Development of a Framework Identifying Domains and Elements of Importance for Arthritis Rehabilitation

Mari Klokkerud, Kare Birger Hagen, Ingvild Kjeken, Ann Bremander, Kim Horslev-Petersen, Thea Vliet Vlieland, Margreth Grotle

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Background: Rehabilitation is effective and beneficial for patients with arthritis. The lack of a common structure for describing the content of rehabilitation makes it difficult to compare, transfer and implement research evidence into clinical practice. Objective: To develop a framework comprising domains and elements of importance when describing arthritis rehabilitation. Methods: On the basis of a systematic literature search and review, the framework was developed through a 9-step development process, including 5 Delphi consensus rounds within the Scandinavian Team Arthritis Register - European Team Initiative for Care Research (STAR-ETIC) collaboration, a group of clinicians, researchers and patients from northern Europe. Results: Based on Donabedian's healthcare model, the International Classification of Function, Disability and Health, and a rehabilitation model by D. T. Wade, 4 domains (context, structure, process and outcome) were defined. Within each domain, the most important and relevant key elements for describing rehabilitation were selected. This framework contains 1 key element under context, 9 under structure, 3 under process, and 9 under outcome. Conclusion: The STAR-ETIC framework can be used to describe arthritis rehabilitation, by emphasizing key elements in 4 main domains. A common framework may facilitate comparisons of rehabilitation programmes across countries and different levels of care, and may improve the implementation of rehabilitation research in clinical practice.
Original languageEnglish
Pages (from-to)406-413
JournalJournal of Rehabilitation Medicine
Issue number5
Publication statusPublished - 2012

Subject classification (UKÄ)

  • Other Medical Sciences not elsewhere specified


  • arthritis
  • rehabilitation
  • framework
  • context
  • structure
  • process
  • outcome


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