RehabilitationPub Date : 2024-10-01Epub Date: 2024-10-22DOI: 10.1055/a-2403-0476
David Bühne, Torsten Alles, Jan Mathis Elling, Christian Hetzel
{"title":"[Results of a Survey Regarding the Implementation of Work-Related Medical Rehabilitation for Patients with Musculoskeletal Disorders: Identification of a Need and the Assessment of Work Demands].","authors":"David Bühne, Torsten Alles, Jan Mathis Elling, Christian Hetzel","doi":"10.1055/a-2403-0476","DOIUrl":"https://doi.org/10.1055/a-2403-0476","url":null,"abstract":"<p><strong>Purpose: </strong>Research indicates that the implementation of work-related medical rehabilitation (WMR) is characterized by pronounced heterogeneity and that the requirements defined by the German Pension Insurance are not consistently met. The study aimed to investigate the implementation of the WMR guideline in patients with musculoskeletal disorders with regard to the identification of a need for WMR as well as the assessment of the individual demands of work.</p><p><strong>Methods: </strong>317 rehabilitation facilities authorized for WMR in patients with musculoskeletal disorders were invited to participate in a nationwide survey. 86 of 317 facilities responded to the self-developed questionnaire and met the inclusion criteria.</p><p><strong>Results: </strong>Although most facilities reported that nearly all patients receive WMR if they have a need for it, the proportion of WMR measures provided was below ten percent in the majority of cases. With regard to work demands, respondents demanded greater involvement of employers in order to strengthen validity.</p><p><strong>Conclusion: </strong>The findings indicate that WMR is largely implemented in accordance with the WMR guideline. The main challenges include meeting the need for WMR and strengthening the involvement of employers in the assessment of work requirements.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":"63 5","pages":"298-306"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512969","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}
RehabilitationPub Date : 2024-08-01Epub Date: 2024-08-08DOI: 10.1055/a-2186-4285
Eike Langheim, Peter Langner, Volker Köllner
{"title":"Psychokardiologie – aus praktischer und klinischer Sicht.","authors":"Eike Langheim, Peter Langner, Volker Köllner","doi":"10.1055/a-2186-4285","DOIUrl":"https://doi.org/10.1055/a-2186-4285","url":null,"abstract":"<p><p>In order to treat and research the development, progression, therapy and prevention of cardiological and psychosomatic disorders and their interactions, the field of psychocardiology has been established in recent years and now offers several treatment options.The well-known somatic risk factors for cardiovascular diseases such as smoking, diabetes mellitus, arterial hypertension and acquired or congenital lipid metabolism disorders, lack of exercise, malnutrition and sleep-related disorders are often related to psychosocial risk factors. Conversely, mental illnesses such as depression and post-traumatic stress disorder can also be viewed as independent risk factors for cardiovascular diseases.Somatic illnesses can, in turn, result in significant psychological reactions that have a severely negative impact on the course of the disease, participation and quality of life.In addition to the scientific research into these connections, psychocardiology offers a clinical specialty that questions, diagnoses and provides treatment for psychosocial connections in cardiovascular patients.The aim of this article is primarily to convey clinical and practical aspects of psychocardiology and the most important psychological comorbidities in connection with heart disease. In addition, it should be shown which therapeutic offers are available in the medical care structures and how therapy can be carried out. Psychotherapy and exercise therapy are preferred for the treatment of these comorbid disorders. The possibility of psychopharmacological therapy for cardiovascular patients is also presented, especially because of possible problematic medication interactions.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":"63 4","pages":"247-261"},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908365","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}
RehabilitationPub Date : 2024-08-01Epub Date: 2024-06-25DOI: 10.1055/a-2291-1343
Alexander Ranker, Bernhard Greitemann, Friedbert Kohler, Christoph Gutenbrunner, Christian Sturm, Uwe Tegtbur, Christoph Egen
