Changes in quality of life according to the SF36 Health Survey of persons with back pain six months after orthopedic in- and outpatient rehabilitation.

Abstract

The objective of the current study was to compare changes of various aspects of quality of life according to the SF36 Health Survey after either inpatient rehabilitation (IPR) or outpatient rehabilitation (OPR) in patients with low back pain. To do this, a follow-up study (6 months) with a case-control design (n=150 matched pairs) of prospectively recruited patients suffering from low back pain and participating either in IPR or in OPR was carried out. To compare the effectiveness of IPR and OPR in terms of quality of life, the effect sizes (ES) of the changes in SF36 subscales 6 months after the rehabilitation programmes had ended were determined in those patients who had displayed abnormal values in the SF36 subscales before the intervention. The most important improvements in both IPR and OPR are found for "bodily pain" and "physical role". The improvement in "physical role" is higher after OPR (OPR 1.7; IPR 1.2), whereas the change in the subscale "mental health index" is lower after OPR (OPR 0.5; IPR 1.0). After adjusting for differing baseline values, improvements of psychosocial aspects such as "vitality" and "social function" tend to be more pronounced after IPR ("vitality": IPR 1.3; OPR 0.8; "social function": IPR 1.0; OPR 0.6). The outcome of IPR and OPR is similar in terms of several aspects of quality of life. However, the differences in psychosocial aspects result in the assumption that patients with impaired mental health, vitality or social abilities might receive a greater benefit from IPR whereas those with an impaired physical role might profit more from OPR. This needs to be studied in more detail in randomized controlled trials.