Rehabilitation最新文献

Our study analyzed whether self-reported functional capacity is more realistic after a functional capacity evaluation has been carried out, i. e. whether the second self-reported functional capacity after testing corresponds more closely to the tester-observed judgement during the test than the first self-reported functional capacity before testing.Patients with orthopedic trauma were referred for functional capacity evaluation at the end of an inpatient rehabilitation program in Austria and were consecutively recruited for a diagnostic before-after study. We assessed self-reported functional capacity before and after completion of functional capacity evaluation as patient-reported outcome and compared it with tester-observed functional capacity when performing the functional capacity evaluation, i. e. our diagnostic procedure. Self-reported functional capacity was assessed with the Spinal Function Sort.In 523 patients, self-reported functional capacity assessed by the Spinal Function Sort increased significantly by 15.4 points after the functional capacity evaluation. This change corresponded to slightly more than 40% of the baseline standard deviation. The frequencies of self-reported moderate and heavy or very heavy work functional capacity increased from 22.2% to 30.4% and 13.6% to 23.5%, respectively, while the frequency of self-reported sedentary functional capacity decreased from 35.2% to 18.9%. The number of patients whose self-reported functional capacity matched the tester-observed functional capacity increased from 19.3% to 34.2% after completion of the functional capacity evaluation.After completion of the functional capacity evaluation, the number of patients significantly increased whose rating of functional capacity matched their tester-observed functional capacity.

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.

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.

In oncological rehabilitation, physical activity therapy takes up a significant part of therapy time. With the aim of maintaining physical activity in the long term, a rehabilitation aftercare program for female breast cancer patients was implemented through the use of a rehabilitation aftercare app (ReNaApp) and evaluated with focus on acceptance, feasibility and optimization potential.The qualitative research was conducted as part of a quasi-randomized longitudinal study in a mixed-methods design. The database consists of guided interviews with breast cancer rehabilitants in the intervention group and a focus group with the rehabilitation team engaged in the realization of the aftercare intervention. The rehabilitants were interviewed 3,6 and 9 months after rehabilitation and the focus group was conducted after recruitment was completed. The data material was analyzed according to Mayring's qualitative content analysis.19 interviews were conducted with seven rehabilitants (Ø 47 years). Eight employees (87.5% female) took part in the focus group, most of whom were medical staff (N=5). The rehabilitation employees reported successful implementation of the intervention. Adapting the practical realization to the clinic's routines, the involvement of several professions and informing the entire rehabilitation team about the study were all considered successful factors. However, the staff also encountered hurdles, including staff shortages and the digital infrastructure. The rehabilitants rated the ReNaApp positively in terms of their satisfaction, usability and the perceived support provided by the application. In addition to the active app users, some respondents indicated that they do not use the ReNaApp because they are physically inactive or do not need support.The feasibility of the aftercare program was confirmed by the rehab team, but the target group should be specified in order to recommend the aftercare offer according to existing needs. In addition to increasing adherence to the program, the limited time and personnel resources can be used in a targeted manner.

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.

Return to work is one of the most important aims in the context of psychosomatic rehabilitation. Studies from outside of Germany have reported that high self-efficacy positively influences time to return to work. In this study, the impact of self-efficacy on return to work was investigated after inpatient treatment in a psychosomatic rehabilitation facility of those with mental health disorders.In a longitudinal study, the participants (N=180) were asked about their return to work self-efficacy, depression symptoms, length of employment prior to rehabilitation, and other demographic variables. Insurance data were used to calculate time to return to work after 12 months. Cox regression analyses were used to identify relevant factors. Additionally, pre-post analyses and correlative relationships regarding self-efficacy and depression were conducted.Higher return to work self-efficacy and longer employment prior to rehabilitation increased the chance for return to work. The treatment showed changes in depressiveness (d=0,97) and return to work self-efficacy (d=|0,36|).In the course of psychosomatic rehabilitation, self-efficacy is important in the process of return to work among employees with mental health disorders.

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.

Dual rehabilitation (dR) of patients with physical and mental illnesses comprises equal care and cooperation between two specialist departments. As part of the multi-method project that aimed to evaluate dR in different indications (DUAL), we explored the acceptance from the rehabilitants' perspective.We conducted 36 semi-structured interviews with rehabilitants of different indications (psycho-gastroenterology, -dermatology, -orthopedics, -diabetology, -cardiology, -pneumology). Interviews were analyzed using qualitative content analysis. Knowledge and access, expectations, experiences, and subjective benefits were explored as indicators for acceptance.Rehabilitants reported appropriate expectations such as improvement of mental and physical complaints or open expectations. Cross-departmental aspects such as admission and ward rounds were experienced as beneficial if there was sufficient exchange and cooperation between specialist departments. In individual psychotherapeutic consultations and groups, an improved understanding of both disorders and contact with fellow patients were important which also had a positive effect outside therapies. The multimodality of the dR was perceived to be beneficial just as the therapists' behavior and offers for counseling on both diseases. Hindering experiences included a lack of interdisciplinarity/coordination between the specialist areas, a lack of individualization in therapy planning and structural aspects in almost all areas. Subjective benefits were improved self-management and symptoms of both illnesses, as well as occupational performance.Appropriate expectations, beneficial experiences with the multimodal therapy components, therapists, and fellow patients as well as perceived positive effects support rehabilitants' satisfaction and indicate a high level of acceptance. Hindering experiences and modification requests suggest ways for overcoming obstacles, for example, by increasing interdisciplinarity and cooperation between the specialist departments. Providing sufficient information and knowledge about dR available to practitioners and patients can further support acceptance and patient participation.