@article{SalzwedelHeidlerMengetal.2020,
  author    = {Salzwedel, Annett and Heidler, Maria-Dorothea and Meng, Karin and Schikora, Martin and Wegscheider, Karl and Reibis, Rona Katharina and V{\"o}ller, Heinz},
  title     = {Impact of cognitive performance on disease-related knowledge six months after multi-component rehabilitation in patients after an acute cardiac event},
  series = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology},
  volume    = {26},
  journal   = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology},
  number    = {1},
  publisher = {Sage Publ.},
  address   = {London},
  issn      = {2047-4873},
  doi       = {10.1177/2047487318791609},
  pages     = {46 -- 55},
  year      = {2020},
  abstract  = {Background Although associations between cardiovascular diseases and cognitive impairment are well known, the impact of cognitive performance on the success of patient education as a core component of cardiac rehabilitation remains insufficiently investigated so far. Design Prospective observational study in two inpatient cardiac rehabilitation centres between September 2014 and August 2015 with a follow-up six months after cardiac rehabilitation. Method At admission to and discharge from cardiac rehabilitation, the cognitive performance of 401 patients (54.5 ± 6.3 years, 80\% men) following an acute coronary syndrome and/or coronary artery bypass graft was tested using the Montreal Cognitive Assessment. Patients' disease-related knowledge was determined using a quiz (22 items for medical knowledge and 12 items for healthy lifestyle and behaviour) at both times and at follow-up. The change in knowledge after cardiac rehabilitation was analysed in multivariable regression models. Potentially influencing parameters (e.g. level of education, medication, cardiovascular risk factors, coronary artery bypass graft, comorbidities, exercise capacity) were considered. Results During cardiac rehabilitation, disease-related knowledge was significantly enhanced in both scales. At follow-up, the average level of medical knowledge was significantly reduced, while lifestyle knowledge remained at a stable level. The maintenance of knowledge after cardiac rehabilitation was predominantly predicted by prior knowledge, cognitive performance at discharge from cardiac rehabilitation and, in the case of medical knowledge, by coronary artery bypass graft. Conclusion Patient education in cardiac rehabilitation led to enhanced disease-related knowledge, but the maintenance of this essentially depended on patients' cognitive performance, especially after coronary artery bypass graft. Therefore, patient education concepts in cardiac rehabilitation should be reconsidered and adjusted as needed.},
  language  = {en}
}
@article{MainkaWisselVoelleretal.2018,
  author    = {Mainka, Stefan and Wissel, J{\"o}rg and V{\"o}ller, Heinz and Evers, Stefan},
  title     = {The Use of Rhythmic Auditory Stimulation to Optimize Treadmill Training for Stroke Patients},
  series = {Frontiers in Neurology},
  volume    = {9},
  journal   = {Frontiers in Neurology},
  publisher = {Frontiers Research Foundation},
  address   = {Lausanne},
  issn      = {1664-2295},
  doi       = {10.3389/fneur.2018.00755},
  pages     = {8},
  year      = {2018},
  abstract  = {The use of functional music in gait training termed rhythmic auditory stimulation (RAS) and treadmill training (TT) have both been shown to be effective in stroke patients (SP). The combination of RAS and treadmill training (RAS-TT) has not been clinically evaluated to date. The aim of the study was to evaluate the efficacy of RAS-TT on functional gait in SR The protocol followed the design of an explorative study with a rater-blinded three arm prospective randomized controlled parallel group design. Forty-five independently walking SP with a hemiparesis of the lower limb or an unsafe and asymmetrical walking pattern were recruited. RAS-TT was carried out over 4 weeks with TT and neurodevelopmental treatment based on Bobath approach (NDT) serving as control interventions. For RAS-TT functional music was adjusted individually while walking on the