TY - CHAP A1 - Kohrmann, M. A1 - Buchschmid, M. A1 - Schanda, Ulrich A1 - Müller, G. T1 - A FEM-based planning tool for the vibro-acoustic design of wooden floors at low frequencies T2 - Proceedings of Inter-Noise 2016 N2 - Within the scope of the recently finished cooperate research project "VibWood" at Technical University of Munich and Rosenheim University of Applied Sciences, fully parametrized numerical models for lightweight wooden floor constructions have been developed and calibrated by experimental modal analyses. Based on a vast parametric study including floating floors and suspended ceilings a database of narrowband sound power levels in the frequency range up to 125 Hz for a wide range of floor dimensions has been set up. A procedure will be presented on how to process the numerical data and derive single number values that allow a comparison to the standardized rating of impact sound insulation according to DIN EN ISO 717-2. The derived data is implemented into a graphical user interface (GUI). This GUI is available for free. The database is open for additional geometries and will be enhanced by different constructions in the near future. KW - Schallmesstechnik KW - Holzbau Y1 - 2016 ER - TY - JOUR A1 - Paolini, Alexander A1 - Kollmannsberger, Stefan A1 - Winter, Christoph A1 - Buchschmid, Martin A1 - Müller, Gerhard A1 - Rabold, Andreas A1 - Mecking, Simon A1 - Schanda, Ulrich A1 - Rank, Ernst T1 - A high-order finite element model for vibration analysis of cross-laminated timber assemblies JF - Building Acoustics N2 - 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. KW - cross-laminated timber KW - finite element method Y1 - 2017 UR - https://doi.org/10.1177%2F1351010X17727126 VL - 2017 IS - 3 SP - 135 EP - 158 ET - 24 ER - TY - JOUR A1 - Grill, E. A1 - Furman, J.M. A1 - Alghwiri, A.A. A1 - Müller, Martin A1 - Whitney, S.L. ED - Bárány Society, T1 - Using core sets of the international classification of functioning, disability and health (ICF) to measure disability in vestibular disorders: study protocol JF - Journal of vestibular research N2 - 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. KW - Vertigo KW - Dizziness KW - Quality of life KW - Activities of daily living Y1 - 2013 IS - 23(6) ER - TY - JOUR A1 - Müller, Martin A1 - Fischer, U. A1 - Bartoszek, G. A1 - Grill, E. A1 - Meyer, G. ED - Springer Nature, T1 - Impact of joint contractures on functioning and social participation in older individuals--development of a standard set (JointConFunctionSet): study protocol JF - BMC Geriatrics N2 - 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. KW - BMC geriatrics Y1 - 2018 ER - TY - JOUR A1 - Grill, E. A1 - Bronstein, A. A1 - Furman, J. A1 - Zee, D.S. A1 - Müller, Martin ED - Bárány Society, T1 - International Classification of Functioning, Disability and Health (ICF) Core Set for patients with vertigo, dizziness and balance disorders JF - Journal of vestibular research N2 - 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. KW - Vertigo KW - Dizziness KW - Quality of life Y1 - 2012 ER - TY - JOUR A1 - Müller, Martin A1 - Grill, E. ED - hps media, T1 - Die Internationale Klassifikation der Funktionsfähigkeit, Behinderung und Gesundheit (ICF). Core Sets im Akutkrankenhaus: Nutzen und Relevanz für Pflegewissenschaft und -praxis. JF - Pflegewissenschaft KW - Core Sets KW - Akutkrankenhaus KW - ICF Y1 - 2011 IS - 13(5) SP - 280 EP - 288 ER - TY - JOUR A1 - Müller, Martin A1 - Grill, E. A1 - Stier-Jarmer, M. A1 - Strobl, R. A1 - Gutenbrunner, C. A1 - Fialka-Moser, V. A1 - Stucki, G. ED - Foundation of Rehabilitation Information, T1 - Validation of the comprehensive ICF Core Sets for patients receiving rehabilitation interventions in the acute care setting JF - Journal of rehabilitation medicine N2 - 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. KW - Classification KW - Cohort study KW - ICF KW - Intensive care KW - outcome assessment Y1 - 2011 IS - 43(2) ER - TY - JOUR A1 - Grill, E. A1 - Strobl, R. A1 - Müller, Martin A1 - Quittan, M. A1 - Kostanjsek, N. A1 - Stucki, G. ED - Foundation of Rehabilitation Information, T1 - ICF Core Sets for early post-acute rehabilitation facilities JF - Journal of rehabilitation medicine N2 - 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. KW - Classification KW - Health status measurements KW - ICF KW - outcome assessment KW - regression analysis KW - Rehabilitation Y1 - 2011 IS - 43(2) ER - TY - JOUR A1 - Müller, Martin A1 - Peters, A. A1 - Doring, A. A1 - Ladwig, K.-H. A1 - Holle, R. A1 - Meisinger, C. A1 - Linkohr, B. A1 - Autenrieth, C. A1 - Baumeister, S. A1 - Behr, J. A1 - Bergner, A. A1 - Bickel, H. A1 - Bidlingmaier, M. A1 - Dias, A. A1 - Emeny, R.T. A1 - Fischer, B. A1 - Grill, E. A1 - Gorzelniak, L. A1 - Hansch, H. A1 - Heidbreder, S. A1 - Heier, M. A1 - Horsch, A. A1 - Huber, D. A1 - Huber, R.M. A1 - Jorres, R.A. A1 - Kaab, S. A1 - Karrasch, A1 - Kirchberger, A1 - Klug, A1 - Kranz, A1 - Kruch, A1 - Lacruz, A1 - Lang, A1 - Mielk, A1 - Nowak, A1 - Schneider, A1 - Schulz, A1 - Seidel, A1 - Strobl, A1 - Thorand, A1 - Wende, A1 - Weidenhammer, A1 - Zimmermann, A1 - Wichmann, ED - Springer Nature, T1 - Multimorbidity and successful aging: the population-based KORA-Age study JF - Zeitschrift für Gerontologie und Geriatrie N2 - 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. KW - Body Mass Index KW - Chronic Condition KW - Questionnaire Respondent KW - Disease Interaction KW - Coronary Problem Y1 - 2018 ER - TY - JOUR A1 - Rabold, Andreas A1 - Buchschmied, M. A1 - Duster, A. A1 - Müller, G. A1 - Rank, E. T1 - Modelling the excitation force of a standard tapping machine on lightweight floor structures JF - Journal of building acustics N2 - Up to now the research and development in the field of building acoustics is based mainly on measurements. In consequence the development and optimization of a new building component is a very tedious and expensive task. A considerable reduction of these costs could be achieved, if the optimization relying on measurements would be replaced – at least to some extent – by a computational prediction model. For these models it is necessary to represent not only the component and the adjacent rooms but also the excitation in a suitable way. This paper gives an overview of models for the excitation generated by a standard tapping machine taking into account the interaction between the impacting steel cylinders of the tapping machine and the vibrating surface of the floor. KW - Tapping Machine KW - Lightweight floors Y1 - 2018 ER - TY - CHAP A1 - Müller, M. A1 - Schulze, Achim A1 - Isenberg, J. A1 - Hund, B. A1 - Beyer, H.-G. T1 - Influence of the water resistivity on the temperature coeffizients of industrial silicon solar cells and on the expected performance behavior T2 - Proceedings of the 25th EU-PVSEC KW - Photovoltaik KW - Industrial silicon solar cells KW - Performance behavior Y1 - 2010 ER - TY - JOUR A1 - Klingshirn, Hanna A1 - Müller, Martin A1 - Beutner, Katrin A1 - Hirt, Julian A1 - Strobl, Ralf A1 - Grill, Eva A1 - Meyer, Gabriele A1 - Saal, Susanne T1 - Implementation of a complex intervention to improve participation in older people with joint contractures living in nursing homes: a process evaluation of a cluster-randomised pilot trial JF - BMC Geriatrics N2 - Background Joint contractures in frail older people are associated with serious restrictions in participation. We developed the Participation Enabling CAre in Nursing (PECAN) intervention, a complex intervention to enable nurses to promote participation in nursing home residents with joint contractures. The aim of this study was to examine the feasibility of the implementation strategy and to identify enablers and barriers for a successful implementation. Methods The implementation of PECAN was investigated in a 6-month pilot cluster-randomised controlled trial (c-RCT). As a key component of the implementation strategy, nominated nurses were trained as facilitators in a one-day workshop and supported by peer-mentoring (visit, telephone counselling). A mixed-methods approach was conducted in conjunction with the pilot trial and guided by a framework for process evaluations of c-RCTs. Data were collected using standardised questionnaires (nursing staff), documentation forms, problem-centred qualitative interviews (facilitators, therapists, social workers, relatives, peer-mentors), and a group discussion (facilitators). A set of predefined criteria on the nursing home level was examined. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed using directed content analysis. Results Seven nursing homes (n = 4 intervention groups, n = 3 control groups) in two regions of Germany took part in the study. Facilitators responded well to the qualification measures (workshop participation: 14/14; workshop rating: “good”; peer-mentor visit participation: 10/14). The usage of peer-mentoring via telephone varied (one to seven contacts per nursing home). Our implementation strategy was not successful in connection with supplying the intervention to all the nurses. The clear commitment of the entire nursing home and the respect for the expertise of different healthcare professionals were emphasised as enablers, whereas a lack of impact on organisational conditions and routines and a lack of time and staff competence were mentioned as barriers. Conclusion The PECAN intervention was delivered as planned to the facilitators but was unable to produce comprehensive changes in the nursing homes and subsequently for the residents. Strategies to systematically include the management and the nursing team from the beginning are needed to support the facilitators during implementation in the main trial. Trial registration German clinical trials register, DRKS00010037. Registered 12 February 2016. KW - Joint contractures KW - Nursing homes KW - Participation KW - Complex intervention KW - Cluster-randomised controlled trials KW - Pilot study KW - Implementation strategy KW - Process evaluation Y1 - 2020 UR - https://doi.org/10.1186/s12877-020-01655-z VL - 20 SP - 270 ER - TY - JOUR A1 - Seckler, Eva A1 - Regauer, Verena A1 - Rotter, Thomas A1 - Bauer, Petra A1 - Müller, Martin T1 - Barriers to and facilitators of the implementation of multi-disciplinary care pathways in primary care: a systematic review JF - BMC Family Practice N2 - Background: Care pathways (CPWs) are complex interventions that have the potential to reduce treatment errors and optimize patient outcomes by translating evidence into local practice. To design an optimal implementation strategy, potential barriers to and facilitators of implementation must be considered. The objective of this systematic review is to identify barriers to and facilitators of the implementation of CPWs in primary care (PC). Methods: A systematic search via Cochrane Library, CINAHL, and MEDLINE via PubMed supplemented by hand searches and citation tracing was carried out. We considered articles reporting on CPWs targeting patients at least 65 years of age in outpatient settings that were written in the English or German language and were published between 2007 and 2019. We considered (non-)randomized controlled trials, controlled before-after studies, interrupted time series studies (main project reports) as well as associated process evaluation reports of either methodology. Two independent researchers performed the study selection; the data extraction and critical appraisal were duplicated until the point of perfect agreement between the two reviewers. Due to the heterogeneity of the included studies, a narrative synthesis was performed. Results: Fourteen studies (seven main project reports and seven process evaluation reports) of the identified 8154 records in the search update were included in the synthesis. The structure and content of the interventions as well as the quality of evidence of the studies varied. The identified barriers and facilitators were classified using the Context and Implementation of Complex Interventions framework. The identified barriers were inadequate staffing, insufficient education, lack of financial compensation, low motivation and lack of time. Adequate skills and knowledge through training activities for health professionals, good multi-disciplinary communication and individual tailored interventions were identified as facilitators. Conclusions: In the implementation of CPWs in PC, a multitude of barriers and facilitators must be considered, and most of them can be modified through the careful design of intervention and implementation strategies. Furthermore, process evaluations must become a standard component of implementing CPWs to enable other projects to build upon previous experience. KW - Systematic review KW - Critical pathways KW - Primary health care KW - General practitioners Y1 - 2020 UR - https://doi.org/10.1186/s12875-020-01179-w VL - 21 SP - 113 ER - TY - JOUR A1 - Lindner, Johannes A. A1 - Müller, M.G. A1 - Briesen, H. A1 - Foerst, P. T1 - Monitoring temperature evolution and drying of coating on a single fluidized particle by infrared thermography JF - Powder Technology N2 - Coating is an important step for the protection of drugs and flavors in the pharmaceutical and food industry. This paper presents a method for the experimental investigation of the coating process of a single freestream-fluidized particle by an infrared camera. The coating is dispersed by a nozzle with ultrasonic fluid atomization, allowing constant droplet size at different spray rates. The temperature of the fluidized particle was measured online by an infrared camera. The application of the coating on the particle in a spray cycle and the subsequent solvent vaporization is linked to the temperature and hence monitored during the whole coating process. The cyclic coating process of a Wurster coater is hence reproduced. The temperature evolution for different coating amounts in a single spray cycle, for different particle sizes, materials and temperature levels is monitored. A micro-computed tomography image shows the result of the levitator coating, giving a homogeneous layer. KW - powder KW - technology KW - Monitoring temperature evolution Y1 - 2021 UR - https://doi.org/10.1016/j.powtec.2020.12.069 VL - 382 SP - 331 EP - 338 ER - TY - JOUR A1 - Weitere, Markus A1 - Altenburger, Rolf A1 - Anlanger, Christine A1 - Baborowski, Martina A1 - Bärlund, Ilona A1 - Beckers, Liza-Marie A1 - Borchardt, Dietrich A1 - Brack, Werner A1 - Brase, Lisa A1 - Busch, Wibke A1 - Chatzinotas, Antonis A1 - Deutschmann, Björn A1 - Eligehausen, Jens A1 - Frank, Karin A1 - Graeber, Daniel A1 - Griebler, Christian A1 - Hagemann, Jeske A1 - Herzsprung, Peter A1 - Hollert, Henner A1 - Inostroza, Pedro A. A1 - Jäger, Christoph G. A1 - Kallies, René A1 - Kamjunke, Norbert A1 - Karrasch, Bernhard A1 - Kaschuba, Sigrid A1 - Kaus, Andrew A1 - Klauer, Bernd A1 - Knöller, Kay A1 - Koschorreck, Matthias A1 - Krauss, Martin A1 - Kunz, Julia V. A1 - Kurz, Marie J. A1 - Liess, Matthias A1 - Mages, Margarete A1 - Müller, Christin A1 - Muschket, Matthias A1 - Musolff, Andreas A1 - Norf, Helge A1 - Pöhlein, Florian A1 - Reiber, Lena A1 - Risse-Buhl, Ute A1 - Schramm, Karl-Werner A1 - Schmitt-Jansen, Mechthild A1 - Schmitz, Markus A1 - Strachauer, Ulrike A1 - von Tümpling, Wolf A1 - Weber, Nina A1 - Wild, Romy A1 - Wolf, Christine A1 - Brauns, Mario T1 - Disentangling multiple chemical and non-chemical stressors in a lotic ecosystem using a longitudinal approach JF - Science of the Total Environment N2 - Meeting ecological and water quality standards in lotic ecosystems is often failed due to multiple stressors. However, disentangling stressor effects and identifying relevant stressor-effect-relationships in complex environmental settings remain major challenges. By combining state-of-the-art methods from ecotoxicology and aquatic ecosystem analysis, we aimed here to disentangle the effects