TY - CHAP A1 - Horstmannshoff, Caren A1 - Borchers, Peggy A1 - Voigt, Karen A1 - Müller, Martin A1 - Bauer, Petra ED - Deutsche Gesellschaft für Physiotherapiewissenschaft (DGPTW), T1 - Einfluss von Physiotherapie auf die subjektiv empfundene Beeinträchtigung von Mobilität und Teilhabe bei Menschen mit Schwindel und Gleichgewichtsstörungen: Eine Subgruppenanalyse in der Interventionsgruppe der clusterrandomisierten, kontrollierten Studie MobilE-PHY2 T2 - 8. Forschungssymposium Physiotherapie KW - Schwindel KW - Primärversorgung KW - Physiotherapie KW - RCT KW - Mobilität Y1 - 2024 ER - TY - GEN A1 - Pott, Claudia A1 - Leonhardt, Denise A1 - Fegl, Marlene A1 - Dreischulte, Tobias A1 - Koller, Daniela A1 - Bauer, Petra T1 - Ambulante Interprofessionelle Diagnostik der außerhäuslichen gehbezogenen Teilhabe von Personen nach einem Schlaganfall PARTICIPATE-MOB: Integratives Review N2 - Hintergrund: Nach einem Schlaganfall erleben viele Betroffene Einschränkungen bei der außerhäuslichen gehbezogenen Teilhabe [1, 2]. Diese erfordern eine umfassende und interprofessionelle Diagnostik, um Prognosestellung und Auswahl geeigneter restitutiver, kompensatorischer bzw. adaptiver Interventionen zu gewährleisten [3, 4]. Hierzu fehlen allerdings Empfehlungen. Ziel des Integrativen Reviews war die Exploration der ambulanten interprofesssionellen Diagnostik der außerhäuslichen gehbezogenen Teilhabe (iD-agT) als Konzept. Aufbauend auf den Ergebnissen sollen Handlungsempfehlungen formuliert und ein praxisnahes Toolkit im Rahmen einer Multi-Methods-Studie entwickelt werden (Abb. 1) [5]. Methoden: Es wurde ein Integratives Review [6] durchgeführt. Die Qualitätsbewertung erfolgte anhand des Mixed Methods [7], des Joanna Briggs Critical Appraisal Tools [8], der Critical Appraisal Skills Programme-Checkliste [9] und des Appraisal of Guidelines for Research & Evaluation [10]. Die Analyse der eingeschlossenen Artikel erfolgte in Anlehnung an die qualitative Inhaltsanalyse [11] und anhand der Modelle für "Interprofessionelle Zusammenarbeit" [12] und "Außerhäusliches Gehen" [13]. Ergebnisse: 8 Studien, 3 Reviews, 1 Meta-Ethnographie und 1 Leitlinie (N=13) (Qualität moderat/hoch) wurden eingeschlossen. Sie adressieren Zusammenhänge (Gehverhalten, Selbstwirksamkeit, Balance/Stürzen, Bewältigungsstrategien, Umweltfaktoren und Teilhabe); Orthesen-gestützte Rehabilitation; Beurteilungsinstrumente und Zugehörigenrolle. Problemlösestrategien und Performanz sollten im außerhäuslichen Real-Setting evaluiert werden. Interprofessionelle Zusammenarbeit wird kaum berichtet. Schlussfolgerung: Ambulante iD-agT erfordert ein gemeinsames Konzeptverständnis, teambasierte Teilhabe-Definition, die Integration von Assessments verhaltensbezogener Faktoren und digitale Messungen. Literatur: [1] doi:10.1080/09593985.2019.1698085 [2] doi:10.1177/0269215507081922 [3] doi:10.1177/1747493019897847 [4] doi:10.1177/17474930231205207 [5] doi:10.1136/bmjopen-2024-084316 [6] doi:10.1177/1094428120935507 [7] doi:10.1016/j.jclinepi.2019.03.008 [8] Joanna Briggs Institut. JBI Critical Appraisal Tool - Checklist for systematic Reviews and Reasearch Syntheses. Im Internet: https://jbi.global/sites/default/files/2019-05/JBI_Critical_Appraisal-Checklist_for_Systematic_Reviews2017_0.pdf; Stand: 01.08.2024 [9] Critical Appraisal Skills Programme. Qualitative Studies Checklist. Im Internet: https://casp-uk.net/casp-tools-checklists/qualitative-studies-checklist/; Stand: 01.06.2025 [10] AGREE Next Steps Consortium. The AGREE II Instrument. Im Internet: www.agreetrust.org; Stand: 01.09.2024 [11] Mayring P. Qualitative Inhaltsanalyse. Grundlagen und Techniken. 