treadmill. Pre and post-assessments consisted of the fast gait speed test (FGS), a gait analysis with the locometre (LOC), 3 min walking time test (3MWT), and an instrumental evaluation of balance (IEB). Raters were blinded to group assignments. An analysis of covariance (ANCOVA) was performed with affiliated measures from pre-assessment and time between stroke and start of study as covariates. Thirty-five participants (mean age 63.6 +/- 8.6 years, mean time between stroke and start of study 42.1 +/- 23.7 days) completed the study (11 RAS-TT, 13 TT, 11 NDT). Significant group differences occurred in the FGS for adjusted post-measures in gait velocity [F-(2,F- (34)) = 3.864, p = 0.032; partial eta(2) = 0.205] and cadence [F-(2,F- 34) = 7.656, p = 0.002; partial eta(2) = 0.338]. Group contrasts showed significantly higher values for RAS-TT. Stride length results did not vary between the groups. LOC, 3MWT, and IEB did not indicate group differences. One patient was withdrawn from TT because of pain in one arm. The study provides first evidence for a higher efficacy of RAS-TT in comparison to the standard approaches TT and NDT in restoring functional gait in SP. The results support the implementation of functional music in neurological gait rehabilitation and its use in combination with treadmill training.},
  language  = {en}
}
@article{HansenAbreuDohertyetal.2019,
  author    = {Hansen, Dominique and Abreu, Ana and Doherty, Patrick and V{\"o}ller, Heinz},
  title     = {Dynamic strength training intensity in cardiovascular rehabilitation: is it time to reconsider clinical practice? A systematic review},
  series = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology},
  volume    = {26},
  journal   = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology},
  number    = {14},
  publisher = {Sage Publ.},
  address   = {London},
  issn      = {2047-4873},
  doi       = {10.1177/2047487319847003},
  pages     = {1483 -- 1492},
  year      = {2019},
  abstract  = {When added to endurance training, dynamic strength training leads to significantly greater improvements in peripheral muscle strength and power output in patients with cardiovascular disease, which may be relevant to enhance the patient's prognosis. As a result, dynamic strength training is recommended in the rehabilitative treatment of many different cardiovascular diseases. However, what strength training intensity should be selected remains under intense debate. Evidence is nonetheless emerging that high-intensity strength training (≥70\% of one-repetition maximum) is more effective to increase acutely myofibrillar protein synthesis, cause neural adaptations and, in the long term, increase muscle strength, when compared to low-intensity strength training. Moreover, multiple studies report that high-intensity strength training causes fewer increments in (intra-)arterial blood pressure and cardiac output, as opposed to low-intensity strength training, thus potentially pointing towards sufficient medical safety for the cardiovascular system. The aim of this systematic review is therefore to discuss this line of evidence, which is in contrast to current clinical practice, and to re-open the debate as to what dynamic strength training intensities should actually be applied.},
  language  = {en}
}
@article{AlgharablyBolbrinkerLeziusetal.2017,
  author    = {Algharably, Engi A. H. and Bolbrinker, Juliane and Lezius, Susanne and Reibis, Rona Katharina and Wegscheider, Karl and V{\"o}ller, Heinz and Kreutz, Reinhold},
  title     = {Uromodulin associates with cardiorenal function in patients with hypertension and cardiovascular disease},
  series = {Journal of hypertension},
  volume    = {35},
  journal   = {Journal of hypertension},
  publisher = {Lippincott Williams \& Wilkins},
  address   = {Philadelphia},
  issn      = {0263-6352},
  doi       = {10.1097/HJH.0000000000001432},
  pages     = {2053 -- 2058},
  year      = {2017},
