Weier Lisa, Steinhäuser Jost, Träder Jens-Martin, Deck Ruth
Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck.
Institut für Allgemeinmedizin, Universität zu Lübeck.
Rehabilitation (Stuttg). 2021 Jun;60(3):195-203. doi: 10.1055/a-1286-2595. Epub 2021 Jan 21.
Back pain is one of the most common and costly health disorders in Germany. Rehabilitation measures for back pain often show a lack of long-term effects after rehabilitation treatment. The "Neues Credo" aftercare concept has proven to be promising in increasing the long-term effects. In the current study, it was piloted and evaluated in general practitioners' practices.
A prospective observational study was carried out. Nine orthopedic rehabilitation clinics and N=178 general practitioners were involved in the aftercare. The intervention was evaluated by means of written surveys of 85 rehabilitation patients with chronic back pain at 3 points in time. The outcomes were functional capacity and participation; the secondary outcomes were subjective health and physical activity. The long-term effects were evaluated by analyses of variance with repeated measurements.
At the end of the rehabilitation, the main outcome functional capacity shows a significant improvement of small magnitude, all secondary outcomes show significant medium to large effects. During the follow-up period, the participants were able to significantly increase their physical activity. Especially with respect to endurance training and workout. Twelve months after rehabilitation, significant improvements can still be seen in all outcomes. The range of parameters describing effect size are below the usual thresholds for clinically important changes.
Rehabilitation aftercare like the program "Neues Credo" shows similar lasting effects when supported by the general practitioner instead of the rehabilitation clinic. The successes decrease somewhat 12 months after the rehabilitation, but we still see significant differences in all outcomes compared to baseline. There is a high satisfaction with the program by rehabilitants and general practitioners. Since general practitioners are the first contact after rehabilitation a transfer of the program into routine care would be promising.
背痛是德国最常见且成本高昂的健康问题之一。背痛的康复措施在康复治疗后往往缺乏长期效果。“新信条”后续护理概念在增强长期效果方面已被证明颇具前景。在当前研究中，该概念在全科医生诊所进行了试点和评估。
开展了一项前瞻性观察研究。九家骨科康复诊所和N = 178名全科医生参与了后续护理。通过对85名慢性背痛康复患者在三个时间点进行书面调查来评估干预措施。主要结果是功能能力和参与度；次要结果是主观健康状况和身体活动。通过重复测量方差分析评估长期效果。
在康复结束时，主要结果功能能力有小幅显著改善，所有次要结果有显著的中等到较大效果。在随访期间，参与者能够显著增加身体活动。特别是在耐力训练和锻炼方面。康复十二个月后，所有结果仍有显著改善。描述效应大小的参数范围低于临床重要变化的通常阈值。
像“新信条”这样的康复后续护理在全科医生而非康复诊所的支持下显示出类似的持久效果。康复十二个月后效果有所下降，但与基线相比，我们在所有结果中仍看到显著差异。康复者和全科医生对该项目满意度很高。由于全科医生是康复后的首次接触对象，将该项目纳入常规护理将大有可为。
