TY - JOUR A1 - Fayyaz, Susann A1 - Japtok, Lukasz A1 - Schumacher, Fabian A1 - Wigger, Dominik A1 - Schulz, Tim Julius A1 - Haubold, Kathrin A1 - Gulbins, Erich A1 - Völler, Heinz A1 - Kleuser, Burkhard T1 - Lysophosphatidic acid inhibits insulin signaling in primary rat hepatocytes via the LPA(3) receptor subtype and is increased in obesity JF - Cellular physiology and biochemistry : international journal of experimental cellular physiology, biochemistry and pharmacology N2 - Background/Aims: Obesity is a main risk factor for the development of hepatic insulin resistance and it is accompanied by adipocyte hypertrophy and an elevated expression of different adipokines such as autotaxin (ATX). ATX converts lysophosphatidylcholine to lysophosphatidic acid (LPA) and acts as the main producer of extracellular LPA. This bioactive lipid regulates a broad range of physiological and pathological responses by activation of LPA receptors (LPA1-6). Methods: The activation of phosphatidylinositide 3-kinases (PI3K) signaling (Akt and GSK-3ß) was analyzed via western blotting in primary rat hepatocytes. Incorporation of glucose into glycogen was measured by using radio labeled glucose. Real-time PCR analysis and pharmacological modulation of LPA receptors were performed. Human plasma LPA levels of obese (BMI > 30, n = 18) and normal weight individuals (BMI 18.5-25, n = 14) were analyzed by liquid chromatography tandem-mass spectrometry (LC-MS/MS). Results: Pretreatment of primary hepatocytes with LPA resulted in an inhibition of insulin-mediated Gck expression, PI3K activation and glycogen synthesis. Pharmacological approaches revealed that the LPA3-receptor subtype is responsible for the inhibitory effect of LPA on insulin signaling. Moreover, human plasma LPA concentrations (16: 0 LPA) of obese participants (BMI > 30) are significantly elevated in comparison to normal weight individuals (BMI 18.5-25). Conclusion: LPA is able to interrupt insulin signaling in primary rat hepatocytes via the LPA3 receptor subtype. Moreover, the bioactive lipid LPA (16: 0) is increased in obesity. KW - Lysophosphatidic acid KW - Insulin signaling KW - Adipose tissue KW - Autotaxin KW - Hepatic insulin resistance KW - LPA(3) receptor subtype Y1 - 2017 U6 - https://doi.org/10.1159/000480470 SN - 1015-8987 SN - 1421-9778 VL - 43 SP - 445 EP - 456 PB - Karger CY - Basel 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 - GEN A1 - Völler, Heinz A1 - Bindl, Dominik A1 - Nagels, Klaus A1 - Hofmann, Reiner A1 - Vettorazzi, Eik A1 - Wegscheider, Karl A1 - Fleck, Eckart A1 - Nagel, Eckhard T1 - Remote telemonitoring in chronic heart failure does not reduce healthcare cost but improves quality of life BT - endpoints of the cardiobbeat trail T2 - Journal of the American College of Cardiology N2 - Background: Evidence that home telemonitoring (HTM) for patients with chronic heart failure (CHF) offers clinical benefit over usual care is controversial as is evidence of a health economic advantage. Therefore the CardioBBEAT trial was designed to prospectively assess the health economic impact of a dedicated home monitoring system for patients with CHF based on actual costs directly obtained from patients’ health care providers. Methods: Between January 2010 and June 2013, 621 patients (mean age 63,0 ± 11,5 years, 88 % male) with a confirmed diagnosis of CHF (LVEF ≤ 40 %) were enrolled and randomly assigned to two study groups comprising usual care with and without an interactive bi-directional HTM (Motiva®). The primary endpoint was the Incremental Cost-Effectiveness Ratio (ICER) established by the groups’ difference in total cost and in the combined clinical endpoint “days alive and not in hospital nor inpatient care per potential days in study” within the follow up of 12 months. Secondary outcome measures were total mortality and health related quality of life (SF-36, WHO-5 and KCCQ). Results: In the intention-to-treat analysis, total mortality (HR 0.81; 95% CI 0.45 – 1.45) and days alive and not in hospital (343.3 ± 55.4 vs. 347.2 ± 43.9; p = 0.909) were not significantly different between HTM and usual care. While the resulting primary endpoint ICER was not positive (-181.9; 95% CI −1626.2 ± 1628.9), quality of life assessed by SF-36, WHO-5 and KCCQ as a secondary endpoint was significantly higher in the HTW group at 6 and 12 months of follow-up. Conclusions: The first simultaneous assessment of clinical and economic outcome of HTM in patients with CHF did not demonstrate superior incremental cost effectiveness compared to usual care. On the other hand, quality of life was improved. It remains open whether the tested HTM solution represents a useful innovative approach in the recent health care setting. Y1 - 2017 SN - 0735-1097 SN - 1558-3597 VL - 69 IS - 11 Supplement SP - 672 EP - 672 PB - Elsevier CY - New York ER - TY - JOUR A1 - Linden, Michael A1 - Bernert, Sebastian A1 - Funke, Ariane A1 - Dreinhöfer, Karsten E. A1 - Jöbges, Michael A1 - von Kardorff, Ernst A1 - Riedel-Heller, Steffi G. A1 - Spyra, Karla A1 - Völler, Heinz A1 - Warschburger, Petra A1 - Wippert, Pia-Maria T1 - Medizinische Rehabilitation unter einer Lifespan-Perspektive T1 - Medical rehabilitation from a lifespan perspective JF - Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz N2 - Die Lifespan-Forschung untersucht die Entwicklung von Individuen über den gesamten Lebenslauf. Die medizinische Rehabilitation hat nach geltendem Sozialrecht die Aufgabe, chronische Krankheiten abzuwenden, zu beseitigen, zu