@article{JahnReindlMuelleretal.2019, author = {Jahn, Eva and Reindl, Anton and M{\"u}ller, Martin and Haddadin, Sami}, title = {Die neuen Assistenten}, series = {Altenheim}, journal = {Altenheim}, number = {3}, pages = {28 -- 31}, year = {2019}, language = {de} } @article{NguyenThalhammerBeutneretal.2019, author = {Nguyen, Natalie and Thalhammer, Regina and Beutner, Katrin and Saal, Susanne and Servaty, Ricarda and Klingshirn, Hanna and Icks, Andrea and Freyberg, Kristina and Vomhof, Markus and Mansmann, Ulrich and Le, Lien and M{\"u}ller, Martin and Meyer, Gabriele}, title = {Effectiveness of a complex intervention to improve participation and activities in nursing home residents with joint contractures (JointConEval): study protocol of a multicentre cluster-randomised controlled trial [DRKS-ID:DRKS00015185]}, series = {Trials}, volume = {20}, journal = {Trials}, pages = {305}, year = {2019}, abstract = {Background: Nursing home residents are frequently affected by joint contractures, which impacts their participation and daily activities. A complex intervention, the Participation Enabling Care in Nursing (PECAN), was previously developed and pilot tested to address their needs. Its effectiveness and safety will be evaluated in the present study. Methods/design: This multicentre cluster-randomised controlled trial will be conducted in 32 nursing homes spread over two regions of Germany. A total of 578 residents over 65 years old with joint contractures will be included. To compare the effect of the PECAN intervention with optimised standard care (usual care and an information session), randomisation will take place at a cluster level. The individually tailored intervention was designed using the biopsychosocial model in the International Classification of Functioning, Disability and Health (ICF) to reduce activity limitations and participation restrictions resulting from existing joint contractures by addressing barriers and by strengthening supportive factors on an individual level and an organisational level. The implementation strategy comprises a facilitators' workshop, a peer mentoring approach including a peer mentor visit and telephone peer counselling, an in-house information event, an information session for the nursing team and a training session on collegial consultation for the facilitators. The in-house information event will also take place in the nursing homes of the control group. The primary outcome is the residents' participation and activities after 12 months of follow-up as assessed using the PaArticular Scales. The secondary outcome is the residents' quality of life. A cost-effectiveness analysis (costs per additional resident who experienced a decrease of ten points in the participation or activities subscale of the PaArticular Scales) and a cost-utility analysis (costs per additional quality adjusted life year) will be conducted. We will investigate barriers and facilitators in a comprehensive process evaluation. Discussion: We expect a clinically relevant improvement of participation and activities in residents with joint contractures. Our findings will provide important insights regarding participation in the situation of the affected individuals.}, language = {en} } @article{PaoliniKollmannsbergerWinteretal.2017, author = {Paolini, Alexander and Kollmannsberger, Stefan and Winter, Christoph and Buchschmid, Martin and M{\"u}ller, Gerhard and Rabold, Andreas and Mecking, Simon and Schanda, Ulrich and Rank, Ernst}, title = {A high-order finite element model for vibration analysis of cross-laminated timber assemblies}, series = {Building Acoustics}, volume = {2017}, journal = {Building Acoustics}, number = {3}, edition = {24}, pages = {135 -- 158}, year = {2017}, abstract = {The vibration behavior of cross-laminated timber components in the low-frequency range can be predicted with high accuracy by the finite element method. However, the modeling of assembled cross-laminated timber components has been studied only scarcely. The three-dimensional p-version of the finite element method, which is characterized by hierarchic high-order shape functions, is well suited to consider coupling and support conditions. Furthermore, a small number of degrees of freedom can be obtained in case of thin-walled structures using p-elements with high aspect ratios and anisotropic ansatz spaces. In this article, a model for cross-laminated timber assemblies made of volumetric high-order finite elements is presented. Two representative types of connections are investigated, one with an elastomer between the cross-laminated timber components and the other without. The model is validated, and suitable ranges for the stiffness parameters of the finite elements which represent the junctions are identified.}, language = {en} } @article{GrillFurmanAlghwirietal.2013, author = {Grill, E. and Furman, J.M. and Alghwiri, A.A. and M{\"u}ller, Martin and Whitney, S.L.}, title = {Using core sets of the international classification of functioning, disability and health (ICF) to measure disability in vestibular disorders: study protocol}, series = {Journal of vestibular research}, journal = {Journal of vestibular research}, number = {23(6)}, editor = {B{\´a}r{\´a}ny Society,}, year = {2013}, abstract = {Symptom frequency and severity in vestibular disorders often do not correlate well with patients' restrictions of activities of daily living and limitations of participation. Due to the lack of appropriate patient reported outcome measures (PRO), the extent of limitations and restrictions is mostly unknown. The International Classification of Functioning, Disability and Health (ICF) is a conceptual framework and classification to evaluate all aspects of health and disability. An ICF-based measure, the Vestibular and Participation Measure (VAP), was recently proposed. Also, an ICF Core Set for vertigo, dizziness and balance disorders was developed to describe what aspects of functioning should be measured. This study protocol describes the development and cross-cultural validation of a new measure, the VAP-extended (VAP-e), based on VAP and ICF Core Set on three continents. To determine objectivity and cross-cultural validity of the VAP and to find potentially redundant items, Rasch models will be used. The VAP-e will be created by modifying or adding items from the Activities and Participation and Environmental Factors component of the ICF Core Set. Reliability, objectivity and responsiveness of the VAP-e will be tested.