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Ortega-Castillo M, Cuesta-Vargas A, Melloh M, Trinidad-Fernández M. Cross-Cultural Adaptation and Validation of the German Version of the Upper Limb Functional Index. J Sport Rehabil 2024:1-9. [PMID: 39187250 DOI: 10.1123/jsr.2023-0342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 04/25/2024] [Accepted: 06/29/2024] [Indexed: 08/28/2024]
Abstract
CONTEXT The Upper Limb Functional Index (ULFI) is a popular tool with valid psychometric properties to assess upper limb function in patients with musculoskeletal conditions. The aim of the study was to cross-culturally adapt and validate the German version of the ULFI. DESIGN Cross-cultural validation. METHODS A 2-stage cross-cultural adaptation of the ULFI was performed according to international guidelines through consecutive forward and backward translations. Psychometric properties of internal consistency, test-retest reliability, criterion, face and content validity, and factor structure were determined from the included German participants suffering from upper limb conditions (n = 100), who fulfilled the following inclusion criteria: (1) older than 18 years old, (2) German as native language, and (3) medical diagnosis of musculoskeletal upper limb condition. Participants completed the ULFI; Disabilities of the Arm, Shoulder, and Hand; EuroQol Health Questionnaire 5 Dimensions; and Short Form-12 questionnaires. RESULTS The ULFI-G showed good internal consistency (α = .88); excellent test-retest reliability (intraclass correlation coefficient2:1 = .98); directly strong correlation with Disabilities of the Arm, Shoulder, and Hand (r = .84); fair correlation with Disabilities of the Arm, Shoulder, and Hand-sport (r = .54); inversely fair correlation with EuroQol Health Questionnaire 5 Dimensions (r = -.62); and Short Form 12's physical health domain (r = -.7). A single-factor structure was revealed. CONCLUSIONS The ULFI-G showed adequate psychometric properties and proved to be a valid tool for upper limb functional assessment in German population.
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Affiliation(s)
- Miguel Ortega-Castillo
- Department of Physiotherapy, Universidad de Málaga, Málaga, Spain
- Clinimetria Research Group F-14, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Antonio Cuesta-Vargas
- Department of Physiotherapy, Universidad de Málaga, Málaga, Spain
- Clinimetria Research Group F-14, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- School of Clinical Science, Faculty of Health Science, Queensland University Technology, Brisbane, Australia
| | - Markus Melloh
- Wellington Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Manuel Trinidad-Fernández
- Department of Physiotherapy, Universidad de Málaga, Málaga, Spain
- Clinimetria Research Group F-14, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
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Angonese G, Buhl M, Kuhlmann I, Kollmeier B, Hildebrandt A. Prediction of Hearing Help Seeking to Design a Recommendation Module of an mHealth Hearing App: Intensive Longitudinal Study of Feature Importance Assessment. JMIR Hum Factors 2024; 11:e52310. [PMID: 39133539 PMCID: PMC11347899 DOI: 10.2196/52310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 02/22/2024] [Accepted: 05/02/2024] [Indexed: 08/13/2024] Open
Abstract
BACKGROUND Mobile health (mHealth) solutions can improve the quality, accessibility, and equity of health services, fostering early rehabilitation. For individuals with hearing loss, mHealth apps might be designed to support the decision-making processes in auditory diagnostics and provide treatment recommendations to the user (eg, hearing aid need). For some individuals, such an mHealth app might be the first contact with a hearing diagnostic service and should motivate users with hearing loss to seek professional help in a targeted manner. However, personalizing treatment recommendations is only possible by knowing the individual's profile regarding the outcome of interest. OBJECTIVE This study aims to characterize individuals who are more or less prone to seeking professional help after the repeated use of an app-based hearing test. The goal was to derive relevant hearing-related traits and personality characteristics for personalized treatment recommendations for users of mHealth hearing solutions. METHODS In total, 185 (n=106, 57.3% female) nonaided older individuals (mean age 63.8, SD 6.6 y) with subjective hearing loss participated in a mobile study. We collected cross-sectional and longitudinal data on a comprehensive set of 83 hearing-related and psychological measures among those previously found to predict hearing help seeking. Readiness to seek help was assessed as the outcome variable at study end and after 2 months. Participants were classified into help seekers and nonseekers using several supervised machine learning algorithms (random forest, naïve Bayes, and support vector machine). The most relevant features for prediction were identified using feature importance analysis. RESULTS The algorithms correctly predicted action to seek help at study end in 65.9% (122/185) to 70.3% (130/185) of cases, reaching 74.8% (98/131) classification accuracy at follow-up. Among the most important features for classification beyond hearing performance were the perceived consequences of hearing loss in daily life, attitude toward hearing aids, motivation to seek help, physical health, sensory sensitivity personality trait, neuroticism, and income. CONCLUSIONS This study contributes to the identification of individual characteristics that predict help seeking in older individuals with self-reported hearing loss. Suggestions are made for their implementation in an individual-profiling algorithm and for deriving targeted recommendations in mHealth hearing apps.
