2021-09-23
Wheelchair accessories of REHAB Innovations Centre ONLINE
Empulse F55
Empulse F55

P+L Innovations presents Trivida, the world’s first wheel that enables maximum accessibility and the user’s change of position out of and into the wheelchair. By removing the upper segment of the wheel, lateral transfer from the wheelchair to an external seating surface and vice versa are possible. This significantly reduces the physical strain on patients, their relatives and caregivers. The new Empulse F55 wheelchair hoist from Sunrise Medica combines high performance and a pleasurable ride. The angle and height are continuously adjustable so weight to be shifted onto the front wheel, thus increasing traction and manoeuvrability. The traction device is compatible with many rigid-frame and foldable wheelchairs, thus reducing the burden on the joints of the arms and shoulders.

Loopwheel
Loopwheel

The e-motion DuoDrive from the Alber company enables wheelchair users to cover longer distances without having to manually push the hand rim. In addition to the familiar residual power assistance, the wireless control unit can also activate and control a permanent driving function as a second operating mode. Similar to cruise control, the wheelchair maintains its speed – even on upgrades as steep as 10%. This means that the wheelchair has two drive modes, which the user can switch between whenever desired or required. Tetra Equipment likewise presents an innovative product: the Loopwheel for wheelchairs. These shock-absorbent wheels have carbon springs and specially developed hubs to absorb vibrations and shocks, thus making it easier for the wheelchair to overcome thresholds, uneven surfaces and kerbs, while simultaneously reducing pain, spasticity and fatigue for users and their aides.

2021-09-23
Automotive solutions of REHAB Innovations Centre ONLINE
VW Caddy Maxi
VW Caddy Maxi

MobiTEC presents its new VW Caddy Maxi in REHAB’S ONLINE Innovation Centre. This lowered vehicle integrates many special solutions to facilitate safe and comfortable transportation. The lowered vehicle floor and the floor pan are highlights: both are almost entirely level, with very slight inclinations of just 2° and 1.5°, respectively. Greater safety for children in road traffic is assured by HERNIK company’s new IPAI LGT child seat, which includes thorax pads and a five-point harness as standard equipment. To facilitate individual modifications, the HERNIK also offers various accessories such as an abduction wedge, seat angle adjustment, and a support and safety pad.

PARAVAN’s VW T6.1 Extended lowers the vehicle’s floor from the A-pillar to the C-pillar to provide a flexible mobility solution for self-drivers and passengers in wheelchairs. Thanks to the optimized entry height, even tall people can easily enter the vehicle’s interior. The handicapped-accessible conversions to the vehicle allow the driver’s seat and the front passenger’s seat to be interchanged so the latter can be locked into position behind the steering wheel and used as the driver’s seat.

2021-09-23
children's aids of REHAB Innovations Centre ONLINE
Heidelberger Liegebär Lasse 2020
Heidelberger Liegebär Lasse 2020

As a manufacturer of rehabilitation aids, Rehatec presents the Heidelberger Liegebär Lasse 2020 child-standing device, which is available in various sizes. Both vertically and horizontally adjustable in height, the device can be vertically lowered all the way to the floor by means of a pneumatic spring or electric motor. The backrest board is individually adjustable as well: its angle of inclination ranges from 0° to 90°. Twenty-two different frame colours and six different covers offer the option of individualized styling. Among other highlights from its current portfolio, Schuchmann presents the “till” inclined lying board. This innovative board facilitates safe and comfortable transfers from a lying to a standing position. Various adjustment options allow individual adaptation to suit the unique shape of each child’s body. Thoracic and pelvic pads provide support and enable a stable standing position.

Volaris presents the Panthera Bambino 3 children’s wheelchair, which is suitable for children from 4 to 12 years of age. The new width adapter for the seat and the adjustable side guard can be readjusted to accommodate a growing child. Thanks to intelligent, easily removable push bars, this wheelchair can also be used without an accompanying person, thus facilitating autonomous mobility for children.

2021-09-23
Wheelchair skating - a fascinating hobby

“Do what you want to do and go for it!!!” This crystal-clear message comes from someone who has taken a few low blows in terms of his health. Til Augustin from Chemnitz is not quite eighteen years old and has already spent “years” of his life at Leipzig University Hospital. But he says the hospital’s school is so “fab” that he’s sailing smoothly toward his Abitur (school leaving examination) two years from now. And Til has a special hobby: wheelchair skating.

German and world championships spur him on

Til first came into contact with wheelchair skating at a trade fair when he was fourteen, and his enthusiasm for this breakneck sport – at least it looks like a breakneck sport – was unstoppable. A national pro and a coach for wheelchair sports took him under their wings. “It would have been nothing without Patrick and Timon”, Til is sure. And that’s how it – and he – really became something. The three latest jewels in the crown of Til’s Wheelchair Motocross (WCMX) career are two German championships and a world championship in his young age group. HIs great role models David Lebuser and, in the USA, Aaron Fotheringham set milestones when they threw themselves and their wheelchairs into halfpipe and skate arenas.

When life gives you a wheelchair, find a skate park!

Of course, all this demands the right equipment. In addition to a helmet, back protection and pads for the arms and legs, an extremely resilient and highly customized wheelchair with special suspension is a must. Such a wheelchair is “essential for survival” for Til, who was born paralyzed from the navel downward with caudal regression syndrome and a back tumour, and has since undergone countless operations and most recently lost half his hip and a piece of his thigh bone. Donations financed his first sports wheelchair. Til’s aid supplier from Cologne works together with the Reha-Sport-Club Rhineland accordingly knows exactly what WCMX heroes need. There are about 100 such athletes of all ages in Germany. “WCMX is super inclusive”, Til says. “The new skate park in Chemnitz is almost barrier-free. Young people with and without handicaps all cavort there.”

