Mazières Bernard, Thevenon André, Coudeyre Emmanuel, Chevalier Xavier, Revel Michel, Rannou Francois
Service de Rhumatologie, CHU Larrey, 24, chemin de Pouvourville, TSA 30030, 31059 Toulouse Cedex 9, France.
Joint Bone Spine. 2008 Oct;75(5):589-96. doi: 10.1016/j.jbspin.2008.02.016. Epub 2008 Sep 19.
To develop recommendations regarding adherence to physical therapy programs by patients with hip or knee osteoarthritis.
We used the method recommended by the French Society for Physical and Rehabilitation Therapy (SOFMER), which combines a systematic literature review, a practice survey, and validation by a multidisciplinary panel of experts.
When setting up exercise programs for patients with lower limb osteoarthritis, measures should be taken to increase effectiveness by optimizing adherence. Patient selection is among these measures, as exercise programs are more likely to succeed in patients with a history of being physically active, a positive view of the suggested program, and/or favorable social and material conditions. Regardless of the type of exercise, the program should be tailored to exercise capacity and pain level (professional consensus). Patient adherence can be improved by explaining the expected results to the patient, asking the patient to keep a self-evaluation diary, conducting long-term evaluations (by phone or mail), and providing follow-up visits.
Studies of adherence according to the type of exercise are needed. The relevance of widely used incentives in patients with hip or knee osteoarthritis should be evaluated in new therapeutic trials.
制定关于髋或膝骨关节炎患者坚持物理治疗方案的建议。
我们采用了法国物理与康复治疗协会（SOFMER）推荐的方法，该方法结合了系统的文献综述、实践调查以及多学科专家小组的验证。
在为下肢骨关节炎患者制定运动方案时，应采取措施通过优化依从性来提高有效性。患者选择是这些措施之一，因为运动方案在有体育活动史、对建议方案持积极态度和/或具备良好社会及物质条件的患者中更有可能成功。无论运动类型如何，方案都应根据运动能力和疼痛程度进行调整（专业共识）。向患者解释预期结果、要求患者记录自我评估日记、进行长期评估（通过电话或邮件）以及提供随访，可提高患者的依从性。
需要根据运动类型对依从性进行研究。应在新的治疗试验中评估髋或膝骨关节炎患者广泛使用的激励措施的相关性。
