TY - JOUR A1 - Eichler, Sarah A1 - Salzwedel, Annett A1 - Harnath, Axel A1 - Butter, Christian A1 - Wegscheider, Karl A1 - Chiorean, Mihai A1 - Völler, Heinz A1 - Reibis, Rona Katharina T1 - Nutrition and mobility predict all-cause mortality in patients 12 months after transcatheter aortic valve implantation JF - Clinical research in cardiology : official journal of the German Cardiac Society. N2 - 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. KW - TAVI KW - Frailty KW - Mortality KW - Malnutrition KW - Mobility Y1 - 2018 U6 - https://doi.org/10.1007/s00392-017-1183-1 SN - 1861-0684 SN - 1861-0692 VL - 107 IS - 4 SP - 304 EP - 311 PB - Springer CY - Heidelberg 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 - GEN A1 - Eichler, Sarah A1 - Völler, Heinz A1 - Reibis, Rona Katharina A1 - Wegscheider, Karl A1 - Butter, Christian A1 - Harnath, Axel A1 - Salzwedel, Annett T1 - Geriatric or cardiac rehabilitation? BT - Predictors of treatment pathways in advanced age patients after transcatheter aortic valve implantation T2 - Postprints der Universität Potsdam : Mathematisch-Naturwissenschaftliche Reihe N2 - Background Aim of the study was to find predictors of allocating patients after transcatheter aortic valve implantation (TAVI) to geriatric (GR) or cardiac rehabilitation (CR) and describe this new patient group based on a differentiated characterization. Methods From 10/2013 to 07/2015, 344 patients with an elective TAVI were consecutively enrolled in this prospective multicentric cohort study. Before intervention, sociodemographic parameters, echocardiographic data, comorbidities, 6-min walk distance (6MWD), quality of life and frailty (score indexing activities of daily living [ADL], cognition, nutrition and mobility) were documented. Out of these, predictors for assignment to CR or GR after TAVI were identified using a multivariable regression model. Results After TAVI, 249 patients (80.7 ± 5.1 years, 59.0% female) underwent CR (n = 198) or GR (n = 51). GR patients were older, less physically active and more often had a level of care, peripheral artery disease as well as a lower left ventricular ejection fraction. The groups also varied in 6MWD. Furthermore, individual components of frailty revealed prognostic impact: higher values in instrumental ADL reduced the probability for referral to GR (OR:0.49, p <  0.001), while an impaired mobility was positively associated with referral to GR (OR:3.97, p = 0.046). Clinical parameters like stroke (OR:0.19 of GR, p = 0.038) and the EuroSCORE (OR:1.04 of GR, p = 0.026) were also predictive. Conclusion Advanced age patients after TAVI referred to CR or GR differ in several parameters and seem to be different patient groups with specific needs, e.g. regarding activities of daily living and mobility. Thus, our data prove the eligibility of both CR and GR settings. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 647 KW - TAVI KW - Treatment pathways KW - Frailty KW - Geriatric rehabilitation Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-473958 SN - 1866-8364 ER - TY - JOUR A1 - Eichler, Sarah A1 - Salzwedel, Annett A1 - Reibis, Rona A1 - Nothroff, Jörg A1 - Harnath, Axel A1 - Schikora, Martin A1 - Butter, Christian A1 - Wegscheider, Karl A1 - Völler, Heinz T1 - Multicomponent cardiac rehabilitation in patients after transcatheter aortic valve implantation BT - predictors of functional and psychocognitive recovery JF - European journal of preventive cardiology : the official ESC journal for primary & secondary cardiovascular prevention, rehabilitation and sports cardiology N2 - Background: In the last decade, transcatheter aortic valve implantation has become a promising treatment modality for patients with aortic stenosis and a high surgical risk. Little is known about influencing factors of function and quality of life during multicomponent cardiac rehabilitation. Methods: From October 2013 to July 2015, patients with elective transcatheter aortic valve implantation and a subsequent inpatient cardiac rehabilitation were enrolled in the prospective cohort multicentre study. Frailty-Index (including cognition, nutrition, autonomy and mobility), Short Form-12 (SF-12), six-minute walk distance (6MWD) and maximum work load in bicycle ergometry were performed at admission and discharge of cardiac rehabilitation. The relation between patient characteristics and improvements in 6MWD, maximum work load or SF-12 scales were studied univariately and multivariately using regression models. Results: One hundred and thirty-six patients (80.6 +/- 5.0 years, 47.8% male) were enrolled. 