}, language = {en} } @article{MuellerFischerBartoszeketal.2013, author = {M{\"u}ller, Martin and Fischer, U. and Bartoszek, G. and Grill, E. and Meyer, G.}, title = {Impact of joint contractures on functioning and social participation in older individuals--development of a standard set (JointConFunctionSet): study protocol}, series = {BMC Geriatrics}, journal = {BMC Geriatrics}, editor = {Springer Nature,}, year = {2013}, abstract = {Background Joint contractures are frequent in older individuals in geriatric care settings. Even though they are used as indicator of quality of care, there is neither a common standard to describe functioning and disability in patients nor an established standardized assessment to describe and quantify the impact of joint contractures on patients' functioning. Thus, the aim of our study is (1) to develop a standard set for the assessment of the impact of joint contractures on functioning and social participation in older individuals and (2) to develop and validate a standardized assessment instrument for describing and quantifying the impact of joint contractures on the individuals' functioning. Methods The standard set for joint contractures integrate the perspectives of all potentially relevant user groups, from the affected individuals to clinicians and researchers. The development of this set follows the methodology to develop an International Classification of Functioning Disability and Health (ICF) Core Set and involves a formal decision-making and consensus process. Evidence from four preparatory studies will be integrated including qualitative interviews with patients, a systematic review of the literature, a survey with health professionals, and a cross sectional study with patients affected by joint contractures. The assessment instrument will be developed using item-response-theory models. The instrument will be validated. Discussion The standard set for joint contractures will provide a list of aspects of functioning and health most relevant for older individuals in geriatric care settings with joint contractures. This list will describe body functions, body structures, activities and participation and related environmental factors. This standard set will define what aspects of functioning should be assessed in individuals with joint contractures and will be the basis of the new assessment instrument to evaluate the impact of joint contractures on functioning and social participation.}, language = {en} } @article{GrillBronsteinFurmanetal.2012, author = {Grill, E. and Bronstein, A. and Furman, J. and Zee, D.S. and M{\"u}ller, Martin}, title = {International Classification of Functioning, Disability and Health (ICF) Core Set for patients with vertigo, dizziness and balance disorders}, series = {Journal of vestibular research}, journal = {Journal of vestibular research}, editor = {B{\´a}r{\´a}ny Society,}, year = {2012}, abstract = {Vertigo, dizziness and balance disorders have major impact on independence, employability, activities and participation. There are many measures for the assessment of the impact of vertigo, but no consensus exists on which aspects should be measured. The objective of this study was to develop international standards (ICF Core Sets) for patients with vertigo and dizziness to describe functioning. The development of the ICF Core Sets involved a formal decision-making and consensus process, integrating evidence from preparatory studies including qualitative interviews with patients, a systematic review of the literature, a survey with health professionals, and empirical data collection from patients. Twenty-seven experts selected 100 second level categories for the comprehensive Core Set and 29 second level categories for the Brief Core Set. The largest number of categories was selected from the ICF component Activities and Participation (40). Twenty-five categories were selected from the component Body Functions, six from Body Structures, and 29 from Environmental Factors. The ICF Core Set for vertigo is designed for physicians, nurses, therapists and other health professionals working in inpatient or ambulatory settings. ICF Core Sets create patient-relevant outcomes that can be used as evidence for the success of treatments.}, language = {en} } @article{MuellerGrill2011, author = {M{\"u}ller, Martin and Grill, E.}, title = {Die Internationale Klassifikation der Funktionsf{\"a}higkeit, Behinderung und Gesundheit (ICF). Core Sets im Akutkrankenhaus: Nutzen und Relevanz f{\"u}r Pflegewissenschaft und -praxis.}, series = {Pflegewissenschaft}, journal = {Pflegewissenschaft}, number = {13(5)}, editor = {hps media,}, pages = {280 -- 288}, year = {2011}, language = {de} } @article{MuellerGrillStierJarmeretal.2011, author = {M{\"u}ller, Martin and Grill, E. and Stier-Jarmer, M. and Strobl, R. and Gutenbrunner, C. and Fialka-Moser, V. and Stucki, G.}, title = {Validation of the comprehensive ICF Core Sets for patients receiving rehabilitation interventions in the acute care setting}, series = {Journal of rehabilitation medicine}, journal = {Journal of rehabilitation medicine}, number = {43(2)}, editor = {Foundation of Rehabilitation Information,}, year = {2011}, abstract = {Objective: To examine the relevance and completeness of the comprehensive International Classification of Functioning, Disability and Health (ICF) Core Sets for patients with rehabilitation needs in acute hospital care. Design: Multi-centre cohort study. Patients: A total of 391 patients (50.1\% female, mean age 63.4 years) from 4 university hospitals in Austria, Germany and Switzerland and one Austrian general hospital. Methods: Data on functioning were collected using the respective comprehensive acute ICF Core Sets. Data were extracted from patients' medical record sheets and interviews with health professionals and patients. Results: Most of the categories of the comprehensive ICF Core Sets describing impairments, limitations or restrictions occurred in a considerable proportion of the study population. The most outstanding limitations and restrictions of the patients were problems with sleep and blood vessel functions, walking and moving and self-care. Thirty-eight aspects of functioning not previously covered by the comprehensive ICF Core Sets were ranked as relevant. Conclusion: Categories of the comprehensive ICF Core Sets for the acute hospital situation were confirmed. Some additional categories not covered by the Set in its present version emerged from the interviews, and should be considered for inclusion in a finalized version.