Hybrid In-Patient Rehabilitation (HIRE) - Study

Non-inferiority of a hybrid outpatient rehabilitation due to musculoskeletal disorders: a randomized controlled trial


Tele-rehabilitative therapy programs are becoming increasingly important, among other things, due to the possibility of more flexible implementation in the rehabilitative setting. In recent years, the development and use of digital technologies in rehabilitation has received a major boost. However, current studies on digital therapy measures mainly focus on the aftercare and prevention sector. 

The study is funded by the German Pension Fund and scientifically accompanied and evaluated by the Section Rehabilitation and Work, Institute of Social Medicine and Epidemiology, University of Lübeck.


The primary purpose of this study is to evaluate the effect of hybrid rehabilitation compared to conventional rehabilitation on pain-specific self-efficacy.


This is a multicenter randomized controlled trial. Patient recruitment planned for six months started in April 2022 in eight full-day outpatient rehabilitation facilities of the ZAR group.

The intervention group will receive the digitally implemented back school curriculum for back pain, which will be developed by Caspar Health specifically for this study and made available to patients via Caspar software. The control group carries out the back school curriculum for back pain as a face-to-face event.

The curriculum is divided into seven modules and is implemented via education, interaction, homework and tests of the patients. The surveys take place at four measurement points: at the beginning and end of the outpatient rehab as well as three months and twelve months after the end of the rehab. The primary outcome criterion will be the participants' pain-specific self-efficacy (FESS). Secondary outcome parameters will be motivation, knowledge, functional and work ability. 

The practicability of the digital application will also be investigated through qualitative interviews with the patients, physicians and therapists involved.


The study is scheduled to be completed in 2023. An interim report on the short-term results of the study is scheduled to be published Q4 2022. If hybrid rehab is shown to be equivalent to face-to-face rehab after completion of the evaluation, this would provide rehab facilities with an additional mode of delivery that opens up the opportunity to further flexibilize rehabilitative care.

Literature: Registered in the german clinical trials register - DRKS-ID of the study: DRKS00028770 

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