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Empfehlungen für die Durchführung des motorischen Assessments der unteren Extremität zur ICF-basierten Verlaufsbeurteilung der Mobilität in der stationären geriatrischen Rehabilitation

Bericht eines interdisziplinären Konsensusprozesses

Recommendation of an assessment protocol to describe geriatric inpatient rehabilitation of lower limb mobility based on ICF

An interdisciplinary consensus process

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Zusammenfassung

Aufgrund steigender Nachfrage nach geriatrischen Rehabilitationsleistungen zwingen begrenzte Ressourcen zu objektiven und transparenten Allokationsentscheidungen. Ziel einer interdisziplinären Konsensusgruppe war die kritische Evaluierung der gängigen motorischen Assessmentverfahren der unteren Extremität und die Empfehlung geeigneter motorischer Tests zur Verlaufsbeurteilung der Mobilität in der stationären geriatrischen Rehabilitation. Die motorischen Domänen Stehen, Gehen, Gehen mit Zusatzaufgabe, Sitz-Stand-Transfer, Liegen-Sitz-Stand-Transfer vom Bett und Treppensteigen wurden zur Beurteilung der motorischen Leistungsfähigkeit der unteren Extremität und zur Formulierung von Zielen in einem motorischen Assessment empfohlen. Da nicht für alle Domänen spezifische und ausreichend validierte Testverfahren vorliegen, wurde ein künftiger Handlungsbedarf aufgezeigt. Neben einer standardisierten Erfassung der körperlichen Leistungsfähigkeit (Kapazität) ist die mobilitätsbezogene Aktivität und Teilhabe im Sinne der International Classification of Functioning, Disability, and Health (ICF) in Zukunft verstärkt miteinzubeziehen. Am Körper getragene Sensoren stellen hierbei eine vielversprechende Perspektive dar, um den Verlauf der Rehabilitation zu objektivieren.

Abstract

Because of the growing demand of geriatric rehabilitation, objective and clear indication decisions are needed with respect to limited financial resources. The aim of an interdisciplinary consensus group was to critically evaluate the most commonly used tests of functional performance of the lower limbs and to recommend useful tests to document progress of inpatient rehabilitation. Assessment of standing, walking, walking with a dual-task, sit-to-stand transfer, lying-to-sit-to-stand transfer, and stair climbing were recommended to document functional performance of the lower limbs and to describe rehabilitation targets. Future research is needed, because reasonably validated assessment tools do not exist for all of these domains. In addition to a standardized assessment of physical capacity, physical activity and participation with regard to the International Classification of Functioning, Disability, and Health (ICF) context have to be assessed. Body fixed sensors seem to be a promising assessment tool to objectively document progress in rehabilitation.

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Literatur

  1. Bachmann S, Finger C, Huss A et al (2010) Inpatient rehabilitation specifically designed for geriatric patients: systematic review and meta-analysis of randomised controlled trials. BMJ 340:c1718

    Article  PubMed  Google Scholar 

  2. Berg KO, Wood-Dauphinee SL, Williams JI, Maki B (1992) Measuring balance in the elderly: validation of an instrument. Can J Public Health 83 (Suppl 2):7–11

    Google Scholar 

  3. Botolfsen P, Helbostad JL, Moe-Nilssen R, Wall JC (2008) Reliability and concurrent validity of the Expanded Timed Up-and-Go test in older people with impaired mobility. Physiother Res Int 13(2):94–106

    Article  PubMed  Google Scholar 

  4. Brooks D, Davis AM, Naglie G (2007) The feasibility of six-minute and two-minute walk tests in in-patient geriatric rehabilitation. Can J Aging 26(2):159–162

    Article  PubMed  Google Scholar 

  5. Cesari M, Onder G, Zamboni V et al (2008) Physical function and self-rated health status as predictors of mortality: results from longitudinal analysis in the ilSIRENTE study. BMC Geriatr 8:34

    Article  PubMed  Google Scholar 

  6. Collen FM, Wade DT, Robb GF, Bradshaw CM (1991) The Rivermead Mobility Index: a further development of the Rivermead Motor Assessment. Int Disabil Stud 13(2):50–54

    Article  PubMed  CAS  Google Scholar 

  7. Bruin ED de, Hartmann A, Uebelhart D et al (2008) Wearable systems for monitoring mobility-related activities in older people: a systematic review. Clin Rehabil 22(10–11):878–895

    Google Scholar 

  8. Bruin ED de, Najafi B, Murer K et al (2007) Quantification of everyday motor function in a geriatric population. J Rehabil Res Dev 44(3):417–428

    Article  PubMed  Google Scholar 

  9. Guralnik JM, Simonsick EM, Ferrucci L et al (1994) A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 49(2):M85–M94

    PubMed  CAS  Google Scholar 

  10. Jones CJ, Rikli RE, Beam WC (1999) A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Res Q Exerc Sport 70(2):113–119

    PubMed  CAS  Google Scholar 

  11. Jorstad EC, Hauer K, Becker C, Lamb SE (2005) Measuring the psychological outcomes of falling: a systematic review. J Am Geriatr Soc 53(3):501–510