  abstract  = {Objective:Common genetic variants in the gene encoding uromodulin (UMOD) have been associated with renal function, blood pressure (BP) and hypertension. We investigated the associations between an important single nucleotide polymorphism (SNP) in UMOD, that is rs12917707-G>T, and estimated glomerular filtration rate (eGFR), BP and cardiac organ damage as determined by echocardiography in patients with arterial hypertension.Methods:A cohort of 1218 treated high-risk patients (mean age 58.5 years, 83\% men) with documented cardiovascular disease (81\% with coronary heart disease) was analysed.Results:The mean values for 24-h SBP and DBP were 124.714.7 and 73.9 +/- 9.4mmHg; mean eGFR was 77.5 +/- 18.3ml/min per 1.73m(2), mean left ventricular ejection fraction was 59.3 +/- 9.9\% and mean left ventricular mass index in men and women was 53.9 +/- 23.2 and 54.9 +/- 23.7g/m(2.7) with 50.4\% of patients having left ventricular hypertrophy. A significant association between rs12917707 and eGFR was observed with T-allele carriers showing significantly higher eGFR values (+2.6ml/min per 1.73m(2), P=0.006) than noncarriers. This SNP associated also with left atrial diameter (P=0.007); homozygous carriers of the T-allele had smaller left atrial diameter (-1.5mm) than other genotype groups (P=0.040). No significant associations between rs12917707 and other cardiac or BP phenotypes were observed.Conclusions:These findings extend the previously documented role of UMOD for renal function also to treated high-risk patients with arterial hypertension and reveal a novel association with left atrial remodelling and thus a potential cardiorenal link modulated by UMOD.},
  language  = {en}
}
@article{SalzwedelReibisHeidleretal.2019,
  author    = {Salzwedel, Annett and Reibis, Rona Katharina and Heidler, Maria-Dorothea and Wegscheider, Karl and V{\"o}ller, Heinz},
  title     = {Determinants of Return to Work After Multicomponent Cardiac Rehabilitation},
  series = {Archives of Physical Medicine and Rehabilitation},
  volume    = {100},
  journal   = {Archives of Physical Medicine and Rehabilitation},
  number    = {12},
  publisher = {Elsevier},
  address   = {Philadelphia},
  issn      = {0003-9993},
  doi       = {10.1016/j.apmr.2019.04.003},
  pages     = {2399 -- 2402},
  year      = {2019},
  abstract  = {Objectives: To explore predictors of return to work in patients after acute coronary syndrome and coronary artery bypass grafting, taking into account cognitive performance, depression, physical capacity, and self-assessment of the occupational prognosis. Design: Observational, prospective, bicentric. Setting: Postacute 3-week inpatient cardiac rehabilitation (CR). Participants: Patients (N=401) <65 years of age (mean 54.5 +/- 6.3y), 80\% men. Interventions: Not applicable. Main Outcome Measures: Status of return to work (RTW) 6 months after discharge from CR. Results: The regression model for RTW showed negative associations for depression (odds ratio 0.52 per SD, 95\% confidence interval 0.36-0.76, P=.001), age (odds ratio 0.72, 95\% confidence interval 0.52-1.00, P=.047), and in particular for a negative subjective occupational prognosis (expected incapacity for work odds ratio 0.19, 95\% confidence interval 0.06-0.59, P=.004; unemployment odds ratio 0.08, 95\% confidence interval 0.01-0.72, P=.024; retirement odds ratio 0.07, 95\% confidence interval 0.01-0.067, P=.021). Positive predictors were employment before the cardiac event (odds ratio 9.66, 95\% confidence interval 3.10-30.12, P<.001), capacity to work (fit vs unfit) at discharge from CR (odds ratio 3.15, 95\% confidence interval 1.35-7.35, P=.008), and maximum exercise capacity (odds ratio 1.49, 95\% confidence interval 1.06-2.11, P=.022). Cognitive performance had no effect.},
  language  = {en}
}
@misc{SalzwedelVoellerReibis2019,
  author    = {Salzwedel, Annett and V{\"o}ller, Heinz and Reibis, Rona Katharina},
  title     = {Vocational reintegration in coronary heart disease patients - the holistic approach of the WHO biopsychosocial concept},
  series = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology},
  volume    = {26},
  journal   = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology},
  number    = {13},
  publisher = {Sage Publ.},
  address   = {London},
  issn      = {2047-4873},
  doi       = {10.1177/2047487319850699},