6MWD and maximum work load increased by 56.3 +/- 65.3 m (p < 0.001) and 8.0 +/- 14.9 watts (p < 0.001), respectively. An improvement in SF-12 (physical 2.5 +/- 8.7, p = 0.001, mental 3.4 +/- 10.2, p = 0.003) could be observed. In multivariate analysis, age and higher education were significantly associated with a reduced 6MWD, whereas cognition and obesity showed a positive predictive value. Higher cognition, nutrition and autonomy positively influenced the physical scale of SF-12. Additionally, the baseline values of SF-12 had an inverse impact on the change during cardiac rehabilitation. Conclusions: Cardiac rehabilitation can improve functional capacity as well as quality of life and reduce frailty in patients after transcatheter aortic valve implantation. An individually tailored therapy with special consideration of cognition and nutrition is needed to maintain autonomy and empower octogenarians in coping with challenges of everyday life. KW - Cardiac rehabilitation KW - TAVI KW - frailty KW - quality of life KW - exercise capacity Y1 - 2017 U6 - https://doi.org/10.1177/2047487316679527 SN - 2047-4873 SN - 2047-4881 VL - 24 IS - 3 SP - 257 EP - 264 PB - Sage Publ. CY - London ER - TY - JOUR A1 - Salzwedel, Annett A1 - Rabe, Sophie A1 - Zahn, Thomas A1 - Neuwirth, Julia A1 - Eichler, Sarah A1 - Haubold, Kathrin A1 - Wachholz, Anne A1 - Reibis, Rona Katharina A1 - Völler, Heinz T1 - Nutzerinteresse an mobilen digitalen Assistenzsystemen zur Förderung körperlicher Aktivität bei Studierenden und Mitarbeitern einer Universität T1 - User Interest in Digital Health Technologies to Enhance Physical Activity in Students and Staff of a University JF - Gesundheitswesen N2 - Hintergrund Einem Großteil der Bevölkerung gelingt es trotz ausreichenden Wissens um die protektiven Effekte nicht, ausreichende körperliche Aktivität in den Alltag zu integrieren. Digitale Assistenzsysteme könnten hierbei unterstützend eingesetzt werden. Dies setzt jedoch das Interesse potentieller Nutzer voraus. Methode In einer Online-Befragung wurden im Juni/Juli 2015 Mitarbeiter und Studierende der Universität Potsdam zum individuellen Ausmaß der sportlichen Aktivität, dem Interesse an elektronischer Trainingsunterstützung und weiteren Parametern befragt. Ergebnis 1217 Studierende und 485 Mitarbeiter (67,3 bzw. 67,5% Frauen, 26±4,9 bzw. 42,7±11,7 Jahre) nahmen an der Studie teil. Die empfohlene sportliche Aktivität (≥3 Tage bzw. 150 min/Woche) wurde von 70,1% der Mitarbeiter und 52,7% der Studierenden nicht erreicht. Innerhalb dieser Gruppen zeigten 53,2% (Studierende) bzw. 44,2% (Mitarbeiter), unabhängig von Alter, Geschlecht, BMI bzw. Bildungsniveau, Interesse an einer elektronischen Trainingsunterstützung. Schlussfolgerung Auch in jüngeren Bevölkerungsgruppen mit hohem Bildungsniveau ist die Mehrzahl der Personen unzureichend körperlich aktiv. Ein Interesse an Trainingsunterstützung besteht in etwa der Hälfte dieser sportlich inaktiven Gruppe. Dies legt den Schluss nahe, dass der personalisierte Einsatz mobiler Assistenzsysteme für die positive Beeinflussung des Lebensstils zunehmend an Bedeutung gewinnen könnte. N2 - Introduction Though health-enhancing effects of physical activity are well documented, the majority of the population is unable to implement present recommendations into daily routine. Mobile health (mHealth) technologies might be able to increase the physical activity level. However, the interest of potential users is a mandatory basis for this. Method We conducted an online-survey from 06-07/2015 by asking students and employees from the University of Potsdam for their activity level, interest in mHealth training support and other relevant parameters. Results 1 217 students and 485 employees (67.3 % and 67.5 % female, 26.0 +/- 4.9 and 42.7 +/- 11.7 years, respectively) participated in the survey. 70.1 % of employees and 52.7 % of students did not follow the recommendation for physical activity (3 times per week). 