Individually equipped aids are “essential for survival”

Til also uses his customized wheelchair in everyday life because it is the only one that is completely tailored to suit his stiff back, partly missing pelvis and corrected ribs. He recently has applied to his health insurer for a similar model in a version suitable for everyday use. “We’ll see if that goes through, but we haven’t found any other wheelchair that fits my physique like this.” An everyday wheelchair is important because although his family’s apartment is on the ground floor, it is not very spacious and stairsteps lead up to the front door.

Til’s mother Gundel Augustin supports her son in his hobby: “With eight special children, one of whom is especially special, you sometimes have to be more relaxed and simply let go. Besides, I always look fate in the face with optimism. When I trust my kids with something and let them learn from their experiences, everything usually goes well and they end up stronger afterwards.” Gundel accompanies her son to Leipzig for his many hospital stays. “That’s when my rescue chain of family and friends has to step in. I’m very grateful to them.”

This single mother is currently heading for her dream job: “I’ll be starting my new job this fall as a social pedagogue with administrative training. My task will be to coordinate the lives of refugees in our area after their initial reception here. All my talents will be needed.”

And what’s next for Til’s talent? What’s your dream, Til? He responds without missing a beat: “First, I want to get my driver’s license and then tour Europe with a converted camper van and a dog. That would be cool.” His mother has a down-to-earth dream of three weeks off, with nothing but free time for herself and her interests.

Inclusive sports facility: playing sports together at REHAB

Who knows, maybe you’ll meet Til and Gundel at REHAB? For example, at the Inclusive Sports Facility, where interested people with and without handicaps can get to know inclusive sports and try them out. In previous years, a daily program featuring wheelchair versions of rugby, fencing and basketball, as well as frisbee, inclusive field hockey and wheelsoccer, encouraged people to join in and play together. The program for the upcoming REHAB will be available in March 2022.

2021-09-23
Information on the new law GKV-IPReG
Christiana Hennemann
Christiana Hennemann

The GKV-IPReG is a law that is intended to strengthen intensive care and rehabilitation. Applicable to statutory health insurance companies, the statute had already sparked much controversy in its formative phase. The first draft, known as RISG, was strongly criticized by relevant associations and affected individuals. It sparked such vociferous protests in front of the Bundestag that the Federal Ministry of Health changed the statute’s name and contents several times before the law ultimately took effect under the name IPReG at the end of 2020. Health Minister Spahn promised: “People who need intensive care should receive it at whatever location is best for them. Mandatory quality specifications for intensive care at private homes, in hospitals and in institutional residential facilities are intended to ensure that care is strengthened, especially for patients who are often no longer able to speak for themselves.” But affected individuals and their relatives view the situation quite differently. They are acutely concerned that self-determination will be massively curtailed. The decision as to where long-term care will be given now lies with the health insurers and the Medical Service of the Health Funds. The IPReG does not reflect the system of out-of-hospital intensive care, which was established many years ago and is supported by qualified homecare providers and nursing services to enable optimal participation and self-determined living at home. Recipients and givers of intensive care are wary of a tendency toward long-term hospitalization of patients under the pretext that nursing care is better provided in institutional facilities than in family environments.

The Federal Joint Committee (Gemeinsamer Bundesausschuss – GBA) is now tasked with drafting the implementation guideline for the IPReG. Associations of patients and professional groups are among those that have been invited to submit comments. The Interest Group for Self-determined Living (Interessengemeinschaft Selbstbestimmt Leben –ISL) writes in the conclusion of its commentary on the submitted draft guideline: “A common thread of external control and professed solicitude, coupled with a very obvious strengthening of institutional care and efficiency, runs through the guideline. Contrariwise, the affected individuals deserve to be regarded as self-determined, competent and capable people. The insured persons affected here are not objects to passively receive solicitous authoritarian treatment, but possess the right, the power and the self-determination to make their own decisions. The right of wish and choice is not only anchored in the UN Convention on the Rights of Persons with Disabilities, but also in Germany’s constitution.”

Affected individuals and their relatives, experts from the fields of medicine, caregiving and medical technology, relevant associations and other activists have joined forces and formed a thinktank to develop provide constructive criticism of the IPReG. Their aim is to ensure that individual intensive care is provided in the genuine best interests of the affected individuals. The separation of care for children and adolescents as stipulated by the age limit of 18 years is extremely important for rehaKIND e.V. Families are already heavily burdened by the struggle for assistance and care options; far too few specialized caregivers are available; and since the beginning of the coronavirus pandemic, siblings must be looked after and taught via homeschooling. Everyone involved is at the end of their tether.

Since September 2020, expertise has been gathered in regularly scheduled Zoom meetings to inform the GBA and the Federal Ministry of Health about the realities of caregiving. These demands are also based on the UN Convention on the Rights of Persons with Disabilities, the German constitution, the social security laws and numerous fundamental publications.

At least one good thing has come from the IPReG: networking is progressing on personal and professional levels. New networks to ensure the individual quality of care have been formed and will continue to actively participate in shaping the legal and political framework. Two activists from the thinktank summarized their personal motivations in this regard.

The blogger and doctoral candidate in mathematics Tim Melkert views the issue quite pragmatically: “Through my work in the thinktank, I hope to have explained at least once to the members of the Federal Joint Committee (GBA) what degree of autonomy and self-determination some individuals with continuous ventilation like myself already enjoy today and how drastically our lives would be externally controlled and restricted if we were strictly subjected to the implementation guidelines specified by the GKV-IPReG.”

The journalist, care expert and activist Laura Mench likewise has her own opinion about IPREG: “As a person with a progressive disease whose perspective for the future involves invasive ventilation, I am personally affected and deeply concerned about the situation surrounding the GKV-IPReG. I am participating in the thinktank because only by working together can we influence events and contribute toward shaping the development of guidelines for implementation.”

