PTMeta-AnalysisArchives of rehabilitation research and clinical translation2021

Measuring Change in Health Status Over Time (Responsiveness): A Meta-analysis of the SF-36 in Cardiac and Pulmonary Rehabilitation.

Flora-Joan van Rotterdam, Michael Hensley, Michael Hazelton

PMID 34179763

WHAT IT FOUND

In cardiac rehab, SF-36 mental scores tracked pre-post change more consistently than physical scores.

In lung rehab, physical scores matched disease-specific respiratory outcomes poorly. This is about the questionnaire, not treatment benefit.

Key findings

01In cardiac rehabilitation, the SF-36 Mental Composite Score tracked pre-to-post change more consistently than the Physical Composite Score.

02In pulmonary rehabilitation, change in the SF-36 Physical Composite Score matched change in the Chronic Respiratory Questionnaire poorly.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The analysis grouped patient groups rather than whole studies, so standard checks for heterogeneity, sensitivity, and publication bias were not done. Inconsistent reporting of change scores limited which studies could be included, and only 9 groups could be used for some individual-domain analyses. The study assessed whether questionnaire scores moved together before and after rehabilitation; it did not test whether rehabilitation caused health-status improvement. Correlation between pre and post scores does not prove agreement or responsiveness. The pulmonary rehabilitation comparison used only 5 studies and 9 groups for SF-36 composite scores. One retrospective study was an outlier, and removing it changed some plots but not the overall conclusion.

The easy way to misread this

Do not read SF-36 pre-post changes as proof that cardiac or pulmonary rehabilitation improved health. This paper assessed whether the questionnaire tracked change, not whether the intervention caused improvement.

Read it on PubMed →