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  • Rehabilitation
  • Springer  (161)
  • Sage Publications  (5)
  • German Medical Science; Düsseldorf, Köln  (2)
  • Hindawi  (2)
  • American Institute of Physics (AIP)
  • 1
    Keywords: Medicine ; Human Physiology ; Neurosciences ; Pathology ; Rehabilitation ; Sports Medicine ; Biomedicine ; Neurosciences ; Human Physiology ; Pathology ; Sports Medicine ; Rehabilitation ; Biomedicine general ; Springer eBooks
    Description / Table of Contents: Historical perspectives in understanding traumatic brain injury and in situating disruption in CBF in the pathotrajectory of head trauma -- Situating Cerebral Blood Flow in the Pathotrajectory of Head Trauma -- Modeling of traumatic brain injury and its implications in studying the pathology of repeated mild impacts to the head -- The presence of venous damage and microbleeds in traumatic brain injury and the potential future role of angiographic and perfusion magnetic resonance imaging -- Situating the Endothelin System in the pathotrajectory of TBI-induced changes in haemodynamics -- Age and Sex Differences in Cerebral Blood Flow and Autoregulation after Pediatric Traumatic Brain Injury -- New Frontiers in Clinical Trials Aimed at Improving Outcome Following Traumatic Brain Injury
    Abstract: 〈p〉Traumatic brain injury (TBI) has caught the ear of the general public in the last few years in the context of injuries seen both in athletes and the military.℗ Despite TBI being situated as a critical problem in society for multiple decades, the underlying pathotrajectory of TBI has only recently been truly appreciated.℗ Only recently has TBI research begun to develop better models of TBI that more closely recapitulate the human condition, make new advances in our ability to image pathophysiological sequelae in the brain following TBI, place a greater emphasis on studying the vascular dysfunction that accompanies head trauma, and, very recently, explore a new understanding of how age and sex can alter outcome to brain injury.〈/p〉〈p〉While this book was developed to satisfy a wide audience, from patient to caregiver, basic scientist to clinical scientist, the overall goal is to present the most current information known about head trauma and to expose areas where we may be deficient in understanding the nuances of TBI.℗ ℗ In particular, focus will be placed on the largest gap in our knowledg途the influence of cerebral blood flow (CBF) and metabolism in outcome following injury. This volume explores such varied concepts as the influence of CBF in the pathotrajectory of TBI, modeling TBI as a means to understand underlying pathological states associated with brain injury victims, disrupted vasculature following head trauma and advanced imaging techniques, vasoreactive substances underlying disrupted blood flow, the role of age and sex on injury outcome, and the latest pre-clinical rationale for focusing on CBF and strategies to improve blood flow as a means to improve outcome in patients suffering the effects of TBI.℗ Taken together, the information contained in ́€œCerebral Blood Flow, Metabolism, and Head Traumဝ is designed to both educate and illuminate anyone associated with TBI, with the hopes of stimulating future research.〈/p〉
    Pages: : digital.
    ISBN: 9781461441489
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  • 2
    Keywords: Medicine ; Neurology ; Pain Medicine ; Rehabilitation ; Psychology, clinical ; Medicine & Public Health ; Pain Medicine ; Health Psychology ; Rehabilitation ; Neurology ; Springer eBooks
    ISBN: 9781441916518
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  • 3
    Keywords: Medicine ; Human Physiology ; Neurosciences ; Neurology ; Rehabilitation ; Biomedicine ; Neurosciences ; Human Physiology ; Neurology ; Rehabilitation Medicine ; Springer eBooks
    Description / Table of Contents: Modulation of motor cortical connections through timed stimulation: animal studies -- Connection between premotor and motor cortices in primates -- Excitability of intracortical circuits in the primary motor cortex -- Effects of cortical stimulation on cortical functional connectivity: Imaging studies -- Accessing cortical connectivity using TMS -- Connections between cortical areas during grasping and modulation by brain stimulation -- Modulation of functional connectivity with transcranial direct current stimulation -- Cortical connections to motor cortex and their modulation in behavioural tasks (e.g. posterior parietal cortex, premotor cortex) -- The functional role of interhemispheric interactions in human motor control -- Functional modulation of primary motor cortex during action selection -- Enhancement of normal cortical functions through brain stimulation -- Movement disorders -- Stroke -- Multiple sclerosis -- Spinal cord injury -- Psychiatric diseases
    Abstract: 〈p〉The study and modulation of cortical connections is a rapidly growing area in neuroscience.℗ This unique book by prominent researchers in the field covers recent advances in this area.℗ The first section of the book describes studies of cortical connections, modulation of cortical connectivity and changes in cortical connections with activities such as motor learning and grasping in primates. ℗ The second section covers the use of non-invasive brain stimulation to study and modulate cortical connectivity in humans.℗ The last section describes changes in brain connectivity in neurological and psychiatric diseases, and potential new treatments that manipulate brain connectivity.℗ This book provides an up-to-date view of the study of cortical connectivity, and covers its role in both fundamental neuroscience and potential clinical applications.〈/p〉
    Pages: VIII, 365 p. 63 illus., 37 illus. in color. : digital.
    ISBN: 9783642327674
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  • 4
    Keywords: Medicine ; Orthopedics ; Orthopedic surgery ; Rehabilitation ; Sports Medicine ; Endoscopic surgery ; Medicine & Public Health ; Surgical Orthopedics ; Sports Medicine ; Orthopedics ; Conservative Orthopedics ; Rehabilitation Medicine ; Minimally Invasive Surgery ; Springer eBooks
    Pages: : digital
    ISBN: 9780857296092
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  • 5
    Keywords: Medicine ; Rehabilitation ; Medicine & Public Health ; Rehabilitation ; Rehabilitation Medicine ; Springer eBooks
    Description / Table of Contents: 〈p〉Pr©♭face -- Imagerie IRM du plexus brachial normale et pathologique -- M©♭thodes d€™éxploration ©♭lectrophysiologique du plexus brachial -- Nouvelles ©♭chelles d́€™©♭valuation clinique des atteintes du syst©·me nerveux p©♭riph©♭rique -- Paralysie traumatique du plexus brachial de l€™ádulte℗ : prise en charge chirurgicale initiale -- Paralysie du plexus brachial obst©♭trical. Actualit©♭s et perspectives -- Chirurgie palliative dans les s©♭quelles de l©♭sions du plexus brachial chez l€™ádulte -- Faisabilit©♭ de l€™éxploration du d©♭fil©♭ cervico-thoracobrachial sous endoscopie℗ : ©♭tude cadav©♭rique -- Prise en charge r©♭©♭ducative. Quoi de neuf℗ ? -- L€™áppareillage dans les l©♭sions du plexus brachial de l€™ádulte -- Traitement du d©♭s©♭quilibre musculaire du plexus brachial -- Prise en charge de la douleur dans les l©♭sions du plexus brachial -- Particularit©♭s de l€™éxpertise dans les suites d€™úne atteinte traumatique du plexus brachial.〈/p〉
    Abstract: 〈p〉Cet ouvrage traite de la prise en charge des traumatismes du plexus brachial chez l€™ádulte et l€™énfant. Les auteurs font une mise © jour des m©♭thodes actuelles d́€™©♭valuation clinique, iconographique et ©♭lectrophysiologique ainsi que des techniques chirurgicales pr©♭conis©♭es en fonction du stade et du type de l©♭sion. 〈/p〉〈p〉℗ 〈/p〉〈p〉Les traitements ©♭voluent ; les proc©♭dures de r©♭©♭ducation, d€™áppareillage et de prise en charge de la douleur sont ©♭troitement li©♭es au traitement chirurgical. Les d©♭marches r©♭adaptatives et r©♭paratrices sont ©♭labor©♭es en fonction du projet de vie du patient.〈/p〉〈p〉℗ 〈/p〉〈p〉Cet ouvrage s€™ádresse aux praticiens chirurgiens, m©♭decins ou param©♭dicaux qui souhaitent mettre © jour leurs connaissances dans ce domaine.〈/p〉
    ISBN: 9782817803340
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  • 6
    Keywords: Medicine ; Dermatology ; Rehabilitation ; Surgery ; Medicine & Public Health ; Surgery ; Plastic Surgery ; Dermatology ; Rehabilitation ; Springer eBooks
    Pages: : digital.
