[Predictors of the Use of Different Occupational Rehabilitation Measures: A Comparison of Integration Measures, Partial Qualifications and Full Training]. / Prädiktoren für die Inanspruchnahme unterschiedlicher Leistungen zur Teilhabe am Arbeitsleben: Ein Vergleich von Integrationsmaßnahmen, Teilqualifizierungen und Vollausbildungen.

PURPOSE: Occupational rehabilitation is an essential part of supporting return to work by the statutory pension insurance institutes. It is useful if health-related restrictions threaten the ability to work. There are various forms of occupational rehabilitation which differ considerably in terms of content, structure, duration, intensity of care and costs. The aim of the study was to identify personal characteristics that can influence the use of three different occupational rehabilitation measures. METHODS: All rehabilitants who underwent an occupational rehabilitation in the cooperating occupational rehabilitation centre (Berufsförderungswerk) from 2009 to 2014 under the funding of the German Federal Pension Fund were included in the analysis. A multinomial logistic regression was calculated in order to obtain information on the predictors of utilization of three occupational rehabilitation measures (integration measure, partial qualification, full training). As potential influencing factors, various sociodemographic characteristics as well as various parameters that reflect the employment status of rehabilitants in the previous year were included in the model. RESULTS: The analyses included a total of 934 rehabilitants who had completed an integration measure (n=443), partial qualification (n=315) or full training (n=176). In the final logistic regression model, gender (p<0.0001), age (p<0.0001), education level (p=0.0033), driving license (p<0.0001), willingness to move (p=0.0012), recognized disability (p=0.0404) and the employment status in the third month before the start of the measure (p=0.0020) proved to be significant predictors of utilization. CONCLUSION: The utilization of the different occupational rehabilitation measures is determined by various influencing factors. In particular, the more extensive and cost-intensive full training are more likely to be taken up by younger, male and more highly qualified rehabilitants.

Effects of a 12-week home exercise therapy program on pain and neuromuscular activity in patients with patellofemoral pain syndrome.

INTRODUCTION: The aim of this study is to evaluate the effects of a 12-week home exercise therapy program on pain, function and neuromuscular activity of the vastus medialis and vastus lateralis. MATERIALS AND METHODS: Fifty patients with patellofemoral pain syndrome were treated with a 12-week online home exercise program. The primary outcomes of pain and function were assessed at the 12-week follow-up using the Visual Analog Scale and Kujala Score, respectively. Secondary outcomes were the muscle onset time and the ratio of vastus medialis and vastus lateralis during different daily activities. RESULTS: After 12 weeks, patients showed significant (p < 0.05) improvements of 27 points on the Visual Analog Scale and 10 points on Kujala Score. Differences in pre-post comparison regarding both temporal and amplitude-related neurophysiological differences between the vastus medialis and lateralis were only found when the subjects were divided into groups of different electromyographic patterns. Then changes in the pre-post comparison were particularly evident in the patient group with a delayed vastus medialis onset and a lower activity of the vastus medialis compared to the VL. CONCLUSION: Pain and function improved significantly after a home exercise therapy program in patients with patellofemoral pain syndrome. In addition, patients with a delayed onset or reduced activity of the vastus medialis compared to the vastus lateralis experienced a reduction in this imbalance.

Immediate effects of an elastic patellar brace on pain, neuromuscular activity and knee kinematics in subjects with patellofemoral pain.

INTRODUCTION: The aim of this randomized controlled trial was to investigate immediate effects of a patellar brace on pain, neuromuscular activity, and knee kinematics in subjects with patellofemoral pain syndrome. MATERIALS AND METHODS: Fifty subjects with a diagnosis of patellofemoral pain syndrome completed 6 activities each with and without a patellar brace in a randomized order. The subjects were asked to rate their perceived pain on a Visual Analog Scale after each activity. During the activities, neuromuscular activity of vastus medialis and vastus lateralis, as well as knee angles were measured. RESULTS: Subjects showed a statistically significant pain reduction of 33-56% on the Visual Analog Scale during all activities while wearing the brace. Two groups with different onset patterns for vastus medialis and vastus lateralis were identified: one group who activated vastus medialis prior to vastus lateralis, and one who activated vastus medialis after vastus lateralis. In the subgroup of subjects activating vastus lateralis prior to vastus medialis, bracing resulted in a significantly (p = 0.048) earlier onset of vastus medialis by 56 ms. In all but one activity, the vastus medialis/vastus lateralis ratio without the patellar brace was < 1.0 and inverted with the patellar brace > 1.0. Knee angles in the sagittal plane increased significantly with the patellar brace in two activities. CONCLUSION: Patellofemoral bracing results in an immediate decrease of pain, an earlier onset of vastus medialis and inverted vastus medialis/vastus lateralis ratio and altered knee kinematics.

Application of functional data analysis to explore movements: walking, running and jumping - A systematic review.

Background Signals are continuously captured during the recording of motion data. Statistical analysis, however, usually uses only a few aspects of the recorded data. Functional data analysis offers the possibility to analyze the entire signal over time. Research question The review is based on the question of how functional data analysis is used in the study of lower limb movements. Methods The literature search was based on the databases EMBASE, PUBMED and OVID MEDLINE. All articles on the application of functional data analysis to motion-associated variables trajectories, ground reaction force,electromyography were included. The references were assessed independently by two reviewers. Results In total 1448 articles were found in the search. Finally, 13 articles were included in the review. All were of moderate methodological quality. The publication year of the studies ranges from 2009 to 2019. Healthy volunteers and persons with cruciate ligament injuries, knee osteoarthritis, gluteal tendinopathy, idiopathic torsional deformities, slipped capital femoral epiphysis and chronic ankle instability were examined in the studies. Movements were analyzed on basis of kinematics (3D motion analysis), ground reaction forces and electromyography. Functional Data Analysis was used in terms of landmark registration, functional principal component analysis, functional t-test and functional ANOVA. Significance Functional data analysis provides the possibility to gain detailed and in-depth insights into the analysis of motion patterns. As a result of the increase in references over the past year, the FDA is becoming more important in the analysis of continuous signals and the explorative analysis of movement data.