[The Lübeck Scale of Basic Mobility : Assessment of geriatric patients with severely impaired mobility]. / Die Lübecker Skala der Basis-Mobilität : Assessment schwer in ihrer Mobilität beeinträchtigter geriatrischer Patienten.

BACKGROUND: In the geriatric assessment of mobility, the timed up and go (TUG) test is often used; however, many inpatients are unable to master this test. The Lübeck Scale of Basic Mobility (LSBM) was developed as a performance test for this target group. OBJECTIVE: The study investigated the properties of the 7­task LSBM, which has a scaling at item level based on the 5­level assessment of impairments according to the ICF. MATERIAL AND METHODS: In 77 patients who had not mastered the TUG test at acute geriatric hospital admission, the LSBM was completed at intervals of 7-18 days (t0, t1), including one rating by 2 investigators. For convergent validity, the De Morton Mobility Index (DEMMI) was used. RESULTS: The LSBM score and DEMMI score were highly correlated (-0.880, p < 0.001). A floor effect did not occur with LSBM and occurred with DEMMI in 5 patients (6.5%). The predictive validity for predicting coping with TUG test at discharge based on the sum score at t0 was -0.577 for the LSBM, and 0.542 for the DEMMI (Spearman's correlation, p = 0.001). The interrater reliability of the LSBM was 0.983 (p < 0.001), the correlation between test and retest was 0.836 (p < 0.001) and the internal consistency via Cronbach's α was 0.876. The effect size as a measure of change sensitivity was Cohen's d 0.711. CONCLUSION: The LSBM facilitates treatment goal setting and allows standardized documentation of even small improvements and deteriorations in patients with reduced basic mobility.

[Self-assessment of daily activities using the Duruöz Hand Index-Validation of the German translation]. / Selbstbeurteilung von Alltagsaktivitäten mittels Duruöz-Hand-Index ­ Validierung der deutschen Übersetzung.

BACKGROUND: Independence in activities of daily living depends to a large extent on the upper extremities; however, the instruments widely used in geriatrics to assess self-care abilities do not allow a focus on this body region. In order to map the fluctuating course of hand function-dependent daily living skills with a self-assessment instrument, rheumatologists have developed the Duruöz Hand Index (DHI). OBJECTIVE: The German translation authorized by Duruöz was tested for its applicability in the assessment of geriatric outpatient and day hospital patients and test quality criteria were determined. MATERIAL AND METHODS: Study participants completed the DHI three times. A postgraduate student blinded to the results performed an anamnesis and examination. The geriatric team made an inter-professional assessment of hand function-related daily living skills twice with at least 2­week intervals. RESULTS: Data collection was performed from 16 November 2016 to 27 April 2017 on 101 geriatric day hospital or outpatient patients. Retest reliability was high (0.937), as was internal consistency (Cronbach's α 0.949). Difficulty with activities of daily living correlated more closely with joint mobility (Keitel Index) and fine motor skills (20 cents test) than with hand strength. CONCLUSION: The DHI provides a survey of difficulties with activities of daily living that is focused on the upper extremities. Because about one in three patients required assistance (answering follow-up questions, reading aloud) despite the exclusion of patients with more severely impaired cognition and vision, the examiner should remain present.

[Non-pharmaceutical therapy of candidates for geriatric rehabilitation: Non-pharmaceutical therapy prescribed by SHI-accredited doctors after application for outpatient geriatric rehabilitative care]. / Heilmittelversorgung geriatrischer Rehabilitationskandidaten in Schleswig-Holstein: Vertragsärztlich verordnete Heilmitteltherapie nach Beantragung ambulanter geriatrischer rehabilitativer Versorgung.

BACKGROUND: The rejection of an application for ambulant geriatric rehabilitation (AGRV) is usually justified by the argument that non-pharmaceutical therapy prescribed by doctors accredited by social housing institutions (SHI) would suffice. The reality in healthcare during the 6 months following an application is unknown. METHODS: In this study 203 patients who had made an application for AGRV in the second half of 2010 in Flensburg, Lübeck or Ratzeburg were interviewed by telephone. RESULTS: The survey revealed that 25.7% of the applications for AGRV had been rejected. The majority of these patients received no ambulant non-pharmaceutical therapy (e.g. physical therapy, physiotherapy, occupational therapy, speech therapy or psychological therapy), less than 20% received more than 12 therapy sessions and in most cases exclusively physiotherapy. The 141 successful AGRV applicants received additional ambulant therapies of a similar magnitude. CONCLUSION: The difference between the intensified interdisciplinary therapy offered in the AGRV and additionally and the offer to rejected applicants is substantial.