@misc{SalzwedelRabeZahnetal.2017, author = {Salzwedel, Annett and Rabe, Sophie and Zahn, Thomas and Neuwirth, Julia and Eichler, Sarah and Haubold, Kathrin and Wachholz, Anne and Reibis, Rona Katharina and V{\"o}ller, Heinz}, title = {User Interest in Digital Health Technologies to Encourage Physical Activity}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-401872}, pages = {8}, year = {2017}, abstract = {Background: Although the benefits for health of physical activity (PA) are well documented, the majority of the population is unable to implement present recommendations into daily routine. Mobile health (mHealth) apps could help increase the level of PA. However, this is contingent on the interest of potential users. Objective: The aim of this study was the explorative, nuanced determination of the interest in mHealth apps with respect to PA among students and staff of a university. Methods: We conducted a Web-based survey from June to July 2015 in which students and employees from the University of Potsdam were asked about their activity level, interest in mHealth fitness apps, chronic diseases, and sociodemographic parameters. Results: A total of 1217 students (67.30\%, 819/1217; female; 26.0 years [SD 4.9]) and 485 employees (67.5\%, 327/485; female; 42.7 years [SD 11.7]) participated in the survey. The recommendation for PA (3 times per week) was not met by 70.1\% (340/485) of employees and 52.67\% (641/1217) of students. Within these groups, 53.2\% (341/641 students) and 44.2\% (150/340 employees)—independent of age, sex, body mass index (BMI), and level of education or professional qualification—indicated an interest in mHealth fitness apps. Conclusions: Even in a younger, highly educated population, the majority of respondents reported an insufficient level of PA. About half of them indicated their interest in training support. This suggests that the use of personalized mobile fitness apps may become increasingly significant for a positive change of lifestyle.}, language = {en} } @misc{RauchDavosDohertyetal.2016, author = {Rauch, Bernhard and Davos, Constantinos H. and Doherty, Patrick and Saure, Daniel and Metzendorf, Maria-Inti and Salzwedel, Annett and V{\"o}ller, Heinz and Jensen, Katrin and Schmid, Jean-Paul}, title = {The prognostic effect of cardiac rehabilitation in the era of acute revascularisation and statin therapy}, series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, number = {418}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-405346}, pages = {26}, year = {2016}, abstract = {Background The prognostic effect of multi-component cardiac rehabilitation (CR) in the modern era of statins and acute revascularisation remains controversial. Focusing on actual clinical practice, the aim was to evaluate the effect of CR on total mortality and other clinical endpoints after an acute coronary event. Design Structured review and meta-analysis. Methods Randomised controlled trials (RCTs), retrospective controlled cohort studies (rCCSs) and prospective controlled cohort studies (pCCSs) evaluating patients after acute coronary syndrome (ACS), coronary artery bypass grafting (CABG) or mixed populations with coronary artery disease (CAD) were included, provided the index event was in 1995 or later. Results Out of n=18,534 abstracts, 25 studies were identified for final evaluation (RCT: n=1; pCCS: n=7; rCCS: n=17), including n=219,702 patients (after ACS: n=46,338; after CABG: n=14,583; mixed populations: n=158,781; mean follow-up: 40 months). Heterogeneity in design, biometrical assessment of results and potential confounders was evident. CCSs evaluating ACS patients showed a significantly reduced mortality for CR participants (pCCS: hazard ratio (HR) 0.37, 95\% confidence interval (CI) 0.20-0.69; rCCS: HR 0.64, 95\% CI 0.49-0.84; odds ratio 0.20, 95\% CI 0.08-0.48), but the single RCT fulfilling Cardiac Rehabilitation Outcome Study (CROS) inclusion criteria showed neutral results. CR participation was also associated with reduced mortality after CABG (rCCS: HR 0.62, 95\% CI 0.54-0.70) and in mixed CAD populations. Conclusions CR participation after ACS and CABG is associated with reduced mortality even in the modern era of CAD treatment. However, the heterogeneity of study designs and CR programmes highlights the need for defining internationally accepted standards in CR delivery and scientific evaluation.