ABSTRACT
BACKGROUND: This prospective, randomised longitudinal study examined the effects of inpatient medical rehabilitation. METHOD: Data was collated on the day of admission (n=261), day of discharge (n=261) and 6 months after discharge (n=243). The length of the rehabilitation measure changed every 3 months from 3 weeks (n=127) to 4 weeks (n=134) and back again. On all three specific days the VAS, the Roland-Morris-Questionnaire (RMQ) and the SF-36 were applied. The distance between fingers and floor and the Schober-sign were measured on the first and second day. The Mainz Pain Staging System (MPSS) was used to classify pain chronicity. RESULTS: On the day of discharge all parameters show an improvement. When the differing rehabilitation times are compared we can see the longer period scores better in VAS and Schober. 6 months after the rehabilitation all parameters show a slight improvement over the first day--except VAS--and a deterioration compared to the second--except RMQ. No significant predominance of the 4 week rehabilitation period is recognizable. CONCLUSION: The length of the rehabilitation measure alone seems to have no real effect on the permanence of the positive treatment of back complaints. It has advantages, though, for the result on the day of discharge.
Subject(s)
Low Back Pain/rehabilitation , Patient Admission , Activities of Daily Living/classification , Adult , Disability Evaluation , Female , Germany , Humans , Length of Stay , Longitudinal Studies , Low Back Pain/etiology , Male , Middle Aged , Pain Measurement , Prospective Studies , Rehabilitation Centers , Treatment OutcomeABSTRACT
The need for standardized and unified performance capacity assessment in orthopedic rehabilitation has led to the attempt to use an existing standardized procedure. Graduated disease features have been defined which are relevant for work and their effects on performance capacity been formulated as rules. In this way so-called disease-conditioned performance capacities are obtained which help to identify problems in carrying out various activities. These activities can be directly assessed using tests. Appropriate tests are listed in a table.
Subject(s)
Disability Evaluation , Musculoskeletal Diseases/rehabilitation , Outcome Assessment, Health Care/standards , Rehabilitation, Vocational/standards , Germany , Humans , Joint Diseases/rehabilitation , Low Back Pain/rehabilitation , Musculoskeletal Diseases/psychology , Reference Standards , Sick Role , Social MedicineABSTRACT
Low back pain and arthrosis are influencing the quality of life of people concerned and are leading to high expenses for the health and social system. A merely medical rehabilitation is often insufficient in case the person concerned is unable to fulfil the requirement at work. But vocational rehabilitation is often connected with long processing and waiting times. To counteract these, cooperative approaches have been developed between rehabilitation clinics and vocational retraining centres (Berufsförderungswerke, BFW) over the last few years. The Bad Eilsen rehabilitation centre of the LVA Hannover has worked with the Bad Pyrmont BFW since 1998. According to this project, "Occupationally Orientated Medical Rehabilitation" (Berufsorientierte medizinische Rehabilitation, BOR), the participants are extensively informed and tested in the retraining centre, they can also perform occupation-specific tasks. The aim of the study was to compare processing and waiting times with and without BOR. The results available so far show that a majority of the participants of the BOR measures could be occupationally reintegrated. In many cases work promotion measures were introduced earlier. BOR measures not only lead to a considerable acceleration of procedures, they also improve the occupational reintegration of the insured to a high degree.
Subject(s)
Low Back Pain/rehabilitation , Occupational Diseases/rehabilitation , Osteoarthritis/rehabilitation , Rehabilitation, Vocational/methods , Adult , Disability Evaluation , Education, Professional, Retraining , Female , Germany , Humans , Male , Middle Aged , Outcome and Process Assessment, Health Care , Patient Satisfaction , Vocational GuidanceABSTRACT
AIM: Studies in rehabilitation research put great value on patients' self-assessment. Patients with hip or knee diseases who need an orthopaedic rehabilitation suffer mainly pain, reduction of walking distance and other disabilities that impact on the activities of daily life. The Lequesne scores for the hip and knee are an indicator to show the degree of disabilities. The aim of the study was to prove that the Lequesne indices are reliable instruments for the individual to express the outcome of rehabilitation. We tested the Lequesne indices in daily clinical work, in the handling and in the acceptance. METHOD: Since May 1999 the rehabilitation center Bad Eilsen uses the Lequesne questionnaires as self-report questionnaire instruments for patients with hip and knee disabilities. 145 patients with hip and 122 patients with knee diseases filled in the questionnaires correctly and handed them back. RESULTS: The Lequesne indices are able to show developments in both directions; improvement as well as change for the worse. The Lequesne questionnaires are helpful to complete the common clinical parameters. CONCLUSION: Using the Lequesne questionnaires as a self-report instrument in our daily routine we are able to obtain a good reflection of individual health condition and the quality of outcome in rehabilitation.
Subject(s)
Femur Head Necrosis/rehabilitation , Osteoarthritis, Hip/rehabilitation , Osteoarthritis, Knee/rehabilitation , Outcome Assessment, Health Care/statistics & numerical data , Patient Satisfaction , Adult , Arthroplasty, Replacement, Hip/rehabilitation , Arthroplasty, Replacement, Knee/rehabilitation , Female , Follow-Up Studies , Humans , Male , Middle Aged , Postoperative Complications/rehabilitation , Surveys and QuestionnairesABSTRACT
The Lequesne Algofunctional Index is a widespread international instrument and recommended by the World Health Organization (WHO) for outcome measurement in hip and knee diseases. Up to now there has been no German version of the questionnaire fulfilling the guidelines for cross-cultural adaptation and providing satisfactory metric quality. Based on these guidelines, we developed the German version of the Lequesne Algofunctional Index regarding osteoarthritis of the hip and knee joints presented in this article. All of the questions it contains have been worded as whole sentences, questions concerning walking performance have been substantiated by examples. In testing of the metric outcome (hip: n = 112; knee: n = 83), both questionnaires showed an excellent reliability (IKK > 0,88). As a validity criterion, the correlation with the WOMAC score was tested. We received a Spearman coefficient between 0,63 and 0,81, indicating a high correlation. Time needed to fill in the Lequesne score was 2 min. in patients, physicians took 1,2 min. to evaluate the questionnaire. Regarding the questionnaires handed back, the Lequesne score showed better results than the WOMAC index. Sensitivity, measured by the "standardized response mean", was good in both regions for the total score. Comparing the data received on pain-related questions, the WOMAC score however showed a better sensitivity. The German version of the Lequesne Algofunctional Index is a suitable outcome instrument to measure the intensity of pain, walking capacity and activity of daily life in patients with osteoarthritis of hip and knee joints.
