Reha-Nachsorge Neues Credo: Der Einfluss von Bewegungstagebüchern auf den Reha-Erfolg bei orthopädischen Rehabilitanden

Background: An aftercare strategy for rehabilitation patients with chronic back pain, named New Credo, was developed in a project funded by the DRV Bund. A substantial goal of the concept is the initiation and maintenance of physical activity in everyday life of rehabilitation patients. Activity diaries are used as a support to achieve those goals. Physical activities diaries which are continuously kept by patients and monitored by the rehabilitation clinic should motivate the rehabilitation patients to maintain to be physically active in daily life. The aim is that the rehabilitation patients perpetuate their health outcomes achieved by the end of rehabilitation over a longer period of time. The present article focuses on the impact of the physical activity diaries on health outcomes e. g. social participation, physical functioning, vitality and depression. Method: The data for this secondary analysis originates from a prospective controlled, multi-centre longitudinal study. In this study 6, rehabilitation clinics in Schleswig-Holstein were involved: 3 clinics in the intervention arm and 3 control clinics. The participants of the intervention group (IG) took part in the new aftercare strategy and constitute the initial sample for the present analysis. For the evaluation of the physical activity diaries, different scores were calculated (score for keeping the diaries). The analysis of the correlation between keeping the physical activity diaries and outcome parameters were conducted by multiple regression analyses. Results: At the 12 month-follow-up n=116 evaluable data sets were available (questionnaires for all 3 points of measurements and 3 physical activity diaries). We observed significant correlations between the extent of keeping the physical activity diaries and the primary outcomes: rehabilitation patients, who completed the physical activity diary more comprehensively were significantly less restricted in participation at follow-up and had a significantly higher functional capacity compared to those rehabilitants keeping their diary less comprehensive. Similar results can be identified for the secondary outcome parameters (vitality and depression). The variance by keeping the diaries explains 3-6% of the improvements. Discussion and conclusion: Regardless of the extent of keeping physical activity diaries patients reported a high acceptance of this intervention. Significant effects can be demonstrated with respect to the long-term effects. In all regression models the proportion of explained variance for the long-term success by the score for keeping the physical activity diaries was small. This is not hardly or barely surprising as keeping physical activity diaries is an extremely low-threshold intervention. However, the findings show that rehabilitation patients receive an important support by the physical activity diaries with regard to the integration of physical activity in their daily life.