Let us hope that the affected and concerned individuals, who are often the best experts in their own field, will be heard before the Federal Joint Committee (GBA) publishes the implementation guidelines. To help accomplish this goal, the thinktank is launching a poster campaign showing the great diversity in the people who need out-of-hospital intensive care and in the lives they lead. Many adults among them pursue productive careers and thus contribute to Germany’s gross national product.

Link to tips about the detailed essentials and participants of the thinktank: https://www.cody.care/gkv-ipreg-thinktank/

Link to the GKV-IPReG: https://www.cody.care/gkv-ipreg/

2021-09-23
REHADAT - Database around disability, occupation and participation

“Hello! My name is Ariadne and I can support you in your search for assistive resources. However, I do not replace professional advice.” This is how the digital assistant introduces herself when she offers to navigate advice seekers through the new REHADAT Assistive Resource Finder app.

With fourteen portals, as well as numerous publications, apps and seminars, REHADAT is a central, free and impartial information service on participation and inclusion of people with disabilities. REHADAT began as a digital database of specialized literature and has grown to become a contact and collection point for everything worth knowing about disability, medicine, therapy, professional life and much more. REHADAT will have its own booth at REHAB 2022, where professional and private visitors can learn about REHADAT’s s digital information and consulting services.

REHADAT informs about more than just vocational integration

It all began in 1989, when REHADAT (which is now funded by the Federal Ministry of Labour and Social Affairs) was initially only about vocational integration for people with disabilities. Mareike Decker, a consultant at REHADAT, summarizes its evolution: “We have long known that people should be viewed holistically and that work is a big part of life. But if there are difficulties in a person’s residential environment, with their access to assistance devices, with legal issues, or health and family problems, then an isolated vocational information system does not help.” As a trained occupational therapist, Decker works enthusiastically in the REHADAT team to bring together the wealth of knowledge and life-enhancing information for those affected and their professional environments in rehabilitation and vocation. Employers, for example, will find helpful information collected here about hiring people with disabilities as well as best practice examples. REHADAT’s services are barrier-free and accessible at no cost.

Assistive resources, practical examples, legal information, statistics, addresses, literature, education, research and further training: the knowledge available from REHADAT is comprehensive and, thanks to cross-linking with international institutions, it also extends far beyond Europe’s borders. For quick and accurately targeted dialogues with responsible institutions or organizations, REHADAT can respond either through a conversation with a real person or by interacting with digital Alexa, who goes by the name “Ariadne” here as she guides questioners through an extensive database of relevant knowledge.

Tips and explanatory videos on social media and YouTube

In addition to the portals, there are also easily readable, illustrated and comprehensive brochures on a wide variety of disease patterns ranging from diabetes through hearing impairment to rheumatism. REHADAT’s team collects knowledge and prepares it so that even non-medical people can readily understand it and get helpful tips. Resources for vocation and work, degree of disability and compensatory levy: many topics are explained in an ever-growing collection of videos on YouTube. Mareike Decker adds: “Sharing with users and feedback from them are extremely important to us because we want to offer practical added value for the people who consult REHADAT, many of whom are facing personally difficult and challenging circumstances. By informing people impartially and reliably, and by offering them a broad range of information, we pursue our goal of creating a basis for individual options for action.”

Link tips:

Central access: www.rehadat.de

Resources:

https://www. hilfsmittelfinder.de

Brochures on the design of occupational participation for individual disease patterns (knowledge series): https://www.rehadat.de/presse-service/publikationen/

Tips on issues related to disability and occupation::

https://www.rehadat-gutepraxis.de

https://www.youtube.com/channel/UCVymJtubI33eFXHiJ4OyHyQ

Further addresses of aid providers and central contact points:

https://www.rehadat-adressen.de

2021-07-14
Exhibitor and product database

Numerous companies have already decided to participate in REHAB 2022 and will present their new rehabilitation, orthopedic and medical technology products as well as innovations for care and therapy at the upcoming REHAB. Already now, the companies and their products can be found in our exhibitor and product database.

REHAB overview hall
2021-07-13
Preliminary floorplans for download

Extended exhibition area in 3 halls

By opening the third hall, we can now accommodate your specific placement wishes better than ever before.

Would you like to take part in REHAB 2022 as an exhibitor, increase the area of your stand or change your placement? Then take a look at the preliminary floorplans and secure your preferred stand space.

REHAB site plan
2021-05-05
How Finnish artist Jenni-Juulia turns a fragile world into art

Jenni-Juulia Wallinheimo-Heimonen is a total work of art herself - her open nature and her unusual politically influenced artmaking cannot be overlooked with indifference. She combines her life and experiences with OI – also called brittle bone disease – with creativity and her artistic training at Aalto University in Helsinki to create a specific perspective. Her creative expression is rich: starting with textile art, Jenni-Julia has expanded her repertoire to include video art, sculptures, installations, and performances.

In Germany, interest in her artistic work is growing.

Growing up in a family with visual impairment (on her father's side) and osteogenesis imperfecta/ OI (on her mother's side) in the fourth generation, she lives a life of ingenious practices designed for coping with everyday life that have been passed on from generation to generation. When OI family members break a bone, for example, certain routines are adapted to the changed situation to continue everyday life as normally as possible. Living with physical limitations is normality for the family members and becomes a special way of life - even if outsiders and the physically unimpaired would like to classify this lifestyle as adaptation, extreme courage or even survival.

Projekt Chairwomen
Projekt Chairwomen

Jenni-Juulia’s intention is to change the perception of disability.

Her artistic work starts with the following questions: Why are rare diseases not protected as a part of biodiversity? Why do non-disabled people determine how we should live, what aids we should use, and thus deny us the opportunities to live out our personal lifestyles? Why is charity confused with human rights?