}, language = {en} } @article{GrillStroblMuelleretal.2011, author = {Grill, E. and Strobl, R. and M{\"u}ller, Martin and Quittan, M. and Kostanjsek, N. and Stucki, G.}, title = {ICF Core Sets for early post-acute rehabilitation facilities}, series = {Journal of rehabilitation medicine}, journal = {Journal of rehabilitation medicine}, number = {43(2)}, editor = {Foundation of Rehabilitation Information,}, year = {2011}, abstract = {Objective: To identify candidate categories for International Classification of Functioning, Disability and Health (ICF) Core Sets for the reporting and measurement of functioning in patients in early post-acute rehabilitation facilities. Design: Prospective multi-centre cohort study. Patients: Patients receiving rehabilitation interventions for musculoskeletal, neurological or cardiopulmonary injury or disease in early post-acute rehabilitation facilities. Methods: Functioning was coded using the ICF. The criterion for selecting candidate categories for the ICF Core Sets was based on their ability to discriminate between patients with high or low functioning status. Discrimination was assessed using multivariable regression models, the independent variables being all of the ICF categories of the respective comprehensive ICF Core Set. Analogue ratings of overall functioning as reported by patients and health professionals were used as dependent variables. Results: A total of 165 patients were included in the study (67 neurological, 37 cardiopulmonary, 61 musculoskeletal), mean age 67.5 years, 46.1\% female. Selection yielded 38 categories for neurological, 32 for cardiopulmonary, and 31 for musculoskeletal. Conclusion: The present selection of categories can be considered an initial proposal, serving to identify the issues most relevant for the assessment and monitoring of functioning in patients undergoing early post-acute rehabilitation for neurological, cardiopulmonary, and musculoskeletal conditions.}, language = {en} } @article{MuellerPetersDoringetal.2011, author = {M{\"u}ller, Martin and Peters, A. and Doring, A. and Ladwig, K.-H. and Holle, R. and Meisinger, C. and Linkohr, B. and Autenrieth, C. and Baumeister, S. and Behr, J. and Bergner, A. and Bickel, H. and Bidlingmaier, M. and Dias, A. and Emeny, R.T. and Fischer, B. and Grill, E. and Gorzelniak, L. and Hansch, H. and Heidbreder, S. and Heier, M. and Horsch, A. and Huber, D. and Huber, R.M. and Jorres, R.A. and Kaab, S. and Karrasch, and Kirchberger, and Klug, and Kranz, and Kruch, and Lacruz, and Lang, and Mielk, and Nowak, and Schneider, and Schulz, and Seidel, and Strobl, and Thorand, and Wende, and Weidenhammer, and Zimmermann, and Wichmann,}, title = {Multimorbidity and successful aging: the population-based KORA-Age study}, series = {Zeitschrift f{\"u}r Gerontologie und Geriatrie}, journal = {Zeitschrift f{\"u}r Gerontologie und Geriatrie}, editor = {Springer Nature,}, year = {2011}, abstract = {Background Multimorbidity in the older population is well acknowledged to negatively affect health-related quality of life (HRQL). Several studies have examined the independent effects of single diseases; however, little research has focused on interaction between diseases. The purpose of this study was to assess the impact of six self-reported major conditions and their combinations on HRQL measured by the EQ-5D. Methods The EQ-5D was administered in the population-based KORA-Age study of 4,565 Germans aged 65 years or older. A generalised additive regression model was used to assess the effects of chronic conditions on HRQL and to account for the nonlinear associations with age and body mass index (BMI). Disease interactions were identified by a forward variable selection method. Results The conditions with the greatest negative impact on the EQ-5D index were the history of a stroke (regression coefficient -11.3, p < 0.0001) and chronic bronchitis (regression coefficient -8.1, p < 0.0001). Patients with both diabetes and coronary disorders showed more impaired HRQL than could be expected from their separate effects (coefficient of interaction term -8.1, p < 0.0001). A synergistic effect on HRQL was also found for the combination of coronary disorders and stroke. The effect of BMI on the mean EQ-5D index was inverse U-shaped with a maximum at around 24.8 kg/m2. Conclusions There are important interactions between coronary problems, diabetes mellitus, and the history of a stroke that negatively affect HRQL in the older German population. Not only high but also low BMI is associated with impairments in health status.}, language = {en} } @article{SaalMeyerBeutneretal.2018, author = {Saal, S. and Meyer, G. and Beutner, K. and Klingshirn, H. and Strobl, R. and Grill, E. and Mann, E. and K{\"o}pke, S. and Bleijlevens, M.H.C. and Bartoszek, G. and Stephan, A.-J. and Hirt, J. and M{\"u}ller, Martin}, title = {Development of a complex intervention to improve participation of nursing home residents with joint contractures: a mixed-method study}, series = {BMC Geriatrics}, journal = {BMC Geriatrics}, year = {2018}, abstract = {Background Joint contractures in nursing home residents limit the capacity to perform daily activities and restrict social participation. The purpose of this study was to develop a complex intervention to improve participation in nursing home residents with joint contractures. Methods The development followed the UK Medical Research Council framework using a mixed-methods design with re-analysis of existing interview data using a graphic modelling approach, group discussions with nursing home residents, systematic review of intervention studies, structured 2-day workshop with experts in geriatric, nursing, and rehabilitation, and group discussion with professionals in nursing homes. Results Graphic modelling identified restrictions in the use of transportation, walking within buildings, memory functions, and using the hands and arms as the central target points for the intervention. Seven group discussions with 33 residents revealed various aspects related to functioning and disability according the International Classification of Functioning, Disability