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Affiliation(s)
- Giulia Angonese
- Cluster of Excellence Hearing4All, Oldenburg, Germany
- Psychological Methods and Statistics Lab, Department of Psychology, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
| | - Mareike Buhl
- Cluster of Excellence Hearing4All, Oldenburg, Germany
- IHU reConnect, Institut de l'Audition, Fondation Pour l'Audition, Inserm, AP-HP, Institut Pasteur, Université Paris Cité, F-75012 Paris, France
| | - Inka Kuhlmann
- Cluster of Excellence Hearing4All, Oldenburg, Germany
- Psychological Methods and Statistics Lab, Department of Psychology, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
| | - Birger Kollmeier
- Cluster of Excellence Hearing4All, Oldenburg, Germany
- Department of Medical Physics and Acoustics, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
- Research Center Neurosensory Science, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
| | - Andrea Hildebrandt
- Cluster of Excellence Hearing4All, Oldenburg, Germany
- Psychological Methods and Statistics Lab, Department of Psychology, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
- Research Center Neurosensory Science, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
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Willy K, Meyer T, Eckardt L, Morina N. Selection of social comparison standards in cardiac patients with and without experienced defibrillator shock. Sci Rep 2024; 14:5551. [PMID: 38448440 PMCID: PMC10917798 DOI: 10.1038/s41598-024-51366-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/04/2024] [Indexed: 03/08/2024] Open
Abstract
Patients with an implantable cardioverter-defibrillator (ICD) often report psychological distress. Literature suggests that patients with physical disease often compare their well-being and coping to fellow patients. However, we lack knowledge on social comparison among patients with ICD. In this study, we examined psychological distress and social comparison selection in patients with (ICD+) and without experienced ICD shocks (ICD-). We theorized that relative to ICD- patients, those with ICD+ display higher levels of psychological distress and thereby compare more frequently with fellow patients with more severe disease, but better disease coping and try to identify more strongly with these standards to improve their own coping. We recruited 92 patients with (ICD+, n = 38) and without an experienced ICD shock (ICD-, n = 54), who selected one of four comparison standards varying in disease severity and coping capacity. Relative to ICD-, ICD+ patients reported higher levels of device-related distress, but there were no significant differences in anxiety, depression, or quality of life. ICD+ patients selected more often comparison standards with poor coping and, irrespective of standard choice, displayed more negative mood following comparison. Our results show that ICD+ patients tend to perform unfavorable comparisons to fellow patients, which might explain higher psychological distress and worse coping. These findings warrant further research into social comparison as a relevant coping mechanism in ICD patients.
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Affiliation(s)
- Kevin Willy
- Institute of Psychology, University of Münster, Münster, Germany.
- Department of Cardiology II, University Hospital of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
| | - Thomas Meyer
- Institute of Psychology, University of Münster, Münster, Germany
| | - Lars Eckardt
- Department of Cardiology II, University Hospital of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Nexhmedin Morina
- Institute of Psychology, University of Münster, Münster, Germany
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Steinhauser S, Ganter MT, Stadelmann V, Hofer CK. Whole-Body Electrostatic Pain Treatment in Adults with Chronic Pain: A Prospective Multicentric Observational Clinical Trial. Pain Ther 2024; 13:69-85. [PMID: 38015366 PMCID: PMC10796901 DOI: 10.1007/s40122-023-00560-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 10/31/2023] [Indexed: 11/29/2023] Open
Abstract
INTRODUCTION In the treatment of patients with chronic pain, whole-body electrostatic therapy using the Elosan Cabin C1 has been proposed as an adjunctive therapy. So far, data on the use of this cabin are limited. Promising results with a significant reduction in pain scores have been obtained in a small group of patients. However, treatment with Elosan Cabin C1 has not been the subject of evaluation in a larger patient population. The aim of this study was to investigate the efficacy and adverse effects of electrostatic treatment in such a population. METHODS Prospective, multi-center, observational clinical trial conducted in daily practice in a large adult ambulatory population with chronic pain. Each patient received eight weekly Elosan C1 treatment sessions for up to 9 weeks. Treatment was added to an established conservative pain management. Pain scores (visual analog scale (VAS) 0-100, primary outcome) and sleep quality (seven-point Likert scale, secondary outcome) were assessed before, during, and at the end of the treatment period; quality of life (SF-12: Physical Component Summary = PCS, Mental Component Summary = MCS; secondary outcome) was assessed before and at the end of the treatment period. Subgroup analyses were performed for sex, age, duration of pain, initial pain location, pain entity, and pain medication at the start of treatment. RESULTS A total of 192 patients were enrolled, 143 patients (74.5%) had a complete set of 8 treatment sessions. A reduction in pain scores from 68 ± 14 points to 47 ± 22 points was observed (p < 0.001), 65% of patients (responders) had a reduction of > 15 points. Female patients had a significantly better response than male patients with a higher number of responders (76% vs. 38%; p < 0.001). Patients with a pain history < 1 year had a significantly better response than patients with a pain history > 1 year. The Physical Component Summary (PCS) increased from 36 ± 11 to 41 ± 11 (+ 18%, p < 0.001) and the Mental Component Summary (MCS) from 41 ± 7 to 43 ± 7 (+ 6%, p = 0.3). Overall sleep quality improved significantly from 4.6 ± 1.7 to 3.73 ± 1.7 points (p < 0.001), with a higher proportion of responders in the female group (37 vs. 18%; p < 0.034). No serious adverse events were observed during treatment. CONCLUSIONS Electrostatic therapy with Elosan Cabin C1 may be a useful and effective adjunct therapy for patients with chronic pain. The results suggest that female patients and those with a recent history of pain experience the greatest benefit. TRIAL REGISTRATION NCT04818294 (clinicaltrials.gov).
