Rehabilitation nach Polytrauma

Matthey, Francesca von; Biberthaler, Peter

doi:10.1007/s00132-015-3081-4

Cited by 8 publications

(6 citation statements)

References 19 publications

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“…Their main concerns were restricted mobility and activity levels, pain and anxiety/depression. These results mirror the current evidence base which reports a moderate impact on quality of life and mood at 12-months and 18-months post-traumatic injury 23–25 ; in particular, the relationship between pain and depression/anxiety and the impact on recovery after orthopaedic trauma 26,27 - Crichlow 28 found a 45% rate of depression in orthopaedic trauma patients. O’Donnell 29 suggested introducing PTSD/depression screening at 1-week and 3-months post-injury to identify patients with increased risk of disability and to allow early intervention.…”

Section: Discussionsupporting

confidence: 87%

“…32 However, there is some consensus that good pain management, early effective rehabilitation and psychological support will prevent long-term disability and help the individual return to work. 4,23,33 There was no correlation between ISS or RCS-ET and outcome, which suggests these tools are not predicative in this patient group; in fact, those with a low ISS (ISS ¼ 9) reported some of the worst outcomes. Type of injury appears to be a more useful predictive marker.…”

Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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Patient experiences of rehabilitation following traumatic complex musculoskeletal injury – A mixed methods pilot study

Silvester

Trompeter

Hing

2021

Trauma

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Introduction The aim of this pilot study was to measure patient reported outcomes and evaluate their rehabilitation experience following traumatic complex musculoskeletal (CMSK) injury. Methods A mixed methods prospective observational study was undertaken between December 2015 and March 2018 to explore patient reported outcomes following CMSK injury sustained as a result of major trauma and perception of their rehabilitation and its impact on their recovery. The participants were asked to complete a series of outcome measures at 18-months post-injury. The data was anonymised and analysed by the lead researcher. Results Thirty patients were recruited into the study (19 males, 11 females) between 23 and 76 years of age (median 52 years). Their injury profile was split between open fractures 30%, pelvic fractures 23%, multiple fractures 27% and polytrauma 20%. The majority (60%) reported moderate disability at 18-months post injury with 50% returning to full time employment. Patients with multiple or open fractures reported the worst outcomes. There was no relationship between frequency, quantity or duration of physiotherapy and outcome. However, 77% reported supplementing their NHS rehabilitation with other interventions such as gym membership, hydrotherapy and psychological therapies. The thematic analysis showed that patients considered intensity, quality and coordinated timely access to rehabilitation as the most important factors. Conclusion From a patient perspective, the current NHS rehabilitation provision does not appear to meet their complex needs. In addition to physical and vocational rehabilitation, patients wanted effective pain management and psychological support. Strengthening current therapy services and involving other sectors (e.g. Citizen’s Advice) could help achieve this. Early access to an intensive multidisciplinary rehabilitation programme was perceived to have positive benefits and improve outcomes.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 85%

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Patient experiences of rehabilitation following traumatic complex musculoskeletal injury – A mixed methods pilot study

Silvester

Trompeter

Hing

2021

Trauma

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“…Die flächendeckend mangelhafte Rehabilitation in nerhalb der Akutkliniken besteht für andere Versicherte weiter hin und das, obwohl seit Inkrafttreten des SGB IX am 1. Juli 2001 ein gesetzlicher Anspruch auf Frührehabilitation im Akutkran kenhaus besteht[39]. Hinsichtlich der Finanzierung der fachübergreifenden Frühreha bilitation ergibt sich für die durchführenden Häuser eine schwer kalkulierbare Situation, wenn die Akutversorgung und die Frührehabilitation im gleichen Krankenhaus durchgeführt wer den.…”

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“…Aus den hier vorgelegten Ergebnissen ergibt sich ein erheblicher zukünftiger Forschungsbedarf einschließlich der Förderung von Modellprojekten zur Etablierung unfallchirurgischer Frühreha bilitationsstationen in der Regelversorgung der schwerstverletz ten Patienten.Nicht nur der medizinische Fortschritt, auch die Veränderungen der Lebensarbeitszeit, die Verknappung des Arbeitskräftepoten zials und der demografische Wandel steigern die Bedeutung der medizinischen Rehabilitation, auch in Bezug auf das Polytrauma. Hierbei schließt die fachübergreifende Frührehabilitation die re habilitative Versorgungslücke zwischen dem letzten chirurgi schen Eingriff und der postakuten Rehabilitation[8,10,39]. In Zukunft werden weitere Daten benötigt, auch mit größeren Fallzahlen, die die Effektivität der fachübergreifenden Frühreha bilitation im Vergleich und langfristig überprüfen, um die weite re Etablierung frührehabilitativer Strukturen für nichtgeriatri sche und nichtneurologische Patienten zu rechtfertigen.…”

