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

Abstract

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). 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). Nonrandomized intervention trial. 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. 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. Four weeks of inpatient rehabilitation improves HRQoL in new, but not experienced prosthetic users.