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Affiliation(s)
- Stephan Steinhauser
- Division of Anaesthesia, Schulthess Klinik, Lengghalde 2, 8008, Zurich, Switzerland.
| | - Michael Thomas Ganter
- Institute of Anaesthesiology and Intensive Care Medicine, Hirslanden Clinic, Zurich, Switzerland
| | - Vincent Stadelmann
- Department of Research and Development, Schulthess Klinik, Zürich, Switzerland
| | - Christoph Karl Hofer
- Division of Anaesthesia, Schulthess Klinik, Lengghalde 2, 8008, Zurich, Switzerland
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Peinado Molina RA, Hernández Martínez A, Martínez Vázquez S, Martínez Galiano JM. Influence of pelvic floor disorders on quality of life in women. Front Public Health 2023; 11:1180907. [PMID: 37942254 PMCID: PMC10629477 DOI: 10.3389/fpubh.2023.1180907] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/25/2023] [Indexed: 11/10/2023] Open
Abstract
Objective To determine whether the different pelvic floor disorders are associated with changes in perceived quality of life (QoL), globally and in its sub-dimensions. Methods An observational study was conducted with women in Spain between 2021 and 2022. Information was collected using a self-developed questionnaire on sociodemographic data, employment, history and health status, lifestyle and habits, obstetric history, and health problems. The SF-12 questionnaire was used to assess quality of life. The Pelvic Floor Distress Inventory (PFDI-20) was used to assess the presence and impact of pelvic floor problems, and includes the POPDI-6 subscales for prolapse, CRADI- 8 for colorectal symptoms, and UDI-6 for urinary symptoms. Crude (MD) and adjusted mean differences (aMD) were estimated with their respective 95% confidence intervals (CI). Results Thousand four hundred and forty six women participated in the study with a mean age of 44.27 (SD = 14.68). A statistical association was observed between all the pelvic floor disorders and QoL, overall and in all its dimensions (p <0.001), in the bivariable analysis. The lowest scores were observed in the emotional component. After adjusting for confounding factors, the pelvic floor disorders in general (aMD -0.21, 95% CI: -0.23 to -0.20), the impact of uterine prolapse symptoms (aMD -0.20, 95% CI: -0.27 to -0.12), the colorectal-anal symptoms (aMD -0.15, 95% CI: -0.22 to -0.09), and urinary symptoms (aMD -0.07, 95% CI: -0.13 to -0.03) was negatively associated on the score on the SF-12 questionnaire (p <0.05). Conclusions Women who have a pelvic floor dysfunction, symptoms of pelvic organ prolapse, colorectal-anal symptoms, or urinary symptoms, have a worse perceived quality of life in all dimensions. Prolapse symptoms have the biggest impact, and the emotional component of QoL is the most affected sub-domains.
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Affiliation(s)
| | - Antonio Hernández Martínez
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla la Mancha, Ciudad Real, Spain
| | | | - Juan Miguel Martínez Galiano
- Department of Nursing, University of Jaén, Jaén, Spain
- Epidemiology and Public Health CIBER (CIBERESP), Madrid, Spain
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Gehle T, Lau S, Hackbarth M, Zieschang T, Koschate J. Physical performance and compensation strategies of older adults to maintain physical fitness and well-being during the COVID-19 pandemic in Germany. BMC Geriatr 2023; 23:239. [PMID: 37081379 PMCID: PMC10117253 DOI: 10.1186/s12877-023-03952-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 04/05/2023] [Indexed: 04/22/2023] Open
Abstract
INTRODUCTION During the first wave of the COVID-19 pandemic in March 2020, worldwide restrictions in social life, including the closure of sport facilities, led to a reduction of physical activity and subjective well-being. The aim of this study is to describe physical training habits, and subjective well-being in relation to objective training data from a chip-controlled fitness circuit in the rural area of Oldenburg, Germany. MATERIALS AND METHODS Overall, 35 older adults (20 women 71 ± 6 y/o and 15 men, 72 ± 7 y/o), regularly exercising in a chip-controlled fitness circuit before the lockdown in March 2020, were interviewed. The training data from February to August 2020 from six strength and two endurance exercise devices were extracted and compared to data before and up to three months after the lockdown. Additionally, participants' personal characteristics, physical activities and quality of life before, during, and after the first lockdown were assessed. RESULTS The leg score (pre, postJune, postJuly, postAugust: 1207 ± 469 kg, 1248 ± 477 kg, 1254 ± 516 kg, 1283 ± 493 kg; p = 0.137) and endurance scores (ergometer: 0.93 ± 0.35 min- 1 · watt- 1, 0.86 ± 0.31 min- 1 · watt- 1, 0.86 ± 0.31 min- 1 · watt- 1, 0.85 ± 0.28 min- 1 · watt- 1 ; p = 0.442) were not significantly different, in contrast to the rowing score (1426 ± 582 kg, 1558 ± 704 kg, 1630 ± 757 kg, 1680 ± 837 kg; p < 0.001). A significant increase of total energy expenditure (p = 0.026), mainly through gardening, walking, and bike riding was observed. The greatest personal limitation reported, was the loss of social contacts. CONCLUSION The presented data did not show a decrease in training performance, but a slight trend towards an increase. A compensatory increase in regular outdoor activities seems to have a protective effect against a loss of training performance and may have the potential to stabilize subjective well-being during lockdown periods.