of multiple chemical and non-chemical stressors along a longitudinal land use gradient in a third-order river in Germany. We distinguished and evaluated four dominant stressor categories along this gradient: (1) Hydromorphological alterations: Flow diversity and substrate diversity correlated with the EU-Water Framework Directive based indicators for the quality element macroinvertebrates, which deteriorated at the transition from near-natural reference sites to urban sites. (2) Elevated nutrient levels and eutrophication: Low to moderate nutrient concentrations together with complete canopy cover at the reference sites correlated with low densities of benthic algae (biofilms). We found no more systematic relation of algal density with nutrient concentrations at the downstream sites, suggesting that limiting concentrations are exceeded already at moderate nutrient concentrations and reduced shading by riparian vegetation. (3) Elevated organic matter levels: Wastewater treatment plants (WWTP) and stormwater drainage systems were the primary sources of bioavailable dissolved organic carbon. Consequently, planktonic bacterial production and especially extracellular enzyme activity increased downstream of those effluents showing local peaks. (4) Micropollutants and toxicity-related stress: WWTPs were the predominant source of toxic stress, resulting in a rapid increase of the toxicity for invertebrates and algae with only one order of magnitude below the acute toxic levels. This toxicity correlates negatively with the contribution of invertebrate species being sensitive towards pesticides (SPEARpesticides index), probably contributing to the loss of biodiversity recorded in response to WWTP effluents. Our longitudinal approach highlights the potential of coordinated community efforts in supplementing established monitoring methods to tackle the complex phenomenon of multiple stress. KW - Multiple stress KW - Running waters KW - Indicators KW - Ecological functions KW - Effect based analyses Y1 - 2021 UR - https://doi.org/10.1016/j.scitotenv.2020.144324 VL - 769 SP - 144324 ER - TY - JOUR A1 - Kisch, Rebecca A1 - Bergmann, Antje A1 - Koller, Daniela A1 - Leidl, Reiner A1 - Mansmann, Ulrich A1 - Müller, Martin A1 - Sanftenberg, Linda A1 - Schelling, Joerg A1 - Sundmacher, Leonie A1 - Voigt, Karen A1 - Grill, Eva T1 - Patient trajectories and their impact on mobility, social participation and quality of life in patients with vertigo/dizziness/balance disorders and osteoarthritis (MobilE-TRA): study protocol of an observational, practice-based cohort study JF - BMJ OPEN N2 - Introduction Mobility limitations have a multitude of different negative consequences on elderly patients including decreasing opportunities for social participation, increasing the risk for morbidity and mortality. However, current healthcare has several shortcomings regarding mobility sustainment of older adults, namely a narrow focus on the underlying pathology, fragmentation of care across services and health professions and deficiencies in personalising care based on patients’ needs and experiences. A tailored healthcare strategy targeted at mobility of older adults is still missing. Objective The objective is to develop multiprofessional care pathways targeted at mobility sustainment and social participation in patients with vertigo/dizziness/balance disorders (VDB) and osteoarthritis (OA) . Methods Data regarding quality of life, mobility limitation, pain, stiffness and physical function is collected in a longitudinal observational study between 2017 and 2019. General practitioners (GPs) recruit their patients with VDB or OA. Patients who visited their GP in the last quarter will be identified in the practice software based on VDB and OA-related International Classification of Diseases 10th Revision. Study material will be sent from the practice to patients by mail. Six months and 12 months after baseline, all patients will receive a mail directly from the study team containing the follow-up questionnaire. GPs fill out questionnaires regarding patient diagnostics, therapy and referrals. Ethics and dissemination The study was approved by the ethical committee of the Ludwig-Maximilians-Universität München and of the Technische Universität Dresden. Results will be published in scientific, peer-reviewed journals and at national and international conferences. Results will be disseminated via newsletters, the project website and a regional conference for representatives of local and national authorities. KW - vertigo KW - dizziness Y1 - 2018 UR - http://dx.doi.org/10.1136/bmjopen-2018-022970 VL - 8 IS - 4 ER - TY - JOUR A1 - Servaty, Ricarda A1 - Kersten, Annalena A1 - Brukamp, Kirsten A1 - Möhler, Ralph A1 - Müller, Martin T1 - Implementation of robotic devices in nursing care. Barriers and facilitators: an integrative review JF - BMJ Open N2 - Background: Robots in healthcare are gaining increasing attention; however, their implementation is challenging due to the complexity of both interventions themselves and the contexts in which they are implemented. The objective of this integrative review is to identify barriers to and facilitators of the implementation of robotic systems in nursing. Methods: Articles published from 2002 to 2019 reporting on projects to implement robotic devices in nursing care were searched on Medline (via PubMed), CINAHL and databases on funded research projects (Community Research and Development Information Services and Technische Informationsbibliothek) and in journals for robotic research in November 2017 and July 2019 for an update. No restrictions regarding study designs were imposed. All included articles underwent quality assessments with design-specific critical appraisal tools. Barriers to and facilitators of implementation were classified using the Context and Implementation of Complex Interventions framework. Results: After removing all duplicates, the search revealed 11 204 studies, of which 17 met the inclusion criteria and were included in the synthesis. The majority of the studies dealt with the implementation of robots designed to support individuals, either living at home or in nursing homes (n=11). The studies were conducted in Europe, the USA and New Zealand and were carried out in nursing homes, individual living environments, hospital units and laboratories. The quality of reporting and quality of evidence were low in most studies. The most frequently reported barriers were in socioeconomic and ethical domains and were within the implementation outcomes domain. The most frequently reported facilitators were related to the sociocultural context, implementation process and implementation strategies. Discussion: This review identified barriers to and facilitators of the implementation of robotic devices in nursing within different dimensions. The results serve as a basis for the development of suitable implementation strategies to reduce potential barriers and promote the integration of elements to facilitate implementation. PROSPERO registration number: CRD42018073486. KW - nursing KW - robotic device Y1 - 2020 UR - https://dx.doi.org/10.1136/bmjopen-2020-038650 VL - 10 IS - 9 SP - e038650 ER - TY - JOUR A1 - Silies, Katharina A1 - Schley, Angelika A1 - Sill, Janna A1 - Fleischer, Steffen A1 - Müller, Martin A1 - Balzer, Katrin T1 - Die COVID-19-Pandemie im akutstationären Setting aus Sicht von Führungspersonen und Hygienefachkräften in der Pflege BT - Eine qualitative Studie JF - Pflege N2 - Hintergrund: Die COVID-19-Pandemie ist eine Ausnahmesituation ohne Präzedenz und erforderte zahlreiche Ad-hoc-Anpassungen in den Strukturen und Prozessen der akutstationären Versorgung. Ziel: Ziel war es zu untersuchen, wie aus Sicht von Führungspersonen und Hygienefachkräften in der Pflege die stationäre Akutversorgung durch die Pandemiesituation beeinflusst wurde und welche Implikationen sich daraus für die Zukunft ergeben. Methoden: Qualitative Studie bestehend aus semistrukturierten Interviews mit fünf Verantwortlichen des leitenden Pflegemanagements und drei Hygienefachkräften in vier Krankenhäusern in Deutschland. Die Interviews wurden mittels qualitativer Inhaltsanalyse ausgewertet. Ergebnisse: Die Befragten beschrieben den auf die prioritäre Versorgung von COVID-19-Fällen hin umstrukturierten Klinikalltag. Herausforderungen waren Unsicherheit und Angst bei den Mitarbeiter_innen, relative Ressourcenknappheit von Material und Personal und die schnelle Umsetzung neuer Anforderungen an die Versorgungleistung. Dem wurde durch gezielte Kommunikation und Information, massive Anstrengungen zur Sicherung der Ressourcen und koordinierte Steuerung aller Prozesse durch bereichsübergreifende, interprofessionelle Task Forces begegnet. Schlussfolgerungen: Die in der COVID-19-Pandemie vorgenommenen Anpassungen zeigen Entwicklungspotenziale für die zukünftige Routineversorgung auf, z. B. könnten neue Arbeits- und Skill Mix-Modelle aufgegriffen werden. Für die Konkretisierung praktischer Implikationen sind vertiefende Analysen der Daten mit zeitlichem Abstand erforderlich. N2 - Background: The COVID-19-pandemic is an unprecedented, exceptional situation and necessitates numerous adaptations of structures and processes in the acute inpatient setting. Aim: The aim of this study was to explore how acute inpatient care was influenced by the pandemic and which implications may result for the future from nursing managers’ and hygiene specialists’ point of view. Methods: Qualitative study based on semi-structured interviews with five nursing managers and three hygiene specialists in four German acute care hospitals. Interviews were interpreted by using content analysis. Results: Interviewees described how everyday routines in their hospitals were adapted to the prioritized care for COVID-19 patients. Main challenges were uncertainty and anxiety among staff, relative scarcity of equipment and workforce resources and rapid implementation of new requirements for treatment capacities. This was addressed by targeted communication and information, large efforts to ensure resources and coordinated control of all processes by cross-department, interprofessional task forces. Conclusions: Adaptations made to the structures and procedures of care delivery during the pandemic hold potential for future improvements of routine care, e. g. new workplace and skill mix models. To identify detailed practical implications, a renewed and deepened data analysis is needed at a later point of time, with a larger distance to the period of the pandemic. KW - Krankenhäuser KW - Pflegemanagement KW - COVID-19-Pandemie KW - Rationierung KW - qualitative Studie Y1 - 2020 UR - https://doi.org/10.1024/1012-5302/a000756 VL - 33 IS - 5 SP - 289 EP - 298 ER - TY - JOUR A1 - Regauer, Verena A1 - Seckler, Eva A1 - Müller, Martin A1 - Bauer, Petra T1 - Physical therapy interventions for older people with vertigo, dizziness and balance disorders addressing mobility and participation: a systematic review JF - BMC Geriatrics N2 - Background Vertigo, dizziness and balance disorders (VDB) are among the most relevant contributors to the burden of disability among older adults living in the community and associated with immobility, limitations of activities of daily living and decreased participation. The aim of this study was to identify the quality of evidence of physical therapy interventions that address mobility and participation in older patients with VDB and to characterize the used primary and secondary outcomes. Methods A systematic search via MEDLINE (PubMed), Cochrane Library, CINAHL, PEDro, forward citation tracing and hand search was conducted initially in 11/2017 and updated in 7/2019. We included individual and cluster-randomized controlled trials and trials with quasi-experimental design, published between 2007 and 2017/2019 and including individuals ≥65 years with VDB. Physical therapy and related interventions were reviewed with no restrictions to outcome measurement. Screening of titles, abstracts and full texts, data extraction and critical appraisal was conducted by two independent researchers. The included studies were heterogeneous in terms of interventions and outcome measures. Therefore, a narrative synthesis was conducted. Results A total of 20 randomized and 2 non-randomized controlled trials with 1876 patients met the inclusion criteria. The included studies were heterogeneous in terms of complexity of interventions, outcome measures and methodological quality. Vestibular rehabilitation (VR) was examined in twelve studies, computer-assisted VR (CAVR) in five, Tai Chi as VR (TCVR) in three, canal repositioning manoeuvres (CRM) in one and manual therapy (MT) in one study. Mixed effects were found regarding body structure/function and activities/participation. Quality of life and/or falls were assessed, with no differences between groups. VR is with moderate quality of evidence superior to usual care to improve balance, mobility and symptoms. Conclusion To treat older individuals with VDB, VR in any variation and in addition to CRMs seems to be effective. High-quality randomized trials need to be conducted to inform clinical decision making. Trial registration PROSPERO 2017 CRD42017080291. KW - Aged KW - Aged, 80 and over KW - Dizziness, KW - Mobility limitation KW - Nervous system diseases KW - Physical therapy modalities KW - Postural balance KW - Social participation KW - Treatment outcome KW - Vertigo Y1 - 2020 UR - https://doi.org/10.1186/s12877-020-01899-9 VL - 20 SP - 494 ER - TY - JOUR A1 - Regauer, Verena A1 - Seckler, Eva A1 - Grill, Eva A1 - Ippisch, Richard A1 - Jahn, Klaus A1 - Bauer, Petra A1 - Müller, Martin T1 - Development of a complex intervention to improve mobility and participation of older people with vertigo, dizziness and balance disorders in primary care: a mixed methods study JF - BMC Family Practice N2 - Background Vertigo, dizziness and balance disorders (VDB) are common in older people and cause restrictions in mobility and social participation. Due to a multifactorial aetiology, health care is often overutilised, but many patients are also treated insufficiently in primary care. The purpose of this study was to develop a care pathway as a complex intervention to improve mobility and participation in older people with VDB in primary care. Methods The development process followed the UK Medical Research Council guidance using a mixed-methods design with individual and group interviews carried out with patients, physical therapists (PTs), general practitioners (GPs), nurses working in community care and a multi-professional expert panel to create a first draft of a care pathway (CPW) and implementation strategy using the Consolidated Framework of Implementation Research and the Expert recommendations for Implementing Change. Subsequently, small expert group modelling of specific components of the CPW was carried out, with GPs, medical specialists and PTs. The Behaviour Change Wheel was applied to design the intervention´s approach to behaviour change. To derive theoretical assumptions, we adopted Kellogg´s Logic Model to consolidate the hypothesized chain of causes leading to patient-relevant outcomes. Results Individual interviews with patients showed that VDB symptoms need to be taken more seriously by GPs. Patients demanded age-specific treatment offers, group sessions or a continuous mentoring by a PT. GPs required a specific guideline for diagnostics and treatment options including psychosocial interventions. Specific assignment to and a standardized approach during physical therapy were desired by PTs. Nurses favoured a multi-professional documentation system. The structured three-day expert workshop resulted in a first draft of CPW and potential implementation strategies. Subsequent modelling resulted in a CPW with components and appropriate training materials for involved health