}, language = {en} } @misc{BaritelloSalzwedelSuendermannetal.2021, author = {Baritello, Omar and Salzwedel, Annett and S{\"u}ndermann, Simon and Niebauer, Josef and V{\"o}ller, Heinz}, title = {The Pandora's Box of frailty assessments: Which is the best for clinical purposes in TAVI patients? A critical review}, series = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, volume = {10}, journal = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, edition = {19}, publisher = {Universit{\"a}tsverlag Potsdam}, address = {Potsdam}, issn = {1866-8364}, doi = {10.25932/publishup-55044}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-550440}, pages = {1 -- 17}, year = {2021}, abstract = {Frailty assessment is recommended before elective transcatheter aortic valve implantation (TAVI) to determine post-interventional prognosis. Several studies have investigated frailty in TAVI-patients using numerous assessments; however, it remains unclear which is the most appropriate tool for clinical practice. Therefore, we evaluate which frailty assessment is mainly used and meaningful for ≤30-day and ≥1-year prognosis in TAVI patients. Randomized controlled or observational studies (prospective/retrospective) investigating all-cause mortality in older (≥70 years) TAVI patients were identified (PubMed; May 2020). In total, 79 studies investigating frailty with 49 different assessments were included. As single markers of frailty, mostly gait speed (23 studies) and serum albumin (16 studies) were used. Higher risk of 1-year mortality was predicted by slower gait speed (highest Hazard Ratios (HR): 14.71; 95\% confidence interval (CI) 6.50-33.30) and lower serum albumin level (highest HR: 3.12; 95\% CI 1.80-5.42). Composite indices (five items; seven studies) were associated with 30-day (highest Odds Ratio (OR): 15.30; 95\% CI 2.71-86.10) and 1-year mortality (highest OR: 2.75; 95\% CI 1.55-4.87). In conclusion, single markers of frailty, in particular gait speed, were widely used to predict 1-year mortality. Composite indices were appropriate, as well as a comprehensive assessment of frailty. View Full-Text}, language = {en} } @misc{EichlerSalzwedelRabeetal.2019, author = {Eichler, Sarah and Salzwedel, Annett and Rabe, Sophie and Mueller, Steffen and Mayer, Frank and Wochatz, Monique and Hadzic, Miralem and John, Michael and Wegscheider, Karl and V{\"o}ller, Heinz}, title = {The Effectiveness of Telerehabilitation as a Supplement to Rehabilitation in Patients After Total Knee or Hip Replacement}, series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, number = {589}, issn = {1866-8364}, doi = {10.25932/publishup-44096}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-440965}, pages = {14}, year = {2019}, abstract = {Background: Telerehabilitation can contribute to the maintenance of successful rehabilitation regardless of location and time. The aim of this study was to investigate a specific three-month interactive telerehabilitation routine regarding its effectiveness in assisting patients with physical functionality and with returning to work compared to typical aftercare. Objective: The aim of the study was to investigate a specific three-month interactive telerehabilitation with regard to effectiveness in functioning and return to work compared to usual aftercare. Methods: From August 2016 to December 2017, 111 patients (mean 54.9 years old; SD 6.8; 54.3\% female) with hip or knee replacement were enrolled in the randomized controlled trial. At discharge from inpatient rehabilitation and after three months, their distance in the 6-minute walk test was assessed as the primary endpoint. Other functional parameters, including health related quality of life, pain, and time to return to work, were secondary endpoints. Results: Patients in the intervention group performed telerehabilitation for an average of 55.0 minutes (SD 9.2) per week. Adherence was high, at over 75\%, until the 7th week of the three-month intervention phase. Almost all the patients and therapists used the communication options. Both the intervention group (average difference 88.3 m; SD 57.7; P=.95) and the control group (average difference 79.6 m; SD 48.7; P=.95) increased their distance in the 6-minute-walk-test. Improvements in other functional parameters, as well as in quality of life and pain, were achieved in both groups. The higher proportion of working patients in the intervention group (64.6\%; P=.01) versus the control group (46.2\%) is of note. Conclusions: The effect of the investigated telerehabilitation therapy in patients following knee or hip replacement was equivalent to the usual aftercare in terms of functional testing, quality of life, and pain. Since a significantly higher return-to-work rate could be achieved, this therapy might be a promising supplement to established aftercare.