Evidenzbasierte Verfahren in der motorischen Rehabilitation nach Schlaganfall

Abstract

In this review, treatments for motor rehabilitation after stroke will be presented. In particular, randomised, controlled trials, meta-analyses and systematic reviews, mainly from the years 2009 - 2011, were taken into consideration. In summary, evidence is best for constraint-induced movement therapy and Botulinum toxin type A in patients with focal spasticity. Superiority has been demonstrated for the administration of drugs (serotonin re-uptake inhibitors and L-dopa), mirror therapy, the use of virtual reality, electromechanical devices to restore independent walking, and fitness and circuit training. Other therapies (bilateral arm training, treadmill therapy, robot-assisted arm therapy) did not show superiority. For sensory training and repetitive transcranial magnetic stimulation large clinical studies still need to be done.

Effects of Treadmill Training on Limb Motor Function and Acetylcholinesterase Activity in Rats with Stroke

“…These factors have been shown to influence the quality of life of patients with stroke. Physiotherapists attempt to rehabilitate upper limb function through repetitive practice and other therapeutic interventions that pay special attention to strength, endurance, coordination, speed, and reintegration of specific motor functions into a patient's everyday routine33, 34 ) . A number of previous studies have investigated the role of exercise in promoting stroke rehabilitation.…”

Beneficial Effects of Antecedent Exercise Training on Limb Motor Function and Calpain Expression in a Rat Model of Stroke

“…These are many of the factors that have been shown to influence the quality of life of stroke patients. Physiotherapists have tried to aid in return of upper limb function for patients, by conducting repetitive practice through several therapeutic interventions, paying special attention to strength, endurance, coordination, speed, and ways to integrate motor function into the patient's everyday activities29, 30 ) . A number of previous studies have investigated the role of exercise in promoting stroke rehabilitation.…”

Schlaganfallrehabilitation

“…Die Behandlungsverfahren unterscheiden sich in ihrer Effektivität nachweislich kaum voneinander (vgl. Liepert, 2010;Hesse et al, 2008,). In Deutschland ist vor allem die Bobath-Therapie vorherrschend.…”