professionals. A specific implementation strategy is now available. Conclusion A mixed-methods design was suggested to be a suitable approach to develop a complex intervention and its implementation strategy. We will subsequently test the intervention for its acceptability and feasibility in a feasibility study accompanied by a comprehensive process evaluation to inform a subsequent effectiveness trial. Trial Registration The research project is registered in “Projektdatenbank Versorgungsforschung Deutschland” (Project-ID: VfD_MobilE-PHY_17_003910; date of registration: 30.11.2017). KW - Critical Pathways KW - Implementation Science KW - Primary Health Care KW - Aged KW - Vertigo KW - Dizziness KW - General Practitioners KW - Physical Therapy Modalities Y1 - 2021 UR - https://doi.org/10.1186/s12875-021-01441-9 VL - 22 SP - 89 ER - TY - JOUR A1 - Seckler, Eva A1 - Regauer, Verena A1 - Krüger, Melanie A1 - Gabriel, Anna A1 - Hermsdörfer, Joachim A1 - Niemietz, Carolin A1 - Bauer, Petra A1 - Müller, Martin T1 - Improving mobility and participation of older people with vertigo, dizziness and balance disorders in primary care using a care pathway: feasibility study and process evaluation JF - BMC Family Practice N2 - Background Community-dwelling older people are frequently affected by vertigo, dizziness and balance disorders (VDB). We previously developed a care pathway (CPW) to improve their mobility and participation by offering standardized approaches for general practitioners (GPs) and physical therapists (PTs). We aimed to assess the feasibility of the intervention, its implementation strategy and the study procedures in preparation for the subsequent main trial. Methods This 12-week prospective cohort feasibility study was accompanied by a process evaluation designed according to the UK Medical Research Council’s Guidance for developing and evaluating complex interventions. Patients with VDB (≥65 years), GPs and PTs in primary care were included. The intervention consisted of a diagnostic screening checklist for GPs and a guide for PTs. The implementation strategy included specific educational trainings and a telephone helpline. Data for mixed-method process evaluation were collected via standardized questionnaires, field notes and qualitative interviews. Quantitative data were analysed using descriptive statistics, qualitative data using content analysis. Results A total of five GP practices (seven single GPs), 10 PT practices and 22 patients were included in the study. The recruitment of GPs and patients was challenging (response rates: GP practices: 28%, PT practices: 39%). Ninety-one percent of the patients and all health professionals completed the study. The health professionals responded well to the educational trainings; the utilization of the telephone helpline was low (one call each from GPs and PTs). Familiarisation with the routine of application of the intervention and positive attitudes were emphasized as facilitators of the implementation of the intervention, whereas a lack of time was mentioned as a barrier. Despite difficulties in the GPs’ adherence to the intervention protocol, the GPs, PTs and patients saw benefit in the intervention. The patients’ treatment adherence to physical therapy was good. There were minor issues in data collection, but no unintended consequences. Conclusion Although the process evaluation provided good support for the feasibility of study procedures, the intervention and its implementation strategy, we identified a need for improvement in recruitment of participants, the GP intervention part and the data collection procedures. The findings will inform the main trial to test the interventions effectiveness in a cluster RCT. Trial registration Projektdatenbank Versorgungsforschung Deutschland (German registry Health Services Research) VfD_MobilE-PHY_17_003910, date of registration: 30.11.2017; Deutsches Register Klinischer Studien (German Clinical Trials Register) DRKS00022918, date of registration: 03.09.2020 (retrospectively registered). KW - Critical pathways KW - Primary health care KW - General practitioners KW - Aged KW - Vertigo KW - Dizziness KW - Physical therapy modalities KW - Implementation science KW - Feasibility studies Y1 - 2021 UR - https://doi.org/10.1186/s12875-021-01410-2 VL - 22 SP - 62 ER - TY - JOUR A1 - Regauer, Verena A1 - Seckler, Eva A1 - Campbell, Craig A1 - Phillips, Amanda A1 - Rotter, Thomas A1 - Bauer, Petra A1 - Müller, Martin T1 - German translation and pre-testing of Consolidated Framework for Implementation Research (CFIR) and Expert Recommendations for Implementing Change (ERIC) JF - Implementation Science Communications N2 - Background Implementation frameworks may support local implementation strategies with a sound theoretical foundation. The Consolidated Framework for Implementation Research (CFIR) facilitates identification of contextual barriers and facilitators, and the Expert Recommendations for Implementing Change (ERIC) allows identifying adequate implementation strategies. Both instruments are already used in German-speaking countries; however, no standardised and validated translation is available thus far. The aim of this study was to translate the CFIR and ERIC framework into German, in order to increase the use of these frameworks and the adherence to evidence-based implementation efforts in German-speaking countries. Methods The translation of the original versions of the CFIR and ERIC framework was guided by the World Health Organisation’s recommendations for the process of translating and adapting both conceptual frameworks. Accordingly, a four-step process was employed: first, forward translation from English into German was conducted by a research team of German native speakers with fluent knowledge of the English language. Second, a bilingual expert panel comprising one researcher with German as his mother tongue and expert command of the English language and one English language expert and university teacher reviewed the translation and discussed inconsistencies with the initial translators. Third, back-translation into English was conducted by an English native speaking researcher. The final version was pre-tested with 12 German researchers and clinicians who were involved in implementation projects using cognitive interviews. Results The translation and review process revealed some inconsistencies between the original version and the German translations. All issues could be solved by discussion. Central aspects of the items were confirmed in 60 to 70% of the items, and modifications were proposed in 30% of the items. Finally, we revised one CFIR-item heading after pre-testing. The final version was given consent by all involved parties. Conclusions Now, two validated and tested implementation frameworks to guide implementation efforts are available in the German language and can be used to increase the application of agreed-on implementation strategies into practice. KW - Implementation science KW - Implementation strategies KW - Knowledge translation strategies KW - Consolidated Framework for Implementation Research KW - Expert Recommendations for Implementing Change Y1 - 2021 UR - https://doi.org/10.1186/s43058-021-00222-w VL - 2 SP - 120 ER - TY - JOUR A1 - Saal, S. A1 - Meyer, G. A1 - Beutner, K. A1 - Klingshirn, H. A1 - Strobl, R. A1 - Grill, E. A1 - Mann, E. A1 - Köpke, S. A1 - Bleijlevens, M.H.C. A1 - Bartoszek, G. A1 - Stephan, A.-J. A1 - Hirt, J. A1 - Müller, Martin T1 - Development of a complex intervention to improve participation of nursing home residents with joint contractures: a mixed-method study JF - BMC Geriatrics N2 - 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). KW - Contractures KW - Nursing homes KW - Social participation KW - Disability and health Y1 - 2018 UR - https://doi.org/10.1186/s12877-018-0745-z ER - TY - JOUR A1 - Saal, Susanne A1 - Beutner, Katrin A1 - Bogunski, Julia A1 - Obermüller, Kathrin A1 - Müller, Martin A1 - Grill, Eva A1 - Meyer, Gabriele ED - Oxford Academic, T1 - Interventions for the prevention and treatment of disability due to acquired joint contractures in older people: a systematic review JF - Age and Ageing N2 - 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. KW - ultrasonography KW - elderly KW - disability KW - muscle spasticity Y1 - 2018 IS - 46 ER - TY - JOUR A1 - Grill, Eva A1 - Müller, Martin A1 - Mansmann, Ulrich ED - Springer Verlag, T1 - Health-exploring complexity: an interdisciplinary systems approach HEC 2016 JF - European journal of epidemiology N2 - 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. KW - Health Y1 - 2016 IS - 31 ER - TY - JOUR A1 - Müller, Martin A1 - Oberhauser, Cornelia A1 - Fischer, Uli A1 - Bartoszek, Gabriele A1 - Saal, Susanne A1 - Strobl, Ralf A1 - Meyer, Gabriele A1 - Grill, Eva ED - CrossMark, T1 - 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 JF - International Journal of Nursing Studies N2 - 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. KW - Contractures KW - Nursing homes KW - Social participation KW - Disability evaluation Y1 - 2016 IS - 59 ER - TY - JOUR A1 - Bartoszek, G. A1 - Fischer, U. A1 - Müller, Martin A1 - Strobl, R. A1 - Grill, E. A1 - Nadolny, S. A1 - Meyer, G. ED - BioMed Central, T1 - 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 JF - BMC Geriatrics N2 - 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. KW - joint contracture KW - Aged KW - Outcome KW - Geriatric rehabilitation Y1 - 2016 ER - TY - JOUR A1 - Bartoszek, Gabriele A1 - Fischer, Uli A1 - Clarmann von Clarenau, Stephan A1 - Grill, Eva A1 - Mau, Wilfried A1 - Meyer, Gabriele A1 - Strobl, Ralf A1 - Thiesemann, Rüdiger A1 - Nadolny, Stephan A1 - Müller, Martin ED - Science direct, T1 - 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 JF - Archives of gerontology and geriatrics N2 - 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. KW - joint contracture KW - older people KW - activities of daily living KW - social participation Y1 - 2015 VL - 61 ER - TY - JOUR A1 - Müller, Martin A1 - Bartoszek, G. A1 - Beutner, K. A1 - Klingshirn, H. A1 - Saal, S. A1 - Stephan, A.-J. A1 - Strobl, R. A1 - Grill, E. A1 - Meyer, G. ED - NCBI, T1 - Developing and piloting a multifactorial intervention to address participation and quality of life in nursing home residents with joint contractures JF - German medical science N2 - 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. KW - Contractures KW - Aged KW - disabled persons KW - complex interventions KW - participation Y1 - 2018 ER - TY - JOUR A1 - Fischer, U. A1 - Müller, Martin A1 - Strobl, R. A1 - Bartoszek, G. A1 - Meyer, G. A1 - Grill, E. ED - minerva medica, T1 - Prevalence of functioning and disability in older patients with joint contractures: a cross-sectional study JF - European Journal of physical and rehabilitation medicine KW - Contractures KW - Geriatric assessment KW - outcome assessment KW - social participation KW - cross-sectional studies Y1 - 2015 ER - TY - JOUR A1 - Müller, Martin A1 - Whitney, S. L. A1 - Alghwiri, A. A1 - Alshebber, K. A1 - Strobl, R. A1 - Aghadir, A. A1 - Almomani, M. O. A1 - Furman, J. M. A1 - Grill, E. ED - PlumX Metrics, T1 - Subscales of the vestibular activities and participation questionnaire could be applied across cultures JF - European journal of epidemiology N2 - 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. KW - Dizziness KW - Vertigo KW - Quality of life KW - Activities of daily living KW - social participation Y1 - 2018 ER - TY - JOUR A1 - Fischer, U. A1 - Bartoszek, G. A1 - Müller, Martin A1 - Strobl, R. A1 - Meyer, G. A1 - Grill, E. ED - Taylor and Francis online, T1 - 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 JF - Disability and Rehabilitation N2 - 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. KW - joint contracture KW - Geriatrics KW - outcome assessment KW - qualitative research KW - social participation Y1 - 2014 ER - TY - JOUR A1 - Fischer, U. A1 - Müller, Martin A1 - Strobl, R. A1 - Bartoszek, G. A1 - Meyer, G. A1 - Grill, E. ED - Elaine Tilka, Miller T1 - 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 JF - Rehabilitation nursing N2 - 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 KW - joint contracture KW - disability KW - rehabilitation Y1 - 2014 ER - TY - JOUR A1 - Müller, Martin A1 - Strobl, R. A1 - Jahn, K. A1 - Linkohr, B. A1 - Ladwig, K.H. A1 - Mielk, A. A1 - Grill, E. ED - Springer Link, T1 - Impact of vertigo and dizziness on self-perceived participation and autonomy in older adults: Results from the KORA-Age study JF - Quality of life research N2 - 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. KW - Aged KW - Aged and over 80 KW - participation KW - autonomy KW - chronic conditions KW - vertigo KW - dizziness Y1 - 2018 ER - TY - JOUR A1 - Müller, Martin A1 - Strobl, R. A1 - Jahn, K. A1 - Linkohr, B. A1 - Peters, A. A1 - Grill, E. ED - Oxford Academic, T1 - Burden of disability attributable to vertigo and dizziness in the aged: results from the KORA-Age study JF - European journal of public health N2 - 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. KW - Dizziness KW - Vertigo KW - disability Y1 - 2018 ER - TY - JOUR A1 - Grill, E. A1 - Strupp, M. A1 - Müller, Martin A1 - Jahn, K. ED - Springer Link, T1 - Health services utilization of patients with vertigo in primary care: a retrospective cohort study JF - Journal of neurology N2 - 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), Menière’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. KW - Primary health care KW - Vertigo KW - Dizziness KW - Utilization Y1 - 2014 ER - TY - JOUR A1 - Strobl, R. A1 - Müller, Martin A1 - Thorand, B. A1 - Linkohr, B. A1 - Autenrieth, C. S. A1 - Peters, A. A1 - Grill, E. ED - Elsevier, T1 - Men benefit more from midlife leisure-time physical activity than women regarding the development of late-life disability--results of the KORA-Age study JF - science direct N2 - Objective Encouraging physical activity is an important public health measure to reduce disability prevalence in the aged. The aims of this study were to determine the association between midlife physical activity and late-life disability and to investigate gender-specific differences. Method This data originates from the KORA-Age cohort, a follow-up in 2008 of the MONICA (Multinational Monitoring of Trends and Determinants in Cardiovascular Diseases)/KORA (Cooperative Health Research in the Region of Augsburg) S1–S4 surveys (1984–2001) situated in Augsburg, a city in Southern Germany. We applied a multivariable hurdle model to investigate the association of physical activity and disability. Results We analysed 3333 persons with a mean follow-up of 18 ± 5.5 years. Using hurdle models, moderate activity and high activity had a protective effect on the occurrence of disability (OR (odds ratio) = 0.80 and 0.73), but not on severity (i.e. number of limitations). We observed a strong gender-specific difference in this association, with men benefitting more from exercise. Conclusion Elevated physical activity reduces the risk of becoming disabled and postpones the onset of disability by several years, but we could not show an effect on the severity of disability. In addition, men seem to benefit more from leisure-time physical activity than women KW - Aged KW - Aged 80 and over KW - physical activity KW - Disability evaluation Y1 - 2014 ER - TY - JOUR A1 - Schaeffler, F. A1 - Müller, Martin A1 - Huppert, D. A1 - Brandt, T. A1 - Tiffe, T. A1 - Grill, E. ED - Springer Link, T1 - Consequences of visual height intolerance for quality of life: a qualitative study. JF - Quality of life research N2 - Purpose Visual height intolerance (vHI) occurs when a trigger causes the apprehension of losing balance and falling. Depending on the severity of vHI, an avoidance behavior may develop in about 50 % of the thus afflicted, and it can have considerable impact on