mindern, auszugleichen, eine Verschlimmerung zu verhüten und Negativfolgen für die Lebensführung zu reduzieren. Dies erfordert in wissenschaftlicher wie in praxisbezogener Hinsicht die Entwicklung einer Lebensspannenperspektive als Voraussetzung für die Klassifikation und Diagnostik chronischer Erkrankungen, die Beschreibung von verlaufsbeeinflussenden Faktoren, kritischen Lebensphasen und Critical Incidents (kritische Verlaufszeitpunkte), die Durchführung von prophylaktischen Maßnahmen, die Entwicklung von Assessmentverfahren zur Erfassung und Bewertung von Verläufen oder Vorbehandlungen, die Auswahl und Priorisierung von Interventionen, eine Behandlungs- und Behandlerkoordination auf der Zeitachse, die Präzisierung der Aufgabenstellung für spezialisierte Rehabilitationsmaßnahmen, wie beispielsweise Rehabilitationskliniken, und als Grundlage für die Sozialmedizin. Aufgrund der Vielfalt der individuellen Risikokonstellationen, Krankheitsverläufe und Behandlungssituationen über die Lebensspanne hinweg, bedarf es in der medizinischen Rehabilitation in besonderer Weise einer personalisierten Medizin, die zugleich rehabilitationsförderliche und -behindernde Umweltfaktoren im Rehabilitationsverlauf berücksichtigt. N2 - Lifespan research investigates the development of individuals over the course of life. As medical rehabilitation deals with primary and secondary prophylaxis, treatment, and compensation of chronic illnesses, a lifespan perspective is needed for the classification and diagnosis of chronic disorders, the assessment of course modifying factors, the identification of vulnerable life periods and critical incidents, the implementation of preventive measures, the development of methods for the evaluation of prior treatments, the selection and prioritization of interventions, including specialized inpatient rehabilitation, the coordination of therapies and therapists, and for evaluations in social and forensic medicine. Due to the variety of individual risk constellations, illness courses and treatment situations across the lifespan, personalized medicine is especially important in the context of medical rehabilitation, which takes into consideration hindering and fostering factors alike. KW - Medical rehabilitation KW - Lifespan KW - Chronic illness KW - Personalized medicine KW - Prevention KW - Medizinische Rehabilitation KW - Lebensspanne KW - Chronische Krankheit KW - Personalisierte Medizin KW - Prävention Y1 - 2017 U6 - https://doi.org/10.1007/s00103-017-2520-2 SN - 1436-9990 SN - 1437-1588 VL - 60 SP - 445 EP - 452 PB - Springer CY - New York ER - TY - JOUR A1 - Reibis, Rona Katharina A1 - Salzwedel, Annett A1 - Falk, Johannes A1 - Völler, Heinz T1 - Berufliche Wiedereingliederung nach akutem Herzinfarkt T1 - Return to Work after Acute Myocardial Infarction JF - Deutsche medizinische Wochenschrift : DMW ; Organ der Deutschen Gesellschaft für Innere Medizin (DGIM) ; Organ der Gesellschaft Deutscher Naturforscher und Ärzte (GDNÄ) N2 - Die berufliche Wiedereingliederung von Patienten nach akutem Herzinfarkt stellt sowohl aus gesellschaftlicher wie auch aus individueller Sicht einen entscheidenden Schritt zur vollständigen Rekonvaleszenz dar. Lediglich 10% der Patienten werden durch kardiale Probleme an der Reintegration behindert. Neben medizinischen und berufsbezogenen Faktoren determinieren insbesondere psychosoziale Parameter eine erfolgreiche Wiederaufnahme der Tätigkeit. Verschiedene Programme der Rentenversicherungsträger werden dabei unterstützend angeboten. N2 - Vocational reintegration provides a key goal for patients after myocardial infarction both from social as well as from individual perspective. Return to work rate is determined by medical parameters such as left ventricular function, residual ischemia and rhythm stability, as well as by occupational requirement profile such as the blue or white collar work, night shifts and the way capacity. Psycho-social factors including depression, self-assessment of their own situation and pre-existing cognitive impairment to a large extent determine the reintegration. Optimally, re-employment should be performed immediately after cardiac rehabilitation in patient after uncomplicated myocardial infarction. After a long hospitalization phase a stepwise inclusion is recommended. In failed reintegration particularly in younger workers retraining should be considered. KW - berufliche Wiedereingliederung KW - Herzinfarkt KW - hamburger model KW - Prädiktoren KW - Rentenversicherung KW - return to work KW - myocardial infarction KW - predictors KW - pension insurance Y1 - 2017 U6 - https://doi.org/10.1055/s-0042-124425 SN - 0012-0472 SN - 1439-4413 VL - 142 SP - 617 EP - 624 PB - Thieme CY - Stuttgart ER - TY - JOUR A1 - Schulz-Behrendt, Claudia A1 - Salzwedel, Annett A1 - Rabe, Sophie A1 - Ortmann, K. A1 - Völler, Heinz T1 - Aspekte beruflicher und sozialer Wiedereingliederung aus Sicht kardiovaskulär erkrankter Rehabilitanden in besonderen beruflichen Problemlagen T1 - Subjective Aspects of Return to Work and Social Reintegration in Patients with Extensive Work-related Problems in Cardiac Rehabilitation BT - Ergebnisse einer qualitativen Erhebung BT - Results of a Qualitative Investigation JF - Die Rehabilitation : Zeitschrift für Praxis und Forschung in der Rehabilitation N2 - Ziel: Untersucht wurden subjektive bio-psycho-soziale Auswirkungen chronischer Herz- und Gefäßerkrankungen, Bewältigungsstrategien und Formen sozialer Unterstützung bei Rehabilitanden in besonderen