}, language = {en} } @misc{ReibisKuehlSalzwedeletal.2018, author = {Reibis, Rona Katharina and K{\"u}hl, Uwe and Salzwedel, Annett and Rasawieh, Mortesa and Eichler, Sarah and Wegscheider, Karl and V{\"o}ller, Heinz}, title = {Return to work in heart failure patients with suspected viral myocarditis}, series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, volume = {5}, journal = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, number = {378}, issn = {1866-8364}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-407637}, year = {2018}, abstract = {Background: Endomyocardial biopsy is considered as the gold standard in patients with suspected myocarditis. We aimed to evaluate the impact of bioptic findings on prediction of successful return to work. Methods: In 1153 patients (48.9 ± 12.4 years, 66.2\% male), who were hospitalized due to symptoms of left heart failure between 2005 and 2012, an endomyocardial biopsy was performed. Routine clinical and laboratory data, sociodemographic parameters, and noninvasive and invasive cardiac variables including endomyocardial biopsy were registered. Data were linked with return to work data from the German statutory pension insurance program and analyzed by Cox regression. Results: A total of 220 patients had a complete data set of hospital and insurance information. Three quarters of patients were virus-positive (54.2\% parvovirus B19, other or mixed infection 16.7\%). Mean invasive left ventricular ejection fraction was 47.1\% ± 18.6\% (left ventricular ejection fraction <45\% in 46.3\%). Return to work was achieved after a mean interval of 168.8 ± 347.7 days in 220 patients (after 6, 12, and 24 months in 61.3\%, 72.2\%, and 76.4\%). In multivariate regression analysis, only age (per 10 years, hazard ratio, 1.27; 95\% confidence interval, 1.10-1.46; p = 0.001) and left ventricular ejection fraction (per 5\% increase, hazard ratio, 1.07; 95\% confidence interval, 1.03-1.12; p = 0.002) were associated with increased, elevated work intensity (heavy vs light, congestive heart failure, 0.58; 95\% confidence interval, 0.34-0.99; p < 0.049) with decreased probability of return to work. None of the endomyocardial biopsy-derived parameters was significantly associated with return to work in the total group as well as in the subgroup of patients with biopsy-proven myocarditis. Conclusion: Added to established predictors, bioptic data demonstrated no additional impact for return to work probability. Thus, socio-medical evaluation of patients with suspected myocarditis furthermore remains an individually oriented process based primarily on clinical and functional parameters.}, language = {en} } @misc{SalzwedelHeidlerHauboldetal.2016, author = {Salzwedel, Annett and Heidler, Maria-Dorothea and Haubold, Kathrin and Schikora, Martin and Reibis, Rona Katharina and Wegscheider, Karl and J{\"o}bgens, Michael and V{\"o}ller, Heinz}, title = {Prevalence of mild cognitive impairment in employable patients after acute coronary event in cardiac rehabilitation}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-104113}, pages = {55 -- 60}, year = {2016}, abstract = {Introduction: Adequate cognitive function in patients is a prerequisite for successful implementation of patient education and lifestyle coping in comprehensive cardiac rehabilitation (CR) programs. Although the association between cardiovascular diseases and cognitive impairments (CIs) is well known, the prevalence particularly of mild CI in CR and the characteristics of affected patients have been insufficiently investigated so far. Methods: In this prospective observational study, 496 patients (54.5 ± 6.2 years, 79.8\% men) with coronary artery disease following an acute coronary event (ACE) were analyzed. Patients were enrolled within 14 days of discharge from the hospital in a 3-week inpatient CR program. Patients were tested for CI using the Montreal Cognitive Assessment (MoCA) upon admission to and discharge from CR. Additionally, sociodemographic, clinical, and physiological variables were documented. The data were analyzed descriptively and in a multivariate stepwise backward elimination regression model with respect to CI. Results: At admission to CR, the CI (MoCA score < 26) was determined in 182 patients (36.7\%). Significant differences between CI and no CI groups were identified, and CI group was associated with high prevalence of smoking (65.9 vs 56.7\%, P = 0.046), heavy (physically demanding) workloads (26.4 vs 17.8\%, P < 0.001), sick leave longer than 1 month prior to CR (28.6 vs 18.5\%, P = 0.026), reduced exercise capacity (102.5 vs 118.8 W, P = 0.006), and a shorter 6-min walking distance (401.7 vs 421.3 m, P = 0.021) compared to no CI group. The age- and education-adjusted model showed positive associations with CI only for sick leave more than 1 month prior to ACE (odds ratio [OR] 1.673, 95\% confidence interval 1.07-2.79; P = 0.03) and heavy workloads (OR 2.18, 95\% confidence interval 1.42-3.36; P < 0.01). Conclusion: The prevalence of CI in CR was considerably high, affecting more than one-third of cardiac patients. Besides age and education level, CI was associated with heavy workloads and a longer sick leave before ACE.