{"title":"[Validated German PROMs for People with Major Amputation of the Lower Extremity - A Narrative Review Based on the Final Report of the LEAD and COMPASS Initiative of the ISPO].","authors":"Alexander Ranker, Bernhard Greitemann, Friedbert Kohler, Christoph Gutenbrunner, Christian Sturm, Uwe Tegtbur, Christoph Egen","doi":"10.1055/a-2291-1343","DOIUrl":"10.1055/a-2291-1343","url":null,"abstract":"<p><p>Patient-reported outcome measures (PROMs) play an important role in the rehabilitation of people with major limb amputations. Patient-completed questionnaires help collect specific constructs on this patient population. The COMPASS and LEAD initiatives, carried out by the International Society for Prosthetics and Orthotics (ISPO), underscore the importance of regularly collecting high-quality PROMs. These are essential for the evaluation of rehabilitation needs, progress, and success. In the final report of ISPO's major international initiative, PROMs recommendations of the expert panel are tabulated. In Table 3.2 of the report, ISPO lists n=12 PROMs that were included in the narrow consensus process were considered to be of acceptable quality, and therefore recommended. The aim of this systematic review was to specifically search for these recommended PROMS regarding their availability in a German and validated version in order to identify potential gaps. All PROMs that were available in a German and validated version were then examined further with regard to the quality of the validation study, using the checklist of COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). Through a systematic literature search, six validated German-language versions were found. Only four of these met the quality standards of the COSMIN checklist sufficiently. Overall, this review shows serious gaps in the availability in the German language of validated versions of PROMs used internationally and recommended as standard by the ISPO. This gap needs to be closed by guideline-oriented translation and subsequent validation studies in order to be able to offer and collect the PROMS recommended by the ISPO also for German-speaking patient populations.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":"220-228"},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452200","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}
RehabilitationPub Date : 2024-08-01Epub Date: 2024-06-25DOI: 10.1055/a-2300-3524
Clara Breidenbach, Nicole Ernstmann, Sophie Schellack, Marie Degenhardt, Paula Heidkamp, Lina Heier, Kati Hiltrop, Oliver Rick, Johannes Soff, Christoph Kowalski
{"title":"[Return to Work after Cancer - a Systematic Review of Predictors in Germany].","authors":"Clara Breidenbach, Nicole Ernstmann, Sophie Schellack, Marie Degenhardt, Paula Heidkamp, Lina Heier, Kati Hiltrop, Oliver Rick, Johannes Soff, Christoph Kowalski","doi":"10.1055/a-2300-3524","DOIUrl":"10.1055/a-2300-3524","url":null,"abstract":"<p><strong>Introduction: </strong>More than one third of cancer survivors are of working age. Return to work (RTW) with and after cancer treatment is therefore an important issue for this group - but this is often accompanied with many challenges. The aim of this systematic review was to identify predictors of RTW after cancer from the literature specifically for Germany and to place these factors chronologically in the oncological course of treatment.</p><p><strong>Methods: </strong>A systematic search was performed using PubMed in June 2022. Included were all papers original published in German or English between 2000 and 2022 and referring to a German sample, regardless of study design.</p><p><strong>Results: </strong>From a total of 8,381 hits in the meta-database, 30 publications were finally considered in the synthesis of results. Higher age, lower education, lower socioeconomic status, higher disease stage, more progressive disease course, more severe side effects of treatment, (more severe) fatigue, higher psychological distress, worse health status, occupational status as a blue collar worker and manual labor, unemployment prior to diagnosis, more negative perceptions of the work(place) environment, and lower intention to work and lower work ability/ subjective prognosis of employability were associated with lower likelihood of RTW after cancer in the literature. Treatment type and use of rehabilitation were also found to be associated with RTW.</p><p><strong>Discussion: </strong>Sociodemographic, disease-related, psychosocial, and work-related predictors of RTW after cancer in Germany were identified. The results may help to develop targeted support measures that can be applied in specific phases of treatment. The comparability of the literature on predictors for RTW is limited due to a high heterogeneity in the operationalization of RTW and methodological approaches. There is need for further standardization in this area.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":"229-237"},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452199","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}
RehabilitationPub Date : 2024-06-01Epub Date: 2023-11-03DOI: 10.1055/a-2134-2243
Tobias Knoop, Nadja Scheiblich, Stephan Dettmers, Thorsten Meyer-Feil
