Kool N, Kool J, Bachmann S. Duration of rehabilitation therapy to achieve a minimal clinically important difference in mobility, walking endurance and patient-reported physical health: an observational study.
J Rehabil Med 2023;
55:jrm12322. [PMID:
37987632 PMCID:
PMC10680980 DOI:
10.2340/jrm.v55.12322]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/07/2023] [Indexed: 11/22/2023] Open
Abstract
OBJECTIVE
To compare the duration of exercise therapy needed to achieve a minimal clinically important difference in mobility, walking endurance and patient-reported global physical health in patients referred for inpatient rehabilitation after knee surgery, hip surgery, or with multiple sclerosis or Parkinson's disease.
DESIGN
Retrospective pre-post intervention observational cohort study.
SUBJECTS
A total of 388 patients (57% women, mean age 65.6 years (standard deviation 9.5)) with a minimum length of stay 10 days were included between 1 January 2020 and 30 April 2021.
METHODS
Outcomes were assessed at the start of, and discharge from, rehabilitation, using the following measures: mobility (Timed Up and Go test), walking endurance (6-minute walk test), patient-reported global physical health (Global Physical Health subscale of the 10-item Patient-Reported Outcomes Measurement Information System). The duration of exercise therapy needed to achieve a minimal clinically important difference was determined using anchor-based and distribution-based methods.
RESULTS
The duration of therapy needed to achieve a minimal clinically important difference was longer in patients with multiple sclerosis or Parkinson's disease (18-88 h) than in patients after knee or hip surgery (8-25 h). In all patient groups, the duration of exercise therapy needed, determined using the distribution-based method, was shortest for patient-reported global physical health (knee surgery 9.6 h, hip surgery 6.8 h, multiple sclerosis 38.7 h, Parkinson's disease 18.4 h).
CONCLUSION
The duration of active therapies required to achieve a minimal clinically important difference in physical outcomes varies widely (range 8-88 h) among different patient groups and outcomes.
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