With her politically motivated works, she touches on a sore point and motivates the public to become involved and think. Her art is a means of communication aimed at changing the perception of disability.

She mobilises all means to this end.

Tickle the crippled
Tickle the crippled

Her creative means of expression range from textile art to video art, sculptures, and installations through to performances

With her “Wheelchair piano“ project, she uses music as an element that unites everyone, overcoming linguistic barriers in interaction between “people with features uncomfortable to behold” and the physically unimpaired.

In "Tickle the crippled", Jenni-Juulia, lying in a plexiglass bubble, invites passers-by to touch her through gloves integrated into the skin of a bubble. The differing reactions from the public reflect the differences in generations’ attitudes towards disabilities: adults are gripped by shyness, unease, and rejection whereas children can easily embrace this "unusual offer" in a playful manner. This is evidence that the way we deal with disability evolves from "normality" to "exclusion" from the influence exerted by our society during the course of our lives.

Her son's febrile illness inspired her to create a special garment, the “thermochromic fever shirt”. The colour of its fabric changes as soon as the body temperature rises above 37 degrees. The body's fight against an invading disease is thus made visible in an aesthetic way and translated into a positive process.

The “Chairwomen performance” project simulates a situation in which a pedestrian assumes the physical disability of a wheelchair user. The pedestrian is seated on chair whilst her legs have been rendered immovable with artificial extensions. The intention is to demonstrate that the surrounding environment itself or an incorrectly adjusted aid can be the reason for the disability and thereby force the person into a hopeless situation.

Even though Jenni-Juulia’s artistic work takes a critical look at the way our society deals with disability, her interpretation always has a positive touch, an aesthetic lightness, with humour and playful ideas. She always reaches out to us as onlookers and encourages us to communicate and think.

Wheelchair piano
Wheelchair piano

Read more about Jenni-Juulia at http://www.kolumbus.fi/jenni_juulia/

Find out more about OI/ osteogenesis imperfecta at Deutsche Gesellschaft für Osteogenesis imperfecta (Glasknochen) Betroffene e.V.

2021-05-05
The future of care: outpatient treatment possible with innovative training methods from rehabilitation clinics
Balance training

On the premise that vertical gait training is mostly offered in specialised rehabilitation and therapeutic facilities and therefore provides no lasting training success or consolidation of what has been learned in a home environment, the ema treadmill was “invented” by a start-up in France. People with neurological and orthopaedic disorders are currently treated intensively in clinics and rehabilitation centres to start with. This intensity and long-term training must be assured after the acute phase too, however, if the accomplishments are to be retained over time and further developed.

Jens Kleine, head of Made for Movement Deutschland, is convinced: “In future, it will be important for a constantly growing number of patients to receive treatment at the smaller-scale, local therapy practices on an outpatient basis. This will also be reflected by the facilities that these therapy practices offer in future. The “ema” system is affordable, requires only little floor space, and is easy to use. Even a home-training version is planned for the coming year”.

Ezy Gain App per Bluetooth

The smart treadmill provides training for gait and balance – taking off up to 100 % of the load. The automatic verticalization also relieves the burden on therapists as they no longer need to physically set the patient upright. Inbuilt sensors supply analyses and feedback on patient assessment, performance, and progress whenever they are required.

The software basis is provided by the Ezy Gain app, which is connected to the treadmill via Bluetooth and offers a wide range of analytic capabilities.

The large selection of games and programmes covers exercises for specific tasks for the daily routine. A virtual-reality (VR) option enhances the training experience by employing complex tasks for improving cognitive stimulation, assuring optimum utilisation of neuroplasticity, and ensuring that a response from the “memory of movement” is provoked with all the senses.

At REHAB 2022 in Karlsruhe, Made for Movement will offer a three-part training environment for different settings: the ema treadmill system, the Innowalk Pro as a robotic movement exerciser, also for people suffering severe congenital disabilities, effects of serious accidents, and chronic muscular disorders, as well as the K-Force plates for balance training, which also enable children and young people to have fun even in small spaces using the same Ezy Gain app.

2021-05-05
“gOT it!” – YouTube channel explains complex orthopaedic engineering and biomechanics
Thomas Wetzelsperger at the computer

Thomas Wetzelsperger sees his purpose in presenting complex interrelationships that are initially hard to understand in a way that makes them more comprehensible for colleagues in the industry and interested young people.

“The new knowledge helps us to provide superior care for our patients and to attend better to their individual needs; and that, after all, is our principal task”.

Nowadays, of course, this can obviously be achieved far more effectively by using moving images: he has been operating a private YouTube channel featuring explanatory and learning videos covering interesting topics concerning orthopaedic engineering and biomechanics since September 2020.

The young engineer does it all in his free time alongside his fulltime job at Pohlig GmbH. “I wanted to present important and interesting findings from the training in a more accessible and understandable way, for anyone interested in orthopaedic technology. Ideally, the benefit can be reaped by users, technicians, engineers, relatives, therapists, and others”, he says.

Almost 500 subscribers and meanwhile more than 14 videos are clear evidence of well-spent leisure time

The spectrum of topics ranging from physical and medical aspects of care, joint torque and ground reaction force, lower-leg orthoses, and knee protheses through to “sewing corsets”.

In entertaining animations lasting 10-20 minutes each, complex manual skills and specialist knowledge are imparted in such a way that even young professionals and interested individuals feel the urge to open up their minds more fully to what the profession involves and the multifaceted tasks of an orthopaedic and rehab technician.

Two videos with the tongue-in-cheek title “5 things I wish I’d known BEFORE the apprenticeship” make it clear to young people looking for people-centred technical careers, too, just how diverse and also underrated the profile of the profession is.

