A comparison of patient characteristics and rehabilitation treatment content of chronic low back pain (CLBP) and stroke patients across six European countries

Background: So far no studies have been conducted on the issue of comparability of rehabilitation treatment profiles and patient characteristics across countries. These aspects might have implications for the feasibility of treating patients abroad but also for the comparison of treatment outcome on an international level. Objective: This study attempts to compare the patient characteristics and treatment profiles in six European countries of two rehabilitation categories (chronic low back pain (CLBP) and stroke) and to reveal possible consequences for international treatment and multi-centre studies. Design: Cross-sectional study comparing demographic variables, treatment profiles, generic health (SF-36) and disabilities (RDQ for CLBP and the Barthel index for stroke) in six European countries. Subjects: 255 patients with CLBP and 246 patients with stroke, treated in 36 different institutions in Austria (AUT), Finland (FIN), Germany (GER), Ireland (IR), Italy (IT) and The Netherlands (NL). Results: The treatment profiles of CLBP patients show marked differences between countries and three categories of treatment can be distinguished: (a) predominant physiotherapy (IR, IT), (b) all disciplines equally provided (NL, GER, AUS) and (c) treatment concentrated in four disciplines (FIN). Striking differences are also found for patient characteristics, characterised by in particular the younger and more disabled Dutch patients and the older and less disabled (mostly female) Italian patients. International stroke rehabilitation was more similar between countries; however, a few differences in patient characteristics were found which again could mostly be ascribed to the Dutch and Italian patients. Conclusion: International treatment and outcome assessment of CLBP patients is not possible unless standardisation is considered of treatment content and patient selection. For stroke treatment international traffic and multi-centre outcome assessment might be more feasible.