their daily life and interpersonal interactions. It seems obvious that such experiences may be impairing and distressing, but this has not yet been examined systematically. Objective of this study was to examine the consequences of vHI for quality of life. Methods A qualitative, phenomenological exploratory approach was chosen. Individual face-to-face interviews were conducted with individuals who had reported in a previous study that they were susceptible to vHI. The interview transcripts were segregated into distinct meaning units, which were used to create a coding guideline with meta- and subcodes. Meaning units were then systematically extracted and assigned to the appropriate codes. Weights and links were used to assign priorities for interpretation. Results Eighteen participants were interviewed (mean age 53, range 30–73; 11 females). Data analysis resulted in 29 meta-codes and 115 subcodes. Responses indicated that vHI can be very disabling and has a relevant impact on quality of life and daily activities of the affected persons, including their family life and behavior towards partner, children and friends. Conclusion Relevant topics for further quantitative studies were identified, for example, strategies of compensation and the influence of vHI on family life. Other quantitative studies should determine whether comorbidities and the typologies found in this study have consequences for individual therapeutic approaches. KW - Qualitative study KW - Quality of life KW - visual height intolerance KW - acrophobia KW - fear of heigts KW - anxiety Y1 - 2014 ER - TY - JOUR A1 - Roehrig, N. A1 - Strobl, R. A1 - Müller, Martin A1 - Perz, S. A1 - Kaab, S. A1 - Martens, E. A1 - Peters, A. A1 - Linkohr, B. A1 - Grill, E. ED - PlumX Metrics, T1 - Directed acyclic graphs helped to identify confounding in the association of disability and electrocardiographic findings: results from the KORA-Age study JF - Journal of clinical epidemiology N2 - Objectives To examine the association between electrocardiographic (ECG) findings and disability status in older adults. Study Design and Setting KORA-Age, a population-based cross-sectional study of the MONICA/KORA project, a randomized sample from Southern Germany of people aged 65 years or older. Results A total of 534 (51.5%) of 1,037 participants were characterized as disabled. Disabled participants were on average 4.5 years older than those who were not disabled. Crude associations of left-axis deviation, ventricular conduction defects, atrial fibrillation, and QT prolongation with disability status were significant (P < 0.05). In models controlled for age and sex, these effects remained constant except for QT prolongation. In the models adjusted for the minimal sufficient adjustment set (consisting of the variables sex, physical activity, age, obesity, diabetes, education, heart diseases, income, lung diseases, and stroke) identified by a directed acyclic graph (DAG), no significant association could be shown. Conclusion Associations between specific ECG findings and disability were found in unadjusted analysis and logistic models adjusted for age and sex. However, when adjusting for other possible confounders identified by the DAG, all these associations were no longer significant. It is important to adequately identify confounding in such settings. KW - Electrocardiography KW - ECG abnormalities KW - disability evaluation KW - aged KW - directed acrylic graph KW - cross-sectional study Y1 - 2014 ER - TY - JOUR A1 - Müller, Martin A1 - Grill, E. A1 - Furman, J.M. A1 - Alghwiri, A.A. A1 - Whitney, S.L. ED - IOS Press content Library, T1 - Using core sets of the international classification of functioning, disability and health (ICF) to measure disability in vestibular disorders: study protocol JF - Barany Society June 10, 2012 Symposium on Measures for Level of Functioning and Quality of Life in People with Vestibular Disorders N2 - 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. KW - Dizziness KW - Vertigo KW - Quality of life Y1 - 2012 ER - TY - JOUR A1 - Müller, Martin A1 - Fischer, U. A1 - Bartoszek, G. A1 - Grill, E. A1 - Meyer, G. ED - Springer Nature, T1 - Impact of joint contractures on functioning and social participation in older individuals--development of a standard set (JointConFunctionSet) JF - BMC Geriatrics N2 - Background Free movement of the limbs is a prerequisite of mobility and autonomy in old age. Joint contractures, i.e. restrictions in full range of motion of any joint due to deformity, disuse or pain, are common problems of frail older people, particularly in nursing home residents. Contractures are among the most unexplored and underreported syndromes in clinical and homecare settings. Epidemiological studies indicate a wide range of prevalence of joint contractures in older individuals between 20% and 80%. This variation is due to different definitions of contracture and varying diagnostic criteria or data collection methods, different research settings, sample size and study participants? characteristics. The aetiology of joint contractures is multifaceted. In older people contractures may be caused by a variety of health conditions and situations, but immobility due to an acute injury or disease seems to be the major risk factor. Upper limb joint contractures may result in loss of ability to dress or eat independently while lower limb contractures may lead to instability and inability to walk independently and higher risk of bed confinement. Joint contractures further increase the risk of other adverse patient outcomes like pain, pressure ulcers and risk of falls. Thus, joint contractures are a major cause for excess disability in older people with a significant impact on overall quality of life and functioning. Preventive and rehabilitation interventions targeting joint contractures may decrease morbidity, increase functioning and quality of life, and, ultimately, prevent long-term disability. In the United States of America, presence of joint contractures is an established indicator of quality of care in nursing facilities. In Germany, joint contracture risk assessment and prevention have recently been defined as a quality indicator of nursing home care that should be regularly monitored by experts from the statutory health insurance system. Nursing homes are obliged to report whether they regularly assess the risk of joint contracture and administer relevant preventive measures. In clinical settings, joint contractures are assessed by measuring the range of motion. However, from a patient- and nursing-oriented perspective the relevance of a systematic registration of contractures in care-dependent older people is unclear unless their impact on functioning is understood. Contracture assessment is only an intermediate step in the evaluation of patient-relevant outcomes such as quality of life, functioning, and the ability to participate in everyday life and social participation. Arguably, a clinical definition of joint contracture is difficult because the contracture?s severity is determined by the consequences on activities of daily living, quality of life and social participation. In addition, there is no consensus on aspects most relevant to the affected individuals. A variety of functional measures is currently used for the assessment and evaluation of geriatric patients. To date, there is no consensus on common concepts for the choice of outcome measures specifically for evaluating the impact of interventions targeted on joint KW - Contractures KW - Aged KW - 80 and over KW - disabled persons KW - outcome assessment KW - geriatric rehabilitation Y1 - 2018 ER - TY - JOUR A1 - Müller, Martin ED - Academic onFile, T1 - Identification of aspects of functioning, disability and health relevant to patients experiencing vertigo: a qualitative study using the international classification of functioning, disability and health JF - Health and quality of life outcomes N2 - Background Vertigo and dizziness are among the most common health problems in medical practice [1, 2, 3, 4, 5]. Vertigo and dizziness include both consequences of disease as well as definable disease entities such as benign paroxysmal positional vertigo, Meniere?s disease, or vestibular migraine. Irrespective of the various causes and underlying health conditions, vertigo and dizziness have significant impact on functioning and overall quality of life of the affected individuals To give some examples, the most common peripheral-vestibular disorder benign paroxysmal positioning vertigo - which is also the most frequent type of vestibular disorder - causes brief rotatory vertigo attacks, mainly triggered by rapid head movements, e.g. when turning around in the bed or lacing shoes. Central-peripheral disorders, which may be caused by brain ischemia, multiple sclerosis, or other permanent or transient brain lesions, can make vertigo attacks lasting from minutes to even weeks [6]. In addition, vertigo and dizziness are a considerable burden to economy and health care [4, 7, 8]. Precondition of effective management and treatment of potentially disabling conditions like vertigo is - besides careful diagnosis of the underlying condition -the assessment of outcomes which are relevant to the patient. This is not only important to monitor treatment effects but also to set goals and to plan therapy [6]. As summarized by Morris et al. [9] outcome measures in vertigo vary by the entities they are addressing, such as subjective experience of disability or signs and symptoms. Most of them reflect either the patients? or health professionals? experience. As an example, the frequently used Dizziness Handicap Inventory [10] addresses the patients? experience of the consequences of vertigo on daily living. Most outcome measures are developed and validated on the basis of empirical findings or professional experience [11]. However, none of them refer to a common theoretical framework. A theoretical framework is fundamental for defining an Outcome measurement and helps to ensure that the whole potential spectrum of issues is reflected [12]. In addition to the lack of theoretical foundation there is still no agreement on standards used to measure outcomes in patients with vertigo. This is illustrated by a recently published Cochrane Review in the field of vestibular rehabilitation which noted 15 different outcome measures of patients? complaints in 21 studies [13]. To address both these issues, the Integrated Center for Research and Treatment of Vertigo, Balance and Ocular Motor Disorders ( IFB LMU ) at the Ludwig-Maximilians-Universität in Munich set up a project that aims to develop an international standard for the description of functioning and disability in patients with vertigo and dizziness based on the International Classification of Functioning, Disability and Health (ICF). With the ICF, which is part of the family of international classifications of the World Health Organisation (WHO), there is a common theoretical framework for describing and measuring health and disability. The ICF models the individuals' functioning and health as a complex interaction between a health condition. KW - Dizziness KW - Vertigo KW - Quality of life KW - aged Y1 - 2018 ER - TY - JOUR A1 - Reuschenbach, B. A1 - Cassier-Woidasky, A.K. A1 - Mahler, C. A1 - Mayer, H. A1 - Richter, M.T. A1 - Berendonk, C. A1 - Hoben, M. A1 - Müller, Martin A1 - Flerchinger, C. A1 - Zündel, M. A1 - Schiff, A. ED - BELTZ, T1 - Methodennutzung, -präferenz und -fortbildungsbedarfe in der deutschsprachigen Pflegewissenschaft - Ergebnisse einer Online-Befragung. Use, preference and educational needs of research methods in nursing science in german speaking countries - results of an online survey JF - Pflege und Gesellschaft KW - Pflege KW - Pflegewissenschaft KW - Pflegeausbildung Y1 - 2012 IS - 17(3) ER - TY - JOUR A1 - Grill, E. A1 - Müller, Martin A1 - Quittan, M. A1 - Fialka-Moser, V. A1 - Strobl, R. A1 - Kostanjsek, N. A1 - Stucki, G. ED - Medical Journals Limited, T1 - Brief ICF Core Sets for the acute hospital JF - Journal of Rehabilitation Medicine N2 - Objective: To identify candidate categories for brief International Classification of Functioning, Disability and Health (ICF) Core Sets for the reporting and measurement of functioning in patients in the acute hospital. Design: Prospective multi-centre cohort study. Patients: Patients receiving rehabilitation interventions for musculoskeletal, neurological or cardiopulmonary injury or disease in acute hospitals. Methods: Functioning and contextual factors were coded using the ICF. The criterion for selecting candidate categories for the brief 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 391 patients were included in the study (91 neurological, 109 cardiopulmonary, 191 musculoskeletal), mean age 63.4 years, 50.1% female. Selection yielded 33 categories for neurological, 31 for cardiopulmonary, and 30 for musculoskeletal. Conclusion: The present selection of categories can be considered an initial proposal, serving to identify the ICF categories most relevant for the practical assessment and monitoring of functioning in patients with acute neurological, cardiopulmonary, and musculoskeletal conditions. KW - Classification KW - Health status measurements KW - ICF KW - Intensive care KW - outcome assessment KW - Regression analysis Y1 - 2011 ER - TY - JOUR A1 - Müller, Martin A1 - Grill, E. A1 - Strobl, R. ED - Medical Journals Limited, T1 - Core Sets for early post-acute rehabilitation facilities JF - Journal Rehabilitation Medicine N2 - 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. KW - Classification KW - Health status measurements KW - ICF KW - outcome assessment KW - regression analysis KW - Rehabilitation Y1 - 2018 ER - TY - JOUR A1 - Müller, Martin A1 - Grill, E. A1 - Quittan, M. A1 - Strobl, R. A1 - Kostanjsek, N. A1 - Stucki, G. ED - Medical Journals Limited, T1 - ICF Core Set for patients in geriatric post-acute rehabilitation facilities JF - Journal of Rehabilitation Medicine N2 - Objective: To identify candidate categories for International Classification of Functioning, Disability and Health (ICF) Core Sets for the reporting and clinical measurement of functioning in older patients in early post-acute rehabilitation facilities. Design: Prospective multi-centre cohort study. Patients: Older patients receiving rehabilitation interventions in early post-acute rehabilitation facilities. Methods: Functioning was coded using the ICF. The criterion for selecting candidate categories for the brief 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 209 patients were included in the study, mean age 80.4 years, 67.0% female. Selection yielded a total of 29 categories for the functioning part and 9 categories for the contextual part of the ICF. Conclusion: The present selection of categories can be considered an initial proposal, serving to identify the issues most relevant for the clinical assessment and monitoring of functioning in older patients undergoing early post-acute rehabilitation. KW - Aged 80 and over KW - Classification KW - Clinical KW - Health status measurements KW - ICF KW - Outcome assessment KW - regression analysis KW - Rehabilitation Y1 - 2018 ER - TY - JOUR A1 - Müller, Martin A1 - Grill, E. A1 - Strobl, R. ED - Medical Journals Limited, T1 - Goals of patients with rehabilitation needs in acute hospitals: goal achivement is an indicator for improved functioning JF - Journal of Rehabilitation Medicine N2 - Objective: To identify goals of patients with rehabilitation needs in the acute hospital setting using the International Classification of Functioning, Disability and Health (ICF), to examine association of goal achievement with improvement in overall functioning, and to examine whether ICF Core Sets for the acute hospital cover patients goals. Design: Multi-centre cohort study. Patients: A total of 397 