and Health domains body functions, body structures, activities and participation, environmental factors, and personal factors. The systematic review included 17 studies with 992 participants: 16 randomised controlled trials and one controlled trial. The findings could not demonstrate any evidence in favour of an intervention. The structured 2-day expert workshop resulted in a variety of potential intervention components and implementation strategies. The group discussion with the professionals in nursing homes verified the feasibility of the components and the overall concept. The resulting intervention, Participation Enabling CAre in Nursing (PECAN), will be implemented during a 1-day workshop for nurses, a mentoring approach, and supportive material. The intervention addresses nurses and other staff, residents, their informal caregivers, therapists, and general practitioners. Conclusions In view of the absence of any robust evidence, the decision to use mixed methods and to closely involve both health professionals and residents proved to be an appropriate means to develop a complex intervention to improve participation of and quality of life in nursing home residents. We will now evaluate the PECAN intervention for its impact and feasibility in a pilot study in preparation for an evaluation of its effectiveness in a definitive trial. Trial registration German clinical trials register, reference number DRKS00010037 (12 February 2016).}, language = {en} } @article{SaalBeutnerBogunskietal.2017, author = {Saal, Susanne and Beutner, Katrin and Bogunski, Julia and Oberm{\"u}ller, Kathrin and M{\"u}ller, Martin and Grill, Eva and Meyer, Gabriele}, title = {Interventions for the prevention and treatment of disability due to acquired joint contractures in older people: a systematic review}, series = {Age and Ageing}, journal = {Age and Ageing}, number = {46}, editor = {Oxford Academic,}, year = {2017}, abstract = {Background acquired joint contractures have significant effects on quality of life and functioning. Objective to determine the effects of interventions to prevent and treat disabilities in older people with acquired joint contractures. Methods systematic search (last 8/2016) via Cochrane Library, PubMed, EMBASE, PEDro, CINAHL, trial registries, reference lists of retrieved articles and scientific congress pamphlets. Controlled and randomised controlled trials in English or German comparing an intervention with another intervention or standard care were included. Two independent researchers performed the selection of publications, data extraction and critical appraisal. Results seventeen studies with 992 participants met the inclusion criteria: 16 randomised controlled trials and 1 controlled trial (nursing homes = 4, community settings = 13). The methodological quality of the studies varied. Splints were examined in four studies, stretching exercises in nine studies, and ultrasound, passive movement therapy, bed-positioning and group exercise were each examined in one study. Studies on splints revealed inconclusive results regarding joint mobility or spasticity. Five of seven studies that assessed active stretching programmes for healthy older people reported statistically significant effects on joint mobility in favour of the intervention. Pain, quality of life, activity limitations and participation restrictions were rarely assessed. Conclusion the evidence for the effectiveness of interventions to prevent and treat disability due to joint contractures is weak, particularly for established nursing interventions such as positioning and passive movement. Better understanding is required regarding the delivery of interventions, such as their intensity and duration. In addition to functional issues, activities and social participation should also be studied as outcomes.}, language = {en} } @article{GrillMuellerMansmann2016, author = {Grill, Eva and M{\"u}ller, Martin and Mansmann, Ulrich}, title = {Health-exploring complexity: an interdisciplinary systems approach HEC 2016}, series = {European journal of epidemiology}, journal = {European journal of epidemiology}, number = {31}, editor = {Springer Verlag,}, year = {2016}, abstract = {Health is a complex process with potentially interacting components from the molecular to the societal and environmental level. Adequate research designs and data analysis methods are needed to improve our understanding of this complexity, to ultimately derive high quality evidence to inform patients, health professionals, and health policy decision makers. Also, effective patient-centred health care has to address the complexity of health, functioning, and disability, not only by implementing interventions, but also by using information technologythatrepresentsthecomplexityofhealthcaretoinformallactors. Given this background, we developed the concept of our conference HEC2016 as an interdisciplinary European event in beautiful Bavaria, in the city of Mu ¨nchen. Quite ironically this is the place, where William of Ockham, whose ideas of parsimony are the very opposite of complexity, accused of heresy, spent 17 years under the protection of the Bavarian King Ludwig IV. Furthermore, our local public health hero Max von Pettenkofer (1818-1901) contributed a lot to the basic systemic understanding of health, especially the relevance of a healthy environment. Under the joint theme of health as a complex system we joined the activities of five scientific disciplines: Medical Informatics, Medical Biometry, Bioinformatics, Epidemiology and Health Data Management. The mission behind this interdisciplinary effort was to serve as an important scientific forum for the exchange of new ideas and applications to strengthen health sciences on a national and international level. The analysis of health as a complex system opens needed perspectives on a challenging reality: filtering current hypotheses, resolving controversies, and tailoring interventions to the need of the individual within a health system environment. The conference encouraged the dialogue of the disciplines in order to advance our understanding of health and to decrease burden of disease. HEC2016 brought together the annual conferences of the German Association for Medical Informatics, Biometry and Epidemiology (GMDS), the German Society for Epidemiology (DGEpi), the International Epidemiological Association- European