  pages     = {1383 -- 1385},
  year      = {2019},
  language  = {en}
}
@article{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 = {PLoS ONE},
  volume    = {15},
  journal   = {PLoS ONE},
  number    = {5},
  publisher = {Plos 1},
  address   = {San Francisco},
  issn      = {1932-6203},
  doi       = {10.1371/journal.pone.0232752},
  pages     = {17},
  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}
}
@article{VoellerHeyne2020,
  author    = {V{\"o}ller, Heinz and Heyne, Karen},
  title     = {Evaluation of the Accuracy of the LumiraDx INR Test Using Patients in Receipt of Phenprocoumon Anticoagulation Therapy},
  series = {Point of care : the journal of near-patient testing \& technology},
  volume    = {19},
  journal   = {Point of care : the journal of near-patient testing \& technology},
  number    = {3},
  publisher = {Lippincott Williams \& Wilkins},
  address   = {Philadelphia},
  issn      = {1533-029X},
  doi       = {10.1097/POC.0000000000000207},
  pages     = {72 -- 76},
  year      = {2020},
  abstract  = {Background: The LumiraDx INR Test is a new point-of-care diagnostic test designed to analyze fingerstick blood samples. The test was assessed in patients receiving phenprocoumon (NCT04074980). Methods: Venous plasma international normalized ratio (INR) was measured using the LumiraDx INR Test. LumiraDx INR Test-ascertained capillary whole blood INR was compared with venous plasma INR measured using the IL ACL Elite Pro and Sysmex CS-5100 reference instruments. Results: A total of 102 patients receiving phenprocoumon were recruited. The INR results from venous plasma and capillary whole blood that were analyzed on the LumiraDx INR Test correlated well with those measured using the IL ACL Elite Pro (plasma: n = 25, r = 0.981; capillary blood: n = 74, r = 0.949) and the Sysmex CS-5100 (n = 73, r = 0.950). Conclusions: The LumiraDx INR Test showed high accuracy in analyzing venous plasma and capillary whole blood from patients receiving phenprocoumon.},
  language  = {en}
}
@article{EichlerSalzwedelHarnathetal.2018,
  author    = {Eichler, Sarah and Salzwedel, Annett and Harnath, Axel and Butter, Christian and Wegscheider, Karl and Chiorean, Mihai and V{\"o}ller, Heinz and Reibis, Rona Katharina},
  title     = {Nutrition and mobility predict all-cause mortality in patients 12 months after transcatheter aortic valve implantation},
  series = {Clinical research in cardiology : official journal of the German Cardiac Society.},
  volume    = {107},
  journal   = {Clinical research in cardiology : official journal of the German Cardiac Society.},
  number    = {4},
  publisher = {Springer},
  address   = {Heidelberg},
  issn      = {1861-0684},
  doi       = {10.1007/s00392-017-1183-1},
  pages     = {304 -- 311},
  year      = {2018},
  abstract  = {The aim of the study was to determine pre-interventional predictors for all-cause mortality in patients after transcatheter aortic valve implantation (TAVI) with a 12-month follow-up. From 10/2013 to 07/2015, 344 patients (80.9 +/- 5.0 years, 44.5\% male) with an elective TAVI were consecutively enrolled prospectively in a multicentre cohort study. Prior to the intervention, sociodemographic parameters, echocardiographic data and comorbidities were documented. All patients performed a 6-min walk test, Short Form 12 and a Frailty Index (score consisting of activities of daily living, cognition, nutrition and mobility). Peri-interventional complications were documented. Vital status was assessed over telephone 12 months after TAVI. Predictors for all-cause mortality were identified using a multivariate regression model. At discharge, 333 patients were alive (in-hospital mortality 3.2\%; n = 11). During a follow-up of 381.0 +/- 41.9 days, 46 patients (13.8\%) died. The non-survivors were older (82.3 +/- 5.0 vs. 80.6 +/- 5.1 years; p = 0.035), had a higher number of comorbidities (2.6 +/- 1.3 vs. 2.1 +/- 1.3; p = 0.026) and a lower left ventricular ejection fraction (51.0 +/- 13.6 vs. 54.6 +/- 10.6\%; p = 0.048). Additionally, more suffered from diabetes mellitus (60.9 vs. 44.6\%; p = 0.040). While the global Frailty Index had no predictive power, its individual components, particularly nutrition (OR 0.83 per 1 pt., CI 0.72-0.95; p = 0.006) and mobility (OR 5.12, CI 1.64-16.01; p = 0.005) had a prognostic impact. Likewise, diabetes mellitus (OR 2.18, CI 1.10-4.32; p = 0.026) and EuroSCORE (OR 1.21 per 5\%, CI 1.07-1.36; p = 0.002) were associated with a higher risk of all-cause mortality. Besides EuroSCORE and diabetes mellitus, nutrition status and mobility of patients scheduled for TAVI offer prognostic information for 1-year all-cause mortality and should be advocated in the creation of contemporary TAVI risk scores.},
