Content » Vol 45, Issue 5

Original report

What’s in the black box of arthritis rehabilitation? A comparison of rehabilitation practice for patients with inflammatory arthritis in Northern Europe

Margreth Grotle, Mari Klokkerud, Ingvild Kjeken, Ann Bremander, Sofia Hagel, Britta Strömbeck , Kim Hørslev-Petersen, Jorit Meesters, Thea P. M. Vliet Vlieland, Kåre B. Hagen
National resource center for rehabilitation in rheumathology, Diakonhjemmets hospital, Oslo, Norway. E-mail:
DOI: 10.2340/16501977-1125


Background: In evaluating complex interventions, it is a challenge for researchers to provide transparent reporting of the intervention content with sufficient detail and clarity such that effects can be compared across studies or countries.
Objective: To describe and compare the content of current rehabilitation for patients with inflammatory arthritis across 4 northern European countries.
Patients and methods: A total of 731 patients with inflammatory rheumatic diseases participated in a multicentre, longitudinal observational study carried out in Sweden, The Netherlands, Denmark and Norway. Data on context, structure and process were reported by patients and teams at the different participating study sites according to the Scandinavian Team Arthritis Register – European Team Intiative for Care Research (STAR-ETIC) framework.
Results: Although large similarities were found in the context, there were important differences between the Netherlands and the Scandinavian countries. Regarding structure, there were considerable differences in the length of the rehabilitation period across settings and countries. The most evident differences concerned process variables, especially the type and dosage of individual treatment modalities.
Conclusion: The variation in important aspects of arthritis rehabilitation found in the present study underline the need for transparent and standardized description of these variables when comparing effects across settings and countries. A standardized description of current practice can be achieved by the STAR-ETIC framework.

Lay Abstract


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