• van Delft-Schreurs C C H M CCHM Network Emergency Care Brabant, Elisabeth-TweeSteden Hospital, The Netherlands. Electronic address: k.v.delft@nazb.nl., van Son M A C MAC The Netherlands Society of Occupational Medicine-Centre of Excellence, The Netherlands. Electronic address: m.vanson@nvab-online.nl., de Jongh M A C MAC Network Emergency Care Brabant, Elisabeth-TweeSteden Hospital, The Netherlands. Electronic address: m.d.jongh@nazb.nl., Lansink K W W KWW Network Emergency Care Brabant, Elisabeth-TweeSteden Hospital, The Netherlands; Department of Surgery, Elisabeth-TweeSteden Hospital, The Netherlands. E, J de Vries, and Verhofstad M H J MHJ Department of Trauma Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands. Electronic address: m.verhofstad@erasmusmc.nl..
• Network Emergency Care Brabant, Elisabeth-TweeSteden Hospital, The Netherlands. Electronic address: k.v.delft@nazb.nl.
• Injury. 2017 Sep 1; 48 (9): 1978-1984.

PurposeThe purpose of this study was two-fold. The first goal was to investigate which variables were associated with the remaining physical limitations of severely injured patients after the initial rehabilitation phase. Second, we investigated whether physical limitations were attributable to the association between psychological complaints and quality of life in this patient group.MethodsPatients who were 18 years or older and who had an injury severity score (ISS)>15 completed a set of questionnaires at one time-point after their rehabilitation phase (15-53 months after their trauma). The Short Musculoskeletal Function Assessment (SMFA) questionnaire was used to determine physical limitations. The Hospital Anxiety and Depression Scale, the Dutch Impact of Event Scale and the Cognitive Failure Questionnaire were used to determine psychological complaints, and the World Health Organization Quality of Life assessment instrument-BREF was used to measure general Quality of Life (QOL). Differences in physical limitations were investigated for several trauma- and patient-related variables using non-parametric independent-sample Mann-Whitney U tests. Multiple linear regression was performed to investigate whether the decreased QOL of severely injured patients with psychological complaints could be explained by their physical limitations.ResultsOlder patients, patients with physical complaints before the injury, patients with higher ISS scores, and patients who had an injury of the spine or of the lower extremities reported significantly more physical problems. Additionally, patients with a low education level, patients who were living alone, and those who were unemployed reported significantly more long-term physical problems. Severely injured patients without psychological complaints reported significantly less physical limitations than those with psychological complaints. The SMFA factor of Lower extremity dysfunction was a confounder of the association between psychological complaints and QOL in all QOL domains.ConclusionsLong-term physical limitations were mainly reported by patients with psychological complaints. The decreased QOL of severely injured patients with psychological complaints can partially be explained by physical limitations, particularly those involving lower extremity function. Experienced physical limitations were significantly different for some trauma and patient characteristics. These characteristics may be used to select patients for whom a rehabilitation programme would be useful.Copyright © 2017. Published by Elsevier Ltd.

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