13. Aufl. Weinheim: Beltz; 2022 [12] doi:10.1080/13561820500082677 [13] doi:10.1186/s12883-016-0656-6 KW - interprofessionelle Diagnostik KW - Teilhabe Y1 - 2026 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 - 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 - 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 - GEN A1 - Seckler, Eva A1 - Kronast, Verena A1 - Bauer, Petra A1 - Müller, Martin T1 - Development and feasibility of a multi-disciplinary care pathway in primary care to improve mobility and participation of older individuals with vertigo, dizziness and balance disorders Y1 - 2026 ER - TY - GEN A1 - Germann, Eva A1 - Regauer, Verena A1 - Bauer, Petra A1 - Müller, Martin T1 - Development of multi-disciplinary care pathways in primary care to improve mobility and participation of older patients with vertigo, dizziness and balance disorders. Y1 - 2018 ER - TY - GEN A1 - Kronast, Verena A1 - Seckler, Eva A1 - Müller, Martin A1 - Bauer, Petra T1 - Physical therapy interventions for older people with vertigo, dizziness and balance disorders adressing mobility and participation: a rapid review KW - VDB, mobility, participation Y1 - 2019 ER - TY - JOUR A1 - Hösl, Matthias A1 - Schupfinger, Alexander A1 - Klich, Luisa A1 - Geest, Linda A1 - Bauer, Petra A1 - V. Bonfert, Michaela A1 - Afifi, Faik K. A1 - Nader, Sean A1 - Berweck, Steffen T1 - Relationship between kinematic gait quality and caregiver-reported everyday mobility in children and youth with spastic Cerebral Palsy JF - European Journal of Paediatric Neurology N2 - Background: 3D gait analysis (3DGA) is a common assessment in Cerebral Palsy (CP) to quantify the extent of movement abnormalities. Yet, 3DGA is performed in laboratories and may thus be of debatable significance to everyday life. Aim The aim was to assess the relationship between kinematic gait abnormality and everyday mobility in ambulatory children and youth with spastic CP. Methods: 73 paediatric and juvenile patients with uni- or bilateral spastic CP (N = 21 USCP, N = 52, BSCP, age: 4–20 y, GMFCS I-III) underwent a 3DGA, while the MobQues47 Questionnaire quantified caregiver-reported mobility. We calculated the Gait Profile Score (GPS), a metric that summarizes how far the lower limb joint angles during walking deviate from those of matched controls. Results: The GPS correlated well with indoor and outdoor mobility (rho = −0.69 and −0.70, both p < 0.001) and the relationships were not significantly different for USCP and BSCP. Still, mobility was lower in BSCP (p < 0.001) and more compromised outdoors (p = 0.002). Indoor mobility could be predicted by walking speed, GPS and age (adj. R2 = 0.62). Outdoor mobility was best predicted by walking speed and GPS (adj. R2 = 0.60). The additive explained variance by the GPS was even higher outdoors than indoors (17.1% vs. 11.4%). Conclusions: Measuring movement deviations with 3DGA seems equally meaningful in uni- and bilaterally affected children and has considerable relevance for real-life ambulation, particurlarly outdoors, where children with spastic CP typically face greater difficulties. Therapeutic strategies that achieve faster walking and reduction of kinematic deviations may increase outdoor mobility. KW - Cerebral palsy KW - Mobility KW - Gait analysis KW - Gait profile score Y1 - 2023 UR - https://doi.org/10.1016/j.ejpn.2022.11.009 VL - 42 SP - 88 EP - 96 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 -