TY - JOUR A1 - Eichler, Sarah A1 - Salzwedel, Annett A1 - Rabe, Sophie A1 - Mueller, Steffen A1 - Mayer, Frank A1 - Wochatz, Monique A1 - Hadzic, Miralem A1 - John, Michael A1 - Wegscheider, Karl A1 - Völler, Heinz T1 - The Effectiveness of Telerehabilitation as a Supplement to Rehabilitation in Patients After Total Knee or Hip Replacement BT - Randomized Controlled Trial JF - JMIR Rehabilitation and Assistive Technologies N2 - 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. KW - telerehabilitation KW - home-based KW - total hip replacement KW - total knee replacement KW - exercise therapy KW - aftercare KW - rehabilitation Y1 - 2019 U6 - https://doi.org/10.2196/14236 SN - 2369-2529 VL - 6 IS - 2 PB - jmir rehab CY - Toronto ER - TY - JOUR A1 - Hadzic, Miralem A1 - Eichler, Sarah A1 - Völler, Heinz A1 - Salzwedel, Annett T1 - Akzeptanz und Nutzung eines telemedizinischen Rehabilitationsprogramms für Patienten mit Knie- oder Hüft-Totalendoprothese JF - Bewegungstherapie und Gesundheitssport : B & G ; offizielles Organ des Deutschen Verbandes für Gesundheitssport und Sporttherapie e.V. (DVGS) N2 - 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. N2 - Ziel der Studie: Die langfristige Nutzung telemedizinischer Angebote hängt nicht nur von deren Wirksamkeit, sondern auch von der Akzeptanz und Zufriedenheit der Patienten ab. Für eine telemedizinische Bewegungstherapie für Patienten nach Implantation einer Knie- oder Hüft-Totalendoprothese und erfolgter Anschlussrehabilitation wurde die Wirksamkeit bereits in einer randomisiert kontrollierten Studie untersucht. Dieser Beitrag fokussiert die Akzeptanz und das Nutzungsverhalten der Patienten hinsichtlich des eingesetzten telerehabilitativen Systems. Methodik: Zur Erfassung der Technikakzeptanz wurden 48 Patienten (53±7 Jahre; 26 Frauen; 35 Hüft-/13 Knie-TEP) im Anschluss an eine dreimonatige telemedizinische Bewegungstherapie mittels des Telehealth Usability Questionnaire befragt. Der Fragebogen besteht aus 21 Items (siebenstufige Likert-Skala) in sechs Skalen (z. B. Nützlichkeit, Qualität der Interaktionen, Verlässlichkeit). In einer zusätzlichen Skala wurden systemspezifische Fragen zusammengefasst. Die Ergebnisse wurden als Skalenprozent (100 ≙ vollkommene Zustimmung) dargestellt. Das Nutzungsverhalten wurde anhand systemgenerierter Prozessdaten zum Training sowie zu integrierten Sprach-/Textnachrichten untersucht. Ergebnisse: Die TUQ-Skalen „Nützlichkeit“ (Mdn 95,2) sowie „Benutzerfreundlichkeit und Erlernbarkeit“ (Mdn 92,9) wurden am höchsten bewertet, während die „Verlässlichkeit“ (Mdn 57,1) und „Qualität der Interaktionen“ (Mdn 71,4) die geringsten Ausprägungen zeigten. Die systemspezifische Skala wurde im oberen Quartil eingeordnet (Mdn 85,7). In der ersten Woche führten 39 Patienten (81%), in der zweiten 45 Patienten (94%) mindestens eine Trainingsübung mit dem System durch. Der Anteil aktiver Patienten (≥1 Übung/Woche) reduzierte sich im weiteren Verlauf auf 75% (n=36) in der 7. Woche und 48% (n=23) in der 12. Woche. Die systemeigenen Kommunikationsmöglichkeiten wurden nach Therapiestart zunächst häufig genutzt: in der ersten Woche sendeten 42 Patienten (88%) Nachrichten, 47 Patienten (98%) erhielten Nachrichten von ihrem Therapeuten. In der 7. Woche sendeten/erhielten 9 (19%) bzw. 13 (27%) Patienten Nachrichten über das System. Schlussfolgerung: Die Patienten nahmen die telemedizinische Bewegungstherapie überwiegend als nützlich und benutzerfreundlich wahr und schienen im Wesentlichen mit dem System zufrieden, das sich damit für den kurzfristigen Einsatz von 6 bis 8 Wochen im Anschluss an eine Anschlussrehabilitation als gut geeignet zeigte. T2 - Acceptance and use of a telemedical rehabilitation program for patients with total