[Post-COVID Rehabilitation].

INTRODUCTION: COVID-19 is a multi-organ disease with a broad spectrum of manifestations. Many affected individuals have major difficulties in resuming their previous daily routine or occupation as a result of the disease. Currently, no causal therapeutic approaches are available for the treatment of post-COVID disease. Due to the wide range of possible symptoms, an interprofessional and integrated treatment should be used, while rehabilitation and interventions should be based on the objective findings as well as on the patient's goals. Fatigue and cognitive impairment are among the most common symptoms, which can limit both occupational participation and coping with everyday life. Fatigue management is a central component of rehabilitation. The workload should be increased very slowly; indications of post-exertional malaise must be given special consideration. Due to the fluctuating course of the disease, a periodic reevaluation and adjustment of the workload may be necessary.

Clinical validation of a contactless respiration rate monitor.

Respiratory rate (RR) is an often underestimated and underreported vital sign with tremendous clinical value. As a predictor of cardiopulmonary arrest, chronic obstructive pulmonary disease (COPD) exacerbation or indicator of health state for example in COVID-19 patients, respiratory rate could be especially valuable in remote long-term patient monitoring, which is challenging to implement. Contactless devices for home use aim to overcome these challenges. In this study, the contactless Sleepiz One+ respiration monitor for home use during sleep was validated against the thoracic effort belt. The agreement of instantaneous breathing rate and breathing rate statistics between the Sleepiz One+ device and the thoracic effort belt was initially evaluated during a 20-min sleep window under controlled conditions (no body movement) on a cohort of 19 participants and secondly in a more natural setting (uncontrolled for body movement) during a whole night on a cohort of 139 participants. Excellent agreement was shown for instantaneous breathing rate to be within 3 breaths per minute (Brpm) compared to thoracic effort band with an accuracy of 100% and mean absolute error (MAE) of 0.39 Brpm for the setting controlled for movement, and an accuracy of 99.5% with a MAE of 0.48 Brpm for the whole night measurement, respectively. Excellent agreement was also achieved for the respiratory rate statistics over the whole night with absolute errors of 0.43, 0.39 and 0.67 Brpm for the 10th, 50th and 90th percentiles, respectively. Based on these results we conclude that the Sleepiz One+ can estimate instantaneous respiratory rate and its summary statistics at high accuracy in a clinical setting. Further studies are required to evaluate the performance in the home environment, however, it is expected that the performance is at similar level, as the measurement conditions for the Sleepiz One+ device are better at home than in a clinical setting.

[Primary and Secondary Fall Prevention in the Rehabilitation: A Practical Approach to Fall Prevention]. / Primäre und sekundäre Sturzprävention in der Rehabilitation: Hinweise zur Sturzprophylaxe.

Active fall prevention requires analysis of the mechanisms provoking falls and the subsequent initiation of appropriate counteracting measures. This is crucial for the quality management of all rehabilitation programs. There is primary and secondary fall prevention. For the latter, specific and individualized measures have to be taken after the first fall. We here present a practical approach to fall prevention for a better rehabilitation outcome. Fall prevention intervention represents a key component of rehabilitation programs.

Multiple system atrophy of the cerebellar type (MSA-C) with concomitant beta-amyloid and tau pathology.

Multiple system atrophy (MSA) is a rapidly progressive sporadic α-synucleinopathy with adult onset characterized by progressive cerebellar ataxia, basal ganglia symptoms, autonomic dysfunction and pyramidal tract signs. While full-blown dementia is considered an exclusion criterion according to Consensus Guidelines, mild cognitive deficits such as fronto-executive dysfunction have been reported in some MSA individuals. However, the underlying anatomic correlate still has to be elucidated. We here report a 74-year-old patient with a clinical diagnosis of "probable MSA of the cerebellar type (MSA-C)" who developed pronounced clinical symptoms of fronto-executive dysfunction. Neuropathologic investigations revealed (1) numerous glial cytoplasmic inclusions (GCI) in the putamen, mesencephalon and cerebellum, (2) pronounced betaamyloid pathology in the frontal lobe and (3) mild hippocampal τ-pathology. In this patient, fronto-executive dysfunction can easily be explained by frontal degeneration typical for AD. These findings challenge the concept of cognitive dysfunction as a core feature of MSA as long as concomitant pathology other than MSA has not been reliably excluded by post mortem analysis.