Publications by authors named "Vincent Grote"

5 Publications

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Comparison of patient- and clinician-reported outcome measures in lower back rehabilitation: introducing a new integrated performance measure (t2D).

Qual Life Res 2021 Jun 15. Epub 2021 Jun 15.

Ludwig Boltzmann Institute for Rehabilitation Research, Reizenpfenninggasse 1, 1140, Vienna, Austria.

Purpose: Patient- and clinician-reported outcome measures (PROMs, CROMs) are used in rehabilitation to evaluate and track the patient's health status and recovery. However, controversy still exists regarding their relevance and validity when assessing a change in health status.

Methods: We retrospectively analyzed the changes in a CROM (Fingertip-To-Floor Test - FTF) and PROMs (ODI, HAQ-DI, NPRS, EQ5D) and the associations between these outcomes in 395 patients with lower back pain (57.2 ± 11.8 years, 49.1% female). We introduced a new way to measure and classify outcome performance using a distribution-based approach (t2D). Outcome measures were assessed at baseline and after 21 days of inpatient rehabilitation.

Results: Overall, the rehabilitation (Cohens d = 0.94) resulted in a large effect size outcome. Medium effect sizes were observed for FTF (d = 0.70) and PROMs (d > 0.50). Best performance rating was observed for pain (NPRS). We found that 13.9% of patients exhibited a deterioration in the PROMs, but only 2.3%, in the FTF. The correlation between the PROMs and FTF were low to moderate, with the highest identified for HAQ-DI (rho = 0.30-0.36); no significant correlations could be shown for changes. High consistency levels were observed among the performance scores (t2D) in 68.9% of the patients.

Conclusions: Different and complementary assessment modalities of PROMs and CROMs can be used as valuable tools in the clinical setting. Results from both types of measurements and individual performance assessments in patients provide a valid basis for the meaningful interpretation of the patients' health outcomes.

Trial Registration: This clinical study was entered retrospectively on August 14, 2020 into the German Clinical Trials Register (DRKS, registration number: DRKS00022854).
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http://dx.doi.org/10.1007/s11136-021-02905-2DOI Listing
June 2021

General and Disease-Specific Health Indicator Changes Associated with Inpatient Rehabilitation.

J Am Med Dir Assoc 2020 12 28;21(12):2017.e10-2017.e27. Epub 2020 Jul 28.

Division of Physiology, Otto Loewi Research Center, Medical University of Graz, Graz, Austria; Human Research Institute, Weiz, Austria.

Objectives: Rehabilitation plays a vital role in the mitigation and improvement of functional limitations associated with aging and chronic conditions. Moderating factors such as sex, age, the medical diagnosis, and rehabilitation timing for admission status, as well as the expected change related to inpatient rehabilitation, are examined to provide a valid basis for the routine assessment of the quality of medical outcomes.

Design: An observational study was carried out, placing a focus on general and disease-specific health measurements, to assess representative results of multidisciplinary inpatient rehabilitation. Aspects that were possibly confounding and introduced bias were controlled based on data from a quasi-experimental (waiting) control group.

Measures: Existing data or general health indicators were extracted from medical records. The indicators included blood pressure, resting heart rate, self-assessed health, and pain, as well as more disease-specific indicators of physical function and performance (eg, activities of daily living, walking tests, blood lipids). These are used to identify moderating factors related to health outcomes.

Setting And Participants: A standardized collection of routine data from 16,966 patients [61.5 ± 12.5 years; 7871 (46%) women, 9095 (54%) men] with different medical diagnoses before and after rehabilitation were summarized using a descriptive evaluation in terms of a content and factor analysis.

Results: Without rehabilitation, general health indicators did not improve independently and remained stable at best [odds ratio (OR) = 0.74], whereas disease-specific indicators improved noticeably after surgery (OR = 3.20). Inpatient rehabilitation was shown to reduce the risk factors associated with certain lifestyles, optimize organ function, and improve well-being in most patients (>70%; cutoff: z-difference >0.20), with a standardized mean difference (SMD) seen in overall medical quality outcome of -0.48 ± 0.37 [pre- vs post-rehabilitation: η = 0.622; d = -1.22; 95% confidence interval (95% CI) -1.24 to -1.19]. The baseline medical values obtained at the beginning of rehabilitation were influenced by indication, age, and sex (all P < .001); however, these factors have less significant effects on improvements in general health indicators (η < 0.01). According to the disease-specific results, the greatest improvements were found in older patients (SMD for patients >60 vs ≤60 years: 95% CI 0.08-0.11) and during the early rehabilitation stage (η = 0.063).

Conclusions And Implications: Compared with those who received no inpatient rehabilitation, patients who received rehabilitation showed greater improvements in 2 independent areas, general and disease-specific health measures, regardless of their diagnosis, age, and sex. Due to the study design and the use of a nonrandomized waiting group, causal conclusions must be drawn with caution. However, the comparability and stability of the presented results strongly support the validity of the observed improvements associated with inpatient rehabilitation.
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http://dx.doi.org/10.1016/j.jamda.2020.05.034DOI Listing
December 2020

Dynamics of Vagal Activity Due to Surgery and Subsequent Rehabilitation.

