TY - JOUR A1 - Salzwedel, Annett A1 - Reibis, Rona Katharina A1 - Heidler, Maria-Dorothea A1 - Wegscheider, Karl A1 - Völler, Heinz T1 - Determinants of Return to Work After Multicomponent Cardiac Rehabilitation JF - Archives of Physical Medicine and Rehabilitation N2 - 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. KW - Acute coronary syndrome KW - Cardiac rehabilitation KW - Coronary artery bypass grafting KW - Motivation KW - Rehabilitation KW - Return to work Y1 - 2019 U6 - https://doi.org/10.1016/j.apmr.2019.04.003 SN - 0003-9993 SN - 1532-821X VL - 100 IS - 12 SP - 2399 EP - 2402 PB - Elsevier CY - Philadelphia ER - TY - JOUR A1 - Hirschmüller, Anja A1 - Konstantinidis, Lukas A1 - Baur, Heiner A1 - Müller, Steffen A1 - Mehlhorn, Alexander A1 - Kontermann, Julia A1 - Grosse, Ulrich A1 - Südkamp, Norbert P. A1 - Helwig, Peter T1 - Do changes in dynamic plantar pressure distribution, strength capacity and postural control after intra-articular calcaneal fracture correlate with clinical and radiological outcome? JF - Injury : international journal of the care of the injured N2 - Fractures of the calcaneus are often associated with serious permanent disability, a considerable reduction in quality of life, and high socio-economic cost. Although some studies have already reported changes in plantar pressure distribution after calcaneal fracture, no investigation has yet focused on the patient's strength and postural control. Method: 60 patients with unilateral, operatively treated, intra-articular calcaneal fractures were clinically and biomechanically evaluated >1 year postoperatively (physical examination, SF-36, AOFAS score, lower leg isokinetic strength, postural control and gait analysis including plantar pressure distribution). Results were correlated to clinical outcome and preoperative radiological findings (Bohler angle, Zwipp and Sanders Score). Results: Clinical examination revealed a statistically significant reduction in range of motion at the tibiotalar and the subtalar joint on the affected side. Additionally, there was a statistically significant reduction of plantar flexor peak torque of the injured compared to the uninjured limb (p < 0.001) as well as a reduction in postural control that was also more pronounced on the initially injured side (standing duration 4.2 +/- 2.9 s vs. 7.6 +/- 2.1 s, p < 0.05). Plantar pressure measurements revealed a statistically significant pressure reduction at the hindfoot (p = 0.0007) and a pressure increase at the midfoot (p = 0.0001) and beneath the lateral forefoot (p = 0.037) of the injured foot. There was only a weak correlation between radiological classifications and clinical outcome but a moderate correlation between strength differences and the clinical questionnaires (CC 0.27-0.4) as well as between standing duration and the clinical questionnaires. Although thigh circumference was also reduced on the injured side, there was no important relationship between changes in lower leg circumference and strength suggesting that measurement of leg circumference may not be a valid assessment of maximum strength deficits. Self-selected walking speed was the parameter that showed the best correlation with clinical outcome (AOFAS score). Conclusion: Calcaneal fractures are associated with a significant reduction in ankle joint ROM, plantar flexion strength and postural control. These impairments seem to be highly relevant to the patients. Restoration of muscular strength and proprioception should therefore be aggressively addressed in the rehabilitation process after these fractures. KW - Intra-articular calcaneal fracture KW - Calcaneus KW - Muscle strength KW - Peak torque KW - Plantar pressure distribution KW - Proprioception KW - Postural control KW - Balance KW - Gait KW - Rehabilitation Y1 - 2011 U6 - https://doi.org/10.1016/j.injury.2010.09.040 SN - 0020-1383 VL - 42 IS - 10 SP - 1135 EP - 1143 PB - Elsevier CY - Oxford ER - TY - JOUR A1 - Kiefer, Thomas A1 - Krahl, Dorothea A1 - Hirt, Carsten A1 - Völler, Heinz A1 - Voelkel, Lorenz A1 - Daeschlein, Georg T1 - Influence of treatment caused impairments on anxiety and depression in patients with cancer of the Esophagus or the Esophagogastric junction JF - Journal of gastrointestinal cancer N2 - Purpose After therapy of cancer of the esophagus or the esophagogastric junction, patients often suffer from anxiety and depression. Some risk factors for elevated anxiety and depression are reported, but the influence of steatorrhea, the frequency of which has only recently been reported, has not yet been investigated. Method Using the Hospital Anxiety and Depression Scale (HADS), we analyzed the correlation of anxiety and depression with