Nuñez M, Nuñez E, Segur J M, Macule F, Quinto L, Hernandez M V, Vilalta C
Orthopaedic Surgery Department, Hospital Clinic, Rheumatology, Villarroel 170, Barcelona, Spain.
Osteoarthritis Cartilage. 2006 Mar;14(3):279-85. doi: 10.1016/j.joca.2005.10.002. Epub 2005 Nov 23.
To evaluate the effect of therapeutic education and functional readaptation (TEFR) on health-related quality of life (HRQL) in patients diagnosed with osteoarthritis on a waiting list for total knee replacement (TKR).
Randomized controlled trial of 9 months duration was conducted. One hundred consecutive outpatients (71 females, mean age 71 years (range 50-86), mean disease duration 11.84+/-10.52 months) were included. Patients were randomized in two groups. The intervention group received TEFR added to conventional (pharmacological) treatment (n=51). The control group received conventional (pharmacological) treatment only (n=49). The main outcome variable was self-reported HRQL measured by the Spanish version of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes were general HRQL measured by Short Form Health Survey general questionnaire (SF-36), number of visits to general physicians and their cost. Assessments were done at baseline and at 9 months.
Eighty patients completed the study. Significant improvement in the WOMAC function was found at 9 months in the TERF group with respect to the control group (P=0.035). Consumption of analgesics increased significantly in the TERF group compared with controls (P=0.036). Significant improvements in pain (P=0.027) measured by WOMAC and in bodily pain (P=0.043) and physical function (P=0.031), measured by SF-36, were observed in the intervention group with respect to baseline.
The function dimension measured by WOMAC of patients who received both pharmacological treatment and TERF improved with respect to the control group receiving only pharmacological treatment. This suggests that a program of TEFR during the period on the waiting list for TKR may reduce the negative impact of this situation.
评估治疗性教育与功能再适应（TEFR）对全膝关节置换术（TKR）等待名单上诊断为骨关节炎患者的健康相关生活质量（HRQL）的影响。
进行了为期9个月的随机对照试验。纳入了100名连续门诊患者（71名女性，平均年龄71岁（范围50 - 86岁），平均病程11.84±10.52个月）。患者被随机分为两组。干预组在接受常规（药物）治疗的基础上加用TEFR（n = 51）。对照组仅接受常规（药物）治疗（n = 49）。主要结局变量是通过西班牙文版的西安大略和麦克马斯特大学骨关节炎指数（WOMAC）测量的自我报告的HRQL。次要结局包括通过简短健康调查问卷通用问卷（SF - 36）测量的总体HRQL、全科医生就诊次数及其费用。在基线和9个月时进行评估。
80名患者完成了研究。与对照组相比，TERF组在9个月时WOMAC功能有显著改善（P = 0.035）。与对照组相比，TERF组的镇痛药消耗量显著增加（P = 0.036）。干预组与基线相比，通过WOMAC测量的疼痛（P = 0.027）以及通过SF - 36测量的身体疼痛（P = 0.043）和身体功能（P = 0.031）有显著改善。
与仅接受药物治疗的对照组相比，接受药物治疗和TERF的患者通过WOMAC测量的功能维度有所改善。这表明在TKR等待期间的TEFR计划可能会减少这种情况的负面影响。
