title: Effects of inpatient rehabilitation in hip and knee osteoarthritis: a naturalistic prospective cohort study with intraindividual control of effects.
abstract: OBJECTIVE
  To quantify pain, function, and health-related quality of life in comparison with normative data, and to quantify intervention effects.
  
  
  METHODS
  Naturalistic cohort study without a control group. Correction of the effects observed during the intervention by those observed during waiting time prior to the intervention.
  
  
  METHODS
  Inpatient rehabilitation clinic.
  
  
  METHODS
  Patients with hip (n=88) and knee (n=164) osteoarthritis.
  
  
  METHODS
  Comprehensive, multidisciplinary inpatient rehabilitation lasting 3 weeks.
  
  
  METHODS
  Medical Outcomes Study 36-Item Short-Form Health Survey and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).
  
  
  RESULTS
  Four or more comorbid conditions had 45.3% of the hip and 51.8% of the knee patients on entry to and discharge from the clinic. On entry, physical health and some dimensions of psychosocial health were significantly diminished compared with population norms. At discharge, hip osteoarthritis had improved by a corrected effect size of .20 to .47 in pain, .04 to .39 in function, and -.04 to .32 in psychosocial health. Knee osteoarthritis showed a corrected effect size of .43 to .62 in pain, .19 to .51 in function, and .19 to .30 in psychosocial health. All but 1 effect in WOMAC pain and WOMAC function were higher than the minimal clinically important differences.
  
  
  CONCLUSIONS
  Hip and knee osteoarthritis patients admitted to the inpatient intervention were affected by a substantial burden of disease and comorbidities. Inpatient rehabilitation resulted in small to moderate, statistically significant, and clinically important improvements in pain, function, and psychosocial health.
authors.affiliation: Rehabilitation Clinic ("RehaClinic"), Bad Zurzach, Switzerland. Electronic address: fangst@vtxmail.ch.
authors.forename: Felix
authors.initials: F
authors.lastname: Angst
authors.forename: Martin L
authors.initials: ML
authors.lastname: Verra
authors.forename: Susanne
authors.initials: S
authors.lastname: Lehmann
authors.forename: Thomas
authors.initials: T
authors.lastname: Benz
authors.forename: André
authors.initials: A
authors.lastname: Aeschlimann
mesh_terms: D000368:Aged; D015897:Comorbidity; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000453:epidemiology / Q000534:rehabilitation*; D020370:Osteoarthritis, Knee / Q000453:epidemiology / Q000534:rehabilitation*; D011446:Prospective Studies; D012047:Rehabilitation Centers; D016896:Treatment Outcome
keywords: ES; MCID; Medical Outcomes Study 36-Item Short-Form Health Survey; Osteoarthritis; Outcome assessment (health care); RCT; Rehabilitation; SF-36; SMD; WOMAC; Western Ontario and McMaster Universities Osteoarthritis Index; effect size; minimal clinically important difference; randomized controlled trial; standardized mean difference