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Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin 2014; 24(03): 117-124
DOI: 10.1055/s-0034-1370952
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Die nicht invasive Untersuchung faszialer Strukturen – Eine narrative Übersichtsarbeit

Non-invasive Screening of Fascial Tissues – A Narrative Review
J. Wilke
1   Department of Sports Sciences, Goethe University Frankfurt, Frankfurt
,
W. Banzer
1   Department of Sports Sciences, Goethe University Frankfurt, Frankfurt
› Author Affiliations
Further Information

Publication History

eingereicht: 06 November 2013

angenommen: 11 February 2014

Publication Date:
26 June 2014 (online)

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Zusammenfassung

Fragestellung:

Die Behandlung von Faszien hat in den vergangenen Jahren aufgrund neuer histologischer Erkenntnisse an Bedeutung gewonnen. Das Ziel dieser Übersichtsarbeit ist, die im Rahmen faszienorientierter Therapien einsetzbaren Untersuchungsinstrumente vorzustellen und hinsichtlich ihrer Testgüte zu beurteilen.

Material:

Die Datenbanken PubMed, ScienceDirect und Google Scholar wurden nach Publika­tionen durchsucht, die die Untersuchung oder Therapie faszialer Strukturen thematisieren. Für die im Rahmen dieser Studien eingesetzten Testverfahren wurden in einem zweiten Schritt Untersuchungen zur Reliabilität und Validität identifiziert.

Ergebnisse:

Zur Verlaufskontrolle von faszialen Behandlungen kommen neben funktionsorientierten Verfahren wie der Schmerzerfassung mittels Skalen insbesondere die Palpation, die Algometrie, die Myotonometrie, die Sonografie sowie die Sono-Elastografie zum Einsatz. Obwohl Skalen und algometrische Messungen eine hohe Reliabilität aufweisen, liefern sie unspezifische und subjektiv beeinflusste Resultate. Auch die Myotonometrie misst einen Komplex verschiedener Gewebe und lässt keine spezifischen Aussagen über Faszien zu. Deren isolierte Beurteilung ermöglichen das Ultraschall sowie die Sono-Elastografie. Nur bei letzterer lassen sich die Ergebnisse quantifizieren.

Diskussion:

Das Hauptproblem der meisten Verfahren liegt in der fehlenden Spezifität im Sinne der isolierten Untersuchung von Faszien. Mit der Sono-Elastografie existiert ein vielversprechendes Diagnostikum, das aber durch hohe Anschaffungskosten und Probleme bei der Standardisierung von Messungen nicht in jedem Setting einsetzbar ist.

Schlussfolgerung:

Die Entwicklung und Validierung von Verfahren zur Untersuchung faszialer Strukturen besitzt unverändert eine hohe Relevanz.

Abstract

Purpose:

Treatments of fascial tissues have gain­ed in importance due to recent histological find­ings. Thus, a considerable demand for diagnostic tools has risen. This review aims to present the instruments most frequently employed for evaluating the efficacy of fascial treatments.

Methods:

PubMed, ScienceDirect and Google Scholar were searched for publications on screen­ing or treatment of fascial tissues. Subsequently studies evaluating reliability and validity of the instruments employed in the studies of the first literature research were targeted.

Results:

To assess the success of interventions directed to fascia, pain scores, algometry, myotonometry, sonography and sono-elastography are utilized. Although both scores and algometry provide reliable measures, the results are tissue-unspecific and dependent on the subject’s impression. Likewise, myotonometry investigates a complex of different tissues. Sonography and sono-elastography do allow an isolated view on fascia. However, only the latter enables the examiner to quantify results.

Discussion:

A lack of specifity in providing information solely about fascia represents the main problem of the diagnostic instruments. Sono-Elastography is a promising method, but not applicable in each setting due to high acquisition costs and lack of standardization in measurements.

Conclusions:

Development and validation of screening tools for fascia continue to retain high relevance.

Schlüsselwörter

Faszien - Osteopathie - Messverfahren - Bindegewebe - Behandlung - Bewegungssystem

Key words

fascia - osteopathic medicine - screening tools - connective tissue - treatment - soft tissue
 

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