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Schmerz und Bewegungsangst im Alter

Notwendigkeit zur interdisziplinären Herangehensweise

Pain and fear of movement in the elderly

The need for an interdisciplinary approach

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Zusammenfassung

Eine körperlich-aktivierende Therapie ist auch bei chronischen Schmerzen im Alter leitliniengerecht und wichtig zur Erhaltung der Selbstständigkeit. Ältere Schmerzpatienten sind jedoch oft nur schwer für diese Verfahren zu gewinnen, was mit ungünstigen Einstellungen, geringer Selbstwirksamkeit, Schmerz- und Sturzängsten zusammenhängt. Sturzängste spielen bei der Reduzierung der Aktivität bei Schmerzpatienten womöglich eine bedeutsamere Rolle als die aus der Schmerzforschung bekannten „fear avoidance beliefs“. Auch die Ängstlichkeit der Pflegenden kann zu einer Aktivitätseinschränkung der Älteren führen. Grunderkrankungen und Medikamentenwirkungen müssen bei bewegungsorientierten Therapien beachtet werden. Es erscheint nötig, spezielle Therapiebausteine für alle Versorgungssektoren zu entwickeln, dabei altersspezifische Motivationsstrategien einzubauen und sich gut interdisziplinär abzustimmen.

Abstract

According to evidence-based guidelines a physically activating therapy approach in older chronic pain patients is necessary for the preservation of autonomy. Often the elderly are not easy to motivate for this because of inappropriate attitudes, low self-efficacy, fear of pain and fear of falling. The latter might be more important for self-induced restriction of activity in older pain patients than fear avoidance beliefs known from pain research. The fear of caregivers concerning pain and falls can also lead to physical restrictions in the elderly. The underlying diseases and drug effects have to be borne in mind in exercise-oriented therapy. It seems necessary to design special therapy elements for all national care sectors using age-specific motivation strategies and to assure an interdisciplinary cooperation.

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  1. Institut für Medizinische Psychologie, FB Medizin der Philipps-Universität Marburg, Karl-von-Frisch-Str. 4, 35032, Marburg, Deutschland

    C. Leonhardt

  2. Fachbereich Pflege und Gesundheit, Fachhochschule Münster, Münster, Deutschland

    M. Laekeman

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  1. C. Leonhardt
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Correspondence to C. Leonhardt.

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Leonhardt, C., Laekeman, M. Schmerz und Bewegungsangst im Alter. Schmerz 24, 561–568 (2010). https://doi.org/10.1007/s00482-010-0976-1

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