knee or hip replacement KW - Telemedicine KW - tele-rehabilitation KW - acceptance KW - use KW - orthopaedic KW - rehabilitation KW - Telemedizin KW - Telerehabilitation KW - Akzeptanz KW - Nutzung KW - orthopädische Rehabilitation Y1 - 2022 U6 - https://doi.org/10.1055/a-1714-3629 SN - 1613-0863 SN - 1613-3269 VL - 38 IS - 01 SP - 20 EP - 25 PB - Thieme CY - Stuttgart ER - TY - JOUR A1 - Haupt, T. A1 - Wolschke, M. A1 - Rabe, Sophie A1 - Scholz, I. A1 - Smurawski, A. A1 - Salzwedel, Annett A1 - Thomas, F. A1 - Reich, H. A1 - Völler, Heinz A1 - Liebach, J. A1 - Eichler, Sarah T1 - ReMove-It – Entwicklung einer telemedizinisch assistierten Bewegungstherapie für die Rehabilitation nach Intervention an der unteren Extremität T1 - ReMove-It - Development of telemedicine assisted Movement Therapy for Rehabilitation after lower Extremity Intervention JF - B&G Bewegungstherapie und Gesundheitssport N2 - Knie- und Hüftgelenksarthrose zählen zu den zehn häufigsten Einzeldiagnosen in orthopädischen Praxen. Die Wirksamkeit einer stationären Rehabilitation für Patienten nach Knie- oder Hüft-Totalendoprothese (TEP) ist in mehreren Studien belegt. Dennoch stellt die mittel- und langfristige Nachhaltigkeit zum Erhalt des Therapieerfolges eine große Herausforderung dar. Das Ziel des Projekts ReMove-It ist es, einen Wirksamkeitsnachweis für eintelemedizinisch assistiertes Interventionstraining für Patienten nach einem operativen Eingriff an den unteren Extremitäten zu erbringen. In dem Beitrag wird anhand von Erfahrungsberichten dargestellt, wie das interaktive Übungsprogramm für Knie- und Hüft-TEP-Patienten entwickelt und das telemedizinische Assistenzsystem MeineReha® in den Behandlungsalltag von drei Rehakliniken integriert wurde. Ebenso werden der Aufbau und Ablauf der klinischen Studie dargestellt und das System aus Sicht der beteiligten Ärzte, und Therapeuten bewertet. N2 - Knee and hip joint arthrosis are among the ten most common diagnoses in orthopedic clinics. The effectiveness of inpatient rehabilitation after a total knee or hip replacement has been documented by numerous studies. However, the mid-term and long-term sustainability of a therapeutic success poses a big challenge. The aim of the project ReMove-is to provide a proof of concept for telemedical assisted intervention training for patients after an operation to their lower extremities. This article, based on testimonies, describes how the interactive exercise program for total knee and hip replacement patients was developed and how the telemedical assistance system MeineReha (R) is integrated into the day-to-day treatment of rehabilitation clinics. Similarly, the composition and execution of the clinical study is described and the system evaluated from the view of doctors and therapists. KW - Computer-assisted home training KW - simplicity KW - patient-friendly operation system KW - direct feedback KW - motion analysis KW - communication KW - supervising therapist KW - rehabilitation KW - temporal and spatial independence (flexibility) KW - high self-motivation Y1 - 2017 U6 - https://doi.org/10.1055/s-0043-118139 SN - 1613-0863 SN - 1613-3269 VL - 33 IS - 5 SP - 221 EP - 226 PB - Thieme CY - Stuttgart ER - TY - JOUR A1 - Reibis, Rona Katharina A1 - Kühl, Uwe A1 - Salzwedel, Annett A1 - Rasawieh, Mortesa A1 - Eichler, Sarah A1 - Wegscheider, Karl A1 - Völler, Heinz T1 - Return to work in heart failure patients with suspected viral myocarditis JF - SAGE Open Medicine N2 - 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. KW - Return to work KW - rehabilitation KW - endomyocardial biopsy KW - prediction KW - myocarditis Y1 - 2017 U6 - https://doi.org/10.1177/2050312117744978 SN - 2050-3121 VL - 5 PB - Sage CY - Thousand Oaks, Calif. ER -