steatorrhea, appetite, and weight loss in 72 patients with cancer of the esophagus or of the esophagogastric junction, who were treated at our rehabilitation clinic between January 2011 and December 2014. In addition, effectiveness of psychological interviews was analyzed. Results We have evaluable anxiety questionnaires from 51 patients showing a median anxiety value of 5 (range 0-13). As for the depression, results from evaluable questionnaires of 54 patients also showed a median value of 5 (range 0-15). Increased anxiety and depression values (> 7) were observed in 25.4% and 37.0% of the patients respectively. Patients who were admitted with steatorrhea for rehabilitation showed a statistically higher anxiety value (median 6.3 vs. 4.7, p < 0.05), reduced appetite, and a weight loss above 15 kg depicting a correlation to anxiety and depression. Psychological conversations helped lowering the depression but had no influence on anxiety. Conclusions Impairments after cancer treatment, such as steatorrhea, appetite loss, and weight loss, should be interpreted as an alarm signal and should necessitate screening for increased anxiety and depression. Psychological therapy can help improving the extent of the depression. KW - Anxiety KW - Depression KW - Esophagus carcinoma KW - Exocrine pancreas KW - insufficiency KW - Rehabilitation KW - Steatorrhea Y1 - 2019 U6 - https://doi.org/10.1007/s12029-018-00193-7 SN - 1941-6628 SN - 1941-6636 VL - 51 IS - 1 SP - 30 EP - 34 PB - Springer CY - New York ER - TY - THES A1 - Lichtenberg, Bianca T1 - Kindersoldaten in Afrika : Sozialisations- und Entwicklungsbedingungen von Kindern und Jugendlichen in Kriegsgebieten am Beispiel von Kindersoldaten in Afrika T1 - Child soldiers in Africa : socialisation and developmental conditions of children and youths in war-torn regions using the example of child soldiers in Africa N2 - In ca. 75% der weltweiten Kriege und bewaffneten Konflikte sind Kindersoldaten involviert; diese Fakten lassen die Kindersoldatenproblematik zu einem weltumspannenden Problem werden. Weltweit sind ca. 300.000 Kindersoldaten unter achtzehn Jahren in kriegerische Konflikte eingebunden und als Soldaten, Träger, Boten, Minensucher oder in anderweitigen Diensten tätig. Das Schicksal der Kindersoldaten lässt sich vor allem in Asien und Afrika feststellen. Auf beiden Kontinenten werden sogar 7- bis 12-Jährige in kriegerische Auseinandersetzungen verwickelt. Nach dem United Nations International Children’s Emergency Fund (UNICEF) ist die größte Anzahl an Kindersoldaten in Afrika zu finden, was auch mit der Tatsache in Zusammenhang steht, dass die meisten Konflikte heutzutage auf dem Afrikanischen Kontinent ausgetragen werden. Von großer erziehungswissenschaftlicher Bedeutung ist das Thema, da Kinder und Jugendliche, die mit kriegerischen Konfliktsituationen aufwachsen und unter diesen Bedingungen sozialisiert werden, selbst bereit sind, Gewalt auszuüben. Das gilt selbstverständlich bereits für Kinder und Jugendliche, die zwar nicht als Kombattanten in das Kriegsgeschehen verwickelt werden, aber von denen dennoch Gewalt als ein alltäglicher Zustand erfahren wird. Gesellschaftliche Werte, wie zum Beispiel Hilfsbereitschaft oder der friedliche Umgang miteinander, werden durch die generalisierte Gewalt auf eine harte Probe gestellt. Das Handeln der Erwachsenen ist durch den kriegerischen Kontext bestimmt und die gesellschaftlichen Werte werden dadurch insgesamt verändert. Kinder und Jugendliche, die in kriegerischen Situationen aufwachsen, haben zudem nur selten die Möglichkeit, eine Ausbildung zu absolvieren und sich somit eine Perspektive für die Zukunft abseits des Kampfes zu sichern. Sie fühlen sich häufig allein gelassen, machtlos und schutzlos. In diesen hoffnungslosen Lebensumständen ist ein Anschluss an eine gewaltbereite Gruppe für einige Kinder und Jugendliche ein Weg, Nahrung, Schutz und eine kurzfristige – am bloßen Überleben orientierte - Perspektive zu gewinnen. Werden die Kinder und Jugendlichen zu Mitgliedern gewaltbereiter Gruppen, so wachsen sie in einem System der Gewalt auf, in dem sie lernen, sich mit Gewalt ihren Lebensunterhalt und ihr Überleben zu sichern. Ein Teufelskreis entsteht, in dessen Kern die Frage steht, wie Kinder und Jungendliche, die keinen Frieden und auch keinen friedvollen Umgang mit sich selbst und anderen Personen kennen, als Zivilisten Frieden schaffen können. Die Problematik der Kindersoldaten stellt also nicht nur eine Bedrohung der Kindheit, sondern eine Bedrohung der zivilen Gesellschaftsstruktur dar, gefährdet die regionale Stabilität und somit die Chancen folgender Generationen, dem Schicksal des Kindersoldatentums zu entgehen. N2 - Worldwide about 300,000 child