Region (IEA-EEF) and the European Federation for Medical Informatics Association (EFMI, MIE 2016). HEC2016 took place in Mu ¨nchen, Germany, in the main building of the Ludwig-Maximilians-Universita ¨t (LMU) from 28 August to 2 September 2016 under the auspices of the Institute for MedicalInformationProcessing,BiometryandEpidemiologyofLMU. The conference received 832 contributions for oral and poster presentation (Table 1). Fourteen percent of them were from outside Europe with the largest group of 10 \% from Asia (Table 2). Scientific program committees and reviewers selected 408 submissions as oral contributions and 303 for poster presentations. The program was surrounded by twelve tutorials held by international renowned scientists and covered a broad spectrum from innovative biostatistical and epidemiological methods to tutorials in application of innovative software, scientific writing and data protection issues. Over 50 panel discussions and workshops allowed in-depth exchange of ideas on specific topics and underscored the interactive nature of HEC2016. A special focus of HEC2016 was on the promotion of young scientists from all disciplines whose participation was supported by numerous travel grants. We would like to express our deepest gratitude to all the colleagues who supported us as speakers, committee members and reviewers, lent us a hand before, during and after the conference, gave critical but friendly comments at all stages of the preparations, supported us by providing coffee, audience or Butterbrezen, and specifically to those who submitted contributions to the conference and attended the conference and its many tutorials, lectures and sessions. We extend our gratitude to the Deutsche Forschungsgemeinschaft for generous financial support (grant no. GR 3608/4-1). Last not least we would like to thank our families who allowed us to spend most of our weekends with organizing this conference, to William of Ockham for lending us his razor (from time to time) and to Max von Pettenkofer for guidance.}, language = {en} } @article{MuellerOberhauserFischeretal.2016, author = {M{\"u}ller, Martin and Oberhauser, Cornelia and Fischer, Uli and Bartoszek, Gabriele and Saal, Susanne and Strobl, Ralf and Meyer, Gabriele and Grill, Eva}, title = {The PaArticular Scales - A new outcome measure to quantify the impact of joint contractures on activities and participation in individuals in geriatric care: Development and Rasch analysis}, series = {International Journal of Nursing Studies}, journal = {International Journal of Nursing Studies}, number = {59}, editor = {CrossMark,}, year = {2016}, abstract = {Background Joint contractures are frequent conditions in individuals in geriatric care settings and are associated with activity limitations and participation restrictions. As such, relevant intervention programs should address these aspects, and the effectiveness of such programs should be determined by assessing improvement in activities and participation. However, no patient-centred and psychometrically sound outcome measures for this purpose are available so far. Objectives The objectives of this study were to develop and to validate a new outcome measure, the PaArticular Scales, to quantify activities and participation in older individuals with joint contractures. Specific aims were (A) to operationalize the content of an International Classification of Functioning, Disability and Health-based standard set towards meaningful questions and to combine them to a questionnaire and (B) to assess the psychometric properties of the developed questionnaire, in detail to evaluate test-retest reliability, objectivity, internal consistency reliability and criterion validity. Design Operationalization was reached by an expert consensus conference and a subsequent expert Delphi survey. Psychometric properties were assessed in a cross-sectional study. Settings Nursing homes, geriatric rehabilitation facilities. Participants 23 experts (nurses, physicians, physical and occupational therapists) participated in the consensus conference and the Delphi survey. A total of 191 individuals with joint contractures (as confirmed by physician, nurse or physical therapist) between 65 and 102 years, living in nursing homes or as patients in geriatric rehabilitation were enrolled in the cross-sectional study. Methods Rasch Partial Credit Modelling. Results The consensus conference and Delphi survey resulted in a questionnaire with 86 items of the International Classification of Functioning, Disability and Health. Test-retest-reliability among those was acceptable (Cohen's weighted kappa: 0.779). The Rasch analysis revealed two independent interval-scaled scales with 24 items for the Activities scale and 11 items for the Participation scale with high internal consistency reliability. Cronbach's alpha was 0.96 for the Activities scale and 0.92 for the Participation scale. Criterion validity was -0.40 and -0.30 for the Activities scale and for the Participation scale, respectively. Conclusions The PaArticular Scales, a new patient-centred and psychometric sound outcome measures to comprehensively assess the impact of joint contractures in geriatric care, are available now. These developed scales will serve as primary outcomes in a scheduled evaluation of a complex intervention to improve participation and quality of life in nursing home residents with joint contractures.}, language = {de} } @article{BartoszekFischerMuelleretal.2016, author = {Bartoszek, G. and Fischer, U. and M{\"u}ller, Martin and Strobl, R. and Grill, E. and Nadolny, S. and Meyer, G.