}, language = {en} } @misc{ZochLesniakDobberkeSchlittetal.2020, author = {Zoch-Lesniak, Beate and Dobberke, Jeanette and Schlitt, Axel and Bongarth, Christa and Glatz, Johannes and Sp{\"o}rl-D{\"o}nch, Sieglinde and Koran, Iryna and V{\"o}ller, Heinz and Salzwedel, Annett}, title = {Performance Measures for Short-Term Cardiac Rehabilitation in Patients of Working Age}, series = {Postprints der Universit{\"a}t Potsdam : Mathematisch-Naturwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam : Mathematisch-Naturwissenschaftliche Reihe}, issn = {1866-8364}, doi = {10.25932/publishup-47392}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-473922}, pages = {16}, year = {2020}, abstract = {Objective: To determine immediate performance measures for short-term, multicomponent cardiac rehabilitation (CR) in clinical routine in patients of working age, taking into account cardiovascular risk factors, physical performance, social medicine, and subjective health parameters and to explore the underlying dimensionality. Design: Prospective observational multicenter register study in 12 rehabilitation centers throughout Germany. Setting: Comprehensive 3-week CR.}, language = {en} } @misc{SalzwedelReibisHadzicetal.2019, author = {Salzwedel, Annett and Reibis, Rona Katharina and Hadzic, Miralem and Buhlert, Hermann and V{\"o}ller, Heinz}, title = {Patients' expectations of returning to work, co-morbid disorders and work capacity at discharge from cardiac rehabilitation}, series = {Postprints der Universit{\"a}t Potsdam Humanwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam Humanwissenschaftliche Reihe}, number = {574}, issn = {1866-8364}, doi = {10.25932/publishup-43726}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-437263}, pages = {301 -- 308}, year = {2019}, abstract = {Objective: We aimed to characterize patients after an acute cardiac event regarding their negative expectations around returning to work and the impact on work capacity upon discharge from cardiac rehabilitation (CR). Methods: We analyzed routine data of 884 patients (52±7 years, 76\% men) who attended 3 weeks of inpatient CR after an acute coronary syndrome (ACS) or cardiac surgery between October 2013 and March 2015. The primary outcome was their status determining their capacity to work (fit vs unfit) at discharge from CR. Further, sociodemographic data (eg, age, sex, and education level), diagnoses, functional data (eg, exercise stress test and 6-min walking test [6MWT]), the Hospital Anxiety and Depression Scale (HADS) and self-assessment of the occupational prognosis (negative expectations and/or unemployment, W{\"u}rzburger screening) at admission to CR were considered. Results: A negative occupational prognosis was detected in 384 patients (43\%). Out of these, 368 (96\%) expected not to return to work after CR and/or were unemployed before CR at 29\% (n=113). Affected patients showed a reduced exercise capacity (bicycle stress test: 100 W vs 118 W, P<0.01; 6MWT: 380 m vs 421 m, P<0.01) and were more likely to receive a depression diagnosis (12\% vs 3\%, P<0.01), as well as higher levels on the HADS. At discharge from CR, 21\% of this group (n=81) were fit for work (vs 35\% of patients with a normal occupational prognosis (n=175, P<0.01)). Sick leave before the cardiac event (OR 0.4, 95\% CI 0.2-0.6, P<0.01), negative occupational expectations (OR 0.4, 95\% CI 0.3-0.7, P<0.01) and depression (OR 0.3, 95\% CI 0.1-0.8, P=0.01) reduced the likelihood of achieving work capacity upon discharge. In contrast, higher exercise capacity was positively associated. Conclusion: Patients with a negative occupational prognosis often revealed a reduced physical performance and suffered from a high psychosocial burden. In addition, patients' occupational expectations were a predictor of work capacity at discharge from CR. Affected patients should be identified at admission to allow for targeted psychosocial care.