Effects of a web-based rehabilitation aftercare on subjective health, work ability and motivation: a partially randomized controlled trial

Abstract

Background Rehabilitation is seen as crucial in dealing with the demographic change in many European countries. In Germany, for example, after having stayed in a rehabilitation center, patients have the possibility to participate in aftercare programs aimed at promoting long-term health behaviour. Despite the relevance of follow-up support for patients’ long-term health and work ability, participation rates in aftercare programs are quite low. Here, web-based aftercare programs can be a viable alternative to the traditional face-to-face programs due to their flexibility in time and location. This research project aims to use quantitative and qualitative methods to gain more insight into the potential of web-based aftercare programs. Methods The goal is to recruit up to 1150 patients at baseline in five rehabilitation centers across Germany. For ethical reasons, partially randomized experimental study design is used to quantitatively assess the effectiveness of web-based aftercare programs. All patients are offered the traditional face-to-face aftercare treatment (IRENA). When patients deny to participate in traditional face-to-face aftercare, they are randomly distributed into either web-based aftercare (digIRENA) or a control group. In all three groups, the SF-12, which measures subjective health, and the WAI, which measures working ability, will be used at baseline, 13 weeks, 26 weeks and 43 weeks after the patients have left the rehabilitation center. BREQ-2, which measures motivation, is used only in the traditional aftercare group and the web-based aftercare group. A multivariate analysis of variance with repeated measurement and latent growth curve models will be used to compare the development of the variables in the three groups. For the qualitative part of the study, interviews with patients and therapists will be conducted to shed light on the applicability, acceptance, and usability of web-based aftercare programs. Discussion This study may provide valuable insight into the potential of web-based rehabilitation aftercare programs as a way to supplement traditional face-to-face programs. This seems particularly promising if it can manage to reach those patients who do not currently participate in traditional face-to-face rehabilitation aftercare programs due to time and location constraints. Trial registration The trial has been registered at the German Register of Clinical Studies (DRKS) with the registration number: DRKS00022467.

Validity, reliability, and invariance across sex of a German version of the Behavioral Regulation in Exercise Questionnaire

“…Therefore, its removal led to reinstating the previously validated structure of the sub-scale of “introjected regulation” as presented in the BREQ-2, i.e., with three items. This constitutes no particular problem, considering that not only the structure of BREQ-2 (including the mentioned sub-scale) had been already validated both in its original language (Markland and Tobin, 2004 ) and in German (Witzki and Leyk, 2014 ), but it was also widely used in previous literature in the field of exercise and health (Jekauc et al, 2021 ; Kovács and Kovács, 2021 ; Ostendorf et al, 2021 ). Regarding item 14, which belonged to the “amotivation” sub-scale, our findings are not in line with the outcomes from validation processes in other languages (González-Cutre et al, 2010 ; Cid et al, 2018 ; Cavicchiolo et al, 2022 ; Chai et al, 2022 ; Luo et al, 2022 ).…”

Leveraging Emerging Technologies to Expand Accessibility and Improve Precision in Rehabilitation and Exercise for People with Disabilities

“…Historically, home-based rehabilitation programs have been limited to using detailed written instructions and illustrations, before evolving into video-based instructions delivered through videotape or digital video disk [57][58][59]61,64,69,72,84]. More recently, the advent of high-speed internet, massive data storage capacity, and affordable digital videography have revolutionized in-home rehabilitation programming, through the emergence of web-based tele-rehabilitation [86][87][88][89]. Specifically, these advancements in telecommunications technology offer a more versatile approach to tele-exercise, which allows clinicians to efficiently create and upload large libraries of custom video content that can be ac-cessed by users from any device with internet connectivity (i.e., tablet, smart phone, etc.).…”