TY - JOUR A1 - Salzwedel, Annett A1 - Reibis, Rona Katharina A1 - Hadzic, Miralem A1 - Buhlert, Hermann A1 - Völler, Heinz T1 - Patients’ expectations of returning to work, co-morbid disorders and work capacity at discharge from cardiac rehabilitation JF - Vascular Health and Risk Management N2 - Objective: We aimed to characterize patients after an acute cardiac event regarding their negative expectations around returning to work and the impact on work capacity upon discharge from cardiac rehabilitation (CR). Methods: We analyzed routine data of 884 patients (52±7 years, 76% men) who attended 3 weeks of inpatient CR after an acute coronary syndrome (ACS) or cardiac surgery between October 2013 and March 2015. The primary outcome was their status determining their capacity to work (fit vs unfit) at discharge from CR. Further, sociodemographic data (eg, age, sex, and education level), diagnoses, functional data (eg, exercise stress test and 6-min walking test [6MWT]), the Hospital Anxiety and Depression Scale (HADS) and self-assessment of the occupational prognosis (negative expectations and/or unemployment, Würzburger screening) at admission to CR were considered. Results: A negative occupational prognosis was detected in 384 patients (43%). Out of these, 368 (96%) expected not to return to work after CR and/or were unemployed before CR at 29% (n=113). Affected patients showed a reduced exercise capacity (bicycle stress test: 100 W vs 118 W, P<0.01; 6MWT: 380 m vs 421 m, P<0.01) and were more likely to receive a depression diagnosis (12% vs 3%, P<0.01), as well as higher levels on the HADS. At discharge from CR, 21% of this group (n=81) were fit for work (vs 35% of patients with a normal occupational prognosis (n=175, P<0.01)). Sick leave before the cardiac event (OR 0.4, 95% CI 0.2–0.6, P<0.01), negative occupational expectations (OR 0.4, 95% CI 0.3–0.7, P<0.01) and depression (OR 0.3, 95% CI 0.1–0.8, P=0.01) reduced the likelihood of achieving work capacity upon discharge. In contrast, higher exercise capacity was positively associated. Conclusion: Patients with a negative occupational prognosis often revealed a reduced physical performance and suffered from a high psychosocial burden. In addition, patients’ occupational expectations were a predictor of work capacity at discharge from CR. Affected patients should be identified at admission to allow for targeted psychosocial care. KW - cardiac rehabilitation KW - return to work KW - work capacity KW - negative expectation KW - occupational prognosis Y1 - 2019 U6 - https://doi.org/10.2147/VHRM.S216039 SN - 1176-6344 SN - 1178-2048 VL - 15 SP - 301 EP - 308 PB - Dove Medical Press CY - Albany, Auckland ER - TY - GEN A1 - Salzwedel, Annett A1 - Hadzic, Miralem A1 - Buhlert, Hermann A1 - Völler, Heinz T1 - Impact of self-assessment of return to work on employable discharge from multi-component cardiac rehabilitation T2 - European heart journal N2 - Impact of self-assessment of return to work on employable discharge from multi-component cardiac rehabilitation. Retrospective unicentric analysis of routine data from cardiac rehabilitation in patients below 65 years of age. Presentation in the "Cardiovascular rehabilitation revisited" high impact abstract session during ESC Congress 2018. Y1 - 2018 SN - 0195-668X SN - 1522-9645 VL - 39 SP - 21 EP - 22 PB - Oxford Univ. Press CY - Oxford ER - TY - GEN A1 - Salzwedel, Annett A1 - Reibis, Rona Katharina A1 - Hadzic, Miralem A1 - Buhlert, Hermann A1 - Völler, Heinz T1 - Patients’ expectations of returning to work, co-morbid disorders and work capacity at discharge from cardiac rehabilitation T2 - Postprints der Universität Potsdam Humanwissenschaftliche Reihe N2 - Objective: We aimed to characterize patients after an acute cardiac event regarding their negative expectations around returning to work and the impact on work capacity upon discharge from cardiac rehabilitation (CR). Methods: We analyzed routine data of 884 patients (52±7 years, 76% men) who attended 3 weeks of inpatient CR after an acute coronary syndrome (ACS) or cardiac surgery between October 2013 and March 2015. The primary outcome was their status determining their capacity to work (fit vs unfit) at discharge from CR. Further, sociodemographic data (eg, age, sex, and education level), diagnoses, functional data (eg, exercise stress test and 6-min walking test [6MWT]), the Hospital Anxiety and Depression Scale (HADS) and self-assessment of the occupational prognosis (negative expectations and/or unemployment, Würzburger screening) at admission to CR were considered. Results: A negative