Hopman-Rock M, Westhoff M H
TNO Prevention and Health, Division of Public Health, Leiden, The Netherlands.
J Rheumatol. 2000 Aug;27(8):1947-54.
Evaluation of a self-management program for patients with osteoarthritis (OA) of the hip or knee. The program, which consisted of 6 weekly sessions of 2 hours, included health education by a peer and physical exercises taught by a physical therapist.
Randomized controlled trial. Inclusion criteria were diagnosis of OA of the hip or knee according to ACR clinical and radiographic criteria and age 55 to 75 years.
on waiting list for joint replacement. There were pretest, posttest, and followup (6 months) assessments. The experimental group consisted of 56 patients, the control group 49. Outcome variables were pain, quality of life, activity restrictions, knowledge about OA, self-efficacy, body mass index (BMI), and mobility measures. Attention was also paid to effects on health care utilization and lifestyle behavior.
Significant MANOVA group x time effects (p < 0.05, one-sided) were found for pain, quality of life, strength of the left M. quadriceps, knowledge, self-efficacy, BMI, physically active lifestyle, and visits to the physical therapist. Most effects were moderate at posttest assessment and smaller at followup. No effects were found for range of motion and functional tasks.
The program was reasonably effective, but more attention should be paid to proactive followup interventions and to the selection of participants.
评估一项针对髋或膝骨关节炎（OA）患者的自我管理项目。该项目包括每周一次、每次两小时的6次课程，内容有同伴进行的健康教育以及物理治疗师教授的体育锻炼。
随机对照试验。纳入标准为根据美国风湿病学会（ACR）临床和影像学标准诊断为髋或膝OA且年龄在55至75岁之间。
在等待关节置换名单上。进行了预测试、后测试和随访（6个月）评估。实验组有56名患者，对照组有49名。结果变量包括疼痛、生活质量、活动受限、关于OA的知识、自我效能感、体重指数（BMI）和活动能力测量。还关注了对医疗保健利用和生活方式行为的影响。
在疼痛、生活质量、左股四头肌力量、知识、自我效能感、BMI、积极的生活方式以及看物理治疗师的次数方面，发现了显著的多变量方差分析（MANOVA）组×时间效应（p < 0.05，单侧）。大多数效应在后测试评估时为中等程度，在随访时较小。在关节活动范围和功能任务方面未发现效应。
该项目有一定效果，但应更多关注积极的随访干预和参与者的选择。
