TY - JOUR A1 - Marx, R. A1 - Philips, H. A1 - Bassenge, D. A1 - Nosper, M. A1 - Roehrig, B. A1 - Linck-Eleftheriadis, S. A1 - Strandt, G. A1 - Salzwedel, Annett A1 - Pabst, F. T1 - Progress of Rehabilitation for Cardiac Patients Depending on the Degree of Self-Sufficiency at Admission JF - Die Rehabilitation : Zeitschrift für Praxis und Forschung in der Rehabilitation N2 - Zusammenfassung Ziel der Studie: Es existieren kaum Publikationen uber das Rehabilitationsergebnis kardiologischer Patienten unter Berucksichtigung eines erhohten medizinischen, pflegerischen und therapeutischen Versorgungsaufwands (Barthel-Index70). Es war Ziel der Studie, die in einem Zeitraum von 2 Jahren aufgenommen Rehabilitanden (n=387) einer gesetzlichen Krankenkasse, aufgeteilt in jeweils eine Gruppe selbstversorgender und versorgungsaufwandiger Patienten, bezuglich ihrer Unterschiede in dem Rehabilitationsergebnis zu uberprufen. Methodik: In Abhangigkeit des Versorgungsaufwandes wurde das Rehabilitationsergebnis sowie Unterschiede im Verlauf hinsichtlich der korperlichen Leistungsfahigkeit, des emotionalen Status und der Aktivitaten des taglichen Lebens, gemessen an Barthelindex, FIM-Index, HADS-Werten, Komplikationen, Funktionsuntersuchungen, Belastungstests, Rehabilitationsdauer und Entlassungsform, gepruft. Ergebnisse: Die in Hinblick auf medizinischen, pflegerischen und therapeutischen Aufwand versorgungsaufwandigen Patienten waren alter, langer im Krankenhaus und in der Rehabilitation, sie hatten mehr Komplikationen und deutlich mehr Begleiterkrankungen. Sie wurden haufiger ins Akutkrankenhaus verlegt. Sie hatten eine hohere Steigerungsrate der Selbstversorgungsindices und eine relevante Steigerung bei den Belastungstests. Schlussfolgerung: Ein hoher Versorgungsaufwand multimorbider kardiologischer Patienten ist keine Kontraindikation gegen eine Rehabilitation, da auch bei dieser Patientengruppe die tragerspezifischen Rehabilitationsziele erreicht wurden. Abstract Introduction: There are hardly any publications about the outcome of cardiac rehabilitation considering patients with an increased need for medical, nursing and therapeutic care. The aim of this study, which consecutively included n=387 statutory health insurance inpatients over a period of 2 years, was to find out differences in outcome in self-care patients (Barthel index>70) as compared to patients with a need for complex care (Barthel index70). Methods: Rehabilitation outcomes concerning physical capacity, emotional status and activities of daily living as measured by Barthel index, FIM index, HADS, clinical complications, exercise test, duration of rehabilitation and form of dismission were analyzed and compared between both groups. Results: The inpatients with a Barthel index 70 at admission were older, had a longer stay in hospital and in rehabilitation, developed more complications and more often suffered from concomitant diseases. They were readmitted to hospital more often. They showed a comparatively higher increase in indices of self-care and a significant increase in physical performance tests. Conclusion: Higher medical care expenses of multimorbid cardiac inpatients are no contraindication against rehabilitation, because even in this group the specific rehabilitation aims of the healthcare payers can be reached. KW - kardiologische Rehabilitation KW - Rehabilitationspotenzial KW - Qualitatssicherung KW - Versorgungsaufwandig KW - Multimorbiditat KW - cardiac rehabilitation KW - rehabilitation potential KW - quality assurance KW - complex care KW - multimorbidity Y1 - 2016 U6 - https://doi.org/10.1055/s-0041-111524 SN - 0034-3536 SN - 1439-1309 VL - 55 SP - 34 EP - 39 PB - Thieme CY - Stuttgart ER - TY - GEN A1 - Salzwedel, Annett A1 - Heidler, Maria-Dorothea A1 - Haubold, Kathrin A1 - Schikora, Martin A1 - Reibis, Rona Katharina A1 - Wegscheider, Karl A1 - Jöbgens, Michael A1 - Völler, Heinz T1 - Prevalence of mild cognitive impairment in employable patients after acute coronary event in cardiac rehabilitation N2 - 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. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 314 KW - cardiac rehabilitation KW - cognitive impairment KW - prevalence KW - acute coronary event KW - patient education Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-104113 SP - 55 EP - 60 ER - TY - GEN A1 - Reibis, Rona Katharina A1 - Salzwedel, Annett A1 - Buhlert, Hermann A1 - Wegscheider, Karl A1 - Eichler, Sarah A1 - Völler, Heinz T1 - Impact of training methods and patient characteristics on exercise capacity in patients in cardiovascular rehabilitation T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Aim: We aimed to identify patient characteristics and comorbidities that correlate with the initial exercise capacity of cardiac rehabilitation (CR) patients and to study the significance of patient characteristics, comorbidities and training methods for training achievements and final fitness of CR patients. Methods: We studied 557 consecutive patients (51.7 Æ 6.9 years; 87.9% men) admitted to a three-week in-patient CR. Cardiopulmonary exercise testing (CPX) was performed at discharge. Exercise capacity (watts) at entry, gain in training volume and final physical fitness (assessed by peak O 2 utilization (VO 2peak ) were analysed using analysis of covariance (ANCOVA) models. Results: Mean training intensity was 90.7 Æ 9.7% of maximum heart rate (81% continuous/19% interval training, 64% additional strength training). A total of 12.2 Æ 2.6 bicycle exercise training sessions were performed. Increase of training volume by an average of more than 100% was achieved (difference end/beginning of CR: 784 Æ 623 watts  min). In the multivariate model the gain in training volume was significantly associated with smoking, age and exercise capacity at entry of CR. The physical fitness level achieved at discharge from CR as assessed by VO 2peak was mainly dependent on age, but also on various factors related to training, namely exercise capacity at entry, increase of training volume and training method. Conclusion: CR patients were trained in line with current guidelines with moderate-to-high intensity and reached a considerable increase of their training volume. The physical fitness level achieved at discharge from CR depended on various factors associated with training, which supports the recommendation that CR should be offered to all cardiac patients. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 442 KW - cardiac rehabilitation KW - exercise tests KW - cardiorespiratory fitness KW - multivariate modelling Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-405302 IS - 442 ER -