  language  = {en}
}
@article{HadzicEichlerVoelleretal.2022,
  author    = {Hadzic, Miralem and Eichler, Sarah and V{\"o}ller, Heinz and Salzwedel, Annett},
  title     = {Akzeptanz und Nutzung eines telemedizinischen Rehabilitationsprogramms f{\"u}r Patienten mit Knie- oder H{\"u}ft-Totalendoprothese},
  series = {Bewegungstherapie und Gesundheitssport : B \& G ; offizielles Organ des Deutschen Verbandes f{\"u}r Gesundheitssport und Sporttherapie e.V. (DVGS)},
  volume    = {38},
  journal   = {Bewegungstherapie und Gesundheitssport : B \& G ; offizielles Organ des Deutschen Verbandes f{\"u}r Gesundheitssport und Sporttherapie e.V. (DVGS)},
  number    = {01},
  publisher = {Thieme},
  address   = {Stuttgart},
  organization    = {Arbeitsgrp ReMove-It},
  issn      = {1613-0863},
  doi       = {10.1055/a-1714-3629},
  pages     = {20 -- 25},
  year      = {2022},
  abstract  = {Objective of the study: The long-term use of telemedical programs depends not only on their effectiveness, but also on patient acceptance and satisfaction. The effectiveness of telemedical exercise therapy for patients after implantation of a total knee or hip prosthesis and subsequent rehabilitation has already been examined in a randomized controlled study. This article focuses on the patient's acceptance and usage behaviour with regard to the tele-rehabilitation system. Methodology: 48 patients (53 +/- 7 years; 26 women; 35 hip/13 knee TEP) were questioned after a three-month telemedical movement therapy using the Telehealth Usability Questionnaire (TUQ) to determine the acceptance of the technology. The questionnaire consisted of 21 items (seven-point Likert scale) in six scales (e. g. usefulness, quality of interactions, reliability). System-specific questions were summarized on an additional scale. The results were presented as a percentage of the scale (100 estimates complete agreement). The usage behaviour was examined using system-generated process data for training and integrated voice/text messages. Results: The TUQ scales "Usefulness" (Mdn 95.2) and "Ease of use and learnability" (Mdn 92.9) were rated the highest, while "Reliability" (Mdn 57.1) and "Quality of interactions" ( Mdn 71.4) showed the lowest levels. The system-specific scale was placed in the upper quartile (Mdn 85.7). In the first week, 39 patients (81\%) and in the second 45 patients (94\%) performed at least one training exercise with the system. The proportion of active patients (>= 1 exercise/week) decreased in the further course to 75\% (n=36) in the 7th week and 48\% (n=23) in the 12th week. The system communication options were initially used frequently after the start of therapy: in the first week, 42 patients (88\%) sent messages, 47 patients (98\%) received messages from their therapist respectively. In week 7, 9 (19\%) and 13 (27\%) patients sent/received messages via the system respectively. Conclusion: Most of the patients perceived telemedical movement therapy as useful and user-friendly and seemed to be largely satisfied with the system. This proved to be well suited for short-term use of 6 to 8 weeks following subsequent rehabilitation.},
  language  = {de}
}
@article{HeidlerSalzwedelJoebgesetal.2018,
  author    = {Heidler, Maria-Dorothea and Salzwedel, Annett and J{\"o}bges, Michael and L{\"u}ck, Olaf and Dohle, Christian and Seifert, Michael and von Helden, Andrea and Hollweg, Wibke and V{\"o}ller, Heinz},
  title     = {Decannulation of tracheotomized patients after long-term mechanical ventilation - results of a prospective multicentric study in German neurological early rehabilitation hospitals},
