A bio-psycho-social exercise program (RÜCKGEWINN) for chronic low back pain in rehabilitation aftercare - Study protocol for a randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>There is strong, internationally confirmed evidence for the short-term effectiveness of multimodal interdisciplinary specific treatment programs for chronic back pain. However, the verification of long-term sustainability of achieved effects is missing so far. For long-term improvement of pain and functional ability high intervention intensity or high volume seems to be necessary (> 100 therapy hours). Especially in chronic back pain rehabilitation, purposefully refined aftercare treatments offer the possibility to intensify positive effects or to increase their sustainability. However, quality assured goal-conscious specific aftercare programs for the rehabilitation of chronic back pain are absent.</p> <p>Methods/Design</p> <p>This study aims to examine the efficacy of a specially developed bio-psycho-social chronic back pain specific aftercare intervention (RÜCKGEWINN) in comparison to the current usual aftercare (IRENA) and a control group that is given an educational booklet addressing pain-conditioned functional ability and back pain episodes. Overall rehabilitation effects as well as predictors for compliance to the aftercare programs are analysed. Therefore, a multicenter prospective 3-armed randomised controlled trial is conducted. 456 participants will be consecutively enrolled in inpatient and outpatient rehabilitation and assigned to either one of the three study arms. Outcomes are measured before and after rehabilitation. Aftercare programs are assessed at ten month follow up after dismissal form rehabilitation.</p> <p>Discussion</p> <p>Special methodological and logistic challenges are to be mastered in this trial, which accrue from the interconnection of aftercare interventions to their residential district and the fact that the proportion of patients who take part in aftercare programs is low. The usability of the aftercare program is based on the transference into the routine care and is also reinforced by developed manuals with structured contents, media and material for organisation assistance as well as training manuals for therapists in the aftercare.</p> <p>Trial Registration</p> <p>Trial Registration number: NCT01070849</p

New Products and Services: Analysis of Regulations Shaping New Markets: Study Funded by the European Commission, DG Enterprise / Innovation Policy Unit, in the Framework of the Innovation / SMEs Programme, Part of the Fifth Research Framework Programme

New products and services are the driving force of a dynamic and persperous economy. Besides the direct public promotion of new products and services, e.g. by public funding for research and innovation activities, framework conditions are crucial for the success of new products and services in the market. In contrast to direct support measures, this report focuses on regulations shaping new markets as indirect, but crucial framework conditions, which have often far reaching and ambivalent impacts and are therefore an important topic for policy makers, e.g. as discussed at the World Economic Forum 2004 in Davos. The study "New Products and Services. Analysis of Regulations Shaping New Markets" aims to to reduce the lack of adequate, reliable and systematic knowledge on the relation between regulation, including deregulation, on the one hand and the emergence of new markets on the other. On that basis, the aim is to develop suggestions for a regulatory framework which allows the emergence of new markets, and even to use regulation systematically as an instrument to foster innovation

Das Gesundheitswesen aus Innovationssystemperspektive: Acht Thesen und Handlungsmöglichkeiten. Teil 1

The German Health Care System seen from an Innovation Systems Perspective: Eight Theses and Options for ActionThe need for reform and the future viability of the German health care system have been at the centre of political and academic debates for many years. So far, innovation research has been rather irrelevant in this context. Nevertheless, it allows for a new view of the health care system since it investigates the obstacles and potentials of both technical-economic and organisational-social innovations. From this innovation systems perspective, the paper presents eight theses on the German health care system and discusses a variety of options for action in order to develop the system further