Netherlands Institute for Health Services Research and Clinical Health Science, University Medical Center Utrecht, The Netherlands.
Arthritis Care Res (Hoboken). 2010 Aug;62(8):1087-94. doi: 10.1002/acr.20182.
To determine the effect of patient exercise adherence within the prescribed physical therapy treatment period and after physical therapy discharge on patient outcomes of pain, physical function, and patient self-perceived effect in individuals with osteoarthritis (OA) of the hip and/or knee.
We performed a prospective observational followup study in which 150 patients with OA of the hip and/or knee receiving exercise therapy were followed for 60 months. Data were obtained from a randomized controlled trial, with assessments at baseline and 3, 15, and 60 months of followup. The association between exercise adherence and patient outcomes of pain, physical function, and self-perceived effect was examined using generalized estimating equations analyses.
Adherence to recommended home exercises and being more physically active were significantly associated with better treatment outcomes of pain, self-reported physical function, physical performance, and self-perceived effect. The association between adherence and outcome was consistent over time. Adherence to home activities was only associated with better self-perceived effect.
Better adherence to recommended home exercises as well as being more physically active improves the long-term effectiveness of exercise therapy in patients with OA of the hip and/or knee. Both within and after the treatment period, better adherence is associated with better patient outcomes of pain, physical function, and self-perceived effect. Since exercise adherence declines over time, future research should focus on how exercise behavior can be stimulated and maintained in the long term.
确定患者在规定的物理治疗治疗期间内和物理治疗出院后坚持锻炼对髋和/或膝关节骨关节炎（OA）患者疼痛、身体功能和患者自我感知效果的影响。
我们进行了一项前瞻性观察随访研究，其中 150 例髋和/或膝关节 OA 接受运动治疗的患者随访 60 个月。数据来自一项随机对照试验，在基线、3、15 和 60 个月随访时进行评估。使用广义估计方程分析评估锻炼依从性与疼痛、身体功能和自我感知效果等患者结局之间的关系。
坚持推荐的家庭锻炼和更积极的身体活动与疼痛、自我报告的身体功能、身体表现和自我感知效果的治疗结果显著相关。依从性与结局之间的关联随时间保持一致。家庭活动的依从性仅与更好的自我感知效果相关。
更好地坚持推荐的家庭锻炼以及更积极的身体活动可提高髋和/或膝关节 OA 患者运动疗法的长期效果。在治疗期间内和之后，更好的依从性与疼痛、身体功能和自我感知效果等患者结局的改善相关。由于锻炼依从性随时间推移而下降，未来的研究应重点关注如何长期激发和维持锻炼行为。
