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 - 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 - 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 -