Changes in EQ-5D-5L health state in new and experienced lower limb prosthetic users after 4 weeks of specialized inpatient rehabilitation.

Abstract

Background: Rehabilitation of persons with lower limb loss generally report on outcome measures related to gait and mobility, but little is known how an inpatient exercise intervention influences health-related quality of life (HRQoL).

Objective: This study compared the effect of a 4-week rehabilitation intervention (INT) on the HRQoL of new (NEW) prosthetic users that received their prosthesis at the inpatient facility (NEW-INT) to experienced prosthetic users with several previous inpatient stays (EXP-INT).

Study design: Nonrandomized intervention trial.

Methods: In this nonrandomized intervention trial, the NEW-INT completed the EuroQol-5 Dimensions-5 Levels (EQ-5D-5L) questionnaire at Admission, when they became Independent in walking and at Discharge. The EXP-INT completed the questionnaire at Admission and Discharge. A control group of experienced prosthetic users (EXP-CON) not partaking in the intervention completed the EQ-5D-5L questionnaire at 4-week intervals. The participants health state was recorded at all time points using a visual analog scale (EQ-VAS). An EQ-index was calculated based on the 5 dimensions of the EQ-5D-5L.

Results: At Admission, the EQ-index score of the NEW-INT (n = 18) was significantly lower compared to the EXP-INT (n = 19) (P = 0.014). The NEW-INT improved the median [interquartile range] EQ-index scores significantly from Admission to Discharge; 0.23 [0.55] vs. 0.73 [0.20], P = 0.001, whereas the EXP-INT showed no change from Admission to Discharge; 0.71 [0.23] vs. 0.65 [0.26]. At Discharge, the EQ-index scores of the NEW-INT and EXP-INT were similar. Only the NEW-INT showed significant improvements in the mean ± standard deviation EQ-VAS values from Admission (55.8 ± 20.2) to Discharge (66.4 ± 15.7), P = 0.018. The mobility dimension was the most responsive EQ-5D-5L dimension but improved significantly only for the NEW-INT from Admission to Discharge (P = 0.001). For the EXP-CON (n = 19), there were no significant changes from Test 1 to Test 2.

Conclusion: Four weeks of inpatient rehabilitation improves HRQoL in new, but not experienced prosthetic users.