Rehabilitation最新文献

Aim of the study: The present work is intended to give an overview of rehabilitation of patients with post COVID-19 condition covered by the German Pension Insurance in 2021.

Methods: Cross-sectional analysis of medical rehabilitation completed in 2021, in which COVID-19 sequelae were coded in first or second place in the uniform discharge report according to the International Statistical Classification of Diseases and Related Health Problems was carried out. The codes U08(.9), U09(.9) and U10(.9) as well as the corresponding codes from 2020 were taken into the evaluation as COVID-19-related diseases. Children's rehabilitation and oncological rehabilitation for pensioners and their relatives were excluded. Statistically, relative and absolute frequencies are given for nominal and ordinal variables, and median and quartiles for continuous, skewed distributed variables.

Results: 9,666 rehabilitations with one of the codes mentioned in first or second place remained. 54.8% of the patients were women and 43.2% men. The median age was 54 and 55 years (women/men). In all, 64.4% of the rehabilitations were carried out in the pulmonary medicine department. Owing to somatic indications, almost 50% of these patients in rehabilitation remained in the clinic beyond the regular approval period. The most common other diagnoses were diseases of the respiratory system. In 80.7% of those affected, the treating physicians considered the post-COVID-19 condition-associated symptoms as improved through rehabilitation. Furthermore, employment was subject to social security contributions for 88.0% of these patients, and 30.5% were employed in the fields of health, social affairs, teaching, and education. Of those affected, 63.8% were on sick leave when they were admitted, 63.0% when they were discharged. With regard to performance in the last job or on the general job market, over 90.0% received a prognosis for 6 hours and more.

Conclusion: The importance of post-COVID-19 condition in the context of medical rehabilitation increased significantly over the course of 2021. The disease causes long periods of disability. With regard to performance, the available analyses give a positive picture; only 6.5% of those individuals undergoing rehabilitation were assessed as having a reduced capacity to earn of less than 3 hours on the general labor market.

Background: The Long Covid syndrome, a condition that is induced by SARS-CoV-2, affects patients in their social and professional life due to persistent symptoms and functional deficits. Medical rehabilitation aims to reduce participation incapacity and restore the ability to work. So far, it is not known what happens to the occupational situation of people affected by Long Covid after pneumological rehabilitation.

Methods: The overall study is designed as a multicentric and prospective observational study with a mixed-method design. Covid-19 rehabilitation patients undergoing pneumological rehabilitation aged between 18 and 65 years were recruited. The questionnaire data of persons that were employed at baseline were evaluated. The written survey took place at the beginning and at end of rehabilitation and, additionally, after six months. The data collected included terms such as return to work, occupational stress and changes, subjective prognosis of gainful employment (SPE scale) and occupational performance and working ability (WAI).

Results: The sample comprised N=173 participants (68.2% female) and the average age was 52.5 years. 85.5% of the rehabilitation patients were fit for work six months after rehabilitation and returned to a job. Absenteeism, subjectively perceived performance, and work ability improved statistically significantly over time (p<0.01). The risk of early retirement still existed six months after rehabilitation in 41.3% of the study participants. The participation limitations were statistically significantly reduced during the follow-up with a medium effect size (ES=0.60, p<0.01). In the logistic regression, the WAI proved to be a significantly protective predictor of return to work, while cognitive corona symptoms and high levels of cognitive fatigue proved to be risk factors.

Conclusion: The majority of rehabilitation patients are gainfully employed six months after pneumological rehabilitation, although persistent symptoms and a reduced ability to work are also reported even after rehabilitation. In the rehabilitation of employed persons, work-related elements, for example clarification of work-related questions and preparation for occupational demands (e. g. concentration, stress, physical demands), could support a sustained return to work.

Background: Some people suffering from Covid-19 can be affected by persistent symptoms and long-term consequences of the disease (Long Covid) beyond their acute phase. Consequently, this can lead to restrictions in participation. Therefore, the focus is on medical rehabilitation in which Long Covid is treated as a new challenge.