In times of a skills shortage in this industry, an important stimulus and an “open-access” offer for getting to know a job outline.

“Quality beats quantity”, which is why more topical videos, all of them self-produced, are in the pipeline and will appear eventually. After all, I’ve a got a full-time job as well, says Thomas Wetzelsperger with a grin.

Many practical, hands-on courses are being cancelled at present because the training facilities are obviously unable to permit any direct contact with patients so a YouTube channel like this comes at just the right time.

Link to the channel:

2021-05-05
Humour as a door-opener for inclusion – cool videos from “Aktion Mensch” are beneficial

“5 situations that people without disabilities never experience” shows clearly, with a wink, how people with and without a wide variety of disabilities experience our coexistence. It brings a smile, but still induces us to pause and think: together and with interest in one another it is completely normal to be different, and that is how we can really live inclusion.

Laughter is the best medicine

Against barriers in people’s minds, too. This is the young comedian’s philosophy, and he not only makes his audience laugh, but makes them think as well: about our society, inclusion, and about how important it is to stand up for issues that are important for us.

He is only 15 years old and is already a superstar on the Internet: Carl Josef celebrated his breakthrough in the German comedy scene in 2019 with an appearance in the stand-up show “Nightwash”.

In the 6-part mini-series “The Outsider. Nothing can stop us. Except kerbs.”, working jointly with Aktion Mensch, he is now making the case for a more inclusive society. Along with many other familiar YouTubers and comedians, like Cindy Klink, Freshtorge, and Phil Laude, he shows how precious differences are in our society. True to the motto: “All different. Cool together.”

More Information

2020-12-02
Care under pressure in Germany – 2/3 of those in need of care are looked after at home

Germany’s population is becoming overaged. The number of those in need of care is rising dramatically and there is already a shortage of care professionals: where the number of people in Germany in need of care had still been 2.3m in 2010, the federal government’s latest Care Report is assuming a figure of 3.5m in Germany 2030 and 4.5m in 2050. Dementia-type illnesses like Alzheimer are becoming more widespread and are increasing the complexity of the task of providing sufferers with adequate care. 2/3 of those requiring care are still attended to at home. The Care Report mentions the challenge of promoting and maintaining immediate family’s willingness to provide care, supporting them as needed, and strengthening the commitment of volunteers.

We asked Frau Brigitte Bührlen, chairwoman of the foundation WIR! Stiftung pflegende Angehörige e.V. about the current situation:

Brigitte Bührlen
Brigitte Bührlen, Quelle: Stiftung Pflegende

What do caregiving relatives generally have to contend with?

Caregiving relatives are not involved in political decisions that affect their strenuous daily nursing routine. We have never really reformed our traditional system, founded on 19th century family structures. Only new and professional carers have been added. Caregiving relatives have no legal right to payments or to have their say - even though they bear the brunt of the work.

What benefits are available to those in need of care and their relatives?

There are numerous “individual pots” and federal arrangements with no transparent information for those concerned. The most important ones are care allowances for home care, non-cash care benefits, burden-relief monies, care-assistance allowances, allowances for home-environment improvement measures, nursing aids and support for caregivers’ social security, partial-inpatient day and night care, short-term care, and transitional care. When a particular degree of need of care has been established, the person requiring care can obtain benefits from the nursing insurance fund. If the person is given care at home, the care allowance is paid to the person in need of care. This does not give caring relatives any legal claim to payment or transparent integration into the overall care process, however.

Are the currently available services wisely coordinated with one another and how do I obtain them?

An information brochure published by the Federal Ministry of Health (BMG), for example, provides details about the adopted measures and care services.

Those concerned are often completely unaware of the benefits available to them. These measures are also developed from an administrative and provider perspective. Their meaningful and practicable application is not called into question. The persons concerned must adjust to what is offered, not the other way round. Local welfare and care centres can help, but they are chronically understaffed and do not know all the existing services.

Nursing-home accommodation is often the last resort, but to take care of parents in addition to one's own occupation is often not possible and multiple burdens arising from care obligations are not sustainable in the long-term. What are the solutions?

We should completely redraft the care system. In Scandinavia, care has been declared the responsibility of the state and is funded from tax revenues. A case manager deals with the needs and organises the care. If desired and as befits their own resources, relatives can handle (sub-)areas of the care themselves against payment.

For Germany and as an initial step, I would like to see the introduction of case managers and emergency assistance that is reliably at hand when poorly coordinated nursing measures fail at short notice.

Must politics improve involvement of caregiving relatives?

Absolutely! Politicians passed care into the hands of free enterprise and self-administration on the principle of supply and demand. As soon as business interests are paramount, however, it is no longer those affected that matter, but efficiency and profit. The question of responsibility must be clarified as well: in Germany, no government protection or control mechanism exists in care matters.

Caregiving relatives as well as disabled people and those in need of care must therefore be represented in every advisory body and be able to control what the money in Germany is spent on.

What can relatives do themselves to improve the situation?

I encourage caregiving relatives to bring their interests and wishes directly into the structures of politics. We are a large and relevant group of the population and must network better.

2020-09-15
The end of assumption of approval! - Federal Social Court of Germany backpedals at patients’ expense
The right of patients

Part of the legislator’s intention behind the Patient Rights Act at the beginning of 2013 was the noble objective of compelling statutory health insurance providers to make decisions more quickly. Since then, they must take decisions on applications within 3 weeks or 5 weeks (after obtaining an expert report). If this deadline is missed, the so-called “assumption of approval” comes into effect. The service is then deemed to have been approved as applied for.

A comparable arrangement was adopted for all rehabilitation insurers in the Federal Participation Act (BTHG) as well as in volume nine of the German Social Security Code (SGB IX), the law on rehabilitation and participation of people with disabilities.

prompt care of children

Particularly where children and adolescents are involved, the time that elapses between application for a technical aid and its delivery is extremely important. Children and adolescents are still growing, continuing their development, and therefore require prompt provision for each one’s specific needs appropriate for their age.