{"title":"[Social work in medical rehabilitation - Development of an empirically grounded programme theory].","authors":"Tobias Knoop, Nadja Scheiblich, Stephan Dettmers, Thorsten Meyer-Feil","doi":"10.1055/a-2134-2243","DOIUrl":"10.1055/a-2134-2243","url":null,"abstract":"<p><strong>Purpose: </strong>Social workers are part of the interprofessional rehabilitation team. However, evidence for the effectiveness and a theoretically compatible description of their work are lacking. The aim of the research project \"Sozialarbeiterischer Wirkmechanismen in der medizinischen Rehabilitation (SWIMMER)\" was the development of a programme theory of social work in medical rehabilitation.</p><p><strong>Methods: </strong>In this qualitative research project, we conducted interviews with social workers and leading staff, recorded counselling sessions, and made participant observation in rehabilitation facilities. Sampling and analysis were based on grounded theory.</p><p><strong>Results: </strong>Data from 42 interviews, 14 counselling sessions and 140 hours of participant observations were analysed. Three core categories of a programme theory regarding practice of social work were developed: (i) work types (e. g., information work and supporting applications), (ii) interaction settings (exchange with rehabilitants, the rehabilitation team and external actors) and (iii) tasks of social services (e. g., development of vocational perspectives or professional/social participation, financial and social security). The consequences of social work practice were differentiated into output (e. g., number of applications submitted or options mentioned for a return to work) and outcome factors (e. g., participation in the society or a perspective on this and the well-being of the rehabilitants). A central characteristic is presented (co-production with the rehabilitants).</p><p><strong>Conclusion: </strong>The hypotheses of the mechanisms of action are grounded in the data and should be explored in further studies. In addition to being useful for practitioners, the model is also suitable for classifying the results of scientific studies.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":"161-168"},"PeriodicalIF":0.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488995","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}
RehabilitationPub Date : 2024-06-01Epub Date: 2024-03-29DOI: 10.1055/a-2192-3688
Annika Sternberg, Matthias Bethge, Jona Ober, Lisa Weier, Dieter Benninghoven
{"title":"[Sensitivity and specificity of the PHQ-9 for identifying suicidality in medical rehabilitation].","authors":"Annika Sternberg, Matthias Bethge, Jona Ober, Lisa Weier, Dieter Benninghoven","doi":"10.1055/a-2192-3688","DOIUrl":"10.1055/a-2192-3688","url":null,"abstract":"<p><strong>Purpose: </strong>Suicidality is rarely assessed in patients treated in German rehabilitation centers, although individuals with physical and mental impairments have an increased risk for suicidality. The item 9 of the 9-item depression module of the Patient Health Questionnaire (PHQ-9) asks about the desire to be dead or to harm oneself and could be used as a possible screening for suicidality. The Columbia Suicide Severity Rating Scale (C-SSRS) is a standardized interview to assess suicidality. We assessed the prevalence of suicidality in orthopedic and cardiac rehabilitation using the C-SSRS and the PHQ-9, examined the diagnostic accuracy of the item 9 of the PHQ-9 and of the PHQ-9 total score for identifying suicidality and surveyed the acceptance of the suicidality assessment by the rehabilitants.</p><p><strong>Methods: </strong>Study participants were screened with the PHQ-9 and subsequently interviewed using C-SSRS. Sensitivity and specificity of the item 9 of the PHQ-9 and the PHQ-9 total score were tested for the presence of suicidality assessed with the C-SSRS and in a sensitivity analysis for the presence of nonspecific active suicidal ideation (item 2 of the C-SSRS). We calculated the area under the curve (AUC) to predict the ability of the PHQ-9 to discriminate between individuals with and without acute suicidality. Screening and interview were evaluated by the rehabilitants.</p><p><strong>Results: </strong>Among 405 study participants, the prevalence of acute suicidality measured by the C-SSRS was 0.5%. 4% reported nonspecific active suicidal ideation on the C-SSRS. 10.4% reported suicidal ideation on item 9 of the PHQ-9. The sensitivity of item 9 and the PHQ-9 total score for identifying acute suicidality was only 50.0% (95% CI: 1.3% to 98.7%). However, item 9 was sensitive (81.3%, 95% CI: 54.4% to 96.0%) and specific (92.5%, 95% CI: 89.5% to 95.0%) for identifying nonspecific active suicidal ideation. Estimators for sensitivity were highly uncertain because of the low prevalence of acute suicidality. Addressing suicidality was rated as useful and helpful by study participants.</p><p><strong>Conclusion: </strong>If the response to item 9 is positive, the immediate risk of suicide is low. However, PHQ-9 is suitable for identifying patients with non-specific suicidal thoughts. A conspicuous score on the item 9 of the PHQ-9 should be further clarified by a psychotherapist.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":"180-188"},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140327421","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}
RehabilitationPub Date : 2024-06-01Epub Date: 2023-09-14DOI: 10.1055/a-2133-2552
Marco Streibelt, Pia Zollmann, Heinz Völler, Johannes Falk, Annett Salzwedel