patients (50% female, mean age 63 years) from 5 hospitals in Austria, Switzerland and Germany. Methods: A semi-structured questionnaire was used to assess patient goals and goal achievement. Overall functioning from the patients' and health professionals' perspective was assessed on a numerical rating scale. Improvement in functioning was calculated using a residualized gain score. Association between goal achievement and improvement in overall functioning was assessed with logistic regression. Results: A total of 397 patients reported achievement of at least 1 goal. Eighty-eight percent of the goals were translated into categories of the ICF. Logistic regression analyses revealed significant association between goal achievement and overall functioning. Conclusion: The ICF might be useful to identify and structure patient's goals in acute hospital care. The association between goal achievement and improved functioning underlines that it is essential to involve the patient in the process of planning rehabilitation interventions in acute hospitals. KW - Advance care planning KW - Classification KW - Cohort study KW - ICF KW - Intensive Care KW - Outcome assessment Y1 - 2018 ER - TY - CHAP A1 - Buchschmid, M. A1 - Kohrmann, M. A1 - Winter, C. A1 - Müller, G. A1 - Völtl, R. A1 - Schanda, Ulrich T1 - Vibroacoustic Characteristics of Light-Weighted Slabs. Part 2: Measurement-Based Investigation of the Sound Radiation of Suspended Ceilings T2 - Deutsche Gesellschaft für Akustik e.V. (ed.), Fortschritte der Akustik - DAGA N2 - In this contribution a method for the prediction of the radiated sound out of the velocity field of a vibrating ceiling is presented. The numerical method was validated via measurements on a real structure using a pp-probe. It is based on Integral Transform techniques and can be applied in the postprocessing of a FEM simulation (harmonic analysis) [1]. The method was verified by measurements on the real structure and can be used for parametrical studies. Rounding off the Parts 1 and 2 of this publication nomograms, based on dimensionless parameters, can be developed to predict the sound radiation of light weight slabs. Hereby different sets of geometry as well as different configurations of ceilings can be studied in order to describe the acoustical and dynamical behaviour of wooden ceilings. KW - Schallmesstechnik KW - Holzbau Y1 - 2013 ER - TY - CHAP A1 - Kohrmann, M. A1 - Buchschmid, M. A1 - Greim, A. A1 - Müller, G. A1 - Schanda, Ulrich T1 - Vibroacoustic Characteristics of lightweighted Slabs. Part 1: Aspects of Numerical Modeling, Model Updating and Parametric Studies using the Buckingham π -Theorem T2 - Deutsche Gesellschaft für Akustik e.V. (ed.), AIA-DAGA N2 - In order to set up guidelines for the design of light-weighted ceilings for timber constructions to be used by engineers in practice, investigations based on both measurements and numerical models have been carried out [1, 2, 3]. The setup and the calibration of the numerical model of the structure are outlined briefly. A semi-analytical approach for the prediction of radiated sound is presented, which is based on Integral Transform Methods. The method can be applied in the post processing of a Finite Element computation. Thus as a first step the structure, consisting of a timber slab, a floating floor and a suspended ceiling, is built up in a Finite Element model, where the material properties of wood and the characteristics of the system are considered. The model is parameterized in order to enable computations with varying geometry and material parameters and calibrated with the help of measurements using model updating techniques. The velocity pattern resulting out of the FEM computation is transformed from the spatial into the wavenumber domain and from the time into the frequency domain using Fourier Transform Methods. Applying this velocity pattern as a boundary condition to the Helmholtz Equation, which results out of the Fourier Transform of the wave equation, the wavenumbers, which fulfil the radiation condition, can be selected and the pressure field in the adjacent acoustic fluid can be computed. Due to the properties of the Fourier-Transform the radiated sound power can be calculated efficiently in the transformed domain out of pressure and velocity. In a second part of the contribution the model for the air cushion in the suspended ceiling is discussed, where a FSI-model for the acoustic fluid and the structure is compared against engineering approaches using simplifications concerning mass distribution and transfer impedances between the individual nodes at the interface KW - Schallmesstechnik KW - Holzbau Y1 - 2013 ER - TY - CHAP A1 - Kohrmann, M. A1 - Buchschmid, M. A1 - Müller, G. A1 - Völtl, R. A1 - Schanda, Ulrich T1 - Numerical models for the prediction of vibroacoustical characteristics of light-weighted ceilings T2 - Internoise 2013 N2 - In order to set up guidelines for the design of light-weighted ceilings for timber constructions to be used by engineers in practice, investigations based on both measurements and numerical models have been carried out within the cooperative research project “VibWood”. In this contribution the setup and the calibration of the numerical model of the structure as well as the prediction of radiated sound are discussed, where a special focus is set on a dimensionless description in order to deduce information for a wide range of system’s specifications. The structure, consisting of a timber slab, a floating floor and a suspended ceiling, is built up in a Finite Element model, where the material properties of wood and the characteristics of the system (e.g.support conditions, contact phenomena dynamic properties of individual parts) are considered. The model is parameterized in order to enable computations with varying geometry and material parameters. After calibrating the FE-model with the help of measurements using model updating techniques dimensionless parameters are defined based on the Buckingham-π- Theorem and computations are carried out in order to specify guidelines for various systems. The radiation of sound is computed in a post processing using Integral Transform Methods. KW - Schallmesstechnik KW - Holzbau Y1 - 2013 ER - TY - RPRT A1 - Kohrmann, M. A1 - Völtl, R. A1 - Müller, G. A1 - Schanda, Ulrich A1 - Buchschmid, M. T1 - Abschlussbericht zum AiF Forschungsvorhaben "VibWood". Planungshilfen zur schall- und schwingungstechnischen Beschreibung von Holzdecken und zur Bewertung und Dimensionierung von angepassen Schwingungsschutzsystemen KW - Holzbau KW - Schallmesstechnik Y1 - 2014 ER - TY - CHAP A1 - Mecking, S. A1 - Völtl, R. A1 - Winter, C. A1 - M., Buchschmid A1 - Schanda, Ulrich A1 - Müller, G. T1 - Methodenvergleich zur Bestimmung von Verlustfaktoren von Massivholzelementen T2 - Deutsche Gesellschaft für Akustik e.V. (ed.), Fortschritte der Akustik - DAGA N2 - Die mithilfe der Abklingmethode ermittelten Verlustfaktoren sind bei mehreren Eigenfrequenzen pro Frequenzband zuverlässig. Die Ergebnisse der Resonanzbreitenmethode beziehen sich dagegen auf die Eigenfrequenzen und sind nur bei einer geringen Modenüberlappung zuverlässig. Beide Methoden sind gleichwertig, wenn mehrere Eigenschwingungen im Frequenzband vorhanden sind und die Modenüberlappung gleichzeitig gering ist. Für einseitig überlagerte Resonanzkurven wurde eine einfache Alternative der Resonanzbreitenmethode vorgeschlagen. Die Ergebnisse wurden im Rahmen des gemeinsam von der TU München, der HS Rosenheim und dem ift Rosenheim durchgef¨uhrten DFG-AiF Forschungsvorhabens ”Vibroakustik im Planungsprozess für Holzbauten” erarbeitet. Das IGF-Vorhaben 17328N/1 der Forschungsvereinigung HS Rosenheim wurde über die AiF im Rahmen des Programms zur Förderung der Industriellen Gemeinschaftsforschung (IGF) vom Bundesministerium für Wirtschaft und Energie aufgrund eines Beschlusses des Deutschen Bundestages gefördert. KW - Schallmesstechnik KW - Holzbau Y1 - 2014 ER - TY - CHAP A1 - Winter, C. A1 - Buchschmid, M. A1 - Mecking, S. A1 - Müller, G. A1 - Schanda, Ulrich T1 - Ein hybrider FEM/SEA Ansatz zur Prognose der Schallübertragung an Bauteilstößen T2 - Deutsche Gesellschaft für Akustik e.V. (ed.), Fortschritte der Akustik - DAGA N2 - Es wurden Stoßstellendämm-Maße Kij für verschiedene Bauteilverbindungen von BSPH-Elementen gemessen. Diese zeigen eine gute Übereinstimmung zu anderen Werten aus der Literatur. Bei den Stoßstellen wurde der Einfluss von Elastomerlagern untersucht. Die Ergebnisse zeigen einen deutlichen Einfluss auf die Kij. Eine Berechnung der Kij mithilfe von Kopplungsverlustfaktoren ηij, welche aus einem SEAModell resultieren, zeigen eine ausreichende Übereinstimmung. Weitere Schritte der Modellierung zur Überprüfung dieser Erkenntnisse und zur Abbildung von Elastomeren sind notwendig. Der Beitrag ist Teil des gemeinsam von der TU München, der HS Rosenheim und dem ift Rosenheim durchgeführten DFG-AiF Forschungsvorhabens Vibroakustik im Planungsprozess für Holzbauten. Das IGF-Vorhaben 17328 N/1 der Forschungsvereinigung HS Rosenheim wurde über die AiF im Rahmen des Programms zur Förderung der Industriellen Gemeinschaftsforschung (IGF) vom Bundesministerium für Wirtschaft und Energie aufgrund eines Beschlusses des Deutschen Bundestages gefördert. KW - Holzbau KW - Schallmesstechnik Y1 - 2014 ER - TY - CHAP A1 - Winter, C. A1 - Buchschmid, M. A1 - Weineisen, C. A1 - Müller, G. A1 - Schanda, Ulrich T1 - Modelling the Sound Transmission across Junctions of Building Components by Energy Influence Coefficients T2 - European Association for Structural Dynamics (ed.), EURODYN N2 - A trend towards lightweight structures, e.g. timber structures, is noticeable in civil engineering, which implies the necessity to predict vibroacoustic characteristics like the transmission of structure-borne sound in order to fulfil requirements regarding serviceability. This contribution focuses on the investigation of junctions of building components e.g. between wall and ceiling. It is part of a joint research project with the aim to catalogue the coupling for a variety of junctions. The resulting database may serve to predict the transmission of structure-borne sound which is typically carried out either using a Finite Element (FEM) approach, suitable for the low frequency range, or by means of energy methods like the Statistical Energy Analysis (SEA) for the high frequency range. Therefore the so-called mid frequency gap emerges, which is examined and attempted to be closed. In this context SEA-averaging techniques are applied in the postprocessing of FEM calculations to obtain an adapted “SEAlike” approach. By varying the subsystems to be excited it is possible to determine Energy Influence Coefficients (EIC), which describe the specific energy content of the different subsystems with respect to the input power. Using this hybrid approach vibroacoustic predictions can be performed also in the mid frequency range. Inverting the EIC-matrix Coupling Loss Factors as well as Damping Loss Factors of the different subsystems can be calculated if the subsystem definition fulfils the SEA-requirements. The application of the method in combination to a classical SEA calculation and to laboratory measurements is presented. KW - Schallmesstechnik KW - Holzbau Y1 - 2014 ER - TY - JOUR A1 - Peters, A. A1 - Doring, A. A1 - Ladwig, K.-H. A1 - Meisinger, C. A1 - Linkohr, B. A1 - Autenrieth, C. A1 - Baumeister, S.E. A1 - Behr, J. A1 - Bergner, A. A1 - Bickel, H. A1 - Bidlingmaier, M. A1 - Dias, A. A1 - Emeny, R.T. A1 - Fischer, B. A1 - Grill, E. A1 - Gorzelniak, L. A1 - Hansch, H. A1 - Heidbreder, S. A1 - Heier, M. A1 - Horsch, A. A1 - Huber, D. A1 - R. M., Huber A1 - Jorres, R.A. A1 - Kaab, S. A1 - Karrasch, S. A1 - Kirchberger, I. A1 - Klug, G. A1 - Kranz, B. A1 - Kuch, B. A1 - Lacruz, M.E. A1 - Lang, O. A1 - Mielck, A. A1 - Nowak, D. A1 - Perz, S. A1 - Schneider, A. A1 - Schulz, H. A1 - Müller, Martin A1 - Seidl, H. A1 - Strobl, R. A1 - Thorand, B. A1 - Wende, R. A1 - Weidenhammer, W. A1 - Zimmermann, A.-K. A1 - Wichmann, H.-E. A1 - Holle, R. ED - BioMed Central, T1 - Multimorbidity and successful aging: the population-based KORA-Age study JF - Health and quality of life outcomes N2 - 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. KW - Aging KW - Multimorbidity KW - KORA Study Y1 - 2011 ER - TY - CHAP A1 - Völtl, R. A1 - Schanda, Ulrich A1 - Kohrmann, M. A1 - Buchschmid, M. A1 - Müller, G. T1 - Simultaneous operational vibration analysis of different layers of lightweight timber floors T2 - Internoise 2013 N2 - Within the scope of the research project "VibWood", operational vibration analyses of timber floor constructions were carried out. In order to understand the vibration behaviour of and the sound transmission through the layers of the constructions the coupling between them was investigated. The transfer function from the point of excitation to a pattern of receiving positions located on each of the layers of the construction was measured using a swept sine excitation. As a result, the frequency range of decoupling between the base floor and the floating floor and between the base floor and the suspended ceiling could be identified and the individual vibration behavior analyzed. The measurements also included the radiated sound power from the suspended ceiling. There is indication that there is not necessarily a correlation between the eigenmodes of the suspended ceiling and the maxima of the radiated sound power KW - Schallmesstechnik KW - Holzbau Y1 - 2018 ER - TY - CHAP A1 - Völtl, R. A1 - Kohrmann, M. A1 - Schanda, Ulrich A1 - Buchschmid, M. A1 - Müller, G. T1 - Messung und Berechnung der Schwingungen von Holzdecken im Prüfstand T2 - Deutsche Gesellschaft für Akustik e.V. DAGA N2 - Im Rahmen des AIF-Forschungsprojektes VibWood werden im Deckenprüfstand der HS Rosenheim unterschiedliche Holzdeckenkonstruktionen hinsichtlich ihres Schwingungsverhaltens im Bereich zwischen 4 Hz und 200 Hz untersucht. Parallel dazu werden diese Holzdeckenkonstruktionen an der TU München mittels FE-Berechnungen modelliert. Für die Untersuchungen steht ein Prüfstand zur Verfügung, welcher die Möglichkeit bietet, Decken oder Deckenelemente mit Abmessungen von max. 5,5 m x 5,5 m auf einer Stahlwinkelkonsole aufzulagern. Die Deckenelemente können so durch Messung der Übertragungsfunktionen hinsichtlich ihrer Schwingungsformen untersucht werden. Ein Ziel der Untersuchungen ist es, die tieffrequenten Schwingungen von Holzdecken mit Hilfe von Schwingungstilgern deutlich zu reduzieren. Es werden erste Ergebnisse der Validierung der FE-Modelle vorgestellt, insbesondere der Einfluss der Auflagerung der Deckenelemente auf die Übertragungsfunktion. Weiterhin werden Messergebnisse für unterschiedliche Anregungsarten diskutiert KW - Holzbau KW - Schallmesstechnik Y1 - 2012 ER - TY - JOUR A1 - Klingshirn, H. A1 - Mittrach, R. A1 - Braitmayer, K. A1 - Strobl, R. A1 - Bender, A. A1 - Grill, E. A1 - Müller, Martin T1 - RECAPDOC - a questionnaire for the documentation of rehabilitation care utilization in individuals with disorders of consciousness in long-term care in Germany: development and pretesting JF - BMC Health Services Research N2 - Background A multitude of different rehabilitation interventions and other specific health care services are offered for individuals with disorders of consciousness in long-term care settings. To investigate the association of those services and patient-relevant outcomes, a specific instrument to document the utilization of those services is needed. The purpose of this study was to develop such a questionnaire administered to caregivers in epidemiological studies or patient registries in Germany. Methods The development process of the RECAPDOC questionnaire was carried out in three steps. Step 1 consisted of a systematic literature review and an online-based expert survey to define the general content. Step 2 was an expert interview to evaluate the preliminary content of the questionnaire. Step 3 was a pretest including cognitive interviews with caregivers. After each step, the results were combined into a new version of the questionnaire. Results The first version of the questionnaire included items on utilization of medical care, medical aids, nursing and therapeutic care. The results of the expert interview led to the integration of five new items and the modification of six other items. The pretest led to some minor modifications of the questionnaire since it was rated as feasible and acceptable. The final questionnaire consisted of 29 items covering the domains “living situation”, “social insurance status”, “utilisation of home health care”, “domestic services”, “outpatient health care”, “specific diagnostic measures”, “adaptive technologies”, “medical aids” and “utilization of therapies”. Also the experience of family support and multidisciplinary collaboration of health professionals is covered. Conclusions The developed questionnaire is a first step to make the situation of patients with disorders of consciousness in the long-term care setting accessible for evaluation in epidemiological studies and in the context of patient registries. However, further reliability and validity studies are needed. KW - Questionnaire development KW - Cognitive Interview KW - Pretest KW - Rehabilitation KW - Long-term care KW - Disorder of consciousness KW - Vegetative state KW - Minimaly conscious state Y1 - 2018 UR - https://doi.org/10.1186/s12913-018-3153-3 VL - 18 SP - 329 ER - TY - JOUR A1 - Kovacs, E. A1 - Strobl, R. A1 - Phillips, A. A1 - Stephan, A.