beruflichen Problemlagen (BBPL). Methodik: Für die qualitative Untersuchung wurden 17 Patienten (48,9±7,0 Jahre, 13 männl.) mit BBPL (SIMBO-C>30) in leitfadengestützten Interviews befragt. Die Auswertung erfolgte softwaregestützt nach dem inhaltsanalytischen Ansatz von Mayring. Ergebnisse: Im Rahmen der Krankheitsauswirkungen benannten die Patienten soziale, einschließlich beruflicher Aspekte mit 62% der Aussagen deutlich häufiger als physische oder psychische Faktoren (9 bzw. 29%). Angewandte Bewältigungsstrategien und erfahrene Unterstützungsleistungen richteten sich jedoch überwiegend auf körperliche Einschränkungen (70 bzw. 45%). Schlussfolgerung: Obgleich soziale Krankheitsauswirkungen für die befragten Rehabilitanden subjektiv bedeutsam waren, gelang die Entwicklung geeigneter Bewältigungsstrategien nur unzureichen N2 - Objective This study investigated subjective biopsychosocial effects of coronary heart disease (CHD), coping strategies and social support in patients undergoing cardiac rehabilitation (CR) and having extensive work-related problems. Methods A qualitative investigation was performed in 17 patients (48.9 +/- 7.0 y, 13 male) with extensive work-related problems (SIMBO-C > 30). All patients were interviewed with structured surveys. Data analysis was performed using a software that is based on the content analysis approach of Mayring. Results In regard to effects of disease, patients indicated social aspects including occupational aspects (62 %) more often than physical or mental factors (9 or 29 %). Applied coping strategies and support services are mainly focused on physical impairments (70 or 45 %). Conclusions The development of appropriate coping strategies was insufficient although social effects of disease were subjectively meaningful for patients in CR. KW - cardiac rehabilitation KW - extensive work-related problems KW - social support KW - return to work KW - kardiologische Rehabilitation KW - besondere berufliche Problemlagen KW - soziale Unterstützung KW - berufliche Wiedereingliederung Y1 - 2017 U6 - https://doi.org/10.1055/s-0042-121379 SN - 0034-3536 SN - 1439-1309 VL - 56 IS - 3 SP - 181 EP - 188 PB - Thieme CY - Stuttgart ER - TY - JOUR A1 - Heidler, Maria-Dorothea A1 - Bidu, Laura A1 - Völler, Heinz A1 - Salzwedel, Annett T1 - Prädiktoren des kognitiven Outcomes beatmeter Frührehabilitationspatienten T1 - Predictors of cognitive outcome in ventilated early rehabilitation patients JF - Der Nervenarzt : Organ der Deutschen Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde ; Mitteilungsblatt der Deutschen Gesellschaft für Neurologie N2 - Hintergrund Patienten, die nach gescheitertem Weaning von der Intensivstation in die Frührehabilitation (FR) verlegt werden, weisen neben motorischen Einschränkungen oft auch Defizite in ihrer kognitiven Leistungsfähigkeit auf. Welche patientenseitigen Faktoren das kognitive Outcome am Ende der FR beeinflussen, ist noch unzureichend untersucht. Zielstellung Ermittlung von Prädiktoren auf das kognitive Leistungsvermögen initial beatmeter FR-Patienten. Methode Zwischen 01/2014 und 12/2015 wurden 301 Patienten (68,3 ± 11,4 Jahre, 67 % männlich) einer neurologischen Phase-B-Weaningstation konsekutiv in eine prospektive Beobachtungsstudie eingeschlossen. Zur Ermittlung möglicher Einflussfaktoren auf das kognitive Outcome (operationalisiert mittels Neuromentalindex [NMI]) wurden soziodemografische Daten, kritische Erkrankung, Komorbiditäten, Parameter zu Weaning und Dekanülierung sowie diverse Scores zur Ermittlung funktionaler Parameter erhoben und mittels ANCOVA multivariat ausgewertet. Ergebnisse Insgesamt 248 Patienten (82 %) konnten erfolgreich geweant werden, 155 (52 %) dekanüliert, 75 Patienten (25 %) verstarben, davon 39 (13 %) unter Palliativtherapie. Für die überlebenden Patienten (n = 226) konnten im finalen geschlechts- und altersadjustierten statistischen Modell unabhängige Prädiktoren des NMI bei Entlassung aus der FR ermittelt werden: Wachheit und erfolgreiche Dekanülierung waren positiv mit dem NMI assoziiert, während als kritische Erkrankungen hypoxische Hirnschädigungen, Hirninfarkte und Schädel-Hirn-Traumata einen negativen Einfluss auf die kognitive Leistungsfähigkeit hatten. Das berechnete Modell begründet 57 % der Varianz des NMI (R2 = 0,568) und weist damit eine hohe Erklärungsqualität auf. Schlussfolgerung Aufgrund des erhöhten Risikos für eine verminderte kognitive Leistungsfähigkeit zum Ende der FR sollten vor allem Patienten nach Hypoxie, Hirninfarkt und Schädel-Hirn-Trauma intensiv neuropsychologisch betreut werden. Da weiterhin eine erfolgreiche Dekanülierung mit verbesserten kognitiven Leistungen assoziiert ist, sollte – vor allem bei wachen Patienten – zudem ein zügiges Trachealkanülenmanagement im therapeutischen Fokus stehen. N2 - After weaning failure, patients who are transferred from intensive care units to early rehabilitation centers (ERC) not only suffer from motor deficits but also from cognitive deficits. It is still uncertain which patient factors have an impact on cognitive outcome at the end of early rehabilitation. Investigation of predictors of cognitive performance for initially ventilated early rehabilitation patients. A total of 301 patients (mean age 68.3 +/- 11.4 years, 67% male) were consecutively enrolled in an ERC for a prospective observational study between January 2014 and December 2015. To investigate influencing factors on cognitive outcome operationalized by the neuromental index (NMI), we collected sociodemographic