    ISBN: 9783709103159
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  • 7
    Keywords: Medicine ; Neurology ; Pain Medicine ; Rehabilitation ; Medicine & Public Health ; Neurology ; Rehabilitation ; Pain Medicine ; Springer eBooks
    Pages: : digital.
    ISBN: 9788847024632
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  • 8
    Keywords: Medicine ; Maternal and infant welfare ; Rehabilitation ; Early childhood education ; Social work ; Developmental psychology ; Medicine & Public Health ; Maternal and Child Health ; Child and School Psychology ; Childhood Education ; Rehabilitation ; Social work ; Springer eBooks
    Pages: : digital.
    ISBN: 9781461423355
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  • 9
    Keywords: Medicine ; Anesthesiology ; Rehabilitation ; Surgery ; Medicine & Public Health ; Plastic Surgery ; Surgery ; Rehabilitation ; Anesthesiology ; Oral and Maxillofacial Surgery ; Springer eBooks
    Pages: : digital
    ISBN: 9781848821163
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  • 10
    Keywords: Medicine ; Human Physiology ; Orthopedics ; Rehabilitation ; Sports Medicine ; Medicine & Public Health ; Sports Medicine ; Orthopedics ; Human Physiology ; Rehabilitation ; Springer eBooks
    Edition: 3rd ed. 2012.
    ISBN: 9781461411505
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  • 11
    Keywords: Medicine ; Neurology ; Physical Therapy ; Rehabilitation ; Medicine & Public Health ; Neurology ; Rehabilitation Medicine ; Physiotherapy ; Springer eBooks
    Pages: : digital
    Edition: 2012.
    ISBN: 9781447122777
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  • 12
    Keywords: Medicine ; Radiology, Medical ; Orthopedics ; Orthopedic surgery ; Rehabilitation ; Physical Therapy ; Sports Medicine ; Medicine & Public Health ; Surgical Orthopedics ; Orthopedics ; Sports Medicine ; Imaging / Radiology ; Rehabilitation ; Physiotherapy ; Springer eBooks
    Pages: : digital
    ISBN: 9783642227691
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  • 13
    Keywords: Medicine ; Radiology, Medical ; Internal Medicine ; Neurology ; Neurosurgery ; Psychiatry ; Rehabilitation ; Medicine & Public Health ; Neurology ; Rehabilitation ; Internal Medicine ; Neurosurgery ; Psychiatry ; Neuroradiology ; Springer eBooks
    Pages: : digital.
    ISBN: 9781447124405
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  • 14
    Unknown
    London : Springer
    Keywords: Medicine ; Internal Medicine ; Physical Therapy ; Rehabilitation ; Rheumatology ; Medicine & Public Health ; Rheumatology ; Internal Medicine ; Physiotherapy ; Rehabilitation Medicine ; Springer eBooks
    Pages: : digital
    ISBN: 9781848820937
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  • 15
    Keywords: Medicine ; Neurosciences ; Anesthesiology ; Critical care medicine ; Neurology ; Neurosurgery ; Rehabilitation ; Medicine & Public Health ; Neurology ; Neurosurgery ; Anesthesiology ; Intensive / Critical Care Medicine ; Rehabilitation Medicine ; Neurosciences ; Springer eBooks
    Pages: XVI, 170 p. : digital.
    ISBN: 9782817801278
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  • 16
    Keywords: Medicine ; Gynecology ; Neurology ; Rehabilitation ; Urology ; Medicine & Public Health ; Urology/Andrology ; Gynecology ; Neurology ; Rehabilitation Medicine ; Springer eBooks
    Pages: : digital
    ISBN: 9783642035807
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  • 17
    Keywords: Medicine ; Orthopedics ; Rehabilitation ; Sports Medicine ; Medicine & Public Health ; Orthopedics ; Sports Medicine ; Rehabilitation ; Springer eBooks
    Pages: : digital
    ISBN: 9788847017023
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  • 18
    Unknown
    London : Springer
    Keywords: Medicine ; Internal Medicine ; Cardiology ; Rehabilitation ; Heart / Surgery ; Medicine & Public Health ; Cardiology ; Rehabilitation ; Cardiac Surgery ; Internal Medicine ; Springer eBooks
    Pages: : digital
    ISBN: 9781848827943
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  • 19
    Keywords: Medicine ; Neurology ; Rehabilitation ; Medicine & Public Health ; Rehabilitation Medicine ; Neurology ; Springer eBooks
    Pages: : digital
    ISBN: 9782817802206
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  • 20
    Keywords: Medicine ; Radiology, Medical ; Radiotherapy ; Oncology ; Head / surgery ; Rehabilitation ; Medicine & Public Health ; Radiotherapy ; Oncology ; Imaging / Radiology ; Head and Neck Surgery ; Rehabilitation ; Springer eBooks
    Pages: : digital
    ISBN: 9788847018068
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  • 21
    Keywords: Medicine ; Radiology, Medical ; Radiotherapy ; Oncology ; Cancer / Surgery ; Psychotherapy ; Rehabilitation ; Medicine & Public Health ; Oncology ; Surgical Oncology ; Imaging / Radiology ; Radiotherapy ; Rehabilitation ; Psychotherapy ; Springer eBooks
    ISBN: 9782817802251
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  • 22
    Keywords: Medicine ; Orthopedics ; Rehabilitation ; Medicine & Public Health ; Orthopedics ; Rehabilitation ; Medicine/Public Health, general ; Springer eBooks
    Pages: : digital
    ISBN: 9783642171772
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  • 23
    Keywords: Medicine ; Nursing ; Otorhinolaryngology ; Rehabilitation ; Speech pathology ; Applied psychology ; Medicine & Public Health ; Speech pathology ; Otorhinolaryngology ; Nursing ; Rehabilitation ; Psychotherapy and Counseling ; Education (general) ; Springer eBooks
    Pages: : digital
    ISBN: 9788847018037
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  • 24
    Keywords: Medicine ; Emergency Medicine ; Critical care medicine ; Pneumology ; Neurology ; Rehabilitation ; Medicine & Public Health ; Pneumology/Respiratory System ; Intensive / Critical Care Medicine ; Emergency Medicine ; Rehabilitation Medicine ; Neurology ; Springer eBooks
    Pages: : digital
    ISBN: 9788847015487
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  • 25
    Keywords: Medicine ; Rehabilitation ; Speech pathology ; Curriculum planning ; Medicine & Public Health ; Rehabilitation Medicine ; Speech pathology ; Curriculum Studies ; Springer eBooks
    Pages: : digital
    ISBN: 9788847014152
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  • 26
    Keywords: Medicine ; Neurology ; Orthopedics ; Rehabilitation ; Medicine & Public Health ; Rehabilitation ; Orthopedics ; Neurology ; Springer eBooks
    Pages: : digital
    ISBN: 9788847014787
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  • 27
    Keywords: Medicine ; Rehabilitation ; Psychology, clinical ; Medicine & Public Health ; Rehabilitation ; Neuropsychology ; Springer eBooks
    Pages: : digital
    ISBN: 9782817800349
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  • 28
    Keywords: Medicine ; Orthopedics ; Orthopedic surgery ; Rehabilitation ; Medicine & Public Health ; Orthopedics ; Surgical Orthopedics ; Rehabilitation Medicine ; Springer eBooks
    Pages: : digital
    ISBN: 9783642008979
