Rehabilitation最新文献

{"title":"[Processes and Outcomes of Work-Oriented Case Management during and after Medical Rehabilitation for Substance Use Disorders: A Workshop Report from the BORA-TB Project].","authors":"Helen Gissendanner, Thorsten Meyer-Feil","doi":"10.1055/a-2624-8247","DOIUrl":"https://doi.org/10.1055/a-2624-8247","url":null,"abstract":"<p><p>Case workers in a vocational support program for persons with addiction disorders (\"BORA-TB\") accompanied rehabilitants for up to 12 months after rehabilitation treatment. Positive return-to-work (RTW) effects were not statistically verifiable using survey data from the evaluation study. This raises the question of methodological adjustments to the assessment of outcomes. The work summarized here sought to identify and analyze the different paths along which consultation interactions progressed, including the different forms of outcomes they terminated in, to reach an understanding of how these can be influenced by or understood through individual and contextual factors.For the analysis of n=50 individual consultations, data taken from the primary documentation of services received by clients as reported by case managers were combined with statistical measures and free-hand text notes from clients' self-report questionnaires. These data were reiteratively compared within and between cases following the principles of Grounded Theory.Eleven types of consultation processes were differentiated. Each represents a specific pattern of case manager tasks and methods, forms of (possible) outcomes, and prognoses for disease management in relation to the client's situation at the start of consultation and to personal characteristics. The wide range of reported case management tasks included praise for independently achieved vocational successes, legal support, and analyses of clients' personality characteristics for (change) motivation. Outcomes differed depending on client´s life situation and needs, yet is always defined as greater participation in vocational and social environments. Prognoses for each type taking into consideration variation in consultation processes and forms of outcomes suggest hypotheses about suitable disease management.Alternative approaches to the evaluation of outcomes in caseworkers' support of persons with addiction disorders appear feasible with available data on consultation processes. They also seem appropriate given the heterogeneity of affected persons' situations. A validation of the approach used here and a quantitative analysis of type distributions could yield more suitable instruments for measuring treatment outcomes in addiction research.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Rehabilitation of Health Care and Social Workers after COVID-19 Infection: Results of a Retrospective Cross-sectional Study].","authors":"Svenja Mertens, Albert Nienhaus, Matthias Morfeld, Claudia Westermann, Uwe Koch-Gromus","doi":"10.1055/a-2633-6179","DOIUrl":"https://doi.org/10.1055/a-2633-6179","url":null,"abstract":"<p><p>During the COVID-19 pandemic, healthcare workers showed a twofold increased risk of infection. Many still report persisting symptoms a few months after initial infection such as fatigue, headaches and cognitive impairment, often resulting in incapacity to work and reduced ability to carry out tasks of everyday life. When such symptoms persist for longer than three months, it is known as post-covid-syndrome (PCS). Only a few studies have evaluated outpatient rehabilitation for post-covid conditions. The objective of this study was to assess patient experience and satisfaction with rehabilitation measures.In November 2022, insured healthcare workers were asked to participate in a retrospective cross-sectional study via paper-pencil survey. The survey included sociodemographic and job-related information, acute and persisting COVID-19 symptoms, inpatient and outpatient rehabilitation measures, and their subjective experience of those measures. Data interpretation followed a descriptive analysis, while analysis of variances was used to identify significant differences.Out of the 394 people contacted, n=211 participated in the survey (response rate: 53.6%). No or mild PCS could not be found in the sample; 4.9% showed moderate and 95.1% severe PCS. In total, n=194 people reported having undergone rehabilitation measures, with 16.5% receiving outpatient and 23.7% receiving inpatient rehabilitation; 59.8% reported rehabilitation in both settings. Of the participants, 114 (65.9%) reported subjective improvement of their symptoms following rehabilitation measures. The analysis of variance did not show a significant difference between settings (p=0.054).The findings indicate that patients still experience a high burden due to persisting symptoms, but many of them report a subjectively perceived improvement of symptoms following rehabilitation measures. In this survey, outpatient rehabilitation was used mainly as follow-up after inpatient care and was essential for maintaining any improvement achieved.