Skip to main content
Top
Published in: Health and Quality of Life Outcomes 1/2013

Open Access 01-12-2013 | Research

Effect on health-related quality of life of a multimodal physiotherapy program in patients with chronic musculoskeletal disorders

Authors: Antonio Ignacio Cuesta-Vargas, Manuel González-Sánchez, María Jesús Casuso-Holgado

Published in: Health and Quality of Life Outcomes | Issue 1/2013

Login to get access

Abstract

Background

Musculoskeletal disorders are major causes of morbidity in the world, and these conditions have a strong negative influence in terms of health-related quality of life. The purpose of this study was to evaluate the effect of an 8-week multimodal physical therapy program on general health state and health-related quality of life in patients with chronic musculoskeletal disorders.

Methods

There were 244 participants in this prospective cohort analysis with 8-week follow-up. The primary outcome was general health state (physical and mental components), determined with the Short Form-12 Health Survey (SF-12). The secondary outcome was health related quality of life, determined with the EuroQoL-5D and VAS. The intervention was evaluated by comparing pre- and post-outcome measurements. T-tests were performed for paired data.

Results

Differences were statistically significant for physical health state: +1.68 (p < 0.05) (baseline: 42.38); mental health state: +3.15 (p < 0.001) (baseline: 46.57); and health related quality of life: +0.18 (EuroQoL 5D) (baseline: 46.57) and +7.22 (EuroQoL_VAS) (p < 0.001) (baseline: 60.81). Intervention resulted in clinically relevant changes in terms of percentage improvement from baseline scores.

