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  • 1
    In: Die Rehabilitation, Georg Thieme Verlag KG, Vol. 60, No. 06 ( 2021-12), p. 374-383
    Abstract: Ziel der Studie Das Ziel dieser prospektiven Validierungsstudie war es, den Prosthesis Mobility Questionnaire 2.0 (PMQ) leitlinienkonform ins Deutsche zu übersetzen und anschließend mittels Verfahren der klassischen Test-Theorie auf Validität und Reliabilität zu überprüfen. Methodik Der PMQ wurde gemäß ISPOR-Leitlinien zweifach vorwärts- und zweifach rückwärtsübersetzt und mittels Pilottest (N=10) finalisiert. Anschließend erfolgte eine Überprüfung der Gütekriterien an N=61 Patienten mit unilateraler Majoramputation der unteren Extremität von März 2020 bis August 2020. Die konvergente Konstruktvalidität wurde mittels der deutschen Version des Locomotor Capabilities Index-5 (LCI-5-D), dem Rivermead Mobility Index (RMI), dem Timed up and go Test (TUG) sowie anhand der Mobilitätsgrade ermittelt. Zur Überprüfung der internen Konsistenz wurde Cronbachs Alpha berechnet sowie die Trennschärfe durch Item-Skala-Korrelationen ermittelt. Die Test-Retest-Reliabilität wurde mittels ICC (2,1) berechnet. Darauf aufbauend wurde die minimale detektierbare Differenz berechnet. Ergebnisse Der Übersetzungsprozess erforderte kleine Änderungen nach dem Pilottest. Die Validierungsstudie wurde an N=61 Patienten durchgeführt (56,59±13,16 Jahre, m/w=38/23). Im Mittel konnte ein PMQ von 26,23±8,89 Punkten erreicht werden. Decken- oder Bodeneffekte zeigten sich im Gesamtscore nicht. Die Konstruktvalidität zeigte starke positive Korrelationen zum LCI-5-D (r=0,74, p 〈 0,001), RMI (r=0,63 p 〈 0,001) sowie Mobilitätsgraden (r=0,61 p 〈 0,001). Ebenso eine moderate negative Korrelation zum TUG (r=− 0,49, p 〈 0,001). Die interne Konsistenz war sehr gut (Cronbachs Alpha=0,95). Alle Items zeigten einen Wert größer r=0,40 bei der Item-zu-Gesamtscore Korrelation. Test-Retest-Reliabilität war mit einem ICC (2,1)=0,98 exzellent bei einem Erhebungsintervall zwischen T0 und T1 von 3,2±2,83 Tagen. Darauf aufbauend betrug die minimale detektierbare Differenz 3,40 Punkte. Schlussfolgerung Die deutsche Version des Prosthesis Mobility Questionnaire 2.0 ist ein valides und reliables Selbsteinschätzungs-Instrument zur Messung der Mobilität und Funktionsfähigkeit von Patienten mit Exoprothese bei unilateraler Majoramputation der unteren Extremität. Es kann für den deutschsprachigen Raum verwendet werden.