soldiers under eighteen years of age are involved in armed conflicts as soldiers, porters, messengers or other services. The fate of child soldiers is particularly in Asia and Africa identified. On both continents are even 7 - up to 12-year-old implicated in armed conflicts. According to the United Nations International Children's Emergency Fund (UNICEF) the largest number of child soldiers is found in Africa, which is also related to the fact that most conflicts today are held on the African continent. Children and adolescents, who grow up during armed conflict and are socialiesed under these conditions are willing to use violence. They experience violence as a condition of everyday. Social values, such as peaceful dealings with each other, are affected by the generalized violence. Children and young people who grow up in war situations, have also rarely the possibility of training and school education. They often feel alone, helpless and defenceless without having a perspective for their future. In these desperate living conditions an active affiliation with a violent group is for some children and adolescents a way to gain food, protection and a short-term-perspective which is oriented on mere survival. KW - Kindersoldaten KW - Kinder und Krieg KW - Rekrutierung KW - Demobilisierung KW - Rehabilitation KW - Child Soldiers KW - Children and War KW - Initiation KW - Demobilization KW - Rehabilitation Y1 - 2007 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus-19854 ER - TY - JOUR A1 - Busch, Aglaja A1 - Blasimann, Angela A1 - Henle, Philipp A1 - Baur, Heiner T1 - Neuromuscular activity during stair descent in ACL reconstructed patients BT - a pilot study JF - The Knee N2 - Background: The anterior cruciate ligament (ACL) rupture is a severe knee injury. Altered kinematics and kinetics in ACL reconstructed (ACL-R) patients compared to healthy participants (ACL-I) are known and attributed to an altered sensorimotor control. However, studies on neuromuscular control often lack homogeneous patient cohorts. The objective was to examine neuromuscular activity during stair descent in patients one year after ACL reconstruction. Method: Neuromuscular activity of vastus medialis (VM) and lateralis (VL), biceps femoris (BF) and semitendinosus (ST) was recorded by electromyography in 10 ACL-R (age: 26 +/- 10 years; height: 175 +/- 6 cm; mass: 75 +/- 14 kg) and 10 healthy matched controls (age: 31 +/- 7 years; height: 175 +/- 7 cm; mass: 68 +/- 10 kg). A 10-minute walking treadmill warm-up was used for submaximal normalization. Afterwards participants descended 10 times a six-step stairway at a self-selected speed. The movement was separated into pre-activation (PRE), weight acceptance (WA) and push-off phase (PO). Normalized root mean squares for each muscle, limb and movement phase were calculated. Kruskal-Wallis ANOVA compared ACL-R injured and contralateral leg and the ACL-I leg (alpha = 0.05). Results: Significant increased normalised activity in ST during WA in ACL-R injured leg compared to ACL-I and during PO in VL in the ACL-R contralateral leg compared to ACL-I. Decreased activity was shown in VM in ACL-R injured compared to contralateral leg (p < 0.05). Conclusion: Altered neuromuscular activations are present one year after ACL reconstruction compared to the contralateral and healthy matched control limb. Current standard rehabilitation programs may not be able to fully restore sensorimotor control and demand further investigations. (C) 2018 Elsevier B.V. All rights reserved. KW - Knee KW - Neuromuscular control KW - Sensorimotor control KW - Electromyography KW - Rehabilitation Y1 - 2019 U6 - https://doi.org/10.1016/j.knee.2018.12.011 SN - 0968-0160 SN - 1873-5800 VL - 26 IS - 2 SP - 310 EP - 316 PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Gärtner, Mirijam A1 - Nottebrock, Henning A1 - Fourie, Helanya A1 - Privett, Sean D. J. A1 - Richardson, David M. T1 - Plant invasions, restoration, and economics perspectives from South African fynbos JF - Perspectives in plant ecology, evolution and systematics N2 - Restoration is gaining importance in the management of plant invasions. As the success of restoration projects is frequently determined by factors other than ecological ones, we explored the ecological and financial feasibility of active restoration on three different invaded sites in South Africa's Cape Floristic Region. The aim of our study was to identify cost-effective ways of restoring functional native ecosystems following invasion by alien plants. Over three years we evaluated different restoration approaches using field trials and experimental manipulations (i.e. mechanical clearing, burning, different soil restoration techniques