occupational prognosis was detected in 384 patients (43%). Out of these, 368 (96%) expected not to return to work after CR and/or were unemployed before CR at 29% (n=113). Affected patients showed a reduced exercise capacity (bicycle stress test: 100 W vs 118 W, P<0.01; 6MWT: 380 m vs 421 m, P<0.01) and were more likely to receive a depression diagnosis (12% vs 3%, P<0.01), as well as higher levels on the HADS. At discharge from CR, 21% of this group (n=81) were fit for work (vs 35% of patients with a normal occupational prognosis (n=175, P<0.01)). Sick leave before the cardiac event (OR 0.4, 95% CI 0.2–0.6, P<0.01), negative occupational expectations (OR 0.4, 95% CI 0.3–0.7, P<0.01) and depression (OR 0.3, 95% CI 0.1–0.8, P=0.01) reduced the likelihood of achieving work capacity upon discharge. In contrast, higher exercise capacity was positively associated. Conclusion: Patients with a negative occupational prognosis often revealed a reduced physical performance and suffered from a high psychosocial burden. In addition, patients’ occupational expectations were a predictor of work capacity at discharge from CR. Affected patients should be identified at admission to allow for targeted psychosocial care. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 574 KW - cardiac rehabilitation KW - return to work KW - work capacity KW - negative expectation KW - occupational prognosis Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-437263 SN - 1866-8364 IS - 574 SP - 301 EP - 308 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 - 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 - JOUR A1 - Völler, Heinz A1 - Salzwedel, Annett A1 - Nitardy, Aischa A1 - Buhlert, Hermann A1 - Treszl, Andras A1 - Wegscheider, Karl T1 - Effect of cardiac rehabilitation on functional and emotional status in patients after transcatheter aortic-valve implantation JF - European journal of preventive cardiology : the official ESC journal for primary & secondary cardiovascular prevention, rehabilitation and sports cardiology N2 - Background Transcatheter aortic-valve implantation (TAVI) is an established alternative therapy in patients with severe aortic stenosis and a high surgical risk. Despite a rapid growth in its use, very few data exist about the efficacy of cardiac rehabilitation (CR) in these patients. We assessed the hypothesis that patients after TAVI benefit from CR, compared to patients after surgical aortic-valve replacement (sAVR). Methods From September 2009 to August 2011, 442 consecutive patients after TAVI (n=76) or sAVR (n=366) were referred to a 3-week CR. Data regarding patient characteristics as well as changes of functional (6-min walk test. 6-MWT), bicycle exercise test), and emotional status (Hospital Anxiety and Depression Scale) were retrospectively evaluated and compared between groups after propensity score adjustment. Results Patients after TAVI were significantly older (p<0.001), more female (p<0.001), and had more often coronary artery disease (p=0.027), renal failure (p=0.012) and a pacemaker (p=0.032). During CR, distance in 6-MWT (both groups p0.001) and exercise capacity (sAVR p0.001, TAVI p0.05) significantly increased in both groups. Only patients after sAVR demonstrated a significant reduction in anxiety and depression (p0.001). After propensity scores adjustment, changes were not significantly different between sAVR and TAVI, with the exception of 6-MWT (p=0.004). Conclusions Patients after TAVI benefit from cardiac rehabilitation despite their older age and comorbidities. CR is a helpful tool to maintain independency for daily life activities and participation in socio-cultural life. KW - Cardiac rehabilitation KW - emotional status KW - functional capacity KW - surgical aortic valve replacement (sAVR) KW - transcatheter aortic valve implantation (TAVI) Y1 - 2015 U6 - https://doi.org/10.1177/2047487314526072 SN - 2047-4873 SN - 2047-4881 VL - 22 IS - 5 SP - 568 EP - 574 PB - Sage Publ. CY - London ER - TY - CHAP A1 - Nitardy, Aischa A1 - Salzwedel, Annett A1 - Wegscheider, Karl A1 - Jawari, Amir A1 - Buhlert, Hermann A1 - Völler, Heinz T1 - Effect of cardiac rehabilitation on functional and emotional status in patients after transcatheter aortic-valve replacement T2 - Circulation : an American Heart Association journal KW - Cardiac rehabilitation KW - TAVI KW - Transcatheter Aortic Valve Implantation KW - Aortic valve KW - Exercise tests Y1 - 2012 SN - 0009-7322 SN - 1524-4539 VL - 126 IS - 21 PB - Lippincott Williams & Wilkins CY - Philadelphia 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 - TY - JOUR A1 - Salzwedel, Annett A1 - Reibis, Rona Katharina A1 - Wegscheider, Karl A1 - Eichler, Sarah A1 - Buhlert, Hermann A1 - Kaminski, Stefan A1 - Völler, Heinz T1 - Cardiopulmonary exercise testing is predictive of return to work in cardiac patients after multicomponent rehabilitation JF - Clinical research in cardiology : official journal of the German Cardiac Society. N2 - Return to work (RTW) is a pivotal goal of cardiac rehabilitation (CR) in patients after acute cardiac event. We aimed to evaluate cardiopulmonary exercise testing (CPX) parameters as predictors for RTW at discharge after CR. We analyzed data from a registry of 489 working-age patients (51.5 +/- A 6.9 years, 87.9 % men) who had undergone inpatient CR predominantly after percutaneous coronary intervention (PCI 62.6 %), coronary artery bypass graft (CABG 17.2 %), or heart valve replacement (9.0 %). Sociodemographic and clinical parameters, noninvasive cardiac diagnostic (2D echo, exercise ECG, 6MWT) and psychodiagnostic screening data, as well as CPX findings, were merged with RTW data from the German statutory pension insurance program and analyzed for prognostic ability. During a mean follow-up of 26.5 +/- A 11.9 months, 373 (76.3 %) patients returned to work, 116 (23.7 %) did not, and 60 (12.3 %) retired. After adjustment for covariates, elective CABG (HR 0.68, 95 % CI 0.47-0.98; p = 0.036) and work intensity (per level HR 0.83, 95 % CI 0.73-0.93; p = 0.002) were negatively associated with the probability of RTW. Exercise capacity in CPX (in Watts) and the VE/VCO2-slope had independent prognostic significance for RTW. A higher work load increased (HR 1.17, 95 % CI 1.02-1.35; p = 0.028) the probability of RTW, while a higher VE/VCO2 slope decreased (HR 0.85, 95 % CI 0.76-0.96; p = 0.009) it. CPX also had prognostic value for retirement: the likelihood of retirement decreased with increasing exercise capacity (HR 0.50, 95 % CI 0.30-0.82; p = 0.006). KW - Cardiac rehabilitation KW - Prognosis KW - Exercise capacity KW - Coronary disease KW - Social medicine Y1 - 2016 U6 - https://doi.org/10.1007/s00392-015-0917-1 SN - 1861-0684 SN - 1861-0692 VL - 105 SP - 257 EP - 267 PB - Springer CY - Heidelberg ER - TY - JOUR A1 - Reibis, Rona Katharina A1 - Salzwedel, Annett A1 - Buhlert, Hermann A1 - Wegscheider, Karl A1 - Eichler, Sarah A1 - Völler, Heinz T1 - Impact of training methods and patient characteristics on exercise capacity in patients in cardiovascular rehabilitation JF - European journal of preventive cardiology : the official ESC journal for primary & secondary cardiovascular prevention, rehabilitation and sports cardiology N2 - Aim We aimed to identify patient characteristics and comorbidities that correlate with the initial exercise capacity of cardiac rehabilitation (CR) patients and to study the significance of patient characteristics, comorbidities and training methods for training achievements and final fitness of CR patients. Methods We studied 557 consecutive patients (51.76.9 years; 87.9% men) admitted to a three-week in-patient CR. Cardiopulmonary exercise testing (CPX) was performed at discharge. Exercise capacity (watts) at entry, gain in training volume and final physical fitness (assessed by peak O-2 utilization (VO2peak) were analysed using analysis of covariance (ANCOVA) models. Results Mean training intensity was 90.7 +/- 9.7% of maximum heart rate (81% continuous/19% interval training, 64% additional strength training). A total of 12.2 +/- 2.6 bicycle exercise training sessions were performed. Increase of training volume by an average of more than 100% was achieved (difference end/beginning of CR: 784 +/- 623 wattsxmin). In the multivariate model the gain in training volume was significantly associated with smoking, age and exercise capacity at entry of CR. The physical fitness level achieved at discharge from CR as assessed by VO2peak was mainly dependent on age, but also on various factors related to training, namely exercise capacity at entry, increase of training volume and training method. Conclusion CR patients were trained in line with current guidelines with moderate-to-high intensity and reached a considerable increase of their training volume. The physical fitness level achieved at discharge from CR depended on various factors associated with training, which supports the recommendation that CR should be offered to all cardiac patients. KW - Cardiac rehabilitation KW - exercise tests KW - cardiorespiratory fitness KW - multivariate modelling Y1 - 2016 U6 - https://doi.org/10.1177/2047487315600815 SN - 2047-4873 SN - 2047-4881 VL - 23 SP - 452 EP - 