{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T01:38:52Z","timestamp":1776908332675,"version":"3.51.2"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rehabilitation (Stuttg)"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>war es zu untersuchen, ob die Rehabilitationserfolge, operationalisiert als\nPr\u00e4-post-Ver\u00e4nderungen, bei R\u00fcckenschmerzen in Deutschland seit 1990\nzugenommen haben und ob sie sich in einem Bereich von klinischer Relevanz\nbewegen.<\/jats:p>\n                  <jats:p>Es wurde nach Studien gesucht, die zu mindestens 2 Messzeitpunkten Verl\u00e4ufe\nvon Schmerzintensit\u00e4t, Depressivit\u00e4t, Katastrophisieren, Vitalit\u00e4t,\nFunktionskapazit\u00e4t und Arbeitsunf\u00e4higkeitstagen berichteten. Mit den\nstandardisierten Mittelwertdifferenzen wurden Metaanalysen gem\u00e4\u00df dem\nRandom-Effects-Modell durchgef\u00fchrt, getrennt nach kurz-, mittel- und\nlangfristigen Effekten. Die Mittelwertdifferenzen wurden zus\u00e4tzlich an den\nSkalenbreiten der jeweiligen Messinstrumente standardisiert und\nmetaanalytisch kombiniert. 15% der Skalenbreite galt als Schwelle f\u00fcr\nklinische Relevanz der Ver\u00e4nderung. Subgruppenanalysen pr\u00fcften, ob Studien,\ndie nach 2004 publiziert worden waren, bessere Rehaerfolge berichteten als\n\u00e4ltere Studien. Ein \u00e4hnliches Ziel verfolgten Metaregressionen mit dem\nPublikationsjahr als Moderatorvariable.<\/jats:p>\n                  <jats:p>Insgesamt wurden 80 Studien mit 19\u2009844 Teilnehmenden einbezogen, darunter 57%\nkontrollierte Studien und 5 Studien mit Usual Care als Vergleichsgruppe. Die\nMetaanalysen ergaben m\u00e4\u00dfige bis moderate Erfolge bei hoher Heterogenit\u00e4t und\nmittlerer Studienqualit\u00e4t, allerdings \u2013 mit Ausnahme einer kurzfristigen\nSteigerung der Vitalit\u00e4t \u2013 ohne praktische Relevanz. J\u00fcngere Studien\nberichteten g\u00fcnstigere Verl\u00e4ufe als \u00e4ltere allein bei kurzfristiger\nVerbesserung der Funktionskapazit\u00e4t (0,21 vs. 0,38, p=0,014). Die\nMetaregressionen best\u00e4tigten diesen Befund. Die Heterogenit\u00e4t der Ergebnisse\nwar erheblich und konnte durch Studienmerkmale wie Ausgangslage, Alter der\nTeilnehmenden oder Anzahl der Studienzentren nicht erkl\u00e4rt werden. Die\nInkonsistenz belastet die Ergebnisse mit erheblicher Unsicherheit. Sie\nverweist zudem auf einen Mangel in der Gleichf\u00f6rmigkeit der Versorgung.<\/jats:p>\n                  <jats:p>Trotz zahlreicher Bem\u00fchungen um Verbesserungen in der Struktur- und\nProzessqualit\u00e4t gab es keine Anhaltspunkte daf\u00fcr, dass sich die Erfolge der\nRehabilitation bei R\u00fcckenschmerzen seit 1990 mehr als nur marginal\ngesteigert haben. Sie bleiben \u00fcberwiegend auf einem niedrigen Niveau\nunterhalb der Relevanzschwelle. Aussagekr\u00e4ftige randomisierte kontrollierte\nStudien (RCTs) zur absoluten Wirksamkeit fehlen weiterhin.<\/jats:p>","DOI":"10.1055\/a-2733-7180","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:27:41Z","timestamp":1764721661000},"page":"84-92","source":"Crossref","is-referenced-by-count":0,"title":["Gibt es Fortschritte in der deutschen Rehabilitation bei\nR\u00fcckenschmerzen? Systematisches Review mit Metaanalysen und Metaregressionen von\nStudien seit 1990"],"prefix":"10.1055","volume":"65","author":[{"given":"J\u00fcrgen","family":"H\u00f6der","sequence":"additional","affiliation":[{"name":"Hamburg"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,12,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1055\/s-2003-40099","article-title":"Die Wirksamkeit station\u00e4rer medizinischer Rehabilitation in Deutschland bei\nchronischen R\u00fcckenschmerzen: eine systematische Literatur\u00fcbersicht\n1980\u20132001","volume":"42","author":"A H\u00fcppe","year":"2003","journal-title":"Rehabilitation"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1055\/s-2004-834602","article-title":"Zur Wirksamkeit von station\u00e4rer medizinischer Rehabilitation in Deutschland bei\nchronischen R\u00fcckenschmerzen: Aktualisierung und methodenkritische 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