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Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin 2018; 28(03): 171-183
DOI: 10.1055/a-0584-0168
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Mechanische Schwingungstherapie in der Orthopädischen Rehabilitation

Evaluation stationärer Rehabilitationsmaßnahmen mit orthopädischen Patienten bei Anwendung einer mechanischen SchwingungstherapieVibration Therapy in Orthopaedic RehabilitationEvaluation of in-Patient Rehabilitation Measures in Orthopaedic Patients Using a Mechanical Vibration Couch
Vincent Grote
1   Humanomed Consult GmbH, Wissenschaftliche Dokumentation, Klagenfurt, Austria
,
Elke Böttcher
2   Humanomed Zentrum Althofen, SKA Orthopädische Rehabilitation, Austria
,
Seada Zahirovic
2   Humanomed Zentrum Althofen, SKA Orthopädische Rehabilitation, Austria
,
Maximilian Moser
3   Medizinische Universitat Graz, Institut für Physiologie, Graz, Austria
4   Human Research Institut, Weiz, Austria
,
Henry Puff
2   Humanomed Zentrum Althofen, SKA Orthopädische Rehabilitation, Austria
› Author Affiliations
Further Information

Publication History

received 22 August 2017

accepted 26 February 2018

Publication Date:
22 May 2018 (online)

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Zusammenfassung

Fragestellung Klinische Anwendungen von mechanischen Schwingungstherapien werden widersprüchlich diskutiert. Orthopädische Krankheitsbilder, wie Endoprothesen, gelten als Kontraindikation.

Material und Methoden Im Rahmen einer 3-wöchigen stationären Rehabilitation wurden 109 orthopädischen PatientInnen (61,4±8 Jahre) stratifiziert einer Versuchsgruppe zugeteilt: Schwingungstherapieliege (Tiktaalik), Überwassermassage (Hydrojet) und Scheinbehandlung (Placebo). Auswirkungen auf medizinische Ergebnisqualität und Herzfrequenzvariabilität wurden geprüft.

Ergebnisse Bei einer Therapiedauer von 12 Min lagen die selbst wählbaren Schwingungsfrequenzen der Therapieliege zwischen 11 und 15 Hz im Brustbereich (Vibrationsschwingung) und 3 bis sieben Hz im Beckenbereich (Lateralschwingung). 2 PatientInnen mussten die Schwingungstherapie vorzeitig abbrechen (Kopfschmerz, Schwindel). Als Folge der Mobilisierung durch die Rehabilitationsmaßnahmen kam es zu einer Zunahme der sympathikotonen Aktivierung. Es konnten Verbesserungen in Schmerzempfinden (VAS) und motorischer Funktion (Beweglichkeit, Muskelkraft) festgestellt werden. Eine Interaktion des Rehabilitationsverlauf mit den Versuchsgruppen wurde unmittelbar zu den Therapieeinheiten beobachtet: Die Beweglichkeit, Muskelkraft und Wachheit nahm in der Tiktaalik-Gruppe stärker zu. Dabei zeichnete sich mechanische Schwingungstherapie insbesondere durch eine stärkere parasympathische Aktivierung aus - es kam in der Nachruhephase zu einer signifikant stärkeren Entspannung.

Diskussion und Schlussfolgerung Die Studienergebnisse zeigen, dass eine mechanische Schwingungsbehandlung im Liegen eine Erweiterung des bestehenden Therapieangebots in der orthopädischen Rehabilitation darstellt.

Abstract

Purpose Clinical uses of mechanical whole body vibration therapies are the subject of contradictory debate. Orthopaedic pathologies, including the presence of endoprostheses, are considered to be contraindications.

Materials and Methods Within the context of a 3-week in-patient rehabilitation programme 109 orthopaedic patients (61,4±8 years) were stratified to one of the trial groups: vibration therapy couch (Tiktaalik), dry water massage (Hydrojet) and sham treatment (placebo). Effects on the quality of medical results and heart rate variability were examined.

Results The therapy had a duration of 12 min. The vibration frequency of the treatment couch was self-selectable between 11 and 15 Hz in the chest region and 3 and 7 Hz in the pelvic region. Two patients had to stop the vibration therapy early (headaches, dizziness). The rehabilitation measures allowed mobilisation, leading to increased activation of the sympathetic nervous system. Improvements in pain perception (VAS) and motor function (flexibility, muscle strength) were identified during the course of the rehabilitation. An interaction of the rehabilitation process with the trial groups was observed immediately after each unit of therapy: The flexibility, muscle strength and alertness improved more markedly in the Tiktaalik group. At the same time the mechanical vibration therapy distinguished itself particularly by more marked parasympathetic modulation – there was significantly greater relaxation in the post-treatment rest phase.

Discussion and Conclusions The study results show that mechanical vibration therapy represents an addition to the currently available treatment options for orthopaedic rehabilitation.

Schlüsselwörter

Orthopädie - Rehabilitation - Herzfrequenzvariabilität - Schwingungsliege - Whole Body Vibration (WBV)

Key words

orthopaedics - rehabilitation - heart rate variability - vibration couch - whole body vibration (WBV)
 

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