Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

A082 the importance of sport in rehabilitation after traumatic injuries the concept of the vbg

206 views

Published on

A082 the importance of sport in rehabilitation after traumatic injuries the concept of the vbg

  • Be the first to comment

A082 the importance of sport in rehabilitation after traumatic injuries the concept of the vbg

  1. 1. The importance of sports in rehabilitation after traumatic injuries – RI World Congress Edinburgh, 25-27 October 2016 Susan Riedel & Eckehard Froese, German Social Accident Insurance VBG The concept of the German Social Accident Insurance VBG
  2. 2. 227.10.2016 The Importance of Sports Acute Treatment Medical Rehabilitation Social Rehabilitation Early mobilization Rehab Group Training Community- based Sporting Activity Sports Therapy Recover Improve Prevent/Participate Susan Riedel & Eckehard Froese, Sports after traumatic injuries
  3. 3. 327.10.2016 Structures ServicesProcedures VBG Concept for Promoting Sports For promoting sports in each phase of rehabilitation it is necessary: to provide appropriate structures in authorized clinics and rehab facilities to adapt own procedures for analyzing and planning sports activities to offer services to enhance participation in sports Susan Riedel & Eckehard Froese, Sports after traumatic injuries
  4. 4. 427.10.2016 Activity-orientated objectives of sports Susan Riedel & Eckehard Froese, Sports after traumatic injuries Therapy goals focus on improving physical fitness and mental health, including the gain in self-confidence in one's own abilities
  5. 5. 527.10.2016 Acute Treatment Several studies have shown the benefits of early controlled mobilization and activity during acute treatment: Early mobilization promotes healing and is more productive in achieving a good outcome after fracture care, knee ligament surgery, cartilage repair and spine care Early activity not only enhances the injured area, but it also keeps it from losing function in the non-injured parts (Orthopedics today, Role of early motion in healing fractures and ligaments realized in last 25 years, 2005) Susan Riedel & Eckehard Froese, Sports after traumatic injuries
  6. 6. 627.10.2016 Structures in Acute Treatment DGUV-Requirements concerning mobilization: Each authorized hospital has to provide a qualified acute-rehab-team under constant medical supervision for Remedial gymnastics Physical therapy Ergo therapy Susan Riedel & Eckehard Froese, Sports after traumatic injuries
  7. 7. 727.10.2016 Principles of rehabilitation of professional sportsmen: Complex course of treatment Whole-body-therapy Early and intensive intervention Focus on specific sport requirements Objectives: To speed up the return to full strength, endurance and range of motion To maintain the proper functioning of the uninjured parts of the body To correct risk factors of injuries such as imbalances, muscle tightness or decreased proprioception Medical Rehabilitation (1) Susan Riedel & Eckehard Froese, Sports after traumatic injuries
  8. 8. 827.10.2016 Medical Rehabilitation (2) Treatment as in-patients or out-patients Application 5 - 6 days a week, at least 2 hours (outpatient)/ 4 hours (inpatient) per day Combination of following elements, increasingly provided as active exercises: Remedial gymnastics Medical training therapy Physical therapy Ergo therapy Susan Riedel & Eckehard Froese, Sports after traumatic injuries
  9. 9. 927.10.2016 Structures in Medical Rehabilitation DGUV-staff requirements concerning medical training therapy: Physiotherapists with additional qualification in sports physiotherapy Qualified sports teacher with additional qualification in medical training therapy DGUV-facility and equipment requirements: Sufficient therapy area (at least 80 m²) with exercise equipment such as: Isokinetic exercise machine Medical exercise equipment Bicycle ergometer Wall bars Rowing machine Susan Riedel & Eckehard Froese, Sports after traumatic injuries
  10. 10. 1027.10.2016 Preventing decline in health after medical rehabilitation Adults with permanent disabilities have a 2 to 3 times higher prevalence of secondary conditions (Kienne et al., Am J Public Health 2004 ) As a consequence physical activity after rehabilitation is essential for minimizing the risk of a gradual decline in health and secondary conditions: Susan Riedel & Eckehard Froese, Sports after traumatic injuries Health&Function Accident 1 2 3 4 5 6 7 8 9 10 11 12 Recovery months Minimum level of function Rehab Risk of secondary conditions Own representation based on James H. Rimmer „Getting beyond the plateau: Importance of exercise, 2012