    Type of Medium: Online Resource
    ISSN: 0034-3536 , 1439-1309
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    Language: German
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2021
    detail.hit.zdb_id: 203752-X
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  • 2
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  American Journal of Physical Medicine & Rehabilitation Vol. 100, No. 6 ( 2021-6), p. 539-545
    In: American Journal of Physical Medicine & Rehabilitation, Ovid Technologies (Wolters Kluwer Health), Vol. 100, No. 6 ( 2021-6), p. 539-545
    Abstract: The aim of this study was to investigate the interrater reliability and intrarater reliability of the flexor pollicis longus muscle stretch reflex (FPLR) and compare it with clinically established reflexes. Design A total of 71 healthy volunteers participated. The FPLR, biceps reflex, brachioradialis reflex, and patellar tendon reflex of each participant were tested bilaterally and rated by eight examiners (four experienced, four inexperienced). For intrarater reliability evaluation, five examiners rated the reflexes of four volunteers at four different points in time. Results Analysis of the interrater reliability with Gwet’s AC1 demonstrated almost perfect agreement for FPLR (Gwet’s AC1 = 0.90), biceps reflex (Gwet’s AC1 = 0.90), and patellar tendon reflex (Gwet’s AC1 = 0.95) when using binary data (reflex present vs. absent). Only fair agreement was found for the brachioradialis reflex (Gwet’s AC1 = 0.56). Experienced raters had a higher agreement than inexperienced raters did when rating the biceps reflex and the patellar tendon reflex. The intrarater reliability was almost perfect for the patellar tendon reflex (Gwet’s AC1 = 0.94), followed by the FPLR (Gwet’s AC1 = 0.83) with substantial agreement and the biceps reflex (Gwet’s AC1 = 0.57) with moderate agreement. Conclusion The FPLR is a reliable diagnostic neuromuscular test and may therefore be useful in the clinical examination for C8/T1 nerve root lesions or pathologies of the interosseous anterior nerve. To Claim CME Credits Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME Objectives Upon completion of this article, the reader should be able to: (1) Elicit the flexor pollicis longus muscle stretch reflex; (2) Discuss the disadvantage of kappa statistics in assessing the interrater reliability when the prevalence of the studied trait is very high or very low; and (3) Name the spinal nerves involved in the innervation of the flexor pollicis longus muscle. Level Advanced Accreditation The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
    Type of Medium: Online Resource
    ISSN: 1537-7385 , 0894-9115
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2272463-1
    detail.hit.zdb_id: 2049617-5
    SSG: 31
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  • 3
    In: International Journal of Rehabilitation Research, Ovid Technologies (Wolters Kluwer Health), Vol. 44, No. 3 ( 2021-09), p. 233-240
    Abstract: This study aimed to compare, through Rasch analysis, the psychometric properties of the Locomotor Capabilities Index (LCI-5) and Prosthetic Mobility Questionnaire (PMQ 2.0) in German lower-limb prosthesis users. The questionnaires were concurrently administered to a convenience sample of 98 consecutively recruited individuals with lower limb amputation (LLA) (male/female = 61/37; mean age 57 ± 14 years). LCI-5 showed disordered rating scale thresholds (one response option in three items required collapsing); local dependence between two items (resolved by creating a testlet); underfit of one item (‘Get up from the floor’); and presence of a second weak dimension. PMQ 2.0 showed a correctly functioning rating scale; good fit of the data to the model (apart from some overfit); local dependence between two items (absorbed by creating a testlet); and essential unidimensionality. At scale co-calibration onto a common interval-scaled metric, PMQ 2.0 was better targeted than LCI-5 (i.e. the extent of item difficulty was more appropriate for the sample) and its operational range allowed a more precise measurement of higher locomotor abilities. The correlation between LCI-5 and PMQ 2.0 scores was rho =  0.78. In conclusion, LCI-5 revealed some drawbacks, confirming a previous Rasch study; refinement of its rating scale and item selection seems therefore warranted. The PMQ 2.0 demonstrated good overall measurement quality, in line with previous Italian and Slovene studies. The operational range of the PMQ 2.0 makes it more suitable than LCI-5 for assessing people with high locomotor abilities.
    Type of Medium: Online Resource
    ISSN: 0342-5282
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2030422-5
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  • 4
    In: Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin, Georg Thieme Verlag KG, Vol. 32, No. 04 ( 2022-08), p. 218-228
    Abstract: Eine Majoramputation ist für die Betroffenen ein äußerst belastender Eingriff und mit großen Herausforderungen für die gesellschaftliche und berufliche Wiedereingliederung verbunden. Bei der Versorgung von Amputationspatient*innen besteht ein hoher Bedarf an ärztlicher und therapeutischer Behandlung sowie sozialmedizinischer Steuerung. Die sektoralen Versorgungsstrukturen sind regional sehr unterschiedlich aufgestellt und decken häufig den Bedarf nicht adäquat ab. Dem Entlassmanagement kommt hierbei eine Schlüsselposition zu. Ein Innovationsfondsprojekt des Gemeinsamen Bundesausschusses (G-BA) implementiert und evaluiert gegenwärtig modellhaft eine optimierte Versorgung für Menschen nach Majoramputation durch Einführung eines sektorenübergreifenden Caremanagement und der Einführung einer ambulanten Interimsphase in einer Hochschulambulanz für Physikalische und Rehabilitative Medizin (PRM) und Therapie. Der Beitrag berichtet über die Umsetzung, die gemachten Erfahrungen und über erste Ergebnisse.