Methods: A prospective, exploratory observational study will be conducted. The written survey of Long Covid rehabilitants takes place at the beginning and end of the pneumological rehabilitation. The aim of the study is to describe the rehabilitation contents and goals, the subjective burdens, the social and occupational participation as well as the health-related changes. Among other factors, disease-specific symptoms, quality of life, participation, psychological impairments, fatigue, and performance were recorded.

Results: Long Covid rehabilitants (N=221) participate in the written survey. At the end of rehabilitation, the questionnaire survey indicated significant improvements in almost all outcome parameters with a large effect (p<0.01; ES between 0.76 (anxiety) and 1.30 (fatigue)). All corona symptoms, such as breathlessness on exertion, fatigue or lack of strength improved significantly at the end of rehabilitation. Moreover, the rehabilitants most frequently name the improvement of their health (92%), the increase of their performance (92%) and the improvement of the respiratory muscle strength (78%) as rehabilitation goals. In fact, these goals are achieved by 60 to 70%, significantly fewer rehabilitation patients reach the restoration of their ability to work (32%) or a better ability to concentrate (17%). Respiratory physiotherapy, endurance training and medical training therapy are described as most helpful. At the end of rehabilitation, 76% rated their rehabilitation success as good to excellent based on a single question.

Conclusion: The first data of the study reveal that Long Covid rehabilitants are exposed to substantial burdens. Through medical rehabilitation, the patients experience medical and social support and experience significant improvements in all recorded health-related outcomes.

Purpose: The aim of the study was to provide an insight into the care situation of long COVID patients in inpatient medical rehabilitation facilities in Germany.

Methods: For this purpose, a standardized online survey was conducted among 1,080 inpatient medical rehabilitation facilities in Germany.

Results: A total of 338 cases were available for the analysis. Of these, 173 (51%) reported treating long COVID. The cumulative total number of rehabilitants with long COVID treated in the facilities up to the time of the survey was 11,948. The results showed that rehabilitation facilities were mostly prepared for the care of patients with Long COVID. Lack of capacity was reported especially by those rehabilitation facilities that treated rehabilitants with long COVID in pneumology departments. Furthermore, capacity bottlenecks were related to the total number of patients with long COVID in the rehabilitation facility ("proportion of rehabilitants with long COVID to all rehabilitants in the department"). Heterogeneity was found in the treatment concept for long COVID and the allocation of patients to a specific department.

Conclusion: The results of the long COVID inventory underline the importance of medical rehabilitation in the treatment of the long-term health and participation-related consequences of COVID-19.

Changes in the employment market and improvements in the current prosthetic treatment have encouraged German Statutory Health Insurance e. V. (DGUV) to re-examine the standard values for reduced earning capacity after work related accidents. The new standard values for reduced earning capacity came into force on 01.11.2019. The present article summarises the consensus paper of the group of independent experts.

Purpose: The aim of this study was to measure the status of digitalization and the opportunities and challenges for rehabilitation facilities connected to telematics infrastructure.

Methods: A partially standardized online survey of all providers of rehabilitation facilities in Bavaria (n=33) was carried out. The questionnaire with 36 questions included a scale based on the Electronic Medical Record Adoption Model (EMRAM).

Results: The level of digitization was reported as level 0 in 70% of the rehabilitation facilities (level model to 7). The transmission of patient-related data (incoming and outgoing) is often analogue, whereas the processing within the facility is already predominantly digital in many cases. When connecting to the telematics infrastructure, installation, training of staff and adaptation of work organization required quite a bit of effort.

Conclusion: Changes in the legal-financial situation in Germany open up new opportunities for increased digitalization of rehabilitation facilities. Hurdles are related to IT security requirements, staff training, and the low level of digitalization in hospitals, among doctors, and patients, which make digital data transmission difficult.