}, title = {Outcome measures in older persons with acquired joint contractures: a systematic review and content analysis using the ICF (International Classification of Functioning, Disability and Health) as a reference}, series = {BMC Geriatrics}, journal = {BMC Geriatrics}, editor = {BioMed Central,}, year = {2016}, abstract = {Background: Joint contractures are a common health problem in older persons with significant impact on activities of daily living. We aimed to retrieve outcome measures applied in studies on older persons with joint contractures and to identify and categorise the concepts contained in these outcome measures using the ICF (International Classification of Functioning, Disability and Health) as a reference. Methods: Electronic searches of Medline, EMBASE, CINAHL, Pedro and the Cochrane Library were conducted (1/2002-8/2012). We included studies in the geriatric rehabilitation and nursing home settings with participants aged ≥ 65 years and with acquired joint contractures. Two independent reviewers extracted the outcome measures and transferred them to concepts using predefined conceptual frameworks. Concepts were subsequently linked to the ICF categories. Results: From the 1057 abstracts retrieved, 60 studies met the inclusion criteria. We identified 52 single outcome measures and 24 standardised assessment instruments. A total of 1353 concepts were revealed from the outcome measures; 96.2 \% could be linked to 50 ICF categories in the 2nd level; 3.8 \% were not categorised. Fourteen of the 50 categories (28 \%) belonged to the component Body Functions, 4 (8 \%) to the component Body Structures, 26 (52 \%) to the component Activities and Participation, and 6 (12 \%) to the component Environmental Factors. Conclusions: The ICF is a valuable reference for identifying and quantifying the concepts of outcome measures on joint contractures in older people. The revealed ICF categories remain to be validated in populations with joint contractures in terms of clinical relevance and personal impact.}, language = {en} } @article{BartoszekFischerClarmannvonClarenauetal.2015, author = {Bartoszek, Gabriele and Fischer, Uli and Clarmann von Clarenau, Stephan and Grill, Eva and Mau, Wilfried and Meyer, Gabriele and Strobl, Ralf and Thiesemann, R{\"u}diger and Nadolny, Stephan and M{\"u}ller, Martin}, title = {Development of an International Classification of Functioning, Disability and Health (ICF)-based standard set to describe the impact of joint contractures on participation of older individuals in geriatric care settings}, series = {Archives of gerontology and geriatrics}, volume = {61}, journal = {Archives of gerontology and geriatrics}, editor = {Science direct,}, year = {2015}, abstract = {Introduction Joint contractures are characterized as impairment of the physiological movement of joints due to deformity, disuse or pain and have major impact especially for older individuals in geriatric care. Some measures for the assessment of the impact of joint contractures exist. However, there is no consensus on which aspects should constantly be measured. Our objective was to develop a standard-set based on the ICF for describing functioning and disability in older individuals with joint contractures in geriatric care settings, giving special emphasis to activities and participation. Methods The ICF-based standard set was developed in a formal decision-making and consensus process and based on an adapted version of the protocol to develop ICF Core Sets. These are sets of categories from the ICF, serving as standards for the assessment, communication and reporting of functioning and health for clinical studies, clinical encounters and multi-professional comprehensive assessment and management. Results Twenty-three experts from Germany and Switzerland selected 105 categories of the ICF component Activities and Participation for the ICF-based standard set. The largest number of categories was selected from the chapter Mobility (50 categories, 47.6\%). Conclusions The standard set for older individuals with joint contractures provides health professionals with a standard for describing patients' activity limitations and participation restrictions. The standard set also provides a common basis for the development of patient-centered measures and intervention programs. The preliminary version of the ICF-based standard set will be tested in subsequent studies with regard to its psychometric properties.}, language = {en} } @article{MuellerBartoszekBeutneretal.2015, author = {M{\"u}ller, Martin and Bartoszek, G. and Beutner, K. and Klingshirn, H. and Saal, S. and Stephan, A.-J. and Strobl, R. and Grill, E. and Meyer, G.}, title = {Developing and piloting a multifactorial intervention to address participation and quality of life in nursing home residents with joint contractures}, series = {German medical science}, journal = {German medical science}, editor = {NCBI,}, year = {2015}, abstract = {Background: Joint contractures are common problems in frail older people in nursing homes. Irrespective of the exact extent of older individuals in geriatric care settings living with joint contractures, they appear to be a relevant problem. Also, the new emphasis on the syndrome of joint contractures, e. g. by the German statutory long term care insurance, led to an increase in assessment and documentation efforts and preventive interventions in clinical care. However, more attention should be paid to the actual situation of older individuals in nursing homes with prevalent joint contractures, particularly their experience of related activity limitations and participation restrictions. Thus, the aim of this study is 1) to develop a tailored intervention to improve functioning, and especially participation and quality of life in older residents with joint contractures in nursing homes and 2) to test the feasibility of the intervention accompanied by a rigorous process evaluation. Methods: The complex intervention, which will be developed in this project follows the UK Medical Research Council (MRC) framework and integrates the perspectives of all potentially relevant user groups, from the affected individuals to clinicians and researchers. The development process will comprise a systematic literature review, reanalysis of existing data and the integration of the knowledge of the affected individuals and experts. The developed intervention including a comprehensive process evaluation will be pilot tested with residents with joint contractures in three nursing homes. Discussion: The projected study will provide a tailored intervention to improve functioning, participation and quality of life in older residents with joint contractures in nursing homes. With this focus, the intervention will support patient relevant outcomes. The pilot study including process evaluation will offer a first opportunity to indicate the size of the intervention's effect and prepare further studies.}, language = {en} } @article{FischerMuellerStrobletal.2015, author = {Fischer, U. and M{\"u}ller, Martin and Strobl, R. and Bartoszek, G. and Meyer, G. and Grill, E.