Conclusions

Eight weeks of a Multimodal Physical Therapy Program seemed to moderately enhance the general health state and HRQoL of patients with chronic musculoskeletal diseases. This kind of therapeutic exercise can be recommended to patients with chronic low back pain, chronic neck pain and osteoarthritis, at least in the short term.
Appendix
Available only for authorised users
Literature
2.
go back to reference Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D: Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain 2006,10(4):287–333. 10.1016/j.ejpain.2005.06.009PubMedCrossRef Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D: Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain 2006,10(4):287–333. 10.1016/j.ejpain.2005.06.009PubMedCrossRef
3.
go back to reference Bergman S, Jacobsson LT, Herrström P, Petersson IF: Health status as measured by SF-36 reflects changes and predicts outcome in chronic musculoskeletal pain: a 3-year follow up study in the general population. Pain 2004,108(1–2):115–123.PubMedCrossRef Bergman S, Jacobsson LT, Herrström P, Petersson IF: Health status as measured by SF-36 reflects changes and predicts outcome in chronic musculoskeletal pain: a 3-year follow up study in the general population. Pain 2004,108(1–2):115–123.PubMedCrossRef
4.
go back to reference Eriksen J, Ekholm O, Sjögren P, Rasmussen NK: Development of and recovery from long-term pain. A 6-year follow-up study of a cross-section of the adult Danish population. Pain 2004,108(1–2):154–162.PubMedCrossRef Eriksen J, Ekholm O, Sjögren P, Rasmussen NK: Development of and recovery from long-term pain. A 6-year follow-up study of a cross-section of the adult Danish population. Pain 2004,108(1–2):154–162.PubMedCrossRef
5.
go back to reference Antonopoulou M, Alegakis A, Hadjipavlou A, Lionis C: Studying the association between musculoskeletal disorders, quality of life and mental health. A primary care pilot study in rural Crete, Greece. BMC Musculoskelet Disord 2009, 10: 143–150. 10.1186/1471-2474-10-143PubMedCentralPubMedCrossRef Antonopoulou M, Alegakis A, Hadjipavlou A, Lionis C: Studying the association between musculoskeletal disorders, quality of life and mental health. A primary care pilot study in rural Crete, Greece. BMC Musculoskelet Disord 2009, 10: 143–150. 10.1186/1471-2474-10-143PubMedCentralPubMedCrossRef
6.
go back to reference Sackett DL, Straus S, Richardson WS, Rosenberg W, Haynes RB: Evidence-based medicine: How to practice and teach EBM. Churchill Livingstone, New York; 2000. (2nd ed.) Sackett DL, Straus S, Richardson WS, Rosenberg W, Haynes RB: Evidence-based medicine: How to practice and teach EBM. Churchill Livingstone, New York; 2000. (2nd ed.)
7.
go back to reference American College of Occupational and Environmental Medicine Occupational medicine practice guidelines: evaluation and management of common health problems and functional recovery in workers. In Chronic pain. American College of Occupational and Environmental Medicine (ACOEM), Elk Grove Village (IL); 2008. American College of Occupational and Environmental Medicine Occupational medicine practice guidelines: evaluation and management of common health problems and functional recovery in workers. In Chronic pain. American College of Occupational and Environmental Medicine (ACOEM), Elk Grove Village (IL); 2008.
8.
go back to reference American College of Occupational and Environmental Medicine Occupational medicine practice guidelines: evaluation and management of common health problems and functional recovery in workers. In Low back disorders. 2nd edition. American College of Occupational and Environmental Medicine (ACOEM), Elk Grove Village (IL); 2007. American College of Occupational and Environmental Medicine Occupational medicine practice guidelines: evaluation and management of common health problems and functional recovery in workers. In Low back disorders. 2nd edition. American College of Occupational and Environmental Medicine (ACOEM), Elk Grove Village (IL); 2007.
9.
go back to reference Childs JD, Cleland JA, Elliott JM, Teyhen DS, Wainner RS, Whitman JM, Sopky BJ, Godges JJ, Flynn TW, Association APT: Neck pain: clinical practice guidelines linked to the international classification of functioning, disability, and health from the orthopaedic section of the american physical therapy association. J Orthop Sports Phys Ther 2008,38(9):A1–34.PubMedCrossRef Childs JD, Cleland JA, Elliott JM, Teyhen DS, Wainner RS, Whitman JM, Sopky BJ, Godges JJ, Flynn TW, Association APT: Neck pain: clinical practice guidelines linked to the international classification of functioning, disability, and health from the orthopaedic section of the american physical therapy association. J Orthop Sports Phys Ther 2008,38(9):A1–34.PubMedCrossRef
