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Der Orthopäde

, Volume 48, Issue 11, pp 917–926 | Cite as

Körperliche Aktivität, Training und Ernährung bei Rheuma

Adjuvante Behandlungsoptionen bei entzündlich-rheumatischen Erkrankungsbildern
  • M. Dreher
  • M. Kosz
  • A. SchwartingEmail author
Leitthema

Zusammenfassung

Hintergrund und Fragestellung

Die gesundheitlich positiven Wirkungsweisen von körperlicher Aktivität, körperlichem Training und einer Anpassung der Ernährung sind für viele Erkrankungsbilder wissenschaftlich weitestgehend belegt. Auch bei entzündlich-rheumatischen Erkrankungen wird von positiven Effekten auf das Krankheitsbild und deren potenziellen Komorbiditäten durch die beiden adjuvanten Behandlungsoptionen ausgegangen. Ihre Wirkungsweisen werden in dieser Übersichtsarbeit näher betrachtet.

Material und Methode

Auf Basis einer Literaturrecherche wurden in diese Arbeit randomisierte kontrollierte Studien (RCT), nicht-RCT-Studien, systematische Übersichtsarbeiten und Empfehlungen von Fachgesellschaften einbezogen.

Ergebnisse

Körperliche Aktivität und Training zeigen eine positive Wirkung auf die Erkrankung und darüber hinaus auf deren Komorbiditäten. Zudem existieren auf Basis der Bewegungs- und Trainingsempfehlungen des American College of Sports Medicine (ACSM) und der American Heart Association (AHA) Ansatzpunkte, die durch die European League Against Rheumatism (EULAR) adaptiert wurden, um Intensität, Dauer und Umfänge zu steuern. Ebenso bieten ernährungsmedizinische Ansätze präventive und rehabilitative Möglichkeiten.

Diskussion

Die Steigerung der körperlichen Aktivität, das regelmäßige körperliche Training sowie die Anpassung der Ernährung sollten ein grundlegender additiver Bestandteil der Therapie bei entzündlich-rheumatischen Erkrankungen sein. In einzelnen Subaspekten ist die Studienlage sehr heterogen und bedarf weiterer Forschung.

Schlüsselwörter

Diät Sport Psoriasis-Arthritis Rheumatoide Arthritis Spondyloarthritis 

Abkürzungen

1 RM

„One repetition maximum“

ACSM

American College of Sports Medicine

AHA

American Heart Association

BMI

Body-Mass-Index

BSG

Blutsenkungsgeschwindigkeit

CRP

C‑reaktives Protein

DAS28

Disease Activity Score 28

DMARD

„Disease-modifying anti-rheumatic drugs“

EULAR

European League Against Rheumatism

IFN‑γ

Interferon-gamma

IL

Interleukin

MET

Metabolisches Äquivalent

Min

Minuten

NSAR

Nichtsteroidale Antirheumatika

PNF

Propriozeptive Neuromuskuläre Fazilitation

RCT

Randomisierte kontrollierte Studie

Sek

Sekunden

sTNFR

„Soluble tumor necrosis factor receptors“

TNF

„Tumor necrosis factor“

WHO

Weltgesundheitsorganisation

Physical activity, exercise and nutrition in rheumatism

Adjuvant treatment options for inflammatory-rheumatic diseases

Abstract

Background and objectives

The positive effects of physical activity, physical training and an adaptation of diet on health have been scientifically proven for many diseases. Focusing on inflammatory rheumatic diseases and their potential comorbidities, positive effects are assumed from these two adjuvant treatment opportunities, which are examined in more detail in this review.

Material and methods

Based on a literature search, randomized controlled trials (RCTs), non-RCT studies, reviews and recommendations from professional societies were included.

Results

Physical activity and training show positive effects on the disease itself and also on its comorbidities with existing certainty. In addition, the exercise and training recommendations of the American College of Sports Medicine (ACSM) and the American Heart Association (AHA) provide recommendations, which were adapted by the European League Against Rheumatism (EULAR) to control intensity, duration and training extent. Nutritional medical approaches also provide preventive and rehabilitative beneficial possibilities.

Discussion

The increase of physical activity, regular physical training and the adaptation of diet should be a basic additive component of the treatment of inflammatory rheumatic diseases. In individual sub-aspects, the study situation is very heterogeneous and requires further research.

Keywords

Diet Sports Psoriatic arthritis Rheumatoid Arthritis Spondyloarthritis 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

M. Dreher, M. Kosz und A. Schwarting geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  1. 1.Schwerpunkt Rheumatologie und klinische ImmunologieUniversitätsmedizin MainzMainzDeutschland
  2. 2.ACURA Rheumazentrum Rheinland-PfalzBad KreuznachDeutschland

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