Mobility means Participation - Development und evaluation of a standardized mobility and physical activity-orientated follow-up program for people with paraplegia

Status:

completed 06/2015

Aims:

- Developing a follow-up concept which, in the future, contributes to a more successful reintegration of people with an acquired paraplegia in the various areas of social life (sports, recreational activities, professional career, etc.). -Evaluating of the positive influence of mobility and physical activity as a central part of participation in social life in depth based on the findings of the project "Participation by mobility".

Activities/Methods:

Designing of assessment systems, integration of the rehabilitation manager in the process, the realization of the type of mediating system in the patient's living environment and the development and realization of training modules for the professional groups participating in the project. Creating of recommendations for the maintenance of the physical performance of persons with paraplegia, available for the practice.

Results:

The research project "mobility is participation" intended to develop a unitary mobility and exercise-oriented aftercare concept, which contributes to an improvement of social participation of people with acquired spinal cord injury. Focal point of the concept was the use of the Activity-Test for wheelchair mobility (AMR®) as routine diagnostics and also the expansion of a network of hospitals, insurants and mobility-guides. After data-record and evaluation of individual need for support by the hospital, the 5 federal-wide deployed mobility-guides, also wheelchair users with a wealth experience in physical activity and sport, conducted conversations with the insurants, in consideration of personal factors and preferences as existing impairments (in the range of wheelchair-mobility and independence in everyday-life). After verification an improvement of the concept for practical implementation, the following mobility and exercise-oriented aftercare concept is recommended: - By use of AMR®-Test and a short questionaire, the hospital therapists can identify a person’s need of support and consolation concerning mobility, physical activity and sports. - A mobility-guide is linked to every hospital (ideally wheelchair users, peer-concept), who takes over the consolation at an early stage of treatment (possibly in the hospital already). - Information about state of mobility and need of consolation were transferred to the insurance company if the insurant agrees. This transfer happens basically for general information and to provide a basis for a dialog with the insurant. For the evaluation of the concept a dataset of 308 insured persons with acquired spinal cord injury (ø age: 46, 49 years; 92% male; 85% readmissions; 76% paraplegia) was raised in the period 01.03.2013 to 30.06.2015. On the basis of AMR® tests and questionnaires following key results can be reported: - 40,3% of the total sample showed a medium to high need of support in wheelchair-mobility. 65,6% considered a mobility training after discharge from hospital as useful. The most difficulties in daily life cause doing a wheelie, crossing obstacles, ramps and stairs. - More than 60% of the questioned insurants, especially recently injured people, wished for advice by a mobility-guide regarding to mobility and exercise offerings located nearby. Beside of general mobility-training were table tennis, fitness/gymnastics, archery, hand bike, swimming and basketball the most questioned offers. - Contacting insurants with a consulting request by the mobility-guides was in 87,5% successful (duration: ø 58 days, scope: ø 3 contacting establishments). - 94,5% of the final surveys‘ participants rated the concept of mobility-guides as useful. 93,3% of the participants were satisfied with the offered activities. - As a result of the individual consolation, 27,4% of the insurants who participated regularly in the exercise-offerings, 13,7% participated irregularly in the offerings and 28,8% want to become active members in the consulted offerings in the future. - People who were active in job, leisure and sport, had a higher mobility and rated their physical and psychic quality of life higher.

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