10.
go back to reference Cibulka MT, White DM, Woehrle J, Harris-Hayes M, Enseki K, Fagerson TL, Slover J, Godges JJ: Hip pain and mobility deficits–hip osteoarthritis: clinical practice guidelines linked to the international classification of functioning, disability, and health from the orthopaedic section of the american physical therapy association. J Orthop Sports Phys Ther 2009,39(4):A1–25.PubMedCentralPubMedCrossRef Cibulka MT, White DM, Woehrle J, Harris-Hayes M, Enseki K, Fagerson TL, Slover J, Godges JJ: Hip pain and mobility deficits–hip osteoarthritis: clinical practice guidelines linked to the international classification of functioning, disability, and health from the orthopaedic section of the american physical therapy association. J Orthop Sports Phys Ther 2009,39(4):A1–25.PubMedCentralPubMedCrossRef
11.
go back to reference Haskell WL: What to look for in assessing responsiveness to exercise in a health context. Med Sci Sports Exerc 2001,33(Suppl 6):S454-S458.PubMedCrossRef Haskell WL: What to look for in assessing responsiveness to exercise in a health context. Med Sci Sports Exerc 2001,33(Suppl 6):S454-S458.PubMedCrossRef
12.
go back to reference Harding V, Simmonds MJ, Watson PJ, The International Association for the study of Pain Vol 6;3: Clinical Updates Physical Therapy for Chronic Pain. 1998. Harding V, Simmonds MJ, Watson PJ, The International Association for the study of Pain Vol 6;3: Clinical Updates Physical Therapy for Chronic Pain. 1998.
13.
go back to reference Haskell WL, Lee I, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath GW, Thompson PD, Bauman A: Physical Activity and Public Health: Updated Recommendation for Adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 2007,39(8):1423–1434. 10.1249/mss.0b013e3180616b27PubMedCrossRef Haskell WL, Lee I, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath GW, Thompson PD, Bauman A: Physical Activity and Public Health: Updated Recommendation for Adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 2007,39(8):1423–1434. 10.1249/mss.0b013e3180616b27PubMedCrossRef
14.
go back to reference Bell JA, Burnett A: Exercise for the Primary, Secondary and Tertiary Prevention of Low Back Pain in the Workplace: A Systematic Review. J Occup Rehabil 2009, 19: 8–24. 10.1007/s10926-009-9164-5PubMedCrossRef Bell JA, Burnett A: Exercise for the Primary, Secondary and Tertiary Prevention of Low Back Pain in the Workplace: A Systematic Review. J Occup Rehabil 2009, 19: 8–24. 10.1007/s10926-009-9164-5PubMedCrossRef
15.
go back to reference Mason LW, Goolkasian P, McCain GA: Evaluation of a Multimodal Treament Program for Fibromyalgia. J Behav Med 1998,21(2):163–178. 10.1023/A:1018727924432PubMedCrossRef Mason LW, Goolkasian P, McCain GA: Evaluation of a Multimodal Treament Program for Fibromyalgia. J Behav Med 1998,21(2):163–178. 10.1023/A:1018727924432PubMedCrossRef
16.
go back to reference Salo P, Häkkinen A, Kautianinen H, Ylinen J: Effect of neck strength training on healthrelated quality of life in females with chronic neck pain: a randomized controlled 1-year follow-up study. Health Qual Life Outcomes 2010, 8: 48–54. 10.1186/1477-7525-8-48PubMedCentralPubMedCrossRef Salo P, Häkkinen A, Kautianinen H, Ylinen J: Effect of neck strength training on healthrelated quality of life in females with chronic neck pain: a randomized controlled 1-year follow-up study. Health Qual Life Outcomes 2010, 8: 48–54. 10.1186/1477-7525-8-48PubMedCentralPubMedCrossRef
17.
go back to reference Iwamoto J, Sato Y, Takeda T, Matsumoto H: Effectiveness of exercise for osteoarthritis of the knee: A review of the literature. World J Orthop 2011,2(5):37–42. 10.5312/wjo.v2.i5.37PubMedCentralPubMedCrossRef Iwamoto J, Sato Y, Takeda T, Matsumoto H: Effectiveness of exercise for osteoarthritis of the knee: A review of the literature. World J Orthop 2011,2(5):37–42. 10.5312/wjo.v2.i5.37PubMedCentralPubMedCrossRef
18.
go back to reference Abell JE, Hootman JM, Zack MM, Moriarty D, Helmick CG: Physical activity and health related quality of life among people with arthritis. J Epidemiol Community Health 2005,59(5):380–385. 10.1136/jech.2004.028068PubMedCentralPubMedCrossRef Abell JE, Hootman JM, Zack MM, Moriarty D, Helmick CG: Physical activity and health related quality of life among people with arthritis. J Epidemiol Community Health 2005,59(5):380–385. 10.1136/jech.2004.028068PubMedCentralPubMedCrossRef
