Neurologie und Rehabilitation最新文献

{"title":"Rechtliche Rahmenbedingungen, Qualitätssicherungsprogramme, Zertifizierungen, DRGs, OPS, Pflege als Therapie","authors":"C. Wallesch","doi":"10.14624/nr2104002","DOIUrl":"https://doi.org/10.14624/nr2104002","url":null,"abstract":"The establishment of structural and minimum features within the DRG system by the operations and procedure key (OPS) gave the neurological early rehabilitation phase B a definitional framework and ensured standardization. In the field of nursing, it has given rise to a new self-image and a boost to interdisciplinarity. The assignment of patients at the interface between acute inpatient treatment and rehabilitation remains problematic. The article gives an overview of the regulatory framework","PeriodicalId":53664,"journal":{"name":"Neurologie und Rehabilitation","volume":"539 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78882587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Das Team in der Neurorehabilitation","authors":"T. Mokrusch","doi":"10.14624/nr2104001","DOIUrl":"https://doi.org/10.14624/nr2104001","url":null,"abstract":"Neurological rehabilitation is rehabilitative therapy that is concerned with neurological patients in a multi-professional team under the leadership of a physician. The members of this interdisciplinary team work together closely with an intense exchange of knowledge and competence. This primary treatment team includes specialists in neuropsychology, speech therapy, occupational therapy and physiotherapy (including physical therapy), along with social workers and co-therapeutic nursing. Other forms of therapy may also be included. A secondary team is defined by the cooperation of the neurologist with other medical fields, e.g., neurosurgery, geriatrics, psychiatry, orthopedics and neuropediatrics. A tertiary team exists in the form of organizational cooperation between the medical und economic clinic management with insurance companies and political decision makers. Every kind of rehabilitation is basically multi-professional from an organizational viewpoint, and it is performed interdisciplinarily applying the methods of all therapeutic disciplines to create synergies. This particularly applies to neurorehabilitation, as in this field – generally following a disease or an injury to the brain as the central regulation organ – several different disorders occur in combination: sensorimotor symptoms and signs like paralysis, spasticity, dysphagia and loss of coordination; cognitive or speech disorders; or finally psychological alterations like depression or anxiety. Therefore it is particularly important that the professional team members match and coordinate their therapeutic procedures to reach common rehabilitative goals. »Multi-professional« in this context means that the representatives of the different therapeutic fields work with the patient on an advanced competency level, and »interdisciplinary« means that the members of the team work together closely with thorough cross-consultation between their disciplines. Transdisciplinary cooperation represents the highest level of team competency and includes regularly adopting the tasks and therapeutic procedures from other disciplines. All kinds of cooperation are performed under the supervision of a physician who assumes full responsibility for the rehabilitative therapy, including the prescription of medication and introduction of acute interventions, e.g., surgical procedures. This paper is only concerned with the primary – therapeutic – team. The secondary and tertiary forms of team cooperation are planned to be published separately.","PeriodicalId":53664,"journal":{"name":"Neurologie und Rehabilitation","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84019947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alertness-Grundmessung als stärkster Prädiktor für den Erwerbsstatus bei Patienten mit MS sechs Monate nach der Rehabilitation","authors":"S. Marchione, C. Dettmers, A. Weimer-Jaekel, B. Godde, M. Jöbges","doi":"10.14624/nr2103002","DOIUrl":"https://doi.org/10.14624/nr2103002","url":null,"abstract":"Baseline alertness as the strongest predictor of employment status in patients with MS 6 months after rehabilitationS. Marchione, C. Dettmers, A. Weimer-Jaekel, B. Godde, M. JoebgesAbstractIntroduction: Fatigue is a dominant impairment in multiple sclerosis, which often also limits the professional performance of patients with MS (PwMS). In clini-cal practice fatigue is often difficult to assess. The question of our study was whether the objective cognitive fatigability – measured as reaction time or tonic alertness – or the subjective self-assessment of the patient – recorded by the Fatigue Scale for Motor and Cognitive Functions (FSMC) – predicts employment status 6 months after discharge from rehabilitation.Methods: PwMS whose rehabilitation measures were paid for by the government pension fund, and who had doubts about maintaining their professional per-formance in terms of their workload, underwent further testing. Tonic alertness from the test battery