrierung, der zweite Aspekt der LSVT-Konzepte, ermöglicht es den Patienten wieder normale Lautstärke und Bewegungsausschläge als nicht zu laut oder zu groß zu empfinden. Die Kalibrierung setzt sich dadurch mit den Widerständen auseinander, die einem generalisierten Einsatz physiologischer Amplituden im Alltag entgegenstehen. Sowohl das Training als auch die didaktische Vermittlung des Konzeptes sind auf Parkinson-Patienten zugeschnitten. Die Implementierung in den klinischen Alltag bleibt eine Herausforderung, die Akzeptanz für diesen anspruchsvollen Therapieansatz wächst jedoch vielversprechend.

Summary

Exercising with single focus on amplitude by defining hypokinesia as a key deficit in Parkinson’s disease, was introduced by the LSVT concept (Lee Silverman Voice Treatment) for people with PD, with a focus on the speech motor system (LSVT-LOUD) and more recently extended to address the limb motor systems with focus on amplitude of movement and activities of daily living (LSVT-BIG). This article describes the LSVT-BIG concept against the background of other evidence based physiotherapeutic approaches for people with Parkinson’s disease to improve motor skills and motor independence.

Sensory calibration is another unique aspect of LSVT-BIG,which teaches patients with PD that movements that feel “too loud” or “too big” are actually within normal limits. Calibration addresses the barriers to generalization of normal amplitude use. Both exercising and didactic intervention of the LSVT-BIG concept is facing effectively the Parkinson’s specific pathology. The implementation of LSVT-BIG into clinical practice in Germany is still challenging, however the acceptance grows promising.

Schlüsselwörter

LSVT-BIG - Amplitude - Kalibrierung - Parkinson

Keywords

LSVT-BIG - amplitude - calibration - Parkinson
 

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