and sowing of native species) to reduce elevated soil nutrient levels and to re-establish native fynbos communities. Furthermore we investigated the possibility of introducing native fynbos species that can be used for sustainable harvesting to create an incentive for restoration on private land. Diversity and evenness of native plant species increased significantly after restoration at all three sites, whereas cover of alien plants decreased significantly, confirming that active restoration was successful. However, sowing of native fynbos species had no significant effect on native cover, species richness, diversity or evenness in the Acacia thicket and Kikuyu field, implying that the ecosystem was sufficiently resilient to allow autogenic recovery following clearing and burning of the invasive species. Soil restoration treatments resulted in an increase of available nitrogen in the Acacia thicket, but had no significant effects in the Eucalyptus plantation. However, despite elevated available soil nitrogen levels, native species germinated irrespective whether sown or unsown (i.e. regeneration from the soil seed bank). Without active introduction of native species, native grasses, forbs and other shrubs would have dominated, and proteoids and ericoids (the major fynbos growth forms) would have been under-represented. The financial analysis shows that income from flower harvesting following active restoration consistently outweighs income following passive restoration, but that the associated increase in income does not always justify the higher costs. We conclude that active restoration can be effective and financially feasible when compared to passive restoration, depending on the density of invasion. Active restoration of densely invaded sites may therefore only be justifiable if the target area is in a region of high conservation priority. KW - Biological invasions KW - Cost-benefit analysis KW - Degradation KW - Exotic species KW - Flower harvesting KW - Rehabilitation Y1 - 2012 U6 - https://doi.org/10.1016/j.ppees.2012.05.001 SN - 1433-8319 VL - 14 IS - 5 SP - 341 EP - 353 PB - Elsevier CY - Jena ER - TY - JOUR A1 - Muschalla, Beate A1 - Jöbges, Michael T1 - Prevalence and Characteristics of Work Anxiety in Medical Rehabilitation Patients BT - a cross-sectional observation study JF - Archives of Physical Medicine and Rehabilitation N2 - Objective: To investigate frequency, type, and characteristics of work anxieties in patients with somatic illness. Design: Cross-sectional observation study. Setting: Neurology, orthopedic, and cardiology rehabilitation clinics. Participants: Patients (N=4610; age, 18-65y) with work anxieties. Interventions: Not applicable. Main Outcome Measures: Patients who scored high on at least 2 of 9 items in the work-anxiety screening questionnaire and who reported impairment were investigated with a differential diagnostic interview on work anxieties and with the Mini-International Neuropsychiatric Interview on non work-related common mental disorders. Patients also filled out a self-rating questionnaire on their subjective symptom load and sociodemographic data. Results: Approximately 20% to 27% of the investigated inpatients in somatic rehabilitation (altogether n=393) received a work-anxiety diagnosis. Patients with orthopedic illness report highest work anxiety and have previous longest sick leave (20.6wk in the past 12mo). Patients with orthopedic illness suffer from work-related adjustment disorder with anxiety, social anxieties, and workplace phobias, whereas patients with cardiac illness are more often affected by hypochondriac anxieties. Anxieties of insufficiency and worrying occur equally in all indications. Conclusions: About a quarter of patients in somatic rehabilitation are in need of additional diagnostic attention owing to work anxieties. Differential diagnostic of work anxiety is needed for initiating adequate therapeutic action. Somatic rehabilitation physicians should be aware of work anxieties in their patients, especially in patients with orthopedic illness with previous long-term sick leave. (c) 2017 by the American Congress of Rehabilitation Medicine KW - Anxiety KW - Mental health KW - Rehabilitation KW - Sick leave KW - Workplace Y1 - 2017 U6 - https://doi.org/10.1016/j.apmr.2017.06.017 SN - 0003-9993 SN - 1532-821X VL - 99 IS - 1 SP - 57 EP - 64 PB - Elsevier CY - Philadelphia ER - TY - JOUR A1 - Gmeiner, Michaela Silvia A1 - Warschburger, Petra T1 - Psychotherapie bei juveniler Adipositas BT - gerechtfertigt und sinnvoll? JF - Psychotherapeut N2 - Background Obesity is widespread in childhood and adolescence. Medical rehabilitation measures with a comprehensive range of treatment options