  series = {BMC Anesthesiology},
  volume    = {18},
  journal   = {BMC Anesthesiology},
  publisher = {BMC},
  address   = {London},
  issn      = {1471-2253},
  doi       = {10.1186/s12871-018-0527-3},
  pages     = {7},
  year      = {2018},
  abstract  = {Background: In the course of neurological early rehabilitation, decannulation is attempted in tracheotomized patients after weaning due to its considerable prognostic significance. We aimed to identify predictors of a successful tracheostomy decannulation. Methods: From 09/2014 to 03/2016, 831 tracheotomized and weaned patients (65.4 +/- 12.9 years, 68\% male) were included consecutively in a prospective multicentric observation study. At admission, sociodemographic and clinical data (e.g. relevant neurological and internistic diseases, duration of mechanical ventilation, tracheotomy technique, and nutrition) as well as functional assessments (Coma Recovery Scale-Revised (CRS-R), Early Rehabilitation Barthel Index, Bogenhausener Dysphagia Score) were collected. Complications and the success of the decannulation procedure were documented at discharge. Results: Four hundred seventy patients (57\%) were decannulated. The probability of decannulation was significantly negatively associated with increasing age (OR 0.68 per SD = 12.9 years, p < 0.001), prolonged duration of mechanical ventilation (OR 0.57 per 33.2 days, p < 0.001) and complications. An oral diet (OR 3.80; p < 0.001) and a higher alertness at admission (OR 3.07 per 7.18 CRS-R points; p < 0.001) were positively associated. Conclusions: This study identified practically measurable predictors of decannulation, which in the future can be used for a decannulation prognosis and supply optimization at admission in the neurological early rehabilitation clinic.},
  language  = {en}
}
@article{SalzwedelHeidlerHauboldetal.2017,
  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},
  series = {Vascular Health and Risk Management},
  volume    = {13},
  journal   = {Vascular Health and Risk Management},
  publisher = {Dove Medical Press Ltd},
  address   = {Albany, Auckland},
  issn      = {1176-6344},
  doi       = {10.2147/VHRM.S121086},
  pages     = {55 -- 60},
  year      = {2017},
  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{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}
}
@article{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 = {Vascular Health and Risk Management},
  volume    = {15},
  journal   = {Vascular Health and Risk Management},
  publisher = {Dove Medical Press},
  address   = {Albany, Auckland},
  issn      = {1176-6344},
  doi       = {10.2147/VHRM.S216039},
  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{SalzwedelHadzicBuhlertetal.2018,
  author    = {Salzwedel, Annett and Hadzic, Miralem and Buhlert, Hermann and V{\"o}ller, Heinz},
  title     = {Impact of self-assessment of return to work on employable discharge from multi-component cardiac rehabilitation},
  series = {European heart journal},
  volume    = {39},
  journal   = {European heart journal},
  publisher = {Oxford Univ. Press},
  address   = {Oxford},
  issn      = {0195-668X},
  pages     = {21 -- 22},
  year      = {2018},
  abstract  = {Impact of self-assessment of return to work on employable discharge from multi-component cardiac rehabilitation. Retrospective unicentric analysis of routine data from cardiac rehabilitation in patients below 65 years of age. Presentation in the "Cardiovascular rehabilitation revisited" high impact abstract session during ESC Congress 2018.},
  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{ReibisSalzwedelBonaventuraetal.2017,
  author    = {Reibis, Rona Katharina and Salzwedel, Annett and Bonaventura, Klaus and V{\"o}ller, Heinz and Wegscheider, Karl},
  title     = {Improvement of left ventricular ejection fraction in revascularized postmyocardial patients},
  series = {Postprints der Universit{\"a}t Potsdam : Mathematisch Naturwissenschaftliche Reihe},
  journal   = {Postprints der Universit{\"a}t Potsdam : Mathematisch Naturwissenschaftliche Reihe},