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  • 29
    Keywords: Medicine ; Family medicine ; Radiology, Medical ; Neurology ; Rehabilitation ; Medicine & Public Health ; General Practice / Family Medicine ; Neurology ; Neuroradiology ; Rehabilitation Medicine ; Springer eBooks
    Pages: : digital
    ISBN: 9782817800417
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  • 30
    Keywords: Medicine ; Oncology ; Rehabilitation ; Quality of Life ; Quality of Life / Research ; Medicine & Public Health ; Oncology ; Rehabilitation Medicine ; Quality of Life Research ; Springer eBooks
    Pages: : digital
    ISBN: 9782287795015
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  • 31
    Keywords: Medicine ; Pediatrics ; Rehabilitation ; Psychology, clinical ; Developmental psychology ; Medicine & Public Health ; Rehabilitation Medicine ; Neuropsychology ; Developmental psychology ; Clinical Psychology ; Pediatrics ; Springer eBooks
    Pages: : digital
    ISBN: 9788847015753
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  • 32
    Keywords: Medicine ; Orthopedic surgery ; Rehabilitation ; Sports Medicine ; Trauma ; Medicine & Public Health ; Sports Medicine ; Surgical Orthopedics ; Traumatic Surgery ; Rehabilitation ; Medicine/Public Health, general ; Springer eBooks
    Pages: : digital
    ISBN: 9782817800073
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  • 33
    Keywords: Medicine ; Neurology ; Rehabilitation ; Medicine & Public Health ; Rehabilitation Medicine ; Neurology ; Springer eBooks
    Pages: : digital
    ISBN: 9782817801094
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  • 34
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    German Medical Science; Düsseldorf, Köln
    In:  15. Jahrestagung der Deutschen Gesellschaft für Thoraxchirurgie; 20060427-20060429; Weimar; DOC06dgt51 /20060426/
    Publication Date: 2006-04-27
    Keywords: Trichterbrust ; Thorakoplastik ; NUSS ; Analgesiekonzept ; Rehabilitation ; ddc: 610
    Language: German
    Type: conferenceObject
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  • 35
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    Unknown
    German Medical Science; Düsseldorf, Köln
    In:  15. Jahrestagung der Deutschen Gesellschaft für Thoraxchirurgie; 20060427-20060429; Weimar; DOC06dgt50 /20060426/
    Publication Date: 2006-04-27
    Keywords: Fast-Track ; Rehabilitation ; Thoraxchirurgie ; ddc: 610
    Language: German
    Type: conferenceObject
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  • 36
    Electronic Resource
    Electronic Resource
    Springer
    Der Gynäkologe 33 (2000), S. 494-502 
    ISSN: 1433-0393
    Keywords: Schlüsselwörter Mammakarzinom ; Zervixkarzinom ; Korpuskarzinom ; Ovarialkarzinom ; Rehabilitation ; Keywords Oncology ; Rehabilitation ; Gynaecological carcinomas ; Physiotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract In Germany about 41% of malignant neoplasies of women are carcinomas of mamma, cervix, Corpus uteri and ovary. Therapy of these malignomas consists of surgery, radio-, chemo- or hormonotherapy. Apart from therapeutic effects primary therapy may have negative effects in different physical, psychical and social aspects. These side effects are the concern of stationary oncological rehabilitation. Interdisciplinary cooperation makes it possible to consider the individual requirements of the patient.
    Notes: Zusammenfassung In Deutschland machen das Mamma-, Zervix-, Korpus- und Ovarialkarzinom ca. 41% der malignen Neoplasien bei der Frau aus. Die Behandlung dieser Malignome beinhaltet Operation, Strahlen-, Chemo- oder Hormontherapie. Neben der therapeutischen Wirkung kann es bei den Patientinnen durch die Primärbehandlung auch zu unterschiedlich ausgeprägten Beeinträchtigungen im physischen, psychischen oder sozialen Bereich kommen. An dieser Stelle greift die stationäre onkologische Rehabilitation an, die in interdisziplinärer Zusammenarbeit die individuellen Bedürfnisse der Patientinnen berücksichtigt.
    Type of Medium: Electronic Resource
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  • 37
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Schizophrenie ; Kognitive Therapie ; Kognitive Funktionsstörungen ; Strategieaufbau ; Bewältigung ; Key words Schizophrenia ; Information processing ; Cognitive therapy ; Strategy building ; Rehabilitation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary A critical review of current approaches and principles of cognitive remediation strategies in rehabilitation of schizophrenia is given. Selection of cognitive functions targeted in compensatory training programs could be based on results of neuropsychological predictor research on social and vocational functioning in community and neuropsychological rate limiting factors in rehabilitation. Methodological flaws in data base, missing of task analysis of more complex skills like social perception, social skills and interpersonal problem solving and the lack of evaluation of training generalization on work performance are discussed. Finally the cognitive remediation program developed in the Department of General Psychiatry and Psychotherapy/University of Freiburg, Germany is proposed. The components focused on training in attention, memory, and executive function (decision making, planning). Compensatory strategy building, and computer-mediated automatization are integrated in a group settting.
    Notes: Zusammenfassung In dieser Übersicht werden die aktuellen Trainingsverfahren der spezifischen Rehabilitation kognitiver Funktionsstörungen schizophrener Patienten sowie Kriterien für die Auswahl der Trainingsziele dargestellt. Neuere Arbeiten zur differentiellen Bedeutung für die Prädiktion sozialen und beruflichen Funktionsniveaus sowie für das Rehabilitationspotential können gegenwärtig die Auswahl kognitiver Trainingsziele empirisch legitimieren. Die aktuelle empirische Befundlage wird kritisch diskutiert: fehlende Analyse des kognitiven Anforderungsprofils sozialen und beruflichen Funktionierens, sozialer Wahrnehmung, interpersonellen Problemlösens (task analysis); mangelndes Wissen über Transfervoraussetzungen und ihre Wirkmechanismen sowie über setting-Aspekte, fehlende Regeln für eine Integration in einen verhaltenstherapeutischen Gesamtbehandlungsplan; methodische Mängel: Einfluss von Testwiederholungseffekten, zu kleine Stichproben (power-Defizite: Übersehen statistisch signifikanter Effekte), fehlende a-Adjustierung trotz multiplen Testens und unzureichender Einbezug der Effektgeneralisierung auf rehabilitativ bedeutsame Alltagskontexte. Abschließend wird ein computerunterstütztes Bewältigungstraining in der Gruppe zur Ausweitung des Rehabilitationspotentials vorgestellt, das an der Psychiatrischen Univ.-Klinik Freiburg entwickelt und gegenwärtig an der Abteilung für Klinische und Sozialpsychiatrie, Klinikum Karlsbad Langensteinbach (Ltd. Arzt: Dr. M. Clauß) erprobt wird. Das Training ist strategieorientiert und fokussiert die Bereiche Aufmerksamkeit, verbales Kurz- und Langzeitgedächtnis sowie Handlungsplanung und -organisation/exekutive Funktionen.
