Zusammenfassung
Beeinträchtigungen des sensomotorischen Systems treten mit zunehmendem Alter auch bei „gesunden Menschen“ auf und werden als Ursache für eine eingeschränkte Bewegungssicherheit und ein erhöhtes Sturzrisiko angesehen. Im Alter unterliegen die Strukturen des sensomotorischen Systems Veränderungen im Sinne einer Neuro- und Myopathie. Infolge der Abnahme von Muskelmasse und -qualität wird die Muskulatur als Erfolgsorgan des sensomotorischen Systems hinsichtlich Kraft, Ausdauer und Kontraktionsschnelligkeit weniger leistungsfähig. Die neuromuskuläre Bewegungskoordination ist so verändert, dass das Timing und die Kontraktionsstärke von synergistisch als auch antagonistisch wirkenden Muskeln beim älteren Menschen oft nicht mehr optimal aufeinander abgestimmt sind. Altersabhängige Veränderungen finden sich auch im kollagenen Bindegewebe der Muskeln, Sehnen und anderen Strukturen. Eine veränderte Sehnennachgiebigkeit (Compliance) könnte eine reduzierte Ansprechbarkeit der Rezeptoren auf mechanische Reize bewirken und sowohl verlängerte neuromuskuläre Reaktionszeiten oder aber auch eine reduzierte neuromuskuläre Aktivierung im Muskel erklären. Die Körperbalancefunktion zeigt beim älteren Menschen eine erhebliche Zunahme der posturalen Schwankungen, die von einem erhöhten Sturzrisiko begleitet sind. Das Gangbild ist weniger dynamisch, Schrittzeit und -weite variieren im Alter erheblich stärker als bei jungen Menschen.
Abstract
Impaired functioning of the sensorimotor system in otherwise healthy elderly people is considered as a major risk factor for both decreased movement safety and falls. Aging is accompanied by structural changes within the sensorimotor system, such as neuropathy and myopathy. Muscle mass and functional quality decrease with increasing age. Muscle is the final pathway of the sensorimotor system, and in the elderly population muscle strength, endurance and contraction velocity are all decreased. Neuromuscular movement coordination may be impaired with respect to the timing and the fine tuning process of muscle strength between synergistically and antagonistically working muscle groups. Age-related changes may also be observed in the connective tissues of muscle tendons, ligaments and other structures. Alterations of tendon compliance may change the responsiveness and thresholds of receptors and thus contribute to increased delays of automatic muscle responses or altered neuromuscular activation of muscles. Postural balance functions also decrease in the elderly. Altered postural automatic responses following postural perturbations correlate well with an increased risk of falls in the elderly population. Gait performance in the elderly becomes less dynamic, and stride time and step width vary considerably more than in young people.
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Ebenbichler, G. Sensomotorik im Alter. Manuelle Medizin 49, 414–417 (2011). https://doi.org/10.1007/s00337-011-0885-0
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DOI: https://doi.org/10.1007/s00337-011-0885-0