data, parameters about the critical illness, comorbidities, weaning and decannulation as well as different functional scores at admission and discharge and carried out multivariate analyses by ANCOVA. Of the patients 248 (82%) were successfully weaned, 155 (52%) decannulated and 75 patients (25%) died of whom 39 (13%) were under palliative treatment. For the survivors (n = 226) we could identify independent predictors of the NMI at discharge from the ERC in the final sex and age-adjusted statistical model: alertness and decannulation were positively associated with the NMI whereas hypoxia, cerebral infarction and traumatic brain injury had a negative impact on cognitive ability. The model justifies 57% of the variance of the NMI (R-2 = 0.568) and therefore has a high quality of explanation. Because of increased risk of cognitive deficits at discharge of ERC, all patients who suffered from hypoxia, cerebral infarction or traumatic brain injury should be intensively treated by neuropsychologists. Since decannulation is also associated with positive cognitive outcome, a rapid decannulation procedure should also be an important therapeutic target, especially in alert patients. KW - Early rehabilitation KW - Ventilation KW - Decannulation KW - Cognition KW - Neuromental index KW - Frührehabilitation KW - Beatmung KW - Dekanülierung KW - Kognition KW - Neuromentalindex Y1 - 0201 U6 - https://doi.org/10.1007/s00115-017-0311-5 SN - 0028-2804 SN - 1433-0407 VL - 88 SP - 905 EP - 910 PB - Springer CY - New York ER - TY - JOUR A1 - Kiefer, Thomas A1 - Krahl, Dorothea A1 - Osthoff, Kathrin A1 - Thuss-Patience, Peter A1 - Bunse, Jörg A1 - Adam, Ulrich A1 - Jansen, Marc H. A1 - Ott, Rudolf A1 - Pfitzmann, Robert A1 - Pross, Matthias A1 - Kohlmann, Thomas A1 - Daeschlein, Georg A1 - Buhlert, Hermann A1 - Völler, Heinz A1 - Hirt, Carsten T1 - Importance of Pancreatic Enzyme Replacement Therapy after Surgery of Cancer of the Esophagus or the Esophagogastric Junction JF - Nutrition and cancer : an international journal N2 - After surgical treatment of cancer of the esophagus or the esophagogastric junction we observed steatorrhea, which is so far seldom reported. We analyzed all patients treated in our rehabilitation clinic between 2011 and 2014 and focused on the impact of surgery on digestion of fat. Reported steatorrhea was anamnestic, no pancreatic function test was made. Here we show the results from 51 patients. Twenty-three (45%) of the patients reported steatorrhea. Assuming decreased pancreatic function pancreatic enzyme replacement therapy (PERT) was started or modified during the rehabilitation stay (in the following called STEA(+)). These patients were compared with the patients without steatorrhea and without PERT (STEA(-)). Maximum weight loss between surgery and rehabilitation start was 18 kg in STEA(+) patient and 15.3 kg in STEA(-) patients. STEA(+) patients gained more weight under PERT during the rehabilitation phase (3 wk) than STEA(-) patients without PERT (+1.0 kg vs. -0.3 kg, P = 0.032). We report for the first time, that patients after cancer related esophageal surgery show anamnestic signs of exocrine pancreas insufficiency and need PERT to gain body weight. Y1 - 2017 U6 - https://doi.org/10.1080/01635581.2017.1374419 SN - 0163-5581 SN - 1532-7914 VL - 70 IS - 1 SP - 69 EP - 72 PB - Routledge, Taylor & Francis Group CY - Abingdon ER - TY - GEN A1 - Kiefer-Trendelenburg, Thomas Hermann A1 - Völler, Heinz A1 - Nothroff, Jörg A1 - Schikora, Martin A1 - Bartels-Reinisch, Birgit A1 - Heyne, Karolin A1 - Daeschlein, Georg T1 - Prevalence of patients with multiresistant pathogens (MRP) in rehabilitation clinics T2 - Oncology Research and Treatment Y1 - 2017 SN - 2296-5270 SN - 2296-5262 VL - 40 SP - 198 EP - 198 PB - Karger CY - Basel 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 - Vigorito, Carlo A1 - Abreu, Ana A1 - Ambrosetti, Marco A1 - Belardinelli, Romualdo A1 - Corra, Ugo A1 - Cupples, Margaret A1 - Davos, Constantinos H. A1 - Hoefer, Stefan A1 - Iliou, Marie-Christine A1 - Schmid, Jean-Paul A1 - Völler, Heinz A1 - Doherty, Patrick T1 - Frailty and cardiac rehabilitation: A call to action from the EAPC Cardiac Rehabilitation Section JF - European journal of preventive cardiology : the official ESC journal for primary & secondary cardiovascular prevention, rehabilitation and sports cardiology N2 - Frailty is a geriatric syndrome characterised by a vulnerability status associated with declining function of multiple physiological systems and loss of physiological reserves. Two main models of frailty have been advanced: the phenotypic model (primary frailty) or deficits accumulation model (secondary frailty), and different instruments have been proposed and validated to measure frailty. However measured, frailty correlates to medical outcomes in the elderly, and has been shown to have prognostic value for patients in different clinical settings, such as in patients with coronary artery disease, after cardiac surgery or transvalvular aortic valve replacement, in patients with chronic heart failure or after left ventricular assist device implantation. The prevalence, clinical and prognostic relevance of frailty in a cardiac rehabilitation setting has not yet been well characterised, despite the increasing frequency of elderly patients in cardiac rehabilitation, where frailty is likely to influence the onset, type and intensity of the exercise training programme and the design of tailored rehabilitative interventions for these