TAP-M was used as an indicator of cognitive fatigability. Participants were tested in the morning at 8:00 a.m., after standardized exer-cise at 11:00 a.m., and in the afternoon at 2:00 p.m. In addition, fatigue was determined using a self-assessment questionnaire (FSMC). Six months after discharge from neurological rehabilitation, their employment status was classi-fied through a telephone interview and also compared with our socio-medical performance assessment. Results: A complete data set was collected from 64 patients (43 female; age 48.9 ± 8.7 years; duration of illness 14.7 ± 9.5 years; EDSS 3.8 ± 1.3; 67 % relapsing remitting, 16 % secondary progressive, 17 % primary progressive). According to the International Standard Classification of Occupations (ISCO) code, 86 % were “white collar” workers, for example, in service, office and non-manual jobs. Six months after discharge from the rehabilitation clinic, 15 (23 %) out of 64 PwMS reported working less than 3 hours per day, 35 (55 %) PwMS reported 3 to 6 hours, and the remaining 14 (22 %) PwMS were full-time employees. The mean total value of the FSMC questionnaire for cognition was 38.9 ± 7.4, which was equivalent to severe cognitive fatigue. Eleven of the 14 full-time employees had severe fatigue. The morning alert-ness measurement (alertness1) (β = -.985; p= .003) and, the decline in alert-ness from morning to noon (alertness difference21; β = -.590; p= .033) and from noon to afternoon (alertness difference32; β =-.709; p= .020) were sig-nificant predictors for employment status. A reduction in alertness (increase in reaction time) by 1 SD on the alertness scale increases the probability of not working full-time by a factor of 2.67. Likewise, the probability of not working full-time increases by a factor of 1.80 if fatigability is increased by 1 SD from morning to noon. If fatigability increases by 1 SD from noon to eve-ning, the probability of not working full-time increases by a factor of 2.03. Discussion: The FSMC has no prognostic","PeriodicalId":53664,"journal":{"name":"Neurologie und Rehabilitation","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78258866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Berufliche Teilhabe nach erworbener Hirnschädigung","authors":"T. Brehm","doi":"10.14624/nr2103004","DOIUrl":"https://doi.org/10.14624/nr2103004","url":null,"abstract":"Vocational participation after acquired brain injury – an empirical study of opportunities and barriers from the perspective of affected patients and vocational expertsT. BrehmAbstractThe following article summarizes the results and scientific findings of an empirical study on vocational participation after acquired brain injury. It describes opportunities and barriers from the perspective of affected patients and vocational experts. The empirical study was conducted in the context of a degree course on clinical social work. Essential results related to acquired brain injuries are that invisible disabilities and neu-ropsychological deficits complicate opportunities so that continuous support is needed. At the same time, the acceptance of deficits and changing work related opportunities seem to be resources. Seniority, colleagues, and the relationships between them, seem to play ano-ther important role. Risk factors are a change of leadership, change of work content and problematic relationships between colleagues. A big problem seems to be the cooperation with responsible payers (social insurance). In conclusion, the possibility of rehabilitation depends on the willingness of responsible payers. Keywords: acquired brain injury, rehabilitation phase E, return-to-work, profes-sional reintegration, integration assistance, case management","PeriodicalId":53664,"journal":{"name":"Neurologie und Rehabilitation","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80838152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fallvignetten aus der neurologischen Rehabilitation bei Patienten mit Post-COVID-Syndrom","authors":"C. Dettmers, C. Weich, C. Herrmann, R. Saile, M. Preuß, S. H. Chanyalew, L. Schleicher, D. V. Husen, J. Randerath, S. Stoll, M. Tempfli, M. Vieten, M. Jöbges","doi":"10.14624/nr2103001","DOIUrl":"https://doi.org/10.14624/nr2103001","url":null,"abstract":"Case vignettes from neurological rehabilitation in patients with post-COVID syndrome – Suggested discussion for performance diagnosticsC. Dettmers, C. Weich, C. Herrmann, R. Saile, M. Preuss, S. H. Chanyalew, L. Schleicher, D. Klaasen van Husen, J. Randerath, S. Stoll, M. Tempfli, M. Vieten, M. JöbgesAbstractSecondary illness after a previous infection with SARS-CoV-2 covers a wide spectrum in terms of organ damage, symptoms, duration, course and, above all, the severity of the disease. In patients who have been ventilated for a long time in an intensive care unit, one will look very carefully for lung damage and other organ damage, including cerebral, peripheral neurogenic and myogenic damage, and clarify to what extent the remaining deficits can be attributed to this. At the other end of the spectrum are patients who