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Cross-sectoral coaching for individuals with health impairments and at high risk of permanent work disability: Results of a process evaluation].","authors":"Lea Remus, Marei Grope, Stella Lemke, Matthias Bethge","doi":"10.1055/a-2641-4843","DOIUrl":"https://doi.org/10.1055/a-2641-4843","url":null,"abstract":"<p><p>An innovative case management intervention in the city of Hamburg provides an open facility for individuals at high risk of permanent work disability, offering tailored guidance and support, regardless of the nature and extent of needs and legal jurisdiction. The intervention aims on preserving or restoring employability and preventing chronicity of illnesses or impending disability. Our process evaluation examined the implementation of the intervention.Data were collected in 2021 as part of a mixed-methods study. A questionnaire survey was conducted at the start and after 12 months to analyze changes in health status, employment, and satisfaction with the intervention. Additionally, semi-structured, problem-centered interviews were conducted with stakeholders and participants to analyze the dose given and dose received. We also examined the population reached.Out of 145 eligible participants, 56% completed the initial questionnaire, and 28% successfully filled out the second questionnaire. Over 85% of the participants remained employed within a year. The Work Ability Score increased by an average of two points (p=0.001, n=36). There was a significant decrease in depression and anxiety scores. Participants expressed high satisfaction with all of the intervention components. Nine stakeholders and four participants were interviewed about the dose given and dose received. Stakeholders named services focusing on health and social stabilization to maintain of employability. This was intended to be realized through a cross-sectoral, low-threshold, and coordinating counseling approach. The participants mentioned support to ensure their employability and the opportunities for professional reorientation as offers.A new intervention was implemented to provide support for individuals with health impairments and at high risk of permanent work disability. Despite high initial levels of depression and anxiety, case management support had a positive impact. The Work Ability Score significantly improved. It was observed that the participants' employment situations were largely stabilized. The project will continue and be evaluated through a mixed-methods observational study (https://www.hgua-hamburg.de/).</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Pain Duration and Affected Side Affect Balance in Shoulder Pathologies? A Controlled Study.","authors":"Meryem Buke, Fatma Unver, Gulsum Tikac, Suat Erel","doi":"10.1055/a-2636-9811","DOIUrl":"https://doi.org/10.1055/a-2636-9811","url":null,"abstract":"<p><p>The study investigated the impact of shoulder pathologies on balance and changes associated with pain duration and affected side.A total of fifty-five individuals were included in this study. Individuals with shoulder pathology were grouped according to the duration of pain and the affected side. Balance evaluation was done using the Timed Up and Go (TUG) test and the One Leg Stand (OLS) test performed on hard and soft ground with open and closed eyes.Pain duration negatively affected dynamic balance, and those with pain for less than six months had better TUG results (p=0.027). Additionally, no significant difference was observed in OLS and TUG tests in relation to the affected shoulder side.Shoulder pathology negatively impacts individuals' dynamic and static balance. As the pain duration due to shoulder pathology increases in individuals, dynamic balance is negatively affected.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Development of a Counseling Guide for Rehabilitation Specialist Counseling in the German Pension Insurance System on the Requirements of the Federal Participation Act: A Delphi Study].","authors":"Anna-Lena Baasner, Stella Lemke, Stefanie Gröhl, Katja Nebe, Matthias Bethge","doi":"10.1055/a-2619-1175","DOIUrl":"https://doi.org/10.1055/a-2619-1175","url":null,"abstract":"<p><p>The aim of this study was to develop a concept for implementing the requirements of the Federal Participation Act (Bundesteilhabegesetz, BTHG) in rehabilitation counseling through the use of a Delphi study.We employed a modified Delphi technique, involving twelve rehabilitation counselors and seven managerial experts in the field of vocational rehabilitation services. Based on a legal analysis, three focus groups were formed to explore potential implementation strategies and best practice examples for meeting the statutory requirements of the BTHG. Subsequently, two rounds of written Delphi surveys were conducted to reach consensus on a counseling concept in line with the BTHG.After two Delphi rounds, structured feedback was statistically evaluated, resulting in 58 recommendations. The recommendations address issues such as determining the right of choice and preference, assessing individual life realities during counseling sessions, providing information and support in workplace integration management, implementing coordinated service provision in counseling, and networking efforts, as well as general counseling topics.The results outline the requirements that the BTHG imposes on rehabilitation counseling and provide a solid foundation for advisory practices.