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  • 38
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Stroke Unit ; Schlaganfalltherapie ; Frührehabilitation ; Integratives Behandlungskonzept ; Keywords Stroke Unit ; Acute treatment ; Rehabilitation ; Integrative treatment concept
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract The experiences of a rural stroke unit since 1997 are reported. A special referral concept was developed with the emergency services and hospitals of the region. As a result, 35% of patients arrived in the stroke unit within 3 hours after onset of stroke symptoms. This corresponds with the data from larger cities. The major peculiarity of the Günzburg Stroke Unit is that, after emergency diagnostic and therapeutic procedures, 41% of the patients with mainly internistic problems were transferred to another regional hospital and only 40% were admitted to the inpatient stroke unit. Moreover, among these were an above-average proportion of patients with intracerebral hemorrhage (24% of the inpatients in 1998), and complete acute treatment and rehabilitation were carried out in the same hospital according to an integrative treatment concept. Since 1997, the average hospitalization duration decreased from 11.4 days to 5.9 days and the number of patients per month increased to an average of 22.3. The total hospitalization duration – including inpatient rehabilitation – was 33.9 days. All in all, a comparably good stroke treatment thus is possible outside urban regions.
    Notes: Zusammenfassung Die Erfahrungen einer seit 1997 bestehenden Stroke Unit im überwiegend ländlichen Raum werden berichtet. Im Rahmen eines speziellen Zuweisungskonzeptes erreichten 35% der Patienten die Klinik innerhalb von 3 h nach Symptombeginn, was den Angaben aus Ballungszentren entspricht. Wesentliche Besonderheit der Günzburger Stroke Unit ist, dass nach der “präklinischen” Notfalldiagnostik und -therapie 41% der Patienten mit im Vordergrund stehenden internistischen Problemen in die umliegenden Krankenhäuser eingewiesen und nur 40% auf der Stroke Unit aufgenommen wurden. Darüber hinaus wurden relativ viele Patienten mit intrazerebralen Blutungen (24% der stationären Patienten im Jahr 1998) versorgt, und entsprechend einem integrierten Konzept erfolgte die Akutversorgung und Frührehabilitation im Hause. Seit 1997 konnte die durchschnittliche Verweildauer auf der Stroke Unit von zunächst 11,4 auf 5,9 Tage verkürzt werden bei gleichzeitigem Anstieg der Fallzahl auf 22,3 Patienten/Monat. Die Gesamtverweildauer einschließlich Frührehabilitation lag bei 33,9 Tagen. Die Erfahrungen belegen, dass auch außerhalb von Ballungszentren eine gut vergleichbare Schlaganfallversorgung möglich ist.
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  • 39
    ISSN: 1433-7347
    Keywords: Key words Anterior cruciate ¶ligament ; Screening examination ; Rehabilitation ; Knee injuries
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: Abstract This report describes the development and current use of decision-making criteria for returning patients to high-level physical activity with nonoperative management of anterior cruciate ligament ruptures, and presents the results of treatment for patients who met our criteria as candidates for nonoperative rehabilitation and attempted to return to high-level physical activity with nonoperative management. The screening examination consists of four one-legged hop tests, the incidence of knee giving-way, a self-report functional survey, and a self-report global knee function rating. We screened 93 consecutive patients with acute unilateral anterior cruciate ligament rupture, classifying them as either candidates (n = 39, 42%) or noncandidates (n = 54, 58%) for nonoperative management. Of the 39 rehabilitation candidates 28 chose nonoperative management and returned to preinjury activity levels, 22 of whom (79%) returned to preinjury activity levels without further episodes of instability or a reduction in functional status. No patient sustained additional articular or meniscal damage as a result of rehabilitation or return to activity. The decision-making scheme described in this study shows promise in determining who can safely postpone surgical reconstruction and temporarily return to physically demanding activities. Continued study to refine and further validate the decision-making scheme is recommended.
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  • 40
    ISSN: 1433-7347
    Keywords: Key words Knee injury ; Patellar dislocation ; Isokinetic testing ; Muscle performance ; Rehabilitation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: Abstract Eighty-two patients (50 women, 32 men) underwent isokinetic muscle testing on average 13 years after a conservatively treated unilateral primary patellar dislocation. Three study groups were formed according to the natural history of recovery: group A (n = 32), patients with only primary conservative treatment; group B (n = 34) patients with conservative (group B1; ¶n = 24) or surgical (group B2; n = 10) treatment of redislocations; group C (n = 16) patients with other residual complaints (anterior knee, pain subluxations) requiring surgery. The Cybex 6000 dynamometer system was used as the testing machine for quadriceps and hamstrings muscles, with proportional deficits of peak torque as the test parameter. Isokinetic testing revealed both quadriceps and hamstring muscle atrophy even after long-term recovery from injury. There were statistically significant differences between the three study groups at both tested speeds of quadriceps muscles ¶(60 rad/s, P 〈 0.002; 180 rad/s, ¶P 〈 0.009). Groups B1 and B2 presented similar results. The muscle performance findings are probably due to more than one factor: primary immobilization, poor outcome, patellofemoral degeneration, redislocations, and residual knee complaints followed by surgery and deficiency in motor control of thigh muscle had – together or separately – an effect on muscle performance.
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  • 41
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Intensivmedizin ; Lebensqualität ; Polytrauma ; Langzeitergebnisse ; Rehabilitation ; Keywords Quality of life ; Intensive care ; Multiple trauma ; Long-term outcome ; Rehabilitation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Introduction. Long-term treatment in surgical intensive care units (SICU) subjects the patient to a high degree of somatic, psychological, and social stress. The aim of this study was to determine their outcome in terms of quality of life and health status. Methods. All patients from a 4-year period in a SICU with a length of stay (LOS) of 30 days or more were included. All survivors were interviewed and examined after 35±14 months; they also completed several questionnaires (Munich Inventory for Quality of Life and Health Status, POMS, and Spitzer Quality of Life Index). Results. One hundred one patients fulfilled the inclusion criteria, and 46 survived until follow-up. Forty-one (89%) could be traced and examined. Male:female ratio was 31:10, age 42±17 years, and LOS 51±19 days, Diagnoses on admittance were multiple trauma (n=32) and other (n=9). When classifying patients according to physical impairment, one third each showed no, mediocre, or severe limitations. Subjective appraisal of quality of life and well-being was sufficient for about half the patients in every test. Trauma victims experienced more severe impairment of quality of life. There were no differences between sex, age, or time until follow-up. Conclusion. After prolonged SICU treatment, about half of the patients report limitations in their quality of life as a result of their illness and the subsequent treatment. Some patients, in particular after trauma, exhibit striking psychosocial problems despite satisfactory somatic treatment results. These problems can be positively addressed in rehabilitative efforts.
    Notes: Zusammenfassung Fragestellung. Die Langzeitbehandlung auf Intensivstationen (ICU) bedeutet eine erhebliche somatische, psychische und soziale Belastung für die Patienten. Um die Ergebnisse im Langzeitverlauf beurteilen zu können, wurden nach der Entlassung Lebensqualität und Gesundheitszustand von Überlebenden untersucht. Methodik. Alle Patienten, die während eines 4 Jahres Zeitraumes auf einer operativen ICU mindestens 30 Tage in Behandlung gewesen waren, wurden in die Untersuchung eingeschlossen. Die Überlebenden wurden 35±14 Monate nach der Entlassung körperlich untersucht und ausführlich befragt. Zur Anwendung kamen außerdem Selbst- und Fremdbeurteilungsskalen (Münchner Inventar für Lebensqualität und Gesundheit, POMS, Spitzer Quality-of-life-Index). Ergebnisse. 101 Patienten wurden mindestens 30 Tage behandelt. Die Mortalität bis zur Nachuntersuchung betrug 55%. Von den 46 verbleibenden Patienten konnten 41 (89%) untersucht werden (m/w=31/10; Alter 41,6±17,2 Jahre; Liegedauer 51±19 Tage; Diagnosen: Trauma n=32, andere n=9). Je ein Drittel der Patienten zeigten keine, mittlere oder schwere körperliche Beeinträchtigungen. Lebensqualität und Gesundheit wurden von ca. der Hälfte, unabhängig vom Testverfahren, als zufriedenstellend beurteilt. Traumapatienten waren in allen Bereichen stärker belastet. Es zeigte sich keine Abhängigkeit von Alter, Geschlecht und Zeitraum bis zur Nachuntersuchung. Schlussfolgerungen. Patienten nach Langzeitintensivbehandlung weisen etwa zur Hälfte deutliche Einschränkungen ihrer Lebensqualität auch als Folge der Erkrankung oder Behandlung auf. Besonders Traumapatienten geben trotz somatisch zufriedenstellender Behandlungsergebnisse erhebliche Probleme im psychosozialen Bereich an, die rehabilitativen Maßnahmen zugänglich sind.
