Health-related quality of life after rehabilitation from knee surgery in rural and urban settings: a quasi-experimental study

Abstract Background Injury to the knee joint is associated with physical disability, stiffness, pain, restriction of movement and impairment of the person’s quality of life, with a few treatment options, including surgery and rehabilitation. This study aims to evaluate the impact of a rehabilitation...

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Main Authors: José Moreira, Ana João, Pedro Aguiar, Armando Raimundo, Marina Mesquita, José Flamínio, Manuel Almeida, Paulo Boto
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Musculoskeletal Disorders
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Online Access:https://doi.org/10.1186/s12891-024-08143-0
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author José Moreira
Ana João
Pedro Aguiar
Armando Raimundo
Marina Mesquita
José Flamínio
Manuel Almeida
Paulo Boto
author_facet José Moreira
Ana João
Pedro Aguiar
Armando Raimundo
Marina Mesquita
José Flamínio
Manuel Almeida
Paulo Boto
author_sort José Moreira
collection DOAJ
description Abstract Background Injury to the knee joint is associated with physical disability, stiffness, pain, restriction of movement and impairment of the person’s quality of life, with a few treatment options, including surgery and rehabilitation. This study aims to evaluate the impact of a rehabilitation program on the quality of life reported by patients living in rural and urban areas after knee surgery, using patient-reported outcome measures (PROMs). Methods This quasi-experimental study with two groups of participants undergoing primary knee surgery was carried out in two rehabilitation centers, one in an urban area and another in a rural one. The same intervention was structured, with assessments at the start of the study (t0) and after a 4-week program (t1), and a comparison was made between the gains in rural and urban areas. We used descriptive and inferential analysis to analyze the effect of the intervention on health-related quality of life (HRQoL) using a linear regression model. Results Participants (n = 62 aged between 19 and 84 years (40% of the sample aged over 65years) and 61.9% female, showed improvements in their EQ-5D-5L and HADS scores after the rehabilitation program. Considering the dimensions of HRQoL in both groups, there was a significant improvement in all the components in the rural context (p < 0.005), and improvements in the Mobility (t = 3.48; p = 0.002) and EQ_VAS (t = − 3.77; p = 0.001) components in the urban context. The effect of the program on health gains considering the Mobility was significantly greater in the rural group (− 0.97) compared to the urban group (− 0.13), as well as in the Pain/Disability (− 0.73) vs. (− 0.13) respectively. After analyzing the confounding factors, the rehabilitation center variable indicated gains of the EQ-5D-5L dimensions in a rural context (β= −0.390; t = − 3.041; p = 0.004), with an average reduction in health problems. Conclusion There is evidence that the application of PROMs in rehabilitation programs after knee surgery is fundamental, considering the improvements in HRQoL and the optimization of anxiety/depression states in different contexts. PROMs should be applied systematically in clinical practice throughout the rehabilitation process, objectively measuring the results perceived by patients, and according to each context achieving health gains. Trial registration registry-ClinicTrials; trial registration number-NCT06206018; data of registration-16/01/2024.
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spelling doaj-art-9a1e7181affd42a3a9671756f825a54d2024-12-22T12:07:33ZengBMCBMC Musculoskeletal Disorders1471-24742024-12-0125111010.1186/s12891-024-08143-0Health-related quality of life after rehabilitation from knee surgery in rural and urban settings: a quasi-experimental studyJosé Moreira0Ana João1Pedro Aguiar2Armando Raimundo3Marina Mesquita4José Flamínio5Manuel Almeida6Paulo Boto7Escola Superior de Enfermagem São João de Deus, University of ÉvoraComprehensive Health Research Centre (CHRC), University of ÉvoraPublic Health Research Centre, Comprehensive Health Research Center, NOVA National School of Public Health, CHRC, NOVA University LisbonComprehensive Health Research Centre (CHRC), University of ÉvoraFisicontrolFisioportel Rehabilitation CenterEgas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & SciencePublic Health Research Centre, Comprehensive Health Research Center, NOVA National School of Public Health, CHRC, NOVA University LisbonAbstract Background Injury to the knee joint is associated with physical disability, stiffness, pain, restriction of movement and impairment of the person’s quality of life, with a few treatment options, including surgery and rehabilitation. This study aims to evaluate the impact of a rehabilitation program on the quality of life reported by patients living in rural and urban areas after knee surgery, using patient-reported outcome measures (PROMs). Methods This quasi-experimental study with two groups of participants undergoing primary knee surgery was carried out in two rehabilitation centers, one in an urban area and another in a rural one. The same intervention was structured, with assessments at the start of the study (t0) and after a 4-week program (t1), and a comparison was made between the gains in rural and urban areas. We used descriptive and inferential analysis to analyze the effect of the intervention on health-related quality of life (HRQoL) using a linear regression model. Results Participants (n = 62 aged between 19 and 84 years (40% of the sample aged over 65years) and 61.9% female, showed improvements in their EQ-5D-5L and HADS scores after the rehabilitation program. Considering the dimensions of HRQoL in both groups, there was a significant improvement in all the components in the rural context (p < 0.005), and improvements in the Mobility (t = 3.48; p = 0.002) and EQ_VAS (t = − 3.77; p = 0.001) components in the urban context. The effect of the program on health gains considering the Mobility was significantly greater in the rural group (− 0.97) compared to the urban group (− 0.13), as well as in the Pain/Disability (− 0.73) vs. (− 0.13) respectively. After analyzing the confounding factors, the rehabilitation center variable indicated gains of the EQ-5D-5L dimensions in a rural context (β= −0.390; t = − 3.041; p = 0.004), with an average reduction in health problems. Conclusion There is evidence that the application of PROMs in rehabilitation programs after knee surgery is fundamental, considering the improvements in HRQoL and the optimization of anxiety/depression states in different contexts. PROMs should be applied systematically in clinical practice throughout the rehabilitation process, objectively measuring the results perceived by patients, and according to each context achieving health gains. Trial registration registry-ClinicTrials; trial registration number-NCT06206018; data of registration-16/01/2024.https://doi.org/10.1186/s12891-024-08143-0Patient-reported outcome measuresHealth-related quality of lifeRehabilitationKnee surgeryPhysical activityHealth status
spellingShingle José Moreira
Ana João
Pedro Aguiar
Armando Raimundo
Marina Mesquita
José Flamínio
Manuel Almeida
Paulo Boto
Health-related quality of life after rehabilitation from knee surgery in rural and urban settings: a quasi-experimental study
BMC Musculoskeletal Disorders
Patient-reported outcome measures
Health-related quality of life
Rehabilitation
Knee surgery
Physical activity
Health status
title Health-related quality of life after rehabilitation from knee surgery in rural and urban settings: a quasi-experimental study
title_full Health-related quality of life after rehabilitation from knee surgery in rural and urban settings: a quasi-experimental study
title_fullStr Health-related quality of life after rehabilitation from knee surgery in rural and urban settings: a quasi-experimental study
title_full_unstemmed Health-related quality of life after rehabilitation from knee surgery in rural and urban settings: a quasi-experimental study
title_short Health-related quality of life after rehabilitation from knee surgery in rural and urban settings: a quasi-experimental study
title_sort health related quality of life after rehabilitation from knee surgery in rural and urban settings a quasi experimental study
topic Patient-reported outcome measures
Health-related quality of life
Rehabilitation
Knee surgery
Physical activity
Health status
url https://doi.org/10.1186/s12891-024-08143-0
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