}, title = {Prevalence of functioning and disability in older patients with joint contractures: a cross-sectional study}, series = {European Journal of physical and rehabilitation medicine}, journal = {European Journal of physical and rehabilitation medicine}, editor = {minerva medica,}, year = {2015}, language = {en} } @article{MuellerWhitneyAlghwirietal.2015, author = {M{\"u}ller, Martin and Whitney, S. L. and Alghwiri, A. and Alshebber, K. and Strobl, R. and Aghadir, A. and Almomani, M. O. and Furman, J. M. and Grill, E.}, title = {Subscales of the vestibular activities and participation questionnaire could be applied across cultures}, series = {European journal of epidemiology}, journal = {European journal of epidemiology}, editor = {PlumX Metrics,}, year = {2015}, abstract = {Objectives The objective of this study was to assess the objectivity, cross-cultural validity, and convergent validity of the Vestibular Activities and Participation (VAP) questionnaire among four countries, Germany, United States, Jordan, and Saudi Arabia. Study Design and Setting This was a cross-sectional study conducted in four specialized outpatient dizziness clinics in Germany, United States, Jordan, and Saudi Arabia. Results A total of 453 participants were included in the study. The Rasch analysis revealed two separate subscales. Subscale 1 items included focusing attention, lying down, standing, bending, lifting and carrying objects, and sports. Subscale 2 items included walking long distances, climbing, running, moving around within buildings other than home, using transportation, and driving. The Pearson product-moment correlation between the Dizziness Handicap Inventory and the summary score of the VAP subscale 1 was 0.66 and was 0.64 for subscale 2. Conclusion Owing to its shortness and intercultural adaptability, the new two-scale version of the VAP questionnaire lends itself to clinical practice and research across countries to estimate the effect of vertigo and dizziness on activity limitation and participation restrictions. Psychometrically sound summary scores can be calculated. More extended versions of the VAP can be used for comprehensive clinical assessment where summary scores are not needed or a more detailed documentation is warranted.}, language = {en} } @article{FischerBartoszekMuelleretal.2014, author = {Fischer, U. and Bartoszek, G. and M{\"u}ller, Martin and Strobl, R. and Meyer, G. and Grill, E.}, title = {Patients' view on health-related aspects of functioning and disability of joint contractures: a qualitative interview study based on the International Classification of Functioning, Disability and Health}, series = {Disability and Rehabilitation}, journal = {Disability and Rehabilitation}, editor = {Taylor and Francis online,}, year = {2014}, abstract = {Purpose: The aim of this study was to identify health-relevant aspects of functioning and disability of persons aged 65 years or older with joint contractures, to link the findings to corresponding ICF categories and to describe the patients' perspective. Methods: We conducted 43 qualitative, semi-structured, face-to-face interviews with affected persons in two different locations (Witten, Munich) and in three different settings. Data were analyzed using the "meaning condensation procedure" and then linked to ICF categories. Results: From all interviews a total of 2499 single meaning-concepts were extracted which were linked to 324 different ICF categories. The participants in all settings mainly reported problems related to "Mobility of a single joint (b710)", "Sensation of pain (b280)" and problems related to "Walking (d450)". Almost all participants reported "Products and technology for personal indoor and outdoor mobility and transportation (e120)" as a relevant environmental factor. Conclusions: From the patients' perspective, joint contractures have an impact on multifaceted aspects of functioning and disability, mainly body functions, environmental factors and activities and participation. The results of this study will contribute to the development of a standard instrument for measuring functioning, disability and health-relevant aspects for patients with joint contractures. Implications for Rehabilitation Joint contractures are a major cause for the development of disability in older people. Patients' perspectives and their personal experiences have to be considered when assessing the impact of joint contractures. The International Classification of Functioning, Disability and Health (ICF) is an appropriate framework for describing the patients' multifaceted experience of joint contractures.}, language = {en} } @article{FischerMuellerStrobletal.2014, author = {Fischer, U. and M{\"u}ller, Martin and Strobl, R. and Bartoszek, G. and Meyer, G. and Grill, E.}, title = {Examining Functioning and Contextual Factors in Individuals with Joint Contractures from the Health Professional Perspective Using the ICF: An International Internet-Based Qualitative Expert Survey}, series = {Rehabilitation nursing}, journal = {Rehabilitation nursing}, editor = {Elaine Tilka, Miller}, year = {2014}, abstract = {Purpose The aim of this study was to identify disease-related aspects of functioning and disability in people with joint contractures from a health professionals' perspective and to describe the findings, using categories of the International Classification of Functioning, Disability, and Health (ICF). Design An Internet-based expert survey. Methods We asked international health professionals for typical problems in functioning and important contextual factors of individuals with joint contractures using an Internet-based open-ended questionnaire. All answers were linked to the ICF according to established rules. Absolute and relative frequencies of the linked ICF categories were reported. Findings Eighty experts named 1785 meaning units which could be linked to 256 ICF categories. Among the categories, 24.2\% belonged to the component Body Functions, 20.7\% to Body Structures, 36.3\% to Activities and Participation, and 18.8\% to Environmental Factors. Conclusion Health professionals addressed a large variety of functional problems and multifaceted aspects due to the symptom joint contractures. Clinical Relevance International health professionals reported a large variety of aspects of functioning and health, which are related to joint contractures}, language = {de} } @article{MuellerStroblJahnetal.2014, author = {M{\"u}ller, Martin and Strobl, R. and Jahn, K. and Linkohr, B. and Ladwig, K.H. and Mielk, A. and Grill, E.