-J. A1 - Müller, Martin A1 - Gensichen, J. A1 - Grill, E. T1 - Systematic Review and Meta-analysis of the Effectiveness of Implementation Strategies for Non-communicable Disease Guidelines in Primary Health Care JF - Journal of General Internal Medicine N2 - Background As clinical practice guidelines represent the most important evidence-based decision support tool, several strategies have been applied to improve their implementation into the primary health care system. This study aimed to evaluate the effect of intervention methods on the guideline adherence of primary care providers (PCPs). Methods The studies selected through a systematic search in Medline and Embase were categorised according to intervention schemes and outcome indicator categories. Harvest plots and forest plots were applied to integrate results. Results The 36 studies covered six intervention schemes, with single interventions being the most effective and distribution of materials the least. The harvest plot displayed 27 groups having no effect, 14 a moderate and 21 a strong effect on the outcome indicators in the categories of knowledge transfer, diagnostic behaviour, prescription, counselling and patient-level results. The forest plot revealed a moderate overall effect size of 0.22 [0.15, 0.29] where single interventions were more effective (0.27 [0.17, 0.38]) than multifaceted interventions (0.13 [0.06, 0.19]). Discussion Guideline implementation strategies are heterogeneous. Reducing the complexity of strategies and tailoring to the local conditions and PCPs’ needs may improve implementation and clinical practice. KW - Evidence- based medicine KW - Implementation KW - General practitioner KW - Intervention KW - Harvest plot Y1 - 2018 UR - https://doi.org/10.1007/s11606-018-4435-5 VL - 33 SP - 1142 EP - 1154 ER - TY - CHAP A1 - Zentgraf, Peter A1 - Berge, S. A1 - Chasset, C. A1 - Filippi, H. A1 - Gottzein, E. A1 - Gutiérrez-Cañas, I. A1 - Hartrampf, M. A1 - Krauss, P. A. A1 - Kuehl, C. A1 - Lübke- Ossenbeck, B. A1 - Mittnacht, M. A1 - Montenbruck, O. A1 - Müller, C. A1 - Rueda Boldo, P. A1 - Truffi, A. ED - American Astronautical Society, T1 - PREPARING THE GPS-EXPERIMENT FOR THE SMALL GEO MISSION T2 - 33rd ANNUAL AAS GUIDANCE AND CONTROL CONFERENCE N2 - This paper deals with the preparation of the Small GEO mission and the accommodation of a GPS receiver as an experiment. The expected benefits of using the GPS receiver for Small GEO are explained. The feasibility of using GPS for position determination is investigated by simulation using a MosaicGNSS receiver, which was stimulated by a Spirent RF signal generator. A procedure, how to evaluate flight data on ground is outlined. Success criteria of the experiment and the minimal size of the downlink stream required and reserved for the receiver TM are presented. KW - GPS KW - geosynchronous mission KW - Small GEO telecommunications satellite Y1 - 2018 ER - TY - CHAP A1 - Bauer, Petra A1 - Krewer, Carmen A1 - Golaszweski, Stefan A1 - König, Eberhard A1 - Müller, Friedemann T1 - Functional electrical stimulation assisted cycling – Therapeutic effects on patients with subacute hemiparesis after stroke T2 - Paracelsus Universität Salzburg, Science get together, Juni 2012 KW - Functional Electrical Stimulation KW - Therapeutic Effects KW - Assisted Active Cycling KW - Hemiparesis Y1 - 2012 ER - TY - CHAP A1 - Bergmann, Jeannine A1 - Krewer, Carmen A1 - Bauer, Petra A1 - Jahn, Klaus A1 - König, Eberhard A1 - Müller, Friedemann T1 - Effekte von Roboter-unterstützter Gangtherapie auf die Pusher-Symptomatik – Zwischenauswertung einer randomisiert kontrollierten Therapiestudie. T2 - 23. Jahrestagung der deutschen Gesellschaft für Neurorehabilitation 2013. Neurologie & Rehabilitation, 6 KW - Roboterunterstützte Gangtherapie KW - Pusher- Symptomatik KW - Randomisiert kontrollierte Therapiestudie Y1 - 2013 SP - 377 (EP1-06) ER - TY - CHAP A1 - Bergmann, Jeannine A1 - Krewer, Carmen A1 - Bauer, Petra A1 - Riener, Robert A1 - Müller, Friedemann T1 - Eine randomisierte kontrollierte Pilotstudie zur Effektivität von virtueller Realität in der roboterassistierten Gangtherapie von Patienten nach Schlaganfall. T2 - 5. Gemeinsame Jahrestagung der deutschen Gesellschaft für Neurorehabilitation und der deutschen Gesellschaft für Neurotraumatologie und klinische Neurorehabilitation, Singen, 04.-06.12.2014 KW - Roboterunterstützte Gangtherapie KW - Schlaganfall KW - Randomisiert kontrollierte Pilotstudie Y1 - 2014 ER - TY - JOUR A1 - Bauer, Petra A1 - Krewer, Carmen A1 - Golaszweski, Stefan A1 - König, Eberhard A1 - Müller, Friedemann T1 - Functional electrical stimulation assisted active cycling – Therapeutic effects in patients with hemiparesis from 7 days to 6 months after stroke. A randomized controlled pilot study. JF - Archives of Physical Medicine and Rehabilitation KW - Functional electrical stimulation KW - Assisted active cycling KW - Hemiparesis KW - Randomized controlled pilot study Y1 - 2015 IS - 96/2 SP - 188 EP - 196 ER - TY - JOUR A1 - Bauer, Petra A1 - Müller, Martin A1 - Kronast, Verena A1 - Seckler, Eva T1 - Bundesregierung fördert Versorgungsforschung. MobilE-PHY – physiotherapeutische Interventionen für ältere Menschen mit Schwindel und Gleichgewichtsstörungen JF - Zeitschrift für Physiotherapeuten KW - Schwindel- und Gleichgewichtsstörungen KW - Physiotherapeutische Intervention KW - Versorgungsforschung Y1 - 2018 IS - 01/2018 SP - 42 EP - 44 PB - Pflaum Verlag CY - München ER - TY - JOUR A1 - Bergmann, Jeannine A1 - Krewer, Carmen A1 - Bauer, Petra A1 - König, Alexander A1 - Riener, Robert A1 - Müller, Friedemann T1 - Virtual reality to augment robot-assisted gait training in non-ambulatory patients with a subacute stroke: a pilot randomized controlled trial JF - European Journal of Physical and Rehabilitation Medicine N2 - BACKGROUND: Active performance is crucial for motor learning, and, together with motivation, is believed to be associated with a better rehabilitation outcome. Virtual reality (VR) is an innovative approach to engage and motivate patients during training. There is promising evidence for its efficiency in retraining upper limb function. However, there is insufficient proof for its effectiveness in gait training. AIM: To evaluate the acceptability of robot-assisted gait training (RAGT) with and without VR and the feasibility of potential outcome measures to guide the planning of a larger randomized controlled trial (RCT). DESIGN: Single-blind randomized controlled pilot trial with two parallel arms. SETTING: Rehabilitation hospital. POPULATION: Twenty subacute stroke patients (64±9 years) with a Functional Ambulation Classification (FAC) ≤2. METHODS: Twelve sessions (over 4 weeks) of either VR-augmented RAGT (intervention group) or standard RAGT (control group). Acceptability of the interventions (drop-out rate, questionnaire), patients’ motivation (Intrinsic Motivation Inventory [IMI], individual mean walking time), and feasibility of potential outcome measures (completion rate and response to interventions) were determined. RESULTS: We found high acceptability of repetitive VR-augmented RAGT. The drop-out rate was 1/11 in the intervention and 4/14 in the control group. Patients of the intervention group spent significantly more time walking in the robot than the control group (per session and total walking time; P<0.03). In both groups, motivation measured with the IMI was high over the entire intervention period. The felt pressure and tension significantly decreased in the intervention group (P<0.01) and was significantly lower than in the control group at the last therapy session (r=-0.66, P=0.005). The FAC is suggested as a potential primary outcome measure for a definitive RCT, as it could be assessed in all patients and showed significant response to interventions (P<0.01). We estimated a sample size of 44 for a future RCT. CONCLUSIONS: VR-augmented RAGT resulted in high acceptability and motivation, and in a reduced drop-out rate and an extended training time compared to standard RAGT. This pilot trial provides guidance for a prospective RCT on the effectiveness of VR-augmented RAGT. CLINICAL REHABILITATION IMPACT: VR might be a promising approach to enrich and improve gait rehabilitation after stroke. KW - Virtual reality KW - Robot-assisted gait training KW - Subacute stroke KW - Pilot randomized controlled trial Y1 - 2018 UR - https://doi.org/10.23736/S1973-9087.17.04735-9 VL - 2018 IS - 3 SP - 397 EP - 407 ET - 54 ER - TY - CHAP A1 - Bergmann, Jeannine A1 - Bauer, Petra A1 - Volkening, Katharina A1 - Krewer, Carmen A1 - Müller, Friedemann T1 - Virtual reality-enriched gait training to improve motivation and rehabilitation outcome in subacute stroke patients T2 - 20th European Stroke Conference, Hamburg, Germany, May 2011 KW - Virtual Reality KW - Subacute stroke patients KW - Rehabilitation outcome Y1 - 2011 ER - TY - GEN A1 - Lüftl, Katharina A1 - Müller, Martin ED - Lüftl, T1 - Chancen und Herausforderungen des dualen Bachelorstudienganges Pflege für Studierende, Arbeitgeber, Pflegebedürftige und die Gesellschaft. Festakt zur Eröffnung des Studienganges Pflege an der Hochschule Rosenheim. Mühldorf a. Inn am 14.10.2015 KW - Duales Pflegestudium Y1 - 2018 ER - TY - JOUR A1 - Müller, A. A1 - Stratmann- Schöne, D. A1 - Hammerschmidt (ehem. Klose), Thomas A1 - Leidl, R. T1 - Overview of economic evaluation of positron-emission-tomography JF - The European Journal of Health Economics KW - Economic evaluation KW - Positron-emission-tomography Y1 - 2002 IS - 3 / 1 SP - 59 EP - 65 ER - TY - RPRT A1 - Müller, A. A1 - Stratmann- Schöne, D. A1 - Hammerschmidt (ehem. Klose), Thomas A1 - Leidl, R. T1 - Ökonomische Evaluation der Positronen-Emissions-Tomographie BT - Ein gesundheitsökonomischer HTA-Bericht KW - Ökonomische Evaluation KW - Positronen-Emissions-Tomographie KW - HTA- Bericht Y1 - 2001 ER - TY - JOUR A1 - Müller, A. A1 - Stratmann- Schöne, D. A1 - Hammerschmidt (ehem. Klose), Thomas A1 - Leidl, R. T1 - Eine Übersicht über die ökonomische Evaluation der Positronen-Emissions-Tomographie JF - Bundesgesundheitsblatt KW - Ökonomische Evaluation KW - Positronen-Emissions-Tomographie Y1 - 2001 IS - 44 / 9 SP - 895 EP - 902 ER - TY - CHAP A1 - Ragai, A1 - Schwabenbauer, A1 - Eser, A1 - Müller, ED - ASME, T1 - Effect of Process Parameters on the Electrically-Assisted Sintered Iron-Copper Powder Metals BT - Volume 2: Advanced Manufacturing T2 - ASME 2018 International Mechanical Engineering Congress and Exposition N2 - Electric-current-assisted sintering (ECAS) is a novel process that can potentially replace the conventional sintering method. It is hypothesized that the process can reduce the sintering time and can be used in situ; thus, can be more cost effective. The purpose of this research is to investigate the effect of direct current on the sintered properties of iron-copper powder metal. Experiments were conducted at various conditions to determine the optimal process parameters for this particular powder metal. The parameters investigated were electric current levels and energizing time. Experiments also included sintering the powder using a conventional furnace. Samples from both types of experiments were compared to determine the metallurgical differences due to the sintering process. Mechanical and microstructure examination were conducted to aid in determining the feasibility of ECAS. KW - Electric-current-assisted sintering Y1 - 2018 SN - 978-0-7918-5201-9 U6 - https://doi.org/10.1115/IMECE2018-86891 ER - TY - GEN A1 - Rastinger, Andrea A1 - Weichselgartner, Lisa A1 - Müller, Martin A1 - Lüftl, Katharina T1 - Pflege in der ambulant betreuten Wohngemeinschaft gestalten. Ergebnisse einer qualitativen Studie im Rahmen eines Studienprojektes. (Posterpräsentation) BT - Posterpräsentation T2 - 10. DGP-Hochschultag, Osnabrück 8. November 2019 KW - Pflegestudium Y1 - 2019 ER - TY - JOUR A1 - Saal, Susanne A1 - Klingshirn, Hanna A1 - Beutner, Katrin A1 - Strobl, Ralf A1 - Grill, Eva A1 - Müller, Martin A1 - Meyer, Gabriele T1 - Improved participation of older people with joint contractures living in nursing homes: feasibility of study procedures in a cluster-randomised pilot trial JF - Trials N2 - Background: Acquired joint contractures have a significant impact on functioning and quality of life in nursing home residents. There is very limited evidence on measures for prevention and treatment of disability due to joint contractures. We have developed the PECAN intervention (Participation Enabling CAre in Nursing) to improve social participation in nursing home residents. A cluster-randomised pilot trial was conducted to assess the feasibility of study procedures in preparation for a main trial according to the UK Medical Research Council (MRC) framework. Methods: Nursing homes in two regions of Germany were randomly allocated either to the intervention or optimised standard care (control group). All residents with joint contractures aged > 65 years were eligible for the study. The residents’ data were collected through structured face-to-face interviews by blinded assessors at baseline, after 3 and 6 months. The primary outcome was social participation, measured by a subscale of the PaArticular Scales. Secondary outcomes included activities and instrumental activities of daily living, health-related quality of life, falls and fall-related consequences. Data on the trial feasibility were collected via documentation forms. Results: Seven out of 12 nursing homes agreed to participate and remained in the trial. Of 265 residents who fulfilled the inclusion criteria, 129 were randomised either to the intervention (n = 64) or control group (n = 65) and analysed. A total of 109 (85%) completed the trial after 6 months. The mean age was 85.7 years (SD 7.0), 80% were women. The severity of the residents’ disability differed across the clusters. The completion rate was high (> 95%), apart from the Instrumental Activities of Daily Living Scale. Some items of the PaArticular Scales were not easily understood by residents. The frequency of falls did not differ between study groups. Conclusion: Our data confirmed the feasibility of the overall study design. We also revealed the need to improve the