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Behavioural and patient-individual determinants of quality of life, functioning and physical activity in older adults (MobilE-TRA 2): study protocol of an observational cohort study in a tertiary care setting
  1. Benedict Katzenberger1,2,3,
  2. Lars Schwettmann4,5,
  3. Martin Weigl6,
  4. Alexander Paulus6,
  5. Sara Pedron4,7,
  6. Sebastian Fuchs1,3,6,
  7. Daniela Koller1,2,
  8. Eva Grill1,8
  1. 1Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilians University Munich, Munich, Germany
  2. 2Munich Center of Health Sciences, Ludwig Maximilians University Munich, Munich, Germany
  3. 3Pettenkofer School of Public Health, Ludwig Maximilians University Munich, Munich, Germany
  4. 4Institute of Health Economics and Health Care Management, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany
  5. 5Department of Economics, Martin Luther University Halle Wittenberg, Halle, Germany
  6. 6Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital Munich, Munich, Germany
  7. 7Professorship of Public Health and Prevention, Faculty of Sport and Health Science, Technical University of Munich, Munich, Germany
  8. 8German Centre for Vertigo and Balance Disorders, University Hospital Munich, Munich, Germany
  1. Correspondence to Mr Benedict Katzenberger; benedict.katzenberger{at}


Introduction Vertigo, dizziness and balance problems (VDB) as well as osteoarthritis (OA) are among the health conditions with the greatest impact on mobility and social participation in older adults. Patients with VDB and OA were shown to benefit from specialised care such as vestibular rehabilitation therapy or joint replacement. However, these effects are not permanent and seem to disappear over time. One important reason might be a decreasing adherence to therapy recommendations. Findings from behavioural economics (BE) can help to shed light on individual effects on adherence behaviour and long-term outcomes of VDB and OA.

Objective Based on insights from BE concepts (ie, self-efficacy, intention, and time and risk preferences), MobilE-TRA 2 investigates the determinants of functioning and health-related quality of life (HRQoL) 3 and 12 months after discharge from total hip replacement (THR)/total knee replacement (TKR) in patients with OA and after interdisciplinary evaluation for VDB.

Methods and analysis MobilE-TRA 2 is a longitudinal observational study with data collection in two specialised tertiary care centres at the university hospital in Munich, Germany between 2020 and 2023. Patients aged 60 and older presenting for their first THR/TKR or interdisciplinary evaluation of VDB at Ludwig Maximilians University (LMU) hospital will be recruited for study participation. Three and twelve months after baseline assessment, all patients will receive a follow-up questionnaire. Mixed-effect regression models will be used to examine BE concepts as determinants of adherence, HRQoL and functioning.

Ethics and dissemination The study was approved by the ethics committee at the medical faculty of the LMU Munich under the number 20-727. Results will be published in scientific, peer-reviewed journals and at national and international conferences. Findings will also be disseminated via newsletters, the project website and a regional conference for representatives of local and national authorities.

  • geriatric medicine
  • health economics
  • quality in health care
  • knee
  • hip
  • health services administration & management

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  • Contributors EG, LS, MW and AP are the principal investigators. They conceived and supervised the project. BK coordinated the study. EG, LS, MW, AP and DK contributed to the conception of the cohort and design of the project. DK, BK and EG are responsible for the study’s quality assessment. SF is responsible for the data management at the OPMR and preliminary analysis of the osteoarthritis data. LS and SP are responsible for secondary data management, preliminary analysis and preparation and contribute expertise on behavioural economics. BK, EG, LS, MW SP, SF and AP drafted the manuscript. All authors approved and critically revised the final manuscript.

  • Funding This work is part of the project “Munich Network Healthcare Research—MobilE-Net” and was supported by the German Federal Ministry of Education and Research grant number 01GY1913A.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

  • Provenance and peer review Not commissioned; externally peer reviewed.