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  • 42
    ISSN: 1434-3924
    Keywords: Schlüsselwörter Vordere Kreuzbandruptur ; Lig.-patellae-Transplantat ; Rehabilitation ; Physiotherapie ; Krafttraining ; Keywords Anterior cruciate ligament ; Rehabilitation ; Physiotherapie ; Muscle strengthening
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: In a prospective randomized study, all 133 consecutive ACL ruptures, operated by two experienced surgeons in 1997, were assessed in terms of the benefit derived from four different rehabilitation programs. In all cases an arthroscopically assisted autogenous bone-patellar tendon–bone technique was used. The following four rehabilitation programs were compared: (1) a simple home-based program; (2) home-based program plus physiotherapy for a period of 12 weeks postoperatively; (3) home-based program plus a muscle strengthening program for a period of 3 months, starting 3 months postoperatively; and (4) home-based program plus physiotherapy plus muscle strengthening program (as detailed in 1 and 3 above). Clinical assessments and controls were conducted at 6 and 12 weeks. At 6 months, in addition, an isometric muscle strength measurement (MedX) concerning extension and flexion, comparing the affected leg with the unaffected leg, was applied. The results of these assessments are consistently the same in all four groups: 6 months postoperatively, loss of muscle strength in extension was 50%. No apparent benefit could be detected from either physiotherapy or muscle strengthening or from the combined application of those methods as compared to the home-based program. In conclusion, our investigation shows that a simple home program, supervised by the surgeon, leads to highly satisfactory results in virtually all cases.
    Notes: In einer prospektiven, randomisierten Studie wurden alle 133, während des Jahrs 1997 mittels autologem Lig.-patellae-Transplantat durch 2 erfahrene Chirurgen versorgten vorderen Kreuzbandrupturen in 4 verschieden intensive postoperative Rehabilitationsgruppen eingeteilt. Anhand von protokollierten Verlaufskontrollen nach 6 Wochen, 3 Monaten und 6 Monaten wurde die Effizienz der 4 Rehabilitationsprogramme überprüft. Zusätzlich zum einfachen, durch den Operateur kontrollierten Heimprogramm verordnete Physiotherapiesitzungen vermochten den Frühverlauf nicht zur verbessern. Vergleichende, isometrische Kraftmessungen des operierten gegenüber dem unverletzten Bein (MedX) zeigten in allen 4 Gruppen eine Kraftdifferenz von ungefähr 50% bezüglich der Extension nach 6 Monaten. Auch ein intensives Krafttraining im Zeitraum 3–6 Monate postoperativ vermochte das Kraftdefizit am operierten Bein nicht zu verkleinern. Aufgrund unserer Untersuchungsergebnisse von 4 verschiedenen Rehabilitationsprogrammen nach vorderer Kreuzbandrekonstruktion mit autologem Lig.-patellae-Transplantat, arthroskopisch assistiert, erachten wir in der Regel ein einfaches, vorzugsweise durch den Operateur kontrolliertes Nachbehandlungsschema, in Eigentherapie als Heimprogramm absolviert, zum fristgerechten Erreichen eines guten Operationsresultats für ausreichend.
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  • 43
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    Arthroskopie 13 (2000), S. 186-190 
    ISSN: 1434-3924
    Keywords: Schlüsselwörter Revisionseingriffe ; Rotatorenmanschettenläsion ; Ultraschall ; Rehabilitation ; Keywords Revision operations ; Rotator cuff tears ; Ultrasound ; Rehabilitation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Twenty-four consecutive patients (14 male, 10 female, average age 58 years, 40–73 years) were included in the study during their stationary rehabilitation program. They were examined clinically and by ultrasound an average of 32 days (18–50 days) after operation. Anamnestic and clinical findings did not reveal a clear suspicion of a re-tear. All of the patients showed considerable morphologic and structural sonographic alterations of the rotator cuff. Reliable sonographic signs concomitant with a tear were seen in 18 patients, in 16 cases within the supraspinous muscle. We found 8 type II, 11 type III, and 6 type IV images. Only two of the patients undergoing a revision operation due to a subcutaneous necrosis had changes of blood patterns. Whereas the sonographic criteria for primary tears of the rotator cuff are well defined, re-tears pose real diagnostic problems, especially in case of lack of an earlier postoperative control. Only the lack of sonographic imaging of the rotator cuff compared to earlier postoperative sonographic findings allows a reliable diagnosis of a re-tear, because other pathologic alterations of form and echogenicity are common preoperatively. Owing to this, we recommend an early postoperative ultrasound control as a basic finding, enabling a sufficient control in the further course of rehabilitation.
    Notes: In der Anschlussheilbehandlung nach Eingriffen an der Rotatorenmanschette wurden 24 konsekutive Patienten [14 Männer, 10 Frauen, Durchschnittsalter 58 Jahre (40– 73 Jahre)] durchschnittlich 32 Tage (18–50 Tage) postoperativ klinisch und sonographisch untersucht. Anamnestisch und klinisch waren keine eindeutigen Hinweise auf Rezidivläsionen zu finden. Alle Patienten zeigten erhebliche morphologische und strukturelle Ultraschallveränderungen der Rotatorenmanschette. Sichere sonographische Rupturzeichen fanden sich bei 18 Patienten, davon 16-mal im Bereich des M. supraspinatus. Typ-II-Bilder wurden 8-mal, Typ-III-Bilder 11-mal und Typ-IV-Bilder 6-mal gefunden. Nur jene 2 Patienten, die aufgrund einer subkutanen Nekrosebildung revidiert werden mussten, zeigten Auffälligkeiten der Laborwerte. Während die sonographischen Kriterien für die Diagnose einer primären Rotatorenmanschettenruptur klar definiert sind, stellen Rerupturen den Untersucher vor erhebliche Probleme, insbesondere, wenn frühere postoperative Vergleichsbefunde fehlen. Nur die im Vergleich zu Vorbefunden fehlende sonographische Darstellung der Rotatorenmanschette erlaubt die sichere Diagnose einer Reruptur, da in der Regel bereits präoperativ pathologische Veränderungen der Form und Echogenität der Rotatorenmanschette häufig sind. Daher ist eine frühe postoperative Ultraschalluntersuchung als Basisbefund zu empfehlen, um eine Verlaufskontrolle zu ermöglichen.
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  • 44
    ISSN: 1434-3924
    Keywords: Schlüsselwörter Knietrauma ; Propriozeption ; Neuromuskuläre Veränderungen ; Koordination ; Rehabilitation ; Keywords Knee trauma ; Proprioception ; Neuromuscular alterations ; Coordination ; Rehabilitation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Despite some alterations of receptor thresholds after knee trauma and surgical treatment joint receptors provide the prerequisites for correct proprioception. The peripheral afferent pathway, the spinal and central stimulus processing and the peripheral efferent pathway are intact. Alterated peripheral sensory perception is caused by the knee trauma induced change of proprioception. A reduction of absolute torque, active range of movement, modified muscle selection and delay in neuromuscular latency time are observed. Postoperative exercise should enable the patient to gather positive sensory experience enclose to activities of daily living.
