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Meyer SE, Hoeper JR, Buchholz J, Meyer-Olson D. Technische Alltagshilfen in der Rheumatologie – Was ist
sinnvoll, was ist bewiesen, welche Perspektiven gibt es? AKTUEL RHEUMATOL 2022. [DOI: 10.1055/a-1718-2941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
ZusammenfassungEinschränkungen der Alltagsaktivität sind ein relevantes
gesundheitliches Problem bei Patienten mit entzündlich-rheumatischen
Systemerkrankungen. Technische Alltagshilfen nehmen in der Rehabilitation von
diesen Teilhabeeinschränkungen einen hohen Stellenwert ein. Wir
erläutern Evidenz für den Einsatz von Alltagshilfen und die
neuen Entwicklungen auf diesem Gebiet.
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Affiliation(s)
- Sara Eileen Meyer
- Klinik für Rheumatologie und Immunologie, Medizinische
Hochschule Hannover, Hannover, Germany
- Center for Health Economics Research Hannover, Leibniz Universitat
Hannover, Hannover, Germany
| | - Juliana Rachel Hoeper
- Klinik für Rheumatologie und Immunologie, Medizinische
Hochschule Hannover, Hannover, Germany
- Ergotherapie, m&i Fachklinik Bad Pyrmont, Bad Pyrmont,
Germany
| | - Jens Buchholz
- Rheumatologie/Innere Medizin, m&i Fachklinik Bad
Pyrmont, Bad Pyrmont, Germany
| | - Dirk Meyer-Olson
- Klinik für Rheumatologie und Immunologie, Medizinische
Hochschule Hannover, Hannover, Germany
- Rheumatologie/Innere Medizin, m&i Fachklinik Bad
Pyrmont, Bad Pyrmont, Germany
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Meyer-Olson D, Hoeper K. [Rehabilitation in Rheumatoid Arthritis]. REHABILITATION 2021; 60:339-354. [PMID: 34655068 DOI: 10.1055/a-1275-2657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Die rheumatoide Arthritis stellt unter den Erkrankungen des Bewegungssystems eine
besondere Herausforderung für die Rehabilitationsmedizin dar 1. Eine genaue Kenntnis der Erkrankung,
inklusive der medikamentösen und der nicht medikamentösen
Behandlungsoptionen, ist die wesentliche Voraussetzung für einen
nachhaltigen Rehabilitationserfolg und um den berechtigen Anspruch der
Erkrankten auf berufliche und soziale Partizipation umzusetzen.
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Wirkeffekte serieller Heiltorfbäder bei entzündlich-rheumatischen und degenerativen Erkrankungen. Z Rheumatol 2019; 78:143-154. [DOI: 10.1007/s00393-018-0582-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
Rheumatic diseases usually progress towards morphological and functional deficits and thus cause impairment of physical health and function. Based on this fact, physiotherapeutic options are elementary and indispensable. This article focuses on the significance and importance of physiotherapy in inflammatory and degenerative rheumatic diseases. Furthermore, an overview is presented on the consequences of rheumatic diseases, the reality of supply of physiotherapy, the principles and therapeutic options, and the evidence.
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Braun J, Schneider M, Lakomek HJ. [Cornerstones of quality assurance in medicine in Germany. Important impulse for the situation in treatment of rheumatism]. Z Rheumatol 2016; 75:203-12. [PMID: 26940558 DOI: 10.1007/s00393-016-0054-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The recently passed German hospital structure act (Krankenhausstrukturgesetz) stresses the immense importance of quality for the medical care of the population. How can inpatient and outpatient treatment in the field of rheumatology be improved and how can this be assessed? A very important basis for such measurement approaches are quality indicators, i.e. parameters that indicate to what degree a certain level of quality has already been reached or is planned to be reached in the future. The work performed by the German Rheumatism Research Center (DRFZ) and the Association of Rheumatological Acute Clinics (VRA) in Germany has already used certain quality indicators and this topic has been recently described elsewhere. International quality indicators have also been published in recent years, all for rheumatoid arthritis (RA), the most prevalent inflammatory rheumatic disease and are the central subject of this article. This overview of proposed instruments for quality assessment in rheumatology is intended to initiate a broad discussion on the subject of quality of rheumatological care in Germany.
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Affiliation(s)
- J Braun
- Rheumazentrum Ruhrgebiet, Claudiusstr. 45, 44649, Herne, Deutschland.
| | - M Schneider
- Rheumatologie, Universität Düsseldorf, Düsseldorf, Deutschland
| | - H-J Lakomek
- Rheumatologie, Johannes Wesling Klinikum, Minden, Deutschland
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Mau W, Beyer W, Ehlebracht-König I, Engel JM, Genth E, Lange U. [Treat to participation : Position paper of the German Society for Rheumatology on sustained improvement of functional health of patients with rheumatic and musculoskeletal diseases]. Z Rheumatol 2016; 74:553-7. [PMID: 26238709 DOI: 10.1007/s00393-015-1640-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
From the perspective of patients with rheumatic diseases, the reduction of inflammatory disease activity alone is not a sufficient treatment goal. In addition the functional health and participation also have to be improved. Starting with the first symptoms the empowerment for the self-management of the disease is important for the patients; therefore, the established treat to target-strategy has to be expanded by the functional dimension to treat to participation. The position paper of the German Society for Rheumatology (GSR) summarizes the relevant fields of the multiprofessional action that is frequently necessary. This includes the acquirement of function-related competencies during training, further education and advanced training as well as implementation in the everyday practice of patient care. Furthermore, the GSR acknowledges the need for research related to functional and sociomedical consequences of rheumatic diseases and to individual and combined function-related programs in outpatient and inpatient care in rheumatology.