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Fachübergreifende Frührehabilitation nach Polytrauma – Eine deskriptive Analyse

Elmer

Reißhauer

Schröder

et al. 2016

Phys Med Rehab Kuror

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Zusammenfassung Hintergrund: Fr?hrehabilitation ist der fr?hestm?gliche Einsatz der Rehabilitation im Akutverlauf. Sie schlie?t in der Versorgung des Polytraumas die Rehabilitationsl?cke zwischen unfallchirurgischer Versorgung und Rehabilitationsklinik. Material und Methoden: 50 Polytraumaf?lle mit anschlie?ender fach?bergreifender Fr?hrehabilitation auf einer eigenen Fr?hrehabilitations-Station wurden retrospektiv analysiert. Als prim?re Outcome-Parameter wurden die Mobilit?t (Charit? Mobility Index?) und die ADL-Kompetenz (Barthel-Index) bei ?bernahme auf die Fr?hrehabilitations-Station und Entlassung untersucht. Ergebnisse: Im Verlauf der fach?bergreifenden Fr?hrehabilitation verbesserten sich die Mobilit?t (p<0,001; Effektst?rke |d|=2,5) und die ADL-Kompetenz (p<0,001; Effektst?rke |d|=2,4) hoch signifikant. Diskussion: Daten zum Outcome der Fr?hrehabilitation nach Polytrauma sind bislang kaum vorhanden. In Vorbereitung einer prospektiven kontrollierten Studie werden erstmals grundlegende Daten zu Rehabilitationsergebnissen der Fr?hrehabilitation von Polytrauma-Patienten pr?sentiert. Schlussfolgerung: Es wurde gezeigt, dass die Fr?hrehabilitation nach Polytrauma g?nstige Effekte in Mobilit?t und ADL aufweist.

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Limb development in mouse embryos. I. Analysis of teratogenic effects of retinoic acid

Kochhar

1973

Teratology

270

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Retinoic (vitamin A) acid produced phocomelia and micromelia in DBA/2J fetuses when administered to pregnant mice on the 12th or 13th day of gestation. The incidence of forelimb defects was higher after 12th-(in embryos having 3 3 4 1 somite pairs) than 13th-day treatment (40-51 somite pairs); the reverse was true for hindlimb defects. Hindlimb digits continued to be highly susceptible on the 14th day. Limb defects were not accompanied by body growth retardation or other skeletal malformations except cleft palate. The type and severity of limb defects depended on the average developmental stage of the limb bud at the time of treatment. From the beginning of the period of limb susceptibility, the 12th day, the ontogenetic sequence in which the long bones were rendered abnormal was: radius-ulna, humerus, fibula, tibia, femur or tibia-femur. The sequence in which the long bones lost their susceptibility to retinoic acid was: humerus, femur, ulna, radius, tibia-fibula. The radius appeared to be susceptible i n some embryos at a time when the other long bones had escaped injury. An analysis of the shape of the same bone affected at different periods of prenatal development led to the following proposal. At earlier stages retinoic acid disrupts cellular activities that normally lead to the spatial organization of the mesenchy-ma1 cell condensations, resulting in a modified shape of the cartilage models; at later stages i t prevents the enlargement of the condensations that have already appeared, resulting in smaller than normal models.

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Rehabilitation nach Polytrauma

Cited by 8 publications

References 19 publications

Patient experiences of rehabilitation following traumatic complex musculoskeletal injury – A mixed methods pilot study

Patient experiences of rehabilitation following traumatic complex musculoskeletal injury – A mixed methods pilot study

Fachübergreifende Frührehabilitation nach Polytrauma – Eine deskriptive Analyse

Limb development in mouse embryos. I. Analysis of teratogenic effects of retinoic acid

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