  number    = {882},
  issn      = {1866-8372},
  doi       = {10.25932/publishup-43509},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-435093},
  pages     = {10},
  year      = {2017},
  abstract  = {BACKGROUND: Reduced left ventricular ejection fraction (LVEF) ≤30\% is the most powerful prognostic indicator for sudden cardiac death (SCD) in patients after myocardial infarction (MI), but there are little data about long-term changes of LVEF after revascularization and the following implantation of a cardioverter defibrillator (ICD). METHODS: We performed a retrospective analysis of 277 patients with reduced LVEF at least 1month after MI and complete revascularization. Patients (median time post-MI 23.4months; 74.3\% after PCI, 25.7\% after CABG were assigned either to group 1 (LVEF<30\%) or group 2 (LVEF 30-40\%). Biplane echocardiography was redone after a mean follow-up of 441±220days. RESULTS: LVEF increased significantly in both two groups (group 1: 26.2±4.8\% to 32.4±8.5\%; p<0.001; group 2: 38.2±2.5\% to 44.4±9.6\%; p<0.001). However, statistical analysis of first and second LVEF measurement by means of a LOWESS regression and with an appropriate correction of the regression towards the mean effect revealed only a moderate increase of the mean LVEF from 35 to 37\% (p<0.001) with a large interindividual variation. CONCLUSIONS: The impact of early revascularization on LVEF appears to be low in the majority of post-MI heart failure patients. Owing to the high variability, a single measurement may not be reliable enough to justify a decision on ICD indication.},
  language  = {en}
}
@article{SalzwedelJensenRauchetal.2020,
  author    = {Salzwedel, Annett and Jensen, Katrin and Rauch, Bernhard and Doherty, Patrick and Metzendorf, Maria-Inti and Hackbusch, Matthes and V{\"o}ller, Heinz and Schmid, Jean-Paul and Davos, Constantinos H.},
  title     = {Effectiveness of comprehensive cardiac rehabilitation in coronary artery disease patients treated according to contemporary evidence based medicine},
  series = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology},
  volume    = {27},
  journal   = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology},
  number    = {16},
  publisher = {Oxford Univ. Press},
  address   = {Oxford},
  organization    = {Univ Heidelberg Heinrich Heine Univ},
  issn      = {2047-4873},
  doi       = {10.1177/2047487320905719},
  pages     = {1756 -- 1774},
  year      = {2020},
  abstract  = {Background Despite numerous studies and meta-analyses the prognostic effect of cardiac rehabilitation is still under debate. This update of the Cardiac Rehabilitation Outcome Study (CROS II) provides a contemporary and practice focused approach including only cardiac rehabilitation interventions based on published standards and core components to evaluate cardiac rehabilitation delivery and effectiveness in improving patient prognosis. Design A systematic review and meta-analysis. Methods Randomised controlled trials and retrospective and prospective controlled cohort studies evaluating patients after acute coronary syndrome, coronary artery bypass grafting or mixed populations with coronary artery disease published until September 2018 were included. Resulte Based on CROS inclusion criteria out of 7096 abstracts six additional studies including 8671 patients were identified (two randomised controlled trials, two retrospective controlled cohort studies, two prospective controlled cohort studies). In total, 31 studies including 228,337 patients were available for this meta-analysis (three randomised controlled trials, nine prospective controlled cohort studies, 19 retrospective controlled cohort studies; 50,653 patients after acute coronary syndrome 14,583, after coronary artery bypass grafting 163,101, mixed coronary artery disease populations; follow-up periods ranging from 9 months to 14 years). Heterogeneity in design, cardiac rehabilitation delivery, biometrical assessment and potential confounders was considerable. Controlled cohort studies showed a significantly reduced total mortality (primary endpoint) after cardiac rehabilitation participation