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Affiliation(s)
- W Mau
- Institut für Rehabilitationsmedizin, Medizinische Fakultät der Martin-Luther-Universität Halle-Wittenberg, 06097, Halle (Saale), Deutschland,
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Abstract
Inflammatory and non-inflammatory rheumatic as well as degenerative disorders have a tendency to progress resulting in morphological and functional deficits and thus cause impairment of physical health. To inhibit this debilitating development, physiotherapeutic and exercise strategies are indispensable and in exceptional cases can be necessary for the whole lifetime. This article presents a current overview of the aims of treatment, methods and techniques, modes of action, indications and contraindications and application modalities, as well as the current underlying scientific evidence.
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Mau W, Beyer W, Ehlebracht-König I, Engel JM, Genth E, Jäckel WH, Lange U, Thiele K. [Trends in rehabilitation of patients with rheumatic diseases in Germany]. Z Rheumatol 2014; 73:139-48. [PMID: 24659150 DOI: 10.1007/s00393-013-1259-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Recent Deutsche Gesellschaft für Rheumatologie (DGRh, German Society of Rheumatology) guidelines emphasized the significance of coordinated multidisciplinary care and rehabilitation of patients with inflammatory rheumatic diseases. Nationwide data from the German pension insurance funds showed that inpatient rehabilitation due to rheumatoid arthritis (RA) varied by a factor of 2.6 between the different German states. From 2000 to 2012 rehabilitation measures were reduced by one third, most significantly in men with ankylosing spondylitis (AS). Rehabilitation measures because of RA or AS were provided up to 14 times more frequently by the German statutory pension insurance scheme compared with a large compulsory health insurance which is responsible for rehabilitation measures after retirement. In rehabilitation centers with high numbers of patients with inflammatory rheumatic diseases, higher structural and process quality were demonstrated. In 2011 a total of 40 % of RA patients in the national database of the collaborative arthritis centers showed medium or severe functional limitations. Among these disabled RA patients inpatient rehabilitation was reduced by about 50 % between 1995 and 2011. Out of all RA patients from outpatient rheumatology care with severe functional limitations 38 % had no functional restoration therapy within the previous 12 months with a high variation between rheumatologists. Experiences from other European countries may inspire German rheumatologists and other involved health professionals to initiate a wider range of rehabilitative interventions in the future.
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Affiliation(s)
- W Mau
- Institut für Rehabilitationsmedizin, Medizinische Fakultät der Martin-Luther-Universität Halle-Wittenberg, 06097, Halle (Saale), Deutschland,
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Drambyan Y, Parthier K. [Preservation of ability to work and securing vocational participation : non-pharmaceutical support options for rheumatologists]. Z Rheumatol 2014; 73:20-6. [PMID: 24554254 DOI: 10.1007/s00393-013-1206-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
For patients of working age with chronic rheumatic diseases preservation of the ability to work and therefore for equal participation in professional life is of particular importance. Significant supporting actions by rheumatologists include non-pharmaceutical and non-medical interventions in addition to drug therapy. Measures aiming at sustained working capacity such as physiotherapy, occupational therapy, medical rehabilitation and stepwise return to work have to be utilized. This support can include referral to a counseling service and assistance with the application for medical or vocational rehabilitation programs. In order to ensure sustainable success of the initiated measures it is essential that follow-up care and function-related interventions are supervised by a rheumatologist.
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Affiliation(s)
- Y Drambyan
- Institut für Rehabilitationsmedizin, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, 06097, Halle (Saale), Deutschland,
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Soziale Teilhabe und Alltagsaktivitäten von Patienten mit entzündlich-rheumatischen Erkrankungen. Z Rheumatol 2014; 73:42-8. [PMID: 24554255 DOI: 10.1007/s00393-013-1209-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Neue Entwicklungen bei sozialmedizinischen Konsequenzen und rehabilitativen Interventionen. Z Rheumatol 2014; 73:8-10. [DOI: 10.1007/s00393-013-1204-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ehlebracht-König I, Dorn M. [Work-related medical rehabilitation for patients with rheumatic diseases]. Z Rheumatol 2013; 73:27-34. [PMID: 24337957 DOI: 10.1007/s00393-013-1207-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In recent years work-related rehabilitation has been intensified. Several studies have shown the effectiveness of work-related interventions in medical rehabilitation by improving participation in the work force and reducing sick leave. The German pension insurance fund has developed standardized requirements for medical work-related rehabilitation which include diagnostic procedures to identify patients with specific occupational problems and vocation-related interventions. These requirements address patients across different indications and diagnoses. Rehabilitation centers are assigned to different levels of work-related interventions depending on the intensity and specificity of the profile. Centers providing the complete range of work-related interventions offer differentiated work-related diagnostics, job training and occupational groups in addition to general social advice. In this article four case studies with different priorities regarding vocational interventions are presented.
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Affiliation(s)
- I Ehlebracht-König
- Schwerpunktklinik für Orthopädie und Rheumatologie, Rehazentrum Bad Eilsen, Brunnenpromenade 2, 31707, Bad Eilsen, Deutschland,
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Stellenwert und Bedeutung der physikalischen Medizin im Kontext der konservativen Therapie bei rheumatologischen Patienten. DER ORTHOPADE 2013; 42:813-21. [DOI: 10.1007/s00132-013-2109-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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