What has happened now?

For years, the Federal Social Court of Germany (BSG) has acknowledged this to the benefit of the patient, regardless of whether or not patients have procured the service applied for, e.g. the required technical aid, themselves or the statutory health insurance providers had to be obligated to provide the benefit in kind.

Unnecessarily, and at the expense of patients, the BSG abandoned this positive jurisdiction in its rulings on 26.05.2020 (B 1 KR 9/18 R) and 18.06.2020 (B3 KR 13/19 R). The assumption of approval now only creates a provisional legal position. In simplified terms, this means the patients’ option of procuring the required aid themselves ends as soon as the statutory health insurance provider makes a decision, even if the deadline has passed.

Rapid independent procurement at own expense impossible for families

Jörg Hackstein, chairman of rehaKIND
Jörg Hackstein, chairman of rehaKIND

Based on the example of the provision of technical aids, lawyer Jörg Hackstein, chairman of rehaKIND, explains: “In order to use the assumption of approval, patients must now obtain a technical aid quickly at their own expense in the period between the expiry of the deadline and the belated decision of the statutory health insurance company, in other words, at their own risk and with up-front financing. The entitlement to benefits in kind, i.e. procurement by the patient and the insurance company must pay afterwards, no longer applies. In some cases, it takes a lengthy opposition and appeal procedure to establish whether the purchase was justified.

It can be assumed that only a few families will be willing and financially able to take on this financial risk. The BSG has thus significantly undermined patients’ rights. If the legislator continues to have an interest in strengthening patients' rights and in particular in quick decisions by the statutory health insurance providers, it must effectively sanction the funding agencies' non-adherence to decision deadlines to the benefit of patients and assure this above all for claims for benefits in kind. Very few patients can afford to obtain services themselves at their own risk.”

Jörg Hackstein, lawyer and specialist solicitor for procurement law

Here you can inform yourself about the marketplace Child and Youth Rehabilitation at REHAB:

Child and Youth Rehabilitation

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2020-09-15
Inclusive education between light and shadow – the latest Bertelsmann study takes stock after ten years of inclusion
Inclusion

The implementation was discussed both euphorically and critically in public. Time to take stock and venture an outlook:

The Bertelsmann study published in June 2020 provides no evidence to back up claims that society perceives inclusion as failed. It is true, however, that the growth of inclusion is only making sluggish headway.

Special schools remain: the number of pupils taught in schools for children with learning difficulties is constant nationwide but varies from one German state to another. The number of inclusive pupils is rising as more special educational needs are being identified. High-performing children tend to receive inclusive schooling, which depends on the need for support.

Assessments depend on personal experience

Inclusive lessons at general education schools

The majority of the population is in favour of inclusion, seeing it as promoting greater tolerance, greater social cohesion, and improved coexistence.

The opinion of parents is also good overall. Parents with experience of inclusion give a more positive assessment than those with no specific experience of it. The generally positive perception, however, depends on the nature of the special needs. Parents with experience of inclusion attest to a greater readiness for cooperation amongst teaching staff, better collaboration between parents and teachers, and a more positive relationship between teachers and pupils.

There are proven learning successes in inclusive lessons: more pupils pass the “Hauptschulabschluss” (basic secondary school qualification in Germany) in mainstream schools than those in special schools do. The alignment that inclusive pupils with special needs seek when learning amongst their peers with normal abilities has the effect of enhancing their performance. The motivation of some pupils with special needs, however, declines when faced with the performance of their classmates with unimpaired abilities.

Teaching staff are considerably more critical: all teachers want an additional colleague in inclusive lessons and the majority of them complain about inadequate know-how and missing equipment in schools. Teachers supervising inclusive classes are significantly more positive in their judgment than those without experience are.

According to the study, inclusion cannot be regarded as a failure – the general public and teachers have a mostly negative impression whereas the majority of parents and pupils with experience of inclusion are positive to very positive in their feedback.

Joint painting between inclusion students and normally enabled classmates

Germany is still a long way from reaching its objective: the existing shortage of qualified staff, particularly qualified special-needs teachers, psychologists, and teachers in all areas outside Germany’s upper secondary-school (“Gymnasium”) system, will continue to escalate. Some federal states are making progress with inclusion whereas others are choosing to backpedal. The latest forecasts for the individual German states therefore give grounds to expect stagnation in the implementation of collective learning until 2030.

Information about inclusive sports complex at REHAB can be found:

Inclusive sports complex

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2020-09-15
Artificial intelligence in healthcare: Karlsruhe’s IT competence ensures safe applications
Artificial intelligence

AI-based assistance systems help early identification of illnesses, enable rapid analysis of large volumes of image and laboratory data, and offer the opportunity for individualised therapies.

Prof. Jörn Müller-Quade
Prof. Jörn Müller-Quade

Prof. Jörn Müller-Quade of the KIT Karlsruhe Institute of Technology addresses the issue of better healthcare with the aid of AI and the ensuing challenges for IT security: “Health records are a huge treasure trove that must be learned from ... this is important, particularly in these time of a global pandemic, in order to recognise patterns and develop strategies. The bigger the volumes of data are, the greater are the insights gained from them. The challenge is to use the confidential, personal data and at the same time evaluate it without infringing privacy.”