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Affiliation(s)
- Torben Gehle
- School of Medicine and Health Sciences, Department for Health Services Research, Geriatric Medicine, Carl von Ossietzky University Oldenburg, Oldenburg, Germany.
| | - Sandra Lau
- School of Medicine and Health Sciences, Department for Health Services Research, Geriatric Medicine, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Michel Hackbarth
- School of Medicine and Health Sciences, Department for Health Services Research, Geriatric Medicine, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Tania Zieschang
- School of Medicine and Health Sciences, Department for Health Services Research, Geriatric Medicine, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Jessica Koschate
- School of Medicine and Health Sciences, Department for Health Services Research, Geriatric Medicine, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
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Ballenberger N, Avermann F, Zalpour C. Musculoskeletal Health Complaints and Associated Risk Factors in Freshmen Music Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3169. [PMID: 36833864 PMCID: PMC9964731 DOI: 10.3390/ijerph20043169] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 01/31/2023] [Accepted: 02/05/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Evidence concerning the development of musculoskeletal health complaints (MHCs) among music students is limited due to inappropriate study designs. We aimed to assess the occurrences of MHCs and associated risk factors in freshmen music students compared to students from other disciplines. METHODS A prospective cohort study was conducted. Risk factors such as pain-related, physical, and psychosocial variables were measured at baseline. Episodes of MHCs were recorded monthly. RESULTS A total of 146 music students and 191 students from other disciplines were analyzed. In the cross-sectional comparison, pain-related, physical, and psychosocial variables were significantly altered in music students compared to students from other disciplines. Furthermore, music students with current MHCs differed significantly from music students without current MHCs with respect to physical health, pain, and history of MHCs. Our longitudinal analysis showed that monthly MHCs were higher in music students compared to students from other disciplines. Independent predictors for monthly MHCs in music students were current MHCs and reduced physical function. Predictors for MHCs in students from other disciplines were a history of MHCs and stress. CONCLUSIONS We provided insight into the development of MHCs and risk factors in music students. This may help in the creation of targeted, evidence-based prevention and rehabilitation.
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Affiliation(s)
- Nikolaus Ballenberger
- Faculty of Business Management and Social Sciences, Osnabrück University of Applied Sciences, 49090 Osnabrück, Germany
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Besmens IS, Zoller FE, Guidi M, Giovanoli P, Calcagni M. How to measure success in lower extremity reconstruction, which outcome measurements do we use a systematic review and metanalysis. J Plast Surg Hand Surg 2023; 57:505-532. [PMID: 36779747 DOI: 10.1080/2000656x.2023.2168274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Different factors have to be considered and weighted in the treatment algorithm of lower extremity reconstruction. A combination of both clinicians' and patients' perspectives is necessary to provide a conclusive picture. Currently, there aren't any standardized and validated measurement data sets for lower extremity reconstructions. This makes it necessary to identify the relevant domains. We, therefore, performed a systematic review and metanalysis of outcome measurements and evaluated their ability to measure outcomes after lower extremity reconstruction. A systematic review and metanalysis according to the 'Preferred Reporting Items for Systematic Reviews and Meta-Analyses' protocol were performed for studies reporting at least one structured outcome measurement of lower extremity reconstruction. Both Patient (PROMs)- and Clinician reported outcome measurements (CROMs)were analyzed. Of the 2827 identified articles, 102 were included in the final analysis. In total 86 outcome measurements were identified, 34 CROMs, 44 PROMs and 8 (9.3%) outcome measurements that have elements of both. Twenty-four measure functional outcome, 3 pain, 10 sensations and proprioception, 9 quality of life, 8 satisfaction with the result, 5 measure the aesthetic outcome, 6 contours and flap stability and 21 contain multidomain elements. A multitude of different outcome measurements is currently used in lower extremity reconstruction So far, no consensus has been reached on what to measure and how. Validation and standardization of both PROMs and CROMs in plastic surgery is needed to improve the outcome of our patients, better meet their needs and expectations and eventually optimize extremity reconstruction by enabling a direct comparison of studies' results.