were not hospitalized during the primary infection, for whom fatigue, headache, muscle, limb or other symptoms are in the foreground and whose symptoms often fluctuate in intensity over the course of the disease. For employees in the health sector, a primary infection acquired at work may be recognized as an occupational disease. Subsequent complaints are often subsumed under “post-COVID” by the patient and then also by the attending physician, without proving a causal connection to COVID-19. We present individual case studies from this specific and non-representative group. We were surprised that there were many psy-chological, psychosomatic and psychiatric comorbidities. In the second part we present our diagnostics for cognitive, emotional and motor fatigue and fati-gability. Particularly in this initially non-hospitalized patient group, a thorough somato-psychological differential diagnosis is required in order to determine the causes and the socio-psychosomatic set of conditions. An identification of the different components within the post-COVID complaint complex should enable the most efficient therapy possible in order to initiate reintegration into social life in everyday life and at work. Keywords: Post-COVID syndrome, comorbidity, psychosomatics, fatigue, fatigability, differential diagnostics","PeriodicalId":53664,"journal":{"name":"Neurologie und Rehabilitation","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89590654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatigue bei Patienten mit Multipler Sklerose oder Neuromyelitis optica: ein systematischer Vergleich","authors":"Hildebrandt, H., Belhaj, I., Al-Joudi, H., Eling, P.","doi":"10.14624/nr2101004","DOIUrl":"https://doi.org/10.14624/nr2101004","url":null,"abstract":"","PeriodicalId":53664,"journal":{"name":"Neurologie und Rehabilitation","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74252106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glioblastom präsentiert sich als rezidivierende Stammganglienblutung","authors":"Koman, G., Hartwich, M.","doi":"10.14624/nr2101010","DOIUrl":"https://doi.org/10.14624/nr2101010","url":null,"abstract":"","PeriodicalId":53664,"journal":{"name":"Neurologie und Rehabilitation","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88034642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beeinflusst die Entscheidungskompetenz des Patienten die Auswahl der Immunmodulation?","authors":"Hedwig, A., Hoffmann, J. A., Jöbges, M., Dettmers, C.","doi":"10.14624/nr2101008","DOIUrl":"https://doi.org/10.14624/nr2101008","url":null,"abstract":"","PeriodicalId":53664,"journal":{"name":"Neurologie und Rehabilitation","volume":"106 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84913308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Die zukünftige Rolle der Rehabilitation und deren Finanzierung","authors":"A. Beivers","doi":"10.14624/nr2008003","DOIUrl":"https://doi.org/10.14624/nr2008003","url":null,"abstract":"The future role of rehabilitation and its financing: old and new questions - with and without the corona crisis The motto “rehabilitation before retirement” will soon change disproportionately into the motto “rehabilitation before care” and thus also raise the fundamental question of financing. By the beginning of the 2030s at the latest, there will be an “expenditure boomerang” for the cost-bearers. The corona crisis will exacerbate the problems – but it can also contribute to new concepts for solutions. Rehabilitation clinics, in particular, are important players in establishing new, digital care concepts. While rehabilitation service providers are increasingly acting as regional gatekeepers, this requires new remuneration modes. Capitation models or complex flat rates can be useful here. Implementing these is important in order to do justice to the new, significant role of rehabilitation in a changing care landscape.","PeriodicalId":53664,"journal":{"name":"Neurologie und Rehabilitation","volume":"22 4 Part 1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89345734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Die Auswirkungen der Pflegepersonaluntergrenzen-Verordnung auf die Neurologische Frührehabilitation PhaseB","authors":"T. Platz, C. Dohle, T. Mokrusch, C. Wallesch","doi":"10.14624/nr2002005","DOIUrl":"https://doi.org/10.14624/nr2002005","url":null,"abstract":"The effects of the nursing staff regulation on neurological early rehabilitation The German government has issued a regulation to define the minimal number of qualified nurses per shift in neurological early rehabilitation wards. This does not take into account ward specialization or the vertical organization of nursing, integrating staff in other departments. The German Society for Neurorehabilitation performed a survey among its members in February 2020 to find out which measures hospitals are taking to comply with this new regulation.","PeriodicalId":53664,"journal":{"name":"Neurologie und Rehabilitation","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84930665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}