J PHYSIOTHER:患者教育可改善骨性膝关节炎患者的疼痛和功能障碍,结合运动治疗效果更好

2021-10-08 MedSci原创 MedSci原创

骨性膝关节炎(OA)是世界范围致残的主要原因,50岁以上的人群中有四分之一受到此疾病影响。

骨性膝关节炎(OA)是世界范围致残的主要原因,50岁以上的人群中有四分之一受到此疾病影响。在许多发达国家,与骨性膝关节炎相关的医疗负担正持续增长。例如,2013年澳大利亚仅在膝关节置换手术上就花费了9.05亿澳元,预计到2030年这一数字将上升到13.8亿澳元。

所有主要指南都推荐患者教育、运动治疗和体重管理作为膝骨关节炎患者的一线干预。最近的系统综述已经证实了运动治疗和体重管理的有效性和成本效益。

那么,对于膝骨关节炎患者,患者教育作为独立干预因素或与其他干预因素相结合治疗会有更好的疗效吗?

本研究对患有膝骨关节炎的患者进行了系统回顾,主要目的是评估患者教育对骨性膝关节炎患者自我报告疼痛和功能结果的影响。次要目的是评估患者教育对患者心理结果的影响,并评估治疗师在促进患者教育中发挥的作用。

研究结果显示,患者教育在短期内优于对疼痛和功能障碍的常规护理,但效果不如运动疗法。与单纯患者教育相比,患者教育与运动疗法相结合在短期内对患者的疼痛和功能改善产生了更好的效果。在使用骨关节炎指数进行这些比较时,临床上重要的差异表明,短期内患者教育不如运动疗法治疗疼痛,但患者教育和运动疗法结合治疗的效果更佳。

患者教育与运动治疗相结合的效果

综述结果表明,与常规护理相比,患者教育可以减少疼痛并改善功能,尽管这种差异在临床上可能并不重要,其单独的价值也存疑,但考虑到患者运动功能方面的统计优势和临床重要性的改善,应鼓励将患者教育与运动疗法相结合。

参考文献:Goff A J , Silva D , Merolli M , et al. Patient education improves pain and function in people with knee osteoarthritis with better effects when combined with exercise therapy: a systematic review[J]. Journal of Physiotherapy, 2021.

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    2021-10-10 lmm397
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