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Dipl.-Psych. Roland Küffner
Universität Würzburg
Abteilung Medizinische Psychologie, Medizinische Soziologie und Rehabilitationswissenschaften

Klinikstraße 3
97070 Würzburg
Tel.: 0931 31-2071

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Live-Online aftercare of trained rehabilitees through E-learning

Aftercare should anchor the positive effects of an inpatient rehabilitation into the everyday lives of patients following discharge from the clinic in a sustained manner. This is achieved by strengthening the autonomy and self-management abilities of the patients. However, inpatient aftercare offers mean long journeys and can therefore only be actually utilised by some patients. Therefore, the current study wishes to put to the test a novel concept which transfers the aftercare to the Internet.

Study participants are orthopaedic patients who have taken part in a patient training program for pain management during inpatient rehabilitation. Following their discharge, these patients take part in online group sessions on a monthly basis over a period of six months. The sessions are led by a therapist from the clinic. The group meets in a “virtual seminar room”, which reproduces many aspects of face-to-face group training: As in a telephone conference, all participants can talk directly to one another. Moreover, further media are employed, such as flip charts or OHTs. The goal of the seminars is to maintain the skills learned in the area of pain management in everyday life and to enable participants to tackle possible problems and obstacles directly in their own home environment.

In the framework of the study, this live online aftercare should be developed and implemented in two clinics. A scientific measurement of effectiveness should allow an assessment of weather the measure is suitable for a broader use.

Roland Küffner & Prof. Dr. Dr. Hermann Faller (Project leaders)



Aftercare measures should support the transfer of medical-therapeutic services into everyday life. This is rendered more difficult by the additional expenditure in terms of organisational factors and personnel in the establishments as well as by long journey times and the associated high time expenditure required from the participants. The linking of an inpatient training with an online aftercare offered on the Internet thus represents an alternative to inpatient models. In the study, by way of example, a live online aftercare for orthopaedic rehabilitation is developed and evaluated.

To this aim, orthopaedic patients who have received pain management training in the framework of an inpatient rehabilitation, take part in online group sessions following their discharge. These are carried out in the patients’ own home on a monthly basis for six months. Under the guidance of the therapist from the clinic, the group meets in an “online seminar room” – a virtual seminar environment on the Internet in which many aspects of a real seminar situation can be reproduced: The participants are in contact with one another via language, similar to a telephone conference and can use further media, for example an electronic flip chart or OHTs. The seminars should maintain the abilities for pain management that have been learned, and enable problems that arise to be directly tackled in the patients’ own familiar environment.


Aims/Research questions

The main research question is as follows:

A: Are participants of a live online aftercare better able to adopt the pain management learned during the rehabilitation in their everyday lives and thus maintain the effect of the rehabilitation on the chronic back pain in the long term?

As the concern is with a new type of intervention method, in addition, the following auxiliary questions should be addressed within the study:

B: Can the organisation and implementation of live online aftercare sessions be arranged and standardised such that the measure can be recommended as a routine procedure in rehabilitation?

C: What advantages and disadvantages does the procedure entail?


Study design/Methods

For the summative evaluation of effectiveness, a multi-centre, randomised control group design with four measurement time points was selected. In two rehabilitation centres of the German Association of Pension Insurers, 632 participants should be consecutively recruited and allocated through an external randomisation on the level of training groups of the clinics to the two experimental conditions (cluster randomisation).

In both establishments, behavioural-medicine-oriented pain management training is conducted. The intervention group receives, after their discharge from the rehabilitation clinic, 6 Internet aftercare sessions on this training, while the control group receives no aftercare services (usual care).

Patient data are collected at the beginning, end, as well as 6 and 12 months after the rehabilitation. Primary dependent variables of the treatment success are pain and cognitive and behavioural pain management. Secondary dependent variables are pain-related emotional impairments (depression, anxiety), motivation for pain management as well as the general physical and emotional functional ability. As further dependent variables, patients will be asked about their satisfaction with the rehabilitation and the aftercare offer, respectively.


Current status:

The patient recruitment was initiated at the beginning of 2009. Prior to this, the participating therapists were taught in several blocks how to operate the live online software and about the didactic possibilities thereof. They were trained as “online moderators” to enable them to lead the groups independently in the intervention phase.

In collaboration with the therapists, the work materials for the online sessions were produced and guidelines for conducting the intervention were developed, with the aim of standardising the implementation of the aftercare sessions. Main focuses of the sessions are elements of a planning intervention which supports patients in transferring what they learned during the inpatient rehabilitation to their own everyday lives.

< Evaluation of a planning intervention - Faller  |  influence of SDM on motivation - Neuderth >