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Affiliation(s)
- Inga S Besmens
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Florence E Zoller
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Marco Guidi
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Pietro Giovanoli
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Maurizio Calcagni
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Barchfeld DC, Vagi RK, Lüdtke K, Schieffer E, Güler F, Einecke G, Jäger B, de Zwaan M, Nöhre M. Cognitive-behavioral and dietary weight loss intervention in adult kidney transplant recipients with overweight and obesity: Results of a pilot RCT study (Adi-KTx). Front Psychiatry 2023; 14:1071705. [PMID: 37113542 PMCID: PMC10126341 DOI: 10.3389/fpsyt.2023.1071705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 03/03/2023] [Indexed: 04/29/2023] Open
Abstract
The obesity epidemic and its health consequences have not spared the population of kidney transplant (KTx) candidates and recipients. In addition, KTx recipients are susceptible to weight gain after transplantation. Overweight and obesity after KTx are strongly associated with adverse outcomes. Therefore, we designed a randomized controlled, mono-center study to specifically test the effectiveness of a primarily cognitive-behavioral approach supplemented by nutritional counseling for weight reduction following KTx as the intervention group (IG) in comparison to a brief self-guided intervention as control group (CG). The study was registered in the German Clinical Trials Register (DRKS-ID: DRKS00017226). Fifty-six KTx patients with a BMI from 27 to 40 kg/m2 were included in this study and randomized to the IG or CG. Main outcome was the number of participants achieving a 5% weight loss during the treatment phase. Additionally, participants were assessed 6 and 12 months after the end of the 6-month treatment phase. Participants significantly lost weight without group differences. 32.0% (n = 8) of the patients in the IG and 16.7% (n = 4) of the patients in the CG achieved a weight loss of 5% or more. Weight loss was largely maintained during follow-up. Retention and acceptance rate in the IG was high, with 25 (out of 28) patients completing all 12 sessions and one patient completing 11 sessions. Short-term, cognitive-behaviorally oriented weight loss treatment seems to be feasible and acceptable for patients after KTx who suffer from overweight or obesity. This clinical trial was ongoing at the onset of the COVID-19 pandemic which might have influenced study conduct and results. Clinical Trial Registration: https://clinicaltrials.gov/ DRKS-ID: DRKS00017226.
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Affiliation(s)
- Dana Coco Barchfeld
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Ricarda-Katharina Vagi
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Katrin Lüdtke
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Elisabeth Schieffer
- Department of Cardiology, Angiology and Critical Care Medicine, Philipps University, Marburg, Germany
- Department of Sports Medicine, Hannover Medical School, Hannover, Germany
| | - Faikah Güler
- Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany
| | - Gunilla Einecke
- Department of Nephrology and Rheumatology, University Medical Center Goettingen, Goettingen, Germany
- Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany
| | - Burkard Jäger
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Mariel Nöhre
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
- *Correspondence: Mariel Nöhre,
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Huang J, Fan Y, Zhao K, Yang C, Zhao Z, Chen Y, Yang J, Wang T, Qu Y. Do patients with and survivors of COVID-19 benefit from telerehabilitation? A meta-analysis of randomized controlled trials. Front Public Health 2022; 10:954754. [PMID: 36249181 PMCID: PMC9555811 DOI: 10.3389/fpubh.2022.954754] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/12/2022] [Indexed: 01/24/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) significantly impacts physical, psychological, and social functioning and reduces quality of life, which may persist for at least 6 months. Given the fact that COVID-19 is a highly infectious disease and therefore healthcare facilities may be sources of contagion, new methods avoiding face-to-face contact between healthcare workers and patients are urgently needed. Telerehabilitation is the provision of rehabilitation services to patients at a distance via information and communication technologies. However, high-quality evidence of the efficacy of telerehabilitation for COVID-19 is still lacking. This meta-analysis aimed to investigate the efficacy of telerehabilitation for patients with and survivors of COVID-19. Methods We searched the Cochrane Library, EMBASE, Medline (via PubMed), PEDro, ClinicalTrials.gov, and WHO International Clinical Trials Registry Platform from January 1st, 2020 to April 30th, 2022 for randomized controlled trials published in English, which aimed to evaluate the efficacy of telerehabilitation vs. face-to-face rehabilitation, usual care, or no treatment for COVID-19. Methodological quality and overall evidence quality of the included studies were assessed. The statistical reliability of the data was quantified using the trial sequential analysis. Results Seven randomized controlled trials with eight comparisons were included and all of them were used for meta-analysis. The meta-analyses of absolute values showed the superiority of telerehabilitation over no treatment or usual care for dyspnea (Borg scale: mean difference = -1.88, -2.37 to -1.39; Multidimensional dyspnea-12: mean difference = -3.70, -5.93 to -1.48), limb muscle strength (mean difference = 3.29; 2.12 to 4.47), ambulation capacity (standardized mean difference = 0.88; 0.62 to 1.14), and depression (mean difference = -5.68; -8.62 to -2.74). Significant improvement in these variables persisted in the meta-analyses of change scores. No significant difference was found in anxiety and quality of life. No severe adverse events were reported in any of the included studies. Conclusions Moderate- to very low-quality evidence demonstrates that telerehabilitation may be an effective and safe solution for patients with and survivors of COVID-19 in dyspnea, lower limb muscle strength, ambulation capacity, and depression. Further well-designed studies are required to evaluate the long-term effects, cost-effectiveness, and satisfaction in larger samples.