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Work Participation after Medical Rehabilitation of People with Musculoskeletal Diseases: Representative Analyses Using Routine Data of the German Pension Insurance].","authors":"Matthias Bethge, Pia Zollmann, Richard Albers, Bernhard Greitemann, Marco Streibelt","doi":"10.1055/a-2619-1313","DOIUrl":"https://doi.org/10.1055/a-2619-1313","url":null,"abstract":"<p><p>We analyzed how people with musculoskeletal disorder who completed a rehabilitation program of the German Pension Insurance can be described before medical rehabilitation, how often work participation succeeds thereafter and which administratively available information is associated with work participation.We used the German Pension Insurance's rehabilitation statistics database. Patients with a musculoskeletal disorder who had completed medical rehabilitation in 2017 were included. The analyses were carried out for the group as a whole and stratified by diagnosis group. Work participation was conceptualized both via a monthly status variable up to 24 months after rehabilitation and as a rate of all persons who were employed 12 or 24 months after rehabilitation and the three preceding months. Multiple logistic regression models with stepwise inclusion were calculated to analyze the factors influencing stable work participation.The analysis included 335,792 completed orthopaedic rehabilitations. Two years after the end of rehabilitation, 66.2% of the patients achieved stable work participation. The most relevant factors influencing stable employment were the duration of sickness absence and the income from employment subject to social insurance contributions before the start of rehabilitation.One and two years after completing orthopaedic rehabilitation, around seven out of ten patients are in stable employment. Due to their prognostic validity, the influencing factors identified can be used to determine needs and allocate patients to work-related medical rehabilitation, graded return-to-work and, if necessary, other services for participation in working life.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Practice recommendations for work-related medical rehabilitation in psychosomatic rehabilitation facilities - results of a Delphi process].","authors":"Matthias Bethge, Jessica Roder, Stefan Schulder, Hannes Banaschak, Nina Gabriel, Stefanie Freytag, Andrea Budde, Volker Köllner, Michaela Fleck, Bernhard Koch, Frank Rosbiegal, Markus Bassler","doi":"10.1055/a-2572-4338","DOIUrl":"https://doi.org/10.1055/a-2572-4338","url":null,"abstract":"<p><p>In a recently completed randomized controlled trial, we found that work-related medical rehabilitation (WMR) was implemented very differently in rehabilitation facilities. Its additional effects were particularly evident when the emphasis on work-related issues was clearly communicated to participants. We therefore developed practice recommendations for a structured further development of WMR in psychosomatic rehabilitation facilities.In a two-stage Delphi process, 119 recommendations were evaluated by various experts including people who had received psychosomatic WMR. The assessment of the strength of consensus followed the guidelines of the Association of the Scientific Medical Societies in Germany (AWMF). The results of the first round were discussed with the participants before the second round.A total of 19 and 17 individuals participated in the respective votes. In the second Delphi round, 80 recommendations achieved strong consensus (74.8%) and 24 recommendations achieved consensus (22.4%). Two recommendations received majority approval. One recommendation was rejected by a majority. We reformulated the 106 remaining recommendations according to the AWMF recommendations in order to express the strength of consensus (\"is to\", \"should\", \"can\").The strong consensus on around three quarters of all practice recommendations suggests that the final assessment of the different groups involved was similar. The large number of recommendations that achieved strong consensus indicates the complexity of the intervention. A regular review of the practice recommendations is advisable.