Bearne Lindsay M, Walsh Nicola E, Jessep Sally, Hurley Michael V
Kings College London, London, UK.
Musculoskeletal Care. 2011 Sep;9(3):160-8. doi: 10.1002/msc.209. Epub 2011 Jun 21.
Chronic hip pain is prevalent and disabling and has considerable consequences for the individual, and health and social care. Evidence-based guidelines recommend that patients with chronic hip pain benefit from exercise, but these guidelines are predominantly based on the efficacy of knee rehabilitation programmes. Studies investigating hip rehabilitation programmes suggest that these may not be feasible, citing issues with case identification. This study evaluated the feasibility of an exercise-based rehabilitation programme in a primary care hospital.
Forty-eight participants with chronic hip pain were randomly allocated to receive a five-week exercise and self-management programme or to continue under the management of their general practitioner (GP). Participants were assessed at baseline, six weeks and six months. Outcome measures included Western Ontario and McMaster Universities osteoarthritis index physical function subscale, pain, objective functional performance, self-efficacy, anxiety and depression.
This programme was feasible, well tolerated and easily implemented into a primary healthcare facility. Adherence to the programme was high (81% attendance). Immediately following rehabilitation, all outcomes measures improved (effect sizes 0.2-0.4), although these improvements diminished at six months. There were no differences between the groups (all p > 0.05).
An exercise-based rehabilitation programme was found to be feasible and well tolerated by people with chronic hip pain. The moderate effects in all outcomes immediately following rehabilitation suggested that it warrants further investigation. Issues with diagnosis and adaptations to the programme were identified and will be addressed in a randomized controlled trial.
慢性髋部疼痛普遍存在且使人致残，对个人以及健康和社会护理都有相当大的影响。循证指南建议慢性髋部疼痛患者可从运动中获益，但这些指南主要基于膝关节康复计划的疗效。调查髋部康复计划的研究表明，由于病例识别问题，这些计划可能不可行。本研究评估了在一家基层医疗医院开展基于运动的康复计划的可行性。
48名慢性髋部疼痛参与者被随机分配接受为期五周的运动和自我管理计划，或继续在其全科医生（GP）的管理下。在基线、六周和六个月时对参与者进行评估。结果指标包括西安大略和麦克马斯特大学骨关节炎指数身体功能分量表、疼痛、客观功能表现自我效能感、焦虑和抑郁。
该计划可行，耐受性良好，且易于在基层医疗设施中实施。对该计划的依从性很高（出勤率81%）。康复后所有结果指标立即得到改善（效应量为0.2 - 0.4），尽管这些改善在六个月时有所减弱。两组之间没有差异（所有p> 0.05）。
发现基于运动的康复计划对慢性髋部疼痛患者可行且耐受性良好。康复后所有结果的中度改善表明该计划值得进一步研究。已确定诊断和计划调整方面的问题，并将在一项随机对照试验中解决。