patients. Therefore, we need to start looking for frailty in elderly patients entering cardiac rehabilitation programmes and become more familiar with some of the tools to recognise and evaluate the severity of this condition. Furthermore, we need to better understand whether exercise-based cardiac rehabilitation may change the course and the prognosis of frailty in cardiovascular patients. KW - Frailty KW - cardiac rehabilitation KW - elderly Y1 - 2017 U6 - https://doi.org/10.1177/2047487316682579 SN - 2047-4873 SN - 2047-4881 VL - 24 SP - 577 EP - 590 PB - Sage Publ. CY - London ER - TY - JOUR A1 - Hansen, Dominique A1 - Dendale, Paul A1 - Coninx, Karin A1 - Vanhees, Luc A1 - Piepoli, Massimo F. A1 - Niebauer, Josef A1 - Cornelissen, Veronique A1 - Pedretti, Roberto A1 - Geurts, Eva A1 - Ruiz, Gustavo R. A1 - Corra, Ugo A1 - Schmid, Jean-Paul A1 - Greco, Eugenio A1 - Davos, Constantinos H. A1 - Edelmann, Frank A1 - Abreu, Ana A1 - Rauch, Bernhard A1 - Ambrosetti, Marco A1 - Braga, Simona S. A1 - Barna, Olga A1 - Beckers, Paul A1 - Bussotti, Maurizio A1 - Fagard, Robert A1 - Faggiano, Pompilio A1 - Garcia-Porrero, Esteban A1 - Kouidi, Evangelia A1 - Lamotte, Michel A1 - Neunhaeuserer, Daniel A1 - Reibis, Rona Katharina A1 - Spruit, Martijn A. A1 - Stettler, Christoph A1 - Takken, Tim A1 - Tonoli, Cajsa A1 - Vigorito, Carlo A1 - Völler, Heinz A1 - Doherty, Patrick T1 - The European Association of Preventive Cardiology Exercise Prescription in Everyday Practice and Rehabilitative Training (EXPERT) tool: A digital training and decision support system for optimized exercise prescription in cardiovascular disease. Concept, definitions and construction methodology JF - European journal of preventive cardiology : the official ESC journal for primary & secondary cardiovascular prevention, rehabilitation and sports cardiology N2 - Background Exercise rehabilitation is highly recommended by current guidelines on prevention of cardiovascular disease, but its implementation is still poor. Many clinicians experience difficulties in prescribing exercise in the presence of different concomitant cardiovascular diseases and risk factors within the same patient. It was aimed to develop a digital training and decision support system for exercise prescription in cardiovascular disease patients in clinical practice: the European Association of Preventive Cardiology Exercise Prescription in Everyday Practice and Rehabilitative Training (EXPERT) tool. Methods EXPERT working group members were requested to define (a) diagnostic criteria for specific cardiovascular diseases, cardiovascular disease risk factors, and other chronic non-cardiovascular conditions, (b) primary goals of exercise intervention, (c) disease-specific prescription of exercise training (intensity, frequency, volume, type, session and programme duration), and (d) exercise training safety advices. The impact of exercise tolerance, common cardiovascular medications and adverse events during exercise testing were further taken into account for optimized exercise prescription. Results Exercise training recommendations and safety advices were formulated for 10 cardiovascular diseases, five cardiovascular disease risk factors (type 1 and 2 diabetes, obesity, hypertension, hypercholesterolaemia), and three common chronic non-cardiovascular conditions (lung and renal failure and sarcopaenia), but also accounted for baseline exercise tolerance, common cardiovascular medications and occurrence of adverse events during exercise testing. An algorithm, supported by an interactive tool, was constructed based on these data. This training and decision support system automatically provides an exercise prescription according to the variables provided. Conclusion This digital training and decision support system may contribute in overcoming barriers in exercise implementation in common cardiovascular diseases. KW - Cardiovascular disease KW - rehabilitation KW - exercise training KW - training and decision support system Y1 - 2017 U6 - https://doi.org/10.1177/2047487317702042 SN - 2047-4873 SN - 2047-4881 VL - 24 SP - 1017 EP - 1031 PB - Sage Publ. CY - London ER - TY - JOUR A1 - Eichler, Sarah A1 - Rabe, Sophie A1 - Salzwedel, Annett A1 - Mueller, Steffen A1 - Stoll, Josefine A1 - Tilgner, Nina A1 - John, Michael A1 - Wegscheider, Karl A1 - Mayer, Frank A1 - Völler, Heinz T1 - Effectiveness of an interactive telerehabilitation system with home-based exercise training in patients after total hip or knee replacement: study protocol for a multicenter, superiority, no-blinded randomized controlled trial JF - Trials N2 - Background: Total hip or knee replacement is one of the most frequently performed surgical procedures. Physical rehabilitation following total hip or knee replacement is an essential part of the therapy to improve functional outcomes and quality of life. After discharge from inpatient rehabilitation, a subsequent postoperative exercise therapy is needed to maintain functional mobility. Telerehabilitation may be a potential innovative treatment approach. We aim to investigate the superiority of an interactive telerehabilitation intervention for patients after total hip or knee replacement, in comparison to usual care, regarding physical performance, functional mobility, quality of life and pain. Methods/design: This is an open, randomized controlled, multicenter superiority study with two prospective arms. One hundred and ten eligible and consenting participants with total knee or hip replacement