459 PB - Sage Publ. CY - London ER - TY - GEN A1 - Reibis, Rona Katharina A1 - Salzwedel, Annett A1 - Buhlert, Hermann A1 - Wegscheider, Karl A1 - Eichler, Sarah A1 - Völler, Heinz T1 - Impact of training methods and patient characteristics on exercise capacity in patients in cardiovascular rehabilitation T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Aim: We aimed to identify patient characteristics and comorbidities that correlate with the initial exercise capacity of cardiac rehabilitation (CR) patients and to study the significance of patient characteristics, comorbidities and training methods for training achievements and final fitness of CR patients. Methods: We studied 557 consecutive patients (51.7 Æ 6.9 years; 87.9% men) admitted to a three-week in-patient CR. Cardiopulmonary exercise testing (CPX) was performed at discharge. Exercise capacity (watts) at entry, gain in training volume and final physical fitness (assessed by peak O 2 utilization (VO 2peak ) were analysed using analysis of covariance (ANCOVA) models. Results: Mean training intensity was 90.7 Æ 9.7% of maximum heart rate (81% continuous/19% interval training, 64% additional strength training). A total of 12.2 Æ 2.6 bicycle exercise training sessions were performed. Increase of training volume by an average of more than 100% was achieved (difference end/beginning of CR: 784 Æ 623 watts  min). In the multivariate model the gain in training volume was significantly associated with smoking, age and exercise capacity at entry of CR. The physical fitness level achieved at discharge from CR as assessed by VO 2peak was mainly dependent on age, but also on various factors related to training, namely exercise capacity at entry, increase of training volume and training method. Conclusion: CR patients were trained in line with current guidelines with moderate-to-high intensity and reached a considerable increase of their training volume. The physical fitness level achieved at discharge from CR depended on various factors associated with training, which supports the recommendation that CR should be offered to all cardiac patients. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 442 KW - cardiac rehabilitation KW - exercise tests KW - cardiorespiratory fitness KW - multivariate modelling Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-405302 IS - 442 ER - TY - GEN A1 - Völler, Heinz A1 - Salzwedel, Annett A1 - Nitardy, Aischa A1 - Buhlert, Hermann A1 - Treszl, Andra ́s A1 - Wegscheider, Karl T1 - Effect of cardiac rehabilitation on functional and emotional status in patients after transcatheter aortic-valve implantation T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Background Transcatheter aortic-valve implantation (TAVI) is an established alternative therapy in patients with severe aortic stenosis and a high surgical risk. Despite a rapid growth in its use, very few data exist about the efficacy of cardiac rehabilitation (CR) in these patients. We assessed the hypothesis that patients after TAVI benefit from CR, compared to patients after surgical aortic-valve replacement (sAVR). Methods From September 2009 to August 2011, 442 consecutive patients after TAVI (n=76) or sAVR (n=366) were referred to a 3-week CR. Data regarding patient characteristics as well as changes of functional (6-min walk test. 6-MWT), bicycle exercise test), and emotional status (Hospital Anxiety and Depression Scale) were retrospectively evaluated and compared between groups after propensity score adjustment. Results Patients after TAVI were significantly older (p<0.001), more female (p<0.001), and had more often coronary artery disease (p=0.027), renal failure (p=0.012) and a pacemaker (p=0.032). During CR, distance in 6-MWT (both groups p0.001) and exercise capacity (sAVR p0.001, TAVI p0.05) significantly increased in both groups. Only patients after sAVR demonstrated a significant reduction in anxiety and depression (p0.001). After propensity scores adjustment, changes were not significantly different between sAVR and TAVI, with the exception of 6-MWT (p=0.004). Conclusions Patients after TAVI benefit from cardiac rehabilitation despite their older age and comorbidities. CR is a helpful tool to maintain independency for daily life activities and participation in socio-cultural life. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 385 KW - Cardiac rehabilitation KW - emotional status KW - functional capacity KW - surgical aortic valve replacement (sAVR) KW - transcatheter aortic valve implantation (TAVI) Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-404100 IS - 385 ER -