    Type of Medium: Online Resource
    ISSN: 0940-6689 , 1439-085X
    Language: German
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2022
    detail.hit.zdb_id: 2072467-6
    SSG: 31
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  • 5
    Online Resource
    Online Resource
    Georg Thieme Verlag KG ; 2021
    In:  Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin Vol. 31, No. 05 ( 2021-10), p. 303-310
    In: Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin, Georg Thieme Verlag KG, Vol. 31, No. 05 ( 2021-10), p. 303-310
    Abstract: Hintergrund CO2-Therapie ist seit Jahrzehnten ein etabliertes physikalisch-medizinisches Therapieverfahren. CO2 reagiert mit Wasser zu Kohlensäure und könnte den kutanen pH-Wert verändern. Veränderungen des Wund-pH-Wertes spielen eine große Rolle beim modernen Wundmanagement chronischer Wunden. Da Kohlensäure eine schwache Säure ist, könnte CO2-Therapie den Wund-pH-Wert positiv beeinflussen. Bislang wurde noch keine explorative Datenanalyse durchgeführt, die pH-Veränderung an Wunden und Haut durch CO2-Therapie systematisch analysiert. Das Ziel dieser explorativen Pilotstudie ist es, Veränderungen von Haut-und Wund-pH-Werten vor und nach CO2-Trockengasbädern zu erheben. Dies soll Auskünfte über mögliche weitere Wirkmechanismen von CO2-Therapie geben. Material und Methoden Von April bis Oktober 2020 wurde bei alle Patienten einer physikalisch-medizinischen Universitätsklinik-Ambulanz, die aufgrund Wundheilungsstörungen CO2-Therapie erhalten haben, vor und nach der CO2-Therapie der Haut- bzw. Wund-pH-Wert gemessen. Dies geschah mittels einer pH-Oberflächenmesssonde an 3 Messpunkten: Wundzentrum, intakte Haut im CO2-Expositionsbereich (Kontrolle1) und intake Haut ohne CO2-Exposition (Kontrolle2). Die Daten wurden retrospektiv analysiert. Alle Patienten erhielten CO2-Trockengasbäder im Regelfall mit 12 Therapiesitzungen à 20 min. Ergebnisse Ausgewertet wurden die Messungen von N=13 Patienten (N=936 Messungen). Die gesamte Therapiezeit betrug 5,38±1,67 Wochen. Alle Patienten wiesen initial an der Wunde einen alkalischen pH-Wert auf (7,22±0,81), der sich signifikant von den pH-Werten der intakten Haut unterschied (Kontrolle 1: pH=5,86±0,26; p 〈 0,001, Kontrolle2: pH=4,98±0,28; p 〈 0,001). Im Mittel konnte CO2-Therapie die alkalischen Werte signifikant in Richtung saures Milieu verschieben (p=0,009). Die kutanen pH-Werte intakter Haut wurden alkalischer. Schlussfolgerung CO2-Trockengasbäder verändern den topischen pH-Wert auf Wundflächen und intakter Haut. Sie beeinflussen den oberflächlichen Wund-pH günstig mit einem Shift in Richtung physiologischer Haut-pH-Werte.