Due to interprofessional collaboration in medicine, therapy, and care along with the involvement of other players in the healthcare sector, many people require potential access to patients’ records. “This makes it difficult to protect sensitive heath data from unauthorised access”, says the Karlsruhe cryptographer. “Information technology is a facilitator, but only with a very strict rulebook and multiple levels of security for safe data transmission and access control.” The Federal Ministry of Health is currently preparing the foundations for the electronic prescription and electronic patient file (ePA), “but if the terminal devices, i.e. the PCs of chemists, health insurance companies, and medical professionals, are not secure, we will be faced with problems that could lead to data scandals”, says Müller-Quade, who heads the cryptography and security research group at the KIT and is the initiator of the KASTEL centre of competence for IT security.

Learning systems must be monitored by people

Sensitive Data

In addition to manufacturers’ liability, he also considers certification of AI systems and databases in medicine as well as the electronic patient file to be an essential requirement. “Health records must not be permitted to be used to the detriment of patients, for example where someone could be refused employment due to the disclosure of pre-existing medical conditions.”

The planned introduction of the ePA will give patients full control over their health records, which are then stored on their own PC as well. This makes it all the more important to adhere to the basic principles of IT security – to always use the latest operating system and secure passwords –, otherwise the PC can become an open gateway for intruders and reveal a patient’s medical history.

The computer scientist sees the use of constantly-learning AI systems whose software changes when operating without human surveillance as “a mixed blessing. The decisions taken by an AI system of this kind must always be checked for plausibility by the people performing the treatment. “Doctors must not apply the suggested result without reflection.”

Further information on AI in medicine can also be found in the following whitepaper with a cancer patient as an example:

https://www.plattform-lernende-systeme.de/files/Downloads/Publikationen/AG3_6_Whitepaper_07042020.pdf

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2020-05-07
One year until REHAB - 21st European trade fair for rehabilitation, therapy, care and inclusion
REHAB 2019 Hall 1

One year before REHAB 2021 opens its gates, the effects of the COVID 19 pandemic affect the health and medical technology industry. In order to enable all market participants, exhibitors and visitors to be safe at REHAB 2021, concepts for the adequate implementation of safety measures and hygiene regulations are being providently prepared.

Approximately half of the available exhibition area has already been booked. Months in advance of the upcoming fair, numerous well-known manufacturers, dealers and service providers from Germany and other European countries have reserved their stands in Karlsruhe and thus in Baden-Württemberg, which is Germany’s leading state for medical technology. Returning exhibitors include industry giants such as Otto Bock HealthCare Deutschland GmbH, Paravan GmbH and the Danish company Alu Rehab ApS. Manufacturers of children’s wheelchairs such as Rehatec Dieter Frank GmbH, SORG Rollstuhltechnik GmbH + Co KG and Berollka-aktiv Rollstuhltechnik GmbH have likewise confirmed their intention to participate in REHAB, which is held every two years and is the most important platform for high-quality mobility aids and children’s aids from Germany and other European countries. “The high quality of this trade fair and its visitors convince manufacturers and retailers alike. In 2019, REHAB had approximately 18,500 visitors and 468 exhibitors on 40,000 square meters. We continue to place great importance on optimal distribution of exhibitors in the halls and on the fair’s unique atmosphere”, explains REHAB’s Project Manager Annika Gehrmeyer.

The proven concept of theme-oriented marketplaces such as “Mobility & Daily Living Aids”, “Child & Youth Rehabilitation” and “Cars & Traffic” will continue to structure the comprehensive range of products and services presented at the important trade fair and promote interdisciplinary sharing among experts from the care-giving sector, the health industry, people with disabilities and their carers. In addition to innovations in the assistive aids industry, REHAB provides information about new therapeutic options and offers a diverse supporting program with opportunities for further training, lectures and live demonstrations. A special area on the subject of ambient assisted living (AAL) presents technologies and digital assistance systems for independent living and living in the home and care environment. Interested companies can still book stand space at the early-bird rate until 30 June 2020. The Future Pavilion offers opportunities for start-ups and academic institutions to present their innovations, above all in the areas of digitization and robotics.

2020-05-07
 Arrival of a new tool – the digital workshop for orthotics and prosthetics
Presentation of the digital workflows for Orthetik of the company Mecuris
Presentation of the digital workflows for Orthetik of the company Mecuris

Orthopaedic technicians are often inventors who want to be part of the development process and give the highest possible degree of personal attention to the customer’s needs: growing competition coupled with rising pressure from costs and constraints on time frequently make it difficult to assure this measure of individuality. At the same time, knowledgeable users insist on tailored solutions to suit their own tastes, no longer willing to hide his/her prosthesis from view, for example, and set on fostering a more self-confident relationship with their particular aid.

The fast-paced development in industrial 3D printing and digitalisation now offer new solutions that enable every orthopaedic technician to perform customised and yet digital fabrication. The Munich-based medical engineering company Mecuris, for example, presented a form of “digital workbench”, which meaningfully enhances the work of a technician. The intuitive design enables this digital tool to be used with no previous experience of 3D technology. To achieve this, Mecuris, as a service provider, translates the traditional orthopaedic craft into digital workflows and patient-specific products that can be manufactured using industrial 3D printing.

On its online platform, the company puts these workflows at the disposal of the technician so that he/she can configure customised orthotics and prosthetics. In doing so, the individual steps are kept as straightforward as possible and are partly automated in some areas. This platform is organised into two production units or workshops, one for orthotics and one for prosthetics.

In the orthotics workshop – new since April 2020 – a technician can use the digital procedures and tools according to his/her requirements either in partial steps or as a complete process. The latter ends with the production of a customised 3D-printed orthosis.

In the prosthetics workshop, on the other hand, workshops are available for creating patient-specific prosthetic feet and made-to-measure prosthetics covers.

The individual modules of the digital services – the software solutions, the printing operation, and the certified final products – are constantly being refined as well as adjusted to suit the changing market circumstances, such as the EU Medical Device Regulation.