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Affiliation(s)
- Jiapeng Huang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China,Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, China,Research Laboratory of Neurorehabilitation, Research Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Ye Fan
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China,The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Kehong Zhao
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China,Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, China,Research Laboratory of Neurorehabilitation, Research Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Chunlan Yang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China,Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, China,Research Laboratory of Neurorehabilitation, Research Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Ziqi Zhao
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China,Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, China,Research Laboratory of Neurorehabilitation, Research Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Yin Chen
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China,Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, China,Research Laboratory of Neurorehabilitation, Research Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Jiaen Yang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China,Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, China,Research Laboratory of Neurorehabilitation, Research Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China,Department of Rehabilitation Medicine, Affiliated Foshan Gaoming Hospital of Guangdong Medical University, Guangdong, China
| | - Tingting Wang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China,Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, China,Research Laboratory of Neurorehabilitation, Research Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Yun Qu
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China,Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, China,Research Laboratory of Neurorehabilitation, Research Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China,*Correspondence: Yun Qu
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11
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Breckner A, Litke N, Göbl L, Wiezorreck L, Miksch A, Szecsenyi J, Wensing M, Weis A. Effects and Processes of an mHealth Intervention for the Management of Chronic Diseases: Prospective Observational Study. JMIR Form Res 2022; 6:e34786. [PMID: 36006666 PMCID: PMC9459841 DOI: 10.2196/34786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 06/07/2022] [Accepted: 06/29/2022] [Indexed: 11/16/2022] Open
Abstract
Background Mobile health (mHealth) interventions for self-management are a promising way to meet the needs of patients with chronic diseases in primary care practices. Therefore, an mHealth intervention, TelePraCMan, was developed and evaluated for patients with type 2 diabetes mellitus, chronic obstructive pulmonary disease, high blood pressure, or heart failure in a German primary care setting. TelePraCMan entails a symptom diary, an appointment manager, a manager to document goals, and a warning system. The app should foster the self-management of participating patients. Objective We aimed to examine the effects of TelePraCMan on patient activation and quality of life and explored the underlying contextual factors, impacts, and degree of implementation. Methods In a prospective observational study design, we collected data by using interviews and written questionnaires from participating patients (intervention and control groups) and primary care workers (physicians and practice assistants). The primary outcomes of interest were patient-reported quality of life (12-Item Short Form Survey) and patient activation (patient activation measure). The quantitative analysis focused on differences between patients in the intervention and control groups, as well as before (T0) and after (T1) the intervention. Interviews were analyzed by using qualitative content analysis via MAXQDA (VERBI GmbH). Results At baseline, 25 patients and 24 primary care workers completed the questionnaire, and 18 patients and 21 primary care workers completed the follow-up survey. The patients were predominantly male and, on average, aged 64 (SD 11) years (T0). The primary care workers were mostly female (62%) and, on average, aged 47 (SD 10) years (T0). No differences were observed in the outcomes before and after the intervention or between the intervention and control groups. In the additional interviews, 4 patients and 11 primary care workers were included. The interviewees perceived that the intervention was useful for some patients. However, contextual factors and problems with implementation activities negatively affected the use of the app with patients. The main reasons for the low participation were the COVID-19 pandemic and the target group, which seemed to have less interest in mHealth; the interviewees attributed this to the older age of patients. However, the respondents felt that the app would be better accepted in 5 or 10 years. Conclusions Although the TelePraCMan app was rated as very good and important by the participants, few patients used it. The digital intervention was hardly implemented and had limited impact in the current setting of German primary care. Trial Registration German Clinical Trials Register DRKS00017320; https://tinyurl.com/4uwrzu85
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Affiliation(s)
- Amanda Breckner
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Nicola Litke
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Linda Göbl
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Lars Wiezorreck
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Antje Miksch
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Joachim Szecsenyi
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Michel Wensing
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Aline Weis
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
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12
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Vogel O, Niederer D, Vogt L. Multimodal Exercise Effects in Older Adults Depend on Sleep, Movement Biography, and Habitual Physical Activity: A Randomized Controlled Trial. Front Aging Neurosci 2021; 13:722799. [PMID: 34744686 PMCID: PMC8570408 DOI: 10.3389/fnagi.2021.722799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/21/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The promotion of healthy aging is one of the major challenges for healthcare systems in current times. The present study investigates the effects of a standardized physical activity intervention for older adults on cognitive capacity, self-reported health, fear of falls, balance, leg strength and gait under consideration of movement biography, sleep duration, and current activity behavior. Methods: This single-blinded, randomized controlled trial included 49 community-dwelling older adults (36 women; 82.9 ± 4.5 years of age (Mean [M] ± SD); intervention group = 25; control group = 24). Movement biography, sleep duration, cognitive capacity, self-reported health status, and fear of falls were assessed by means of questionnaires. Leg strength, gait, and current activity levels were captured using a pressure plate, accelerometers, and conducting the functional-reach and chair-rising-test. The multicomponent intervention took place twice a week for 45 min and lasted 16 weeks. Sub-cohorts of different sleep duration were formed to distinguish between intervention effects and benefits of healthy sleep durations. Change scores were evaluated in univariate analyses of covariances (ANCOVAs) between groups and sub-cohorts of different sleep duration in both groups. Changes in cognitive capacity, self-reported health, fear of falls, balance, leg strength, and gait were investigated using the respective baseline values, movement biography, and current activity levels as covariates. Analysis was by intention-to-treat (ITT). Results: We found sub-cohort differences in cognitive capacity change scores [F (3,48) = 5.498, p = 0.003, ηp 2 = 0.287]. Effects on fear of falls [F (1,48) = 12.961, p = 0.001, ηp 2 = 0.240] and balance change scores F (1,48) = 4.521, p = 0.040, ηp 2 = (0.099) were modified by the level of current activity. Effects on gait cadence were modified by the movement biography [F (1,48) = 4.545; p = 0.039, ηp 2 = 0.100]. Conclusions: Unlike for functional outcomes, our multicomponent intervention in combination with adequate sleep duration appears to provide combinable beneficial effects for cognitive capacity in older adults. Trainability of gait, fear of falls, and flexibility seems to be affected by movement biography and current physical activity levels. Trial registration: This study was registered at the DRKS (German Clinical Trials Register) on November 11, 2020 with the corresponding trial number: DRKS00020472.
