What to Expect: Medical Quality Outcomes and Achievements of a Multidisciplinary Inpatient Musculoskeletal System Rehabilitation

Grote, Vincent; Unger, Alexandra; Puff, Henry; Böttcher, Elke

doi:10.5772/intechopen.89596

Cited by 4 publications

(4 citation statements)

References 47 publications

(52 reference statements)

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“…Our success indicators are formed by summarizing the compulsory clinical data. 14,18 1. The GHI is the arithmetic mean of 3 independent variables: body shape [body mass index (BMI) and waist circumference], cardiovascular measurements (blood pressure and resting heart rate), and discomfort [visual analog scales for pain (VAS pain , 0e10) and subjective self-evaluation (EQ-VAS, 0e100)].…”

Section: Medical Outcome Qualitymentioning

confidence: 99%

“…The following is an example calculation for the ISI in orthopedic rehabilitation. 18 Standard scores, also called z-values (z), are calculated by subtracting the (population) mean (m ORT ) from an observation (X À pre or X À post ) and dividing this difference by the standard deviation seen for all orthopedic patients at admission and discharge (SD m ). As shown in the results section, deviations from zero and respectively mean differences in z-values (SMD) can be interpreted as an effect size (cf.…”

Section: Example Calculationmentioning

confidence: 99%

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General and Disease-Specific Health Indicator Changes Associated with Inpatient Rehabilitation

Grote

Unger

Böttcher³

et al. 2020

Journal of the American Medical Directors Association

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Objectives: Rehabilitation plays a vital role in the mitigation and improvement of functional limitations associated with aging and chronic conditions. Moderating factors such as sex, age, the medical diagnosis, and rehabilitation timing for admission status, as well as the expected change related to inpatient rehabilitation, are examined to provide a valid basis for the routine assessment of the quality of medical outcomes. Design: An observational study was carried out, placing a focus on general and disease-specific health measurements, to assess representative results of multidisciplinary inpatient rehabilitation. Aspects that were possibly confounding and introduced bias were controlled based on data from a quasiexperimental (waiting) control group. Measures: Existing data or general health indicators were extracted from medical records. The indicators included blood pressure, resting heart rate, self-assessed health, and pain, as well as more diseasespecific indicators of physical function and performance (eg, activities of daily living, walking tests, blood lipids). These are used to identify moderating factors related to health outcomes. Setting and Participants: A standardized collection of routine data from 16,966 patients [61.5 AE 12.5 years; 7871 (46%) women, 9095 (54%) men] with different medical diagnoses before and after rehabilitation were summarized using a descriptive evaluation in terms of a content and factor analysis. Results: Without rehabilitation, general health indicators did not improve independently and remained stable at best [odds ratio (OR) ¼ 0.74], whereas disease-specific indicators improved noticeably after surgery (OR ¼ 3.20). Inpatient rehabilitation was shown to reduce the risk factors associated with certain lifestyles, optimize organ function, and improve well-being in most patients (>70%; cutoff: z-difference >0.20), with a standardized mean difference (SMD) seen in overall medical quality outcome of À0.48 AE 0.37 [pre-vs postrehabilitation: h p 2 ¼ 0.622; d Cohen ¼ À1.22; 95% confidence interval (95% CI) À1.24 to À1.19]. The baseline medical values obtained at the beginning of rehabilitation were influenced by indication, age, and sex (all P < .001); however, these factors have less significant effects on improvements in general health indicators (h p 2 < 0.01). According to the disease-specific results, the greatest improvements were found in older patients (SMD for patients >60 vs 60 years: 95% CI 0.08e0.11) and during the early rehabilitation stage (h p 2 ¼ 0.063).

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Section: Medical Outcome Qualitymentioning

confidence: 99%

Section: Example Calculationmentioning

confidence: 99%

General and Disease-Specific Health Indicator Changes Associated with Inpatient Rehabilitation

Grote

Unger

Böttcher³

et al. 2020

Journal of the American Medical Directors Association

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“…Lately, complex methods of influence have been widely used in corrective pedagogy and rehabilitation, Budyakova (2020). On the other hand, rehabilitation and conductive pedagogy in terms of MDs are considered in many aspects, including rehabilitation organization (Arkadyeva et al, 2019;Fedorenko et al, 2020); psychological rehabilitation programmes (Razuvaeva et al, 2021;Sinkevich, 2018); a synergy of medical treatment and multidisciplinary rehabilitation (Grote et al, 2019). Scholars and practitioners involved in the social and professional rehabilitation of children and young people with MDs are developing and implementing new methods and techniques of social rehabilitation in rehabilitation centres (Sarancha et al, 2021;Sheremet et al, 2019;Karasievych, 2021;Berbets et al, 2021;Demchenko et al, 2021;Prots, 2021;Kosholap et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Horticultural Therapy Course as an Educational-Therapeutic Tool of Rehabilitation for Individuals with MSDs