    Notes: Nach Knietraumen und operativer Versorgung sind die Voraussetzungen zur korrekten Propriozeption gegeben. Der peripher-afferente Schenkel, die spinale und zentrale Reizverarbeitung sowie der peripher-efferente Schenkel sind nach Kniebinnentraumen und -operationen intakt. Veränderte peripher-sensorische Wahrnehmungen (Afferenzen) sind durch das Knietrauma bedingt. Es kommt zu einer Reduktion des absoluten Krafteinsatzes und der aktiven Beweglichkeit, zu einer Veränderung der Muskelselektion sowie zu Verlängerungen neuromuskulärer Reaktionszeiten. Postoperative Übungen müssen es dem Patienten ermöglichen, alltagsnahe positive sensorische Erfahrungen zu sammeln.
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  • 45
    ISSN: 1614-7456
    Keywords: Rehabilitation ; Robotics ; User interface ; Simulation ; Haptics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science
    Notes: Abstract Advances in software, computing, control architectures, and design practice have led to rehabilitation robots with high-bandwidth, bidirectional user interfaces that allow people to interact with mechatronic systems in highly realistic, cognitively and biomechanically coupled scenarios. Immersive and graphic interfaces to real-time systems such as robots require, robust control environments and high-speed computing to provide safe, human-scale motions and interfaces with sufficient quality to be usable in functional environments. This paper illustrates some emerging applications in rehabilitation, spanning assistive technology, simulation/design aids, and smart therapy devices. Examples will be drawn laregly from work done at the VA Palo Alto Rehabilitation R&D Center.
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  • 46
    ISSN: 1614-7456
    Keywords: Rehabilitation ; Robotics ; Independence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science
    Notes: Abstract The Handy 1 was developed in 1987 by Mike Topping to assist an 11-year-old boy with cerebral palsy to eat unaided. The system is the most successful low-cost, commercially available robotic system in the world to date, and is capable of assisting the most severely disabled with several everyday functions such as eating, drinking, washing, teeth-cleaning, shaving, and make-up application. This paper charts the development of the system, gives an overview of some individual Handy 1 studies, and also looks at the development of the robotic aid to independent living (RAIL) system funded by the European Commission BIOMED II program.
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  • 47
    ISSN: 0044-281X
    Keywords: Schlüsselwörter Neue Medien ; Telematik ; Tele-Reha ; Telemedizin ; Rehabilitation ; Geriatrie ; Altenhilfe ; Key words Telematics ; telerehabilitation ; telemedicine ; rehabilitation ; geriatrics ; health services for the aged
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Modern telecommunication technology (telematics) has the potential to improve the quality of life for elders with physical and mental impairments as well as for their care giving relatives. Videophones, internet resources, and multimedia computers can be used for networking them together with social workers, nurse practitioners, physicians and therapeutic staff in service-centers. This can be viewed as a unique opportunity to establish and maintain instant and personalized access to various medical services in a situation where increasing needs are opposed to decreasing resources. However, it is not yet clear whether telematics is adequate, efficient, and effective in supporting care for geriatric patients. Some studies already showed its applicability and feasibility, but there are still no larger trials showing that maintenance or enhancement of autonomy can be achieved effectively by using new technologies.    This article reviews the literature on telematics in geriatrics and presents data of a tele-rehabilitation project (“TeleReha”, conducted at the Berlin Geriatric Center) which comprised mobility-impaired patients (N=13, mean age 72 yrs), care giving relatives (N=8), and geriatric professionals. Networking was established using ISDN technology with videophones or PC-based videoconferencing systems. Results showed that participants regard telecommunication devices as a valuable resource for their informational and communicational needs. Use of telecommunication systems was inversely related to physical mobility. Having access to professional service and counselling was rated highly important but also the opportunity to establish reliable contacts with non-professionals (relatives, other participants). Despite experienced technical problems, use of telecommunication systems was evaluated more positively in the post-test as compared to the pre-test.    In summary, current experience suggests that telematics can be used efficiently by geriatric patients and by relatives and professionals caring for them. However, evidence for a medically and economically effective use is still scarce. A lack of structural and organizational concepts for geriatric telematics initiatives can be identified which in part may be due to the fact that the considerable potentials of telematics applications are still largely unrecognized by geriatricians.
    Notes: Zusammenfassung Die Darstellung der modernen Kommunikations- und Informationstechnologie in den Medien verspricht auch älteren Menschen eine Chance zur Verbesserung der Lebensqualität. Mit „Neuen Medien” wie Bildtelefon oder PC, dem Internet und der elektronischen Post können geriatrische Patienten mit Beratungseinrichtungen, Ärzten, Therapeuten oder Pflegekräften, aber auch ihren eigenen Angehörigen oder Selbsthilfeeinrichtungen so vernetzt werden, dass sie bildgestützt kommunizieren und Informationen elektronisch erhalten oder übermitteln können. In der vorliegenden Arbeit wird untersucht, ob Versorgungsstrukturen in der Altersmedizin und Altenhilfe durch moderne Informations- und Kommunikationstechnologie („Telematik”) sinnvoll ergänzt oder sogar substituiert werden können. Trotz einer Vielzahl von Untersuchungen zur Telemedizin und zu Telematikanwendungen existieren nur wenige Studien, die eine Eignung für geriatrisch-rehabilitative Belange belegen. Eigene Anwendungserfahrungen aus einem geriatrischen Telematik-Projekt („TeleReha”) am Evangelischen Geriatriezentrum Berlin, in dem geriatrische Patienten und deren Angehörige mit professionellen Kräften aus dem Geriatriezentrum unter der Maßgabe des Erhalts eines Rehabilitationserfolges vernetzt wurden, zeigen aber, dass Telematik-gestützte Dienste von geriatrischen Patienten und deren Angehörigen als eine wertvolle zusätzliche Ressource angesehen werden, wenn sie mit einem qualifizierten Dienstleistungskonzept einhergehen. Abschließend werden die Potentiale, aber auch die Probleme von Telematikanwendungen in der Geriatrie diskutiert. Obwohl sich ein Bedarf beim geriatrischen Klientel identifizieren lässt, fehlt es in der Geriatrie noch an Initiativen, die notwendigen Konzepte und tragfähige Strukturen zu entwickeln. Das beachtliche Potential der telematischen Anwendungen für Geriatrie und Altenhilfe wird noch zu wenig beachtet. Gerade die Geriatrie kann und muss hier ihre spezifische Expertise einbringen, über die andere Disziplinen nicht gleichermaßen verfügen.
