Z Orthop Unfall 2022; 160(01): 84-92
DOI: 10.1055/a-1241-4897
Original Article/Originalarbeit

Patient Reported Outcomes (PROs) – a Tool for Strengthening Patient Involvement and Measuring Outcome in Orthopaedic Outpatient Rehabilitation

Article in several languages: English | deutsch
Marcus Müller
1   Sozialstiftung Bamberg, saludis – Zentrum für rehabilitative Medizin, Orthopädische Rehabilitation, Bamberg, Deutschland
,
Joscha Brunssen
2   Executive Board, Federal Association of Outpatient Medical Rehabilitation Centres (BamR e. V.), Berlin, Germany
,
Martin Messingschlager
3   Acting Chair, Department of Statistics and Econometrics, Otto-Friedrich-University Bamberg, Germany
› Author Affiliations

Abstract

The present study serves to establish Patient Reported Outcomes (PROs) as a tool for strengthening patient involvement and measuring outcomes in orthopaedic outpatient rehabilitation. Assessments by FFbH-R (Hannover Back Function Questionnaire for patients with back problems), Quick-DASH (Disabilities of Arm, Shoulder, and Hand Score for patients with upper extremity lesions), and LEFS (Lower Extremity Function Scale for patients with lower extremity lesions) were employed in 20 outpatient rehabilitation centres over a period of 12 months to evaluate changes in performance and participation from the subjective patient perspective. The following questionnaires were used: FFbH-R status post: lumbar disc surgery; cervical disc surgery; spinal canal decompression; conservative back pain treatment; other; Quick-DASH status post: rotator cuff reconstruction; shoulder arthroplasty; fracture (conservative or osteosynthesis); other; LEFS status post: hip arthroplasty; knee arthroplasty; anterior cruciate ligament repair; osteotomy; fracture (conservative treatment or osteosynthesis); other. Analysis of the 6,751 usable data sets demonstrated significant positive changes in all scores and diagnostic subgroups. The mean difference in score was 14.2 points in the FFbH-R, − 22 points in the Quick-DASH and 18 points in the LEFS. Thus, this study proves the positive effects of orthopaedic rehabilitation in an outpatient setting. PROs were instituted on a permanent basis in seven of the participating institutions.

Key Message
  • PROs serve to strengthen patient involvement in the rehabilitation process and document the subjective rehabilitation outcome, e. g., in the discharge report.

  • PROs are an internal quality assurance tool.

  • As part of this study, it was possible to institute PROs in seven orthopaedic outpatient rehabilitation centres.

  • In all indications PROs demonstrate markedly positive changes during the course of rehabilitation.

  • Despite existing limitations (lack of control group, no follow-up beyond the rehabilitation period, limited comparison with literature), the study documents positive results in orthopaedic outpatient rehabilitation.

Kernbotschaft
  • PROs dienen der verstärkten Einbeziehung der Patienten in den Rehabilitationsprozess und Dokumentation des subjektiven Rehabilitationsergebnisses, z. B. im Entlassbericht.

  • PROs sind ein Instrument zur einrichtungsinternen Qualitätssicherung.

  • PROs konnten im Rahmen dieser Studie in 7 ambulanten orthopädischen Rehabilitationszentren etabliert werden.

  • PROs zeigen für alle Indikationen signifikant positive Veränderungen im Rehabilitationsverlauf.

  • Trotz bestehender Limitationen (fehlende Kontrollgruppe, fehlende Nachbeobachtung über den Rehabilitationszeitraum hinaus, eingeschränkter Vergleich mit der Literatur) dokumentiert die Studie positive Ergebnisse in der ambulanten orthopädischen Rehabilitation.



Publication History

Article published online:
12 October 2020

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