Long-term outcome in patients with osteoarthritis of the hip or knee after comprehensive rehabilitation: A prospective 2 year follow-up study

摘要

Long-term outcome in patients with osteoarthritis of the hip or knee after comprehensive rehabilitation: A prospective 2 year follow-up studyObjective: To examine the course of pain and physical function after a comprehensive inpatient rehabilitation intervention in patients with osteoarthritis (OA) of the hip or knee.Design: Prospective 24-months cohort study with assessments at baseline (entry into clinic), 1 (discharge), 3, 6, 9, 12 and 24 months after baseline.Setting: Inpatient rehabilitation clinic.Patients: Consecutively referred patients to inpatient rehabilitation fulfilling the inclusion criteria.Intervention: Three to four week comprehensive rehabilitation intervention including strengthening exercise, flexibility training, endurance training, relaxationstrategies and consultations for preventive measures. Individual home rehabilitation programs were instructed.Main Outcome Measures and Analysis: Generic health status was followed using the SF-36, condition specific health was followed with the WOMAC questionnaire. Effects were analyzed with sensitivity statistics (effect size, ES) and nonparametric tests.Results: The data of 128 patients with complete follow-up data could be analyzed. Both pain and physical function improved moderately (WOMAC pain: ES = 0.56, WOMAC function ES = 0.44) until discharge of the clinic. While the effect in pain reduction remained significant until month 24 (WOMAC: ES = 0.26), physical function deteriorated close to baseline values after 12 months.Conclusions: Comprehensive in-patient rehabilitation of patients with OA of the hip or knee may improve pain and physical function for 6 months and pain in the long-ter