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  • 48
    ISSN: 1615-6722
    Keywords: Schlüsselwörter Koronare Herzerkrankung ; Perkutane transluminale Koronarangioplastie (PTCA) ; Angina pectoris ; Lebensqualität ; Anschlußheilbehandlung ; Key words Coronary artery disease ; Percutaneous transluminal coronary angioplasty (PTCA) ; angina pectoris ; Quality of life ; Rehabilitation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Background: Quality control becomes increasingly important in interventional cardiology. Since in most health care systems, clinical treatment of patients who underwent percutaneous transluminal coronary angioplasty (PTCA) is left to general practitioners, important information on the clinical long-term outcome is lost for the cardiologic centers. Aim of this study was to evaluate the clinical status of these patients 4 years after treatment with a PTCA at our institution. Patients and Methods: Inclusion criterion was the treatment with a PTCA within July 1, 1989 to June 30, 1991 (549 Patients). A questionnaire was sent to all patients (45±7 months after PTCA). Four time-points were defined: before PTCA (T1), directly after PTCA (T2), 3 months after PTCA (T3) and actual status (T4). Results: Questionnaires of 500/549 (91,1%) patients could be analyzed. One-hundred and fifteen patients (23%) had to undergo reinterventions: 69 (13.8%) had a re-PTCA and 46 (9.2%) patients an operative revascularization. At T4, 11.2% patients still had disturbing angina. Within the study period 35 patients (7%) died. Two-hundred and nineteen patients attended a rehabilitation institution. At T4, the amount of patients with little angina was not different comparing patients with/without the attendance of a rehabilitation institution (60.7% vs 66.4% p = 0.29). The rate of new pensioners after PTCA (n = 114 [22.8%] was higher in the group of patients who attended a rehabilitation (68 patients [13.6%] with vs 48 patients [9.2%] without attendance, p = 0.0036). The attendance of a rehabilitation institution, however, had positive effects on changes of the life stile and eating habits. Conclusions: This retrospective inquiry was found to be a useful tool (response rate 91.1%) for quality control in interventional cardiology. Important information concerning the quality of the interventions (low reintervention rate) and the long-term outcome of our patients (low rate with severe angina at T4) could be aquired.
    Notes: Zusammenfassung Hintergrund: Die Qualitätskontrolle gewinnt in der interventionellen Kardiologie zunehmend an Bedeutung. Da aber die Nachbetreuung von Patienten, die mit einer perkutanen transluminalen Koronarangioplastie (PTCA) behandelt wurden, meist durch die jeweiligen Hausärzte durchgeführt wird, gehen dem kardiologischen Zentrum wichtige Informationen hinsichtlich des klinischen Langzeitverlaufs verloren. Ziel dieser retrospektiven Studie war daher, den klinischen Status dieser Patienten vier Jahre nach der Behandlung mit einer PTCA an unserer Institution zu untersuchen. Patienten und Methode: Einschlußkriterium war die Behandlung mit einer PTCA im Zeitraum vom 1.7.1989 bis 30.6.1991 (549 Patienten). Zur Erhebung der Langzeitergebnisse (45±7 Monate nach PTCA) wurde den Patienten ein Fragebogen zugesandt. Vier Erhebungszeitpunkte wurden definiert: vor PTCA (T1), direkt nach PTCA (T2), drei Monate nach PTCA (T3) und zum Erhebungszeitpunkt (T4). Ergebnisse: Fragebögen von 500/549 (91,1%) Patienten kamen zur Auswertung. 115 (23%) Patienten mußten sich einer Reintervention unterziehen (PTCA: 69 Patienten [13,8%], aortokoronare Venen-Bypass-(ACVB-)Operation: 46 Patienten [9,2%]). Zu T4 hatten 11,2% Patienten stärkere Angina-pectoris-Beschwerden. 35 Patienten (7%) waren im Erhebungszeitraum verstorben. 219 Patienten (52%) nahmen an einer Anschlußheilbehandlung teil. Zu T4 waren diese Patienten nicht häufiger beschwerdefrei als Patienten ohne Anschlußheilbehandlung (60,7% vs. 66,4%, p = 0,29). Der Anteil der nach Intervention neu berenteten Patienten (n = 114 [22,8%] war in der Gruppe mit Anschlußheilbehandlung höher (68 Patienten [13,6%] mit Anschlußheilbehandlung vs. 46 Patienten [9,2%] ohne Anschlußheilbehandlung, p = 0,0036). Positiven Einfluß hatte die Teilnahme an einer Anschlußheilbehandlung auf Änderungen des Lebensstils und der Eßgewohnheiten. Schlußfolgerung: Diese retrospektive Befragung erwies sich als sinnvoll (Antwortrate 91,1%), um Daten zur Qualitätskontrolle zu erheben. Wichtige Informationen sowohl hinsichtlich der Qualität der Koronarinterventionen (niedrige Reinterventionsrate) als auch hinsichtlich des klinischen Langzeitverlaufs (niedriger Anteil von Patienten mit schwerer Symptomatik nach vier Jahren) konnten hierdurch gewonnen werden.
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  • 49
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    International urology and nephrology 32 (2000), S. 137-146 
    ISSN: 1573-2584
    Keywords: Aging ; Demography ; Chronic disease ; Old age ; Health care expenditures ; Medicare ; Long-term care ; Medical subspecialities ; Nephrology ; Internists ; Family practitioners ; Neurology ; Phychiatry ; Rehabilitation ; General surgery ; Surgical subspecialties
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
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  • 50
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    Trauma und Berufskrankheit 2 (2000), S. S95 
    ISSN: 1436-6274
    Keywords: Schlüsselwörter ; Akromioklavikulargelenk ; AC-Dislokation ; Konservative Therapie ; Operative Therapie ; Schmerz ; Funktion ; Rehabilitation ; Key words ; AC joint ; AC dislocation ; Conservative treatment ; Operative treatment ; Pain ; Function ; Rehabilitation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Acute acromioclavicular dislocations may be treated operatively or conservatively. In the past, operative treatment was performed mainly in the German-speaking countries, while conservative treatment was widely accepted in the US. A review of the literature shows that there is no difference between the two procedures in subsequent pain and function. The complication rate is much higher with operative therapy, and the rehabilitation is earlier in conservative treatment. Conservative treatment is thus the superior procedure for the vast majority of patients, and the operation should be recommended only in selected cases and in the presence of type IV, V and VI injuries.
    Notes: Zusammenfassung Die Behandlung der akuten, kompletten Akromioklavikulargelenkluxation kann konservativ oder operativ erfolgen. In der Vergangenheit wurde v. a. im deutschsprachigen Raum die operative Behandlung favorisiert, wobei diesbezüglich eine erhebliche Anzahl von Operationstechniken beschrieben wurde. Demgegenüber steht die v. a. in den USA favorisierte konservative Therapie. Die Auswertung der wenigen, prospektiv randomisierten Studien zeigt eindeutig, daß die konservative Therapie hinsichtlich der zu erwartenden Schmerzen und des funktionellen Resultats gegenüber den operativen Verfahren gleichwertige Ergebnisse erreicht. Die Komplikationsrate sowie die Kosten sind bei der Operation erheblich höher. Die Rehabilitation ist bei der konservativen Behandlung zügiger. Insgesamt ist somit die konservative Therapie bei der überwiegenden Anzahl der Patienten das überlegene Verfahren. Die Operation sollte nur in Ausnahmefällen und bei den höhergradigen Verletzungstypen durchgeführt werden.
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  • 51
    ISSN: 1436-6274
    Keywords: Schlüsselwörter ; Traumatische Schulterluxation ; Diagnostik ; Therapiekonzept ; Rezidivrate ; Rehabilitation ; Keywords ; Traumatic shoulder dislocation ; Diagnostic procedure ; Therapeutic strategy ; Recurrence rate ; Rehabilitation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: For some years a more tailored treatment strategy has become established for traumatic shoulder instability. In more than 90% of cases parameters affecting the choice of treatment can be detected by history-taking, clinical examination, conventional X-rays in true a-p and axillary views and ultrasound examination. For young patients up to around 25 or 30 early arthroscopic revision, preferably after the first dislocation, is recommended because of the high risk of recurrence in such patients. When there have been freequent posttraumatic recurrences and accompanying lesions of the glenoid and rotator cuff open stabilization is favoured. So far there are no clearly defined criteria for patient selection for the open or the arthroscopic procedure. We prefer to make the definitive selection in the course of the arthroscopic examination of the joint. Conservative therapy is indicated for patients older than 30 years who have no accompanying lesions, especially rotator cuff defects, and low levels of stress on the shoulder through sport. The rehabilitation programme should follow a clearly defined strategy, with regular follow-up examinations until the shoulder is painfree during full function.