  11. 11. 1127.10.2016 Adapted physical activity Vibration Training Therapeutic Swimming Nordic Walking Sling- Exercise- Therapy Therapeutic Qi Gong Therapeutic Climbing Securing physical activity behaviour (1) Susan Riedel & Eckehard Froese, Sports after traumatic injuries The motivational effects of adapted physical activity in a rehabilitation context have been linked not only to initiating a desired exercise behavior, but mainly for maintaining it, thus increasing the probability of life-long adherence (H. Rieder: Adapted physical activity. In: Rieder H, Huber G, Werle J, editors. Sport with special groups: A textbook 1996) As a consequence leisure-based adapted physical activities have to be part of medical rehabilitation
  12. 12. 1227.10.2016 Securing physical activity behaviour (2) VBG-requirements for rehab facilities: Formulation of personalized exercise recommendations to integrate physical activity into the new daily routine after rehab and thus to maintain or even improve rehabilitation outcome Susan Riedel & Eckehard Froese, Sports after traumatic injuries
  13. 13. 1327.10.2016 Participation-orientated objectives of sports Susan Riedel & Eckehard Froese, Sports after traumatic injuries Exercise goals focus on enhancing self-empowerment and full participation
  14. 14. 1427.10.2016 Procedures Establishment of participation-orientated procedures: Initial personal contact Holistic case analysis Set up of a participation plan Susan Riedel & Eckehard Froese, Sports after traumatic injuries
  15. 15. 1527.10.2016 Initial Personal Contact Detection of social activities such as leisure-based sports and contextual factors with influence on participation Susan Riedel & Eckehard Froese, Sports after traumatic injuries
  16. 16. 1627.10.2016 Holistic Case Analysis Use of the biopsychosocial approach of the ICF in identifying factors that impact participation Focus on the personal and environmental barriers which may impede the engagement in physical activities Base for tailored services to remove potential barriers to participation Susan Riedel & Eckehard Froese, Sports after traumatic injuries
  17. 17. 1727.10.2016 Participation Plan Participative rehab planning and service selection also with focus on participation in sports Susan Riedel & Eckehard Froese, Sports after traumatic injuries
  18. 18. 1827.10.2016 Services: Personal and Peer Counseling Personalized tailored counseling during and after rehabilitation improves sports participation and daily physical activity behavior (H P van der Ploeg et. al: Counseling increases physical activity behaviour nine weeks after rehabilitation, Br J Sports Med. 2006) VBG Rehab Managers inform about local accessible sports facilities and plan with the client further sporting activities after medical rehabilitation Peer Counseling is used as empowering opportunity to enhance self-motivation and to promote widespread interest in physical activity to teach individuals with permanent disabilities how to exercise safely and effectively Susan Riedel & Eckehard Froese, Sports after traumatic injuries
  19. 19. 1927.10.2016 Services: Life-long Support Life-long support of accident victims especially with permanent disabilities to participate in mainstream and disability-specific sports by assisting in searching for accessible facilities (e.g. find swimming pool with lift or ramp) adapting sports facilities for barrier-free access, if required providing adaptive sports equipment (e.g. sports wheelchair) offering personal assistance (e.g. for showering or changing into sport suits) providing transportation from and to the sports facilities Susan Riedel & Eckehard Froese, Sports after traumatic injuries
  20. 20. 2027.10.2016 Conclusion The systematic integration of elements of sports into the rehab process enhances recovery and minimizes or prevents permanent physical impairments and secondary conditions after traumatic injuries and promotes self-confidence needed to take on other life challenges such as pursuing employment ensures effective, comprehensive and sustainable participation and inclusion in all aspects of life Susan Riedel & Eckehard Froese, Sports after traumatic injuries
  21. 21. 2127.10.2016 Susan Riedel & Eckehard Froese Department of Rehabilitation VBG Head Office, Hamburg susan.riedel@vbg.de & eckehard.froese@vbg.de Susan Riedel & Eckehard Froese, Sports after traumatic injuries

×