19.
go back to reference Brown DW, Balluz LS, Heath GW, Moriarty DG, Ford ES, Giles WH, Mokdad AH: Associations between recommended levels of physical activity and health-related quality of life. Findings from the 2001 Behavioral Risk Factor Surveillance System (BRFSS) survey. Prev Med 2003,37(5):520–528. 10.1016/S0091-7435(03)00179-8PubMedCrossRef Brown DW, Balluz LS, Heath GW, Moriarty DG, Ford ES, Giles WH, Mokdad AH: Associations between recommended levels of physical activity and health-related quality of life. Findings from the 2001 Behavioral Risk Factor Surveillance System (BRFSS) survey. Prev Med 2003,37(5):520–528. 10.1016/S0091-7435(03)00179-8PubMedCrossRef
20.
go back to reference Grahn B, Ekdahl C, Borgquist L: Effects of a multidisciplinary rehabilitation programme on healthrelated quality of life in patients with prolonged musculoskeletal disorders: a 6-month follow-up of a prospective controlled study. Disabil Rehabil 1998,20(8):285–97. 10.3109/09638289809166084PubMedCrossRef Grahn B, Ekdahl C, Borgquist L: Effects of a multidisciplinary rehabilitation programme on healthrelated quality of life in patients with prolonged musculoskeletal disorders: a 6-month follow-up of a prospective controlled study. Disabil Rehabil 1998,20(8):285–97. 10.3109/09638289809166084PubMedCrossRef
21.
go back to reference Dundar U, Solak O, Yigit I, Evcik D, Kavuncu V: Clinical effectiveness of aquatic exercise to treat chronic low back pain: a randomized controlled trial. Spine 2009,34(14):1436–40. 10.1097/BRS.0b013e3181a79618PubMedCrossRef Dundar U, Solak O, Yigit I, Evcik D, Kavuncu V: Clinical effectiveness of aquatic exercise to treat chronic low back pain: a randomized controlled trial. Spine 2009,34(14):1436–40. 10.1097/BRS.0b013e3181a79618PubMedCrossRef
22.
go back to reference Waller B, Lambeck J, Daly D: Therapeutic aquatic exercise in the treatment of low back pain: a systematic review. Clin Rehabil 2009,23(1):3–14. 10.1177/0269215508097856PubMedCrossRef Waller B, Lambeck J, Daly D: Therapeutic aquatic exercise in the treatment of low back pain: a systematic review. Clin Rehabil 2009,23(1):3–14. 10.1177/0269215508097856PubMedCrossRef
24.
go back to reference Hall J, Swinkels A, Briddon J, McCabe CS: Does aquatic exercise relieve pain in adults with neurologic or musculoskeletal disease: a systematic review and meta-analysis of randomized controlled trials. Arch Phys Med Rehabil 2008,89(5):873–883. 10.1016/j.apmr.2007.09.054PubMedCrossRef Hall J, Swinkels A, Briddon J, McCabe CS: Does aquatic exercise relieve pain in adults with neurologic or musculoskeletal disease: a systematic review and meta-analysis of randomized controlled trials. Arch Phys Med Rehabil 2008,89(5):873–883. 10.1016/j.apmr.2007.09.054PubMedCrossRef
25.
go back to reference Batterham S, Heywood S, Keating J: Systematic review and metaanalysis comparing land and aquatic exercise for people with hip or knee arthritis on function, mobility and other health outcomes. BMC Musculoskelet Disord 2011, 12: 123–135. 10.1186/1471-2474-12-123PubMedCentralPubMedCrossRef Batterham S, Heywood S, Keating J: Systematic review and metaanalysis comparing land and aquatic exercise for people with hip or knee arthritis on function, mobility and other health outcomes. BMC Musculoskelet Disord 2011, 12: 123–135. 10.1186/1471-2474-12-123PubMedCentralPubMedCrossRef
26.
go back to reference Cuesta-Vargas AI, García-Romero JC, Diego-Acosta AM, González-Sánchez M, Labajos-Manzanares MT: Clinical effect of deep water running on non-specific low back pain: A randomised trial. SA Journal of Physiotherapy 2009,65(3):1–8. Cuesta-Vargas AI, García-Romero JC, Diego-Acosta AM, González-Sánchez M, Labajos-Manzanares MT: Clinical effect of deep water running on non-specific low back pain: A randomised trial. SA Journal of Physiotherapy 2009,65(3):1–8.
27.
go back to reference Cuesta-Vargas AI, García-Romero JC, Arroyo-Morales M, Diego-Acosta AM, Daly DJ: Exercise, manual therapy, and education with or without high-intensity deep-water running for nonspecific chronic low back pain: a pragmatic randomized controlled trial. Am J Phys Med Rehabil 2011,90(7):526–34. 10.1097/PHM.0b013e31821a71d0PubMedCrossRef Cuesta-Vargas AI, García-Romero JC, Arroyo-Morales M, Diego-Acosta AM, Daly DJ: Exercise, manual therapy, and education with or without high-intensity deep-water running for nonspecific chronic low back pain: a pragmatic randomized controlled trial. Am J Phys Med Rehabil 2011,90(7):526–34. 10.1097/PHM.0b013e31821a71d0PubMedCrossRef