}, title = {Impact of vertigo and dizziness on self-perceived participation and autonomy in older adults: Results from the KORA-Age study}, series = {Quality of life research}, journal = {Quality of life research}, editor = {Springer Link,}, year = {2014}, abstract = {Purpose The impact of vertigo and dizziness on healthy ageing, and especially on participation, is not fully understood. The objective of this study was to investigate the association of vertigo and dizziness with self-perceived participation and autonomy in older non-institutionalised individuals, adjusted for the presence of other health conditions. Specifically, we wanted to investigate the different effects of vertigo and dizziness on specific components of participation, i.e. restrictions in indoor and outdoor autonomy, family role, social life and relationships, and work and education. Methods Data originate from the second wave of the German KORA-Age cohort study collected in 2012. Participation and autonomy was investigated with the Impact on Participation and Autonomy Questionnaire. We used robust regression to analyse the association of vertigo and dizziness with self-perceived participation and autonomy adjusted for covariates. Results A total of 822 participants (49.6 \% female) had a mean age of 78.1 years (SD 6.39). Participation and autonomy were significantly lower in participants with vertigo and dizziness across all domains. Adjusted for age, sex, and chronic conditions, vertigo and dizziness were significantly associated with participation restrictions in all domains except social life and relationships. Conclusion The results of our study indicate that vertigo and dizziness contribute to restrictions in participation and autonomy in individuals of older age. Recognising vertigo and dizziness as independent contributors to loss of autonomy and decreased chances for independent living may create new options for patient care and population health, such as the designing of complex interventions to maintain participation and autonomy.}, language = {en} } @article{MuellerStroblJahnetal.2014, author = {M{\"u}ller, Martin and Strobl, R. and Jahn, K. and Linkohr, B. and Peters, A. and Grill, E.}, title = {Burden of disability attributable to vertigo and dizziness in the aged: results from the KORA-Age study}, series = {European journal of public health}, journal = {European journal of public health}, editor = {Oxford Academic,}, year = {2014}, abstract = {Background: Complaints of vertigo and dizziness are common in primary care in the aged. They can be caused by distinct vestibular disorders, but can also be a symptom in other conditions like non-vestibular sensory loss, vascular encephalopathy or anxiety. The aim of this study was to investigate the specific contribution of vertigo and dizziness to the total burden of disability in aged persons when controlling for the presence of other health conditions. Methods: Data originate from the MONICA/KORA study, a population-based cohort. Survivors of the original cohorts who were 65 years and older were examined by telephone interview in 2009. Disability was assessed with the Health Assessment Questionnaire. Logistic regression was used to adjust for potential confounders and additive regression to estimate the contribution of vertigo and dizziness to disability prevalence. Results: Adjusted for age, sex and other chronic conditions, vertigo and dizziness were associated with disability (odds ratio 1.66, 95\% confidence intervals 1.40-1.98). In both men and women between 65 and 79 years, vertigo and dizziness were among the strongest contributors to the burden of disability with a prevalence of 10.5\% (6.6 to 15.1) in men and 9.0\% (5.7 to 13.0) in women. In men, this effect is stable across all age-groups, whereas it decreases with age in women. Conclusions: Vertigo and dizziness independently and relevantly contribute to population-attributable disability in the aged. They are not inevitable consequences of ageing but arise from distinct disease entities. Careful management of vertigo and dizziness might increase population health and reduce disability.}, language = {en} } @article{GrillStruppMuelleretal.2014, author = {Grill, E. and Strupp, M. and M{\"u}ller, Martin and Jahn, K.}, title = {Health services utilization of patients with vertigo in primary care: a retrospective cohort study}, series = {Journal of neurology}, journal = {Journal of neurology}, editor = {Springer Link,}, year = {2014}, abstract = {Vertigo and dizziness count among the most frequent symptoms in outpatient practices. Although most vestibular disorders are manageable, they are often under- and misdiagnosed in primary care. This may result in prolonged absence from work, increased resource use and, potentially, in chronification. Reliable information on health services utilization of patients with vertigo in primary care is scarce. Retrospective cohort study in patients referred to a tertiary care balance clinic. Included patients had a confirmed diagnosis of benign paroxysmal positional vertigo (BPPV), Meni{\`e}re's disease (MD), vestibular paroxysmia (VP), bilateral vestibulopathy (BVP), vestibular migraine (VM), or psychogenic vertigo (PSY). All previous diagnostic and therapeutic measures prior to the first visit to the clinic were recorded. 2,374 patients were included (19.7 \% BPPV, 12.7 \% MD, 5.8 \% VP, 7.2 \% BVP, 14.1 \% VM, 40.6 \% PSY), 61.3 \% with more than two consultations. Most frequent diagnostic measures were magnetic resonance imaging (MRI, 76.2 \%, 71 \% in BPPV) and electrocardiography (53.5 \%). Most frequent therapies were medication (61.0 \%) and physical therapy (41.3 \%). 37.3 \% had received homoeopathic medication (39 \% in BPPV), and 25.9 \% were treated with betahistine (20 \% in BPPV). Patients had undergone on average 3.2 (median 3.0, maximum 6) diagnostic measures, had received 1.8 (median 2.0, maximum 8) therapies and 1.8 (median 1.0, maximum 17) different drugs. Diagnostic subgroups differed significantly regarding number of diagnostic measures, therapies and drugs. The results emphasize the need for establishing systematic training to improve oto-neurological skills in primary care services not specialized on the treatment of dizzy patients.}, language = {en} }