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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2015 February;66(1):17-24
Practical-oriented ICF based rehabilitation and outcome measurement after total hip and total knee arthroplasty: evaluation of activity and participation
Schaller A. 1, Froboese I. 2
1 Institute of Health Promotion and Clinical Movement Science, German Sport University Cologne, Cologne, Germany;
2 Center for Health through Sport and Movement, German Sport University Cologne, Cologne, Germany
AIM: According to the International Classification of Functioning, Disability and Health (ICF) model, superior rehabilitation aims after total joint arthroplasty (TJA) are improvement of activity and participation. The purpose of this study was to implement the ICF in the stage-specific rehabilitation concept in Germany and develop a praxis-oriented ICF based measurement in order to evaluate activity and participation after total hip (THA) and total knee arthroplasty (TKA).
METHODS: A prospective cohort study in an inpatient rehabilitation center was conducted. Data were collected from 171 patients at start of inpatient rehabilitation (T1), 3-month (T2) and 12-month (T3) after inpatient rehabilitation. Activity was measured by the German questionnaire “Funktionsfragebogen Hannover-Osteoarthritis” (FFbH-OA) and participation by subscales (role physical, role emotional, social functioning) of short-form health survey (sf-36). Independent variables examined included age and gender.
RESULTS: Activity and participation improve significantly from T1 to T3. There are indication-specific differences in course of time. Furthermore, indication specific differences in activity (P=0.01) and role physical (P=0.03) at 12 month follow-up.
CONCLUSION: Patients after TKA are less likely to achieve similar outcomes in activity and participation than those after THA. detailed information about indication-specific course of rehabilitation, based on the ICF model, can be used to advise patients and clinicians and can invalidate influential, but inaccurate, assumptions.