[Validated German PROMs for People with Major Amputation of the Lower Extremity - A Narrative Review Based on the Final Report of the LEAD and COMPASS Initiative of the ISPO].

Patient-reported outcome measures (PROMs) play an important role in the rehabilitation of people with major limb amputations. Patient-completed questionnaires help collect specific constructs on this patient population. The COMPASS and LEAD initiatives, carried out by the International Society for Prosthetics and Orthotics (ISPO), underscore the importance of regularly collecting high-quality PROMs.

[Possibilities of orthopedic technical care for extremity lengthening and reconstruction].

Background: Orthopedic technical care plays a crucial role in improving function and mobility for patients undergoing limb lengthening and reconstruction. The treatment strategy is based on a precise classification of the defect, taking into account factors such as joint instability, muscle pathology and limb length discrepancy.

Choice Of Aids: The selection of orthopedic aids depends on the specific deformity, its classification and the individual needs of the patient.

Experts' Perceived Patient Burden and Outcomes of Knee-ankle-foot-orthoses (Kafos) Vs. Microprocessor-stance-and-swing-phase-controlled-knee-ankle-foot Orthoses (Mp-sscos).

Background: Patients with neuromuscular knee-instability assisted with orthotic devices experience problems including pain, falls, mobility issues and limited engagement in daily activities.

Objectives: The aim of this study was to analyse current real-life burden, needs and orthotic device outcomes in patients in need for advanced orthotic knee-ankle-foot-orthoses (KAFOs).

Methodology: An observer-based semi-structured telephone interview with orthotic care experts in Germany was applied.

[Rehabilitation following the amputation of an extremity].

The rehabilitation of patients with an amputation is challenging and an example of an interdisciplinary team approach. Knowledge of the principal surgical techniques and the needs for a good prosthetic fitting is mandatory for the team members. According to the ideas of International Classification of Functioning, Disabilities and Handicaps the goal of the rehabilitation is to achieve the highest possible participation in private, work and social life of the patient.

[Requirements for trauma rehabilitation centers : Post-acute rehabilitation (phase C) after severe trauma injury].

Severely injured patients need a qualified and seamless rehabilitation after the end of the acute treatment. This post-acute rehabilitation (phase C) places high demands on the rehabilitation facility in terms of personnel, material, organizational and spatial requirements.The working group on trauma rehabilitation of the German Society for Orthopedics and Traumatology e.

[Translation, Adaptation, Reliability and Validity of the German Version of the Prosthesis Mobility Questionnaire 2.0 (PMQ) on Patients with Major Lower Limb Amputation].

Purpose: The aim of this prospective validation study was to translate the Prosthesis Mobility Questionnaire 2.0 (PMQ) into German based on a guideline, following by psychometric testing for its validity and reliability using classical test theory.

Methods: The PMQ was translated into German according to ISPOR guidelines using double forward and double backward translations, finalized by pilot testing (N=10).

[Rehabilitation after Hip Arthroplasty - Between Fast-Track Surgery and Orthogeriatrics].

Surgical procedures as well as length of stay and age limits have changed significantly in recent years in the context of hip arthroplasty. While hospitals are becoming increasingly specialised and patients are sometimes discharged to follow-up rehabilitation after only three to four days, the rehabilitation clinic providing follow-up care has to maintain a well-differentiated treatment pathway in order to meet the different requirements and needs between patients with fast-track surgery and orthogeriatric patients.

Validity and Reliability of the German Version of the Locomotor Capabilities Index-5 (LCI-5).

Background: Before foreign language questionnaires, such as patient reported outcome measures (PROMs), can be scientifically used in the national language, guideline-based translation, cultural adaptation and comprehensive verification of their validity and reliability are needed. The aim of this study was to assess the psychometric properties of the German version of the LCI-5 (LCI-5-D) on a sample of people with lower limb amputation (LLA).

Methods: The LCI-5 was translated into German (LCI-5-D) based on the ISPOR guidelines for cross-cultural adaptation following pilot testing.

[Indications for stump corrections].

Problems in prosthetic fitting or mobility of amputated patients are often caused primarily by insufficient stump quality. To achieve better rehabilitation results and a higher quality of life it is mandatory that the physician treating the patient is able to diagnose stump problems and to indicate stump correction surgery. A skilled knowledge of amputation techniques, different levels of amputation, as well as of prosthetic fitting methods is needed.

Liebe Leserinnen und Leser.

das vorliegende Heft beschäftigt sich dieses Mal mit einem heterogenen Bündel von Arbeiten zur Rehabilitation. Der Rehabilitationsbedarf steigt, gerade durch den demographischen Wandel kommen erhebliche Anforderungen auf die Rehabilitation zu. Umso problematischer ist es, dass es zunehmend erkennbar zu erheblichem Fachkräftemangel in den Rehabilitationseinrichtungen kommt.

[Rehabilitation after Traumatic Fracture of Thoracic and Lumbar Spine].

On the basis of the S2-k guideline "Rehabilitation after traumatic fractures of the thoracic und lumbar spine without neurologic disorder", this article gives an overview of target-oriented rehabilitation of patients with minor fractures or those with column stability and unstable spinal fractures which are stabilised by surgery. To obtain early social and job related reintegration, outpatient or inpatient rehabilitation has to start immediately after treatment in hospital. Rehabilitation must be orientated towards the biopsychosocial model of ICF and has to be adapted for the patient.

Non-Specific Low Back Pain.

Background: For many years, low back pain has been both the leading cause of days lost from work and the leading indication for medical rehabilitation. The goal of the German Disease Management Guideline (NDMG) on nonspecific low back pain is to improve the treatment of patients with this condition.

Methods: The current update of the NDMG on non-specific low back pain is based on articles retrieved by a systematic search of the literature for systematic reviews.

[Prosthetics and Orthotics: Prosthetic Fitting in Lower Extremity in Transfemoral Amputation].

Modern prosthetic equipment often enables reintegration of patients with the amputation of a lower limb into their private life, their professional and social environment to a large extent. Provisioning of the lower extremity with artificial limbs aims at a life as normal as possible for the involved individual. The modules are selected in an interdisciplinary team.

[A German Survey of Goal Setting and Goal Agreement in Medical Rehabilitation].

Aim: To describe the current practice of goal setting and goal agreement in the Medical rehabilitation in Germany.

Methodology: Rehabilitation centers contracted by the German Pension Insurance and covering all indications were approached by a questionnaire survey.

Results: The percentage of questionnaires returned was 48.

[Orthopedic shoes: Still in touch with the times?].

Background: Deformities of the foot due to rheumatic disease, particularly rheumatoid arthritis, occur in 85-95% of patients during the course of their disease.

Objective: This study investigates whether treatment with orthopedic shoes still has a place in modern therapies.

Results: Foot orthotics and technical orthopedic shoes can play an important role in purely conservative treatment as well as postoperative therapy.

[Errors and complications associated with lower limb amputation].

Background: The newly launched "German law of patients' rights" strenghthens the rights of patients and places special emphasis on the right to full information. This includes information on errors, mistakes and complications due to surgery.

Assessment: Surgery complications and mistakes are of main importance especially in the area of amputation because rehabilitation chances are dependent on good surgical quality.

[Protect employability: effects of prevention programs offered by the German pension scheme].

A pilot study was carried out in 4 medical rehabilitation centers to examine the practicability and effectiveness of preventive life-style interventions for employees with risk factors. The programs were developed in cooperation with the German pension scheme and employers. Selection criteria were risk factors as lack of physical activity, overweight, dorsal pain or job strain.