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.

The aim of the study was to explore the goals, achievements and challenges of an outpatient rehabilitation program for obese children and adolescents from the perspective of specialist staff at rehabilitation centres.As part of a multi-stage research project, 19 semi-structured, guideline-based telephone interviews were conducted with the medical and therapeutic staff of four rehabilitation centres and analysed using Framework Analysis.The interviewees agreed that the goal was a long-term and sustainable change in lifestyle. Furthermore, weight loss played an important role in both the goal and success of the rehabilitation program. Implementation of lessons learned into everyday life on a long-term basis, lower motivation of parents and various difficulties encountered by rehabilitants and staff when concomitant measures of the program were carried out during weeks of school term posed a challenge. The (active) role of parents in the outpatient rehabilitation program was shaped by different expectations on the part of all stakeholders and influenced by resources available to the families to different extents. The low number of participants was probably due to the low level of awareness and the small number of outpatient rehabilitation programs in Germany.The outpatient rehabilitation program for obese children and adolescents has potential for success in individual cases. However, the goals of the rehabilitation program should be communicated more transparently, especially with regard to possible weight reduction, which in turn influences the expectations and motivation of children and adolescents and their parents. By involving parents more specifically, various challenges can be addressed and the lessons learned can be implemented more effectively into everyday life.

The aim of this study was to examine work-related inclusion experiences of employees at a university and to explore potential influences on the inclusion experiences of employees with impairment.In a cross-sectional online survey, 199 employees were questioned about their work-related experience of inclusion using the perceived group inclusion scale. Two linear regression models were used, firstly to analyse differences between the experience of inclusion of employees with and without impairment and secondly to investigate the relationship between potential influences and the experience of inclusion among people with impairment. In addition, a qualitative content analysis on challenges and suggestions for improvement was carried out.The experience of inclusion at work (1 to 5 points) was significantly poorer among employees with impairments (n=74) than among employees without impairments (n=125; b=- 0.35; 95% CI: - 0.58 to - 0.11; p=0.004). A visual impairment was significantly associated with a poorer experience of inclusion (b=- 0.57, 95% CI: - 1.05; - 0.10). Employees for whom social support was important had a poorer experience of inclusion (b=- 0.98, 95% CI: - 1.61; - 0.34). Employees with a recognised degree of disability below 50 had better experience of inclusion (b=0.75, 95% CI: 0.19; 1.31) than employees without a recognised degree of disability. Employees who were more open about their impairment had a better experience of inclusion (b=0.13, 95% CI: 0.05; 0.21). Employees with impairment were not fully acquainted with available services. Challenges and suggestions for improvement relate to infra- and organisational structures and social interaction.Employees with impairments had a significantly lower experience of inclusion in our sample. We were able to identify some characteristics that may be associated with the experience of inclusion. Our results do not allow conclusions to be drawn about causal relationships and cannot be generalised. However, our study suggests several practical approaches for improving the experience of inclusion of people with impairment in the university work context.

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.

Social work is part of the interprofessional rehabilitation team and, for example, provides services in the context of so-called special aids in vocational rehabilitation. However, compared to the field of medical rehabilitation, there is still relatively little research on the practice of social work in vocational rehabilitation. The three research projects Tasks and Use of Social Work in Vocational Rehabilitation (ANSAB), Networks and Cooperation in Vocational Rehabilitation (NEKOBERE) and Social Work in Vocational Rehabilitation (SABER) aimed to address this gap by identifying the tasks and roles of social work in this field.The analysis was based on the qualitative study components of the three projects and an online survey of 109 professionals conducted as part of the ANSAB project. Initially, each research team analyzed its own data. Subsequently, a synthesis of the findings was conducted using a best fit framework synthesis approach. The theoretical framework was based on Dahrendorf's role theory.Professionals working in the field of social work perform a wide range of tasks and take on various roles. Among others, the identified roles included Thread-Holder, Rehabilitation Process Companion, "Motherly" Carer and Networker. Tasks could be assigned to these roles. Professionals perceived tasks linked to the roles of the Thread-Holder and Rehabilitation Process Companion (e. g. individual rehabilitation progress discussions) as particularly frequent and important. A potential for role conflict between these two roles was also identified. This may occur, for example, when rehabilitants perceive professionals as representatives of the funding agency, which can lead to reluctance to disclose psychosocial concerns.The results of the three research projects highlight the central importance of professionals working in the field of social work. Building on these findings, practice-oriented recommendations will be developed to support professionalization and further define the competence profile of these professionals.

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.