    Notes: In den letzten Jahren hat sich ein differenziertes Therapiekonzept der traumatischen Schulterinstabilität etabliert. In 〉 90% der Fälle können die therapiebestimmenden ¶Parameter durch Anamnese, klinische Untersuchung, Röntgendiagnostik in True-a.-p.- und axialer Projektion sowie Sonographie gewonnen werden. Bei jungen Patienten bis zum 25.–30. Lebensjahr mit hohem Reluxationsrisiko wird die arthroskopische Frühversorgung, möglichst nach dem ersten Luxationsereignis, empfohlen. Mit zunehmender Anzahl bereits stattgehabter Rezidivluxationen sowie Begleitverletzungen des Glenoids und der Rotatorenmanschette gewinnt die offene Stabilisierung an Bedeutung, wobei die Grenze des arthroskopisch noch Möglichen teilweise nicht eindeutig definiert werden kann. Nach unserer Erfahrung hat es sich bewährt, die endgültige Verfahrenswahl während der arthroskopischen Gelenkinspektion festzulegen. Die Indikation für eine primär konservative Behandlung besteht beim Patienten 〉 30 Jahre mit geringem Funktionsanspruch und ohne Nachweis von Begleitverletzungen, insbesondere der Rotatorenmanschette, im Rahmen der posttraumatischen Diagnostik. Die Rehabilitation sollte nach einem festgelegten Konzept erfolgen und eine regelmäßige ärztliche Verlaufskontrolle bis zur Wiederherstellung einer schmerzfreien Maximalbelastung gewährleisten.
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  • 52
    ISSN: 1436-6274
    Keywords: Schlüsselwörter ; Hauterkrankungen ; Hautarztverfahren ; Beratungsarztverfahren ; Hautschutzmaßnahmen ; Gefahrenabwehr ; Rehabilitation ; §3 BKV ; Erstattungsansprüche ; Keywords ; Dermatoses ; Dermatologists’ procedures ; Consultants’ procedures ; Skin protection ; Risk avoidance ; Rehabilitation ; §3 of the ¶Ordinance on Occupational Illnesses ; Entitlement to reimbursement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Precisely in the case of skin diseases it is particularly important to be informed about an occupational illness as early as possible, because seemingly innocuous initial findings can quickly develop into severe findings that remain with the patient throughout the rest of his or her life if no rehabilitation is carried out. The procedure applied by the dermatologist, complemented by the consultant’s procedure, is designed to support this function of early ascertainment and regulation for the accident insurance underwriter. The rehabilitation of insurance holders with skin diseases should initially entail intensive dermatological treatments aimed at a cure, together with consistent application of skin protection. In-patient treatments in selected climatic conditions are a further option. Occupational benefits for rehabilitation are necessary when there is no question, or no longer any question, of risk avoidance, so that from the health aspect it is no longer possible to take responsibility for advising the patient to stay at the workplace occupied so far. It is immaterial both for medical and for occupational benefits aimed at rehabilitation whether the insurance holder’s entitlement is based on §3 of the Ordinance on Occupational Illnesses or whether the insured event of an occupational illness is recognized. As mentioned above, however, this question can be important in the processing of the reimbursement entitlements between the social insurance institutions involved.
    Notes: Gerade bei Hauterkrankungen ist es besonders wichtig, zum frühestmöglichen Zeitpunkt über eine beruflich verursachte Erkrankung unterrichtet zu werden, weil sich aus harmlosen Anfangsbefunden bei versäumten Rehabilitationsmaßnahmen rasch schwerwiegende, oft zeitlebens bestehende Befunde entwickeln können. Das Hautarztverfahren, ergänzt um das Beratungsarztverfahren, soll diese frühzeitige Erfassungs- und Steuerungsfunktion für die Unfallversicherungsträger unterstützen. Die Rehabilitation von hautkranken Versicherten ist zunächst durch intensive Maßnahmen der dermatologischen Heilbehandlung unter Einübung von konsequenten Hautschutzmaßnahmen durchzuführen. Stationäre Heilbehandlungsmaßnahmen unter besonderen klimatischen Bedingungen ergänzen das Angebot. Berufsfördernde Leistungen zur Rehabilitation sind dann notwendig, wenn Maßnahmen der Gefahrenabwehr nicht oder nicht mehr in Betracht kommen, sodass ein Verbleib am bisherigen Arbeitsplatz gesundheitlich nicht zu verantworten ist. Sowohl bei medizinischen als auch bei berufsfördernden Leistungen zur Rehabilitation macht es keinen Unterschied, ob §3 BKV Grundlage des Leistungsanspruchs des Versicherten ist oder ob der Versicherungsfall der Berufskrankheit anerkannt worden ist. Diese Frage kann aber – wie oben schon erwähnt – für die Abwicklung von Erstattungsansprüchen zwischen den Sozialversicherungsträgern Bedeutung haben.
    Type of Medium: Electronic Resource
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  • 53
    Electronic Resource
    Electronic Resource
    Springer
    Trauma und Berufskrankheit 2 (2000), S. 387-389 
    ISSN: 1436-6274
    Keywords: Schlüsselwörter ; Koordinator ; Bergmannstrost ; Rehabilitation ; Keywords ; Coordinator ; Bergmannstrost ; Rehabilitation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: While the medical care of accident and emergency patients treated by members of our professional association, especially in clinics run by the professional association, is recognized as being of a high standard, in practice the interface between those directly involved in this treatment and the administrative offices responsible within the association has been found to offer room for optimization on both sides. To this end, a coordinator for professional assistance has been appointed at the “Bergmannstrost” clinic run by the professional association. The new coordinator’s office is both a source of information and a support centre, providing assistance and advice for the medical staff of the clinic and also for the administrative staff responsible in the professional association’s offices. The coordinator, who is excellently well aware of the requirements and options for control within the treatment offered by the professional association, gives advice and makes sure that the various matters raised are routed quickly and directly to the correct offices. Looking back over almost 2 years’ experience, optimization of the interface seems to have been successfully achieved. The resultant tightening of the decision-making process has led to accelerated processing of concerns and positive effects on the costs of rehabilitation treatment.
    Notes: Während die medizinische Versorgung Unfallverletzter im bg-lichen Heilverfahren und gerade auch in den BG-Kliniken einen anerkannt hohen Standard aufweist, bot in der Praxis die Schnittstelle zu der Sachbearbeitung der Berufsgenossenschaften wechselseitig Optimierungspotenzial. Dem wurde durch die Installation einer Berufshilfekoordinatorin in den BG-Kliniken Bergmannstrost Rechnung getragen. Einer Informations- und Anlaufstelle also, die gleichermaßen dem medizinischen Personal der BG-Klinik als auch der Sachbearbeitung in den Berufsgenossenschaften als Anlauf- und Beratungsstelle dient. Die Koordinatorin, die exzellent mit den Anforderungen und Steuerungsmöglichkeiten im bg-lichen Heilverfahren vertraut ist, berät oder sorgt dafür, dass die jeweiligen Belange schnell und auf direktem Weg an der richtigen Stelle ankommen. Rückblickend auf einen Erfahrungszeitraum von knapp 2 Jahren scheint die Optimierung der Schnittstelle gelungen zu sein. Durch die dadurch ermöglichte Straffung von Entscheidungsprozessen konnten neben Beschleunigungseffekten positive Wirkungen hinsichtlich der Rehabilitationskosten beobachtet werden.
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