Muskelatrophie durch Mobilisationseinschränkung^[*]

 

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Zusammenfassung

Hintergründe: Immobilisation und einschränkte Mobilität sind von negativen Anpassungsvorgängen des menschlichen Körpers begleitet. Neben einem erhöhten Thromboserisiko und einer allgemeinen Abnahme der Leistungsfähigkeit spielt vor allem die Muskelatrophie eine zentrale Rolle. Ziel der vorliegenden Studie war es, die Folgen einer – über wenige Tage andauernden – reduzierten Mobilität auf die Oberschenkelmuskulatur zu ermitteln.

Patienten und Methoden: 32 Patienten, die elektiv arthroskopisch wegen einer Meniskus- und/oder Knorpelverletzungen am Kniegelenk operiert wurden, wurden präoperativ und am 4. und 7. Tag postoperativ untersucht. Es wurden jeweils am nicht betroffenen, nicht operierten Bein die Umfänge und die Maximalkraft des M. quadriceps femoris gemessen.

Ergebnisse: Die Umfangswerte des Oberschenkels in 20 cm über dem Kniegelenkspalt (KGS) zeigte eine signifikante Abnahme von präoperativ zum 4. Tag und zum 7. Tag postoperativ. Genauso verhielt es sich bei dem Oberschenkelumfang 10 cm über dem KGS zwischen präoperativ und 4. Tag postoperativ. Am Unterschenkel ergaben sich keine signifikanten Veränderungen. Auch die Maximalkraftwerte ließen keine signifikanten Veränderungen erkennen.

Schlussfolgerungen: Eine − nur über wenige Tage bestehende − eingeschränkte Mobilität führt bereits zu einer Reduktion des Muskelquerschnitts der Last tragenden Oberschenkelmuskulatur.

Abstract

Background: Immobilisation and limited mobilisation are associated with negative adaptations of human body, like elevated risk for thrombosis, reduced fitness level and muscle atrophy. The objective of the presented study was to investigate the effect of limited, reduced mobility of a few days on the upper leg muscles.

Patients and Methods: 32 patients who underwent an elective arthroscopic surgery of the knee because of meniscus tear and/or cartilage damage were examined preoperatively and at days 4 and 7 after surgery. Examinations of the not injured and not treated leg focused on measurements of leg circumference and maximum strength of M. quadriceps femoris.

Results: The measurements of circumferences of the upper leg at 20 cm above the knee joint line decreased significantly between preoperative and both postoperative examinations. Also the changing of circumference of the upper leg at 10 cm above the joint line between preoperative and day 4 postoperative was significant. The circumference of lower leg and strength measurements showed no significant changing.

Conclusions: Limited, reduced mobility lasting a few days is followed by reduction of muscle cross section of load bearing upper leg muscles.

^* Die Studie wurde an der Orthopädischen Universitätsklinik Stiftung Friedrichsheim der Johann-Wolfgang-Goethe-Universität Frankfurt am Main erstellt (Leiter zu diesem Zeitpunkt: Prof. Dr. med. Ludwig Zichner).

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