    Article  PubMed  Google Scholar 

  12. Keith RA, Granger CV, Hamilton BB, Sherwin FS (1987) The functional independence measure: a new tool for rehabilitation. Adv Clin Rehabil 1:6–18

    PubMed  CAS  Google Scholar 

  13. Lindemann U, Najafi B, Zijlstra W et al (2008) Distance to achieve steady state walking speed in frail elderly persons. Gait Posture 27(1):91–96

    Article  PubMed  CAS  Google Scholar 

  14. Lindemann U, Nicolai S, Beische D et al (2010) Clinical and dual-tasking aspects in frequent and infrequent fallers with progressive supranuclear palsy. Mov Disord 25(8)1040–1046

    Google Scholar 

  15. Lundin-Olsson L, Nyberg L, Gustafson Y (1998) Attention, frailty, and falls: the effect of a manual task on basic mobility. J Am Geriatr Soc 46(6):758–761

    PubMed  CAS  Google Scholar 

  16. Mahoney FI, Barthel DW (1965) Functional evaluation: the Barthel index. Md State Med J 14:61–65

    PubMed  CAS  Google Scholar 

  17. Marburger C, Jamour M, Rückgauer M et al (2008) KODAS – Instrument zur Erfassung von Qualitätsmerkmalen. Geriatr J 5(1):3333–3338

    Google Scholar 

  18. Podsiadlo D, Richardson S (1991) The timed „Up & Go“: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 39(2):142–148

    PubMed  CAS  Google Scholar 

  19. Runge M, Rehfeld G (2001) Geriatrische Rehabilitation im therapeutischen Team, 2. Aufl. Thieme, Stuttgart

  20. Schwenk M, Schmidt M, Pfisterer M et al (2011) Rollator use adversely impacts on assessment of gait and mobility during geriatric rehabilitation. J Rehabil Med 43(5):424–429

    Article  PubMed  Google Scholar 

  21. Tinetti ME (1986) Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc 34(2):119–126

    PubMed  CAS  Google Scholar 

  22. Vasunilashorn S, Coppin AK, Patel KV et al (2009) Use of the short physical performance battery score to predict loss of ability to walk 400 meters: analysis from the InCHIANTI study. J Gerontol A Biol Sci Med Sci 64(2):223–229

    Article  PubMed  Google Scholar 

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Danksagung

Die Autoren bedanken sich bei Dr. Koch-Gwinner für die fachliche Unterstützung im Konsensusprozess.

Interessenkonflikt

Die korrespondierenden Autoren geben an, dass kein Interessenkonflikt besteht.

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Authors and Affiliations

  1. Klinik für Geriatrische Rehabilitation, Robert-Bosch-Krankenhaus, Auerbachstr. 110, 70376, Stuttgart, Deutschland

    M. Jamour,  C. Becker, S.E. Nicolai & U. Lindemann

  2. Geriatrische Rehabilitationsklinik Ehingen, Spitalstraße 29, 89584, Ehingen, Deutschland

    M. Jamour

  3. Klinik für Rheumatologie und muskuloskelettale Rehabilitation, Rehabilitationszentrum Klinik Valens, Valens, Schweiz

    S. Bachmann

  4. Institut für Bewegungswissenschaften und Sport, ETH Zürich, Zürich, Schweiz

    E.D. de Bruin

  5. Fachhochschule für Gesundheitsberufe, Bochum, Deutschland

    C. Grüneberg

  6. Geriatrische Fachklinik Rheinhessen-Nahe, Bad Münster am Stein-Ebernburg, Deutschland

    J. Heckmann

  7. Klinik für Geriatrische Reha und Physikalische Medizin, Christophsbad GmbH & Co Fachkrankenhaus KG, Göppingen, Deutschland

    C. Marburger

  8. Institut für Anästhesiologie und Notfallmedizin, Westpfalz-Klinikum GmbH Kaiserslautern, Kaiserslautern, Deutschland

    S.E. Nicolai

  9. Bethanien-Krankenhaus, Geriatrisches Zentrum, Klinikum der Universität Heidelberg, Heidelberg, Deutschland

    M. Schwenk

Authors
  1. M. Jamour
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  2. C. Becker
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  3. S. Bachmann
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  4. E.D. de Bruin
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  5. C. Grüneberg
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  6. J. Heckmann
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  7. C. Marburger
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  8. S.E. Nicolai
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  9. M. Schwenk
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  10. U. Lindemann
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Corresponding authors

Correspondence to M. Jamour or C. Becker.

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Jamour, M., Becker, C., Bachmann, S. et al. Empfehlungen für die Durchführung des motorischen Assessments der unteren Extremität zur ICF-basierten Verlaufsbeurteilung der Mobilität in der stationären geriatrischen Rehabilitation. Z Gerontol Geriat 44, 429–436 (2011). https://doi.org/10.1007/s00391-011-0267-1

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  • DOI: https://doi.org/10.1007/s00391-011-0267-1

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