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Affiliation(s)
- Oliver Vogel
- Department of Sports Medicine and Exercise Physiology, Institute of Sports Sciences, Johann Wolfgang Goethe-University, Frankfurt, Germany
| | - Daniel Niederer
- Department of Sports Medicine and Exercise Physiology, Institute of Sports Sciences, Johann Wolfgang Goethe-University, Frankfurt, Germany
| | - Lutz Vogt
- Department of Sports Medicine and Exercise Physiology, Institute of Sports Sciences, Johann Wolfgang Goethe-University, Frankfurt, Germany
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13
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Koob C, Schröpfer K, Coenen M, Kus S, Schmidt N. Factors influencing study engagement during the COVID-19 pandemic: A cross-sectional study among health and social professions students. PLoS One 2021; 16:e0255191. [PMID: 34314450 PMCID: PMC8315536 DOI: 10.1371/journal.pone.0255191] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 07/11/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The aim of this study is to explore factors influencing the study engagement of health and social professions students during the COVID-19 pandemic. While antecedents of study engagement have been studied previously, the factors influencing engagement under pandemic conditions have not yet been investigated. Furthermore, there is a particular need for research among students in health and social professions programs, as these students are particularly affected by the pandemic. As theoretical basis, the study draws on the demands-resources-theory. It is hypothesized that pandemic-related study and personal resources drive engagement during the pandemic, and that pandemic-related demands negatively influence engagement. METHOD The study uses a cross-sectional survey to explore the hypothesized effects. The sample consists of 559 university students of health and social professions in Germany. The study was carried out in July 2020, towards the end of the first digital semester and after the first peak in COVID-19 cases. Data are analyzed using linear multiple regression analysis. RESULTS The findings show that the demands-resources-theory is suitable to explain study engagement even under pandemic conditions. Suitable digital learning formats and social support are identified as important study resources for study engagement during major life events, while emotional resilience, active self-care and academic self-efficacy are identified as important personal resources. CONCLUSIONS Under pandemic conditions academic institutions should focus on providing beneficial teaching formats and innovative ways to support students lacking social networks. Besides, they should consider developing means to help students structuring daily life as well as establishing initiatives to strengthen students' self-efficacy beliefs.
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Affiliation(s)
- Clemens Koob
- Department of Health and Nursing, Catholic University of Applied Sciences Munich, Munich, Germany
| | - Kristina Schröpfer
- Department of Medical Information Processing, Biometry, and Epidemiology—IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Michaela Coenen
- Department of Medical Information Processing, Biometry, and Epidemiology—IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Sandra Kus
- Department of Medical Information Processing, Biometry, and Epidemiology—IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Nicole Schmidt
- Department of Social Work, Munich, Catholic University of Applied Sciences Munich, Munich, Germany
- Gynecology Division, Department of Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland
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14
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Hanke AA, Sundermeier T, Boeck HT, Schieffer E, Boyen J, Braun AC, Rolff S, Stein L, Kück M, Schiffer M, Pape L, de Zwaan M, Haufe S, Kerling A, Tegtbur U, Nöhre M. Influence of Officially Ordered Restrictions During the First Wave of COVID-19 Pandemic on Physical Activity and Quality of Life in Patients after Kidney Transplantation in a Telemedicine Based Aftercare Program-A KTx360° Sub Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239144. [PMID: 33297529 PMCID: PMC7730551 DOI: 10.3390/ijerph17239144] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/03/2020] [Accepted: 12/05/2020] [Indexed: 12/15/2022]
Abstract
Guidelines recommend a healthy lifestyle and regularly physical activity (PA) after kidney transplantation (KTx). The KTx360° program is a multicenter, multisectoral, multimodal, telemedicine-based follow-up care program. Effects of the first COVID-19 wave restrictions on health-related quality of life and PA of supervised KTx360° patients were evaluated using an online questionnaire. Six hundred and fifty-two KTx360° patients were contacted via email and were asked to complete the Freiburg questionnaire of physical activity and the Short form 12 Health Survey (SF-12) online. Pre-pandemic and lockdown data were compared in 248 data sets. While sporting activity decreased during the COVID-19 pandemic, basic and leisure activity increased, resulting in increased overall activity. The physical component scale of the SF-12 was in the low normal range before as well as during the pandemic, with a small but significant increase during the pandemic. The mental component scale showed normal values before and during pandemic with a small but statistically significant decrease. Our study supports the effectiveness of a telemedicine based program for KTx patient care in maintaining PA and quality of life during the first peak of the COVID-19 pandemic. However, further research and observation during the ongoing pandemic are required.
