Sport und Bewegung bilden bei einer Vielzahl von internistischen und orthopädischen Erkrankungen heute einen unverzichtbaren Bestandteil etablierter Behandlungsprogramme. Im psychiatrisch-psychosomatischen Bereich wurde die Bedeutung der körperlichen Fitness für das psychische Befinden zunehmend erkannt, und insbesondere für depressive Erkrankungen konnte bewiesen werden, dass die Symptomatik über ausreichend intensive körperliche Aktivität signifikant beeinflusst werden kann. Die Mehrzahl der kontrollierten Studien verwendete Ausdauertraining, in einigen Studien zeigte Krafttraining aber vergleichbare Effekte. Neben psychologischen Wirkmechanismen wie Abnahme von Vermeidungsverhalten, Verbesserung von Selbstbewusstsein, Eigeninitiative und die Veränderung von dysfunktionalen Kognitionen spielen auch neurobiologische Adaptationsprozesse eine wichtige Rolle (serotonerge Rezeptoren, neurotrope Faktoren). Individuelle Anleitung und kontinuierliche Motivationsarbeit sind eine entscheidende Voraussetzung für den Erfolg sporttherapeutischer Maßnahmen. Abschließend werden daher Empfehlungen für die praktische Anwendung sporttherapeutischer Maßnahmen gegeben.
Abstract
Therapeutic exercise programs have become an obligatory component in the modern treatment of many internal and orthodpaedic conditions. In the field of psychiatry, the interaction of physical fitness and mental well-being has been increasingly recognized. In the meanwhile, solid evidence has emerged that regular exercise is associated with therapeutic effects in psychiatric patients suffering from depressive and possibly other psychiatric disorders. The present article reviews the relevant literature and summarizes neurobiological effects of exercise which might play a role in the effectiveness of therapeutic exercise. For instance, there is experimental evidence, that regular exercise induces a downregulation of central 5-HT2C receptors which play an important role in the pathogenesis of anxiety and depression. The production of brain-derived neurotrophic factor (BDNF)is stimulated in several brain regions. In conclusion, practical aspects and motivational factors have to be regarded in order to successfully establish exercise programs in the treatment of psychiatric disorders.
Schlüsselwörter
Sport - Depression
Key words
exercise - major depression
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