{"title":"[Work Participation after Multimodal Rehabilitation due to Cardiovascular Diseases - Representative Analyses using Routine Data of the German Pension Insurance].","authors":"Marco Streibelt, Pia Zollmann, Heinz Völler, Johannes Falk, Annett Salzwedel","doi":"10.1055/a-2133-2552","DOIUrl":"10.1055/a-2133-2552","url":null,"abstract":"<p><strong>Purpose: </strong>Cardiovascular diseases represent a large proportion of the disease burden of the adult population in Germany. Their importance in rehabilitation has increased continuously in recent years. Several studies have investigated return to work of cardiac patients after rehabilitation, which is relevant from the perspective of pension insurance. However, there is a lack of representative findings for the German region on employment trajectories and their influencing factors.</p><p><strong>Methods: </strong>The rehabilitation statistics database of the German Pension Insurance (GPI) was used for this study. Subjects were patients with cardiovascular diseases undergoing rehabilitation in 2017. Analyses were performed for the total group and differentiated by relevant diagnosis groups. Occupational participation was operationalized via a monthly state variable up to 24 months after rehabilitation and the rate of all persons who were employed at the 12- and 24- month follow-up and in the 3 months before, respectively. Multiple logistic regression models were calculated to analyze the influencing factors.</p><p><strong>Results: </strong>The total sample comprised 59,667 patients. The average age in all groups was between 53 and 56 years. Men were disproportionately represented; 70% of the services were provided as follow-up rehabilitations and 88% in the inpatient setting. Stable employment rates were 66% after one year and 63% after two years in the overall group (disease groups: 49% to 71%). The strongest influencing factors were the amount of pay and the number of sickness absence days before rehabilitation, active employment before rehabilitation, and age.</p><p><strong>Conclusion: </strong>For the first time, representative data on occupational participation following rehabilitation on behalf of the GPI are available for the disease groups considered. The analyses underline the need to focus on occupational perspectives already in medical rehabilitation or directly thereafter.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":"169-179"},"PeriodicalIF":0.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10246105","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}
RehabilitationPub Date : 2024-06-01Epub Date: 2023-11-03DOI: 10.1055/a-2157-2368
Ines Passier, Christoph Kröger, Axel Kobelt-Pönicke
{"title":"[Insured Persons with High and Moderate Risk of Reduced Earning Capacity - Identification, Analysis of the Use of a Counselling Service and Illustration of their Health and Occupational Situation].","authors":"Ines Passier, Christoph Kröger, Axel Kobelt-Pönicke","doi":"10.1055/a-2157-2368","DOIUrl":"10.1055/a-2157-2368","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to investigate the life situation, and analyse the need for rehabilitative interventions as well as the use of counselling service offered to persons insured by the German Pension Insurance Braunschweig - Hannover (DRV BS-H), using the moderate and high risk index for temporary disability penson (RI-EMR).</p><p><strong>Method: </strong>This is a cross-sectional study. The participants were generated from a random sample of the total insured persons of the DRV BS-H. 1778 persons were contacted offering telephone consultation and a request for participation in a questionnaire survey that recorded, among others, symptoms, burdens and impairments. Employed persons were asked about their stress at work, non-employed persons about their motivation to return to work. 391 (24.5%) participated in the questionnaire survey and 157 (9.8%) of those contacted responded to the offer of counselling service. The contents of the counselling sessions were evaluated descriptively. The questionnaire data were analysed comparatively (ANOVA, χ2-test).</p><p><strong>Results: </strong>The offer of the telephone counselling was not used as expected in advance. Insured persons with a high RI-EMR showed more clearly complaints as well as burdens and impairments due to contextual factors than persons with a moderate RI-EMR. The majority of non-employed persons in both groups showed up in the motivational stage of forming intentions with regard to a possible return to employment.</p><p><strong>Conclusion: </strong>The question arises as to how insured persons with prognostically limited participation can be better reached with offers of assistance. The goal of early offer of support services is confronted with the problem that delays occur in the application of the routine data of the DRV and thus of the RI-EMR. Future studies should investigate how to improve insured persons' participation in counselling services and also their motivation to return to work.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":"151-160"},"PeriodicalIF":0.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488986","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}
RehabilitationPub Date : 2024-06-01Epub Date: 2024-06-12DOI: 10.1055/a-2148-7035
Wilfried Mau, Matthias Bethge, Max Emanuel Liebl