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Affiliation(s)
- Alexander A. Hanke
- Institute of Sports Medicine, Hannover Medical School, 30659 Hannover, Germany; (T.S.); (H.T.B.); (E.S.); (J.B.); (A.C.B.); (S.R.); (L.S.); (M.K.); (S.H.); (A.K.); (U.T.)
- Correspondence: ; Tel.: +49-511-5325499
| | - Thorben Sundermeier
- Institute of Sports Medicine, Hannover Medical School, 30659 Hannover, Germany; (T.S.); (H.T.B.); (E.S.); (J.B.); (A.C.B.); (S.R.); (L.S.); (M.K.); (S.H.); (A.K.); (U.T.)
| | - Hedwig T. Boeck
- Institute of Sports Medicine, Hannover Medical School, 30659 Hannover, Germany; (T.S.); (H.T.B.); (E.S.); (J.B.); (A.C.B.); (S.R.); (L.S.); (M.K.); (S.H.); (A.K.); (U.T.)
| | - Elisabeth Schieffer
- Institute of Sports Medicine, Hannover Medical School, 30659 Hannover, Germany; (T.S.); (H.T.B.); (E.S.); (J.B.); (A.C.B.); (S.R.); (L.S.); (M.K.); (S.H.); (A.K.); (U.T.)
| | - Johanna Boyen
- Institute of Sports Medicine, Hannover Medical School, 30659 Hannover, Germany; (T.S.); (H.T.B.); (E.S.); (J.B.); (A.C.B.); (S.R.); (L.S.); (M.K.); (S.H.); (A.K.); (U.T.)
| | - Ana Céline Braun
- Institute of Sports Medicine, Hannover Medical School, 30659 Hannover, Germany; (T.S.); (H.T.B.); (E.S.); (J.B.); (A.C.B.); (S.R.); (L.S.); (M.K.); (S.H.); (A.K.); (U.T.)
| | - Simone Rolff
- Institute of Sports Medicine, Hannover Medical School, 30659 Hannover, Germany; (T.S.); (H.T.B.); (E.S.); (J.B.); (A.C.B.); (S.R.); (L.S.); (M.K.); (S.H.); (A.K.); (U.T.)
| | - Lothar Stein
- Institute of Sports Medicine, Hannover Medical School, 30659 Hannover, Germany; (T.S.); (H.T.B.); (E.S.); (J.B.); (A.C.B.); (S.R.); (L.S.); (M.K.); (S.H.); (A.K.); (U.T.)
| | - Momme Kück
- Institute of Sports Medicine, Hannover Medical School, 30659 Hannover, Germany; (T.S.); (H.T.B.); (E.S.); (J.B.); (A.C.B.); (S.R.); (L.S.); (M.K.); (S.H.); (A.K.); (U.T.)
| | - Mario Schiffer
- Medical Clinic 4: Nephrology and Hypertension, University Hospital Erlangen, 91054 Erlangen, Germany;
| | - Lars Pape
- Department of Pediatric Nephrology, University Hospital Essen, 45122 Essen, Germany;
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, 30625 Hannover, Germany; (M.d.Z.); (M.N.)
| | - Sven Haufe
- Institute of Sports Medicine, Hannover Medical School, 30659 Hannover, Germany; (T.S.); (H.T.B.); (E.S.); (J.B.); (A.C.B.); (S.R.); (L.S.); (M.K.); (S.H.); (A.K.); (U.T.)
- Institute of Sports Science, Leibniz University Hannover, 30167 Hannover, Germany
| | - Arno Kerling
- Institute of Sports Medicine, Hannover Medical School, 30659 Hannover, Germany; (T.S.); (H.T.B.); (E.S.); (J.B.); (A.C.B.); (S.R.); (L.S.); (M.K.); (S.H.); (A.K.); (U.T.)
| | - Uwe Tegtbur
- Institute of Sports Medicine, Hannover Medical School, 30659 Hannover, Germany; (T.S.); (H.T.B.); (E.S.); (J.B.); (A.C.B.); (S.R.); (L.S.); (M.K.); (S.H.); (A.K.); (U.T.)
| | - Mariel Nöhre
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, 30625 Hannover, Germany; (M.d.Z.); (M.N.)
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15
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[Editorial]. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2020; 66:217-219. [PMID: 32876559 DOI: 10.13109/zptm.2020.66.3.217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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