28.
go back to reference Cuesta-Vargas A, Adams L: A pragmatic community-based intervention of multimodal physiotherapy plus deep water running (DWR) for fibromyalgia syndrome: a pilot study. Clin Rheumatol 2011,30(11):1455–1462. 10.1007/s10067-011-1825-zPubMedCrossRef Cuesta-Vargas A, Adams L: A pragmatic community-based intervention of multimodal physiotherapy plus deep water running (DWR) for fibromyalgia syndrome: a pilot study. Clin Rheumatol 2011,30(11):1455–1462. 10.1007/s10067-011-1825-zPubMedCrossRef
29.
go back to reference Cuesta-Vargas AI, Adams N, Salazar JA, Belles A, Hazañas S, Arroyo-Morales M: Deep water running and general practice in primary care for non-specific low back pain versus general practice alone: randomized controlled trial. Clin Rheumatol 2012,31(7):1073–1078. 10.1007/s10067-012-1977-5PubMedCrossRef Cuesta-Vargas AI, Adams N, Salazar JA, Belles A, Hazañas S, Arroyo-Morales M: Deep water running and general practice in primary care for non-specific low back pain versus general practice alone: randomized controlled trial. Clin Rheumatol 2012,31(7):1073–1078. 10.1007/s10067-012-1977-5PubMedCrossRef
30.
go back to reference Smith BH, Elliot AM, Chambers WA, Cairns Smith W, Hannaford PC, Penny K: The impact of chronic pain in the community. Fam Pract 2001, 18: 292–299. 10.1093/fampra/18.3.292PubMedCrossRef Smith BH, Elliot AM, Chambers WA, Cairns Smith W, Hannaford PC, Penny K: The impact of chronic pain in the community. Fam Pract 2001, 18: 292–299. 10.1093/fampra/18.3.292PubMedCrossRef
31.
go back to reference Sintonen H: The 15D instrument of health-related quality of life: properties and applications. Ann Med 2001,33(5):328–336. 10.3109/07853890109002086PubMedCrossRef Sintonen H: The 15D instrument of health-related quality of life: properties and applications. Ann Med 2001,33(5):328–336. 10.3109/07853890109002086PubMedCrossRef
32.
go back to reference Vilagut G, Valderas JM, Ferrer M, Garin O, López-García E, Alonso J: Interpretation of SF-36 and SF-12 questionnaires in Spain: physical and mental components. Med Clin 2008,130(19):726–735. 10.1157/13121076CrossRef Vilagut G, Valderas JM, Ferrer M, Garin O, López-García E, Alonso J: Interpretation of SF-36 and SF-12 questionnaires in Spain: physical and mental components. Med Clin 2008,130(19):726–735. 10.1157/13121076CrossRef
33.
go back to reference Jia H, Lubetkin EI: Estimating. EuroQol EQ-5D scores from Population Healthy Days data. Med Decis Making 2008,28(4):491–499. 10.1177/0272989X07312708PubMedCrossRef Jia H, Lubetkin EI: Estimating. EuroQol EQ-5D scores from Population Healthy Days data. Med Decis Making 2008,28(4):491–499. 10.1177/0272989X07312708PubMedCrossRef
34.
go back to reference Badía X, Roset M, Montserrat S, et al.: The Spanish version of EuroQol: A description and its applications European Quality of Life scale. MedClin (Barc). 1999, 112: 79–85. Badía X, Roset M, Montserrat S, et al.: The Spanish version of EuroQol: A description and its applications European Quality of Life scale. MedClin (Barc). 1999, 112: 79–85.
35.
go back to reference Luo X, Lynn GM, Kakouras I, et al.: Rieability, validity and responsiveness of the short form 12–item survey (SF–12) in patients with back pain. Spine 2003, 1: 1739–1745. Luo X, Lynn GM, Kakouras I, et al.: Rieability, validity and responsiveness of the short form 12–item survey (SF–12) in patients with back pain. Spine 2003, 1: 1739–1745.
36.
go back to reference Ware JE, Kosinski M, Keller SD: SF-12: How to score the SF-12 physical and mental health summary scales. 2nd edition. New England Medical Center, Boston, MA: The health institute; 1995. Ware JE, Kosinski M, Keller SD: SF-12: How to score the SF-12 physical and mental health summary scales. 2nd edition. New England Medical Center, Boston, MA: The health institute; 1995.
37.
go back to reference Van Agt HM, Essink-Bot ML, Krabbe PF, et al.: Test-retest reliability of health state valuations collected with the Euro Qol questionnaire. SocSciMed 1994, 39: 1537–1544. Van Agt HM, Essink-Bot ML, Krabbe PF, et al.: Test-retest reliability of health state valuations collected with the Euro Qol questionnaire. SocSciMed 1994, 39: 1537–1544.
38.