procedures for the recruitment of residents and for data collection before implementation into a main trial. The next step will be an adequately powered main trial to assess the effectiveness and cost-effectiveness of the intervention. KW - Joint contractures KW - Nursing homes KW - Participation KW - Complex intervention KW - Cluster-randomised pilot trial KW - Feasibility trial Y1 - 2019 UR - https://doi.org/10.1186/s13063-019-3522-1 VL - 20 SP - 411 ER - TY - JOUR A1 - Müller, Martin A1 - Meyer, Gabriele T1 - ZEFQ im Gespräch mit Prof. Dr. rer. medic. Martin Müller zum Thema „Robotik in der Pflege“ JF - Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen KW - Robotik in der Pflege Y1 - 2019 UR - https://doi.org/10.1016/j.zefq.2019.07.002 VL - 144-145 SP - 60 EP - 61 ER - TY - JOUR A1 - Müller, Martin T1 - Unglaublich produktive Wissenschaftler? JF - Pflege KW - Wissenschaft Y1 - 2019 UR - https://doi.org/10.1024/1012-5302/a000665 VL - 32 IS - 2 SP - 117 EP - 117 ER - TY - JOUR A1 - Jahn, Eva A1 - Reindl, Anton A1 - Müller, Martin A1 - Haddadin, Sami T1 - Die neuen Assistenten JF - Altenheim KW - Assistenten KW - Robotik Y1 - 2019 IS - 3 SP - 28 EP - 31 ER - TY - JOUR A1 - Nguyen, Natalie A1 - Thalhammer, Regina A1 - Beutner, Katrin A1 - Saal, Susanne A1 - Servaty, Ricarda A1 - Klingshirn, Hanna A1 - Icks, Andrea A1 - Freyberg, Kristina A1 - Vomhof, Markus A1 - Mansmann, Ulrich A1 - Le, Lien A1 - Müller, Martin A1 - Meyer, Gabriele T1 - 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] JF - Trials N2 - 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. KW - Joint contractures KW - Participation KW - Activities KW - Nursing homes KW - International Classification of Functioning KW - Disability and Health (ICF) KW - Complex intervention KW - Multicentre cluster randomised controlled trial Y1 - 2019 UR - https://doi.org/10.1186/s13063-019-3384-6 VL - 20 SP - 305 ER - TY - JOUR A1 - Link, Friederike A1 - Hostmannshoff, Caren A1 - Müller, Martin A1 - Lüftl, Katharina T1 - Wissenschaftliche Karriere bis zur HAW-Professur in pflegebezogenen Studiengängen - Ziel oder Kompromiss? Ergebnisse einer Befragung wissenschaftlicher Nachwuchskräfte an unterschiedlichen Etappen des Karriereweges JF - Lehren & Lernen im Gesundheitswesen N2 - Die Pflegewissenschaft in Deutschland steht vor der Herausforderung, wissenschaftliche Strukturen und Karrierewege auszubilden. Erschwert wird dies durch einen Mangel an wissenschaftlichem Nachwuchs, der das Potential hat, pflegewissenschaftliche Professuren mit wissenschaftlicher Exzellenz und praktischer Erfahrung zu füllen. Ziel dieses Beitrags ist es, darzustellen, was auslösende Momente für wissenschaftliche Karrieren sind, die in Professuren pflegebezogener Studiengänge münden, und welche Kontextbedingungen diese Karrieren beeinflussen. Es soll auch aufgezeigt werden, wie wissenschaftliche Nachwuchskräfte vorgehen, um ihre Ziele zu erreichen und welche Konsequenzen sich daraus für sie und für die Pflegewissenschaft ergeben. Auf dieser Grundlage sollen Empfehlungen für die Nachwuchsförderung entwickelt werden, um mehr geeignete Personen für Professuren in pflegebezogenen Studiengängen zu gewinnen. Vorhandene Daten teilnarrativer Interviews mit ProfessorInnen (n=11) und Masterstudierenden (n=11) sowie Promovierenden (n=10) pflegebezogener Studiengänge wurden im Rahmen einer retrospektiven Datenanalyse mit dem dreistufigen Codierverfahren der Grounded Theory Methodologie ausgewertet. Die Ergebnisse zeigen, dass in der Pflegepraxis gewonnene Erfahrungen auslösende Momente wissenschaftlicher Karrieren sind. Diese lösen den Drang aus, die dort herrschende Situation zu verändern, wobei sich vier Karrieretypen unterscheiden lassen: Typ A forscht, weil er erlebt hat, dass es für pflegerische Phänomene keine geeigneten Pflegeinterventionen gab. Typ B lehrt, um dazu beizutragen, dass Pflegende zukünftig besser ausgebildet werden. Typ C ist als Pflegeperson von ÄrztInnen nicht ausreichend anerkannt worden und absolviert eine wissenschaftliche Qualifikation, um mit ihnen auf Augenhöhe zu gelangen. Typ D wollte in der Praxis bleiben, ist aber bei Weiterentwicklungsprozessen blockiert worden und nimmt als Kompromiss eine Professur an. Identifizierte Kontextfaktoren sind u.a. mangelnde Wertschätzung für wissenschaftliches Handeln in der Pflege und das Fehlen von Stellen für hochschulisch qualifizierte Pflegepersonen in der Praxis. Angesichts der bestehenden Bedingungen können hochschulisch qualifizierte Pflegende in der Praxis nicht Fuß fassen. Als Konsequenz für die Pflegewissenschaft als Disziplin zeigt sich, dass in der Pflegepraxis Vorbilder fehlen, die zukünftige Generationen Pflegender dazu anregen könnten, selbst eine wissenschaftliche Karriere in der Pflege einzuschlagen. Dadurch besteht die Gefahr einer Verkümmerung der Pflegewissenschaft. Auf Grundlage der Ergebnisse wird die durchgängige Implementierung geeigneter Stellen für hochschulisch qualifizierte Pflegepersonen in der Pflegepraxis als Ausgangsbasis wissenschaftlicher Nachwuchsförderung betrachtet. Als Konzept werden Hochschul-Praxis-Partnerschaften skizziert, die beginnend auf Bachelorniveau bis zur Post-doc-Phase Strukturen zu einem systematischen praxisbezogenen wissenschaftlichen Kompetenzauf- und -ausbau für akademisch qualifizierte Pflegende etablieren. KW - Wissenschaftlicher Nachwuchs, Pflegewissenschaft, Karrierewege, Karrieretypen, Professuren, Grounded Theory Methodologie Y1 - 2021 VL - 2021 IS - 6 SP - 73 EP - 86 ER - TY - GEN A1 - Skudlik, Stefanie A1 - Hirt, Julian A1 - Döringer, Tobias A1 - Thalhammer, Regina A1 - Lüftl, Katharina A1 - Prodinger, Birgit A1 - Müller, Martin T1 - Herausforderungen und Versorgungsstrategien im Kontext von Pflegeheimeinzügen in Deutschland: Ein Scoping Review. Poster für den EbM-Kongress vom 22.-24. März 2023 in Potsdam KW - Pflegeheimeinzug Y1 - 2023 ER - TY - GEN A1 - Skudlik, Stefanie A1 - Hirt, Julian A1 - Döringer, Tobias A1 - Thalhammer, Regina A1 - Lüftl, Katharina A1 - Prodinger, Birgit A1 - Müller, Martin T1 - Challenges and care strategies during the transition to nursing home in Germany: A scoping review. European Nursing Kongress am 5. Oktober 2022, online KW - transition to nursing home Y1 - 2022 ER - TY - JOUR A1 - Skudlik, Stefanie A1 - Hirt, Julian A1 - Döringer, Tobias A1 - Thalhammer, Regina A1 - Lüftl, Katharina A1 - Prodinger, Birgit A1 - Müller, Martin T1 - Challenges and care strategies associated with the admission to nursing homes in Germany: a scoping review JF - BMC Nursing N2 - Background The admission to a nursing home is a critical life-event for affected persons as well as their families. Admission related processes are lacking adequate participation of older people and their families. To improve transitions to nursing homes, context- and country-specific knowledge about the current practice is needed. Hence, our aim was to summarize available evidence on challenges and care strategies associated with the admission to nursing homes in Germany. Methods We conducted a scoping review and searched eight major international and German-specific electronic databases for journal articles and grey literature published in German or English language since 1995. Further inclusion criteria were focus on challenges or care strategies in the context of nursing home admissions of older persons and comprehensive and replicable information on methods and results. Posters, only-abstract publications and articles dealing with mixed populations including younger adults were excluded. Challenges and care strategies were identified and analysed by structured content analysis using the TRANSCIT model. Results Twelve studies of 1,384 records were finally included. Among those, seven were qualitative studies, three quantitative observational studies and two mixed methods studies. As major challenges neglected participation of older people, psychosocial burden among family caregivers, inadequate professional cooperation and a lack of shared decision-making and evidence-based practice were identified. Identified care strategies included strengthening shared decision-making and evidence-based practice, improvement in professional cooperation, introduction of specialized transitional care staff and enabling participation for older people. Conclusion Although the process of nursing home admission is considered challenging and tends to neglect the needs of older people, little research is available for the German health care system. The perspective of the older people seems to be underrepresented, as most of the studies focused on caregivers and health professionals. Reported care strategies addressed important challenges, however, these were not developed and evaluated in a comprehensive and systematic way. Future research is needed to examine perspectives of all the involved groups to gain a comprehensive picture of the needs and challenges. Interventions based on existing care strategies should be systematically developed and evaluated to provide the basis of adequate support for older persons and their informal caregivers. KW - transition to nursing home Y1 - 2023 U6 - https://doi.org/10.1186/s12912-022-01139-y VL - 22 ER - TY - JOUR A1 - Fürböck, C. A1 - Litzenberger, M. A1 - Pogany, D. A1 - Gornik, E. A1 - Seliger, Norbert A1 - Müller-Lynch, T. A1 - Stecher, M. A1 - Goßner, H. A1 - Werner, W. T1 - Laser interferometric method for ns-time scale thermal mapping of Smart Power ESD protection devices during ESD stress JF - Microelectronics Reliability Y1 - 2023 U6 - https://doi.org/10.1016/S0026-2714(99)00124-9 SN - 0026-2714 VL - 39 IS - 6 SP - 925 EP - 930 ER - TY - JOUR A1 - Pogany, D. A1 - Seliger, Norbert A1 - Litzenberger, M. A1 - Gossner, H. A1 - Stecher, M. A1 - Müller-Lynch, T. A1 - Werner, W. A1 - Gornik, E. T1 - Damage analysis in smart-power technology electrostatic discharge (ESD) protection devices JF - Microelectronics Reliability Y1 - 2023 U6 - https://doi.org/10.1016/S0026-2714(99)00162-6 SN - 0026-2714 VL - 39 IS - 6 SP - 1143 EP - 1148 ER - TY - CHAP A1 - Fürböck, C. A1 - Pogany, D. A1 - Litzenberger, M. A1 - Gornik, E. A1 - Seliger, Norbert A1 - Gossner, H. A1 - Müller-Lynch, T. A1 - Stecher, M. A1 - Werner, W. T1 - Interferometric temperature mapping during ESD stress and failure analysis of smart power technology ESD protection devices T2 - Electrical Overstress/Electrostatic Discharge Symposium Proceedings KW - ESD KW - smart power device Y1 - 2023 U6 - https://doi.org/10.1109/EOSESD.1999.819067 SP - 241 EP - 250 PB - IEEE ER - TY - JOUR A1 - Fürböck, C. A1 - Pogany, D. A1 - Litzenberger, M. A1 - Gornik, E. A1 - Seliger, Norbert A1 - Gossner, H. A1 - Müller-Lynch, T. A1 - Stecher, M. A1 - Werner, W. T1 - Interferometric temperature mapping during ESD stress and failure analysis of smart power technology ESD protection devices JF - Journal of Electrostatics KW - ESD KW - smart power device Y1 - 2023 VL - 49 SP - 195 EP - 213 ER - TY - CHAP A1 - Wiedl, Sebastian A1 - Karlinger, Peter A1 - Müller, Norbert A1 - Ruckdäschel, Holger T1 - Cellulosefaserverstärktes Polypropylen – Eigenschaftsbeeinflussung durch die Schmelzeaufbereitung T2 - Technomer 2023 N2 - Verarbeitungstemperaturen, Verweilzeit und Scherkräfte sind entscheidend, um die strukturelle Integrität von cellulosebasierten Fasern zu gewährleisten. In dieser Studie wurden die Einflüsse durch die Schmelzeaufbereitung eines cellulosefaserverstärkten Polypropylens auf die Faser und den Faserverbund untersucht. Die Schmelze wurde in einem Plastographen mit verschiedenen Rotordrehzahlen, Schmelzetemperaturen und Verweilzeiten aufbereitet. Um die Auswirkung der Einspeisungsmethode auf den Faserabbau zu analysieren, wurden die Fasern entweder direkt der thermoplastischen Schmelze oder zusammen mit dem Kunststoffgranulat dem Plastographen zugeführt. Die Zugabe der Fasern in die Schmelze geht mit einer erhöhten thermischen und verminderten mechanischen Belastung der Fasern einher. Bei der Prüfung der mechanischen Eigenschaften der verschieden aufbereiteten Compounds zeigten sich signifikante Unterschiede. Wurden die Fasern direkt der Schmelze hinzugefügt, so führte dies zu einer deutlich reduzierten Zugfestigkeit. Optische Unterschiede in den Schliffbildern der spritzgegossenen Prüfstäbe sowie in den Faserlängen nach Compoundierung konnten nicht festgestellt werden. Die verminderte Festigkeit wird folglich auf die unterschiedliche thermische Belastung der Faser während der Verarbeitung zurückgeführt. KW - Cellulosefaser KW - Faserververstärkung KW - Polypropylen KW - Schmelzeaufbereitung KW - Faserbeschickung Y1 - 2023 SN - 978-3-939382-16-4 SP - 1 EP - 14 PB - Technische Universität Chemnitz CY - Chemnitz ER - TY - CHAP A1 - Döringer, Tobias A1 - Horstmannshoff, Caren A1 - Kiesel, Theresia A1 - Schädler, A1 - Voigt, Karen A1 - Müller, Martin A1 - Bauer, Petra T1 - Entwicklung und Evaluierung einer evidenzbasierten Schulung zur physiotherapeutischen Versorgung von Patient*innen mit Schwindel und/oder Gleichgewichtsstörungen im Rahmen eines Versorgungspfades T2 - 7. Forschungssymposium Physiotherapie N2 - Hintergrund Schwindel und/oder Gleichgewichtsstörungen (SG) sind häufige Symptome bei älteren Menschen und beeinträchtigen das tägliche Leben erheblich. Physiotherapie kann eine wichtige Komponente in der Behandlung von SG sein. Aufgrund der multifaktoriellen Ursachen sind die physiotherapeutische Diagnostik und Therapie komplex, werden aber in der Ausbildung kaum thematisiert. Klar strukturierte und evidenzbasierte Schulungen für die differentialdiagnostische Herangehensweise können den Clinical-Reasoning-Prozess und die Therapie von SG verbessern. Eine entsprechende evidenzbasierte Schulung wurde in einem Interventionszweig der multizentrischen Cluster-RCT MobilE-PHY2 begleitend zu einem Decision Tree (DT) für den Clinical-Reasoning-Prozess in der Physiotherapie konzipiert und durchgeführt. Methodik Die Schulung wurde aus den Ergebnissen der Pilotstudie (MobilE-PHY1) und deren Prozessevaluation sowie auf der Grundlage einer dreitägigen Fortbildung von und mit einem Schwindelexperten entwickelt. Inhalte waren die Anwendung des DT, theoretische Grundlagen über Schwindel sowie praktische Übungsanteile. Bei der eintägigen Schulung konnten die Physiotherapeut*innen entweder online oder in Präsenz teilnehmen. Zudem wurde eine Online-Lernplattform bereitgestellt, die neben umfassendem Vor- und Nachbereitungsmaterial die Möglichkeit bot, Feedback z. B. in Form einer Videoanalyse zu bekommen. Die Evaluation erfolgte durch Fragebögen und leitfadengestützte Interviews und ist Teil der Prozessevaluation von MobilE-PHY2. Die Auswertung ab Juni 2023 wird im Mixed-Methods-Design nach Rädiker stattfinden. Ergebnis und Schlussfolgerung Es konnten neun Physiotherapiepraxen am Studienstandort Bayern in die Studie eingeschlossen werden. Aus diesen nahmen 17 Therapeut*innen an den insgesamt drei Schulungen teil. Es wurden zehn Therapeut*innen online und sieben in Präsenz geschult. Basierend auf Interviews mit sechs Therapeut*innen sowie dreizehn Fragebögen werden wichtige Erkenntnisse gewonnen, inwiefern die Schulung (begleitend zum DT) eine geeignete Methode darstellt, die evidenzbasierte physiotherapeutische Versorgung für Patient*innen mit SG zu verbessern. Zudem können Vor- und Nachteile der Online- und Präsenzlehre diskutiert werden. KW - Schwindel KW - Physiotherapie KW - Schulung KW - Evidenzbasierte Praxis KW - Versorgungspfad Y1 - 2023 ER - TY - JOUR A1 - Kirsch, R. A1 - Bergmann, A. A1 - Koller, D. A1 - Leidl, R. A1 - Mansmann, U. A1 - Müller, Martin A1 - Sanftenberg, L. A1 - Schelling, J. A1 - Sundmacher, L. A1 - Voigt, Karen A1 - Grill, E. T1 - Patient trajectories and their impact on mobility, social participation and quality of life in patients with vertigo/dizziness/balance disorders and osteoarthritis (MobilE-TRA): study protocol of an observational, practice-based cohort study JF - BMJ Open N2 - Introduction Mobility limitations have a multitude of different negative consequences on elderly patients including decreasing opportunities for social participation, increasing the risk for morbidity and mortality. However, current healthcare has several shortcomings regarding mobility sustainment of older adults, namely a narrow focus on the underlying pathology, fragmentation of care across services and health professions and deficiencies in personalising care based on patients’ needs and experiences. A tailored healthcare strategy targeted at mobility of older adults is still missing. Objective The objective is to develop multiprofessional care pathways targeted at mobility sustainment and social participation in patients with vertigo/dizziness/balance disorders (VDB) and osteoarthritis (OA) . Methods Data regarding quality of life, mobility limitation, pain, stiffness and physical function is collected in a longitudinal observational study between 2017 and 2019. General practitioners (GPs) recruit their patients with VDB or OA. Patients who visited their GP in the last quarter will be identified in the practice software based on VDB and OA-related International Classification of Diseases 10th Revision. Study material will be sent from the practice to patients by mail. Six months and 12 months after baseline, all patients will receive a mail directly from the study team containing the follow-up questionnaire. GPs fill out questionnaires regarding patient diagnostics, therapy and referrals. Ethics and dissemination The study was approved by the ethical committee of the Ludwig-Maximilians-Universität München and of the Technische Universität Dresden. Results will be published in scientific, peer-reviewed journals and at national and international conferences. Results will be disseminated via newsletters, the project website and a regional conference for representatives of local and national authorities. KW - Vertigo KW - Dizziness KW - Balance Disorders KW - Osteoarthritis KW - Cohort Study Y1 - 2018 UR - http://dx.doi.org/10.1136/bmjopen-2018-022970 VL - 8 IS - 4 SP - e022970 ER - TY - CHAP A1 - Horstmannshoff, Caren A1 - Kiesel, Theresia A1 - Döringer, Tobias A1 - Voigt, Karen A1 - Bauer, Petra A1 - Müller, Martin T1 - Care pathway for evidence-based healthcare of patients with vertigo, dizziness or balance disorders in primary care. First results of the mixed-methods process evaluation T2 - 7. Forschungssymposium Physiotherapie N2 - BACKGROUND Vertigo, dizziness or balance disorders (VDB) affect the mobility and participation of many older people and are also one of the most frequent reasons for visiting the general practitioner's (GP) practice due to multifactorial causes. Physiotherapy (PT) can be crucial for the complex care of people with VDB but is rarely prescribed by GPs. So we developed an evidence-based, multidisciplinary care pathway as a complex intervention following the UK Medical Research Council guideline, which was piloted and is now being evaluated for effectiveness, accompanied by a process evaluation. METHOD The care pathway of the multicentre cluster-RCT (MobilE-PHY2) included decision aids and training for PTs and GPs in the intervention group and optimised standard care in the control group. A mixed-methods process evaluation following Grant’s framework for designing process evaluations examined barriers, facilitating factors and mechanisms of impact in recruiting and reaching participants, implementing the intervention and the response of all participants. Therefore, a logic model was developed illustrating the relationship between the planned work to implement the intervention, the expected mechanism of impact (based on the behaviour change wheel as a change theory), the intended results (output, outcome and impact), and categories of possible influencing factors. The underlying assumption is that a behavioural change in PT and GP is a prerequisite for a change in patient behaviour, which can lead to improved mobility and participation (outcome of MobilE-PHY2). Guided interviews were conducted with patients before the intervention and after six months and with PTs and GPs after six months. Additionally, the training evaluations, completed decision aids and structural questionnaires will be analysed from June 2023. RESULTS AND CONCLUSION At one study site, a total of 37 patients, 17 PTs and nine GPs were included. Interviews were conducted with 16 patients, six PTs and GPs. In the intervention group, 12 PTs and 18 GPs completed decision aids, 13 PTs and two GPs completed evaluation forms, and eight PTs and four GPs completed structural data. The preliminary results of the process evaluation will be reported at the Congress. The results are intended to give indications for a broad implementation of the care pathway, including and promoting physiotherapy and therefore contributing to improved evidence-based healthcare for older people with VDB. KW - process evaluation KW - vertigo KW - cluster-RCT KW - primary care Y1 - 2023 ER - TY - CHAP A1 - Horstmannshoff, Caren A1 - Kiesel, Theresia A1 - Borchers, Peggy A1 - Döringer, Tobias A1 - Bauer, Petra A1 - Voigt, Karen A1 - Müller, Martin T1 - Wirksamkeit und Sicherheit eines evidenzbasierten Versorgungspfades zur Verbesserung von Mobilität und Partizipation für ältere Patient*innen mit Schwindel und Gleichgewichtsstörungen (VDB) in der Primärversorgung: Eine multizentrische cluster-randomisierte kontrollierte Studie T2 - Tag der Forschung TH Rosenheim KW - Schwindel KW - evidenzbasierter Versorgungspfad KW - komplexe Intervention KW - Primärversorgung Y1 - 2023 ER - TY - CHAP A1 - Horstmannshoff, Caren A1 - Sollfrank, Tobias A1 - Jahn, Eva Theresa A1 - Müller, Martin T1 - Interaktion potentieller Nutzer:innengruppen mit einem kooperativen Assistenzroboter für das 3. und 4. Lebensalter (KoBo34) im Rahmen von Testszenarien im Laborkontext T2 - 23. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin KW - Assistenzroboter Y1 - 2022 UR - https://dx.doi.org/10.3205/22ebm099 ER - TY - JOUR A1 - Horstmannshoff, Caren A1 - Skudlik, Stefanie A1 - Petermann, Jenny A1 - Kiesel, Theresia A1 - Döringer, Tobias A1 - Crispin, Alexander A1 - Hermsdörfer, Joachim A1 - Köberlein‑Neu, Juliane A1 - Jahn, Klaus A1 - Schädler, Stefan A1 - Bauer, Petra A1 - Voigt, Karen A1 - Müller, Martin T1 - Effectiveness of an evidence-based care pathway to improve mobility and participation in older patients with vertigo and balance disorders in primary care (MobilE-PHY2): study protocol for a multicentre cluster-randomised controlled trial JF - BMC Trials N2 - Background Vertigo, dizziness or balance disorders (VDB) are common leading symptoms in older people, which can have a negative impact on their mobility and participation in daily live, yet, diagnosis is challenging and specific treatment is often insufficient. An evidence-based, multidisciplinary care pathway (CPW) in primary care was developed and pilot tested in a previous study. The aim of the present study is to evaluate the effectiveness and safety of the CPW in terms of improving mobility and participation in community-dwelling older people with VDB in primary care. Methods For this multicentre cluster randomised controlled clinic trial, general practitioners (GP) will be recruited in two regions of Germany. A total of 120 patients over 60 years old with VDB will be included. The intervention is an algorithmized CPW. GPs receive a checklist for standardise clinical decision making regarding diagnostic screening and treatment of VDB. Physiotherapists (PT) receive a decision tree for evidence-based physiotherapeutic clinical reasoning and treatment of VDB. Implementation strategies comprises educational trainings as well as a workshop to give a platform for exchange for the GPs and PTs, an information meeting and a pocket card for home care nurses and informal caregivers and telephone peer counselling to give all participants the capability, opportunity and the motivation to apply the intervention. In order to ensure an optimised usual care in the control group, GPs get an information meeting addressing the national guideline. The primary outcome is the impact of VDB on participation and mobility of patients after 6 month follow-up, assessed using the Dizziness Handicap Inventory (DHI) questionnaire. Secondary outcomes are physical activity, static and dynamic balance, falls and fear of falling as well as quality of life. We will also evaluate safety and health economic aspects of the intervention. Behavioural changes of the participants as well as barriers, facilitating factors and mechanisms of impact of the implementation will be investigated with a comprehensive process evaluation in a mixed-methods design. Discussion With our results, we aim to improve evidence-based health care of community-dwelling older people with VDB in primary care. KW - Dizziness KW - Vertigo KW - Balance disorder KW - Complex intervention KW - Primary care KW - Care pathway KW - Multicentre cluster randomised controlled trial KW - Mobility KW - Physiotherapy Y1 - 2023 UR - https://doi.org/10.1186/s13063-022-07017-x VL - 24 SP - 91 ER - TY - CHAP A1 - Horstmannshoff, Caren A1 - Borchers, Peggy A1 - Lechner, Theresia A1 - Petermann, Jenny A1 - Skudlik, Stefanie A1 - Döringer, Tobias A1 - Crispin, Alexander A1 - Hermsdörfer, Joachim A1 - Köberlein-Neu, Juliane A1 - Bauer, Petra A1 - Voigt, Karen A1 - Müller, Martin T1 - Wirksamkeit und Sicherheit eines evidenzbasierten Versorgungspfades zur Verbesserung von Mobilität und Teilhabe für ältere Patient*innen mit Schwindel- und/oder Gleichgewichtsstörungen in der Primärversorgung T2 - 21. Deutscher Kongress für Versorgungsforschung (DKVF) KW - Gleichgewichtsstörung KW - Versorgungspfad KW - Komplexe Intervention KW - Schwindel KW - Mobilität KW - Multizentrische randomisierte kontrollierte Studie KW - Physiotherapie KW - Primärversorgung Y1 - 2022 UR - https://dx.doi.org/10.3205/22dkvf413 ER - TY - CHAP A1 - Horstmannshoff, Caren A1 - Skudlik, Stefanie A1 - Petermann, Jenny A1 - Lechner, Theresia A1 - Bauer, Petra A1 - Voigt, Karen A1 - Müller, Martin T1 - Wirksamkeit und Sicherheit eines evidenzbasierten Versorgungspfades zur Verbesserung von Mobilität und Partizipation für ältere Patient*innen mit Schwindel und Gleichgewichtsstörungen in der Primärversorgung T2 - 23. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin KW - Gleichgewichtsstörung KW - Versorgungspfad KW - Komplexe Intervention KW - Schwindel KW - Mobilität KW - Multizentrische randomisierte kontrollierte Studie KW - Physiotherapie KW - Primärversorgung Y1 - 2022 UR - https://dx.doi.org/10.3205/22ebm070 ER - TY - CHAP A1 - Borchers, Peggy A1 - Petermann, Jenny A1 - Katzenberger, Benedict A1 - Bauer, Petra A1 - Horstmannshoff, Caren A1 - Lechner, Theresia A1 - Müller, Martin A1 - Voigt, Karen T1 - Hausärztliche Verordnung und patientenseitige Inanspruchnahme von Physiotherapie bei Patient*innen mit Schwindel- und/oder Gleichgewichtsstörungen - Ergebnisse aus der Kohortenstudie MobilE-TRA T2 - Kongress Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin (DEGAM) KW - Kohortenstudie KW - Schwindel KW - Physiotherapie KW - Leitlinie KW - Inanspruchnahme Y1 - 2022 UR - https://dx.doi.org/10.3205/22degam167 ER - TY - CHAP A1 - Horstmannshoff, Caren A1 - Lechner, Theresia A1 - Schädler, Stefan A1 - Voigt, Karen A1 - Müller, Martin A1 - Bauer, Petra T1 - Handlungsempfehlung zur evidenzbasierten physiotherapeutischen Versorgung von Patient*innen mit Schwindel- und/oder Gleichgewichtsstörungen im Rahmen eines Versorgungspfades in der Primärversorgung T2 - 6. Forschungssymposium der Deutschen Gesellschaft für Physiotherapiewissenschaft (DGPTW) KW - Gleichgewichtsstörung KW - Schwindel KW - Physiotherapie KW - Handlungsempfehlung KW - Versorgungspfad KW - Primärversorgung Y1 - 2022 ER - TY - CHAP A1 - Borchers, Peggy A1 - Petermann, Jenny A1 - Katzenberger, Benedikt A1 - Bauer, Petra A1 - Horstmannshoff, Caren A1 - Lechner, Theresia A1 - Müller, Martin A1 - Voigt, Karen T1 - Physiotherapie bei Schwindel und Gleichgewichtsstörungen: hausärztliche Verordnung und patientenseitige Inanspruchnahme (Ergebnisse aus der Kohortenstudie MobilE-TRA) T2 - Deutscher Kongress für Versorgungsforschung (DKVF) KW - Kohortenstudie KW - Schwindel KW - Physiotherapie KW - Leitlinie KW - Inanspruchnahme Y1 - 2022 UR - https://dx.doi.org/10.3205/22dkvf452 ER - TY - GEN A1 - Link, Friederike A1 - Horstmannshoff, Caren A1 - Müller, Martin A1 - Lüftl, Katharina ED - Lüftl, Katharina T1 - Zwischenergebnisse aus dem Projekt HiPo Health – High Potentials for Healthcare Studies. Vortrag beim Workshop „Partnerschaften zur Förderung von wissenschaftlichem Nachwuchs in der Pflege““. TH Rosenheim am 18.9.2020 KW - wissenschaftliche Karrieren in der Pflege Y1 - 2020 ER - TY - JOUR A1 - Borchers, Peggy A1 - Horstmannshoff, Caren A1 - Katzenberger, Benedict A1 - Petermann, Jenny A1 - Bauer, Petra A1 - Kiesel, Theresia A1 - Müller, Martin A1 - Sanftenberger, Linda A1 - Voigt, Karen T1 - Verordnung und Inanspruchnahme von Physiotherapie bei Schwindel und/oder Gleichgewichtsstörungen: Eine Sekundäranalyse aus der Kohortenstudie MobilE-TRA (Versorgungspfade und ihre Auswirkung auf Mobilität, soziale Teilhabe und Lebensqualität bei Schwindel und Gleichgewichtsstörungen sowie Gelenkerkrankungen) JF - Physioscience N2 - Hintergrund Schwindel und/oder Gleichgewichtsstörungen (S/G) sind komplexe Gesundheitsprobleme bei älteren Menschen und häufige Beratungsanlässe in der Hausarztpraxis. Physiotherapie kann einen positiven Einfluss auf das Gleichgewicht und Sturzrisiko bei Patient*innen mit S/G haben. In der S3-DEGAM-Leitlinie „Akuter Schwindel in der Hausarztpraxis“ werden Empfehlungen für Physiotherapie bei bestimmten Schwindeldiagnosen gegeben. Ob hausärztliche Physiotherapieverordnungen den Empfehlungen der Leitlinie entsprechen, ist nicht bekannt. Bisher liegen keine Daten vor, wie häufig diese Physiotherapieverordnungen tatsächlich durch Patient*innen in Anspruch genommen werden. Ziel Ermittlung von Anteil und Inanspruchnahme hausärztlich verordneter Physiotherapie bei älteren Patient*innen mit S/G innerhalb der Kohortenstudie MobilE-TRA und Untersuchung, ob diese den Empfehlungen der S3-DEGAM-Leitlinie entsprechen. Methode Die Sekundäranalyse beruht auf Daten der Kohortenstudie MobilE-TRA, in der Patient*innen ab 65 Jahren mit S/G in 17 Hausarztpraxen in Bayern und Sachsen befragt wurden. Die Datenerhebung fand von 09/2017–10/2019 statt. Die hausärztliche Verordnung und patientenseitige Inanspruchnahme von Physiotherapie wurden mittels validierten sowie selbstentwickelten Fragebögen erhoben. Die Daten wurden deskriptiv (Mittelwerte, Häufigkeiten) und Verteilungsunterschiede mittels exaktem Test nach Fisher analysiert. Ergebnisse Die Stichprobe umfasste 158 Patient*innen mit S/G. 16 % der Patient*innen hatten aufgrund von S/G Physiotherapie verordnet bekommen. Dabei entsprachen 14,2 % der Physiotherapieverordnungen den Empfehlungen der S3-DEGAM-Leitlinie. 32 % (Bayern 53,8 %; Sachsen 8,3 %) der Patient*innen hatten die Physiotherapie nicht in Anspruch genommen. Dabei lag ein signifikanter regionaler Verteilungsunterschied (p = 0,030; Phi = 0,487 [95 % KI = 0,129–0,846]) vor. Schlussfolgerung Mit 16 % ist die Häufigkeit hausärztlicher Physiotherapieverordnungen bei S/G in der Altersgruppe der über 65-Jährigen vergleichsweise hoch. Die Gründe für die Nichtinanspruchnahme wurden nicht erfasst, weshalb nur Vermutungen bezüglich des regionalen Unterschiedes angestellt werden konnten (z. B. Verfügbarkeit von Physiotherapie). Im Sinne der Planung einer adhärenten Therapie und zur Vermeidung von Versorgungsunterschieden scheint es sinnvoll, sich zukünftig auch mit Gründen einer Nichtinanspruchnahme von Therapien zu beschäftigen. KW - Kohortenstudie KW - Schwindel KW - Physiotherapie KW - Leitlinie KW - Inanspruchnahme Y1 - 2023 ER -