From knowledge to action. Psychologic considerations and ap-proaches to cope with the theory-practice gap in selected thera-peutic fields of stroke rehabilitation.
Feb 2020 - Present. Jakob Tiebel
Evidence-based physiotherapy and occupational therapy in stroke rehabilitation has developed over the last decades into an "evidence-based" therapeutical science and includes forms of therapeutic treatment in which patient-oriented decisions are to be made explicitly on the basis of proven effectiveness. The starting point of this thesis are observations that indicate contradictions between everyday practice and the find-ings of the therapeutic sciences. This results in considerable difficulties in the transfer of theory to practice. The aim of this thesis is to present the problem from a psychological point of view, to discuss the consequences and to think about possible ways to over-come the gap between theory and practice.
Interactive cognitive-motor training with the Dividat Senso: Influence of the difficulty level of different game applications on motivation, emotional gaming experience and physical and cognitive strain.
Dec 2019 - March 2020. Jakob Tiebel
Objectives: 1) To investigate the influence of the difficulty level of different game applications in interactive cognitive-motor training with the Dividat Senso on motivation, emotional gaming experience and physical and cognitive strain and 2) to explain possible correlations between the variables.
Does virtual reality influence patient motivation in upper limb motor therapy post stroke? A Systematic review and meta-analysis.
Dec 2019 - March 2020. Jakob Tiebel
An important predictor of long-term impairment after stroke is the paresis of the arm. For some years now, motor therapy of arm function is increasingly influenced by the use of virtual reality (VR). VR is intended to promote motivation and enjoyment during motor learning. Presumed is that the integration of playful elements into the virtual treatment context (gamification) ensures that patients in VR are more likely to train their motor deficits persistently and with fun. The exercises are therefore more encouraging and motivating than in a conventional setting. However, it is a fact that the myth of increased motivation through VR scientifically has not been proven. Objectives: 1) To discuss the influence of motivation through VR in the context of rehabilitation and with regard to the effects of motor learning and 2) to identify available clinical studies that investigate motivation as an endpoint in group comparison (VR vs. conventional therapy) in order to evaluate it qualitatively and quantitatively.
Interview-based advertising effect analysis and campaign optimization for the distribution of the THERA-Trainer® "Complete Solution for Gait Rehabilitation"
Jun 2019 - Oct 2019. Jakob Tiebel
The general situation in inpatient neurological rehabilitation presents multiple challenges. Research results of recent years show that maximizing task-oriented therapy time significantly improves the outcome of neurological patients. Despite the increasing scarcity of resources, clinics are asked to improve the current standard of therapy. The Medica Medizintechnik GmbH has developed a group therapy concept, which creates a guideline-compliant and economically sustainable range of therapies by using state-of-the-art robotics and computer technology. The therapy can significantly be increased with the same number of staff, and an optimized patient outcome is generated by releasing existing economic potential.
The concept has proven itself. Within the last two years, a targeted number of pilot projects have been successfully completed. The customers are satisfied.
Campaign optimization is planned with a view to a nationwide rollout and the start of international sales. Existing marketing documents are to be checked for their advertising effectiveness and optimally adapted to the needs of the customers.
Sample-size recommendations for robot assisted gait training research
Feb 2019 - Jun 2019. Jakob Tiebel
We developed an app that visualizes an effect size distribution and determined effect size percentiles, representing small, medium and large effects extracted from robot-assisted gait training (RAGT) studies. Based on prevalence assumtions for the exposure in a control intervention and an expected odds ratio (OR) the app allows to specify how many participants a study requires to determine a replicable effect. The estimations are based on widely used conventions for alpha- (0.05) and 1-beta error-probability (0.8).
Digital corporate health management: Effect of the use of functional coordination training on employees' health-related quality of life
Dec 2018 - March 2019. Jakob Tiebel, Jenny Kratky, Monika Giesbrecht
Physical activity is an important factor for health and well-being. A majority of the population does not sufficiently meet the minimum requirements for physical activity in everyday life. Technological progress opens up new perspectives for influencing the health behaviour of employees exactly where it arises, i.e. in everyday working life. Measures to promote occupational health seem to be particularly successful if they not only inform employees, but also get them to act and motivate them on a permanent basis. Scientific studies prove that physical activity can be effectively promoted by digital game applications and that users even prefer these to conventional training measures. The balori® e-coordination system is a sensor-supported exercise platform that records real movements of a user and integrates them into a virtual exercise situation. By a simple exercise instruction with avatar on the screen it works without a trainer and allows a structured coordination and balance training to optimize the quality of movement, speed of action, flexibility as well as to strengthen and stabilize the back and joint muscles. The aim of this project is to investigate the effect of using functional coordination training with the balori® e-coordination system on the health-related quality of life of employees within the framework of company health management.