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity, reliability and responsiveness of the Turkish Version of the Munich Knee Questionnaire.","authors":"Abdulhamit Tayfur, Mensure Aslan, Mehmet Canli, Ömer Alperen Gürses, Mehmet Fevzi Çakmak, Mehmet Yetiş, İsmail Ceylan","doi":"10.1055/a-2618-2483","DOIUrl":"https://doi.org/10.1055/a-2618-2483","url":null,"abstract":"<p><p>Self-reported surveys are an important part of a comprehensive assessment of clinical outcome. This cross-cultural adaptation study aimed to develop a Turkish version of the Munich Knee Questionnaire (MKQ-TR).A total of 200 participants including 112 people with various knee injuries (53.9±14.3 years, 68 males) and 88 healthy participants (30.0±11.9 years, 74 males) were recruited. We analyzed criterion validity with Pearson's correlation coefficients and test-retest reliability with intraclass correlations coefficient (ICC). Standard error of measurement (SEM) and minimal detectable change (MDC) were investigated for absolute reliability.There were strong correlations between MKQ-TR and International Knee Documentation Committee (r=- 0.96, p<0.001) and Knee Injury and Osteoarthritis Outcome Score subscales (range for r=- 0.66 to - 0.96, all p<0.001). Reliability was excellent (ICC>0.90). The SEM results showed that absolute reliability ranged from good to doubtful (5.8-15.9%), hence acceptable. The MKQ-TR had an MDC of 6.14 and 29.7 as the cut-off point. The area under the ROC curve showed excellent (0.991) accuracy with 0.973 sensitivity and 0.977 specificity.MKQ-TR demonstrated excellent validity, reliability and accuracy to evaluate symptoms, pain, daily life activities, sports activities, physical function and quality of life in people with various knee injuries.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Implementation of the Requirements of the Federal Participation Act in Rehabilitation Counseling - A Triangulation of Socio-legal Analysis, Questionnaire Survey and Interview Study].","authors":"Anna-Lena Baasner, Stefanie Gröhl, Stella Lemke, Linda Albersmann, Katja Nebe, Matthias Bethge","doi":"10.1055/a-2563-6856","DOIUrl":"https://doi.org/10.1055/a-2563-6856","url":null,"abstract":"<p><p>The aim of this study was to present the social law requirements for rehabilitation counseling following the Bundesteilhabegesetz (Federal Participation Act; BTHG) and to demonstrate, through questionnaire and interview data, how these aspects are currently being implemented.Using a mixed-methods study, a sociolegal analysis was conducted using the classical legal scientific methodology. We additionally used questionnaires at two time points to assess, among others, the clients' subjective appraisal of counseling. A total of 33 semi-structured expert interviews were conducted with rehabilitation counselors, clients, and social service staff from rehabilitation centers. All results were thematically structured and triangulated. Data were collected as part of the research project \"Accompanying the Implementation of the Federal Participation Act within the Framework of Rehabilitation Counseling\" between October 2022 and February 2024.As a result of the BTHG, requirements for rehabilitation counseling were further emphasized and specified. This particularly pertains to participation in the planning process, development and expansion of networks, early-stage information provision, the right to choose providers, and counseling in rehabilitation clinics. For example, 73% (n=75) reported that they had been informed about their rights and entitlements; however, 4 out of 17 insured individuals stated that they were unfamiliar with the term or content of the right to choose. Counseling in clinics was considered important by all interviewees. Overall, rehabilitation counseling as currently practised meets only partially the requirements specified by the BTHG.The results demonstrate the high and diverse demands that the BTHG places on rehabilitation counseling.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of effectiveness of Mulligan mobilization technique and cervical stabilization training in patients with chronic neck pain: a single-blinded randomized controlled trial.","authors":"Serbay Sekeroz, Emine Aslan Telci, Meryem Buke, Nuray Akkaya","doi":"10.1055/a-2618-6281","DOIUrl":"https://doi.org/10.1055/a-2618-6281","url":null,"abstract":"<p><p>The purpose of the current study was to compare the effectiveness of Mulligan mobilization technique (MMT) and cervical stabilization training (CST) in patients with chronic neck pain.Thirty-six patients with chronic neck pain were randomly assigned to three groups as control, MMT, and CST groups. In the current study, pain intensity, range of motion (ROM), proprioception, head posture, deep neck flexor (DNF) muscle endurance, disability level, and neck awareness were evaluated as outcome measures.All variables showed statistically significant changes following treatment in all groups. MMT and CST were found to be more effective than home exercise regimen (control group) in pain intensity (p=0.001), DNF muscle endurance (p=0.0001), and disability level (p=0.007) but they were not superior to each other. MMT was found to be more effective in increasing ROM (p=0.0001) and neck awareness (p=0.018). Also, CST was found to be more effective in improving head posture (p=0.0001) and proprioception (p=0.001).The study indicated MMT was more effective in increasing ROM and neck awareness, and the CST was more effective in improving head posture and proprioception. Comprehensive perspective can be acquired for health professionals in this field to select the appropriate rehabilitation approaches for patients with chronic neck pain thanks to our results.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}