}, language = {en} } @misc{SalzwedelKoranLangheimetal.2020, author = {Salzwedel, Annett and Koran, Iryna and Langheim, Eike and Schlitt, Axel and Nothroff, J{\"o}rg and Bongarth, Christa and Wrenger, Markus and Sehner, Susanne and Reibis, Rona Katharina and Wegscheider, Karl and V{\"o}ller, Heinz}, title = {Patient-reported outcomes predict return to work and health-related quality of life six months after cardiac rehabilitation}, series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, number = {910}, issn = {1866-8364}, doi = {10.25932/publishup-46983}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-469839}, pages = {19}, year = {2020}, abstract = {Background Multi-component cardiac rehabilitation (CR) is performed to achieve an improved prognosis, superior health-related quality of life (HRQL) and occupational resumption through the management of cardiovascular risk factors, as well as improvement of physical performance and patients' subjective health. Out of a multitude of variables gathered at CR admission and discharge, we aimed to identify predictors of returning to work (RTW) and HRQL 6 months after CR. Design Prospective observational multi-centre study, enrolment in CR between 05/2017 and 05/2018. Method Besides general data (e.g. age, sex, diagnoses), parameters of risk factor management (e.g. smoking, hypertension), physical performance (e.g. maximum exercise capacity, endurance training load, 6-min walking distance) and patient-reported outcome measures (e.g. depression, anxiety, HRQL, subjective well-being, somatic and mental health, pain, lifestyle change motivation, general self-efficacy, pension desire and self-assessment of the occupational prognosis using several questionnaires) were documented at CR admission and discharge. These variables (at both measurement times and as changes during CR) were analysed using multiple linear regression models regarding their predictive value for RTW status and HRQL (SF-12) six months after CR. Results Out of 1262 patients (54±7 years, 77\% men), 864 patients (69\%) returned to work. Predictors of failed RTW were primarily the desire to receive pension (OR = 0.33, 95\% CI: 0.22-0.50) and negative self-assessed occupational prognosis (OR = 0.34, 95\% CI: 0.24-0.48) at CR discharge, acute coronary syndrome (OR = 0.64, 95\% CI: 0.47-0.88) and comorbid heart failure (OR = 0.51, 95\% CI: 0.30-0.87). High educational level, stress at work and physical and mental HRQL were associated with successful RTW. HRQL was determined predominantly by patient-reported outcome measures (e.g. pension desire, self-assessed health prognosis, anxiety, physical/mental HRQL/health, stress, well-being and self-efficacy) rather than by clinical parameters or physical performance. Conclusion Patient-reported outcome measures predominantly influenced return to work and HRQL in patients with heart disease. Therefore, the multi-component CR approach focussing on psychosocial support is crucial for subjective health prognosis and occupational resumption.}, language = {en} } @misc{SalzwedelNosperRoehrigetal.2012, author = {Salzwedel, Annett and Nosper, Manfred and R{\"o}hrig, Bernd and Linck-Eleftheriadis, Sigrid and Strandt, Gert and V{\"o}ller, Heinz}, title = {Outcome quality of in-patient cardiac rehabilitation in elderly patients - identification of relevant parameters}, series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, number = {390}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-404151}, pages = {9}, year = {2012}, abstract = {Background Outcome quality management requires the consecutive registration of defined variables. The aim was to identify relevant parameters in order to objectively assess the in-patient rehabilitation outcome. Methods From February 2009 to June 2010 1253 patients (70.9 ± 7.0 years, 78.1\% men) at 12 rehabilitation clinics were enrolled. Items concerning sociodemographic data, the impairment group (surgery, conservative/interventional treatment), cardiovascular risk factors, structural and functional parameters and subjective health were tested in respect of their measurability, sensitivity to change and their propensity to be influenced by rehabilitation. Results The majority of patients (61.1\%) were referred for rehabilitation after cardiac surgery, 38.9\% after conservative or interventional treatment for an acute coronary syndrome. Functionally relevant comorbidities were seen in 49.2\% (diabetes mellitus, stroke, peripheral artery disease, chronic obstructive lung disease). In three key areas 13 parameters were identified as being sensitive to change and subject to modification by rehabilitation: cardiovascular risk factors (blood pressure, low-density lipoprotein cholesterol, triglycerides), exercise capacity (resting heart rate, maximal exercise capacity, maximal walking distance, heart failure, angina pectoris) and subjective health (IRES-24 (indicators of rehabilitation status): pain, somatic health, psychological well-being and depression as well as anxiety on the Hospital Anxiety and Depression Scale). Conclusion The outcome of in-patient rehabilitation in elderly patients can be comprehensively assessed by the identification of appropriate key areas, that is, cardiovascular risk factors, exercise capacity and subjective health. This may well serve as a benchmark for internal and external quality management.}, language = {en} }