go back to reference Cuesta-Vargas A: Development of software ASETER 2.0 for bio-medical assessment before exercise prescription. Ayuntamiento de Torremolinos, Torremolinos; 2007. Cuesta-Vargas A: Development of software ASETER 2.0 for bio-medical assessment before exercise prescription. Ayuntamiento de Torremolinos, Torremolinos; 2007.
39.
go back to reference Cuesta-Vargas AI, Heywood S: Aerobic fitness testing in chronic nonspecific low back pain: a comparison of deep-water running with cycle ergometry. Am J Phys Med Rehabil 2011,90(12):1030–5. 10.1097/PHM.0b013e318238a29cPubMedCrossRef Cuesta-Vargas AI, Heywood S: Aerobic fitness testing in chronic nonspecific low back pain: a comparison of deep-water running with cycle ergometry. Am J Phys Med Rehabil 2011,90(12):1030–5. 10.1097/PHM.0b013e318238a29cPubMedCrossRef
40.
go back to reference Keller A, Hayden J, Bombardier C, van Tulder M: Effect sizes of non surgical treatments of non specific low back pain. Eur Spine J 2007, 16: 1776–1788. 10.1007/s00586-007-0379-xPubMedCentralPubMedCrossRef Keller A, Hayden J, Bombardier C, van Tulder M: Effect sizes of non surgical treatments of non specific low back pain. Eur Spine J 2007, 16: 1776–1788. 10.1007/s00586-007-0379-xPubMedCentralPubMedCrossRef
41.
go back to reference Martel J, Dugas C, Dubois JD, Descarreaux M: A randomised controlled trial of preventive spinal manipulation with and without a home exercise program for patients with chronic neck pain. BMC Musculoskelet Disord 2011, 12: 41. 10.1186/1471-2474-12-41PubMedCentralPubMedCrossRef Martel J, Dugas C, Dubois JD, Descarreaux M: A randomised controlled trial of preventive spinal manipulation with and without a home exercise program for patients with chronic neck pain. BMC Musculoskelet Disord 2011, 12: 41. 10.1186/1471-2474-12-41PubMedCentralPubMedCrossRef
42.
go back to reference Michalsen A, Traitteur H, Lüdtke R, Brunnhuber S, Meier L, Jeitler M, Büssing A, Kessler C: Yoga for chronic neck pain: a pilot randomized controlled clinical trial. J Pain 2012,13(11):1122–30. 10.1016/j.jpain.2012.08.004PubMedCrossRef Michalsen A, Traitteur H, Lüdtke R, Brunnhuber S, Meier L, Jeitler M, Büssing A, Kessler C: Yoga for chronic neck pain: a pilot randomized controlled clinical trial. J Pain 2012,13(11):1122–30. 10.1016/j.jpain.2012.08.004PubMedCrossRef
43.
go back to reference Fransen M, Nairn L, Winstanley J, Lam P, Edmonds J: Physical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or Tai Chi classes. Arthritis Rheum 2007,57(3):407–14. 10.1002/art.22621PubMedCrossRef Fransen M, Nairn L, Winstanley J, Lam P, Edmonds J: Physical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or Tai Chi classes. Arthritis Rheum 2007,57(3):407–14. 10.1002/art.22621PubMedCrossRef
44.
go back to reference Jigami H, Sato D, Tsubaki A, Tokunaga Y, Ishikawa T, Dohmae Y, Iga T, Minato I, Yamamoto N, Endo N: Effects of weekly and fortnightly therapeutic exercise on physical function and health-related quality of life in individuals with hip osteoarthritis. J Orthop Sci 2012,17(6):737–44.PubMed Jigami H, Sato D, Tsubaki A, Tokunaga Y, Ishikawa T, Dohmae Y, Iga T, Minato I, Yamamoto N, Endo N: Effects of weekly and fortnightly therapeutic exercise on physical function and health-related quality of life in individuals with hip osteoarthritis. J Orthop Sci 2012,17(6):737–44.PubMed
45.
go back to reference Kamioka H, Tsutani K, Okuizumi H, Mutoh Y, Ohta M, Handa S, Okada S, Kitayuguchi J, Kamada M, Shiozawa N, Honda T: Effectiveness of aquatic exercise and balneotherapy: a summary of systematic reviews based on randomized controlled trials of water immersion therapies. J Epidemiol 2010,20(1):2–12. 10.2188/jea.JE20090030PubMedCentralPubMedCrossRef Kamioka H, Tsutani K, Okuizumi H, Mutoh Y, Ohta M, Handa S, Okada S, Kitayuguchi J, Kamada M, Shiozawa N, Honda T: Effectiveness of aquatic exercise and balneotherapy: a summary of systematic reviews based on randomized controlled trials of water immersion therapies. J Epidemiol 2010,20(1):2–12. 10.2188/jea.JE20090030PubMedCentralPubMedCrossRef
Metadata
Title
Effect on health-related quality of life of a multimodal physiotherapy program in patients with chronic musculoskeletal disorders
Authors
Antonio Ignacio Cuesta-Vargas
Manuel González-Sánchez
María Jesús Casuso-Holgado
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2013
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-11-19

Other articles of this Issue 1/2013

Health and Quality of Life Outcomes 1/2013 Go to the issue