in patients after acute coronary syndrome (prospective controlled cohort studies: hazard ratio (HR) 0.37, 95\% confidence interval (CI) 0.20-0.69; retrospective controlled cohort studies HR 0.64, 95\% CI 0.53-0.76; prospective controlled cohort studies odds ratio 0.20, 95\% CI 0.08-0.48), but the single randomised controlled trial fulfilling the CROS inclusion criteria showed neutral results. Cardiac rehabilitation participation was also associated with reduced total mortality in patients after coronary artery bypass grafting (retrospective controlled cohort studies HR 0.62, 95\% CI 0.54-0.70, one single randomised controlled trial without fatal events), and in mixed coronary artery disease populations (retrospective controlled cohort studies HR 0.52, 95\% CI 0.36-0.77; two out of 10 controlled cohort studies with neutral results). Conclusion CROS II confirms the effectiveness of cardiac rehabilitation participation after acute coronary syndrome and after coronary artery bypass grafting in actual clinical practice by reducing total mortality under the conditions of current evidence-based coronary artery disease treatment. The data of CROS II, however, underscore the urgent need to define internationally accepted minimal standards for cardiac rehabilitation delivery as well as for scientific evaluation.},
  language  = {en}
}
@misc{MainkaWisselVoelleretal.2018,
  author    = {Mainka, Stefan and Wissel, J{\"o}rg and V{\"o}ller, Heinz and Evers, Stefan},
  title     = {The use of rhythmic auditory stimulation to optimize treadmill training for stroke patients},
  series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  journal   = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  number    = {655},
  issn      = {1866-8364},
  doi       = {10.25932/publishup-45917},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-459179},
  pages     = {10},
  year      = {2018},
  abstract  = {The use of functional music in gait training termed rhythmic auditory stimulation (RAS) and treadmill training (TT) have both been shown to be effective in stroke patients (SP). The combination of RAS and treadmill training (RAS-TT) has not been clinically evaluated to date. The aim of the study was to evaluate the efficacy of RAS-TT on functional gait in SR The protocol followed the design of an explorative study with a rater-blinded three arm prospective randomized controlled parallel group design. Forty-five independently walking SP with a hemiparesis of the lower limb or an unsafe and asymmetrical walking pattern were recruited. RAS-TT was carried out over 4 weeks with TT and neurodevelopmental treatment based on Bobath approach (NDT) serving as control interventions. For RAS-TT functional music was adjusted individually while walking on the treadmill. Pre and post-assessments consisted of the fast gait speed test (FGS), a gait analysis with the locometre (LOC), 3 min walking time test (3MWT), and an instrumental evaluation of balance (IEB). Raters were blinded to group assignments. An analysis of covariance (ANCOVA) was performed with affiliated measures from pre-assessment and time between stroke and start of study as covariates. Thirty-five participants (mean age 63.6 +/- 8.6 years, mean time between stroke and start of study 42.1 +/- 23.7 days) completed the study (11 RAS-TT, 13 TT, 11 NDT). Significant group differences occurred in the FGS for adjusted post-measures in gait velocity [F-(2,F- (34)) = 3.864, p = 0.032; partial eta(2) = 0.205] and cadence [F-(2,F- 34) = 7.656, p = 0.002; partial eta(2) = 0.338]. Group contrasts showed significantly higher values for RAS-TT. Stride length results did not vary between the groups. LOC, 3MWT, and IEB did not indicate group differences. One patient was withdrawn from TT because of pain in one arm. The study provides first evidence for a higher efficacy of RAS-TT in comparison to the standard approaches TT and NDT in restoring functional gait in SP. The results support the implementation of functional music in neurological gait rehabilitation and its use in combination with treadmill training.},
  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}
}