{"title":"[The National Competency-Based Catalogue of Learning Objectives for Medicine 2.0 for the subject Physical and Rehabilitative Medicine, Naturopathic Medicine. Consensus of Scientific Medical Societies].","authors":"Wilfried Mau, Matthias Bethge, Max Emanuel Liebl","doi":"10.1055/a-2148-7035","DOIUrl":"10.1055/a-2148-7035","url":null,"abstract":"<p><strong>Background: </strong>The learning objectives in the current cross-sectional subject \"Rehabilitation, Physical Medicine, Naturopathic Medicine\" have been revised as part of the further development of the National Competency-Based Catalogue of Learning Objectives for Medicine (NKLM) to its new version 2.0. Since the NKLM is designed as an interdisciplinary catalogue, a subject assignment seemed necessary from the point of view of various stakeholders. Thus, the German Association of Scientific Medical Societies (AWMF) and the German medical faculties initiated a subject assignment process. The assignment process for the subject \"Physical and Rehabilitative Medicine, Naturopathic Medicine\" (PRM-NHV; according to the subject list of the first draft of the planned novel medical license regulations from 2020) is presented in this paper.</p><p><strong>Material and methods: </strong>The AWMF invited its member societies to participate in the assignment of learning objectives of chapters VI, VII, and VIII of the NKLM 2.0 to the individual subjects to which they consider to contribute in teaching. For \"PRM-NHV\", representatives of the societies for rehabilitation sciences (DGRW), physical and rehabilitation medicine (DGPRM), orthopaedics and traumatology (DGOU), as well as for naturopathy (DGNHK) participated. In a structured consensus process according to the DELPHI methodology, the learning objectives were selected and consented. Subsequently, subject recommendations were made by the AWMF for each learning objective.</p><p><strong>Results: </strong>From the NKLM 2.0, a total of 100 competency-based learning objectives of chapters VII and VIII for the subject \"PRM-NHV\" were consented by the representatives of the involved societies for presentation on the NKLM 2.0 online platform.</p><p><strong>Conclusions: </strong>In the context of the revision process of medical studies in Germany and under the umbrella of the AWMF and the German medical faculties, a broad consensus of competency-based learning objectives in the subject \"PRM-NHV\" could be achieved. This provides an important orientation for all medical faculties both for the further development of teaching in the cross-sectional subject \"Rehabilitation, Physical Medicine, Naturopathic Medicine\" according to the 9th revision of the medical license regulations, which has been valid for twenty years, and for the preparation of the corresponding subjects in the draft bill of the novel license regulations.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":"63 3","pages":"189-196"},"PeriodicalIF":2.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312330","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}
RehabilitationPub Date : 2024-04-01Epub Date: 2024-01-20DOI: 10.1055/a-2192-3377
Franziska Ebert, Nikolaus Ballenberger, Markus C Hayden, Dirk Möller, Matthias Limbach, Michael Schuler, Dennis Nowak, Konrad Schultz
{"title":"[Effects of pulmonary rehabilitation on dysfunctional respiratory patterns in patients with uncontrolled asthma].","authors":"Franziska Ebert, Nikolaus Ballenberger, Markus C Hayden, Dirk Möller, Matthias Limbach, Michael Schuler, Dennis Nowak, Konrad Schultz","doi":"10.1055/a-2192-3377","DOIUrl":"10.1055/a-2192-3377","url":null,"abstract":"<p><strong>Purpose: </strong>Dysfunctional breathing patterns (DAM) are deviations from physiologic breathing patterns. DAM seem to be associated with lower asthma control. To date, it is unclear what effect inpatient rehabilitation can have on this problem. The aim of this work is to investigate the effect of pulmonary rehabilitation (PR) on DAM.</p><p><strong>Methods: </strong>The data are based on a randomized controlled trial with a waiting control group. The intervention group (IG) received PR 4 weeks after application approval and the control group (KG) after 5 months. Dysfunctional breathing was assessed by Nijmegen-Questionnaire (NQ). Values ≥ 23 points indicate an existing DAM. Values at the end of rehabilitation (T2) and after three months (T3) were compared (analysis of covariance). Supplemental moderator analysis was performed to examine whether the effect of PR was related to baseline NQ scores.</p><p><strong>Results: </strong>Significant differences in NQ score are found between IG (n=202) and KG (n=210) at T2 (AMD=10.5; 95%CI [9; 12]; d=1.4; p<0.001) and at T3 (AMD=5.8; 95%CI [4.3; 7.3]; d=0.8; p<0.001). There is an interaction effect between the difference in NQ score between the groups at T2 and baseline at T0 (b=5.6; 95%CI [2.2; 11.9]; p<0.001). At T3, this interaction effect was no longer detectable (b=4.5; 95%CI [-3.1; 14.1]; p=807).</p><p><strong>Conclusion: </strong>Inpatient, multimodality, and interdisciplinary PR is associated with significant and clinically relevant improvement in DAM both at discharge and 3 months later. In the short term, patients with existing DAM benefit more from PR than patients without DAM.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":"100-106"},"PeriodicalIF":0.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139514200","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}