title: Health Related Quality of Life in a Dutch Rehabilitation Population: Reference Values and the Effect of Physical Activity.
abstract: OBJECTIVE
  To establish reference values for Health Related Quality of Life (HRQoL) in a Dutch rehabilitation population, and to study effects of patient characteristics, diagnosis and physical activity on HRQoL in this population.
  
  
  METHODS
  Former rehabilitation patients (3169) were asked to fill in a questionnaire including the Dutch version of the RAND-36. Differences between our rehabilitation patients and Dutch reference values were analyzed (t-tests). Effects of patient characteristics, diagnosis and movement intensity on scores on the subscales of the RAND-36 were analyzed using block wise multiple regression analyses.
  
  
  RESULTS
  In total 1223 patients (39%) returned the questionnaire. HRQoL was significantly poorer in the rehabilitation patients compared to Dutch reference values on all subscales (p<0.001) except for health change (p = 0.197). Longer time between questionnaire and last treatment was associated with a smaller health change (p = 0.035). Higher age negatively affected physical functioning (p<0.001), social functioning (p = 0.004) and health change (p = 0.001). Diagnosis affected outcomes on all subscales except role limitations physical, and mental health (p ranged <0.001 to 0.643). Higher movement intensity was associated with better outcomes on all subscales except for mental health (p ranged <0.001 to 0.190).
  
  
  CONCLUSIONS
  HRQoL is poorer in rehabilitation patients compared to Dutch reference values. Physical components of HRQoL are affected by diagnosis. In rehabilitation patients an association between movement intensity and HRQoL was found. For clinical purposes, results of this study can be used as reference values for HRQoL in a rehabilitation setting.
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands.
authors.forename: Leonie A
authors.identifier: http://orcid.org/0000-0003-1721-3953
authors.initials: LA
authors.lastname: Krops
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands.
authors.forename: Eva A
authors.initials: EA
authors.lastname: Jaarsma
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands.|University of Groningen, University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, Groningen, The Netherlands.
authors.forename: Pieter U
authors.initials: PU
authors.lastname: Dijkstra
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands.
authors.forename: Jan H B
authors.initials: JH
authors.lastname: Geertzen
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands.|University of Groningen, University Medical Center Groningen, Center for Sports Medicine, Groningen, The Netherlands.
authors.forename: Rienk
authors.initials: R
authors.lastname: Dekker
mesh_terms: D000328:Adult; D000368:Aged; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011159:Population Surveillance; D011788:Quality of Life; D012016:Reference Values; D012046:Rehabilitation; D011795:Surveys and Questionnaires