    Type of Medium: Online Resource
    ISSN: 0940-6689 , 1439-085X
    Language: German
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2021
    detail.hit.zdb_id: 2072467-6
    SSG: 31
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  • 6
    In: Cephalalgia, SAGE Publications, Vol. 43, No. 1 ( 2023-01), p. 033310242211328-
    Abstract: To compare the effects of acupuncture and medical training therapy in combination or individually with usual care on quality of life, depression, and anxiety in patients with tension-type headache. Methods In this single-center, prospective, randomized, controlled, unblinded trial, 96 adults (38.7(+/−13.3) years of age; 75 females/20 males/one dropout) with frequent episodic or chronic tension-type headache were randomized to one of four treatment groups (n = 24). The treatment groups received six weeks of either acupuncture or medical training therapy as monotherapies or in combination (12 interventions each), or usual care. We assessed depressiveness (PHQ-9), anxiety (GAD-7), and health-related quality of life (SF-12) as secondary outcome parameters at baseline, six weeks, three months, and six months after initiation of treatment. Linear mixed models were calculated. Results Both, acupuncture (baseline to six-weeks change scores: mean: −2(standard deviation: 2.5 points), three months: −2.4(2.4), six-months −2.7(3.6)) and the combination of acupuncture and medical training therapy (−2.7(4.9), −2.2(4.0), −2.2(4.2)) (each within-group p  〈  .05) significantly reduced depressiveness-scores (PHQ-9) to a greater extent than medical training therapy (−0.3(2.0), −0.5(1.6), −0.9(2.6)) or usual care alone (−0.8(2.9), 0.1(2.8), 0.2(3.6)). We found similar results with anxiety scores and the physical sum scores of the SF-12. No severe adverse events occurred. Conclusions Acupuncture and the combination of acupuncture and medical training therapy elicit positive effects on depression, anxiety, quality of life, and symptom intensity in patients with episodic and chronic tension-type headache. Acupuncture appears to play a central role in mediating the therapeutic effects, underscoring the clinical relevance of this treatment. An additive benefit of the combination of both therapies does not appear to be relevant. Trial registration: Registered on 11 February 2019. German Clinical Trials Register, DRKS00016723.
    Type of Medium: Online Resource
    ISSN: 0333-1024 , 1468-2982
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2019999-5
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  • 7
    In: JPO Journal of Prosthetics and Orthotics, Ovid Technologies (Wolters Kluwer Health), Vol. 35, No. 1 ( 2023-1), p. 44-54
    Abstract: The aim of this study was to translate and cross-culturally adapt the Satisfaction with Prosthesis Questionnaire (SAT-PRO) into German and to evaluate its validity and reliability. Materials and Methods The 2-fold forward and backward translations were carried out according to the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines. Subsequently, the German version of the SAT-PRO was administered to 68 patients with major lower-limb amputation (LLA) fitted with a prosthesis. The internal consistency, floor and ceiling effects, item-to-total correlation, and test-retest reliability were determined. In addition, the standard error of the mean (SEM) and minimal detectable change (MDC) were calculated. Convergent construct validity was assessed by correlation to a Numerical Rating Scale for Satisfaction Level (NRS-SAT), the 36-Item Short-Form Health Survey (SF-36), the Rivermead Mobility Index (RMI), and the Medicare Functional Classification Level (K-Levels). Descriptive subgroup analysis included levels of amputation (transtibial vs. transfemoral persons with amputations) and user type (long-term vs. subacute users). Results The mean SAT-PRO total score was 32.27 ± 6.89 (77.6%). Internal consistency was high (Cronbach α = 0.88), and reproducibility demonstrated excellent findings with an intraclass correlation coefficient (ICC 2,1 ) of 0.90 (95% confidence interval [CI], 0.84–0.94). Floor or ceiling effects were not detected. Convergent construct validity indicated a strong correlation to the NRS-SAT ( r = 0.89), K-Levels ( r = 0.66), and RMI ( r = 0.52, all with P 〈 0.001). Moderate to high correlations were shown to all eight domains of the SF-36 (in a range of r = 0.55 [physical function] to r = 0.39 [mental health], all with P 〈 0.001). MDC was 2.32 (MDC% = 3.4%). Conclusions The translation according to ISPOR guidelines and cross-cultural adaptation of the SAT-PRO into German were successfully conducted in the pilot study. The psychometric testing showed high reliability and validity of the German version of the SAT-PRO. Hence, it can be used as an outcome measure to assess a patient's satisfaction with prosthesis in a German-speaking population. Clinical Relevance Statement The SAT-PRO can make an important contribution to the treatment of patients with major LLA. The use of objective measurement parameters and guideline-based translation should be applied to increase the validity and comparability of the data.
    Type of Medium: Online Resource
    ISSN: 1040-8800
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2083552-8
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