will be recruited at admission to subsequent inpatient rehabilitation. After comprehensive, 3-week, inpatient rehabilitation, the intervention group performs a 3-month, interactive, home-based exercise training with a telerehabilitation system. For this purpose, the physiotherapist creates an individual training plan out of 38 different strength and balance exercises which were implemented in the system. Data about the quality and frequency of training are transmitted to the physiotherapist for further adjustment. Communication between patient and physiotherapist is possible with the system. The control group receives voluntary, usual aftercare programs. Baseline assessments are investigated after discharge from rehabilitation; final assessments 3 months later. The primary outcome is the difference in improvement between intervention and control group in 6-minute walk distance after 3 months. Secondary outcomes include differences in the Timed Up and Go Test, the Five-Times-Sit-to-Stand Test, the Stair Ascend Test, the Short-Form 36, the Western Ontario and McMaster Universities Osteoarthritis Index, the International Physical Activity Questionnaire, and postural control as well as gait and kinematic parameters of the lower limbs. Baseline-adjusted analysis of covariance models will be used to test for group differences in the primary and secondary endpoints. Discussion: We expect the intervention group to benefit from the interactive, home-based exercise training in many respects represented by the study endpoints. If successful, this approach could be used to enhance the access to aftercare programs, especially in structurally weak areas. KW - Telerehabilitation KW - Home-based KW - Total hip replacement KW - Total knee replacement KW - Exercise therapy KW - Aftercare Y1 - 2017 U6 - https://doi.org/10.1186/s13063-017-2173-3 SN - 1745-6215 VL - 18 PB - BioMed Central CY - London ER - TY - JOUR A1 - Algharably, Engi A. H. A1 - Bolbrinker, Juliane A1 - Lezius, Susanne A1 - Reibis, Rona Katharina A1 - Wegscheider, Karl A1 - Völler, Heinz A1 - Kreutz, Reinhold T1 - Uromodulin associates with cardiorenal function in patients with hypertension and cardiovascular disease JF - Journal of hypertension N2 - 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. KW - blood pressure KW - cardiovascular complications KW - chronic kidney disease KW - genetics KW - hypertension KW - kidney function KW - organ damage KW - Tamm-Horsfall protein Y1 - 2017 U6 - https://doi.org/10.1097/HJH.0000000000001432 SN - 0263-6352 SN - 1473-5598 VL - 35 SP - 2053 EP - 2058 PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - GEN A1 - Reibis, Rona Katharina A1 - Salzwedel, Annett A1 - Bonaventura, Klaus A1 - Völler, Heinz A1 - Wegscheider, Karl T1 - Improvement of left ventricular ejection fraction in revascularized postmyocardial patients BT - indication for statistical fallacy T2 - Postprints der Universität Potsdam : Mathematisch Naturwissenschaftliche Reihe N2 - 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. T3 - Zweitveröffentlichungen der Universität Potsdam : Mathematisch-Naturwissenschaftliche Reihe - 882 KW - cardioverter-defibrillator KW - heart failure KW - myocardial infarction KW - regression toward the mean Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-435093 SN - 1866-8372 IS - 882 ER - TY - GEN A1 - Vigorito, Carlo A1 - Abreu, Ana A1 - Ambrosetti, Marco A1 - Belardinelli, Romualdo A1 - Corrà, Ugo A1 - Cupples, Margaret A1 - Davos, Constantinos H. A1 - Hoefer, Stefan A1 - Iliou, Marie-Christine A1 - Schmid, Jean-Paul A1 - Völler, Heinz A1 - Doherty, Patrick T1 - Frailty and cardiac rehabilitation BT - a call to action from the EAPC Cardiac Rehabilitation Section T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Frailty is a geriatric syndrome characterised by a vulnerability status associated with declining function of multiple physiological systems and loss of physiological reserves. Two main models of frailty have been advanced: the phenotypic model (primary frailty) or deficits accumulation model (secondary frailty), and different instruments have been proposed and validated to measure frailty. However measured, frailty correlates to medical outcomes in the elderly, and has been shown to have prognostic value for patients in different clinical settings, such as in patients with coronary artery disease, after cardiac surgery or transvalvular aortic valve replacement, in patients with chronic heart failure or after left ventricular assist device implantation. The prevalence, clinical and prognostic relevance of frailty in a cardiac rehabilitation setting has not yet been well characterised, despite the increasing frequency of elderly patients in cardiac rehabilitation, where frailty is likely to influence the onset, type and intensity of the exercise training programme and the design of tailored rehabilitative interventions for these patients. Therefore, we need to start looking for frailty in elderly patients entering cardiac rehabilitation programmes and become more familiar with some of the tools to recognise and evaluate the severity of this condition. Furthermore, we need to better understand whether exercise-based cardiac rehabilitation may change the course and the prognosis of frailty in cardiovascular patients. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 406 KW - frailty KW - cardiac rehabilitation KW - elderly Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-405172 IS - 406 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 - TY - GEN A1 - Eichler, Sarah A1 - Rabe, Sophie A1 - Salzwedel, Annett A1 - Müller, Steffen A1 - Stoll, Josefine A1 - Tilgner, Nina A1 - John, Michael A1 - Wegschneider, Karl A1 - Mayer, Frank A1 - Völler, Heinz T1 - Effectiveness of an interactive telerehabilitation system with home-based exercise training in patients after total hip or knee replacement BT - Study protocol for a multicenter, superiority, no-blinded randomized controlled trial N2 - Background Total hip or knee replacement is one of the most frequently performed surgical procedures. Physical rehabilitation following total hip or knee replacement is an essential part of the therapy to improve functional outcomes and quality of life. After discharge from inpatient rehabilitation, a subsequent postoperative exercise therapy is needed to maintain functional mobility. Telerehabilitation may be a potential innovative treatment approach. We aim to investigate the superiority of an interactive telerehabilitation intervention for patients after total hip or knee replacement, in comparison to usual care, regarding physical performance, functional mobility, quality of life and pain. Methods/design This is an open, randomized controlled, multicenter superiority study with two prospective arms. One hundred and ten eligible and consenting participants with total knee or hip replacement will be recruited at admission to subsequent inpatient rehabilitation. After comprehensive, 3-week, inpatient rehabilitation, the intervention group performs a 3-month, interactive, home-based exercise training with a telerehabilitation system. For this purpose, the physiotherapist creates an individual training plan out of 38 different strength and balance exercises which were implemented in the system. Data about the quality and frequency of training are transmitted to the physiotherapist for further adjustment. Communication between patient and physiotherapist is possible with the system. The control group receives voluntary, usual aftercare programs. Baseline assessments are investigated after discharge from rehabilitation; final assessments 3 months later. The primary outcome is the difference in improvement between intervention and control group in 6-minute walk distance after 3 months. Secondary outcomes include differences in the Timed Up and Go Test, the Five-Times-Sit-to-Stand Test, the Stair Ascend Test, the Short-Form 36, the Western Ontario and McMaster Universities Osteoarthritis Index, the International Physical Activity Questionnaire, and postural control as well as gait and kinematic parameters of the lower limbs. Baseline-adjusted analysis of covariance models will be used to test for group differences in the primary and secondary endpoints. Discussion We expect the intervention group to benefit from the interactive, home-based exercise training in many respects represented by the study endpoints. If successful, this approach could be used to enhance the access to aftercare programs, especially in structurally weak areas. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 353 KW - Aftercare KW - Exercise therapy KW - Home-based KW - Telerehabilitation KW - Total hip replacement KW - Total knee replacement Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-403702 ER - TY - JOUR A1 - Eichler, Sarah A1 - Rabe, Sophie A1 - Salzwedel, Annett A1 - Müller, Steffen A1 - Stoll, Josefine A1 - Tilgner, Nina A1 - John, Michael A1 - Wegschneider, Karl A1 - Mayer, Frank A1 - Völler, Heinz T1 - Effectiveness of an interactive telerehabilitation system with home-based exercise training in patients after total hip or knee replacement BT - Study protocol for a multicenter, superiority, no-blinded randomized controlled trial JF - Trials N2 - Background Total hip or knee replacement is one of the most frequently performed surgical procedures. Physical rehabilitation following total hip or knee replacement is an essential part of the therapy to improve functional outcomes and quality of life. After discharge from inpatient rehabilitation, a subsequent postoperative exercise therapy is needed to maintain functional mobility. Telerehabilitation may be a potential innovative treatment approach. We aim to investigate the superiority of an interactive telerehabilitation intervention for patients after total hip or knee replacement, in comparison to usual care, regarding physical performance, functional mobility, quality of life and pain. Methods/design This is an open, randomized controlled, multicenter superiority study with two prospective arms. One hundred and ten eligible and consenting participants with total knee or hip replacement will be recruited at admission to subsequent inpatient rehabilitation. After comprehensive, 3-week, inpatient rehabilitation, the intervention group performs a 3-month, interactive, home-based exercise training with a telerehabilitation system. For this purpose, the physiotherapist creates an individual training plan out of 38 different strength and balance exercises which were implemented in the system. Data about the quality and frequency of training are transmitted to the physiotherapist for further adjustment. Communication between patient and physiotherapist is possible with the system. The control group receives voluntary, usual aftercare programs. Baseline assessments are investigated after discharge from rehabilitation; final assessments 3 months later. The primary outcome is the difference in improvement between intervention and control