represent an essential pillar of care. As obesity is associated with a wide range of psychosocial burdens, the question arises as to whether psychotherapeutic services should be given even greater consideration. Objective The main goal was to examine the rate of psychological problems among children and adolescents with obesity and their association with the weight loss course. Material and methods The sample consisted of 220 children and adolescents with obesity (8-16 years, M = 13.11 years, SD +/- 1.88 years; 54.5% female) who participated in an inpatient rehabilitation. Emotional and behavioral problems were assessed (strengths and difficulties questionnaire, SDQ via parental report) at the beginning of rehabilitation as well as 6 and 12 months after completion. Anthropometric data for determination of the weight status were collected by medical personnel of the clinics or in the follow-up by family doctors. Results Almost half of the children and adolescents (48.6%) showed abnormal values and girls in particular were affected significantly more often. The descriptive inspection after rehabilitation revealed a similarly high proportion. The presence of psychological problems had a significant negative effect on the weight course. Conclusion Psychological problems should be given greater consideration in the context of obesity therapy. On the one hand potentially burdened children should be identified by screening, on the other hand psychotherapy to reduce psychosocial strain should be an integral part of the treatment concept. N2 - Hintergrund Adipositas ist im Kindes- und Jugendalter stark verbreitet. Medizinische Rehabilitationsmaßnahmen mit ihrem umfassenden Behandlungsangebot stellen eine wesentliche Säule der Versorgung dar. Da Adipositas mit vielfältigen psychosozialen Belastungen verbunden ist, stellt sich die Frage, ob psychotherapeutische Angebote noch stärker berücksichtigt werden sollten. Fragestellung Untersucht wurde, wie verbreitet psychische Auffälligkeiten bei Kindern und Jugendlichen mit Adipositas sind und in welchem Zusammenhang sie zum Gewichtsverlauf stehen. Material und Methoden Die Stichprobe bestand aus 220 Kindern und Jugendlichen mit Adipositas (8 bis 16 Jahre, M = 13,11 Jahre; SD ± 1,88 Jahre; 54,5 % weiblich), die an einer stationären Rehabilitationsmaßnahme teilnahmen. Emotionale- und Verhaltensauffälligkeiten (Strengths and Difficulties Questionnaire, SDQ) wurden zu Rehabilitationsbeginn sowie 6 und 12 Monate nach Rehabilitationsende im Elternbericht erfasst. Zudem wurden Daten zur Bestimmung des Gewichtstatus durch das medizinische Personal der Kliniken bzw. in der Katamnese von Hausärzten erhoben. Ergebnisse Fast die Hälfte der Kinder und Jugendlichen (48,6 %) wies auffällige Werte auf; v. a. Mädchen waren signifikant häufiger betroffen. Die deskriptive Betrachtung nach Rehabilitationsende zeigte einen vergleichbar hohen Anteil. Zudem wirkte sich das Vorliegen psychosozialer Auffälligkeiten signifikant negativ auf den Gewichtsverlauf aus. Schlussfolgerung Psychische Probleme sollten im Rahmen der Adipositastherapie stärker berücksichtigt werden. Zum einen sollten evtl. belastete Kinder durch Screenings identifiziert werden, zum anderen psychotherapeutische Maßnahmen zur Reduktion psychosozialer Belastungen integraler Bestandteil der Behandlung sein. KW - child KW - adolescent KW - weight course KW - psychological problems KW - rehabilitation KW - Kind KW - Jugendlicher KW - Gewichtsverlauf KW - Psychische Auffälligkeit KW - Rehabilitation Y1 - 2020 U6 - https://doi.org/10.1007/s00278-020-00474-2 SN - 0935-6185 SN - 1432-2080 VL - 66 IS - 1 SP - 16 EP - 22 PB - Springer CY - New York ER - TY - JOUR A1 - Puerto Valencia, Laura Maria A1 - Arampatzis, Adamantios A1 - Beck, Heidrun A1 - Dreinhöfer, Karsten E. A1 - Drießlein, Drießlein A1 - Mau, Wilfried A1 - Zimmer, Julia-Marie A1 - Schäfer, Michael A1 - Steinfeldt, Friedemann A1 - Wippert, Pia-Maria T1 - RENaBack: Low back pain patients in rehabilitation: Study Protocol for a Multicenter, Randomized Controlled Trial JF - Trials N2 - Background Millions of people in Germany suffer from chronic pain, in which course and intensity are multifactorial. Besides physical injuries, certain psychosocial risk factors are involved in the disease process. The national health care guidelines for the diagnosis and treatment of non-specific low back pain recommend the screening of psychosocial risk factors as early as possible, to be able to adapt the therapy to patient needs (e.g., unimodal or multimodal). However, such a procedure has been difficult to implement in practice and has not yet been integrated into the rehabilitation care structures across the country. Methods The