Sarancha

Kovinko²,

Maksymchuk³

et al. 2022

RREM

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The article presents the authors’ course “Horticultural Therapy”, which includes various activities related to the interaction with flora and its images. Evidence suggests that Ukrainian discourse lacks methodical materials on horticultural therapy and, thus, requires methods that can contribute to developing the skills of conscious psychological separation from constant parental care, taking responsibility for their lives, setting real-life goals and destroying the position of helplessness in individuals with MSDs. The article aims to theoretically justify, methodically develop and present the results from implementing the authors’ course “Horticultural Therapy” in rehabilitation centres. The authors’ methodical complex is based on the use of the following methods: analysis of theoretical and methodical sources; modelling of educational conditions and programmes; methods of implementing the didactic content in the educational-rehabilitational process; expert evaluation; statistical methods. The verification quasi-experiment of the modelled conditions for corrective learning has shown a significant increase in social skills in individuals with MSDs. Besides, findings confirm the increased levels of their independence, social and personal incentives, household and self-care skills. The international relevance of the article lies in the further development of nature-centric methods of corrective pedagogy, conductive pedagogy and non-medical treatment of CNS diseases, which is an important area of neurorehabilitation today.

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“…[22,23] Outcome measurements are widely used in routine clinical rehabilitation and health care, but current and published results of multiple medical outcomes with individual patient data for inpatient health prevention programs are rare. [24][25][26][27]…”

Section: Introductionmentioning

confidence: 99%

Observational study of an inpatient program for musculoskeletal disorders

Grote

Böttcher²,

Unger

et al. 2021

Medicine

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A new inpatient secondary preventive program for patients with musculoskeletal health problems was introduced throughout Austria. The aim of the current work was to evaluate this "Health Prevention Active" program and its possible influences on the quality of medical results upon hospital discharge.This observational study presents monocentric data for 7448 patients (48.99 ± 6.15 years; 53.7% women) with chronic musculoskeletal disorders who completed a 3-week health program. The focus was placed on measuring medical quality outcomes such as BMI, blood pressure, heart rate, pain, subjective ratings, and achieved power output in cycle ergometer exercise testing. We describe pre-post changes before and after the inpatient program and the results of a follow-up survey conducted after 1 year to identify moderating factors related to health outcomes.The medical baseline showed obvious deficits regarding obesity, hypertension, and subjective symptoms. Of all patients, 36.5% were completely inactive. The patient's gender and physical activity had a high impact on the medical baseline status. In total, the majority of patients (86.2%; SMD = -0.78 ± 0.59) responded well to the health prevention program, independent of their ages and lifestyles.Requirements for secondary prevention programs are high. The results of the study reflect the general problems presented by inactivity, obesity, and subjective symptoms like pain. Physical activity was specifically identified as a major factor for the observed medical baseline status. Abbreviations: h p 2 = effect size (partial Eta 2 ), ADL = activities of daily living, BMI = body mass index, EC = Ethics Committee, GHI = general health index (mean value of MED1, MED2, MED3; z), GVA = "Gesundheitsvorsorge Aktiv" ["Health Prevention Active" program], h = hours, ICD = International statistical classification of diseases and related health problems, idx = index for outcome (z), ISI = indication specific index (mean value of MED4, MED5; z), IV = initial value (baseline, pre), MED1 = shape indicator of MQO (BMI and waist circumference; z), MED2 = cardiovascular indicator of MQO (RR and RHR; z), MED3 = subjective indicator of MQO (VAS and EQ-VAS; z), MED4 = performance indicator of MQO (ergometer power in watts; z), MED5 = ADL indicator of MQO (EQ-5D; z), MQO = medical quality outcome (mean value of GHI and ISI; z), N (n) = sample size, P = significance level (risk of error), PA = physical activity, r = correlation coefficient (Pearson), RHR = resting heart rate, RR = Riva-Rocci (abbreviation for blood pressure measurements), Editor: Sinan Kardes.

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What to Expect: Medical Quality Outcomes and Achievements of a Multidisciplinary Inpatient Musculoskeletal System Rehabilitation

Cited by 4 publications

References 47 publications

General and Disease-Specific Health Indicator Changes Associated with Inpatient Rehabilitation

General and Disease-Specific Health Indicator Changes Associated with Inpatient Rehabilitation

Horticultural Therapy Course as an Educational-Therapeutic Tool of Rehabilitation for Individuals with MSDs

Observational study of an inpatient program for musculoskeletal disorders

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