Front Neurosci 2019 5;13:1116. Epub 2019 Nov 5.

Human Research Institute, Weiz, Austria.

Background: Vagal activity is critical for maintaining key body functions, including the stability of inflammatory control. Its weakening, such as in the aftermatch of a surgery, leaves the body vulnerable to diverse inflammatory conditions, including sepsis.

Methods: Vagal activity can be measured by the cardiorespiratory interaction known as respiratory sinus arrhythmia or high-frequency heart-rate variability (HRV). We examined the vagal dynamics before, during and after an orthopedic surgery. 39 patients had their HRV measured around the period of operation and during subsequent rehabilitation. Measurements were done during 24 h circadian cycles on ten specific days. For each patient, the circadian vagal activity was calculated from HRV data.

Results: Our results confirm the deteriorating effect of surgery on vagal activity. Patients with stronger pre-operative vagal activity suffer greater vagal withdrawal during the peri-operative phase, but benefit from stronger improvements during post-operative period, especially during the night. Rehabilitation seems not only to efficiently restore the vagal activity to pre-operative level, but in some cases to actually improve it.

Discussion: Our findings indicate that orthopedic rehabilitation has the potential to strengthen the vagal activity and hence boost inflammatory control. We conclude that providing a patient with a vagal reinforcement procedure to the surgery ("pre-habilitation") might be a beneficial strategy against post-operative complications. The study also shows the clinical usefulness of quantifying the cardiorespiratory interactions.
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http://dx.doi.org/10.3389/fnins.2019.01116DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6849369PMC
November 2019

Adaption of cardio-respiratory balance during day-rest compared to deep sleep--an indicator for quality of life?

Psychiatry Res 2014 Nov 9;219(3):638-44. Epub 2014 Jun 9.

Department of Endocrinology, Diabetology and Clinical Nutrition, Autonomic Lab, University Hospital Inselspital, University of Berne, Murtenstrasse 21, CH-3010 Bern, Switzerland. Electronic address:

Heart rate and breathing rate fluctuations represent interacting physiological oscillations. These interactions are commonly studied using respiratory sinus arrhythmia (RSA) of heart rate variability (HRV) or analyzing cardiorespiratory synchronization. Earlier work has focused on a third type of relationship, the temporal ratio of respiration rate and heart rate (HRR). Each method seems to reveal a specific aspect of cardiorespiratory interaction and may be suitable for assessing states of arousal and relaxation of the organism. We used HRR in a study with 87 healthy subjects to determine the ability to relax during 5 day-resting periods in comparison to deep sleep relaxation. The degree to which a person during waking state could relax was compared to somatic complaints, health-related quality of life, anxiety and depression. Our results show, that HRR is barely connected to balance (LF/HF) in HRV, but significantly correlates to the perception of general health and mental well-being as well as to depression. If relaxation, as expressed in HRR, during day-resting is near to deep sleep relaxation, the subjects felt healthier, indicated better mental well-being and less depressive moods.
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http://dx.doi.org/10.1016/j.psychres.2014.06.004DOI Listing
November 2014

Cardio-autonomic control and wellbeing due to oscillating color light exposure.

Physiol Behav 2013 Apr 16;114-115:55-64. Epub 2013 Mar 16.

HUMAN RESEARCH INSTITUTE for Health Technology and Prevention Research, Weiz, Austria.

We investigated the cardio-autonomic and psychological effects of colored light cycling with the wavelength of ultradian rhythms. In two consecutive experiments, an explorative, longitudinal test followed by a randomized crossover design, 20 healthy subjects each were exposed to oscillating red, green and blue light. Heart rate, heart rate variability (HRV) and subjective wellbeing were measured. Significant effects of the oscillating color light exposure were observed for heart rate and cardio-autonomic control rhythms, derived from HRV (p≤.001). These effects on HRV were replicated in the second experiment in comparison to a similar white light exposure protocol (p≤.05). Vigilance showed improvement over the two weeks (p≤.001) in the longitudinal study. External color light cycling at the wavelength of blood pressure oscillations appears to amplify the endogenous autonomic oscillations. This leads to an optimization of cardio-autonomic control; an effect that was reflected shortly after the onset of the light exposure sessions by the increase of heart rate variability. From the results, we conclude that it takes repeated light exposure session to foster the positive effects on the psychological aspects, as we observed an increase of subjectively perceived mood only in the longitudinal study, not for the crossover design study. The results of our study imply some possible health effects of a color light exposure that is adjusted to 10 s and 1 min oscillations of humans' ultradian rhythms. These novel results show possible applications of oscillating visual inputs to the activation of processes connected to physiological regulation.
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http://dx.doi.org/10.1016/j.physbeh.2013.03.007DOI Listing
April 2013
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