aim of this study is to implement an individualized therapy and aftercare program within the rehabilitation offer of the German Pension Insurance in the area of orthopedics and to examine its success and sustainability in comparison to the previous standard aftercare program. The study is a multicenter randomized controlled trial including 1204 patients from six orthopedic rehabilitation clinics. A 2:1 allocation ratio to intervention (individualized and home-based rehabilitation aftercare) versus the control group (regular outpatient rehabilitation aftercare) is set. Upon admission to the rehabilitation clinic, participants in the intervention group will be screened according to their psychosocial risk profile. They could then receive either unimodal or multimodal, together with an individualized training program. The program is instructed in the clinic (approximately 3 weeks) and will continue independently at home afterwards for 3 months. The success of the program is examined by means of a total of four surveys. The co-primary outcomes are the Characteristic Pain Intensity and Disability Score assessed by the German version of the Chronic Pain Grade questionnaire (CPG). Discussion An improvement in terms of pain, work ability, patient compliance, and acceptance in our intervention program compared to the standard aftercare is expected. The study contributes to provide individualized care also to patients living far away from clinical centers. Trial registration DRKS, DRKS00020373. Registered on 15 April 2020 KW - Chronic low back pain KW - Aftercare KW - Individualized therapy KW - Randomized controlled trial KW - Rehabilitation Y1 - 2021 U6 - https://doi.org/10.1186/s13063-021-05823-3 SN - 1745-6215 SP - 1 EP - 18 PB - Springer Nature / BMC CY - Heidelberg ER - TY - GEN A1 - Puerto Valencia, Laura Maria A1 - Arampatzis, Adamantios A1 - Beck, Heidrun A1 - Dreinhöfer, Karsten E. A1 - Drießlein, Drießlein A1 - Mau, Wilfried A1 - Zimmer, Julia-Marie A1 - Schäfer, Michael A1 - Steinfeldt, Friedemann A1 - Wippert, Pia-Maria T1 - RENaBack: Low back pain patients in rehabilitation: Study Protocol for a Multicenter, Randomized Controlled Trial T2 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Background Millions of people in Germany suffer from chronic pain, in which course and intensity are multifactorial. Besides physical injuries, certain psychosocial risk factors are involved in the disease process. The national health care guidelines for the diagnosis and treatment of non-specific low back pain recommend the screening of psychosocial risk factors as early as possible, to be able to adapt the therapy to patient needs (e.g., unimodal or multimodal). However, such a procedure has been difficult to implement in practice and has not yet been integrated into the rehabilitation care structures across the country. Methods The aim of this study is to implement an individualized therapy and aftercare program within the rehabilitation offer of the German Pension Insurance in the area of orthopedics and to examine its success and sustainability in comparison to the previous standard aftercare program. The study is a multicenter randomized controlled trial including 1204 patients from six orthopedic rehabilitation clinics. A 2:1 allocation ratio to intervention (individualized and home-based rehabilitation aftercare) versus the control group (regular outpatient rehabilitation aftercare) is set. Upon admission to the rehabilitation clinic, participants in the intervention group will be screened according to their psychosocial risk profile. They could then receive either unimodal or multimodal, together with an individualized training program. The program is instructed in the clinic (approximately 3 weeks) and will continue independently at home afterwards for 3 months. The success of the program is examined by means of a total of four surveys. The co-primary outcomes are the Characteristic Pain Intensity and Disability Score assessed by the German version of the Chronic Pain Grade questionnaire (CPG). Discussion An improvement in terms of pain, work ability, patient compliance, and acceptance in our intervention program compared to the standard aftercare is expected. The study contributes to provide individualized care also to patients living far away from clinical centers. Trial registration DRKS, DRKS00020373. Registered on 15 April 2020 T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 772 KW - Chronic low back pain KW - Aftercare KW - Individualized therapy KW - Randomized controlled trial KW - Rehabilitation Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-554683 SN - 1866-8364 SP - 1 EP - 18 PB - Universitätsverlag Potsdam CY - Potsdam ER -