Backward walking training after stroke - A systematic review and meta analysis
Dec 2018 - Jan 2019. Jakob Tiebel, Martin Huber
Backward walking is an intervention that may be valuable for enhancing walking, balance and self-efficacy to improve mobility function after stroke. Backward walking to improve gait and dynamic balance poststroke is a more recent application and appears to offer a number of potential benefits. This systematic review and rapid meta analysis project is aimed to examine possible effects of backward walking training on changes in stroke patients’ gait ability.
Item analysis: How to calculate the relative information entropy of test and survey items in R?
Nov 2018 - Dec 2018 Jakob Tiebel
A basic requirement for test and survey items is that they are able to detect variance with respect to a latent variable. To do this, item scales must discriminate between test subjects and must have a systematic, clear and sufficiently strong relationship with the underlying construct.
One possibility to examine the variability of an item and express it in a single value is the computation of the relative information content. The relative information content (also called relative entropy) is a dispersion measure for at least nominally scaled variables. But it also can be calculated on higher scale levels.
Sep 2018 - Dec 2019. Jakob Tiebel
In 2015, the first version of the S2e Guideline for the Rehabilitation of Mobility after Stroke (ReMoS) has been published. Today, almost four years later, implementation in clinical practice continues to be sluggish. It seems difficult for practitioners to extract relevant core statements out of around 150 pages of continuous text with over 250 abstractly formulated recommendations. This raises the question of how such weakly structured data can and must be processed in order to enter clinical practice. Aim of the "ReMoS-Mining" project, which began in the middle of last year, was to work up the ReMoS guideline, which is available as a flow text with a weak structure, in order to make the knowledge it contains accessible to a broader mass in compressed form.
Aug 2018 - Dec 2019. Jakob Tiebel
The majority of studies in neuroscience are statistically underpowered. It it not so well known that low power reduces the likelihood that a statistically significant result reflects a true effect in the population. But believe me, it does! With this project I want to show, that the average statistical power of studies in neurorehabilitation science is very low! The consequences of this often include overestimates of effect size and a low reproducibility of results. And the problem also has ethical dimensions...!
Calculation of statistical power in meta-analysis
Jul 2018 - Aug 2018. Jakob Tiebel
Thanks to Daniel Quintana and his blogpost about statistical power calculation for meta-analysis I wrote an excel calculator for my daily work and started to work further on that topic... In the project Database you'll find the 2.0 version of my excel calculator, now with fixed and random effects models and several R-scripts, I advanced from Daniel's.
How to calculate statistical power for your meta-analysis
Cyclic Movement Therapy After Stroke - Meta Analysis
Dec 2017 - April 2018. Jakob Tiebel
Aim of this project is to conduct a meta analysis to find out whether additional lower limb cyclic movement therapy has an effect on walking capacity in patients after stroke.
SmartHealthNet is a research project that brings together medical services, technical aids and all those involved in the care of stroke patients with digital support. We are working towards one goal: individual, needs-based and coordinated care management for people affected by strokes. SmartHealthNet is a federal funded research project. The model is intended to contribute to the future of medical care and can be transferred to the care of other neurological diseases.
Loko-Solution - A Novel Device-Based Circuit Class Therapy Concept In Neurological Rehabilitation
A paradigm shift took place in the field of neurological rehabilitation. Traditional methods of treatment become less important. Evidence-and guideline-based approaches, which are scientifically well examined, strongly oriented on considerations from learning theory and outplaying in their effectiveness, replace them. Technical progress offers numerous possibilities for optimal treatment of neurological movement disorders. During the past years, physiotherapy applies more and more device-based treatments. However, they contrast strongly with the usual methods in neuro rehabilitation, where manual methods, a close contact to the patient and an integral view on the treatment process still dominate. Principals of motor learning are not followed up consequently enough. Patients spend less than 2/3 of their treatment time in physical activity and don’t reach the required number of repetitions which are neccessary for neuronal transformation. Results of latest research show that it is essential to establish performance models to transfer the current evidences into clinical practice. With the Loko Solutions Project we will implement an evidence-based master plan which compensates the weakness of current rehabilitation concepts and is functional in daily clinic routine.
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