Are you interested in the topic of orthopaedic aids? Then take a look at our topic area for this:

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2020-05-07
AAL, telemonitoring and digital consultation hours – how digitalisation is gathering pace in the industry
Instruction via video chat

Prohibited contact, infection risks, and inadequate protective equipment are a major obstacle to attending to patients’ needs in the current COVID-19 pandemic. Both the legislator and the professional associations are temporarily relaxing the conditions for digital consultation hours and care administered by service providers for the duration of the bans on contact.

What are the options?

The use of technical AAL (ambient assisted living) systems in the home environment and in care offers considerable potential for relieving some of the load on care staff and relatives and enabling those in need of assistance to retain as much independence as possible. The “Pflege-Cockpit” (“Care-Cockpit”) app of the Thomashilfen company, for example, provides the means for calling up information about bedridden patients. A decubitus guide-app for caregiving relatives can help with bedsore prevention whereas a patient’s own medication can be checked and controlled with the help of the PApp of RWTH Aachen.

Clinics, SPCs (sociopaediatric centres) and other medical facilities are currently upgrading their operations: general consultation, anamnesis, weekly progress meetings and interdisciplinary consultation hours are possible via telephone or video conference. Mobile monitoring devices and the digital patient file ensure the exchange of treatment documents, prescriptions, X-ray images and the like.

App-based exercise programmes with professional guidance make continuous training possible in the fields of ergotherapy, speech therapy, and rehab-sport: Thieme Tele Care, for example, offers sensor and app-controlled back-strengthening exercises for people with back problems. The Bauerfeind company uses a therapy app for customised exercises with the use of knee bandages. Many other apps in the health and therapy sector can also be found in the Rehadat database. Telephone contact with patients provides further support for therapy already underway.

Medical supply stores use digital platforms for documenting healthcare processes (e.g. BEB or ICF-CY Web app). Subsequent supply runs for consuming specific aids are currently possible without a signature after prescription by telephone as well. Telephone contact to customers or video conferences help to check supplies or to enable instructions to be given online. Apps also offer guidance and information on how to use various aids: they help diabetics, for example, to manage the data of their blood glucose meter or – like Ottobock’s Cockpit app – enable independent prosthetics adjustment. YouTube videos and livechats on how to use daily-living aids such as those by the company Saljol are also useful digital helpers.

Digital technologies are optimising the work processes in crafting too. In the form of 3D printing, digitalisation has arrived in assistive-device fabrication. Digital micromotion studies and scans serve as a basis for treatment.

The problems with data protection and the means for invoicing digitally rendered services have not been satisfactorily clarified yet.

Many service providers are walking the path nonetheless and are investing in the future. User-friendly communication systems, secure means of transmitting patient data, and reliable interfaces between the people involved are necessary parameters for acceptance and successful implementation.

You can also find more information about AAL on the pages:

Plan your visit to REHAB 2021 now

Winners of the 3rd Inclusion Award of the City of Karlsruhe have been selected

The time has come, the 2021 winners of the third Inclusion Award of the City of Karlsruhe have been chosen.

We congratulate Prometheus GmbH, Brigitte Reisz and the Beiertheim primary school for their outstanding work. Keep it up!

We would have been happy to welcome the award winners to our exhibition halls this year and present them with the Karlsruhe Inclusion Award as hosts at the REHAB. Unfortunately, due to the pandemic, REHAB 2021 could not take place, but there is a great film showing the award winners and their commitment to inclusion*.

Next year, from 23 to 25 June 2022, REHAB will again show how important inclusion is in the workplace and will once again dedicate a separate thematic area to the topic: Marketplace Occupation & Education.

*only in German

Award of the 3rd Inclusion Award of the City of Karlsruhe

EU postpones Medical Device Regulation (MDR)
European map with medical equipment

In April, the European Commission decided to postpone the entry into force of the Medical Device Regulation (MDR) by a year – initially until 26 May 2021. This decision serves the fight against the COVID-19 pandemic and is aimed at improving the availability of essential medical products in the EU.

The MDR’s goal is to assure the protection of consumers and patients. The regulation applies for all economic players and healthcare facilities throughout Europe and contains numerous obligations for all players manufacturing medical products, modifying them, making them available on the market, or using them in their business. In this way, many regulations already in existence are being further tightened or fine-tuned.

All requirements relating to the supply of aids in focus

This concerns not only manufacturers but also service providers such as medical supply stores. A present, it is still unclear whether or not transitional periods relating to the existing certification of products will be extended.

The so-called “designated bodies” are the mainstay of the new rigorous tests – only this select few are still permitted to perform certification in “on-site audits”: in view of the current safety measures and the applicable travel restrictions, it is not yet clear if and to what extent the designated bodies can issue the required certificates on time. In order to maintain the supply of medical products in Europe, professional and industry associations are therefore calling for the deferral of the transition periods and an extension of the periods for liquidation of current stocks.

Documentation, hygiene, results monitoring: strict requirements for all

The industry must continue to make preparations nonetheless: specialist retailers/medical product suppliers must fulfil comprehensive traceability and control obligations and cooperate more closely with manufacturers and preliminary suppliers. They must ensure, more than ever, that the manufacturers’ prescribed product-specific storage and transport conditions are adhered to.

The requirements for controls and storage have far-reaching effects on product management because, as is becoming clear during the COVID-19 pandemic, every supplier must always have an accurate overview of existing goods and their condition.

This creates the obligation to provide comprehensive documentation: detailed provisions on hygiene and preparation of the aids must be observed. Dealers, too, must gather, document, evaluate, and relay complaints from users and patients.

The German society for interprofessional aid supplies (DGIHV – Deutsche Gesellschaft für Interprofessionelle Hilfsmittelversorgung e.V.) has reworked all of the key rights and obligations arising for manufacturers and service providers from the EU-MDR into clearly-structured guidelines: www.dgihv.org/mdr/

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