53.2 % (students) and 44.2 % (employees), independent of age, sex, BMI and level of education or professional qualification, indicated their interest in mHealth technology offering training support. Conclusion Even in a younger population with higher education, most respondents reported an insufficient level of physical activity. About half of them indicated their interest in training support. Therefore, the use of personalized mHealth technology may be of increasing significance for a positive change of lifestyle. KW - physical activity KW - digital health KW - prevention KW - lifestyle KW - mHealth KW - körperliche Aktivität KW - digitale Gesundheit KW - Prävention KW - Lebensstil KW - mobile Assistenzsysteme Y1 - 2018 U6 - https://doi.org/10.1055/s-0043-103951 SN - 0941-3790 SN - 1439-4421 VL - 80 IS - 11 SP - 1023 EP - 1025 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 - Dobberke, Jeanette A1 - Baritello, Omar A1 - Hadzic, Miralem A1 - Völler, Heinz A1 - Eichler, Sarah A1 - Salzwedel, Annett T1 - Test-retest reliability of center of pressure measures for postural control assessment in older cardiac patients JF - Gait & posture : official journal of Gait and Clinical Movement Analysis Society (GCMAS) and European Society of Movement Analysis in Adults and Children (ESMAC) N2 - Background Elderly patients are a growing population in cardiac rehabilitation (CR). As postural control declines with age, assessment of impaired balance is important in older CR patients in order to predict fall risk and to initiate counteracting steps. Functional balance tests are subjective and lack adequate sensitivity to small differences, and are further subject to ceiling effects. A quantitative approach to measure postural control on a continuous scale is therefore desirable. Force plates are already used for this purpose in other clinical contexts, therefore could be a promising tool also for older CR patients. However, in this population the reliability of the assessment is not fully known. Research question Analysis of test-retest reliability of center of pressure (CoP) measures for the assessment of postural control using a force plate in older CR patients. Methods 156 CR patients (> 75 years) were enrolled. CoP measures (path length (PL), mean velocity (MV), and 95% confidence ellipse area (95CEA)) were analyzed twice with an interval of two days in between (bipedal narrow stance, eyes open (EO) and closed (EC), three trials for each condition, 30 s per trial), using a force plate. For test-retest reliability estimation absolute differences (& UDelta;: T0-T1), intraclass correlation coefficients (ICC) with 95% confidence intervals, standard error of measurement and minimal detectable change were calculated. Results Under EO condition ICC were excellent for PL and MV (0.95) and good for 95CEA (0.88) with & UDelta; of 10.1 cm (PL), 0.3 cm/sec (MV) and 1.5 cm(2 )(95CEA) respectively. Under EC condition ICC were excellent (> 0.95) for all variables with larger & UDelta; (PL: 21.7 cm; MV: 0.7 cm/sec; 95CEA: 2.4 cm(2)) Significance In older CR patients, the assessment of CoP measures using a force plate shows good to excellent test retest reliability. KW - Cardiac rehabilitation KW - Older patients KW - Postural control KW - Test-retest KW - reliability KW - Force plate Y1 - 2022 U6 - https://doi.org/10.1016/j.gaitpost.2021.12.011 SN - 0966-6362 SN - 1879-2219 VL - 92 SP - 359 EP - 363 PB - Elsevier Science CY - Amsterdam ER - TY - JOUR A1 - Kather, Fritz A1 - Hadzic, Miralem A1 - Hehle, Teresa A1 - Eichler, Sarah A1 - Klein, Julia A1 - Völler, Heinz A1 - Salzwedel, Annett T1 - Test-retest reliability of the Mini Nutritional Assessment- Short Form (MNA-SF) in older patients undergoing cardiac rehabilitation JF - Journal of geriatric cardiology KW - Cardiac rehabilitation KW - Malnutrition KW - Octogenarians KW - Test-retest KW - reliability Y1 - 2020 U6 - https://doi.org/10.11909/j.issn.1671-5411.2020.09.007 SN - 1671-5411 VL - 17 IS - 9 SP - 574 EP - 579 PB - English China Online Journals, ECOJ CY - Windsor [u.a.] ER - TY - CHAP A1 - Völler, Heinz A1 - Salzwedel, Annett A1 - Reibis, Rona Katharina A1 - Kaminski, S. A1 - Buhlert, Hermann A1 - Eichler, Sarah A1 - Wegscheider, Karl T1 - Age and fitness level are strongest limitations of exercise capacity during inpatient cardiac rehabilitation T2 - European heart journal Y1 - 2014 SN - 0195-668X SN - 1522-9645 VL - 35 SP - 899 EP - 899 PB - Oxford Univ. Press CY - Oxford ER - TY - CHAP A1 - Völler, Heinz A1 - Salzwedel, Annett A1 - Reibis, Rona Katharina A1 - Eichler, Sarah A1 - Buhlert, Hermann A1 - Kaminski, Stefan A1 - Wegscheider, Karl T1 - Cardiopulmonary exercise testing is predictive of return to work in cardiac patients after multicomponent rehabilitation T2 - European heart journal Y1 - 2015 SN - 0195-668X SN - 1522-9645 VL - 36 SP - 635 EP - 636 PB - Oxford Univ. Press CY - Oxford ER -