group in 6-minute walk distance after 3 months. Secondary outcomes include differences in the Timed Up and Go Test, the Five-Times-Sit-to-Stand Test, the Stair Ascend Test, the Short-Form 36, the Western Ontario and McMaster Universities Osteoarthritis Index, the International Physical Activity Questionnaire, and postural control as well as gait and kinematic parameters of the lower limbs. Baseline-adjusted analysis of covariance models will be used to test for group differences in the primary and secondary endpoints. Discussion We expect the intervention group to benefit from the interactive, home-based exercise training in many respects represented by the study endpoints. If successful, this approach could be used to enhance the access to aftercare programs, especially in structurally weak areas. KW - Telerehabilitation KW - Home-based KW - Total hip replacement KW - Total knee replacement KW - Exercise therapy KW - Aftercare Y1 - 2017 U6 - https://doi.org/10.1186/s13063-017-2173-3 SN - 1745-6215 VL - 18 SP - 1 EP - 7 PB - BioMed Central CY - London ER - TY - GEN 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 - User Interest in Digital Health Technologies to Encourage Physical Activity BT - Results of a Survey in Students and Staff of a German University N2 - Background: Although the benefits for health of physical activity (PA) are well documented, the majority of the population is unable to implement present recommendations into daily routine. Mobile health (mHealth) apps could help increase the level of PA. However, this is contingent on the interest of potential users. Objective: The aim of this study was the explorative, nuanced determination of the interest in mHealth apps with respect to PA among students and staff of a university. Methods: We conducted a Web-based survey from June to July 2015 in which students and employees from the University of Potsdam were asked about their activity level, interest in mHealth fitness apps, chronic diseases, and sociodemographic parameters. Results: A total of 1217 students (67.30%, 819/1217; female; 26.0 years [SD 4.9]) and 485 employees (67.5%, 327/485; female; 42.7 years [SD 11.7]) participated in the survey. The recommendation for PA (3 times per week) was not met by 70.1% (340/485) of employees and 52.67% (641/1217) of students. Within these groups, 53.2% (341/641 students) and 44.2% (150/340 employees)—independent of age, sex, body mass index (BMI), and level of education or professional qualification—indicated an interest in mHealth fitness apps. Conclusions: Even in a younger, highly educated population, the majority of respondents reported an insufficient level of PA. About half of them indicated their interest in training support. This suggests that the use of personalized mobile fitness apps may become increasingly significant for a positive change of lifestyle. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 342 KW - healthy lifestyle KW - physical activity KW - primary prevention KW - telemedicine Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-401872 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 - User Interest in Digital Health Technologies to Encourage Physical Activity BT - Results of a Survey in Students and Staff of a German University JF - JMIR. Mhealth & Uhealth N2 - Background: Although the benefits for health of physical activity (PA) are well documented, the majority of the population is unable to implement present recommendations into daily routine. Mobile health (mHealth) apps could help increase the level of PA. However, this is contingent on the interest of potential users. Objective: The aim of this study was the explorative, nuanced determination of the interest in mHealth apps with respect to PA among students and staff of a university. Methods: We conducted a Web-based survey from June to July 2015 in which students and employees from the University of Potsdam were asked about their activity level, interest in mHealth fitness apps, chronic diseases, and sociodemographic parameters. Results: A total of 1217 students (67.30%, 819/1217; female; 26.0 years [SD 4.9]) and 485 employees (67.5%, 327/485; female; 42.7 years [SD 11.7]) participated in the survey. The recommendation for PA (3 times per week) was not met by 70.1% (340/485) of employees and 52.67% (641/1217) of students. Within these groups, 53.2% (341/641 students) and 44.2% (150/340 employees)—independent of age, sex, body mass index (BMI), and level of education or professional qualification—indicated an interest in mHealth fitness apps. Conclusions: Even in a younger, highly educated population, the majority of respondents reported an insufficient level of PA. About half of them indicated their interest in training support. This suggests that the use of personalized mobile fitness apps may become increasingly significant for a positive change of lifestyle. KW - physical activity KW - telemedicine KW - primary prevention KW - healthy lifestyle Y1 - 2017 U6 - https://doi.org/10.2196/mhealth.7192 VL - 5 IS - 4 PB - JMIR Publications CY - Toronto ER - TY - JOUR 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 JF - Vascular Health and Risk Management 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. KW - cardiac rehabilitation KW - cognitive impairment KW - prevalence KW - acute coronary event KW - patient education Y1 - 2017 U6 - https://doi.org/10.2147/VHRM.S121086 SN - 1176-6344 SN - 1178-2048 VL - 13 SP - 55 EP - 60 PB - Dove Medical Press Ltd CY - Albany, Auckland ER -